|
PR ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 44373
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$1,809.96 |
| Rate for Payer: Aetna Commercial |
$249.48
|
| Rate for Payer: Aetna Medicare |
$186.18
|
| Rate for Payer: BCBS Complete |
$126.14
|
| Rate for Payer: BCBS MAPPO |
$186.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.96
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: BCN Medicare Advantage |
$186.18
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cofinity Commercial |
$268.10
|
| Rate for Payer: Cofinity Commercial |
$249.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.18
|
| Rate for Payer: Healthscope Commercial |
$223.42
|
| Rate for Payer: Healthscope Whirlpool |
$223.42
|
| Rate for Payer: Meridian Medicaid |
$126.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.49
|
| Rate for Payer: PACE SWMI |
$186.18
|
| Rate for Payer: PHP Medicare Advantage |
$186.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.45
|
| Rate for Payer: Priority Health Medicare |
$186.18
|
| Rate for Payer: Priority Health Narrow Network |
$330.45
|
| Rate for Payer: UHC Medicare Advantage |
$191.77
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
OP
|
$1,518.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$925.18 |
| Max. Negotiated Rate |
$2,114.21 |
| Rate for Payer: Aetna Commercial |
$1,366.20
|
| Rate for Payer: Aetna Medicare |
$1,691.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,114.21
|
| Rate for Payer: ASR ASR |
$1,472.46
|
| Rate for Payer: BCBS Complete |
$971.52
|
| Rate for Payer: BCBS MAPPO |
$1,691.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,176.91
|
| Rate for Payer: BCN Commercial |
$1,176.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,691.37
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$1,426.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,691.37
|
| Rate for Payer: Healthscope Commercial |
$1,518.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,472.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,691.37
|
| Rate for Payer: Mclaren Commercial |
$1,366.20
|
| Rate for Payer: Mclaren Medicaid |
$925.18
|
| Rate for Payer: Mclaren Medicare |
$1,691.37
|
| Rate for Payer: Meridian Medicaid |
$971.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,775.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,945.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,290.30
|
| Rate for Payer: PACE Medicare |
$1,606.80
|
| Rate for Payer: PACE SWMI |
$1,691.37
|
| Rate for Payer: PHP Commercial |
$1,860.51
|
| Rate for Payer: PHP Medicaid |
$925.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,691.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,381.38
|
| Rate for Payer: Priority Health Medicare |
$1,691.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,691.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,335.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,742.11
|
| Rate for Payer: VA VA |
$1,691.37
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$499.75
|
| Rate for Payer: Aetna Medicare |
$372.95
|
| Rate for Payer: BCBS Complete |
$252.94
|
| Rate for Payer: BCBS MAPPO |
$372.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: BCN Commercial |
$549.76
|
| Rate for Payer: BCN Medicare Advantage |
$372.95
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$537.05
|
| Rate for Payer: Cofinity Commercial |
$499.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.95
|
| Rate for Payer: Healthscope Commercial |
$447.54
|
| Rate for Payer: Healthscope Whirlpool |
$447.54
|
| Rate for Payer: Meridian Medicaid |
$252.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$391.60
|
| Rate for Payer: PACE SWMI |
$372.95
|
| Rate for Payer: PHP Medicare Advantage |
$372.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.47
|
| Rate for Payer: Priority Health Medicare |
$372.95
|
| Rate for Payer: Priority Health Narrow Network |
$661.47
|
| Rate for Payer: UHC Medicare Advantage |
$384.14
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
IP
|
$1,518.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$1,062.60 |
| Max. Negotiated Rate |
$1,518.00 |
| Rate for Payer: Aetna Commercial |
$1,366.20
|
| Rate for Payer: ASR ASR |
$1,472.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,176.91
|
| Rate for Payer: BCN Commercial |
$1,176.91
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$1,426.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.40
|
| Rate for Payer: Healthscope Commercial |
$1,518.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,472.46
|
| Rate for Payer: Mclaren Commercial |
$1,366.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,290.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,335.84
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 44378
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$499.75
|
| Rate for Payer: Aetna Medicare |
$372.95
|
| Rate for Payer: BCBS Complete |
$252.94
|
| Rate for Payer: BCBS MAPPO |
$372.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: BCN Commercial |
$549.76
|
| Rate for Payer: BCN Medicare Advantage |
$372.95
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$499.75
|
| Rate for Payer: Cofinity Commercial |
$537.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.95
|
| Rate for Payer: Healthscope Commercial |
$447.54
|
| Rate for Payer: Healthscope Whirlpool |
$447.54
|
| Rate for Payer: Meridian Medicaid |
$252.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$391.60
|
| Rate for Payer: PACE SWMI |
$372.95
|
| Rate for Payer: PHP Medicare Advantage |
$372.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.47
|
| Rate for Payer: Priority Health Medicare |
$372.95
|
| Rate for Payer: Priority Health Narrow Network |
$661.47
|
| Rate for Payer: UHC Medicare Advantage |
$384.14
|
|
|
PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 44370
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$949.90 |
| Rate for Payer: Aetna Commercial |
$346.56
|
| Rate for Payer: Aetna Medicare |
$258.63
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS MAPPO |
$258.63
|
| Rate for Payer: BCBS Trust/PPO |
$316.98
|
| Rate for Payer: BCN Commercial |
$382.15
|
| Rate for Payer: BCN Medicare Advantage |
$258.63
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$372.43
|
| Rate for Payer: Cofinity Commercial |
$346.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.63
|
| Rate for Payer: Healthscope Commercial |
$310.36
|
| Rate for Payer: Healthscope Whirlpool |
$310.36
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.56
|
| Rate for Payer: PACE SWMI |
$258.63
|
| Rate for Payer: PHP Medicare Advantage |
$258.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$459.80
|
| Rate for Payer: Priority Health Medicare |
$258.63
|
| Rate for Payer: Priority Health Narrow Network |
$459.80
|
| Rate for Payer: UHC Medicare Advantage |
$266.39
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING
|
Professional
|
Both
|
$1,292.00
|
|
|
Service Code
|
HCPCS 44366
|
| Min. Negotiated Rate |
$150.38 |
| Max. Negotiated Rate |
$904.40 |
| Rate for Payer: Aetna Commercial |
$311.86
|
| Rate for Payer: Aetna Medicare |
$232.73
|
| Rate for Payer: BCBS Complete |
$157.90
|
| Rate for Payer: BCBS MAPPO |
$232.73
|
| Rate for Payer: BCBS Trust/PPO |
$416.83
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: BCN Medicare Advantage |
$232.73
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cofinity Commercial |
$335.13
|
| Rate for Payer: Cofinity Commercial |
$311.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.73
|
| Rate for Payer: Healthscope Commercial |
$279.28
|
| Rate for Payer: Healthscope Whirlpool |
$279.28
|
| Rate for Payer: Meridian Medicaid |
$157.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$244.37
|
| Rate for Payer: PACE SWMI |
$232.73
|
| Rate for Payer: PHP Medicare Advantage |
$232.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$904.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.35
|
| Rate for Payer: Priority Health Medicare |
$232.73
|
| Rate for Payer: Priority Health Narrow Network |
$413.35
|
| Rate for Payer: UHC Medicare Advantage |
$239.71
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT
|
Professional
|
Both
|
$1,502.00
|
|
|
Service Code
|
HCPCS 44379
|
| Min. Negotiated Rate |
$256.88 |
| Max. Negotiated Rate |
$1,943.09 |
| Rate for Payer: Aetna Commercial |
$531.28
|
| Rate for Payer: Aetna Medicare |
$396.48
|
| Rate for Payer: BCBS Complete |
$269.72
|
| Rate for Payer: BCBS MAPPO |
$396.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,943.09
|
| Rate for Payer: BCN Commercial |
$584.95
|
| Rate for Payer: BCN Medicare Advantage |
$396.48
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cofinity Commercial |
$570.93
|
| Rate for Payer: Cofinity Commercial |
$531.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.48
|
| Rate for Payer: Healthscope Commercial |
$475.78
|
| Rate for Payer: Healthscope Whirlpool |
$475.78
|
| Rate for Payer: Meridian Medicaid |
$269.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$416.30
|
| Rate for Payer: PACE SWMI |
$396.48
|
| Rate for Payer: PHP Medicare Advantage |
$396.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.80
|
| Rate for Payer: Priority Health Medicare |
$396.48
|
| Rate for Payer: Priority Health Narrow Network |
$703.80
|
| Rate for Payer: UHC Medicare Advantage |
$408.37
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 44372
|
| Min. Negotiated Rate |
$150.38 |
| Max. Negotiated Rate |
$645.40 |
| Rate for Payer: Aetna Commercial |
$311.98
|
| Rate for Payer: Aetna Medicare |
$232.82
|
| Rate for Payer: BCBS Complete |
$157.90
|
| Rate for Payer: BCBS MAPPO |
$232.82
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: BCN Commercial |
$343.05
|
| Rate for Payer: BCN Medicare Advantage |
$232.82
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$335.26
|
| Rate for Payer: Cofinity Commercial |
$311.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.82
|
| Rate for Payer: Healthscope Commercial |
$279.38
|
| Rate for Payer: Healthscope Whirlpool |
$279.38
|
| Rate for Payer: Meridian Medicaid |
$157.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$244.46
|
| Rate for Payer: PACE SWMI |
$232.82
|
| Rate for Payer: PHP Medicare Advantage |
$232.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$645.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$412.76
|
| Rate for Payer: Priority Health Medicare |
$232.82
|
| Rate for Payer: Priority Health Narrow Network |
$412.76
|
| Rate for Payer: UHC Medicare Advantage |
$239.80
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$955.00
|
|
|
Service Code
|
HCPCS 44363
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$668.50 |
| Rate for Payer: Aetna Commercial |
$249.19
|
| Rate for Payer: Aetna Medicare |
$185.96
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCBS MAPPO |
$185.96
|
| Rate for Payer: BCBS Trust/PPO |
$283.17
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: BCN Medicare Advantage |
$185.96
|
| Rate for Payer: Cash Price |
$764.00
|
| Rate for Payer: Cash Price |
$764.00
|
| Rate for Payer: Cofinity Commercial |
$267.78
|
| Rate for Payer: Cofinity Commercial |
$249.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.96
|
| Rate for Payer: Healthscope Commercial |
$223.15
|
| Rate for Payer: Healthscope Whirlpool |
$223.15
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.26
|
| Rate for Payer: PACE SWMI |
$185.96
|
| Rate for Payer: PHP Medicare Advantage |
$185.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.45
|
| Rate for Payer: Priority Health Medicare |
$185.96
|
| Rate for Payer: Priority Health Narrow Network |
$330.45
|
| Rate for Payer: UHC Medicare Advantage |
$191.54
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44365
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$768.60 |
| Rate for Payer: Aetna Commercial |
$236.23
|
| Rate for Payer: Aetna Medicare |
$176.29
|
| Rate for Payer: BCBS Complete |
$120.32
|
| Rate for Payer: BCBS MAPPO |
$176.29
|
| Rate for Payer: BCBS Trust/PPO |
$740.68
|
| Rate for Payer: BCN Commercial |
$260.46
|
| Rate for Payer: BCN Medicare Advantage |
$176.29
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$253.86
|
| Rate for Payer: Cofinity Commercial |
$236.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.29
|
| Rate for Payer: Healthscope Commercial |
$211.55
|
| Rate for Payer: Healthscope Whirlpool |
$211.55
|
| Rate for Payer: Meridian Medicaid |
$120.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.10
|
| Rate for Payer: PACE SWMI |
$176.29
|
| Rate for Payer: PHP Medicare Advantage |
$176.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.39
|
| Rate for Payer: Priority Health Medicare |
$176.29
|
| Rate for Payer: Priority Health Narrow Network |
$313.39
|
| Rate for Payer: UHC Medicare Advantage |
$181.58
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44364
|
| Min. Negotiated Rate |
$128.23 |
| Max. Negotiated Rate |
$768.60 |
| Rate for Payer: Aetna Commercial |
$265.61
|
| Rate for Payer: Aetna Medicare |
$198.22
|
| Rate for Payer: BCBS Complete |
$134.64
|
| Rate for Payer: BCBS MAPPO |
$198.22
|
| Rate for Payer: BCBS Trust/PPO |
$700.00
|
| Rate for Payer: BCN Commercial |
$292.72
|
| Rate for Payer: BCN Medicare Advantage |
$198.22
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$265.61
|
| Rate for Payer: Cofinity Commercial |
$285.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.22
|
| Rate for Payer: Healthscope Commercial |
$237.86
|
| Rate for Payer: Healthscope Whirlpool |
$237.86
|
| Rate for Payer: Meridian Medicaid |
$134.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$208.13
|
| Rate for Payer: PACE SWMI |
$198.22
|
| Rate for Payer: PHP Medicare Advantage |
$198.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.19
|
| Rate for Payer: Priority Health Medicare |
$198.22
|
| Rate for Payer: Priority Health Narrow Network |
$352.19
|
| Rate for Payer: UHC Medicare Advantage |
$204.17
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN
|
Professional
|
Both
|
$2,710.00
|
|
|
Service Code
|
HCPCS 44021
|
| Min. Negotiated Rate |
$620.26 |
| Max. Negotiated Rate |
$1,897.00 |
| Rate for Payer: Aetna Commercial |
$1,295.81
|
| Rate for Payer: Aetna Medicare |
$967.02
|
| Rate for Payer: BCBS Complete |
$651.27
|
| Rate for Payer: BCBS MAPPO |
$967.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,724.90
|
| Rate for Payer: BCN Commercial |
$1,418.63
|
| Rate for Payer: BCN Medicare Advantage |
$967.02
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cofinity Commercial |
$1,392.51
|
| Rate for Payer: Cofinity Commercial |
$1,295.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$967.02
|
| Rate for Payer: Healthscope Commercial |
$1,160.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,160.42
|
| Rate for Payer: Meridian Medicaid |
$651.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,015.37
|
| Rate for Payer: PACE SWMI |
$967.02
|
| Rate for Payer: PHP Medicare Advantage |
$967.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$620.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,706.89
|
| Rate for Payer: Priority Health Medicare |
$967.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,706.89
|
| Rate for Payer: UHC Medicare Advantage |
$996.03
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL
|
Professional
|
Both
|
$2,888.00
|
|
|
Service Code
|
HCPCS 44020
|
| Min. Negotiated Rate |
$621.96 |
| Max. Negotiated Rate |
$2,324.52 |
| Rate for Payer: Aetna Commercial |
$1,296.69
|
| Rate for Payer: Aetna Medicare |
$967.68
|
| Rate for Payer: BCBS Complete |
$653.06
|
| Rate for Payer: BCBS MAPPO |
$967.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.52
|
| Rate for Payer: BCN Commercial |
$1,420.10
|
| Rate for Payer: BCN Medicare Advantage |
$967.68
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cofinity Commercial |
$1,393.46
|
| Rate for Payer: Cofinity Commercial |
$1,296.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$967.68
|
| Rate for Payer: Healthscope Commercial |
$1,161.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.22
|
| Rate for Payer: Meridian Medicaid |
$653.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,016.06
|
| Rate for Payer: PACE SWMI |
$967.68
|
| Rate for Payer: PHP Medicare Advantage |
$967.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,021.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,708.65
|
| Rate for Payer: Priority Health Medicare |
$967.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,708.65
|
| Rate for Payer: UHC Medicare Advantage |
$996.71
|
|
|
PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,953.00
|
|
|
Service Code
|
HCPCS 44128
|
| Min. Negotiated Rate |
$153.79 |
| Max. Negotiated Rate |
$1,367.10 |
| Rate for Payer: Aetna Commercial |
$324.19
|
| Rate for Payer: Aetna Medicare |
$241.93
|
| Rate for Payer: BCBS Complete |
$161.48
|
| Rate for Payer: BCBS MAPPO |
$241.93
|
| Rate for Payer: BCBS Trust/PPO |
$726.94
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$241.93
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cofinity Commercial |
$348.38
|
| Rate for Payer: Cofinity Commercial |
$324.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.93
|
| Rate for Payer: Healthscope Commercial |
$290.32
|
| Rate for Payer: Healthscope Whirlpool |
$290.32
|
| Rate for Payer: Meridian Medicaid |
$161.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.03
|
| Rate for Payer: PACE SWMI |
$241.93
|
| Rate for Payer: PHP Medicare Advantage |
$241.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,367.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.34
|
| Rate for Payer: Priority Health Medicare |
$241.93
|
| Rate for Payer: Priority Health Narrow Network |
$423.34
|
| Rate for Payer: UHC Medicare Advantage |
$249.19
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$4,928.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$240.38 |
| Max. Negotiated Rate |
$4,992.47 |
| Rate for Payer: Aetna Commercial |
$3,804.43
|
| Rate for Payer: Aetna Medicare |
$2,839.13
|
| Rate for Payer: BCBS Complete |
$1,906.62
|
| Rate for Payer: BCBS MAPPO |
$2,839.13
|
| Rate for Payer: BCBS Trust/PPO |
$240.38
|
| Rate for Payer: BCN Commercial |
$4,149.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,839.13
|
| Rate for Payer: Cash Price |
$3,942.40
|
| Rate for Payer: Cash Price |
$3,942.40
|
| Rate for Payer: Cofinity Commercial |
$4,088.35
|
| Rate for Payer: Cofinity Commercial |
$3,804.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,839.13
|
| Rate for Payer: Healthscope Commercial |
$3,406.96
|
| Rate for Payer: Healthscope Whirlpool |
$3,406.96
|
| Rate for Payer: Meridian Medicaid |
$1,906.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,981.09
|
| Rate for Payer: PACE SWMI |
$2,839.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,839.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,815.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,449.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,992.47
|
| Rate for Payer: Priority Health Medicare |
$2,839.13
|
| Rate for Payer: Priority Health Narrow Network |
$4,992.47
|
| Rate for Payer: UHC Medicare Advantage |
$2,924.30
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING
|
Professional
|
Both
|
$4,247.00
|
|
|
Service Code
|
HCPCS 44126
|
| Min. Negotiated Rate |
$1,573.22 |
| Max. Negotiated Rate |
$4,324.53 |
| Rate for Payer: Aetna Commercial |
$3,292.59
|
| Rate for Payer: Aetna Medicare |
$2,457.16
|
| Rate for Payer: BCBS Complete |
$1,651.88
|
| Rate for Payer: BCBS MAPPO |
$2,457.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.09
|
| Rate for Payer: BCN Commercial |
$3,594.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,457.16
|
| Rate for Payer: Cash Price |
$3,397.60
|
| Rate for Payer: Cash Price |
$3,397.60
|
| Rate for Payer: Cofinity Commercial |
$3,292.59
|
| Rate for Payer: Cofinity Commercial |
$3,538.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,457.16
|
| Rate for Payer: Healthscope Commercial |
$2,948.59
|
| Rate for Payer: Healthscope Whirlpool |
$2,948.59
|
| Rate for Payer: Meridian Medicaid |
$1,651.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,580.02
|
| Rate for Payer: PACE SWMI |
$2,457.16
|
| Rate for Payer: PHP Medicare Advantage |
$2,457.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,324.53
|
| Rate for Payer: Priority Health Medicare |
$2,457.16
|
| Rate for Payer: Priority Health Narrow Network |
$4,324.53
|
| Rate for Payer: UHC Medicare Advantage |
$2,530.87
|
|
|
PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST
|
Professional
|
Both
|
$3,251.00
|
|
|
Service Code
|
HCPCS 44120
|
| Min. Negotiated Rate |
$236.68 |
| Max. Negotiated Rate |
$2,275.70 |
| Rate for Payer: Aetna Commercial |
$1,626.29
|
| Rate for Payer: Aetna Medicare |
$1,213.65
|
| Rate for Payer: BCBS Complete |
$818.34
|
| Rate for Payer: BCBS MAPPO |
$1,213.65
|
| Rate for Payer: BCBS Trust/PPO |
$236.68
|
| Rate for Payer: BCN Commercial |
$1,778.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,213.65
|
| Rate for Payer: Cash Price |
$2,600.80
|
| Rate for Payer: Cash Price |
$2,600.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.66
|
| Rate for Payer: Cofinity Commercial |
$1,626.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,213.65
|
| Rate for Payer: Healthscope Commercial |
$1,456.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,456.38
|
| Rate for Payer: Meridian Medicaid |
$818.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,274.33
|
| Rate for Payer: PACE SWMI |
$1,213.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,213.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$779.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,275.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,139.64
|
| Rate for Payer: Priority Health Medicare |
$1,213.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,139.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,250.06
|
|
|
PR EO W/O JOINTS CF
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS L3702
|
| Min. Negotiated Rate |
$106.00 |
| Max. Negotiated Rate |
$249.53 |
| Rate for Payer: Aetna Commercial |
$158.29
|
| Rate for Payer: BCBS Complete |
$106.00
|
| Rate for Payer: BCN Commercial |
$249.53
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.50
|
|
|
PR EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN
|
Professional
|
Both
|
$526.00
|
|
|
Service Code
|
HCPCS 93641
|
| Min. Negotiated Rate |
$210.40 |
| Max. Negotiated Rate |
$2,001.73 |
| Rate for Payer: Aetna Commercial |
$765.30
|
| Rate for Payer: BCBS Complete |
$210.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,001.73
|
| Rate for Payer: BCN Commercial |
$835.64
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.65
|
| Rate for Payer: Priority Health Narrow Network |
$807.65
|
|
|
PR EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 93642
|
| Min. Negotiated Rate |
$323.02 |
| Max. Negotiated Rate |
$2,287.54 |
| Rate for Payer: Aetna Commercial |
$432.85
|
| Rate for Payer: Aetna Medicare |
$323.02
|
| Rate for Payer: BCBS Complete |
$680.00
|
| Rate for Payer: BCBS MAPPO |
$323.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,287.54
|
| Rate for Payer: BCN Commercial |
$481.35
|
| Rate for Payer: BCN Medicare Advantage |
$323.02
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$432.85
|
| Rate for Payer: Cofinity Commercial |
$465.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.02
|
| Rate for Payer: Healthscope Commercial |
$387.62
|
| Rate for Payer: Healthscope Whirlpool |
$387.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$339.17
|
| Rate for Payer: PACE SWMI |
$323.02
|
| Rate for Payer: PHP Medicare Advantage |
$323.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.78
|
| Rate for Payer: Priority Health Medicare |
$323.02
|
| Rate for Payer: Priority Health Narrow Network |
$465.78
|
| Rate for Payer: UHC Medicare Advantage |
$332.71
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<
|
Professional
|
Both
|
$1,439.00
|
|
|
Service Code
|
HCPCS 15115
|
| Min. Negotiated Rate |
$138.90 |
| Max. Negotiated Rate |
$1,172.34 |
| Rate for Payer: Aetna Commercial |
$907.93
|
| Rate for Payer: Aetna Medicare |
$677.56
|
| Rate for Payer: BCBS Complete |
$467.43
|
| Rate for Payer: BCBS MAPPO |
$677.56
|
| Rate for Payer: BCBS Trust/PPO |
$138.90
|
| Rate for Payer: BCN Commercial |
$1,172.34
|
| Rate for Payer: BCN Medicare Advantage |
$677.56
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cash Price |
$1,151.20
|
| Rate for Payer: Cofinity Commercial |
$907.93
|
| Rate for Payer: Cofinity Commercial |
$975.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.56
|
| Rate for Payer: Healthscope Commercial |
$813.07
|
| Rate for Payer: Healthscope Whirlpool |
$813.07
|
| Rate for Payer: Meridian Medicaid |
$467.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$711.44
|
| Rate for Payer: PACE SWMI |
$677.56
|
| Rate for Payer: PHP Medicare Advantage |
$677.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,007.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$844.27
|
| Rate for Payer: Priority Health Medicare |
$677.56
|
| Rate for Payer: Priority Health Narrow Network |
$844.27
|
| Rate for Payer: UHC Medicare Advantage |
$697.89
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 15116
|
| Min. Negotiated Rate |
$87.54 |
| Max. Negotiated Rate |
$281.44 |
| Rate for Payer: Aetna Commercial |
$185.48
|
| Rate for Payer: Aetna Medicare |
$138.42
|
| Rate for Payer: BCBS Complete |
$91.92
|
| Rate for Payer: BCBS MAPPO |
$138.42
|
| Rate for Payer: BCBS Trust/PPO |
$281.44
|
| Rate for Payer: BCN Commercial |
$225.28
|
| Rate for Payer: BCN Medicare Advantage |
$138.42
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$199.32
|
| Rate for Payer: Cofinity Commercial |
$185.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.42
|
| Rate for Payer: Healthscope Commercial |
$166.10
|
| Rate for Payer: Healthscope Whirlpool |
$166.10
|
| Rate for Payer: Meridian Medicaid |
$91.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.34
|
| Rate for Payer: PACE SWMI |
$138.42
|
| Rate for Payer: PHP Medicare Advantage |
$138.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.17
|
| Rate for Payer: Priority Health Medicare |
$138.42
|
| Rate for Payer: Priority Health Narrow Network |
$170.17
|
| Rate for Payer: UHC Medicare Advantage |
$142.57
|
|
|
PR EPIDIDYMECTOMY BILATERAL
|
Professional
|
Both
|
$1,051.00
|
|
|
Service Code
|
HCPCS 54861
|
| Min. Negotiated Rate |
$363.59 |
| Max. Negotiated Rate |
$2,782.03 |
| Rate for Payer: Aetna Commercial |
$743.20
|
| Rate for Payer: Aetna Medicare |
$554.63
|
| Rate for Payer: BCBS Complete |
$381.77
|
| Rate for Payer: BCBS MAPPO |
$554.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,782.03
|
| Rate for Payer: BCN Commercial |
$821.46
|
| Rate for Payer: BCN Medicare Advantage |
$554.63
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cofinity Commercial |
$743.20
|
| Rate for Payer: Cofinity Commercial |
$798.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.63
|
| Rate for Payer: Healthscope Commercial |
$665.56
|
| Rate for Payer: Healthscope Whirlpool |
$665.56
|
| Rate for Payer: Meridian Medicaid |
$381.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$582.36
|
| Rate for Payer: PACE SWMI |
$554.63
|
| Rate for Payer: PHP Medicare Advantage |
$554.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.34
|
| Rate for Payer: Priority Health Medicare |
$554.63
|
| Rate for Payer: Priority Health Narrow Network |
$908.34
|
| Rate for Payer: UHC Medicare Advantage |
$571.27
|
|
|
PR EPIDIDYMECTOMY UNILATERAL
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 54860
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$1,211.92 |
| Rate for Payer: Aetna Commercial |
$548.02
|
| Rate for Payer: Aetna Medicare |
$408.97
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS MAPPO |
$408.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,211.92
|
| Rate for Payer: BCN Commercial |
$606.94
|
| Rate for Payer: BCN Medicare Advantage |
$408.97
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cofinity Commercial |
$588.92
|
| Rate for Payer: Cofinity Commercial |
$548.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.97
|
| Rate for Payer: Healthscope Commercial |
$490.76
|
| Rate for Payer: Healthscope Whirlpool |
$490.76
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$429.42
|
| Rate for Payer: PACE SWMI |
$408.97
|
| Rate for Payer: PHP Medicare Advantage |
$408.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$671.13
|
| Rate for Payer: Priority Health Medicare |
$408.97
|
| Rate for Payer: Priority Health Narrow Network |
$671.13
|
| Rate for Payer: UHC Medicare Advantage |
$421.24
|
|
