|
PR CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 30901
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$897.05 |
| Rate for Payer: Aetna Commercial |
$75.78
|
| Rate for Payer: Aetna Medicare |
$56.55
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$56.55
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$232.12
|
| Rate for Payer: BCN Medicare Advantage |
$56.55
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$75.78
|
| Rate for Payer: Cofinity Commercial |
$81.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Healthscope Whirlpool |
$67.86
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.38
|
| Rate for Payer: PACE SWMI |
$56.55
|
| Rate for Payer: PHP Medicare Advantage |
$56.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.26
|
| Rate for Payer: Priority Health Medicare |
$56.55
|
| Rate for Payer: Priority Health Narrow Network |
$78.26
|
| Rate for Payer: UHC Medicare Advantage |
$58.25
|
|
|
PR CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 42960
|
| Min. Negotiated Rate |
$103.73 |
| Max. Negotiated Rate |
$283.41 |
| Rate for Payer: Aetna Commercial |
$211.25
|
| Rate for Payer: Aetna Medicare |
$157.65
|
| Rate for Payer: BCBS Complete |
$108.92
|
| Rate for Payer: BCBS MAPPO |
$157.65
|
| Rate for Payer: BCBS Trust/PPO |
$278.94
|
| Rate for Payer: BCN Commercial |
$235.54
|
| Rate for Payer: BCN Medicare Advantage |
$157.65
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$227.02
|
| Rate for Payer: Cofinity Commercial |
$211.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.65
|
| Rate for Payer: Healthscope Commercial |
$189.18
|
| Rate for Payer: Healthscope Whirlpool |
$189.18
|
| Rate for Payer: Meridian Medicaid |
$108.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.53
|
| Rate for Payer: PACE SWMI |
$157.65
|
| Rate for Payer: PHP Medicare Advantage |
$157.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.41
|
| Rate for Payer: Priority Health Medicare |
$157.65
|
| Rate for Payer: Priority Health Narrow Network |
$283.41
|
| Rate for Payer: UHC Medicare Advantage |
$162.38
|
|
|
PR CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 49446
|
| Min. Negotiated Rate |
$90.74 |
| Max. Negotiated Rate |
$1,438.50 |
| Rate for Payer: Aetna Commercial |
$191.74
|
| Rate for Payer: Aetna Medicare |
$143.09
|
| Rate for Payer: BCBS Complete |
$95.28
|
| Rate for Payer: BCBS MAPPO |
$143.09
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,182.11
|
| Rate for Payer: BCN Medicare Advantage |
$143.09
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cofinity Commercial |
$206.05
|
| Rate for Payer: Cofinity Commercial |
$191.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.09
|
| Rate for Payer: Healthscope Commercial |
$171.71
|
| Rate for Payer: Healthscope Whirlpool |
$171.71
|
| Rate for Payer: Meridian Medicaid |
$95.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.24
|
| Rate for Payer: PACE SWMI |
$143.09
|
| Rate for Payer: PHP Medicare Advantage |
$143.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,438.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.66
|
| Rate for Payer: Priority Health Medicare |
$143.09
|
| Rate for Payer: Priority Health Narrow Network |
$251.66
|
| Rate for Payer: UHC Medicare Advantage |
$147.38
|
|
|
PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,387.18
|
|
|
Service Code
|
HCPCS 27132
|
| Min. Negotiated Rate |
$429.51 |
| Max. Negotiated Rate |
$2,546.60 |
| Rate for Payer: Aetna Commercial |
$2,205.40
|
| Rate for Payer: Aetna Medicare |
$1,645.82
|
| Rate for Payer: BCBS Complete |
$1,121.83
|
| Rate for Payer: BCBS MAPPO |
$1,645.82
|
| Rate for Payer: BCBS Trust/PPO |
$429.51
|
| Rate for Payer: BCN Commercial |
$2,437.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.82
|
| Rate for Payer: Cash Price |
$2,709.74
|
| Rate for Payer: Cash Price |
$2,709.74
|
| Rate for Payer: Cofinity Commercial |
$2,369.98
|
| Rate for Payer: Cofinity Commercial |
$2,205.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.82
|
| Rate for Payer: Healthscope Commercial |
$1,974.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,974.98
|
| Rate for Payer: Meridian Medicaid |
$1,121.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,728.11
|
| Rate for Payer: PACE SWMI |
$1,645.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,068.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,371.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,546.60
|
| Rate for Payer: Priority Health Medicare |
$1,645.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,546.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,695.19
|
|
|
PR CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY
|
Professional
|
Both
|
$1,740.00
|
|
|
Service Code
|
HCPCS 23415
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$1,218.00 |
| Rate for Payer: Aetna Commercial |
$923.19
|
| Rate for Payer: Aetna Medicare |
$688.95
|
| Rate for Payer: BCBS Complete |
$475.48
|
| Rate for Payer: BCBS MAPPO |
$688.95
|
| Rate for Payer: BCBS Trust/PPO |
$94.66
|
| Rate for Payer: BCN Commercial |
$1,030.14
|
| Rate for Payer: BCN Medicare Advantage |
$688.95
|
| Rate for Payer: Cash Price |
$1,392.00
|
| Rate for Payer: Cash Price |
$1,392.00
|
| Rate for Payer: Cofinity Commercial |
$992.09
|
| Rate for Payer: Cofinity Commercial |
$923.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.95
|
| Rate for Payer: Healthscope Commercial |
$826.74
|
| Rate for Payer: Healthscope Whirlpool |
$826.74
|
| Rate for Payer: Meridian Medicaid |
$475.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$723.40
|
| Rate for Payer: PACE SWMI |
$688.95
|
| Rate for Payer: PHP Medicare Advantage |
$688.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.45
|
| Rate for Payer: Priority Health Medicare |
$688.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,076.45
|
| Rate for Payer: UHC Medicare Advantage |
$709.62
|
|
|
PR CORDOCENTESIS INTRAUTERINE
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
HCPCS 59012
|
| Min. Negotiated Rate |
$128.87 |
| Max. Negotiated Rate |
$556.83 |
| Rate for Payer: Aetna Commercial |
$270.24
|
| Rate for Payer: Aetna Medicare |
$201.67
|
| Rate for Payer: BCBS Complete |
$135.31
|
| Rate for Payer: BCBS MAPPO |
$201.67
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: BCN Commercial |
$293.70
|
| Rate for Payer: BCN Medicare Advantage |
$201.67
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$290.40
|
| Rate for Payer: Cofinity Commercial |
$270.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.67
|
| Rate for Payer: Healthscope Commercial |
$242.00
|
| Rate for Payer: Healthscope Whirlpool |
$242.00
|
| Rate for Payer: Meridian Medicaid |
$135.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$211.75
|
| Rate for Payer: PACE SWMI |
$201.67
|
| Rate for Payer: PHP Medicare Advantage |
$201.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.77
|
| Rate for Payer: Priority Health Medicare |
$201.67
|
| Rate for Payer: Priority Health Narrow Network |
$283.77
|
| Rate for Payer: UHC Medicare Advantage |
$207.72
|
|
|
PR CORF RELATED SERV 15 MINS EA
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0409
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$1,772.97 |
| Rate for Payer: Aetna Commercial |
$28.21
|
| Rate for Payer: Aetna Medicare |
$21.05
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$21.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,772.97
|
| Rate for Payer: BCN Commercial |
$33.23
|
| Rate for Payer: BCN Medicare Advantage |
$21.05
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$28.21
|
| Rate for Payer: Cofinity Commercial |
$30.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.05
|
| Rate for Payer: Healthscope Commercial |
$25.26
|
| Rate for Payer: Healthscope Whirlpool |
$25.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.10
|
| Rate for Payer: PACE SWMI |
$21.05
|
| Rate for Payer: PHP Medicare Advantage |
$21.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health Medicare |
$21.05
|
| Rate for Payer: UHC Medicare Advantage |
$21.68
|
|
|
PR CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT
|
Professional
|
Both
|
$3,966.72
|
|
|
Service Code
|
HCPCS 33510
|
| Min. Negotiated Rate |
$1,211.54 |
| Max. Negotiated Rate |
$3,016.19 |
| Rate for Payer: Aetna Commercial |
$2,547.82
|
| Rate for Payer: Aetna Medicare |
$1,901.36
|
| Rate for Payer: BCBS Complete |
$1,272.12
|
| Rate for Payer: BCBS MAPPO |
$1,901.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,333.43
|
| Rate for Payer: BCN Commercial |
$2,770.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,901.36
|
| Rate for Payer: Cash Price |
$3,173.38
|
| Rate for Payer: Cash Price |
$3,173.38
|
| Rate for Payer: Cofinity Commercial |
$2,737.96
|
| Rate for Payer: Cofinity Commercial |
$2,547.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,901.36
|
| Rate for Payer: Healthscope Commercial |
$2,281.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,281.63
|
| Rate for Payer: Meridian Medicaid |
$1,272.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,996.43
|
| Rate for Payer: PACE SWMI |
$1,901.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,901.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,211.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,016.19
|
| Rate for Payer: Priority Health Medicare |
$1,901.36
|
| Rate for Payer: Priority Health Narrow Network |
$3,016.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,958.40
|
|
|
PR CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$4,357.00
|
|
|
Service Code
|
HCPCS 33511
|
| Min. Negotiated Rate |
$1,241.51 |
| Max. Negotiated Rate |
$3,310.37 |
| Rate for Payer: Aetna Commercial |
$2,796.53
|
| Rate for Payer: Aetna Medicare |
$2,086.96
|
| Rate for Payer: BCBS Complete |
$1,396.92
|
| Rate for Payer: BCBS MAPPO |
$2,086.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,241.51
|
| Rate for Payer: BCN Commercial |
$3,041.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,086.96
|
| Rate for Payer: Cash Price |
$3,485.60
|
| Rate for Payer: Cash Price |
$3,485.60
|
| Rate for Payer: Cofinity Commercial |
$3,005.22
|
| Rate for Payer: Cofinity Commercial |
$2,796.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,086.96
|
| Rate for Payer: Healthscope Commercial |
$2,504.35
|
| Rate for Payer: Healthscope Whirlpool |
$2,504.35
|
| Rate for Payer: Meridian Medicaid |
$1,396.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,191.31
|
| Rate for Payer: PACE SWMI |
$2,086.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,086.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,049.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,310.37
|
| Rate for Payer: Priority Health Medicare |
$2,086.96
|
| Rate for Payer: Priority Health Narrow Network |
$3,310.37
|
| Rate for Payer: UHC Medicare Advantage |
$2,149.57
|
|
|
PR CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$9,723.00
|
|
|
Service Code
|
HCPCS 33512
|
| Min. Negotiated Rate |
$1,337.66 |
| Max. Negotiated Rate |
$6,806.10 |
| Rate for Payer: Aetna Commercial |
$3,189.82
|
| Rate for Payer: Aetna Medicare |
$2,380.46
|
| Rate for Payer: BCBS Complete |
$1,591.28
|
| Rate for Payer: BCBS MAPPO |
$2,380.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.66
|
| Rate for Payer: BCN Commercial |
$3,467.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,380.46
|
| Rate for Payer: Cash Price |
$7,778.40
|
| Rate for Payer: Cash Price |
$7,778.40
|
| Rate for Payer: Cofinity Commercial |
$3,189.82
|
| Rate for Payer: Cofinity Commercial |
$3,427.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,380.46
|
| Rate for Payer: Healthscope Commercial |
$2,856.55
|
| Rate for Payer: Healthscope Whirlpool |
$2,856.55
|
| Rate for Payer: Meridian Medicaid |
$1,591.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,499.48
|
| Rate for Payer: PACE SWMI |
$2,380.46
|
| Rate for Payer: PHP Medicare Advantage |
$2,380.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,515.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,806.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,774.78
|
| Rate for Payer: Priority Health Medicare |
$2,380.46
|
| Rate for Payer: Priority Health Narrow Network |
$3,774.78
|
| Rate for Payer: UHC Medicare Advantage |
$2,451.87
|
|
|
PR CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$9,922.00
|
|
|
Service Code
|
HCPCS 33513
|
| Min. Negotiated Rate |
$1,257.88 |
| Max. Negotiated Rate |
$6,945.40 |
| Rate for Payer: Aetna Commercial |
$3,265.42
|
| Rate for Payer: Aetna Medicare |
$2,436.88
|
| Rate for Payer: BCBS Complete |
$1,624.82
|
| Rate for Payer: BCBS MAPPO |
$2,436.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,257.88
|
| Rate for Payer: BCN Commercial |
$3,547.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,436.88
|
| Rate for Payer: Cash Price |
$7,937.60
|
| Rate for Payer: Cash Price |
$7,937.60
|
| Rate for Payer: Cofinity Commercial |
$3,509.11
|
| Rate for Payer: Cofinity Commercial |
$3,265.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,436.88
|
| Rate for Payer: Healthscope Commercial |
$2,924.26
|
| Rate for Payer: Healthscope Whirlpool |
$2,924.26
|
| Rate for Payer: Meridian Medicaid |
$1,624.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,558.72
|
| Rate for Payer: PACE SWMI |
$2,436.88
|
| Rate for Payer: PHP Medicare Advantage |
$2,436.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,547.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,945.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,861.48
|
| Rate for Payer: Priority Health Medicare |
$2,436.88
|
| Rate for Payer: Priority Health Narrow Network |
$3,861.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,509.99
|
|
|
PR CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT
|
Professional
|
Both
|
$11,159.00
|
|
|
Service Code
|
HCPCS 33516
|
| Min. Negotiated Rate |
$1,382.03 |
| Max. Negotiated Rate |
$7,811.30 |
| Rate for Payer: Aetna Commercial |
$3,551.47
|
| Rate for Payer: Aetna Medicare |
$2,650.35
|
| Rate for Payer: BCBS Complete |
$1,767.96
|
| Rate for Payer: BCBS MAPPO |
$2,650.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,382.03
|
| Rate for Payer: BCN Commercial |
$3,858.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,650.35
|
| Rate for Payer: Cash Price |
$8,927.20
|
| Rate for Payer: Cash Price |
$8,927.20
|
| Rate for Payer: Cofinity Commercial |
$3,551.47
|
| Rate for Payer: Cofinity Commercial |
$3,816.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,650.35
|
| Rate for Payer: Healthscope Commercial |
$3,180.42
|
| Rate for Payer: Healthscope Whirlpool |
$3,180.42
|
| Rate for Payer: Meridian Medicaid |
$1,767.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,782.87
|
| Rate for Payer: PACE SWMI |
$2,650.35
|
| Rate for Payer: PHP Medicare Advantage |
$2,650.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,683.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,811.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,200.33
|
| Rate for Payer: Priority Health Medicare |
$2,650.35
|
| Rate for Payer: Priority Health Narrow Network |
$4,200.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,729.86
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 33517
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$1,181.81 |
| Rate for Payer: Aetna Commercial |
$246.27
|
| Rate for Payer: Aetna Medicare |
$183.78
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS MAPPO |
$183.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.81
|
| Rate for Payer: BCN Commercial |
$266.33
|
| Rate for Payer: BCN Medicare Advantage |
$183.78
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$264.64
|
| Rate for Payer: Cofinity Commercial |
$246.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.78
|
| Rate for Payer: Healthscope Commercial |
$220.54
|
| Rate for Payer: Healthscope Whirlpool |
$220.54
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$192.97
|
| Rate for Payer: PACE SWMI |
$183.78
|
| Rate for Payer: PHP Medicare Advantage |
$183.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.92
|
| Rate for Payer: Priority Health Medicare |
$183.78
|
| Rate for Payer: Priority Health Narrow Network |
$289.92
|
| Rate for Payer: UHC Medicare Advantage |
$189.29
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN
|
Professional
|
Both
|
$1,299.00
|
|
|
Service Code
|
HCPCS 33518
|
| Min. Negotiated Rate |
$255.60 |
| Max. Negotiated Rate |
$1,337.66 |
| Rate for Payer: Aetna Commercial |
$542.81
|
| Rate for Payer: Aetna Medicare |
$405.08
|
| Rate for Payer: BCBS Complete |
$268.38
|
| Rate for Payer: BCBS MAPPO |
$405.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.66
|
| Rate for Payer: BCN Commercial |
$586.90
|
| Rate for Payer: BCN Medicare Advantage |
$405.08
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cofinity Commercial |
$583.32
|
| Rate for Payer: Cofinity Commercial |
$542.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.08
|
| Rate for Payer: Healthscope Commercial |
$486.10
|
| Rate for Payer: Healthscope Whirlpool |
$486.10
|
| Rate for Payer: Meridian Medicaid |
$268.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$425.33
|
| Rate for Payer: PACE SWMI |
$405.08
|
| Rate for Payer: PHP Medicare Advantage |
$405.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$255.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$638.89
|
| Rate for Payer: Priority Health Medicare |
$405.08
|
| Rate for Payer: Priority Health Narrow Network |
$638.89
|
| Rate for Payer: UHC Medicare Advantage |
$417.23
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN
|
Professional
|
Both
|
$1,892.00
|
|
|
Service Code
|
HCPCS 33519
|
| Min. Negotiated Rate |
$338.24 |
| Max. Negotiated Rate |
$1,324.40 |
| Rate for Payer: Aetna Commercial |
$717.25
|
| Rate for Payer: Aetna Medicare |
$535.26
|
| Rate for Payer: BCBS Complete |
$355.15
|
| Rate for Payer: BCBS MAPPO |
$535.26
|
| Rate for Payer: BCBS Trust/PPO |
$987.39
|
| Rate for Payer: BCN Commercial |
$775.53
|
| Rate for Payer: BCN Medicare Advantage |
$535.26
|
| Rate for Payer: Cash Price |
$1,513.60
|
| Rate for Payer: Cash Price |
$1,513.60
|
| Rate for Payer: Cofinity Commercial |
$717.25
|
| Rate for Payer: Cofinity Commercial |
$770.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.26
|
| Rate for Payer: Healthscope Commercial |
$642.31
|
| Rate for Payer: Healthscope Whirlpool |
$642.31
|
| Rate for Payer: Meridian Medicaid |
$355.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$562.02
|
| Rate for Payer: PACE SWMI |
$535.26
|
| Rate for Payer: PHP Medicare Advantage |
$535.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$844.22
|
| Rate for Payer: Priority Health Medicare |
$535.26
|
| Rate for Payer: Priority Health Narrow Network |
$844.22
|
| Rate for Payer: UHC Medicare Advantage |
$551.32
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN
|
Professional
|
Both
|
$2,540.00
|
|
|
Service Code
|
HCPCS 33521
|
| Min. Negotiated Rate |
$158.49 |
| Max. Negotiated Rate |
$1,778.00 |
| Rate for Payer: Aetna Commercial |
$859.57
|
| Rate for Payer: Aetna Medicare |
$641.47
|
| Rate for Payer: BCBS Complete |
$425.61
|
| Rate for Payer: BCBS MAPPO |
$641.47
|
| Rate for Payer: BCBS Trust/PPO |
$158.49
|
| Rate for Payer: BCN Commercial |
$929.47
|
| Rate for Payer: BCN Medicare Advantage |
$641.47
|
| Rate for Payer: Cash Price |
$2,032.00
|
| Rate for Payer: Cash Price |
$2,032.00
|
| Rate for Payer: Cofinity Commercial |
$923.72
|
| Rate for Payer: Cofinity Commercial |
$859.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.47
|
| Rate for Payer: Healthscope Commercial |
$769.76
|
| Rate for Payer: Healthscope Whirlpool |
$769.76
|
| Rate for Payer: Meridian Medicaid |
$425.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$673.54
|
| Rate for Payer: PACE SWMI |
$641.47
|
| Rate for Payer: PHP Medicare Advantage |
$641.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,778.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,011.78
|
| Rate for Payer: Priority Health Medicare |
$641.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,011.78
|
| Rate for Payer: UHC Medicare Advantage |
$660.71
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN
|
Professional
|
Both
|
$3,227.00
|
|
|
Service Code
|
HCPCS 33522
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$2,258.90 |
| Rate for Payer: Aetna Commercial |
$965.90
|
| Rate for Payer: Aetna Medicare |
$720.82
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCBS MAPPO |
$720.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.94
|
| Rate for Payer: BCN Commercial |
$1,044.31
|
| Rate for Payer: BCN Medicare Advantage |
$720.82
|
| Rate for Payer: Cash Price |
$2,581.60
|
| Rate for Payer: Cash Price |
$2,581.60
|
| Rate for Payer: Cofinity Commercial |
$965.90
|
| Rate for Payer: Cofinity Commercial |
$1,037.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$720.82
|
| Rate for Payer: Healthscope Commercial |
$864.98
|
| Rate for Payer: Healthscope Whirlpool |
$864.98
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$756.86
|
| Rate for Payer: PACE SWMI |
$720.82
|
| Rate for Payer: PHP Medicare Advantage |
$720.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,258.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,136.79
|
| Rate for Payer: Priority Health Medicare |
$720.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,136.79
|
| Rate for Payer: UHC Medicare Advantage |
$742.44
|
|
|
PR CORONARY ENDARTERCOMY OPEN ANY METHOD
|
Professional
|
Both
|
$1,270.00
|
|
|
Service Code
|
HCPCS 33572
|
| Min. Negotiated Rate |
$143.78 |
| Max. Negotiated Rate |
$889.00 |
| Rate for Payer: Aetna Commercial |
$304.70
|
| Rate for Payer: Aetna Medicare |
$227.39
|
| Rate for Payer: BCBS Complete |
$150.97
|
| Rate for Payer: BCBS MAPPO |
$227.39
|
| Rate for Payer: BCBS Trust/PPO |
$863.77
|
| Rate for Payer: BCN Commercial |
$329.36
|
| Rate for Payer: BCN Medicare Advantage |
$227.39
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cofinity Commercial |
$327.44
|
| Rate for Payer: Cofinity Commercial |
$304.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.39
|
| Rate for Payer: Healthscope Commercial |
$272.87
|
| Rate for Payer: Healthscope Whirlpool |
$272.87
|
| Rate for Payer: Meridian Medicaid |
$150.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$238.76
|
| Rate for Payer: PACE SWMI |
$227.39
|
| Rate for Payer: PHP Medicare Advantage |
$227.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$358.54
|
| Rate for Payer: Priority Health Medicare |
$227.39
|
| Rate for Payer: Priority Health Narrow Network |
$358.54
|
| Rate for Payer: UHC Medicare Advantage |
$234.21
|
|
|
PR CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI
|
Professional
|
Both
|
$1,837.00
|
|
|
Service Code
|
HCPCS 54430
|
| Min. Negotiated Rate |
$407.68 |
| Max. Negotiated Rate |
$3,265.16 |
| Rate for Payer: Aetna Commercial |
$835.53
|
| Rate for Payer: Aetna Medicare |
$623.53
|
| Rate for Payer: BCBS Complete |
$428.06
|
| Rate for Payer: BCBS MAPPO |
$623.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,265.16
|
| Rate for Payer: BCN Commercial |
$922.62
|
| Rate for Payer: BCN Medicare Advantage |
$623.53
|
| Rate for Payer: Cash Price |
$1,469.60
|
| Rate for Payer: Cash Price |
$1,469.60
|
| Rate for Payer: Cofinity Commercial |
$897.88
|
| Rate for Payer: Cofinity Commercial |
$835.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.53
|
| Rate for Payer: Healthscope Commercial |
$748.24
|
| Rate for Payer: Healthscope Whirlpool |
$748.24
|
| Rate for Payer: Meridian Medicaid |
$428.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$654.71
|
| Rate for Payer: PACE SWMI |
$623.53
|
| Rate for Payer: PHP Medicare Advantage |
$623.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.20
|
| Rate for Payer: Priority Health Medicare |
$623.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.20
|
| Rate for Payer: UHC Medicare Advantage |
$642.24
|
|
|
PR CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM
|
Professional
|
Both
|
$738.00
|
|
|
Service Code
|
HCPCS 54435
|
| Min. Negotiated Rate |
$265.61 |
| Max. Negotiated Rate |
$1,738.11 |
| Rate for Payer: Aetna Commercial |
$541.51
|
| Rate for Payer: Aetna Medicare |
$404.11
|
| Rate for Payer: BCBS Complete |
$278.89
|
| Rate for Payer: BCBS MAPPO |
$404.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,738.11
|
| Rate for Payer: BCN Commercial |
$600.09
|
| Rate for Payer: BCN Medicare Advantage |
$404.11
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cofinity Commercial |
$541.51
|
| Rate for Payer: Cofinity Commercial |
$581.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.11
|
| Rate for Payer: Healthscope Commercial |
$484.93
|
| Rate for Payer: Healthscope Whirlpool |
$484.93
|
| Rate for Payer: Meridian Medicaid |
$278.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$424.32
|
| Rate for Payer: PACE SWMI |
$404.11
|
| Rate for Payer: PHP Medicare Advantage |
$404.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$516.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.55
|
| Rate for Payer: Priority Health Medicare |
$404.11
|
| Rate for Payer: Priority Health Narrow Network |
$663.55
|
| Rate for Payer: UHC Medicare Advantage |
$416.23
|
|
|
PR CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI
|
Professional
|
Both
|
$1,322.00
|
|
|
Service Code
|
HCPCS 54420
|
| Min. Negotiated Rate |
$447.73 |
| Max. Negotiated Rate |
$2,612.13 |
| Rate for Payer: Aetna Commercial |
$919.53
|
| Rate for Payer: Aetna Medicare |
$686.22
|
| Rate for Payer: BCBS Complete |
$470.12
|
| Rate for Payer: BCBS MAPPO |
$686.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,612.13
|
| Rate for Payer: BCN Commercial |
$1,014.00
|
| Rate for Payer: BCN Medicare Advantage |
$686.22
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cofinity Commercial |
$919.53
|
| Rate for Payer: Cofinity Commercial |
$988.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.22
|
| Rate for Payer: Healthscope Commercial |
$823.46
|
| Rate for Payer: Healthscope Whirlpool |
$823.46
|
| Rate for Payer: Meridian Medicaid |
$470.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$720.53
|
| Rate for Payer: PACE SWMI |
$686.22
|
| Rate for Payer: PHP Medicare Advantage |
$686.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,121.24
|
| Rate for Payer: Priority Health Medicare |
$686.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,121.24
|
| Rate for Payer: UHC Medicare Advantage |
$706.81
|
|
|
PR CORRECT BUNION,SIMPLE
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 28290
|
| Min. Negotiated Rate |
$542.80 |
| Max. Negotiated Rate |
$949.90 |
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.90
|
|
|
PR CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 28286
|
| Min. Negotiated Rate |
$192.13 |
| Max. Negotiated Rate |
$2,002.26 |
| Rate for Payer: Aetna Commercial |
$386.30
|
| Rate for Payer: Aetna Medicare |
$288.28
|
| Rate for Payer: BCBS Complete |
$201.74
|
| Rate for Payer: BCBS MAPPO |
$288.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,002.26
|
| Rate for Payer: BCN Commercial |
$639.19
|
| Rate for Payer: BCN Medicare Advantage |
$288.28
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Commercial |
$415.12
|
| Rate for Payer: Cofinity Commercial |
$386.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.28
|
| Rate for Payer: Healthscope Commercial |
$345.94
|
| Rate for Payer: Healthscope Whirlpool |
$345.94
|
| Rate for Payer: Meridian Medicaid |
$201.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.69
|
| Rate for Payer: PACE SWMI |
$288.28
|
| Rate for Payer: PHP Medicare Advantage |
$288.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$449.89
|
| Rate for Payer: Priority Health Medicare |
$288.28
|
| Rate for Payer: Priority Health Narrow Network |
$449.89
|
| Rate for Payer: UHC Medicare Advantage |
$296.93
|
|
|
PR CORRECTION HAMMERTOE
|
Professional
|
Both
|
$937.00
|
|
|
Service Code
|
HCPCS 28285
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$1,673.65 |
| Rate for Payer: Aetna Commercial |
$501.95
|
| Rate for Payer: Aetna Medicare |
$374.59
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$374.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.65
|
| Rate for Payer: BCN Commercial |
$860.92
|
| Rate for Payer: BCN Medicare Advantage |
$374.59
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cofinity Commercial |
$501.95
|
| Rate for Payer: Cofinity Commercial |
$539.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.59
|
| Rate for Payer: Healthscope Commercial |
$449.51
|
| Rate for Payer: Healthscope Whirlpool |
$449.51
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$393.32
|
| Rate for Payer: PACE SWMI |
$374.59
|
| Rate for Payer: PHP Medicare Advantage |
$374.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$655.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$586.23
|
| Rate for Payer: Priority Health Medicare |
$374.59
|
| Rate for Payer: Priority Health Narrow Network |
$586.23
|
| Rate for Payer: UHC Medicare Advantage |
$385.83
|
|
|
PR CORRECTION INVERTED NIPPLES
|
Professional
|
Both
|
$1,623.00
|
|
|
Service Code
|
HCPCS 19355
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$1,136.10 |
| Rate for Payer: Aetna Commercial |
$811.26
|
| Rate for Payer: Aetna Medicare |
$605.42
|
| Rate for Payer: BCBS Complete |
$415.77
|
| Rate for Payer: BCBS MAPPO |
$605.42
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$1,109.79
|
| Rate for Payer: BCN Medicare Advantage |
$605.42
|
| Rate for Payer: Cash Price |
$1,298.40
|
| Rate for Payer: Cash Price |
$1,298.40
|
| Rate for Payer: Cofinity Commercial |
$871.80
|
| Rate for Payer: Cofinity Commercial |
$811.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.42
|
| Rate for Payer: Healthscope Commercial |
$726.50
|
| Rate for Payer: Healthscope Whirlpool |
$726.50
|
| Rate for Payer: Meridian Medicaid |
$415.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$635.69
|
| Rate for Payer: PACE SWMI |
$605.42
|
| Rate for Payer: PHP Medicare Advantage |
$605.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.42
|
| Rate for Payer: Priority Health Medicare |
$605.42
|
| Rate for Payer: Priority Health Narrow Network |
$760.42
|
| Rate for Payer: UHC Medicare Advantage |
$623.58
|
|
