|
PR DERMAL FILLER JUVEDERM VOLLURE
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 00118
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
|
|
PR DERMAL FILLER JUVEDERM VOLUMA
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 00091
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$320.00 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: BCBS Complete |
$320.00
|
| Rate for Payer: Cash Price |
$640.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.00
|
|
|
PR DERMAL FILLER RESTYLANE 1/2 UNIT
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 00252
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
|
|
PR DERMAL FILLER RESTYLANE 1 UNIT
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 00253
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$260.00 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
|
|
PR DERMAL FILLER RESTYLANE DEFYNE
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 00360
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
|
|
PR DERMAL FILLER RESTYLANE LYFT
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 00359
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$260.00 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
|
|
PR DERMAL FILLER RESTYLANE REFYNE
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 00361
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
|
|
PR DERMAL FILLER VOLBELLA
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 00092
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
|
|
PR DERMAL FILLER VOLBELLA >1
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 00120
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
|
|
PR DESTROY NERVE,CERV SPINAL MUSCLES
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 64613
|
| Min. Negotiated Rate |
$141.60 |
| Max. Negotiated Rate |
$247.80 |
| Rate for Payer: BCBS Complete |
$141.60
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.80
|
|
|
PR DESTRUCTION BENIGN LESIONS 15/>
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 17111
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$562.50 |
| Rate for Payer: Aetna Commercial |
$106.02
|
| Rate for Payer: Aetna Medicare |
$79.12
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$79.12
|
| Rate for Payer: BCBS Trust/PPO |
$562.50
|
| Rate for Payer: BCN Commercial |
$156.28
|
| Rate for Payer: BCN Medicare Advantage |
$79.12
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$106.02
|
| Rate for Payer: Cofinity Commercial |
$113.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.12
|
| Rate for Payer: Healthscope Commercial |
$94.94
|
| Rate for Payer: Healthscope Whirlpool |
$94.94
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.08
|
| Rate for Payer: PACE SWMI |
$79.12
|
| Rate for Payer: PHP Medicare Advantage |
$79.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.70
|
| Rate for Payer: Priority Health Medicare |
$79.12
|
| Rate for Payer: Priority Health Narrow Network |
$100.70
|
| Rate for Payer: UHC Medicare Advantage |
$81.49
|
|
|
PR DESTRUCTION BENIGN LESIONS UP TO 14
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 17110
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$4,160.00 |
| Rate for Payer: Aetna Commercial |
$86.10
|
| Rate for Payer: Aetna Medicare |
$64.25
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$64.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.00
|
| Rate for Payer: BCN Commercial |
$133.89
|
| Rate for Payer: BCN Medicare Advantage |
$64.25
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$92.52
|
| Rate for Payer: Cofinity Commercial |
$86.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.25
|
| Rate for Payer: Healthscope Commercial |
$77.10
|
| Rate for Payer: Healthscope Whirlpool |
$77.10
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.46
|
| Rate for Payer: PACE SWMI |
$64.25
|
| Rate for Payer: PHP Medicare Advantage |
$64.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.20
|
| Rate for Payer: Priority Health Medicare |
$64.25
|
| Rate for Payer: Priority Health Narrow Network |
$82.20
|
| Rate for Payer: UHC Medicare Advantage |
$66.18
|
|
|
PR DESTRUCTION BENIGN LESIONS UP TO 14
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
17110
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$222.44 |
| Rate for Payer: Aetna Commercial |
$161.10
|
| Rate for Payer: Aetna Medicare |
$177.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: ASR ASR |
$173.63
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$138.78
|
| Rate for Payer: BCN Commercial |
$138.78
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$168.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$179.00
|
| Rate for Payer: Healthscope Whirlpool |
$173.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$161.10
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$152.15
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$195.74
|
| Rate for Payer: PHP Medicaid |
$97.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.32
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$103.46
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.52
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
PR DESTRUCTION BENIGN LESIONS UP TO 14
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 17110
|
| Hospital Charge Code |
17110
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$4,160.00 |
| Rate for Payer: Aetna Commercial |
$86.10
|
| Rate for Payer: Aetna Medicare |
$64.25
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$64.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.00
|
| Rate for Payer: BCN Commercial |
$133.89
|
| Rate for Payer: BCN Medicare Advantage |
$64.25
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$92.52
|
| Rate for Payer: Cofinity Commercial |
$86.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.25
|
| Rate for Payer: Healthscope Commercial |
$77.10
|
| Rate for Payer: Healthscope Whirlpool |
$77.10
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.46
|
| Rate for Payer: PACE SWMI |
$64.25
|
| Rate for Payer: PHP Medicare Advantage |
$64.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.20
|
| Rate for Payer: Priority Health Medicare |
$64.25
|
| Rate for Payer: Priority Health Narrow Network |
$82.20
|
| Rate for Payer: UHC Medicare Advantage |
$66.18
|
|
|
PR DESTRUCTION BENIGN LESIONS UP TO 14
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
17110
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$125.30 |
| Max. Negotiated Rate |
$179.00 |
| Rate for Payer: Aetna Commercial |
$161.10
|
| Rate for Payer: ASR ASR |
$173.63
|
| Rate for Payer: BCBS Trust/PPO |
$138.78
|
| Rate for Payer: BCN Commercial |
$138.78
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$168.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.20
|
| Rate for Payer: Healthscope Commercial |
$179.00
|
| Rate for Payer: Healthscope Whirlpool |
$173.63
|
| Rate for Payer: Mclaren Commercial |
$161.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$152.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.52
|
|
|
PR DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM
|
Professional
|
Both
|
$618.00
|
|
|
Service Code
|
HCPCS 17106
|
| Min. Negotiated Rate |
$177.00 |
| Max. Negotiated Rate |
$947.65 |
| Rate for Payer: Aetna Commercial |
$357.69
|
| Rate for Payer: Aetna Medicare |
$266.93
|
| Rate for Payer: BCBS Complete |
$185.85
|
| Rate for Payer: BCBS MAPPO |
$266.93
|
| Rate for Payer: BCBS Trust/PPO |
$947.65
|
| Rate for Payer: BCN Commercial |
$403.66
|
| Rate for Payer: BCN Medicare Advantage |
$266.93
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cofinity Commercial |
$357.69
|
| Rate for Payer: Cofinity Commercial |
$384.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.93
|
| Rate for Payer: Healthscope Commercial |
$320.32
|
| Rate for Payer: Healthscope Whirlpool |
$320.32
|
| Rate for Payer: Meridian Medicaid |
$185.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$280.28
|
| Rate for Payer: PACE SWMI |
$266.93
|
| Rate for Payer: PHP Medicare Advantage |
$266.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.46
|
| Rate for Payer: Priority Health Medicare |
$266.93
|
| Rate for Payer: Priority Health Narrow Network |
$337.46
|
| Rate for Payer: UHC Medicare Advantage |
$274.94
|
|
|
PR DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY
|
Professional
|
Both
|
$331.00
|
|
|
Service Code
|
HCPCS 46930
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$1,115.77 |
| Rate for Payer: Aetna Commercial |
$195.96
|
| Rate for Payer: Aetna Medicare |
$146.24
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$146.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,115.77
|
| Rate for Payer: BCN Commercial |
$255.24
|
| Rate for Payer: BCN Medicare Advantage |
$146.24
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cofinity Commercial |
$210.59
|
| Rate for Payer: Cofinity Commercial |
$195.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.24
|
| Rate for Payer: Healthscope Commercial |
$175.49
|
| Rate for Payer: Healthscope Whirlpool |
$175.49
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.55
|
| Rate for Payer: PACE SWMI |
$146.24
|
| Rate for Payer: PHP Medicare Advantage |
$146.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.94
|
| Rate for Payer: Priority Health Medicare |
$146.24
|
| Rate for Payer: Priority Health Narrow Network |
$266.94
|
| Rate for Payer: UHC Medicare Advantage |
$150.63
|
|
|
PR DESTRUCTION LESION LID MARGIN </ 1 CM
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 67850
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$347.09 |
| Rate for Payer: Aetna Commercial |
$169.23
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$347.09
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cofinity Commercial |
$169.23
|
| Rate for Payer: Cofinity Commercial |
$181.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$151.55
|
| Rate for Payer: Healthscope Whirlpool |
$151.55
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.73
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$227.73
|
| Rate for Payer: UHC Medicare Advantage |
$130.08
|
|
|
PR DESTRUCTION LESIONS VULVA EXTENSIVE
|
Professional
|
Both
|
$569.00
|
|
|
Service Code
|
HCPCS 56515
|
| Min. Negotiated Rate |
$136.96 |
| Max. Negotiated Rate |
$2,047.16 |
| Rate for Payer: Aetna Commercial |
$280.94
|
| Rate for Payer: Aetna Medicare |
$209.66
|
| Rate for Payer: BCBS Complete |
$143.81
|
| Rate for Payer: BCBS MAPPO |
$209.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,047.16
|
| Rate for Payer: BCN Commercial |
$409.52
|
| Rate for Payer: BCN Medicare Advantage |
$209.66
|
| Rate for Payer: Cash Price |
$455.20
|
| Rate for Payer: Cash Price |
$455.20
|
| Rate for Payer: Cofinity Commercial |
$301.91
|
| Rate for Payer: Cofinity Commercial |
$280.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.66
|
| Rate for Payer: Healthscope Commercial |
$251.59
|
| Rate for Payer: Healthscope Whirlpool |
$251.59
|
| Rate for Payer: Meridian Medicaid |
$143.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.14
|
| Rate for Payer: PACE SWMI |
$209.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$302.99
|
| Rate for Payer: Priority Health Medicare |
$209.66
|
| Rate for Payer: Priority Health Narrow Network |
$302.99
|
| Rate for Payer: UHC Medicare Advantage |
$215.95
|
|
|
PR DESTRUCTION LESIONS VULVA SIMPLE
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 56501
|
| Min. Negotiated Rate |
$86.27 |
| Max. Negotiated Rate |
$1,962.11 |
| Rate for Payer: Aetna Commercial |
$174.96
|
| Rate for Payer: Aetna Medicare |
$130.57
|
| Rate for Payer: BCBS Complete |
$90.58
|
| Rate for Payer: BCBS MAPPO |
$130.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.11
|
| Rate for Payer: BCN Commercial |
$229.32
|
| Rate for Payer: BCN Medicare Advantage |
$130.57
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$188.02
|
| Rate for Payer: Cofinity Commercial |
$174.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.57
|
| Rate for Payer: Healthscope Commercial |
$156.68
|
| Rate for Payer: Healthscope Whirlpool |
$156.68
|
| Rate for Payer: Meridian Medicaid |
$90.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.10
|
| Rate for Payer: PACE SWMI |
$130.57
|
| Rate for Payer: PHP Medicare Advantage |
$130.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.80
|
| Rate for Payer: Priority Health Medicare |
$130.57
|
| Rate for Payer: Priority Health Narrow Network |
$190.80
|
| Rate for Payer: UHC Medicare Advantage |
$134.49
|
|
|
PR DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<
|
Professional
|
Both
|
$229.00
|
|
|
Service Code
|
HCPCS 17280
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$3,247.68 |
| Rate for Payer: Aetna Commercial |
$111.73
|
| Rate for Payer: Aetna Medicare |
$83.38
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$83.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$164.92
|
| Rate for Payer: BCN Medicare Advantage |
$83.38
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$111.73
|
| Rate for Payer: Cofinity Commercial |
$120.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.38
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Healthscope Whirlpool |
$100.06
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.55
|
| Rate for Payer: PACE SWMI |
$83.38
|
| Rate for Payer: PHP Medicare Advantage |
$83.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.22
|
| Rate for Payer: Priority Health Medicare |
$83.38
|
| Rate for Payer: Priority Health Narrow Network |
$105.22
|
| Rate for Payer: UHC Medicare Advantage |
$85.88
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 17270
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$3,247.68 |
| Rate for Payer: Aetna Commercial |
$124.30
|
| Rate for Payer: Aetna Medicare |
$92.76
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$92.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$176.70
|
| Rate for Payer: BCN Medicare Advantage |
$92.76
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$133.57
|
| Rate for Payer: Cofinity Commercial |
$124.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.76
|
| Rate for Payer: Healthscope Commercial |
$111.31
|
| Rate for Payer: Healthscope Whirlpool |
$111.31
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.40
|
| Rate for Payer: PACE SWMI |
$92.76
|
| Rate for Payer: PHP Medicare Advantage |
$92.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.74
|
| Rate for Payer: Priority Health Medicare |
$92.76
|
| Rate for Payer: Priority Health Narrow Network |
$116.74
|
| Rate for Payer: UHC Medicare Advantage |
$95.54
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 17271
|
| Min. Negotiated Rate |
$67.10 |
| Max. Negotiated Rate |
$5,054.50 |
| Rate for Payer: Aetna Commercial |
$136.97
|
| Rate for Payer: Aetna Medicare |
$102.22
|
| Rate for Payer: BCBS Complete |
$70.46
|
| Rate for Payer: BCBS MAPPO |
$102.22
|
| Rate for Payer: BCBS Trust/PPO |
$5,054.50
|
| Rate for Payer: BCN Commercial |
$196.33
|
| Rate for Payer: BCN Medicare Advantage |
$102.22
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$136.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.22
|
| Rate for Payer: Healthscope Commercial |
$122.66
|
| Rate for Payer: Healthscope Whirlpool |
$122.66
|
| Rate for Payer: Meridian Medicaid |
$70.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.33
|
| Rate for Payer: PACE SWMI |
$102.22
|
| Rate for Payer: PHP Medicare Advantage |
$102.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.66
|
| Rate for Payer: Priority Health Medicare |
$102.22
|
| Rate for Payer: Priority Health Narrow Network |
$128.66
|
| Rate for Payer: UHC Medicare Advantage |
$105.29
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 17272
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$29,358.48 |
| Rate for Payer: Aetna Commercial |
$157.29
|
| Rate for Payer: Aetna Medicare |
$117.38
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$117.38
|
| Rate for Payer: BCBS Trust/PPO |
$29,358.48
|
| Rate for Payer: BCN Commercial |
$222.25
|
| Rate for Payer: BCN Medicare Advantage |
$117.38
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$169.03
|
| Rate for Payer: Cofinity Commercial |
$157.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.38
|
| Rate for Payer: Healthscope Commercial |
$140.86
|
| Rate for Payer: Healthscope Whirlpool |
$140.86
|
| Rate for Payer: Meridian Medicaid |
$81.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.25
|
| Rate for Payer: PACE SWMI |
$117.38
|
| Rate for Payer: PHP Medicare Advantage |
$117.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.57
|
| Rate for Payer: Priority Health Medicare |
$117.38
|
| Rate for Payer: Priority Health Narrow Network |
$147.57
|
| Rate for Payer: UHC Medicare Advantage |
$120.90
|
|
|
PR DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 17273
|
| Min. Negotiated Rate |
$87.33 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$178.09
|
| Rate for Payer: Aetna Medicare |
$132.90
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$132.90
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$246.20
|
| Rate for Payer: BCN Medicare Advantage |
$132.90
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$191.38
|
| Rate for Payer: Cofinity Commercial |
$178.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.90
|
| Rate for Payer: Healthscope Commercial |
$159.48
|
| Rate for Payer: Healthscope Whirlpool |
$159.48
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.54
|
| Rate for Payer: PACE SWMI |
$132.90
|
| Rate for Payer: PHP Medicare Advantage |
$132.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.88
|
| Rate for Payer: Priority Health Medicare |
$132.90
|
| Rate for Payer: Priority Health Narrow Network |
$166.88
|
| Rate for Payer: UHC Medicare Advantage |
$136.89
|
|
