|
PR BYPASS W/VEIN ILIOFEMORAL
|
Professional
|
Both
|
$2,550.00
|
|
|
Service Code
|
HCPCS 35565
|
| Min. Negotiated Rate |
$818.35 |
| Max. Negotiated Rate |
$2,032.61 |
| Rate for Payer: Aetna Commercial |
$1,727.46
|
| Rate for Payer: Aetna Medicare |
$1,289.15
|
| Rate for Payer: BCBS Complete |
$859.27
|
| Rate for Payer: BCBS MAPPO |
$1,289.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.43
|
| Rate for Payer: BCN Commercial |
$1,867.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,289.15
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$1,856.38
|
| Rate for Payer: Cofinity Commercial |
$1,727.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,289.15
|
| Rate for Payer: Healthscope Commercial |
$1,546.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,546.98
|
| Rate for Payer: Meridian Medicaid |
$859.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,353.61
|
| Rate for Payer: PACE SWMI |
$1,289.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,289.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,785.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,032.61
|
| Rate for Payer: Priority Health Medicare |
$1,289.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,032.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,327.82
|
|
|
PR BYPASS W/VEIN ILIOILIAC
|
Professional
|
Both
|
$2,760.00
|
|
|
Service Code
|
HCPCS 35563
|
| Min. Negotiated Rate |
$826.44 |
| Max. Negotiated Rate |
$2,053.88 |
| Rate for Payer: Aetna Commercial |
$1,750.19
|
| Rate for Payer: Aetna Medicare |
$1,306.11
|
| Rate for Payer: BCBS Complete |
$867.76
|
| Rate for Payer: BCBS MAPPO |
$1,306.11
|
| Rate for Payer: BCBS Trust/PPO |
$927.69
|
| Rate for Payer: BCN Commercial |
$1,886.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.11
|
| Rate for Payer: Cash Price |
$2,208.00
|
| Rate for Payer: Cash Price |
$2,208.00
|
| Rate for Payer: Cofinity Commercial |
$1,880.80
|
| Rate for Payer: Cofinity Commercial |
$1,750.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.11
|
| Rate for Payer: Healthscope Commercial |
$1,567.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,567.33
|
| Rate for Payer: Meridian Medicaid |
$867.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,371.42
|
| Rate for Payer: PACE SWMI |
$1,306.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$826.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,053.88
|
| Rate for Payer: Priority Health Medicare |
$1,306.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,053.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,345.29
|
|
|
PR BYPASS W/VEIN SPLENORENAL
|
Professional
|
Both
|
$4,809.00
|
|
|
Service Code
|
HCPCS 35536
|
| Min. Negotiated Rate |
$997.96 |
| Max. Negotiated Rate |
$3,366.30 |
| Rate for Payer: Aetna Commercial |
$2,236.27
|
| Rate for Payer: Aetna Medicare |
$1,668.86
|
| Rate for Payer: BCBS Complete |
$1,106.40
|
| Rate for Payer: BCBS MAPPO |
$1,668.86
|
| Rate for Payer: BCBS Trust/PPO |
$997.96
|
| Rate for Payer: BCN Commercial |
$2,408.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,668.86
|
| Rate for Payer: Cash Price |
$3,847.20
|
| Rate for Payer: Cash Price |
$3,847.20
|
| Rate for Payer: Cofinity Commercial |
$2,403.16
|
| Rate for Payer: Cofinity Commercial |
$2,236.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,668.86
|
| Rate for Payer: Healthscope Commercial |
$2,002.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,002.63
|
| Rate for Payer: Meridian Medicaid |
$1,106.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,752.30
|
| Rate for Payer: PACE SWMI |
$1,668.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,668.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,053.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,366.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,621.49
|
| Rate for Payer: Priority Health Medicare |
$1,668.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,621.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,718.93
|
|
|
PR BYPASS W/VEIN SUBCLAVIAN-BRACHIAL
|
Professional
|
Both
|
$2,494.00
|
|
|
Service Code
|
HCPCS 35512
|
| Min. Negotiated Rate |
$752.32 |
| Max. Negotiated Rate |
$1,868.77 |
| Rate for Payer: Aetna Commercial |
$1,593.10
|
| Rate for Payer: Aetna Medicare |
$1,188.88
|
| Rate for Payer: BCBS Complete |
$789.94
|
| Rate for Payer: BCBS MAPPO |
$1,188.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.84
|
| Rate for Payer: BCN Commercial |
$1,716.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,188.88
|
| Rate for Payer: Cash Price |
$1,995.20
|
| Rate for Payer: Cash Price |
$1,995.20
|
| Rate for Payer: Cofinity Commercial |
$1,711.99
|
| Rate for Payer: Cofinity Commercial |
$1,593.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,188.88
|
| Rate for Payer: Healthscope Commercial |
$1,426.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,426.66
|
| Rate for Payer: Meridian Medicaid |
$789.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,248.32
|
| Rate for Payer: PACE SWMI |
$1,188.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,188.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$752.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,745.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,868.77
|
| Rate for Payer: Priority Health Medicare |
$1,188.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,868.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,224.55
|
|
|
PR BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN
|
Professional
|
Both
|
$4,103.00
|
|
|
Service Code
|
HCPCS 35511
|
| Min. Negotiated Rate |
$699.07 |
| Max. Negotiated Rate |
$2,872.10 |
| Rate for Payer: Aetna Commercial |
$1,481.09
|
| Rate for Payer: Aetna Medicare |
$1,105.29
|
| Rate for Payer: BCBS Complete |
$734.02
|
| Rate for Payer: BCBS MAPPO |
$1,105.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.69
|
| Rate for Payer: BCN Commercial |
$1,596.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,105.29
|
| Rate for Payer: Cash Price |
$3,282.40
|
| Rate for Payer: Cash Price |
$3,282.40
|
| Rate for Payer: Cofinity Commercial |
$1,591.62
|
| Rate for Payer: Cofinity Commercial |
$1,481.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,105.29
|
| Rate for Payer: Healthscope Commercial |
$1,326.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,326.35
|
| Rate for Payer: Meridian Medicaid |
$734.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,160.55
|
| Rate for Payer: PACE SWMI |
$1,105.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,105.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$699.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,872.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,737.38
|
| Rate for Payer: Priority Health Medicare |
$1,105.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,737.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,138.45
|
|
|
PR BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS
|
Professional
|
Both
|
$692.00
|
|
|
Service Code
|
HCPCS 35682
|
| Min. Negotiated Rate |
$219.18 |
| Max. Negotiated Rate |
$1,982.71 |
| Rate for Payer: Aetna Commercial |
$465.62
|
| Rate for Payer: Aetna Medicare |
$347.48
|
| Rate for Payer: BCBS Complete |
$230.14
|
| Rate for Payer: BCBS MAPPO |
$347.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCN Commercial |
$500.41
|
| Rate for Payer: BCN Medicare Advantage |
$347.48
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cofinity Commercial |
$500.37
|
| Rate for Payer: Cofinity Commercial |
$465.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.48
|
| Rate for Payer: Healthscope Commercial |
$416.98
|
| Rate for Payer: Healthscope Whirlpool |
$416.98
|
| Rate for Payer: Meridian Medicaid |
$230.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$364.85
|
| Rate for Payer: PACE SWMI |
$347.48
|
| Rate for Payer: PHP Medicare Advantage |
$347.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$544.72
|
| Rate for Payer: Priority Health Medicare |
$347.48
|
| Rate for Payer: Priority Health Narrow Network |
$544.72
|
| Rate for Payer: UHC Medicare Advantage |
$357.90
|
|
|
PR BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION
|
Professional
|
Both
|
$849.00
|
|
|
Service Code
|
HCPCS 35683
|
| Min. Negotiated Rate |
$253.90 |
| Max. Negotiated Rate |
$1,813.65 |
| Rate for Payer: Aetna Commercial |
$542.10
|
| Rate for Payer: Aetna Medicare |
$404.55
|
| Rate for Payer: BCBS Complete |
$266.60
|
| Rate for Payer: BCBS MAPPO |
$404.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,813.65
|
| Rate for Payer: BCN Commercial |
$581.53
|
| Rate for Payer: BCN Medicare Advantage |
$404.55
|
| Rate for Payer: Cash Price |
$679.20
|
| Rate for Payer: Cash Price |
$679.20
|
| Rate for Payer: Cofinity Commercial |
$542.10
|
| Rate for Payer: Cofinity Commercial |
$582.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.55
|
| Rate for Payer: Healthscope Commercial |
$485.46
|
| Rate for Payer: Healthscope Whirlpool |
$485.46
|
| Rate for Payer: Meridian Medicaid |
$266.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$424.78
|
| Rate for Payer: PACE SWMI |
$404.55
|
| Rate for Payer: PHP Medicare Advantage |
$404.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$594.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$633.03
|
| Rate for Payer: Priority Health Medicare |
$404.55
|
| Rate for Payer: Priority Health Narrow Network |
$633.03
|
| Rate for Payer: UHC Medicare Advantage |
$416.69
|
|
|
PR BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL
|
Professional
|
Both
|
$4,735.00
|
|
|
Service Code
|
HCPCS 35566
|
| Min. Negotiated Rate |
$803.02 |
| Max. Negotiated Rate |
$3,314.50 |
| Rate for Payer: Aetna Commercial |
$2,194.33
|
| Rate for Payer: Aetna Medicare |
$1,637.56
|
| Rate for Payer: BCBS Complete |
$1,086.94
|
| Rate for Payer: BCBS MAPPO |
$1,637.56
|
| Rate for Payer: BCBS Trust/PPO |
$803.02
|
| Rate for Payer: BCN Commercial |
$2,368.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,637.56
|
| Rate for Payer: Cash Price |
$3,788.00
|
| Rate for Payer: Cash Price |
$3,788.00
|
| Rate for Payer: Cofinity Commercial |
$2,358.09
|
| Rate for Payer: Cofinity Commercial |
$2,194.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,637.56
|
| Rate for Payer: Healthscope Commercial |
$1,965.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,965.07
|
| Rate for Payer: Meridian Medicaid |
$1,086.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,719.44
|
| Rate for Payer: PACE SWMI |
$1,637.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,637.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,035.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,314.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,578.39
|
| Rate for Payer: Priority Health Medicare |
$1,637.56
|
| Rate for Payer: Priority Health Narrow Network |
$2,578.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,686.69
|
|
|
PR BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC
|
Professional
|
Both
|
$1,925.00
|
|
|
Service Code
|
HCPCS 33891
|
| Min. Negotiated Rate |
$598.10 |
| Max. Negotiated Rate |
$1,489.48 |
| Rate for Payer: Aetna Commercial |
$1,275.45
|
| Rate for Payer: Aetna Medicare |
$951.83
|
| Rate for Payer: BCBS Complete |
$628.00
|
| Rate for Payer: BCBS MAPPO |
$951.83
|
| Rate for Payer: BCBS Trust/PPO |
$745.96
|
| Rate for Payer: BCN Commercial |
$1,368.30
|
| Rate for Payer: BCN Medicare Advantage |
$951.83
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,275.45
|
| Rate for Payer: Cofinity Commercial |
$1,370.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$951.83
|
| Rate for Payer: Healthscope Commercial |
$1,142.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,142.20
|
| Rate for Payer: Meridian Medicaid |
$628.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$999.42
|
| Rate for Payer: PACE SWMI |
$951.83
|
| Rate for Payer: PHP Medicare Advantage |
$951.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,489.48
|
| Rate for Payer: Priority Health Medicare |
$951.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,489.48
|
| Rate for Payer: UHC Medicare Advantage |
$980.38
|
|
|
PR BYP OTH/THN VEIN AORTOBIFEMORAL
|
Professional
|
Both
|
$5,669.00
|
|
|
Service Code
|
HCPCS 35646
|
| Min. Negotiated Rate |
$1,062.44 |
| Max. Negotiated Rate |
$3,968.30 |
| Rate for Payer: Aetna Commercial |
$2,250.54
|
| Rate for Payer: Aetna Medicare |
$1,679.51
|
| Rate for Payer: BCBS Complete |
$1,115.56
|
| Rate for Payer: BCBS MAPPO |
$1,679.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,771.92
|
| Rate for Payer: BCN Commercial |
$2,430.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,679.51
|
| Rate for Payer: Cash Price |
$4,535.20
|
| Rate for Payer: Cash Price |
$4,535.20
|
| Rate for Payer: Cofinity Commercial |
$2,418.49
|
| Rate for Payer: Cofinity Commercial |
$2,250.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,679.51
|
| Rate for Payer: Healthscope Commercial |
$2,015.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,015.41
|
| Rate for Payer: Meridian Medicaid |
$1,115.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,763.49
|
| Rate for Payer: PACE SWMI |
$1,679.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,679.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,062.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,968.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,645.96
|
| Rate for Payer: Priority Health Medicare |
$1,679.51
|
| Rate for Payer: Priority Health Narrow Network |
$2,645.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,729.90
|
|
|
PR BYP OTH/THN VEIN AORTOBI-ILIAC
|
Professional
|
Both
|
$4,846.00
|
|
|
Service Code
|
HCPCS 35638
|
| Min. Negotiated Rate |
$1,080.98 |
| Max. Negotiated Rate |
$3,392.20 |
| Rate for Payer: Aetna Commercial |
$2,290.31
|
| Rate for Payer: Aetna Medicare |
$1,709.19
|
| Rate for Payer: BCBS Complete |
$1,135.03
|
| Rate for Payer: BCBS MAPPO |
$1,709.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.09
|
| Rate for Payer: BCN Commercial |
$2,473.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,709.19
|
| Rate for Payer: Cash Price |
$3,876.80
|
| Rate for Payer: Cash Price |
$3,876.80
|
| Rate for Payer: Cofinity Commercial |
$2,461.23
|
| Rate for Payer: Cofinity Commercial |
$2,290.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,709.19
|
| Rate for Payer: Healthscope Commercial |
$2,051.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,051.03
|
| Rate for Payer: Meridian Medicaid |
$1,135.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,794.65
|
| Rate for Payer: PACE SWMI |
$1,709.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,709.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,080.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,392.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,692.24
|
| Rate for Payer: Priority Health Medicare |
$1,709.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,692.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,760.47
|
|
|
PR BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL
|
Professional
|
Both
|
$4,967.00
|
|
|
Service Code
|
HCPCS 35631
|
| Min. Negotiated Rate |
$1,154.89 |
| Max. Negotiated Rate |
$3,476.90 |
| Rate for Payer: Aetna Commercial |
$2,440.02
|
| Rate for Payer: Aetna Medicare |
$1,820.91
|
| Rate for Payer: BCBS Complete |
$1,212.63
|
| Rate for Payer: BCBS MAPPO |
$1,820.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,452.50
|
| Rate for Payer: BCN Commercial |
$2,633.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,820.91
|
| Rate for Payer: Cash Price |
$3,973.60
|
| Rate for Payer: Cash Price |
$3,973.60
|
| Rate for Payer: Cofinity Commercial |
$2,622.11
|
| Rate for Payer: Cofinity Commercial |
$2,440.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,820.91
|
| Rate for Payer: Healthscope Commercial |
$2,185.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,185.09
|
| Rate for Payer: Meridian Medicaid |
$1,212.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,911.96
|
| Rate for Payer: PACE SWMI |
$1,820.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,820.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,154.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,476.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,866.72
|
| Rate for Payer: Priority Health Medicare |
$1,820.91
|
| Rate for Payer: Priority Health Narrow Network |
$2,866.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,875.54
|
|
|
PR BYP OTH/THN VEIN AORTOFEMORAL
|
Professional
|
Both
|
$3,007.00
|
|
|
Service Code
|
HCPCS 35647
|
| Min. Negotiated Rate |
$966.38 |
| Max. Negotiated Rate |
$2,407.63 |
| Rate for Payer: Aetna Commercial |
$2,046.31
|
| Rate for Payer: Aetna Medicare |
$1,527.10
|
| Rate for Payer: BCBS Complete |
$1,014.70
|
| Rate for Payer: BCBS MAPPO |
$1,527.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,996.45
|
| Rate for Payer: BCN Commercial |
$2,211.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,527.10
|
| Rate for Payer: Cash Price |
$2,405.60
|
| Rate for Payer: Cash Price |
$2,405.60
|
| Rate for Payer: Cofinity Commercial |
$2,199.02
|
| Rate for Payer: Cofinity Commercial |
$2,046.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,527.10
|
| Rate for Payer: Healthscope Commercial |
$1,832.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,832.52
|
| Rate for Payer: Meridian Medicaid |
$1,014.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,603.46
|
| Rate for Payer: PACE SWMI |
$1,527.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,527.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$966.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,104.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,407.63
|
| Rate for Payer: Priority Health Medicare |
$1,527.10
|
| Rate for Payer: Priority Health Narrow Network |
$2,407.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,572.91
|
|
|
PR BYP OTH/THN VEIN AORTOILIAC
|
Professional
|
Both
|
$3,564.00
|
|
|
Service Code
|
HCPCS 35637
|
| Min. Negotiated Rate |
$801.58 |
| Max. Negotiated Rate |
$2,571.49 |
| Rate for Payer: Aetna Commercial |
$2,193.29
|
| Rate for Payer: Aetna Medicare |
$1,636.78
|
| Rate for Payer: BCBS Complete |
$1,085.83
|
| Rate for Payer: BCBS MAPPO |
$1,636.78
|
| Rate for Payer: BCBS Trust/PPO |
$801.58
|
| Rate for Payer: BCN Commercial |
$2,362.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,636.78
|
| Rate for Payer: Cash Price |
$2,851.20
|
| Rate for Payer: Cash Price |
$2,851.20
|
| Rate for Payer: Cofinity Commercial |
$2,356.96
|
| Rate for Payer: Cofinity Commercial |
$2,193.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,636.78
|
| Rate for Payer: Healthscope Commercial |
$1,964.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,964.14
|
| Rate for Payer: Meridian Medicaid |
$1,085.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,718.62
|
| Rate for Payer: PACE SWMI |
$1,636.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,636.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,034.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,494.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,571.49
|
| Rate for Payer: Priority Health Medicare |
$1,636.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,571.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,685.88
|
|
|
PR BYP OTH/THN VEIN AXILLARY-AXILLARY
|
Professional
|
Both
|
$2,172.00
|
|
|
Service Code
|
HCPCS 35650
|
| Min. Negotiated Rate |
$637.72 |
| Max. Negotiated Rate |
$1,585.77 |
| Rate for Payer: Aetna Commercial |
$1,351.28
|
| Rate for Payer: Aetna Medicare |
$1,008.42
|
| Rate for Payer: BCBS Complete |
$669.61
|
| Rate for Payer: BCBS MAPPO |
$1,008.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.34
|
| Rate for Payer: BCN Commercial |
$1,456.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,008.42
|
| Rate for Payer: Cash Price |
$1,737.60
|
| Rate for Payer: Cash Price |
$1,737.60
|
| Rate for Payer: Cofinity Commercial |
$1,452.12
|
| Rate for Payer: Cofinity Commercial |
$1,351.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,008.42
|
| Rate for Payer: Healthscope Commercial |
$1,210.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,210.10
|
| Rate for Payer: Meridian Medicaid |
$669.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,058.84
|
| Rate for Payer: PACE SWMI |
$1,008.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,008.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,520.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,585.77
|
| Rate for Payer: Priority Health Medicare |
$1,008.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,585.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,038.67
|
|
|
PR BYP OTH/THN VEIN AXILLARY-FEMORAL
|
Professional
|
Both
|
$4,108.00
|
|
|
Service Code
|
HCPCS 35621
|
| Min. Negotiated Rate |
$683.73 |
| Max. Negotiated Rate |
$2,875.60 |
| Rate for Payer: Aetna Commercial |
$1,448.12
|
| Rate for Payer: Aetna Medicare |
$1,080.69
|
| Rate for Payer: BCBS Complete |
$717.92
|
| Rate for Payer: BCBS MAPPO |
$1,080.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,170.78
|
| Rate for Payer: BCN Commercial |
$1,565.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,080.69
|
| Rate for Payer: Cash Price |
$3,286.40
|
| Rate for Payer: Cash Price |
$3,286.40
|
| Rate for Payer: Cofinity Commercial |
$1,556.19
|
| Rate for Payer: Cofinity Commercial |
$1,448.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,080.69
|
| Rate for Payer: Healthscope Commercial |
$1,296.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,296.83
|
| Rate for Payer: Meridian Medicaid |
$717.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,134.72
|
| Rate for Payer: PACE SWMI |
$1,080.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,080.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$683.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,875.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,703.86
|
| Rate for Payer: Priority Health Medicare |
$1,080.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,703.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,113.11
|
|
|
PR BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL
|
Professional
|
Both
|
$4,825.00
|
|
|
Service Code
|
HCPCS 35654
|
| Min. Negotiated Rate |
$850.08 |
| Max. Negotiated Rate |
$3,377.50 |
| Rate for Payer: Aetna Commercial |
$1,798.90
|
| Rate for Payer: Aetna Medicare |
$1,342.46
|
| Rate for Payer: BCBS Complete |
$892.58
|
| Rate for Payer: BCBS MAPPO |
$1,342.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.11
|
| Rate for Payer: BCN Commercial |
$1,943.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,342.46
|
| Rate for Payer: Cash Price |
$3,860.00
|
| Rate for Payer: Cash Price |
$3,860.00
|
| Rate for Payer: Cofinity Commercial |
$1,798.90
|
| Rate for Payer: Cofinity Commercial |
$1,933.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,342.46
|
| Rate for Payer: Healthscope Commercial |
$1,610.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,610.95
|
| Rate for Payer: Meridian Medicaid |
$892.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,409.58
|
| Rate for Payer: PACE SWMI |
$1,342.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,342.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,377.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,115.59
|
| Rate for Payer: Priority Health Medicare |
$1,342.46
|
| Rate for Payer: Priority Health Narrow Network |
$2,115.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,382.73
|
|
|
PR BYP OTH/THN VEIN CAROTID-SUBCLAVIAN
|
Professional
|
Both
|
$2,278.00
|
|
|
Service Code
|
HCPCS 35606
|
| Min. Negotiated Rate |
$733.79 |
| Max. Negotiated Rate |
$1,821.96 |
| Rate for Payer: Aetna Commercial |
$1,547.91
|
| Rate for Payer: Aetna Medicare |
$1,155.16
|
| Rate for Payer: BCBS Complete |
$770.48
|
| Rate for Payer: BCBS MAPPO |
$1,155.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.77
|
| Rate for Payer: BCN Commercial |
$1,673.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.16
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cofinity Commercial |
$1,663.43
|
| Rate for Payer: Cofinity Commercial |
$1,547.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.16
|
| Rate for Payer: Healthscope Commercial |
$1,386.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,386.19
|
| Rate for Payer: Meridian Medicaid |
$770.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,212.92
|
| Rate for Payer: PACE SWMI |
$1,155.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,821.96
|
| Rate for Payer: Priority Health Medicare |
$1,155.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,821.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,189.81
|
|
|
PR BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID
|
Professional
|
Both
|
$2,884.00
|
|
|
Service Code
|
HCPCS 35601
|
| Min. Negotiated Rate |
$873.30 |
| Max. Negotiated Rate |
$2,177.30 |
| Rate for Payer: Aetna Commercial |
$1,851.88
|
| Rate for Payer: Aetna Medicare |
$1,382.00
|
| Rate for Payer: BCBS Complete |
$916.96
|
| Rate for Payer: BCBS MAPPO |
$1,382.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,268.45
|
| Rate for Payer: BCN Commercial |
$2,000.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,382.00
|
| Rate for Payer: Cash Price |
$2,307.20
|
| Rate for Payer: Cash Price |
$2,307.20
|
| Rate for Payer: Cofinity Commercial |
$1,990.08
|
| Rate for Payer: Cofinity Commercial |
$1,851.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,382.00
|
| Rate for Payer: Healthscope Commercial |
$1,658.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,658.40
|
| Rate for Payer: Meridian Medicaid |
$916.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,451.10
|
| Rate for Payer: PACE SWMI |
$1,382.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,382.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,018.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,177.30
|
| Rate for Payer: Priority Health Medicare |
$1,382.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,177.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,423.46
|
|
|
PR BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL
|
Professional
|
Both
|
$4,125.00
|
|
|
Service Code
|
HCPCS 35666
|
| Min. Negotiated Rate |
$803.22 |
| Max. Negotiated Rate |
$2,887.50 |
| Rate for Payer: Aetna Commercial |
$1,724.92
|
| Rate for Payer: BCBS Complete |
$843.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.71
|
| Rate for Payer: BCN Commercial |
$1,839.87
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Meridian Medicaid |
$843.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,887.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,002.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,002.82
|
|
|
PR BYP OTH/THN VEIN FEMORAL-FEMORAL
|
Professional
|
Both
|
$2,209.00
|
|
|
Service Code
|
HCPCS 35661
|
| Min. Negotiated Rate |
$675.42 |
| Max. Negotiated Rate |
$1,683.11 |
| Rate for Payer: Aetna Commercial |
$1,427.89
|
| Rate for Payer: Aetna Medicare |
$1,065.59
|
| Rate for Payer: BCBS Complete |
$709.19
|
| Rate for Payer: BCBS MAPPO |
$1,065.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.54
|
| Rate for Payer: BCN Commercial |
$1,546.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,065.59
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cofinity Commercial |
$1,427.89
|
| Rate for Payer: Cofinity Commercial |
$1,534.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,065.59
|
| Rate for Payer: Healthscope Commercial |
$1,278.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,278.71
|
| Rate for Payer: Meridian Medicaid |
$709.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,118.87
|
| Rate for Payer: PACE SWMI |
$1,065.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,065.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,546.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,683.11
|
| Rate for Payer: Priority Health Medicare |
$1,065.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,683.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,097.56
|
|
|
PR BYP OTH/THN VEIN FEMORAL-POPLITEAL
|
Professional
|
Both
|
$2,233.00
|
|
|
Service Code
|
HCPCS 35656
|
| Min. Negotiated Rate |
$668.82 |
| Max. Negotiated Rate |
$1,668.21 |
| Rate for Payer: Aetna Commercial |
$1,417.02
|
| Rate for Payer: Aetna Medicare |
$1,057.48
|
| Rate for Payer: BCBS Complete |
$702.26
|
| Rate for Payer: BCBS MAPPO |
$1,057.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,054.49
|
| Rate for Payer: BCN Commercial |
$1,532.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,057.48
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cash Price |
$1,786.40
|
| Rate for Payer: Cofinity Commercial |
$1,417.02
|
| Rate for Payer: Cofinity Commercial |
$1,522.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,057.48
|
| Rate for Payer: Healthscope Commercial |
$1,268.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,268.98
|
| Rate for Payer: Meridian Medicaid |
$702.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,110.35
|
| Rate for Payer: PACE SWMI |
$1,057.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,057.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$668.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,668.21
|
| Rate for Payer: Priority Health Medicare |
$1,057.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,668.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,089.20
|
|
|
PR BYP OTH/THN VEIN ILIOFEMORAL
|
Professional
|
Both
|
$4,492.00
|
|
|
Service Code
|
HCPCS 35665
|
| Min. Negotiated Rate |
$732.29 |
| Max. Negotiated Rate |
$3,144.40 |
| Rate for Payer: Aetna Commercial |
$1,546.76
|
| Rate for Payer: Aetna Medicare |
$1,154.30
|
| Rate for Payer: BCBS Complete |
$768.90
|
| Rate for Payer: BCBS MAPPO |
$1,154.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.50
|
| Rate for Payer: BCN Commercial |
$1,673.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,154.30
|
| Rate for Payer: Cash Price |
$3,593.60
|
| Rate for Payer: Cash Price |
$3,593.60
|
| Rate for Payer: Cofinity Commercial |
$1,546.76
|
| Rate for Payer: Cofinity Commercial |
$1,662.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,154.30
|
| Rate for Payer: Healthscope Commercial |
$1,385.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,385.16
|
| Rate for Payer: Meridian Medicaid |
$768.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,212.02
|
| Rate for Payer: PACE SWMI |
$1,154.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,154.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$732.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,144.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,821.43
|
| Rate for Payer: Priority Health Medicare |
$1,154.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,821.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,188.93
|
|
|
PR BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART
|
Professional
|
Both
|
$2,160.00
|
|
|
Service Code
|
HCPCS 35671
|
| Min. Negotiated Rate |
$707.16 |
| Max. Negotiated Rate |
$1,765.04 |
| Rate for Payer: Aetna Commercial |
$1,494.05
|
| Rate for Payer: Aetna Medicare |
$1,114.96
|
| Rate for Payer: BCBS Complete |
$742.52
|
| Rate for Payer: BCBS MAPPO |
$1,114.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.67
|
| Rate for Payer: BCN Commercial |
$1,621.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,114.96
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cofinity Commercial |
$1,605.54
|
| Rate for Payer: Cofinity Commercial |
$1,494.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,114.96
|
| Rate for Payer: Healthscope Commercial |
$1,337.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,337.95
|
| Rate for Payer: Meridian Medicaid |
$742.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,170.71
|
| Rate for Payer: PACE SWMI |
$1,114.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,114.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$707.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,512.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,765.04
|
| Rate for Payer: Priority Health Medicare |
$1,114.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,765.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.41
|
|
|
PR BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN
|
Professional
|
Both
|
$2,200.00
|
|
|
Service Code
|
HCPCS 35612
|
| Min. Negotiated Rate |
$653.48 |
| Max. Negotiated Rate |
$2,601.35 |
| Rate for Payer: Aetna Commercial |
$1,381.79
|
| Rate for Payer: Aetna Medicare |
$1,031.19
|
| Rate for Payer: BCBS Complete |
$686.15
|
| Rate for Payer: BCBS MAPPO |
$1,031.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,601.35
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,031.19
|
| Rate for Payer: Cash Price |
$1,760.00
|
| Rate for Payer: Cash Price |
$1,760.00
|
| Rate for Payer: Cofinity Commercial |
$1,484.91
|
| Rate for Payer: Cofinity Commercial |
$1,381.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,031.19
|
| Rate for Payer: Healthscope Commercial |
$1,237.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,237.43
|
| Rate for Payer: Meridian Medicaid |
$686.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,082.75
|
| Rate for Payer: PACE SWMI |
$1,031.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,031.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,540.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,623.54
|
| Rate for Payer: Priority Health Medicare |
$1,031.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,623.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,062.13
|
|
