|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 94070
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$1,284.30 |
| Rate for Payer: Aetna Commercial |
$77.93
|
| Rate for Payer: Aetna Commercial |
$77.93
|
| Rate for Payer: Aetna Medicare |
$58.16
|
| Rate for Payer: Aetna Medicare |
$58.16
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS Complete |
$54.00
|
| Rate for Payer: BCBS MAPPO |
$58.16
|
| Rate for Payer: BCBS MAPPO |
$58.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,284.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,284.30
|
| Rate for Payer: BCN Commercial |
$88.94
|
| Rate for Payer: BCN Commercial |
$88.94
|
| Rate for Payer: BCN Medicare Advantage |
$58.16
|
| Rate for Payer: BCN Medicare Advantage |
$58.16
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$83.75
|
| Rate for Payer: Cofinity Commercial |
$77.93
|
| Rate for Payer: Cofinity Commercial |
$83.75
|
| Rate for Payer: Cofinity Commercial |
$77.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.16
|
| Rate for Payer: Healthscope Commercial |
$69.79
|
| Rate for Payer: Healthscope Commercial |
$69.79
|
| Rate for Payer: Healthscope Whirlpool |
$69.79
|
| Rate for Payer: Healthscope Whirlpool |
$69.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.07
|
| Rate for Payer: PACE SWMI |
$58.16
|
| Rate for Payer: PACE SWMI |
$58.16
|
| Rate for Payer: PHP Medicare Advantage |
$58.16
|
| Rate for Payer: PHP Medicare Advantage |
$58.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.74
|
| Rate for Payer: Priority Health Medicare |
$58.16
|
| Rate for Payer: Priority Health Medicare |
$58.16
|
| Rate for Payer: Priority Health Narrow Network |
$81.74
|
| Rate for Payer: Priority Health Narrow Network |
$81.74
|
| Rate for Payer: UHC Medicare Advantage |
$59.90
|
| Rate for Payer: UHC Medicare Advantage |
$59.90
|
|
|
PR BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 31654
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$791.92 |
| Rate for Payer: Aetna Commercial |
$86.81
|
| Rate for Payer: Aetna Medicare |
$64.78
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS MAPPO |
$64.78
|
| Rate for Payer: BCBS Trust/PPO |
$791.92
|
| Rate for Payer: BCN Commercial |
$174.95
|
| Rate for Payer: BCN Medicare Advantage |
$64.78
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$86.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.78
|
| Rate for Payer: Healthscope Commercial |
$77.74
|
| Rate for Payer: Healthscope Whirlpool |
$77.74
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.02
|
| Rate for Payer: PACE SWMI |
$64.78
|
| Rate for Payer: PHP Medicare Advantage |
$64.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.83
|
| Rate for Payer: Priority Health Medicare |
$64.78
|
| Rate for Payer: Priority Health Narrow Network |
$89.83
|
| Rate for Payer: UHC Medicare Advantage |
$66.72
|
|
|
PR BRONCHOPLASTY GRAFT REPAIR
|
Professional
|
Both
|
$2,895.00
|
|
|
Service Code
|
HCPCS 31770
|
| Min. Negotiated Rate |
$835.81 |
| Max. Negotiated Rate |
$2,026.50 |
| Rate for Payer: Aetna Commercial |
$1,754.26
|
| Rate for Payer: Aetna Medicare |
$1,309.15
|
| Rate for Payer: BCBS Complete |
$877.60
|
| Rate for Payer: BCBS MAPPO |
$1,309.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,379.92
|
| Rate for Payer: BCN Commercial |
$1,909.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,309.15
|
| Rate for Payer: Cash Price |
$2,316.00
|
| Rate for Payer: Cash Price |
$2,316.00
|
| Rate for Payer: Cofinity Commercial |
$1,885.18
|
| Rate for Payer: Cofinity Commercial |
$1,754.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,309.15
|
| Rate for Payer: Healthscope Commercial |
$1,570.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,570.98
|
| Rate for Payer: Meridian Medicaid |
$877.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,374.61
|
| Rate for Payer: PACE SWMI |
$1,309.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,309.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,809.58
|
| Rate for Payer: Priority Health Medicare |
$1,309.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,809.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,348.42
|
|
|
PR BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 31625
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$508.71 |
| Rate for Payer: Aetna Commercial |
$202.55
|
| Rate for Payer: Aetna Medicare |
$151.16
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$151.16
|
| Rate for Payer: BCBS Trust/PPO |
$463.32
|
| Rate for Payer: BCN Commercial |
$508.71
|
| Rate for Payer: BCN Medicare Advantage |
$151.16
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$217.67
|
| Rate for Payer: Cofinity Commercial |
$202.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.16
|
| Rate for Payer: Healthscope Commercial |
$181.39
|
| Rate for Payer: Healthscope Whirlpool |
$181.39
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.72
|
| Rate for Payer: PACE SWMI |
$151.16
|
| Rate for Payer: PHP Medicare Advantage |
$151.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.23
|
| Rate for Payer: Priority Health Medicare |
$151.16
|
| Rate for Payer: Priority Health Narrow Network |
$210.23
|
| Rate for Payer: UHC Medicare Advantage |
$155.69
|
|
|
PR BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON
|
Professional
|
Both
|
$1,234.00
|
|
|
Service Code
|
HCPCS 31629
|
| Min. Negotiated Rate |
$116.51 |
| Max. Negotiated Rate |
$863.80 |
| Rate for Payer: Aetna Commercial |
$242.41
|
| Rate for Payer: Aetna Medicare |
$180.90
|
| Rate for Payer: BCBS Complete |
$122.34
|
| Rate for Payer: BCBS MAPPO |
$180.90
|
| Rate for Payer: BCBS Trust/PPO |
$499.77
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$180.90
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cofinity Commercial |
$242.41
|
| Rate for Payer: Cofinity Commercial |
$260.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.90
|
| Rate for Payer: Healthscope Commercial |
$217.08
|
| Rate for Payer: Healthscope Whirlpool |
$217.08
|
| Rate for Payer: Meridian Medicaid |
$122.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$189.94
|
| Rate for Payer: PACE SWMI |
$180.90
|
| Rate for Payer: PHP Medicare Advantage |
$180.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.44
|
| Rate for Payer: Priority Health Medicare |
$180.90
|
| Rate for Payer: Priority Health Narrow Network |
$251.44
|
| Rate for Payer: UHC Medicare Advantage |
$186.33
|
|
|
PR BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 31627
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$1,591.62 |
| Rate for Payer: Aetna Commercial |
$125.41
|
| Rate for Payer: Aetna Medicare |
$93.59
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCBS MAPPO |
$93.59
|
| Rate for Payer: BCBS Trust/PPO |
$684.15
|
| Rate for Payer: BCN Commercial |
$1,591.62
|
| Rate for Payer: BCN Medicare Advantage |
$93.59
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$134.77
|
| Rate for Payer: Cofinity Commercial |
$125.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.59
|
| Rate for Payer: Healthscope Commercial |
$112.31
|
| Rate for Payer: Healthscope Whirlpool |
$112.31
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.27
|
| Rate for Payer: PACE SWMI |
$93.59
|
| Rate for Payer: PHP Medicare Advantage |
$93.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.65
|
| Rate for Payer: Priority Health Medicare |
$93.59
|
| Rate for Payer: Priority Health Narrow Network |
$129.65
|
| Rate for Payer: UHC Medicare Advantage |
$96.40
|
|
|
PR BRONCHOSCOPY W/EXCISION TUMOR
|
Professional
|
Both
|
$511.00
|
|
|
Service Code
|
HCPCS 31640
|
| Min. Negotiated Rate |
$154.21 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna Commercial |
$323.66
|
| Rate for Payer: Aetna Medicare |
$241.54
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCBS MAPPO |
$241.54
|
| Rate for Payer: BCBS Trust/PPO |
$852.15
|
| Rate for Payer: BCN Commercial |
$354.29
|
| Rate for Payer: BCN Medicare Advantage |
$241.54
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cofinity Commercial |
$347.82
|
| Rate for Payer: Cofinity Commercial |
$323.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.54
|
| Rate for Payer: Healthscope Commercial |
$289.85
|
| Rate for Payer: Healthscope Whirlpool |
$289.85
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$253.62
|
| Rate for Payer: PACE SWMI |
$241.54
|
| Rate for Payer: PHP Medicare Advantage |
$241.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$335.70
|
| Rate for Payer: Priority Health Medicare |
$241.54
|
| Rate for Payer: Priority Health Narrow Network |
$335.70
|
| Rate for Payer: UHC Medicare Advantage |
$248.79
|
|
|
PR BRONCHOSCOPY W/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,115.00
|
|
|
Service Code
|
HCPCS 31635
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$972.60 |
| Rate for Payer: Aetna Commercial |
$227.49
|
| Rate for Payer: Aetna Medicare |
$169.77
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$169.77
|
| Rate for Payer: BCBS Trust/PPO |
$972.60
|
| Rate for Payer: BCN Commercial |
$425.15
|
| Rate for Payer: BCN Medicare Advantage |
$169.77
|
| Rate for Payer: Cash Price |
$892.00
|
| Rate for Payer: Cash Price |
$892.00
|
| Rate for Payer: Cofinity Commercial |
$244.47
|
| Rate for Payer: Cofinity Commercial |
$227.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.77
|
| Rate for Payer: Healthscope Commercial |
$203.72
|
| Rate for Payer: Healthscope Whirlpool |
$203.72
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.26
|
| Rate for Payer: PACE SWMI |
$169.77
|
| Rate for Payer: PHP Medicare Advantage |
$169.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$780.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.15
|
| Rate for Payer: Priority Health Medicare |
$169.77
|
| Rate for Payer: Priority Health Narrow Network |
$236.15
|
| Rate for Payer: UHC Medicare Advantage |
$174.86
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 31645
|
| Min. Negotiated Rate |
$92.02 |
| Max. Negotiated Rate |
$667.24 |
| Rate for Payer: Aetna Commercial |
$190.71
|
| Rate for Payer: Aetna Medicare |
$142.32
|
| Rate for Payer: BCBS Complete |
$96.62
|
| Rate for Payer: BCBS MAPPO |
$142.32
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$397.30
|
| Rate for Payer: BCN Medicare Advantage |
$142.32
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cofinity Commercial |
$204.94
|
| Rate for Payer: Cofinity Commercial |
$190.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.32
|
| Rate for Payer: Healthscope Commercial |
$170.78
|
| Rate for Payer: Healthscope Whirlpool |
$170.78
|
| Rate for Payer: Meridian Medicaid |
$96.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.44
|
| Rate for Payer: PACE SWMI |
$142.32
|
| Rate for Payer: PHP Medicare Advantage |
$142.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.19
|
| Rate for Payer: Priority Health Medicare |
$142.32
|
| Rate for Payer: Priority Health Narrow Network |
$198.19
|
| Rate for Payer: UHC Medicare Advantage |
$146.59
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ
|
Professional
|
Both
|
$602.00
|
|
|
Service Code
|
HCPCS 31646
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$1,008.00 |
| Rate for Payer: Aetna Commercial |
$184.04
|
| Rate for Payer: Aetna Medicare |
$137.34
|
| Rate for Payer: BCBS Complete |
$93.26
|
| Rate for Payer: BCBS MAPPO |
$137.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.00
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: BCN Medicare Advantage |
$137.34
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cofinity Commercial |
$184.04
|
| Rate for Payer: Cofinity Commercial |
$197.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.34
|
| Rate for Payer: Healthscope Commercial |
$164.81
|
| Rate for Payer: Healthscope Whirlpool |
$164.81
|
| Rate for Payer: Meridian Medicaid |
$93.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.21
|
| Rate for Payer: PACE SWMI |
$137.34
|
| Rate for Payer: PHP Medicare Advantage |
$137.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.23
|
| Rate for Payer: Priority Health Medicare |
$137.34
|
| Rate for Payer: Priority Health Narrow Network |
$191.23
|
| Rate for Payer: UHC Medicare Advantage |
$141.46
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 31628
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$915.54 |
| Rate for Payer: Aetna Commercial |
$228.39
|
| Rate for Payer: Aetna Medicare |
$170.44
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$170.44
|
| Rate for Payer: BCBS Trust/PPO |
$915.54
|
| Rate for Payer: BCN Commercial |
$597.26
|
| Rate for Payer: BCN Medicare Advantage |
$170.44
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$245.43
|
| Rate for Payer: Cofinity Commercial |
$228.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.44
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Healthscope Whirlpool |
$204.53
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.96
|
| Rate for Payer: PACE SWMI |
$170.44
|
| Rate for Payer: PHP Medicare Advantage |
$170.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.08
|
| Rate for Payer: Priority Health Medicare |
$170.44
|
| Rate for Payer: Priority Health Narrow Network |
$237.08
|
| Rate for Payer: UHC Medicare Advantage |
$175.55
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 31632
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$996.90 |
| Rate for Payer: Aetna Commercial |
$63.94
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS Trust/PPO |
$996.90
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.68
|
| Rate for Payer: Priority Health Narrow Network |
$66.68
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 31633
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$724.83 |
| Rate for Payer: Aetna Commercial |
$81.94
|
| Rate for Payer: Aetna Medicare |
$61.15
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$61.15
|
| Rate for Payer: BCBS Trust/PPO |
$724.83
|
| Rate for Payer: BCN Commercial |
$115.82
|
| Rate for Payer: BCN Medicare Advantage |
$61.15
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$88.06
|
| Rate for Payer: Cofinity Commercial |
$81.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.15
|
| Rate for Payer: Healthscope Commercial |
$73.38
|
| Rate for Payer: Healthscope Whirlpool |
$73.38
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.21
|
| Rate for Payer: PACE SWMI |
$61.15
|
| Rate for Payer: PHP Medicare Advantage |
$61.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.73
|
| Rate for Payer: Priority Health Medicare |
$61.15
|
| Rate for Payer: Priority Health Narrow Network |
$84.73
|
| Rate for Payer: UHC Medicare Advantage |
$62.98
|
|
|
PR BROWLIFT
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 00532
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,040.00 |
| Max. Negotiated Rate |
$1,820.00 |
| Rate for Payer: BCBS Complete |
$1,040.00
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.00
|
|
|
PR BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY
|
Professional
|
Both
|
$5,875.00
|
|
|
Service Code
|
HCPCS 58954
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$4,112.50 |
| Rate for Payer: Aetna Commercial |
$2,870.28
|
| Rate for Payer: Aetna Medicare |
$2,142.00
|
| Rate for Payer: BCBS Complete |
$1,458.87
|
| Rate for Payer: BCBS MAPPO |
$2,142.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$3,158.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,142.00
|
| Rate for Payer: Cash Price |
$4,700.00
|
| Rate for Payer: Cash Price |
$4,700.00
|
| Rate for Payer: Cofinity Commercial |
$3,084.48
|
| Rate for Payer: Cofinity Commercial |
$2,870.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,142.00
|
| Rate for Payer: Healthscope Commercial |
$2,570.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,570.40
|
| Rate for Payer: Meridian Medicaid |
$1,458.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,249.10
|
| Rate for Payer: PACE SWMI |
$2,142.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,142.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,389.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,112.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,060.22
|
| Rate for Payer: Priority Health Medicare |
$2,142.00
|
| Rate for Payer: Priority Health Narrow Network |
$3,060.22
|
| Rate for Payer: UHC Medicare Advantage |
$2,206.26
|
|
|
PR BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION
|
Professional
|
Both
|
$5,137.00
|
|
|
Service Code
|
HCPCS 58953
|
| Min. Negotiated Rate |
$131.55 |
| Max. Negotiated Rate |
$3,595.90 |
| Rate for Payer: Aetna Commercial |
$2,653.78
|
| Rate for Payer: Aetna Medicare |
$1,980.43
|
| Rate for Payer: BCBS Complete |
$1,348.16
|
| Rate for Payer: BCBS MAPPO |
$1,980.43
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCN Commercial |
$2,921.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,980.43
|
| Rate for Payer: Cash Price |
$4,109.60
|
| Rate for Payer: Cash Price |
$4,109.60
|
| Rate for Payer: Cofinity Commercial |
$2,653.78
|
| Rate for Payer: Cofinity Commercial |
$2,851.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,980.43
|
| Rate for Payer: Healthscope Commercial |
$2,376.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,376.52
|
| Rate for Payer: Meridian Medicaid |
$1,348.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,079.45
|
| Rate for Payer: PACE SWMI |
$1,980.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,980.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,283.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,595.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,830.61
|
| Rate for Payer: Priority Health Medicare |
$1,980.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,830.61
|
| Rate for Payer: UHC Medicare Advantage |
$2,039.84
|
|
|
PR BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC
|
Professional
|
Both
|
$2,382.00
|
|
|
Service Code
|
HCPCS 58956
|
| Min. Negotiated Rate |
$502.94 |
| Max. Negotiated Rate |
$1,986.47 |
| Rate for Payer: Aetna Commercial |
$1,802.06
|
| Rate for Payer: Aetna Medicare |
$1,344.82
|
| Rate for Payer: BCBS Complete |
$917.64
|
| Rate for Payer: BCBS MAPPO |
$1,344.82
|
| Rate for Payer: BCBS Trust/PPO |
$502.94
|
| Rate for Payer: BCN Commercial |
$1,986.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,344.82
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cash Price |
$1,905.60
|
| Rate for Payer: Cofinity Commercial |
$1,936.54
|
| Rate for Payer: Cofinity Commercial |
$1,802.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,344.82
|
| Rate for Payer: Healthscope Commercial |
$1,613.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,613.78
|
| Rate for Payer: Meridian Medicaid |
$917.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,412.06
|
| Rate for Payer: PACE SWMI |
$1,344.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,344.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,924.46
|
| Rate for Payer: Priority Health Medicare |
$1,344.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,924.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,385.16
|
|
|
PR BUDESONIDE NON-COMP UNIT
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS J7626
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$6.30 |
| Rate for Payer: Aetna Commercial |
$1.18
|
| Rate for Payer: Aetna Medicare |
$0.88
|
| Rate for Payer: BCBS Complete |
$3.60
|
| Rate for Payer: BCBS MAPPO |
$0.88
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Medicare Advantage |
$0.88
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$1.26
|
| Rate for Payer: Cofinity Commercial |
$1.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.88
|
| Rate for Payer: Healthscope Commercial |
$1.05
|
| Rate for Payer: Healthscope Whirlpool |
$1.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.92
|
| Rate for Payer: PACE SWMI |
$0.88
|
| Rate for Payer: PHP Medicare Advantage |
$0.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.30
|
| Rate for Payer: Priority Health Medicare |
$0.88
|
| Rate for Payer: UHC Medicare Advantage |
$0.90
|
|
|
PR BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE
|
Professional
|
Both
|
$2,504.00
|
|
|
Service Code
|
HCPCS 61210
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$1,752.80 |
| Rate for Payer: Aetna Commercial |
$495.80
|
| Rate for Payer: Aetna Medicare |
$370.00
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS MAPPO |
$370.00
|
| Rate for Payer: BCBS Trust/PPO |
$324.90
|
| Rate for Payer: BCN Commercial |
$745.05
|
| Rate for Payer: BCN Medicare Advantage |
$370.00
|
| Rate for Payer: Cash Price |
$2,003.20
|
| Rate for Payer: Cash Price |
$2,003.20
|
| Rate for Payer: Cofinity Commercial |
$495.80
|
| Rate for Payer: Cofinity Commercial |
$532.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.00
|
| Rate for Payer: Healthscope Commercial |
$444.00
|
| Rate for Payer: Healthscope Whirlpool |
$444.00
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$388.50
|
| Rate for Payer: PACE SWMI |
$370.00
|
| Rate for Payer: PHP Medicare Advantage |
$370.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,752.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.28
|
| Rate for Payer: Priority Health Medicare |
$370.00
|
| Rate for Payer: Priority Health Narrow Network |
$622.28
|
| Rate for Payer: UHC Medicare Advantage |
$381.10
|
|
|
PR BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG
|
Professional
|
Both
|
$2,672.00
|
|
|
Service Code
|
HCPCS 61250
|
| Min. Negotiated Rate |
$566.58 |
| Max. Negotiated Rate |
$1,870.40 |
| Rate for Payer: Aetna Commercial |
$1,171.87
|
| Rate for Payer: Aetna Medicare |
$874.53
|
| Rate for Payer: BCBS Complete |
$594.91
|
| Rate for Payer: BCBS MAPPO |
$874.53
|
| Rate for Payer: BCBS Trust/PPO |
$918.19
|
| Rate for Payer: BCN Commercial |
$1,288.16
|
| Rate for Payer: BCN Medicare Advantage |
$874.53
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cofinity Commercial |
$1,259.32
|
| Rate for Payer: Cofinity Commercial |
$1,171.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$874.53
|
| Rate for Payer: Healthscope Commercial |
$1,049.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,049.44
|
| Rate for Payer: Meridian Medicaid |
$594.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$918.26
|
| Rate for Payer: PACE SWMI |
$874.53
|
| Rate for Payer: PHP Medicare Advantage |
$874.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,870.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,492.57
|
| Rate for Payer: Priority Health Medicare |
$874.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,492.57
|
| Rate for Payer: UHC Medicare Advantage |
$900.77
|
|
|
PR BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION
|
Professional
|
Both
|
$4,523.00
|
|
|
Service Code
|
HCPCS 61140
|
| Min. Negotiated Rate |
$829.00 |
| Max. Negotiated Rate |
$3,166.10 |
| Rate for Payer: Aetna Commercial |
$1,710.82
|
| Rate for Payer: Aetna Medicare |
$1,276.73
|
| Rate for Payer: BCBS Complete |
$870.45
|
| Rate for Payer: BCBS MAPPO |
$1,276.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,274.79
|
| Rate for Payer: BCN Commercial |
$2,604.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,276.73
|
| Rate for Payer: Cash Price |
$3,618.40
|
| Rate for Payer: Cash Price |
$3,618.40
|
| Rate for Payer: Cofinity Commercial |
$1,838.49
|
| Rate for Payer: Cofinity Commercial |
$1,710.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,276.73
|
| Rate for Payer: Healthscope Commercial |
$1,532.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,532.08
|
| Rate for Payer: Meridian Medicaid |
$870.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,340.57
|
| Rate for Payer: PACE SWMI |
$1,276.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,276.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,166.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,175.44
|
| Rate for Payer: Priority Health Medicare |
$1,276.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,175.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,315.03
|
|
|
PR BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST
|
Professional
|
Both
|
$4,040.00
|
|
|
Service Code
|
HCPCS 61150
|
| Min. Negotiated Rate |
$614.94 |
| Max. Negotiated Rate |
$2,828.00 |
| Rate for Payer: Aetna Commercial |
$1,823.15
|
| Rate for Payer: Aetna Medicare |
$1,360.56
|
| Rate for Payer: BCBS Complete |
$922.11
|
| Rate for Payer: BCBS MAPPO |
$1,360.56
|
| Rate for Payer: BCBS Trust/PPO |
$614.94
|
| Rate for Payer: BCN Commercial |
$2,768.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,360.56
|
| Rate for Payer: Cash Price |
$3,232.00
|
| Rate for Payer: Cash Price |
$3,232.00
|
| Rate for Payer: Cofinity Commercial |
$1,823.15
|
| Rate for Payer: Cofinity Commercial |
$1,959.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,360.56
|
| Rate for Payer: Healthscope Commercial |
$1,632.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,632.67
|
| Rate for Payer: Meridian Medicaid |
$922.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,428.59
|
| Rate for Payer: PACE SWMI |
$1,360.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,360.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,828.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,312.45
|
| Rate for Payer: Priority Health Medicare |
$1,360.56
|
| Rate for Payer: Priority Health Narrow Network |
$2,312.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,401.38
|
|
|
PR BURR HOLE VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$1,834.00
|
|
|
Service Code
|
HCPCS 61120
|
| Min. Negotiated Rate |
$490.54 |
| Max. Negotiated Rate |
$1,670.48 |
| Rate for Payer: Aetna Commercial |
$1,009.40
|
| Rate for Payer: Aetna Medicare |
$753.28
|
| Rate for Payer: BCBS Complete |
$515.07
|
| Rate for Payer: BCBS MAPPO |
$753.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.48
|
| Rate for Payer: BCN Commercial |
$1,112.23
|
| Rate for Payer: BCN Medicare Advantage |
$753.28
|
| Rate for Payer: Cash Price |
$1,467.20
|
| Rate for Payer: Cash Price |
$1,467.20
|
| Rate for Payer: Cofinity Commercial |
$1,084.72
|
| Rate for Payer: Cofinity Commercial |
$1,009.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.28
|
| Rate for Payer: Healthscope Commercial |
$903.94
|
| Rate for Payer: Healthscope Whirlpool |
$903.94
|
| Rate for Payer: Meridian Medicaid |
$515.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$790.94
|
| Rate for Payer: PACE SWMI |
$753.28
|
| Rate for Payer: PHP Medicare Advantage |
$753.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,283.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,288.72
|
| Rate for Payer: Priority Health Medicare |
$753.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,288.72
|
| Rate for Payer: UHC Medicare Advantage |
$775.88
|
|
|
PR BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL
|
Professional
|
Both
|
$3,613.00
|
|
|
Service Code
|
HCPCS 61156
|
| Min. Negotiated Rate |
$284.75 |
| Max. Negotiated Rate |
$2,529.10 |
| Rate for Payer: Aetna Commercial |
$1,663.01
|
| Rate for Payer: Aetna Medicare |
$1,241.05
|
| Rate for Payer: BCBS Complete |
$846.52
|
| Rate for Payer: BCBS MAPPO |
$1,241.05
|
| Rate for Payer: BCBS Trust/PPO |
$284.75
|
| Rate for Payer: BCN Commercial |
$2,525.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,241.05
|
| Rate for Payer: Cash Price |
$2,890.40
|
| Rate for Payer: Cash Price |
$2,890.40
|
| Rate for Payer: Cofinity Commercial |
$1,787.11
|
| Rate for Payer: Cofinity Commercial |
$1,663.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,241.05
|
| Rate for Payer: Healthscope Commercial |
$1,489.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,489.26
|
| Rate for Payer: Meridian Medicaid |
$846.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,303.10
|
| Rate for Payer: PACE SWMI |
$1,241.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,241.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$806.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,529.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,109.19
|
| Rate for Payer: Priority Health Medicare |
$1,241.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,109.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,278.28
|
|
|
PR BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL
|
Professional
|
Both
|
$4,106.00
|
|
|
Service Code
|
HCPCS 61154
|
| Min. Negotiated Rate |
$757.05 |
| Max. Negotiated Rate |
$2,874.20 |
| Rate for Payer: Aetna Commercial |
$1,720.14
|
| Rate for Payer: Aetna Medicare |
$1,283.69
|
| Rate for Payer: BCBS Complete |
$874.69
|
| Rate for Payer: BCBS MAPPO |
$1,283.69
|
| Rate for Payer: BCBS Trust/PPO |
$757.05
|
| Rate for Payer: BCN Commercial |
$2,621.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.69
|
| Rate for Payer: Cash Price |
$3,284.80
|
| Rate for Payer: Cash Price |
$3,284.80
|
| Rate for Payer: Cofinity Commercial |
$1,720.14
|
| Rate for Payer: Cofinity Commercial |
$1,848.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.69
|
| Rate for Payer: Healthscope Commercial |
$1,540.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.43
|
| Rate for Payer: Meridian Medicaid |
$874.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,347.87
|
| Rate for Payer: PACE SWMI |
$1,283.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$833.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,874.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,189.59
|
| Rate for Payer: Priority Health Medicare |
$1,283.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,189.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,322.20
|
|
