|
PR EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 54900
|
| Min. Negotiated Rate |
$509.28 |
| Max. Negotiated Rate |
$2,046.63 |
| Rate for Payer: Aetna Commercial |
$1,047.56
|
| Rate for Payer: Aetna Medicare |
$781.76
|
| Rate for Payer: BCBS Complete |
$534.74
|
| Rate for Payer: BCBS MAPPO |
$781.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,046.63
|
| Rate for Payer: BCN Commercial |
$1,154.74
|
| Rate for Payer: BCN Medicare Advantage |
$781.76
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,047.56
|
| Rate for Payer: Cofinity Commercial |
$1,125.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.76
|
| Rate for Payer: Healthscope Commercial |
$938.11
|
| Rate for Payer: Healthscope Whirlpool |
$938.11
|
| Rate for Payer: Meridian Medicaid |
$534.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$820.85
|
| Rate for Payer: PACE SWMI |
$781.76
|
| Rate for Payer: PHP Medicare Advantage |
$781.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,181.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,276.86
|
| Rate for Payer: Priority Health Medicare |
$781.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,276.86
|
| Rate for Payer: UHC Medicare Advantage |
$805.21
|
|
|
PR EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD
|
Professional
|
Both
|
$1,576.00
|
|
|
Service Code
|
HCPCS 15110
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$1,219.74 |
| Rate for Payer: Aetna Commercial |
$940.18
|
| Rate for Payer: Aetna Medicare |
$701.63
|
| Rate for Payer: BCBS Complete |
$480.40
|
| Rate for Payer: BCBS MAPPO |
$701.63
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,219.74
|
| Rate for Payer: BCN Medicare Advantage |
$701.63
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cofinity Commercial |
$1,010.35
|
| Rate for Payer: Cofinity Commercial |
$940.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.63
|
| Rate for Payer: Healthscope Commercial |
$841.96
|
| Rate for Payer: Healthscope Whirlpool |
$841.96
|
| Rate for Payer: Meridian Medicaid |
$480.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$736.71
|
| Rate for Payer: PACE SWMI |
$701.63
|
| Rate for Payer: PHP Medicare Advantage |
$701.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$875.10
|
| Rate for Payer: Priority Health Medicare |
$701.63
|
| Rate for Payer: Priority Health Narrow Network |
$875.10
|
| Rate for Payer: UHC Medicare Advantage |
$722.68
|
|
|
PR EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 15111
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$212.16 |
| Rate for Payer: Aetna Commercial |
$135.89
|
| Rate for Payer: Aetna Medicare |
$101.41
|
| Rate for Payer: BCBS Complete |
$67.55
|
| Rate for Payer: BCBS MAPPO |
$101.41
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: BCN Medicare Advantage |
$101.41
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$135.89
|
| Rate for Payer: Cofinity Commercial |
$146.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.41
|
| Rate for Payer: Healthscope Commercial |
$121.69
|
| Rate for Payer: Healthscope Whirlpool |
$121.69
|
| Rate for Payer: Meridian Medicaid |
$67.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.48
|
| Rate for Payer: PACE SWMI |
$101.41
|
| Rate for Payer: PHP Medicare Advantage |
$101.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.55
|
| Rate for Payer: Priority Health Medicare |
$101.41
|
| Rate for Payer: Priority Health Narrow Network |
$124.55
|
| Rate for Payer: UHC Medicare Advantage |
$104.45
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U
|
Professional
|
Both
|
$1,235.00
|
|
|
Service Code
|
HCPCS 25450
|
| Min. Negotiated Rate |
$402.36 |
| Max. Negotiated Rate |
$3,253.04 |
| Rate for Payer: Aetna Commercial |
$818.28
|
| Rate for Payer: Aetna Medicare |
$610.66
|
| Rate for Payer: BCBS Complete |
$422.48
|
| Rate for Payer: BCBS MAPPO |
$610.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$913.83
|
| Rate for Payer: BCN Medicare Advantage |
$610.66
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cofinity Commercial |
$818.28
|
| Rate for Payer: Cofinity Commercial |
$879.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.66
|
| Rate for Payer: Healthscope Commercial |
$732.79
|
| Rate for Payer: Healthscope Whirlpool |
$732.79
|
| Rate for Payer: Meridian Medicaid |
$422.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$641.19
|
| Rate for Payer: PACE SWMI |
$610.66
|
| Rate for Payer: PHP Medicare Advantage |
$610.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$954.91
|
| Rate for Payer: Priority Health Medicare |
$610.66
|
| Rate for Payer: Priority Health Narrow Network |
$954.91
|
| Rate for Payer: UHC Medicare Advantage |
$628.98
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 27185
|
| Min. Negotiated Rate |
$465.83 |
| Max. Negotiated Rate |
$1,108.37 |
| Rate for Payer: Aetna Commercial |
$951.17
|
| Rate for Payer: Aetna Medicare |
$709.83
|
| Rate for Payer: BCBS Complete |
$489.12
|
| Rate for Payer: BCBS MAPPO |
$709.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,108.37
|
| Rate for Payer: BCN Commercial |
$1,059.45
|
| Rate for Payer: BCN Medicare Advantage |
$709.83
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$951.17
|
| Rate for Payer: Cofinity Commercial |
$1,022.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.83
|
| Rate for Payer: Healthscope Commercial |
$851.80
|
| Rate for Payer: Healthscope Whirlpool |
$851.80
|
| Rate for Payer: Meridian Medicaid |
$489.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$745.32
|
| Rate for Payer: PACE SWMI |
$709.83
|
| Rate for Payer: PHP Medicare Advantage |
$709.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.08
|
| Rate for Payer: Priority Health Medicare |
$709.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,107.08
|
| Rate for Payer: UHC Medicare Advantage |
$731.12
|
|
|
PR EPISIOTOMY/VAG RPR OTH/THN ATTENDING
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 59300
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$439.02 |
| Rate for Payer: Aetna Commercial |
$197.57
|
| Rate for Payer: Aetna Medicare |
$147.44
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$147.44
|
| Rate for Payer: BCBS Trust/PPO |
$439.02
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: BCN Medicare Advantage |
$147.44
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$212.31
|
| Rate for Payer: Cofinity Commercial |
$197.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.44
|
| Rate for Payer: Healthscope Commercial |
$176.93
|
| Rate for Payer: Healthscope Whirlpool |
$176.93
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.81
|
| Rate for Payer: PACE SWMI |
$147.44
|
| Rate for Payer: PHP Medicare Advantage |
$147.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.22
|
| Rate for Payer: Priority Health Medicare |
$147.44
|
| Rate for Payer: Priority Health Narrow Network |
$208.22
|
| Rate for Payer: UHC Medicare Advantage |
$151.86
|
|
|
PR EPOETIN ALFA, NON-ESRD
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS J0885
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$26.60 |
| Rate for Payer: Aetna Commercial |
$9.21
|
| Rate for Payer: Aetna Medicare |
$6.88
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$6.88
|
| Rate for Payer: BCBS Trust/PPO |
$6.75
|
| Rate for Payer: BCN Commercial |
$6.02
|
| Rate for Payer: BCN Medicare Advantage |
$6.88
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$9.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.88
|
| Rate for Payer: Healthscope Commercial |
$8.25
|
| Rate for Payer: Healthscope Whirlpool |
$8.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.22
|
| Rate for Payer: PACE SWMI |
$6.88
|
| Rate for Payer: PHP Medicare Advantage |
$6.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: Priority Health Medicare |
$6.88
|
| Rate for Payer: UHC Medicare Advantage |
$7.08
|
|
|
PR ERCP,ABLATION TUMOR
|
Professional
|
Both
|
$1,623.00
|
|
|
Service Code
|
HCPCS 43272
|
| Min. Negotiated Rate |
$649.20 |
| Max. Negotiated Rate |
$1,136.10 |
| Rate for Payer: BCBS Complete |
$649.20
|
| Rate for Payer: Cash Price |
$1,298.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.10
|
|
|
PR ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS 43277
|
| Min. Negotiated Rate |
$237.07 |
| Max. Negotiated Rate |
$947.77 |
| Rate for Payer: Aetna Commercial |
$491.74
|
| Rate for Payer: Aetna Medicare |
$366.97
|
| Rate for Payer: BCBS Complete |
$248.92
|
| Rate for Payer: BCBS MAPPO |
$366.97
|
| Rate for Payer: BCBS Trust/PPO |
$947.77
|
| Rate for Payer: BCN Commercial |
$540.97
|
| Rate for Payer: BCN Medicare Advantage |
$366.97
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$528.44
|
| Rate for Payer: Cofinity Commercial |
$491.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.97
|
| Rate for Payer: Healthscope Commercial |
$440.36
|
| Rate for Payer: Healthscope Whirlpool |
$440.36
|
| Rate for Payer: Meridian Medicaid |
$248.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.32
|
| Rate for Payer: PACE SWMI |
$366.97
|
| Rate for Payer: PHP Medicare Advantage |
$366.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.88
|
| Rate for Payer: Priority Health Medicare |
$366.97
|
| Rate for Payer: Priority Health Narrow Network |
$650.88
|
| Rate for Payer: UHC Medicare Advantage |
$377.98
|
|
|
PR ERCP,BALLOON DIL DUCTS
|
Professional
|
Both
|
$1,639.00
|
|
|
Service Code
|
HCPCS 43271
|
| Min. Negotiated Rate |
$655.60 |
| Max. Negotiated Rate |
$1,147.30 |
| Rate for Payer: BCBS Complete |
$655.60
|
| Rate for Payer: Cash Price |
$1,311.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.30
|
|
|
PR ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE
|
Professional
|
Both
|
$1,458.00
|
|
|
Service Code
|
HCPCS 43276
|
| Min. Negotiated Rate |
$301.82 |
| Max. Negotiated Rate |
$1,020.60 |
| Rate for Payer: Aetna Commercial |
$626.24
|
| Rate for Payer: Aetna Medicare |
$467.34
|
| Rate for Payer: BCBS Complete |
$316.91
|
| Rate for Payer: BCBS MAPPO |
$467.34
|
| Rate for Payer: BCBS Trust/PPO |
$841.58
|
| Rate for Payer: BCN Commercial |
$688.54
|
| Rate for Payer: BCN Medicare Advantage |
$467.34
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cofinity Commercial |
$672.97
|
| Rate for Payer: Cofinity Commercial |
$626.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.34
|
| Rate for Payer: Healthscope Commercial |
$560.81
|
| Rate for Payer: Healthscope Whirlpool |
$560.81
|
| Rate for Payer: Meridian Medicaid |
$316.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$490.71
|
| Rate for Payer: PACE SWMI |
$467.34
|
| Rate for Payer: PHP Medicare Advantage |
$467.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.45
|
| Rate for Payer: Priority Health Medicare |
$467.34
|
| Rate for Payer: Priority Health Narrow Network |
$828.45
|
| Rate for Payer: UHC Medicare Advantage |
$481.36
|
|
|
PR ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD
|
Professional
|
Both
|
$1,868.00
|
|
|
Service Code
|
HCPCS 43265
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$1,693.20 |
| Rate for Payer: Aetna Commercial |
$562.57
|
| Rate for Payer: Aetna Medicare |
$419.83
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS MAPPO |
$419.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.20
|
| Rate for Payer: BCN Commercial |
$618.67
|
| Rate for Payer: BCN Medicare Advantage |
$419.83
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cofinity Commercial |
$562.57
|
| Rate for Payer: Cofinity Commercial |
$604.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.83
|
| Rate for Payer: Healthscope Commercial |
$503.80
|
| Rate for Payer: Healthscope Whirlpool |
$503.80
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$440.82
|
| Rate for Payer: PACE SWMI |
$419.83
|
| Rate for Payer: PHP Medicare Advantage |
$419.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,307.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.37
|
| Rate for Payer: Priority Health Medicare |
$419.83
|
| Rate for Payer: Priority Health Narrow Network |
$744.37
|
| Rate for Payer: UHC Medicare Advantage |
$432.42
|
|
|
PR ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 43260
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$949.92 |
| Rate for Payer: Aetna Commercial |
$418.76
|
| Rate for Payer: Aetna Medicare |
$312.51
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$312.51
|
| Rate for Payer: BCBS Trust/PPO |
$949.92
|
| Rate for Payer: BCN Commercial |
$460.83
|
| Rate for Payer: BCN Medicare Advantage |
$312.51
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$418.76
|
| Rate for Payer: Cofinity Commercial |
$450.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.51
|
| Rate for Payer: Healthscope Commercial |
$375.01
|
| Rate for Payer: Healthscope Whirlpool |
$375.01
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$328.14
|
| Rate for Payer: PACE SWMI |
$312.51
|
| Rate for Payer: PHP Medicare Advantage |
$312.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.46
|
| Rate for Payer: Priority Health Medicare |
$312.51
|
| Rate for Payer: Priority Health Narrow Network |
$554.46
|
| Rate for Payer: UHC Medicare Advantage |
$321.89
|
|
|
PR ERCP,INSERT STENT,BILIARY/PANC
|
Professional
|
Both
|
$1,672.00
|
|
|
Service Code
|
HCPCS 43268
|
| Min. Negotiated Rate |
$668.80 |
| Max. Negotiated Rate |
$1,170.40 |
| Rate for Payer: BCBS Complete |
$668.80
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,170.40
|
|
|
PR ERCP,NASOBILIARY DRAIN TUBE
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 43267
|
| Min. Negotiated Rate |
$646.80 |
| Max. Negotiated Rate |
$1,131.90 |
| Rate for Payer: BCBS Complete |
$646.80
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.90
|
|
|
PR ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT
|
Professional
|
Both
|
$1,803.00
|
|
|
Service Code
|
HCPCS 43264
|
| Min. Negotiated Rate |
$216.92 |
| Max. Negotiated Rate |
$1,262.10 |
| Rate for Payer: Aetna Commercial |
$473.13
|
| Rate for Payer: Aetna Medicare |
$353.08
|
| Rate for Payer: BCBS Complete |
$239.53
|
| Rate for Payer: BCBS MAPPO |
$353.08
|
| Rate for Payer: BCBS Trust/PPO |
$216.92
|
| Rate for Payer: BCN Commercial |
$520.44
|
| Rate for Payer: BCN Medicare Advantage |
$353.08
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Cofinity Commercial |
$508.44
|
| Rate for Payer: Cofinity Commercial |
$473.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.08
|
| Rate for Payer: Healthscope Commercial |
$423.70
|
| Rate for Payer: Healthscope Whirlpool |
$423.70
|
| Rate for Payer: Meridian Medicaid |
$239.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.73
|
| Rate for Payer: PACE SWMI |
$353.08
|
| Rate for Payer: PHP Medicare Advantage |
$353.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.19
|
| Rate for Payer: Priority Health Medicare |
$353.08
|
| Rate for Payer: Priority Health Narrow Network |
$626.19
|
| Rate for Payer: UHC Medicare Advantage |
$363.67
|
|
|
PR ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 43275
|
| Min. Negotiated Rate |
$235.79 |
| Max. Negotiated Rate |
$933.51 |
| Rate for Payer: Aetna Commercial |
$488.68
|
| Rate for Payer: Aetna Medicare |
$364.69
|
| Rate for Payer: BCBS Complete |
$247.58
|
| Rate for Payer: BCBS MAPPO |
$364.69
|
| Rate for Payer: BCBS Trust/PPO |
$933.51
|
| Rate for Payer: BCN Commercial |
$537.55
|
| Rate for Payer: BCN Medicare Advantage |
$364.69
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$525.15
|
| Rate for Payer: Cofinity Commercial |
$488.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.69
|
| Rate for Payer: Healthscope Commercial |
$437.63
|
| Rate for Payer: Healthscope Whirlpool |
$437.63
|
| Rate for Payer: Meridian Medicaid |
$247.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$382.92
|
| Rate for Payer: PACE SWMI |
$364.69
|
| Rate for Payer: PHP Medicare Advantage |
$364.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.77
|
| Rate for Payer: Priority Health Medicare |
$364.69
|
| Rate for Payer: Priority Health Narrow Network |
$646.77
|
| Rate for Payer: UHC Medicare Advantage |
$375.63
|
|
|
PR ERCP,RMV F.B./CHANGE STENT
|
Professional
|
Both
|
$1,660.00
|
|
|
Service Code
|
HCPCS 43269
|
| Min. Negotiated Rate |
$664.00 |
| Max. Negotiated Rate |
$1,162.00 |
| Rate for Payer: BCBS Complete |
$664.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.00
|
|
|
PR ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT
|
Professional
|
Both
|
$1,401.00
|
|
|
Service Code
|
HCPCS 43274
|
| Min. Negotiated Rate |
$289.89 |
| Max. Negotiated Rate |
$980.70 |
| Rate for Payer: Aetna Commercial |
$601.31
|
| Rate for Payer: Aetna Medicare |
$448.74
|
| Rate for Payer: BCBS Complete |
$304.38
|
| Rate for Payer: BCBS MAPPO |
$448.74
|
| Rate for Payer: BCBS Trust/PPO |
$813.05
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$448.74
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cofinity Commercial |
$601.31
|
| Rate for Payer: Cofinity Commercial |
$646.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$448.74
|
| Rate for Payer: Healthscope Commercial |
$538.49
|
| Rate for Payer: Healthscope Whirlpool |
$538.49
|
| Rate for Payer: Meridian Medicaid |
$304.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$471.18
|
| Rate for Payer: PACE SWMI |
$448.74
|
| Rate for Payer: PHP Medicare Advantage |
$448.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$795.52
|
| Rate for Payer: Priority Health Medicare |
$448.74
|
| Rate for Payer: Priority Health Narrow Network |
$795.52
|
| Rate for Payer: UHC Medicare Advantage |
$462.20
|
|
|
PR ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE
|
Professional
|
Both
|
$1,322.00
|
|
|
Service Code
|
HCPCS 43278
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$925.40 |
| Rate for Payer: Aetna Commercial |
$562.13
|
| Rate for Payer: Aetna Medicare |
$419.50
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS MAPPO |
$419.50
|
| Rate for Payer: BCBS Trust/PPO |
$722.19
|
| Rate for Payer: BCN Commercial |
$618.18
|
| Rate for Payer: BCN Medicare Advantage |
$419.50
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cofinity Commercial |
$562.13
|
| Rate for Payer: Cofinity Commercial |
$604.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.50
|
| Rate for Payer: Healthscope Commercial |
$503.40
|
| Rate for Payer: Healthscope Whirlpool |
$503.40
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$440.48
|
| Rate for Payer: PACE SWMI |
$419.50
|
| Rate for Payer: PHP Medicare Advantage |
$419.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$743.78
|
| Rate for Payer: Priority Health Medicare |
$419.50
|
| Rate for Payer: Priority Health Narrow Network |
$743.78
|
| Rate for Payer: UHC Medicare Advantage |
$432.08
|
|
|
PR ERCP W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 43261
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$1,040.08 |
| Rate for Payer: Aetna Commercial |
$440.20
|
| Rate for Payer: Aetna Medicare |
$328.51
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$328.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.08
|
| Rate for Payer: BCN Commercial |
$484.28
|
| Rate for Payer: BCN Medicare Advantage |
$328.51
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$473.05
|
| Rate for Payer: Cofinity Commercial |
$440.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.51
|
| Rate for Payer: Healthscope Commercial |
$394.21
|
| Rate for Payer: Healthscope Whirlpool |
$394.21
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.94
|
| Rate for Payer: PACE SWMI |
$328.51
|
| Rate for Payer: PHP Medicare Advantage |
$328.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$582.68
|
| Rate for Payer: Priority Health Medicare |
$328.51
|
| Rate for Payer: Priority Health Narrow Network |
$582.68
|
| Rate for Payer: UHC Medicare Advantage |
$338.37
|
|
|
PR ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI
|
Professional
|
Both
|
$1,590.00
|
|
|
Service Code
|
HCPCS 43263
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$1,113.00 |
| Rate for Payer: Aetna Commercial |
$464.59
|
| Rate for Payer: Aetna Medicare |
$346.71
|
| Rate for Payer: BCBS Complete |
$235.28
|
| Rate for Payer: BCBS MAPPO |
$346.71
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$511.16
|
| Rate for Payer: BCN Medicare Advantage |
$346.71
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$499.26
|
| Rate for Payer: Cofinity Commercial |
$464.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.71
|
| Rate for Payer: Healthscope Commercial |
$416.05
|
| Rate for Payer: Healthscope Whirlpool |
$416.05
|
| Rate for Payer: Meridian Medicaid |
$235.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$364.05
|
| Rate for Payer: PACE SWMI |
$346.71
|
| Rate for Payer: PHP Medicare Advantage |
$346.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.02
|
| Rate for Payer: Priority Health Medicare |
$346.71
|
| Rate for Payer: Priority Health Narrow Network |
$615.02
|
| Rate for Payer: UHC Medicare Advantage |
$357.11
|
|
|
PR ERCP W/SPHINCTEROTOMY/PAPILLOTOMY
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 43262
|
| Min. Negotiated Rate |
$223.65 |
| Max. Negotiated Rate |
$1,187.83 |
| Rate for Payer: Aetna Commercial |
$464.18
|
| Rate for Payer: Aetna Medicare |
$346.40
|
| Rate for Payer: BCBS Complete |
$234.83
|
| Rate for Payer: BCBS MAPPO |
$346.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.83
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$346.40
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cofinity Commercial |
$498.82
|
| Rate for Payer: Cofinity Commercial |
$464.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.40
|
| Rate for Payer: Healthscope Commercial |
$415.68
|
| Rate for Payer: Healthscope Whirlpool |
$415.68
|
| Rate for Payer: Meridian Medicaid |
$234.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$363.72
|
| Rate for Payer: PACE SWMI |
$346.40
|
| Rate for Payer: PHP Medicare Advantage |
$346.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,158.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.43
|
| Rate for Payer: Priority Health Medicare |
$346.40
|
| Rate for Payer: Priority Health Narrow Network |
$614.43
|
| Rate for Payer: UHC Medicare Advantage |
$356.79
|
|
|
PR ESCHAROTOMY EACH ADDITIONAL INCISION
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS 16036
|
| Min. Negotiated Rate |
$52.19 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Aetna Commercial |
$109.73
|
| Rate for Payer: Aetna Medicare |
$81.89
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: BCBS MAPPO |
$81.89
|
| Rate for Payer: BCBS Trust/PPO |
$119.96
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$81.89
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cofinity Commercial |
$109.73
|
| Rate for Payer: Cofinity Commercial |
$117.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.89
|
| Rate for Payer: Healthscope Commercial |
$98.27
|
| Rate for Payer: Healthscope Whirlpool |
$98.27
|
| Rate for Payer: Meridian Medicaid |
$54.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.98
|
| Rate for Payer: PACE SWMI |
$81.89
|
| Rate for Payer: PHP Medicare Advantage |
$81.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.70
|
| Rate for Payer: Priority Health Medicare |
$81.89
|
| Rate for Payer: Priority Health Narrow Network |
$100.70
|
| Rate for Payer: UHC Medicare Advantage |
$84.35
|
|
|
PR ESCHAROTOMY FIRST INCISION
|
Professional
|
Both
|
$843.00
|
|
|
Service Code
|
HCPCS 16035
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$590.10 |
| Rate for Payer: Aetna Commercial |
$257.44
|
| Rate for Payer: Aetna Medicare |
$192.12
|
| Rate for Payer: BCBS Complete |
$130.39
|
| Rate for Payer: BCBS MAPPO |
$192.12
|
| Rate for Payer: BCBS Trust/PPO |
$23.70
|
| Rate for Payer: BCN Commercial |
$281.48
|
| Rate for Payer: BCN Medicare Advantage |
$192.12
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cofinity Commercial |
$276.65
|
| Rate for Payer: Cofinity Commercial |
$257.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.12
|
| Rate for Payer: Healthscope Commercial |
$230.54
|
| Rate for Payer: Healthscope Whirlpool |
$230.54
|
| Rate for Payer: Meridian Medicaid |
$130.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.73
|
| Rate for Payer: PACE SWMI |
$192.12
|
| Rate for Payer: PHP Medicare Advantage |
$192.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.76
|
| Rate for Payer: Priority Health Medicare |
$192.12
|
| Rate for Payer: Priority Health Narrow Network |
$236.76
|
| Rate for Payer: UHC Medicare Advantage |
$197.88
|
|
