|
PR ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR
|
Professional
|
Both
|
$2,758.00
|
|
|
Service Code
|
HCPCS 58356
|
| Min. Negotiated Rate |
$226.42 |
| Max. Negotiated Rate |
$2,491.27 |
| Rate for Payer: Aetna Commercial |
$473.17
|
| Rate for Payer: Aetna Medicare |
$353.11
|
| Rate for Payer: BCBS Complete |
$237.74
|
| Rate for Payer: BCBS MAPPO |
$353.11
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: BCN Commercial |
$2,491.27
|
| Rate for Payer: BCN Medicare Advantage |
$353.11
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cofinity Commercial |
$473.17
|
| Rate for Payer: Cofinity Commercial |
$508.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.11
|
| Rate for Payer: Healthscope Commercial |
$423.73
|
| Rate for Payer: Healthscope Whirlpool |
$423.73
|
| Rate for Payer: Meridian Medicaid |
$237.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.77
|
| Rate for Payer: PACE SWMI |
$353.11
|
| Rate for Payer: PHP Medicare Advantage |
$353.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,930.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$502.77
|
| Rate for Payer: Priority Health Medicare |
$353.11
|
| Rate for Payer: Priority Health Narrow Network |
$502.77
|
| Rate for Payer: UHC Medicare Advantage |
$363.70
|
|
|
PR ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 43273
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$786.11 |
| Rate for Payer: Aetna Commercial |
$154.48
|
| Rate for Payer: Aetna Medicare |
$115.28
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$115.28
|
| Rate for Payer: BCBS Trust/PPO |
$786.11
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: BCN Medicare Advantage |
$115.28
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$166.00
|
| Rate for Payer: Cofinity Commercial |
$154.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.28
|
| Rate for Payer: Healthscope Commercial |
$138.34
|
| Rate for Payer: Healthscope Whirlpool |
$138.34
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$121.04
|
| Rate for Payer: PACE SWMI |
$115.28
|
| Rate for Payer: PHP Medicare Advantage |
$115.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.03
|
| Rate for Payer: Priority Health Medicare |
$115.28
|
| Rate for Payer: Priority Health Narrow Network |
$204.03
|
| Rate for Payer: UHC Medicare Advantage |
$118.74
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE
|
Professional
|
Both
|
$917.00
|
|
|
Service Code
|
HCPCS 44360
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$641.90 |
| Rate for Payer: Aetna Commercial |
$186.39
|
| Rate for Payer: Aetna Medicare |
$139.10
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$139.10
|
| Rate for Payer: BCBS Trust/PPO |
$381.96
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: BCN Medicare Advantage |
$139.10
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cofinity Commercial |
$200.30
|
| Rate for Payer: Cofinity Commercial |
$186.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.10
|
| Rate for Payer: Healthscope Commercial |
$166.92
|
| Rate for Payer: Healthscope Whirlpool |
$166.92
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.06
|
| Rate for Payer: PACE SWMI |
$139.10
|
| Rate for Payer: PHP Medicare Advantage |
$139.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.55
|
| Rate for Payer: Priority Health Medicare |
$139.10
|
| Rate for Payer: Priority Health Narrow Network |
$247.55
|
| Rate for Payer: UHC Medicare Advantage |
$143.27
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 44361
|
| Min. Negotiated Rate |
$99.68 |
| Max. Negotiated Rate |
$678.30 |
| Rate for Payer: Aetna Commercial |
$205.46
|
| Rate for Payer: Aetna Medicare |
$153.33
|
| Rate for Payer: BCBS Complete |
$104.66
|
| Rate for Payer: BCBS MAPPO |
$153.33
|
| Rate for Payer: BCBS Trust/PPO |
$508.22
|
| Rate for Payer: BCN Commercial |
$226.75
|
| Rate for Payer: BCN Medicare Advantage |
$153.33
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$205.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.33
|
| Rate for Payer: Healthscope Commercial |
$184.00
|
| Rate for Payer: Healthscope Whirlpool |
$184.00
|
| Rate for Payer: Meridian Medicaid |
$104.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.00
|
| Rate for Payer: PACE SWMI |
$153.33
|
| Rate for Payer: PHP Medicare Advantage |
$153.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$272.83
|
| Rate for Payer: Priority Health Medicare |
$153.33
|
| Rate for Payer: Priority Health Narrow Network |
$272.83
|
| Rate for Payer: UHC Medicare Advantage |
$157.93
|
|
|
PR ENDOVASC ABDO REPAIR W/PROS
|
Professional
|
Both
|
$5,228.00
|
|
|
Service Code
|
HCPCS 34805
|
| Min. Negotiated Rate |
$2,091.20 |
| Max. Negotiated Rate |
$3,659.60 |
| Rate for Payer: BCBS Complete |
$2,091.20
|
| Rate for Payer: Cash Price |
$4,182.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,659.60
|
|
|
PR ENDOVASCULAR REPAIR ILIAC ARTERY W ILIO-ILIAC PROSTHESIS
|
Professional
|
Both
|
$1,731.00
|
|
|
Service Code
|
HCPCS 34900
|
| Min. Negotiated Rate |
$692.40 |
| Max. Negotiated Rate |
$1,211.70 |
| Rate for Payer: BCBS Complete |
$692.40
|
| Rate for Payer: Cash Price |
$1,384.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.70
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
OP
|
$2,687.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$2,418.30
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$2,606.39
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,083.23
|
| Rate for Payer: BCN Commercial |
$2,083.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$2,525.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,149.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,687.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,606.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$2,418.30
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,283.95
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,445.17
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,907.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,364.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,687.00
|
|
|
Service Code
|
HCPCS 36478
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$1,880.90 |
| Rate for Payer: Aetna Commercial |
$365.27
|
| Rate for Payer: Aetna Medicare |
$272.59
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$272.59
|
| Rate for Payer: BCBS Trust/PPO |
$288.45
|
| Rate for Payer: BCN Commercial |
$1,440.13
|
| Rate for Payer: BCN Medicare Advantage |
$272.59
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$365.27
|
| Rate for Payer: Cofinity Commercial |
$392.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.59
|
| Rate for Payer: Healthscope Commercial |
$327.11
|
| Rate for Payer: Healthscope Whirlpool |
$327.11
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.22
|
| Rate for Payer: PACE SWMI |
$272.59
|
| Rate for Payer: PHP Medicare Advantage |
$272.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$431.94
|
| Rate for Payer: Priority Health Medicare |
$272.59
|
| Rate for Payer: Priority Health Narrow Network |
$431.94
|
| Rate for Payer: UHC Medicare Advantage |
$280.77
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
IP
|
$2,687.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$1,880.90 |
| Max. Negotiated Rate |
$2,687.00 |
| Rate for Payer: Aetna Commercial |
$2,418.30
|
| Rate for Payer: ASR ASR |
$2,606.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,083.23
|
| Rate for Payer: BCN Commercial |
$2,083.23
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$2,525.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,149.60
|
| Rate for Payer: Healthscope Commercial |
$2,687.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,606.39
|
| Rate for Payer: Mclaren Commercial |
$2,418.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,283.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,364.56
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,687.00
|
|
|
Service Code
|
HCPCS 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$1,880.90 |
| Rate for Payer: Aetna Commercial |
$365.27
|
| Rate for Payer: Aetna Medicare |
$272.59
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$272.59
|
| Rate for Payer: BCBS Trust/PPO |
$288.45
|
| Rate for Payer: BCN Commercial |
$1,440.13
|
| Rate for Payer: BCN Medicare Advantage |
$272.59
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$392.53
|
| Rate for Payer: Cofinity Commercial |
$365.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.59
|
| Rate for Payer: Healthscope Commercial |
$327.11
|
| Rate for Payer: Healthscope Whirlpool |
$327.11
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.22
|
| Rate for Payer: PACE SWMI |
$272.59
|
| Rate for Payer: PHP Medicare Advantage |
$272.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$431.94
|
| Rate for Payer: Priority Health Medicare |
$272.59
|
| Rate for Payer: Priority Health Narrow Network |
$431.94
|
| Rate for Payer: UHC Medicare Advantage |
$280.77
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN
|
Professional
|
Both
|
$3,087.00
|
|
|
Service Code
|
HCPCS 36475
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$2,160.90 |
| Rate for Payer: Aetna Commercial |
$366.05
|
| Rate for Payer: Aetna Medicare |
$273.17
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$273.17
|
| Rate for Payer: BCBS Trust/PPO |
$621.81
|
| Rate for Payer: BCN Commercial |
$1,586.74
|
| Rate for Payer: BCN Medicare Advantage |
$273.17
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cofinity Commercial |
$393.36
|
| Rate for Payer: Cofinity Commercial |
$366.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.17
|
| Rate for Payer: Healthscope Commercial |
$327.80
|
| Rate for Payer: Healthscope Whirlpool |
$327.80
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.83
|
| Rate for Payer: PACE SWMI |
$273.17
|
| Rate for Payer: PHP Medicare Advantage |
$273.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,160.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.48
|
| Rate for Payer: Priority Health Medicare |
$273.17
|
| Rate for Payer: Priority Health Narrow Network |
$432.48
|
| Rate for Payer: UHC Medicare Advantage |
$281.37
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 36476
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$510.87 |
| Rate for Payer: Aetna Commercial |
$177.07
|
| Rate for Payer: Aetna Medicare |
$132.14
|
| Rate for Payer: BCBS Complete |
$87.22
|
| Rate for Payer: BCBS MAPPO |
$132.14
|
| Rate for Payer: BCBS Trust/PPO |
$510.87
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Medicare Advantage |
$132.14
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$177.07
|
| Rate for Payer: Cofinity Commercial |
$190.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.14
|
| Rate for Payer: Healthscope Commercial |
$158.57
|
| Rate for Payer: Healthscope Whirlpool |
$158.57
|
| Rate for Payer: Meridian Medicaid |
$87.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.75
|
| Rate for Payer: PACE SWMI |
$132.14
|
| Rate for Payer: PHP Medicare Advantage |
$132.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.53
|
| Rate for Payer: Priority Health Medicare |
$132.14
|
| Rate for Payer: Priority Health Narrow Network |
$208.53
|
| Rate for Payer: UHC Medicare Advantage |
$136.10
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 44121
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$1,138.20 |
| Rate for Payer: Aetna Commercial |
$320.61
|
| Rate for Payer: Aetna Medicare |
$239.26
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS MAPPO |
$239.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.90
|
| Rate for Payer: BCN Commercial |
$348.43
|
| Rate for Payer: BCN Medicare Advantage |
$239.26
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cofinity Commercial |
$344.53
|
| Rate for Payer: Cofinity Commercial |
$320.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.26
|
| Rate for Payer: Healthscope Commercial |
$287.11
|
| Rate for Payer: Healthscope Whirlpool |
$287.11
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.22
|
| Rate for Payer: PACE SWMI |
$239.26
|
| Rate for Payer: PHP Medicare Advantage |
$239.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.23
|
| Rate for Payer: Priority Health Medicare |
$239.26
|
| Rate for Payer: Priority Health Narrow Network |
$419.23
|
| Rate for Payer: UHC Medicare Advantage |
$246.44
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY
|
Professional
|
Both
|
$3,428.00
|
|
|
Service Code
|
HCPCS 44125
|
| Min. Negotiated Rate |
$749.76 |
| Max. Negotiated Rate |
$2,399.60 |
| Rate for Payer: Aetna Commercial |
$1,560.76
|
| Rate for Payer: Aetna Medicare |
$1,164.75
|
| Rate for Payer: BCBS Complete |
$787.25
|
| Rate for Payer: BCBS MAPPO |
$1,164.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,185.51
|
| Rate for Payer: BCN Commercial |
$1,708.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,164.75
|
| Rate for Payer: Cash Price |
$2,742.40
|
| Rate for Payer: Cash Price |
$2,742.40
|
| Rate for Payer: Cofinity Commercial |
$1,677.24
|
| Rate for Payer: Cofinity Commercial |
$1,560.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,164.75
|
| Rate for Payer: Healthscope Commercial |
$1,397.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,397.70
|
| Rate for Payer: Meridian Medicaid |
$787.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,222.99
|
| Rate for Payer: PACE SWMI |
$1,164.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,164.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,399.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,056.15
|
| Rate for Payer: Priority Health Medicare |
$1,164.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,056.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,199.69
|
|
|
PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS
|
Professional
|
Both
|
$2,821.00
|
|
|
Service Code
|
HCPCS 51960
|
| Min. Negotiated Rate |
$876.50 |
| Max. Negotiated Rate |
$2,198.72 |
| Rate for Payer: Aetna Commercial |
$1,808.52
|
| Rate for Payer: Aetna Medicare |
$1,349.64
|
| Rate for Payer: BCBS Complete |
$920.32
|
| Rate for Payer: BCBS MAPPO |
$1,349.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.99
|
| Rate for Payer: BCN Commercial |
$1,988.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,349.64
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cofinity Commercial |
$1,808.52
|
| Rate for Payer: Cofinity Commercial |
$1,943.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,349.64
|
| Rate for Payer: Healthscope Commercial |
$1,619.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,619.57
|
| Rate for Payer: Meridian Medicaid |
$920.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,417.12
|
| Rate for Payer: PACE SWMI |
$1,349.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,349.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,198.72
|
| Rate for Payer: Priority Health Medicare |
$1,349.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,198.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,390.13
|
|
|
PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX
|
Professional
|
Both
|
$3,110.00
|
|
|
Service Code
|
HCPCS 44130
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$2,305.45 |
| Rate for Payer: Aetna Commercial |
$1,749.96
|
| Rate for Payer: Aetna Medicare |
$1,305.94
|
| Rate for Payer: BCBS Complete |
$881.63
|
| Rate for Payer: BCBS MAPPO |
$1,305.94
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,916.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,305.94
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Cofinity Commercial |
$1,880.55
|
| Rate for Payer: Cofinity Commercial |
$1,749.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,305.94
|
| Rate for Payer: Healthscope Commercial |
$1,567.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,567.13
|
| Rate for Payer: Meridian Medicaid |
$881.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,371.24
|
| Rate for Payer: PACE SWMI |
$1,305.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,305.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,177.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,305.45
|
| Rate for Payer: Priority Health Medicare |
$1,305.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,305.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,345.12
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,761.00
|
|
|
Service Code
|
HCPCS 44005
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$1,932.70 |
| Rate for Payer: Aetna Commercial |
$1,453.30
|
| Rate for Payer: Aetna Medicare |
$1,084.55
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS MAPPO |
$1,084.55
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$1,590.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,084.55
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$1,561.75
|
| Rate for Payer: Cofinity Commercial |
$1,453.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,084.55
|
| Rate for Payer: Healthscope Commercial |
$1,301.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,301.46
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,138.78
|
| Rate for Payer: PACE SWMI |
$1,084.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,084.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,913.26
|
| Rate for Payer: Priority Health Medicare |
$1,084.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,913.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,117.09
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
OP
|
$2,761.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,104.40 |
| Max. Negotiated Rate |
$2,761.00 |
| Rate for Payer: Aetna Commercial |
$2,484.90
|
| Rate for Payer: ASR ASR |
$2,678.17
|
| Rate for Payer: BCBS Complete |
$1,104.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,140.60
|
| Rate for Payer: BCN Commercial |
$2,140.60
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$2,595.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,208.80
|
| Rate for Payer: Healthscope Commercial |
$2,761.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,678.17
|
| Rate for Payer: Mclaren Commercial |
$2,484.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,346.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,512.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,960.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,429.68
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
IP
|
$2,761.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,932.70 |
| Max. Negotiated Rate |
$2,761.00 |
| Rate for Payer: Aetna Commercial |
$2,484.90
|
| Rate for Payer: ASR ASR |
$2,678.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,140.60
|
| Rate for Payer: BCN Commercial |
$2,140.60
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$2,595.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,208.80
|
| Rate for Payer: Healthscope Commercial |
$2,761.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,678.17
|
| Rate for Payer: Mclaren Commercial |
$2,484.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,346.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,429.68
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,761.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
44005
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$1,932.70 |
| Rate for Payer: Aetna Commercial |
$1,453.30
|
| Rate for Payer: Aetna Medicare |
$1,084.55
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS MAPPO |
$1,084.55
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$1,590.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,084.55
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$1,453.30
|
| Rate for Payer: Cofinity Commercial |
$1,561.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,084.55
|
| Rate for Payer: Healthscope Commercial |
$1,301.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,301.46
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,138.78
|
| Rate for Payer: PACE SWMI |
$1,084.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,084.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,913.26
|
| Rate for Payer: Priority Health Medicare |
$1,084.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,913.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,117.09
|
|
|
PR ENTERORRHAPHY MULTIPLE PERFORATIONS
|
Professional
|
Both
|
$3,021.00
|
|
|
Service Code
|
HCPCS 44603
|
| Min. Negotiated Rate |
$220.30 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,149.61
|
| Rate for Payer: Aetna Medicare |
$1,604.19
|
| Rate for Payer: BCBS Complete |
$1,079.56
|
| Rate for Payer: BCBS MAPPO |
$1,604.19
|
| Rate for Payer: BCBS Trust/PPO |
$220.30
|
| Rate for Payer: BCN Commercial |
$2,349.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,604.19
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cofinity Commercial |
$2,149.61
|
| Rate for Payer: Cofinity Commercial |
$2,310.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,604.19
|
| Rate for Payer: Healthscope Commercial |
$1,925.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,925.03
|
| Rate for Payer: Meridian Medicaid |
$1,079.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,684.40
|
| Rate for Payer: PACE SWMI |
$1,604.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,604.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,028.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,114.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,826.39
|
| Rate for Payer: Priority Health Medicare |
$1,604.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,826.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,652.32
|
|
|
PR ENTERORRHAPHY SINGLE PERFORATION
|
Professional
|
Both
|
$2,377.00
|
|
|
Service Code
|
HCPCS 44602
|
| Min. Negotiated Rate |
$894.81 |
| Max. Negotiated Rate |
$2,461.85 |
| Rate for Payer: Aetna Commercial |
$1,875.49
|
| Rate for Payer: Aetna Medicare |
$1,399.62
|
| Rate for Payer: BCBS Complete |
$939.55
|
| Rate for Payer: BCBS MAPPO |
$1,399.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,323.39
|
| Rate for Payer: BCN Commercial |
$2,046.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,399.62
|
| Rate for Payer: Cash Price |
$1,901.60
|
| Rate for Payer: Cash Price |
$1,901.60
|
| Rate for Payer: Cofinity Commercial |
$1,875.49
|
| Rate for Payer: Cofinity Commercial |
$2,015.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,399.62
|
| Rate for Payer: Healthscope Commercial |
$1,679.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,679.54
|
| Rate for Payer: Meridian Medicaid |
$939.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,469.60
|
| Rate for Payer: PACE SWMI |
$1,399.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,399.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$894.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,663.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,461.85
|
| Rate for Payer: Priority Health Medicare |
$1,399.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,461.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,441.61
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 44377
|
| Min. Negotiated Rate |
$187.65 |
| Max. Negotiated Rate |
$1,573.28 |
| Rate for Payer: Aetna Commercial |
$389.56
|
| Rate for Payer: Aetna Medicare |
$290.72
|
| Rate for Payer: BCBS Complete |
$197.03
|
| Rate for Payer: BCBS MAPPO |
$290.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,573.28
|
| Rate for Payer: BCN Commercial |
$428.57
|
| Rate for Payer: BCN Medicare Advantage |
$290.72
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$418.64
|
| Rate for Payer: Cofinity Commercial |
$389.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.72
|
| Rate for Payer: Healthscope Commercial |
$348.86
|
| Rate for Payer: Healthscope Whirlpool |
$348.86
|
| Rate for Payer: Meridian Medicaid |
$197.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$305.26
|
| Rate for Payer: PACE SWMI |
$290.72
|
| Rate for Payer: PHP Medicare Advantage |
$290.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.65
|
| Rate for Payer: Priority Health Medicare |
$290.72
|
| Rate for Payer: Priority Health Narrow Network |
$515.65
|
| Rate for Payer: UHC Medicare Advantage |
$299.44
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 44376
|
| Min. Negotiated Rate |
$177.86 |
| Max. Negotiated Rate |
$1,925.65 |
| Rate for Payer: Aetna Commercial |
$369.33
|
| Rate for Payer: Aetna Medicare |
$275.62
|
| Rate for Payer: BCBS Complete |
$186.75
|
| Rate for Payer: BCBS MAPPO |
$275.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,925.65
|
| Rate for Payer: BCN Commercial |
$406.58
|
| Rate for Payer: BCN Medicare Advantage |
$275.62
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$369.33
|
| Rate for Payer: Cofinity Commercial |
$396.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.62
|
| Rate for Payer: Healthscope Commercial |
$330.74
|
| Rate for Payer: Healthscope Whirlpool |
$330.74
|
| Rate for Payer: Meridian Medicaid |
$186.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$289.40
|
| Rate for Payer: PACE SWMI |
$275.62
|
| Rate for Payer: PHP Medicare Advantage |
$275.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$711.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$489.19
|
| Rate for Payer: Priority Health Medicare |
$275.62
|
| Rate for Payer: Priority Health Narrow Network |
$489.19
|
| Rate for Payer: UHC Medicare Advantage |
$283.89
|
|
|
PR ENTEROSCOPY > 2ND PRTN ABLTJ LESION
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44369
|
| Min. Negotiated Rate |
$154.00 |
| Max. Negotiated Rate |
$768.60 |
| Rate for Payer: Aetna Commercial |
$319.00
|
| Rate for Payer: Aetna Medicare |
$238.06
|
| Rate for Payer: BCBS Complete |
$161.70
|
| Rate for Payer: BCBS MAPPO |
$238.06
|
| Rate for Payer: BCBS Trust/PPO |
$593.28
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$238.06
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$342.81
|
| Rate for Payer: Cofinity Commercial |
$319.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.06
|
| Rate for Payer: Healthscope Commercial |
$285.67
|
| Rate for Payer: Healthscope Whirlpool |
$285.67
|
| Rate for Payer: Meridian Medicaid |
$161.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.96
|
| Rate for Payer: PACE SWMI |
$238.06
|
| Rate for Payer: PHP Medicare Advantage |
$238.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$422.75
|
| Rate for Payer: Priority Health Medicare |
$238.06
|
| Rate for Payer: Priority Health Narrow Network |
$422.75
|
| Rate for Payer: UHC Medicare Advantage |
$245.20
|
|
