|
PR EXC FRENUM LABIAL/BUCCAL
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 40819
|
| Min. Negotiated Rate |
$128.01 |
| Max. Negotiated Rate |
$760.22 |
| Rate for Payer: Aetna Commercial |
$257.17
|
| Rate for Payer: Aetna Medicare |
$191.92
|
| Rate for Payer: BCBS Complete |
$134.41
|
| Rate for Payer: BCBS MAPPO |
$191.92
|
| Rate for Payer: BCBS Trust/PPO |
$760.22
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Medicare Advantage |
$191.92
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$276.36
|
| Rate for Payer: Cofinity Commercial |
$257.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.92
|
| Rate for Payer: Healthscope Commercial |
$230.30
|
| Rate for Payer: Healthscope Whirlpool |
$230.30
|
| Rate for Payer: Meridian Medicaid |
$134.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.52
|
| Rate for Payer: PACE SWMI |
$191.92
|
| Rate for Payer: PHP Medicare Advantage |
$191.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.67
|
| Rate for Payer: Priority Health Medicare |
$191.92
|
| Rate for Payer: Priority Health Narrow Network |
$348.67
|
| Rate for Payer: UHC Medicare Advantage |
$197.68
|
|
|
PR EXC/FULGURATION URETHRAL CARUNCLE
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 53265
|
| Min. Negotiated Rate |
$120.77 |
| Max. Negotiated Rate |
$1,099.39 |
| Rate for Payer: Aetna Commercial |
$248.60
|
| Rate for Payer: Aetna Medicare |
$185.52
|
| Rate for Payer: BCBS Complete |
$126.81
|
| Rate for Payer: BCBS MAPPO |
$185.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
| Rate for Payer: BCN Commercial |
$334.26
|
| Rate for Payer: BCN Medicare Advantage |
$185.52
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$248.60
|
| Rate for Payer: Cofinity Commercial |
$267.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.52
|
| Rate for Payer: Healthscope Commercial |
$222.62
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Meridian Medicaid |
$126.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$194.80
|
| Rate for Payer: PACE SWMI |
$185.52
|
| Rate for Payer: PHP Medicare Advantage |
$185.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.69
|
| Rate for Payer: Priority Health Medicare |
$185.52
|
| Rate for Payer: Priority Health Narrow Network |
$303.69
|
| Rate for Payer: UHC Medicare Advantage |
$191.09
|
|
|
PR EXC/FULGURATION URETHRAL POLYP DSTL URETHRA
|
Professional
|
Both
|
$270.00
|
|
|
Service Code
|
HCPCS 53260
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$546.26 |
| Rate for Payer: Aetna Commercial |
$238.29
|
| Rate for Payer: Aetna Medicare |
$177.83
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$177.83
|
| Rate for Payer: BCBS Trust/PPO |
$546.26
|
| Rate for Payer: BCN Commercial |
$302.00
|
| Rate for Payer: BCN Medicare Advantage |
$177.83
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cofinity Commercial |
$238.29
|
| Rate for Payer: Cofinity Commercial |
$256.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.83
|
| Rate for Payer: Healthscope Commercial |
$213.40
|
| Rate for Payer: Healthscope Whirlpool |
$213.40
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.72
|
| Rate for Payer: PACE SWMI |
$177.83
|
| Rate for Payer: PHP Medicare Advantage |
$177.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.25
|
| Rate for Payer: Priority Health Medicare |
$177.83
|
| Rate for Payer: Priority Health Narrow Network |
$291.25
|
| Rate for Payer: UHC Medicare Advantage |
$183.16
|
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,249.00
|
|
|
Service Code
|
HCPCS 49423
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$1,009.05 |
| Rate for Payer: Aetna Commercial |
$93.22
|
| Rate for Payer: Aetna Medicare |
$69.57
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$69.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.05
|
| Rate for Payer: BCN Commercial |
$875.23
|
| Rate for Payer: BCN Medicare Advantage |
$69.57
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cofinity Commercial |
$100.18
|
| Rate for Payer: Cofinity Commercial |
$93.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.57
|
| Rate for Payer: Healthscope Commercial |
$83.48
|
| Rate for Payer: Healthscope Whirlpool |
$83.48
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.05
|
| Rate for Payer: PACE SWMI |
$69.57
|
| Rate for Payer: PHP Medicare Advantage |
$69.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.31
|
| Rate for Payer: Priority Health Medicare |
$69.57
|
| Rate for Payer: Priority Health Narrow Network |
$122.31
|
| Rate for Payer: UHC Medicare Advantage |
$71.66
|
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$711.00
|
|
|
Service Code
|
HCPCS 55500
|
| Min. Negotiated Rate |
$251.55 |
| Max. Negotiated Rate |
$2,419.09 |
| Rate for Payer: Aetna Commercial |
$515.12
|
| Rate for Payer: Aetna Medicare |
$384.42
|
| Rate for Payer: BCBS Complete |
$264.13
|
| Rate for Payer: BCBS MAPPO |
$384.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.09
|
| Rate for Payer: BCN Commercial |
$570.77
|
| Rate for Payer: BCN Medicare Advantage |
$384.42
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cofinity Commercial |
$515.12
|
| Rate for Payer: Cofinity Commercial |
$553.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.42
|
| Rate for Payer: Healthscope Commercial |
$461.30
|
| Rate for Payer: Healthscope Whirlpool |
$461.30
|
| Rate for Payer: Meridian Medicaid |
$264.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.64
|
| Rate for Payer: PACE SWMI |
$384.42
|
| Rate for Payer: PHP Medicare Advantage |
$384.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$631.13
|
| Rate for Payer: Priority Health Medicare |
$384.42
|
| Rate for Payer: Priority Health Narrow Network |
$631.13
|
| Rate for Payer: UHC Medicare Advantage |
$395.95
|
|
|
PR EXC ILEOANAL RSVR W/ILEOSTOMY
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 45136
|
| Min. Negotiated Rate |
$1,129.33 |
| Max. Negotiated Rate |
$3,106.85 |
| Rate for Payer: Aetna Commercial |
$2,340.91
|
| Rate for Payer: Aetna Medicare |
$1,746.95
|
| Rate for Payer: BCBS Complete |
$1,185.80
|
| Rate for Payer: BCBS MAPPO |
$1,746.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.07
|
| Rate for Payer: BCN Commercial |
$2,582.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,746.95
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cofinity Commercial |
$2,515.61
|
| Rate for Payer: Cofinity Commercial |
$2,340.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,746.95
|
| Rate for Payer: Healthscope Commercial |
$2,096.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,096.34
|
| Rate for Payer: Meridian Medicaid |
$1,185.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,834.30
|
| Rate for Payer: PACE SWMI |
$1,746.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,746.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,129.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,106.85
|
| Rate for Payer: Priority Health Medicare |
$1,746.95
|
| Rate for Payer: Priority Health Narrow Network |
$3,106.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,799.36
|
|
|
PR EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,305.90
|
|
|
Service Code
|
HCPCS 33120
|
| Min. Negotiated Rate |
$1,008.52 |
| Max. Negotiated Rate |
$3,256.64 |
| Rate for Payer: Aetna Commercial |
$2,754.75
|
| Rate for Payer: Aetna Medicare |
$2,055.78
|
| Rate for Payer: BCBS Complete |
$1,374.56
|
| Rate for Payer: BCBS MAPPO |
$2,055.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.52
|
| Rate for Payer: BCN Commercial |
$2,991.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.78
|
| Rate for Payer: Cash Price |
$3,444.72
|
| Rate for Payer: Cash Price |
$3,444.72
|
| Rate for Payer: Cofinity Commercial |
$2,960.32
|
| Rate for Payer: Cofinity Commercial |
$2,754.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.78
|
| Rate for Payer: Healthscope Commercial |
$2,466.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,466.94
|
| Rate for Payer: Meridian Medicaid |
$1,374.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,158.57
|
| Rate for Payer: PACE SWMI |
$2,055.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,309.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,014.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,256.64
|
| Rate for Payer: Priority Health Medicare |
$2,055.78
|
| Rate for Payer: Priority Health Narrow Network |
$3,256.64
|
| Rate for Payer: UHC Medicare Advantage |
$2,117.45
|
|
|
PR EXCIS CHEST WALL TUMOR/RIBS
|
Professional
|
Both
|
$2,221.00
|
|
|
Service Code
|
HCPCS 19260
|
| Min. Negotiated Rate |
$888.40 |
| Max. Negotiated Rate |
$1,554.70 |
| Rate for Payer: BCBS Complete |
$888.40
|
| Rate for Payer: Cash Price |
$1,776.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.70
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$455.39 |
| Max. Negotiated Rate |
$1,038.93 |
| Rate for Payer: Aetna Commercial |
$936.87
|
| Rate for Payer: Aetna Medicare |
$699.16
|
| Rate for Payer: BCBS Complete |
$478.16
|
| Rate for Payer: BCBS MAPPO |
$699.16
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$1,038.93
|
| Rate for Payer: BCN Medicare Advantage |
$699.16
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$936.87
|
| Rate for Payer: Cofinity Commercial |
$1,006.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.16
|
| Rate for Payer: Healthscope Commercial |
$838.99
|
| Rate for Payer: Healthscope Whirlpool |
$838.99
|
| Rate for Payer: Meridian Medicaid |
$478.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$734.12
|
| Rate for Payer: PACE SWMI |
$699.16
|
| Rate for Payer: PHP Medicare Advantage |
$699.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$856.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$873.87
|
| Rate for Payer: Priority Health Medicare |
$699.16
|
| Rate for Payer: Priority Health Narrow Network |
$873.87
|
| Rate for Payer: UHC Medicare Advantage |
$720.13
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,585.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$598.96 |
| Max. Negotiated Rate |
$2,275.40 |
| Rate for Payer: Aetna Commercial |
$1,226.25
|
| Rate for Payer: Aetna Medicare |
$915.11
|
| Rate for Payer: BCBS Complete |
$628.91
|
| Rate for Payer: BCBS MAPPO |
$915.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,275.40
|
| Rate for Payer: BCN Commercial |
$1,369.28
|
| Rate for Payer: BCN Medicare Advantage |
$915.11
|
| Rate for Payer: Cash Price |
$1,268.00
|
| Rate for Payer: Cash Price |
$1,268.00
|
| Rate for Payer: Cofinity Commercial |
$1,226.25
|
| Rate for Payer: Cofinity Commercial |
$1,317.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$915.11
|
| Rate for Payer: Healthscope Commercial |
$1,098.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,098.13
|
| Rate for Payer: Meridian Medicaid |
$628.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$960.87
|
| Rate for Payer: PACE SWMI |
$915.11
|
| Rate for Payer: PHP Medicare Advantage |
$915.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,109.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,151.73
|
| Rate for Payer: Priority Health Medicare |
$915.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,151.73
|
| Rate for Payer: UHC Medicare Advantage |
$942.56
|
|
|
PR EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$3,286.00
|
|
|
Service Code
|
HCPCS 15946
|
| Min. Negotiated Rate |
$1,029.64 |
| Max. Negotiated Rate |
$2,363.25 |
| Rate for Payer: Aetna Commercial |
$2,133.00
|
| Rate for Payer: Aetna Medicare |
$1,591.79
|
| Rate for Payer: BCBS Complete |
$1,081.12
|
| Rate for Payer: BCBS MAPPO |
$1,591.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.35
|
| Rate for Payer: BCN Commercial |
$2,363.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,591.79
|
| Rate for Payer: Cash Price |
$2,628.80
|
| Rate for Payer: Cash Price |
$2,628.80
|
| Rate for Payer: Cofinity Commercial |
$2,292.18
|
| Rate for Payer: Cofinity Commercial |
$2,133.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,591.79
|
| Rate for Payer: Healthscope Commercial |
$1,910.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,910.15
|
| Rate for Payer: Meridian Medicaid |
$1,081.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,671.38
|
| Rate for Payer: PACE SWMI |
$1,591.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,591.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,029.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,300.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,987.78
|
| Rate for Payer: Priority Health Medicare |
$1,591.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,987.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,639.54
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,584.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$1,372.69 |
| Rate for Payer: Aetna Commercial |
$1,230.67
|
| Rate for Payer: Aetna Medicare |
$918.41
|
| Rate for Payer: BCBS Complete |
$624.88
|
| Rate for Payer: BCBS MAPPO |
$918.41
|
| Rate for Payer: BCBS Trust/PPO |
$562.50
|
| Rate for Payer: BCN Commercial |
$1,372.69
|
| Rate for Payer: BCN Medicare Advantage |
$918.41
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,230.67
|
| Rate for Payer: Cofinity Commercial |
$1,322.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.41
|
| Rate for Payer: Healthscope Commercial |
$1,102.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,102.09
|
| Rate for Payer: Meridian Medicaid |
$624.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$964.33
|
| Rate for Payer: PACE SWMI |
$918.41
|
| Rate for Payer: PHP Medicare Advantage |
$918.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,108.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.61
|
| Rate for Payer: Priority Health Medicare |
$918.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.61
|
| Rate for Payer: UHC Medicare Advantage |
$945.96
|
|
|
PR EXCISION 1ST &/CERVICAL RIB
|
Professional
|
Both
|
$1,178.00
|
|
|
Service Code
|
HCPCS 21615
|
| Min. Negotiated Rate |
$397.46 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$826.53
|
| Rate for Payer: Aetna Medicare |
$616.81
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$616.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$904.54
|
| Rate for Payer: BCN Medicare Advantage |
$616.81
|
| Rate for Payer: Cash Price |
$942.40
|
| Rate for Payer: Cash Price |
$942.40
|
| Rate for Payer: Cofinity Commercial |
$888.21
|
| Rate for Payer: Cofinity Commercial |
$826.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.81
|
| Rate for Payer: Healthscope Commercial |
$740.17
|
| Rate for Payer: Healthscope Whirlpool |
$740.17
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$647.65
|
| Rate for Payer: PACE SWMI |
$616.81
|
| Rate for Payer: PHP Medicare Advantage |
$616.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$945.21
|
| Rate for Payer: Priority Health Medicare |
$616.81
|
| Rate for Payer: Priority Health Narrow Network |
$945.21
|
| Rate for Payer: UHC Medicare Advantage |
$635.31
|
|
|
PR EXCISION AMPULLA VATER
|
Professional
|
Both
|
$1,811.00
|
|
|
Service Code
|
HCPCS 48148
|
| Min. Negotiated Rate |
$800.24 |
| Max. Negotiated Rate |
$2,199.61 |
| Rate for Payer: Aetna Commercial |
$1,668.33
|
| Rate for Payer: Aetna Medicare |
$1,245.02
|
| Rate for Payer: BCBS Complete |
$840.25
|
| Rate for Payer: BCBS MAPPO |
$1,245.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.41
|
| Rate for Payer: BCN Commercial |
$1,828.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,245.02
|
| Rate for Payer: Cash Price |
$1,448.80
|
| Rate for Payer: Cash Price |
$1,448.80
|
| Rate for Payer: Cofinity Commercial |
$1,668.33
|
| Rate for Payer: Cofinity Commercial |
$1,792.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,245.02
|
| Rate for Payer: Healthscope Commercial |
$1,494.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,494.02
|
| Rate for Payer: Meridian Medicaid |
$840.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,307.27
|
| Rate for Payer: PACE SWMI |
$1,245.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,245.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$800.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,267.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,199.61
|
| Rate for Payer: Priority Health Medicare |
$1,245.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,199.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,282.37
|
|
|
PR EXCISION AURAL POLYP
|
Professional
|
Both
|
$369.00
|
|
|
Service Code
|
HCPCS 69540
|
| Min. Negotiated Rate |
$84.14 |
| Max. Negotiated Rate |
$2,401.65 |
| Rate for Payer: Aetna Commercial |
$169.46
|
| Rate for Payer: Aetna Medicare |
$126.46
|
| Rate for Payer: BCBS Complete |
$88.35
|
| Rate for Payer: BCBS MAPPO |
$126.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,401.65
|
| Rate for Payer: BCN Commercial |
$313.73
|
| Rate for Payer: BCN Medicare Advantage |
$126.46
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cofinity Commercial |
$182.10
|
| Rate for Payer: Cofinity Commercial |
$169.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.46
|
| Rate for Payer: Healthscope Commercial |
$151.75
|
| Rate for Payer: Healthscope Whirlpool |
$151.75
|
| Rate for Payer: Meridian Medicaid |
$88.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.78
|
| Rate for Payer: PACE SWMI |
$126.46
|
| Rate for Payer: PHP Medicare Advantage |
$126.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.76
|
| Rate for Payer: Priority Health Medicare |
$126.46
|
| Rate for Payer: Priority Health Narrow Network |
$185.76
|
| Rate for Payer: UHC Medicare Advantage |
$130.25
|
|
|
PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 21040
|
| Min. Negotiated Rate |
$231.74 |
| Max. Negotiated Rate |
$681.71 |
| Rate for Payer: Aetna Commercial |
$472.77
|
| Rate for Payer: Aetna Medicare |
$352.81
|
| Rate for Payer: BCBS Complete |
$243.33
|
| Rate for Payer: BCBS MAPPO |
$352.81
|
| Rate for Payer: BCBS Trust/PPO |
$332.62
|
| Rate for Payer: BCN Commercial |
$681.71
|
| Rate for Payer: BCN Medicare Advantage |
$352.81
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$508.05
|
| Rate for Payer: Cofinity Commercial |
$472.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.81
|
| Rate for Payer: Healthscope Commercial |
$423.37
|
| Rate for Payer: Healthscope Whirlpool |
$423.37
|
| Rate for Payer: Meridian Medicaid |
$243.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.45
|
| Rate for Payer: PACE SWMI |
$352.81
|
| Rate for Payer: PHP Medicare Advantage |
$352.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.56
|
| Rate for Payer: Priority Health Medicare |
$352.81
|
| Rate for Payer: Priority Health Narrow Network |
$554.56
|
| Rate for Payer: UHC Medicare Advantage |
$363.39
|
|
|
PR EXCISION BONE CYST/BENIGN TUMOR DEEP
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 27066
|
| Min. Negotiated Rate |
$80.30 |
| Max. Negotiated Rate |
$1,261.81 |
| Rate for Payer: Aetna Commercial |
$1,084.61
|
| Rate for Payer: Aetna Medicare |
$809.41
|
| Rate for Payer: BCBS Complete |
$553.76
|
| Rate for Payer: BCBS MAPPO |
$809.41
|
| Rate for Payer: BCBS Trust/PPO |
$80.30
|
| Rate for Payer: BCN Commercial |
$1,207.52
|
| Rate for Payer: BCN Medicare Advantage |
$809.41
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cofinity Commercial |
$1,165.55
|
| Rate for Payer: Cofinity Commercial |
$1,084.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.41
|
| Rate for Payer: Healthscope Commercial |
$971.29
|
| Rate for Payer: Healthscope Whirlpool |
$971.29
|
| Rate for Payer: Meridian Medicaid |
$553.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$849.88
|
| Rate for Payer: PACE SWMI |
$809.41
|
| Rate for Payer: PHP Medicare Advantage |
$809.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$527.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,261.81
|
| Rate for Payer: Priority Health Medicare |
$809.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,261.81
|
| Rate for Payer: UHC Medicare Advantage |
$833.69
|
|
|
PR EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL
|
Professional
|
Both
|
$887.00
|
|
|
Service Code
|
HCPCS 27065
|
| Min. Negotiated Rate |
$340.59 |
| Max. Negotiated Rate |
$4,717.19 |
| Rate for Payer: Aetna Commercial |
$697.15
|
| Rate for Payer: Aetna Medicare |
$520.26
|
| Rate for Payer: BCBS Complete |
$357.62
|
| Rate for Payer: BCBS MAPPO |
$520.26
|
| Rate for Payer: BCBS Trust/PPO |
$4,717.19
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$520.26
|
| Rate for Payer: Cash Price |
$709.60
|
| Rate for Payer: Cash Price |
$709.60
|
| Rate for Payer: Cofinity Commercial |
$749.17
|
| Rate for Payer: Cofinity Commercial |
$697.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.26
|
| Rate for Payer: Healthscope Commercial |
$624.31
|
| Rate for Payer: Healthscope Whirlpool |
$624.31
|
| Rate for Payer: Meridian Medicaid |
$357.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$546.27
|
| Rate for Payer: PACE SWMI |
$520.26
|
| Rate for Payer: PHP Medicare Advantage |
$520.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$340.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$815.51
|
| Rate for Payer: Priority Health Medicare |
$520.26
|
| Rate for Payer: Priority Health Narrow Network |
$815.51
|
| Rate for Payer: UHC Medicare Advantage |
$535.87
|
|
|
PR EXCISION BONE MANDIBLE
|
Professional
|
Both
|
$1,565.00
|
|
|
Service Code
|
HCPCS 21025
|
| Min. Negotiated Rate |
$103.02 |
| Max. Negotiated Rate |
$1,154.25 |
| Rate for Payer: Aetna Commercial |
$862.77
|
| Rate for Payer: Aetna Medicare |
$643.86
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS MAPPO |
$643.86
|
| Rate for Payer: BCBS Trust/PPO |
$103.02
|
| Rate for Payer: BCN Commercial |
$1,154.25
|
| Rate for Payer: BCN Medicare Advantage |
$643.86
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cofinity Commercial |
$927.16
|
| Rate for Payer: Cofinity Commercial |
$862.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$643.86
|
| Rate for Payer: Healthscope Commercial |
$772.63
|
| Rate for Payer: Healthscope Whirlpool |
$772.63
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$676.05
|
| Rate for Payer: PACE SWMI |
$643.86
|
| Rate for Payer: PHP Medicare Advantage |
$643.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,005.47
|
| Rate for Payer: Priority Health Medicare |
$643.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,005.47
|
| Rate for Payer: UHC Medicare Advantage |
$663.18
|
|
|
PR EXCISION CHALAZION MULTIPLE SAME LID
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 67801
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$552.60 |
| Rate for Payer: Aetna Commercial |
$169.91
|
| Rate for Payer: Aetna Medicare |
$126.80
|
| Rate for Payer: BCBS Complete |
$87.22
|
| Rate for Payer: BCBS MAPPO |
$126.80
|
| Rate for Payer: BCBS Trust/PPO |
$552.60
|
| Rate for Payer: BCN Commercial |
$237.49
|
| Rate for Payer: BCN Medicare Advantage |
$126.80
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$182.59
|
| Rate for Payer: Cofinity Commercial |
$169.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.80
|
| Rate for Payer: Healthscope Commercial |
$152.16
|
| Rate for Payer: Healthscope Whirlpool |
$152.16
|
| Rate for Payer: Meridian Medicaid |
$87.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$133.14
|
| Rate for Payer: PACE SWMI |
$126.80
|
| Rate for Payer: PHP Medicare Advantage |
$126.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.73
|
| Rate for Payer: Priority Health Medicare |
$126.80
|
| Rate for Payer: Priority Health Narrow Network |
$227.73
|
| Rate for Payer: UHC Medicare Advantage |
$130.60
|
|
|
PR EXCISION CHALAZION SINGLE
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
HCPCS 67800
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$552.07 |
| Rate for Payer: Aetna Commercial |
$131.04
|
| Rate for Payer: Aetna Medicare |
$97.79
|
| Rate for Payer: BCBS Complete |
$67.99
|
| Rate for Payer: BCBS MAPPO |
$97.79
|
| Rate for Payer: BCBS Trust/PPO |
$552.07
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: BCN Medicare Advantage |
$97.79
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$131.04
|
| Rate for Payer: Cofinity Commercial |
$140.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.79
|
| Rate for Payer: Healthscope Commercial |
$117.35
|
| Rate for Payer: Healthscope Whirlpool |
$117.35
|
| Rate for Payer: Meridian Medicaid |
$67.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.68
|
| Rate for Payer: PACE SWMI |
$97.79
|
| Rate for Payer: PHP Medicare Advantage |
$97.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.21
|
| Rate for Payer: Priority Health Medicare |
$97.79
|
| Rate for Payer: Priority Health Narrow Network |
$176.21
|
| Rate for Payer: UHC Medicare Advantage |
$100.72
|
|
|
PR EXCISION CHEST WALL TUMOR INCLUDING RIBS
|
Professional
|
Both
|
$2,391.00
|
|
|
Service Code
|
HCPCS 21601
|
| Min. Negotiated Rate |
$267.70 |
| Max. Negotiated Rate |
$1,739.79 |
| Rate for Payer: Aetna Commercial |
$1,513.46
|
| Rate for Payer: Aetna Medicare |
$1,129.45
|
| Rate for Payer: BCBS Complete |
$770.70
|
| Rate for Payer: BCBS MAPPO |
$1,129.45
|
| Rate for Payer: BCBS Trust/PPO |
$267.70
|
| Rate for Payer: BCN Commercial |
$1,664.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,129.45
|
| Rate for Payer: Cash Price |
$1,912.80
|
| Rate for Payer: Cash Price |
$1,912.80
|
| Rate for Payer: Cofinity Commercial |
$1,626.41
|
| Rate for Payer: Cofinity Commercial |
$1,513.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,129.45
|
| Rate for Payer: Healthscope Commercial |
$1,355.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,355.34
|
| Rate for Payer: Meridian Medicaid |
$770.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,185.92
|
| Rate for Payer: PACE SWMI |
$1,129.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,129.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,739.79
|
| Rate for Payer: Priority Health Medicare |
$1,129.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,739.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,163.33
|
|
|
PR EXCISION CHOLEDOCHAL CYST
|
Professional
|
Both
|
$2,262.00
|
|
|
Service Code
|
HCPCS 47715
|
| Min. Negotiated Rate |
$380.38 |
| Max. Negotiated Rate |
$2,339.54 |
| Rate for Payer: Aetna Commercial |
$1,773.49
|
| Rate for Payer: Aetna Medicare |
$1,323.50
|
| Rate for Payer: BCBS Complete |
$893.71
|
| Rate for Payer: BCBS MAPPO |
$1,323.50
|
| Rate for Payer: BCBS Trust/PPO |
$380.38
|
| Rate for Payer: BCN Commercial |
$1,944.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,323.50
|
| Rate for Payer: Cash Price |
$1,809.60
|
| Rate for Payer: Cash Price |
$1,809.60
|
| Rate for Payer: Cofinity Commercial |
$1,773.49
|
| Rate for Payer: Cofinity Commercial |
$1,905.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,323.50
|
| Rate for Payer: Healthscope Commercial |
$1,588.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,588.20
|
| Rate for Payer: Meridian Medicaid |
$893.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,389.68
|
| Rate for Payer: PACE SWMI |
$1,323.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,323.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$851.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,583.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,339.54
|
| Rate for Payer: Priority Health Medicare |
$1,323.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,339.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,363.20
|
|
|
PR EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC
|
Professional
|
Both
|
$3,673.00
|
|
|
Service Code
|
HCPCS 21603
|
| Min. Negotiated Rate |
$1,071.39 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$2,217.98
|
| Rate for Payer: Aetna Medicare |
$1,655.21
|
| Rate for Payer: BCBS Complete |
$1,124.96
|
| Rate for Payer: BCBS MAPPO |
$1,655.21
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$2,446.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,655.21
|
| Rate for Payer: Cash Price |
$2,938.40
|
| Rate for Payer: Cash Price |
$2,938.40
|
| Rate for Payer: Cofinity Commercial |
$2,383.50
|
| Rate for Payer: Cofinity Commercial |
$2,217.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,655.21
|
| Rate for Payer: Healthscope Commercial |
$1,986.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,986.25
|
| Rate for Payer: Meridian Medicaid |
$1,124.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,737.97
|
| Rate for Payer: PACE SWMI |
$1,655.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,655.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,071.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,571.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,556.31
|
| Rate for Payer: Priority Health Medicare |
$1,655.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,556.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,704.87
|
|
|
PR EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC
|
Professional
|
Both
|
$3,064.00
|
|
|
Service Code
|
HCPCS 21602
|
| Min. Negotiated Rate |
$977.46 |
| Max. Negotiated Rate |
$32,076.33 |
| Rate for Payer: Aetna Commercial |
$2,028.91
|
| Rate for Payer: Aetna Medicare |
$1,514.11
|
| Rate for Payer: BCBS Complete |
$1,026.33
|
| Rate for Payer: BCBS MAPPO |
$1,514.11
|
| Rate for Payer: BCBS Trust/PPO |
$32,076.33
|
| Rate for Payer: BCN Commercial |
$2,244.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,514.11
|
| Rate for Payer: Cash Price |
$2,451.20
|
| Rate for Payer: Cash Price |
$2,451.20
|
| Rate for Payer: Cofinity Commercial |
$2,028.91
|
| Rate for Payer: Cofinity Commercial |
$2,180.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,514.11
|
| Rate for Payer: Healthscope Commercial |
$1,816.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,816.93
|
| Rate for Payer: Meridian Medicaid |
$1,026.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,589.82
|
| Rate for Payer: PACE SWMI |
$1,514.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,514.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$977.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,144.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,344.90
|
| Rate for Payer: Priority Health Medicare |
$1,514.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,344.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,559.53
|
|
