|
PR EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA
|
Professional
|
Both
|
$2,041.00
|
|
|
Service Code
|
HCPCS 27635
|
| Min. Negotiated Rate |
$375.09 |
| Max. Negotiated Rate |
$1,428.70 |
| Rate for Payer: Aetna Commercial |
$764.16
|
| Rate for Payer: Aetna Medicare |
$570.27
|
| Rate for Payer: BCBS Complete |
$393.84
|
| Rate for Payer: BCBS MAPPO |
$570.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$852.26
|
| Rate for Payer: BCN Medicare Advantage |
$570.27
|
| Rate for Payer: Cash Price |
$1,632.80
|
| Rate for Payer: Cash Price |
$1,632.80
|
| Rate for Payer: Cofinity Commercial |
$821.19
|
| Rate for Payer: Cofinity Commercial |
$764.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.27
|
| Rate for Payer: Healthscope Commercial |
$684.32
|
| Rate for Payer: Healthscope Whirlpool |
$684.32
|
| Rate for Payer: Meridian Medicaid |
$393.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$598.78
|
| Rate for Payer: PACE SWMI |
$570.27
|
| Rate for Payer: PHP Medicare Advantage |
$570.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,428.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$890.57
|
| Rate for Payer: Priority Health Medicare |
$570.27
|
| Rate for Payer: Priority Health Narrow Network |
$890.57
|
| Rate for Payer: UHC Medicare Advantage |
$587.38
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 25130
|
| Min. Negotiated Rate |
$295.43 |
| Max. Negotiated Rate |
$1,161.73 |
| Rate for Payer: Aetna Commercial |
$596.43
|
| Rate for Payer: Aetna Medicare |
$445.10
|
| Rate for Payer: BCBS Complete |
$310.20
|
| Rate for Payer: BCBS MAPPO |
$445.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,161.73
|
| Rate for Payer: BCN Commercial |
$669.98
|
| Rate for Payer: BCN Medicare Advantage |
$445.10
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$596.43
|
| Rate for Payer: Cofinity Commercial |
$640.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.10
|
| Rate for Payer: Healthscope Commercial |
$534.12
|
| Rate for Payer: Healthscope Whirlpool |
$534.12
|
| Rate for Payer: Meridian Medicaid |
$310.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$467.36
|
| Rate for Payer: PACE SWMI |
$445.10
|
| Rate for Payer: PHP Medicare Advantage |
$445.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,112.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$700.10
|
| Rate for Payer: Priority Health Medicare |
$445.10
|
| Rate for Payer: Priority Health Narrow Network |
$700.10
|
| Rate for Payer: UHC Medicare Advantage |
$458.45
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR
|
Professional
|
Both
|
$2,242.00
|
|
|
Service Code
|
HCPCS 27355
|
| Min. Negotiated Rate |
$395.12 |
| Max. Negotiated Rate |
$2,489.35 |
| Rate for Payer: Aetna Commercial |
$805.07
|
| Rate for Payer: Aetna Medicare |
$600.80
|
| Rate for Payer: BCBS Complete |
$414.88
|
| Rate for Payer: BCBS MAPPO |
$600.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$600.80
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cofinity Commercial |
$865.15
|
| Rate for Payer: Cofinity Commercial |
$805.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.80
|
| Rate for Payer: Healthscope Commercial |
$720.96
|
| Rate for Payer: Healthscope Whirlpool |
$720.96
|
| Rate for Payer: Meridian Medicaid |
$414.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$630.84
|
| Rate for Payer: PACE SWMI |
$600.80
|
| Rate for Payer: PHP Medicare Advantage |
$600.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,569.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$939.09
|
| Rate for Payer: Priority Health Medicare |
$600.80
|
| Rate for Payer: Priority Health Narrow Network |
$939.09
|
| Rate for Payer: UHC Medicare Advantage |
$618.82
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION
|
Professional
|
Both
|
$1,049.00
|
|
|
Service Code
|
HCPCS 27358
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$2,110.56 |
| Rate for Payer: Aetna Commercial |
$362.97
|
| Rate for Payer: Aetna Medicare |
$270.87
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$270.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,110.56
|
| Rate for Payer: BCN Commercial |
$397.79
|
| Rate for Payer: BCN Medicare Advantage |
$270.87
|
| Rate for Payer: Cash Price |
$839.20
|
| Rate for Payer: Cash Price |
$839.20
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Commercial |
$362.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$270.87
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Healthscope Whirlpool |
$325.04
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$284.41
|
| Rate for Payer: PACE SWMI |
$270.87
|
| Rate for Payer: PHP Medicare Advantage |
$270.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$734.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$415.67
|
| Rate for Payer: Priority Health Medicare |
$270.87
|
| Rate for Payer: Priority Health Narrow Network |
$415.67
|
| Rate for Payer: UHC Medicare Advantage |
$279.00
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT
|
Professional
|
Both
|
$2,172.00
|
|
|
Service Code
|
HCPCS 27356
|
| Min. Negotiated Rate |
$479.89 |
| Max. Negotiated Rate |
$1,520.40 |
| Rate for Payer: Aetna Commercial |
$979.73
|
| Rate for Payer: Aetna Medicare |
$731.14
|
| Rate for Payer: BCBS Complete |
$503.88
|
| Rate for Payer: BCBS MAPPO |
$731.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.15
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| Rate for Payer: BCN Medicare Advantage |
$731.14
|
| Rate for Payer: Cash Price |
$1,737.60
|
| Rate for Payer: Cash Price |
$1,737.60
|
| Rate for Payer: Cofinity Commercial |
$1,052.84
|
| Rate for Payer: Cofinity Commercial |
$979.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.14
|
| Rate for Payer: Healthscope Commercial |
$877.37
|
| Rate for Payer: Healthscope Whirlpool |
$877.37
|
| Rate for Payer: Meridian Medicaid |
$503.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$767.70
|
| Rate for Payer: PACE SWMI |
$731.14
|
| Rate for Payer: PHP Medicare Advantage |
$731.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,520.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,140.28
|
| Rate for Payer: Priority Health Medicare |
$731.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.28
|
| Rate for Payer: UHC Medicare Advantage |
$753.07
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT
|
Professional
|
Both
|
$1,978.00
|
|
|
Service Code
|
HCPCS 27357
|
| Min. Negotiated Rate |
$529.52 |
| Max. Negotiated Rate |
$1,740.22 |
| Rate for Payer: Aetna Commercial |
$1,082.91
|
| Rate for Payer: Aetna Medicare |
$808.14
|
| Rate for Payer: BCBS Complete |
$556.00
|
| Rate for Payer: BCBS MAPPO |
$808.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.22
|
| Rate for Payer: BCN Commercial |
$1,206.05
|
| Rate for Payer: BCN Medicare Advantage |
$808.14
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cash Price |
$1,582.40
|
| Rate for Payer: Cofinity Commercial |
$1,082.91
|
| Rate for Payer: Cofinity Commercial |
$1,163.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$808.14
|
| Rate for Payer: Healthscope Commercial |
$969.77
|
| Rate for Payer: Healthscope Whirlpool |
$969.77
|
| Rate for Payer: Meridian Medicaid |
$556.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$848.55
|
| Rate for Payer: PACE SWMI |
$808.14
|
| Rate for Payer: PHP Medicare Advantage |
$808.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,384.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,260.29
|
| Rate for Payer: Priority Health Medicare |
$808.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.29
|
| Rate for Payer: UHC Medicare Advantage |
$832.38
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR METACARPAL
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 26200
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$888.30 |
| Rate for Payer: Aetna Commercial |
$597.92
|
| Rate for Payer: Aetna Medicare |
$446.21
|
| Rate for Payer: BCBS Complete |
$309.53
|
| Rate for Payer: BCBS MAPPO |
$446.21
|
| Rate for Payer: BCBS Trust/PPO |
$66.57
|
| Rate for Payer: BCN Commercial |
$669.98
|
| Rate for Payer: BCN Medicare Advantage |
$446.21
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$642.54
|
| Rate for Payer: Cofinity Commercial |
$597.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.21
|
| Rate for Payer: Healthscope Commercial |
$535.45
|
| Rate for Payer: Healthscope Whirlpool |
$535.45
|
| Rate for Payer: Meridian Medicaid |
$309.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$468.52
|
| Rate for Payer: PACE SWMI |
$446.21
|
| Rate for Payer: PHP Medicare Advantage |
$446.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$700.10
|
| Rate for Payer: Priority Health Medicare |
$446.21
|
| Rate for Payer: Priority Health Narrow Network |
$700.10
|
| Rate for Payer: UHC Medicare Advantage |
$459.60
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 26210
|
| Min. Negotiated Rate |
$293.51 |
| Max. Negotiated Rate |
$872.90 |
| Rate for Payer: Aetna Commercial |
$592.19
|
| Rate for Payer: Aetna Medicare |
$441.93
|
| Rate for Payer: BCBS Complete |
$308.19
|
| Rate for Payer: BCBS MAPPO |
$441.93
|
| Rate for Payer: BCBS Trust/PPO |
$497.66
|
| Rate for Payer: BCN Commercial |
$665.57
|
| Rate for Payer: BCN Medicare Advantage |
$441.93
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cofinity Commercial |
$592.19
|
| Rate for Payer: Cofinity Commercial |
$636.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.93
|
| Rate for Payer: Healthscope Commercial |
$530.32
|
| Rate for Payer: Healthscope Whirlpool |
$530.32
|
| Rate for Payer: Meridian Medicaid |
$308.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.03
|
| Rate for Payer: PACE SWMI |
$441.93
|
| Rate for Payer: PHP Medicare Advantage |
$441.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$695.50
|
| Rate for Payer: Priority Health Medicare |
$441.93
|
| Rate for Payer: Priority Health Narrow Network |
$695.50
|
| Rate for Payer: UHC Medicare Advantage |
$455.19
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA
|
Professional
|
Both
|
$2,163.00
|
|
|
Service Code
|
HCPCS 25120
|
| Min. Negotiated Rate |
$327.81 |
| Max. Negotiated Rate |
$1,514.10 |
| Rate for Payer: Aetna Commercial |
$664.21
|
| Rate for Payer: Aetna Medicare |
$495.68
|
| Rate for Payer: BCBS Complete |
$344.20
|
| Rate for Payer: BCBS MAPPO |
$495.68
|
| Rate for Payer: BCBS Trust/PPO |
$351.32
|
| Rate for Payer: BCN Commercial |
$744.26
|
| Rate for Payer: BCN Medicare Advantage |
$495.68
|
| Rate for Payer: Cash Price |
$1,730.40
|
| Rate for Payer: Cash Price |
$1,730.40
|
| Rate for Payer: Cofinity Commercial |
$713.78
|
| Rate for Payer: Cofinity Commercial |
$664.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.68
|
| Rate for Payer: Healthscope Commercial |
$594.82
|
| Rate for Payer: Healthscope Whirlpool |
$594.82
|
| Rate for Payer: Meridian Medicaid |
$344.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$520.46
|
| Rate for Payer: PACE SWMI |
$495.68
|
| Rate for Payer: PHP Medicare Advantage |
$495.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,514.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$777.72
|
| Rate for Payer: Priority Health Medicare |
$495.68
|
| Rate for Payer: Priority Health Narrow Network |
$777.72
|
| Rate for Payer: UHC Medicare Advantage |
$510.55
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS
|
Professional
|
Both
|
$1,113.00
|
|
|
Service Code
|
HCPCS 28100
|
| Min. Negotiated Rate |
$269.87 |
| Max. Negotiated Rate |
$1,087.24 |
| Rate for Payer: Aetna Commercial |
$548.68
|
| Rate for Payer: Aetna Medicare |
$409.46
|
| Rate for Payer: BCBS Complete |
$283.36
|
| Rate for Payer: BCBS MAPPO |
$409.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,087.24
|
| Rate for Payer: BCN Commercial |
$895.74
|
| Rate for Payer: BCN Medicare Advantage |
$409.46
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cofinity Commercial |
$548.68
|
| Rate for Payer: Cofinity Commercial |
$589.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.46
|
| Rate for Payer: Healthscope Commercial |
$491.35
|
| Rate for Payer: Healthscope Whirlpool |
$491.35
|
| Rate for Payer: Meridian Medicaid |
$283.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$429.93
|
| Rate for Payer: PACE SWMI |
$409.46
|
| Rate for Payer: PHP Medicare Advantage |
$409.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$640.36
|
| Rate for Payer: Priority Health Medicare |
$409.46
|
| Rate for Payer: Priority Health Narrow Network |
$640.36
|
| Rate for Payer: UHC Medicare Advantage |
$421.74
|
|
|
PR EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS
|
Professional
|
Both
|
$1,172.00
|
|
|
Service Code
|
HCPCS 24110
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$913.55 |
| Rate for Payer: Aetna Commercial |
$782.24
|
| Rate for Payer: Aetna Medicare |
$583.76
|
| Rate for Payer: BCBS Complete |
$404.13
|
| Rate for Payer: BCBS MAPPO |
$583.76
|
| Rate for Payer: BCBS Trust/PPO |
$45.96
|
| Rate for Payer: BCN Commercial |
$874.25
|
| Rate for Payer: BCN Medicare Advantage |
$583.76
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cofinity Commercial |
$782.24
|
| Rate for Payer: Cofinity Commercial |
$840.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.76
|
| Rate for Payer: Healthscope Commercial |
$700.51
|
| Rate for Payer: Healthscope Whirlpool |
$700.51
|
| Rate for Payer: Meridian Medicaid |
$404.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$612.95
|
| Rate for Payer: PACE SWMI |
$583.76
|
| Rate for Payer: PHP Medicare Advantage |
$583.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.55
|
| Rate for Payer: Priority Health Medicare |
$583.76
|
| Rate for Payer: Priority Health Narrow Network |
$913.55
|
| Rate for Payer: UHC Medicare Advantage |
$601.27
|
|
|
PR EXCISION/DESTRUCTION INTRANASAL LESION INT APPR
|
Professional
|
Both
|
$1,656.00
|
|
|
Service Code
|
HCPCS 30117
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$1,436.22 |
| Rate for Payer: Aetna Commercial |
$432.36
|
| Rate for Payer: Aetna Medicare |
$322.66
|
| Rate for Payer: BCBS Complete |
$279.56
|
| Rate for Payer: BCBS MAPPO |
$322.66
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: BCN Commercial |
$1,436.22
|
| Rate for Payer: BCN Medicare Advantage |
$322.66
|
| Rate for Payer: Cash Price |
$1,324.80
|
| Rate for Payer: Cash Price |
$1,324.80
|
| Rate for Payer: Cofinity Commercial |
$464.63
|
| Rate for Payer: Cofinity Commercial |
$432.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.66
|
| Rate for Payer: Healthscope Commercial |
$387.19
|
| Rate for Payer: Healthscope Whirlpool |
$387.19
|
| Rate for Payer: Meridian Medicaid |
$279.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$338.79
|
| Rate for Payer: PACE SWMI |
$322.66
|
| Rate for Payer: PHP Medicare Advantage |
$322.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,159.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.37
|
| Rate for Payer: Priority Health Medicare |
$322.66
|
| Rate for Payer: Priority Health Narrow Network |
$465.37
|
| Rate for Payer: UHC Medicare Advantage |
$332.34
|
|
|
PR EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 42808
|
| Min. Negotiated Rate |
$107.14 |
| Max. Negotiated Rate |
$764.45 |
| Rate for Payer: Aetna Commercial |
$218.88
|
| Rate for Payer: Aetna Medicare |
$163.34
|
| Rate for Payer: BCBS Complete |
$112.50
|
| Rate for Payer: BCBS MAPPO |
$163.34
|
| Rate for Payer: BCBS Trust/PPO |
$764.45
|
| Rate for Payer: BCN Commercial |
$343.05
|
| Rate for Payer: BCN Medicare Advantage |
$163.34
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$218.88
|
| Rate for Payer: Cofinity Commercial |
$235.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.34
|
| Rate for Payer: Healthscope Commercial |
$196.01
|
| Rate for Payer: Healthscope Whirlpool |
$196.01
|
| Rate for Payer: Meridian Medicaid |
$112.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.51
|
| Rate for Payer: PACE SWMI |
$163.34
|
| Rate for Payer: PHP Medicare Advantage |
$163.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$293.99
|
| Rate for Payer: Priority Health Medicare |
$163.34
|
| Rate for Payer: Priority Health Narrow Network |
$293.99
|
| Rate for Payer: UHC Medicare Advantage |
$168.24
|
|
|
PR EXCISION/DESTRUCTION OPEN ABDOMINAL TUMOR 5 CM/<
|
Professional
|
Both
|
$3,223.00
|
|
|
Service Code
|
HCPCS 49203
|
| Min. Negotiated Rate |
$599.09 |
| Max. Negotiated Rate |
$2,256.10 |
| Rate for Payer: Aetna Commercial |
$1,588.85
|
| Rate for Payer: Aetna Medicare |
$1,185.71
|
| Rate for Payer: BCBS Complete |
$801.79
|
| Rate for Payer: BCBS MAPPO |
$1,185.71
|
| Rate for Payer: BCBS Trust/PPO |
$599.09
|
| Rate for Payer: BCN Commercial |
$1,742.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,185.71
|
| Rate for Payer: Cash Price |
$2,578.40
|
| Rate for Payer: Cash Price |
$2,578.40
|
| Rate for Payer: Cofinity Commercial |
$1,707.42
|
| Rate for Payer: Cofinity Commercial |
$1,588.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,185.71
|
| Rate for Payer: Healthscope Commercial |
$1,422.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,422.85
|
| Rate for Payer: Meridian Medicaid |
$801.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,245.00
|
| Rate for Payer: PACE SWMI |
$1,185.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,185.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$763.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,096.13
|
| Rate for Payer: Priority Health Medicare |
$1,185.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,096.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,221.28
|
|
|
PR EXCISION DISTAL ULNA PARTIAL/COMPLETE
|
Professional
|
Both
|
$1,529.00
|
|
|
Service Code
|
HCPCS 25240
|
| Min. Negotiated Rate |
$281.80 |
| Max. Negotiated Rate |
$1,623.99 |
| Rate for Payer: Aetna Commercial |
$569.06
|
| Rate for Payer: Aetna Medicare |
$424.67
|
| Rate for Payer: BCBS Complete |
$295.89
|
| Rate for Payer: BCBS MAPPO |
$424.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,623.99
|
| Rate for Payer: BCN Commercial |
$638.21
|
| Rate for Payer: BCN Medicare Advantage |
$424.67
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Cofinity Commercial |
$611.52
|
| Rate for Payer: Cofinity Commercial |
$569.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.67
|
| Rate for Payer: Healthscope Commercial |
$509.60
|
| Rate for Payer: Healthscope Whirlpool |
$509.60
|
| Rate for Payer: Meridian Medicaid |
$295.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$445.90
|
| Rate for Payer: PACE SWMI |
$424.67
|
| Rate for Payer: PHP Medicare Advantage |
$424.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,070.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$666.91
|
| Rate for Payer: Priority Health Medicare |
$424.67
|
| Rate for Payer: Priority Health Narrow Network |
$666.91
|
| Rate for Payer: UHC Medicare Advantage |
$437.41
|
|
|
PR EXCISION EPIPHYSEAL BAR
|
Professional
|
Both
|
$1,921.00
|
|
|
Service Code
|
HCPCS 20150
|
| Min. Negotiated Rate |
$644.96 |
| Max. Negotiated Rate |
$4,160.00 |
| Rate for Payer: Aetna Commercial |
$1,324.88
|
| Rate for Payer: Aetna Medicare |
$988.72
|
| Rate for Payer: BCBS Complete |
$677.21
|
| Rate for Payer: BCBS MAPPO |
$988.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.00
|
| Rate for Payer: BCN Commercial |
$1,468.47
|
| Rate for Payer: BCN Medicare Advantage |
$988.72
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cofinity Commercial |
$1,324.88
|
| Rate for Payer: Cofinity Commercial |
$1,423.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$988.72
|
| Rate for Payer: Healthscope Commercial |
$1,186.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,186.46
|
| Rate for Payer: Meridian Medicaid |
$677.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,038.16
|
| Rate for Payer: PACE SWMI |
$988.72
|
| Rate for Payer: PHP Medicare Advantage |
$988.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,534.50
|
| Rate for Payer: Priority Health Medicare |
$988.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,018.38
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN
|
Professional
|
Both
|
$852.00
|
|
|
Service Code
|
HCPCS 15847
|
| Min. Negotiated Rate |
$196.94 |
| Max. Negotiated Rate |
$10,615.31 |
| Rate for Payer: Aetna Commercial |
$531.57
|
| Rate for Payer: BCBS Complete |
$206.79
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.31
|
| Rate for Payer: BCN Commercial |
$536.46
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Meridian Medicaid |
$206.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.40
|
| Rate for Payer: Priority Health Narrow Network |
$603.40
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM
|
Professional
|
Both
|
$4,500.00
|
|
|
Service Code
|
HCPCS 15836
|
| Min. Negotiated Rate |
$377.57 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna Commercial |
$1,044.70
|
| Rate for Payer: Aetna Medicare |
$779.63
|
| Rate for Payer: BCBS Complete |
$536.76
|
| Rate for Payer: BCBS MAPPO |
$779.63
|
| Rate for Payer: BCBS Trust/PPO |
$377.57
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: BCN Medicare Advantage |
$779.63
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Cofinity Commercial |
$1,122.67
|
| Rate for Payer: Cofinity Commercial |
$1,044.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.63
|
| Rate for Payer: Healthscope Commercial |
$935.56
|
| Rate for Payer: Healthscope Whirlpool |
$935.56
|
| Rate for Payer: Meridian Medicaid |
$536.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$818.61
|
| Rate for Payer: PACE SWMI |
$779.63
|
| Rate for Payer: PHP Medicare Advantage |
$779.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$511.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,150.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$981.15
|
| Rate for Payer: Priority Health Medicare |
$779.63
|
| Rate for Payer: Priority Health Narrow Network |
$981.15
|
| Rate for Payer: UHC Medicare Advantage |
$803.02
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA
|
Professional
|
Both
|
$2,149.00
|
|
|
Service Code
|
HCPCS 15839
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$1,504.30 |
| Rate for Payer: Aetna Commercial |
$973.11
|
| Rate for Payer: Aetna Medicare |
$726.20
|
| Rate for Payer: BCBS Complete |
$497.85
|
| Rate for Payer: BCBS MAPPO |
$726.20
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,308.19
|
| Rate for Payer: BCN Medicare Advantage |
$726.20
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cofinity Commercial |
$973.11
|
| Rate for Payer: Cofinity Commercial |
$1,045.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$726.20
|
| Rate for Payer: Healthscope Commercial |
$871.44
|
| Rate for Payer: Healthscope Whirlpool |
$871.44
|
| Rate for Payer: Meridian Medicaid |
$497.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$762.51
|
| Rate for Payer: PACE SWMI |
$726.20
|
| Rate for Payer: PHP Medicare Advantage |
$726.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$910.45
|
| Rate for Payer: Priority Health Medicare |
$726.20
|
| Rate for Payer: Priority Health Narrow Network |
$910.45
|
| Rate for Payer: UHC Medicare Advantage |
$747.99
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH
|
Professional
|
Both
|
$4,500.00
|
|
|
Service Code
|
HCPCS 15832
|
| Min. Negotiated Rate |
$590.65 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna Commercial |
$1,211.80
|
| Rate for Payer: Aetna Medicare |
$904.33
|
| Rate for Payer: BCBS Complete |
$620.18
|
| Rate for Payer: BCBS MAPPO |
$904.33
|
| Rate for Payer: BCBS Trust/PPO |
$634.70
|
| Rate for Payer: BCN Commercial |
$1,348.75
|
| Rate for Payer: BCN Medicare Advantage |
$904.33
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Cofinity Commercial |
$1,302.24
|
| Rate for Payer: Cofinity Commercial |
$1,211.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.33
|
| Rate for Payer: Healthscope Commercial |
$1,085.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,085.20
|
| Rate for Payer: Meridian Medicaid |
$620.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$949.55
|
| Rate for Payer: PACE SWMI |
$904.33
|
| Rate for Payer: PHP Medicare Advantage |
$904.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,150.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.47
|
| Rate for Payer: Priority Health Medicare |
$904.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.47
|
| Rate for Payer: UHC Medicare Advantage |
$931.46
|
|
|
PR EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 69140
|
| Min. Negotiated Rate |
$579.57 |
| Max. Negotiated Rate |
$4,892.06 |
| Rate for Payer: Aetna Commercial |
$1,170.77
|
| Rate for Payer: Aetna Medicare |
$873.71
|
| Rate for Payer: BCBS Complete |
$608.55
|
| Rate for Payer: BCBS MAPPO |
$873.71
|
| Rate for Payer: BCBS Trust/PPO |
$4,892.06
|
| Rate for Payer: BCN Commercial |
$1,334.09
|
| Rate for Payer: BCN Medicare Advantage |
$873.71
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,258.14
|
| Rate for Payer: Cofinity Commercial |
$1,170.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.71
|
| Rate for Payer: Healthscope Commercial |
$1,048.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,048.45
|
| Rate for Payer: Meridian Medicaid |
$608.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$917.40
|
| Rate for Payer: PACE SWMI |
$873.71
|
| Rate for Payer: PHP Medicare Advantage |
$873.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,287.08
|
| Rate for Payer: Priority Health Medicare |
$873.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,287.08
|
| Rate for Payer: UHC Medicare Advantage |
$899.92
|
|
|
PR EXCISION EXTERNAL EAR COMPLETE AMPUTATION
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 69120
|
| Min. Negotiated Rate |
$249.42 |
| Max. Negotiated Rate |
$4,565.04 |
| Rate for Payer: Aetna Commercial |
$506.80
|
| Rate for Payer: Aetna Medicare |
$378.21
|
| Rate for Payer: BCBS Complete |
$261.89
|
| Rate for Payer: BCBS MAPPO |
$378.21
|
| Rate for Payer: BCBS Trust/PPO |
$4,565.04
|
| Rate for Payer: BCN Commercial |
$573.70
|
| Rate for Payer: BCN Medicare Advantage |
$378.21
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cofinity Commercial |
$506.80
|
| Rate for Payer: Cofinity Commercial |
$544.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.21
|
| Rate for Payer: Healthscope Commercial |
$453.85
|
| Rate for Payer: Healthscope Whirlpool |
$453.85
|
| Rate for Payer: Meridian Medicaid |
$261.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$397.12
|
| Rate for Payer: PACE SWMI |
$378.21
|
| Rate for Payer: PHP Medicare Advantage |
$378.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.50
|
| Rate for Payer: Priority Health Medicare |
$378.21
|
| Rate for Payer: Priority Health Narrow Network |
$553.50
|
| Rate for Payer: UHC Medicare Advantage |
$389.56
|
|
|
PR EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 69110
|
| Min. Negotiated Rate |
$211.08 |
| Max. Negotiated Rate |
$2,466.10 |
| Rate for Payer: Aetna Commercial |
$426.80
|
| Rate for Payer: Aetna Medicare |
$318.51
|
| Rate for Payer: BCBS Complete |
$221.63
|
| Rate for Payer: BCBS MAPPO |
$318.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,466.10
|
| Rate for Payer: BCN Commercial |
$694.90
|
| Rate for Payer: BCN Medicare Advantage |
$318.51
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$426.80
|
| Rate for Payer: Cofinity Commercial |
$458.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.51
|
| Rate for Payer: Healthscope Commercial |
$382.21
|
| Rate for Payer: Healthscope Whirlpool |
$382.21
|
| Rate for Payer: Meridian Medicaid |
$221.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.44
|
| Rate for Payer: PACE SWMI |
$318.51
|
| Rate for Payer: PHP Medicare Advantage |
$318.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.81
|
| Rate for Payer: Priority Health Medicare |
$318.51
|
| Rate for Payer: Priority Health Narrow Network |
$465.81
|
| Rate for Payer: UHC Medicare Advantage |
$328.07
|
|
|
PR EXCISION FACIAL BONE
|
Professional
|
Both
|
$978.00
|
|
|
Service Code
|
HCPCS 21026
|
| Min. Negotiated Rate |
$146.87 |
| Max. Negotiated Rate |
$780.90 |
| Rate for Payer: Aetna Commercial |
$555.23
|
| Rate for Payer: Aetna Medicare |
$414.35
|
| Rate for Payer: BCBS Complete |
$288.73
|
| Rate for Payer: BCBS MAPPO |
$414.35
|
| Rate for Payer: BCBS Trust/PPO |
$146.87
|
| Rate for Payer: BCN Commercial |
$780.90
|
| Rate for Payer: BCN Medicare Advantage |
$414.35
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Cofinity Commercial |
$555.23
|
| Rate for Payer: Cofinity Commercial |
$596.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.35
|
| Rate for Payer: Healthscope Commercial |
$497.22
|
| Rate for Payer: Healthscope Whirlpool |
$497.22
|
| Rate for Payer: Meridian Medicaid |
$288.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$435.07
|
| Rate for Payer: PACE SWMI |
$414.35
|
| Rate for Payer: PHP Medicare Advantage |
$414.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.59
|
| Rate for Payer: Priority Health Medicare |
$414.35
|
| Rate for Payer: Priority Health Narrow Network |
$651.59
|
| Rate for Payer: UHC Medicare Advantage |
$426.78
|
|
|
PR EXCISION/FULGURATION URETHRAL PROLAPSE
|
Professional
|
Both
|
$847.00
|
|
|
Service Code
|
HCPCS 53275
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$1,384.67 |
| Rate for Payer: Aetna Commercial |
$345.14
|
| Rate for Payer: Aetna Medicare |
$257.57
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS MAPPO |
$257.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.67
|
| Rate for Payer: BCN Commercial |
$380.68
|
| Rate for Payer: BCN Medicare Advantage |
$257.57
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cofinity Commercial |
$370.90
|
| Rate for Payer: Cofinity Commercial |
$345.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.57
|
| Rate for Payer: Healthscope Commercial |
$309.08
|
| Rate for Payer: Healthscope Whirlpool |
$309.08
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.45
|
| Rate for Payer: PACE SWMI |
$257.57
|
| Rate for Payer: PHP Medicare Advantage |
$257.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$420.94
|
| Rate for Payer: Priority Health Medicare |
$257.57
|
| Rate for Payer: Priority Health Narrow Network |
$420.94
|
| Rate for Payer: UHC Medicare Advantage |
$265.30
|
|
