|
PR EXCISION PREPATELLAR BURSA
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
CPT 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$892.50 |
| Max. Negotiated Rate |
$1,275.00 |
| Rate for Payer: Aetna Commercial |
$1,147.50
|
| Rate for Payer: ASR ASR |
$1,236.75
|
| Rate for Payer: BCBS Trust/PPO |
$988.51
|
| Rate for Payer: BCN Commercial |
$988.51
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,198.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,275.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,236.75
|
| Rate for Payer: Mclaren Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,122.00
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$2,642.03 |
| Rate for Payer: Aetna Commercial |
$494.59
|
| Rate for Payer: Aetna Medicare |
$369.10
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCBS MAPPO |
$369.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.03
|
| Rate for Payer: BCN Commercial |
$556.12
|
| Rate for Payer: BCN Medicare Advantage |
$369.10
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$494.59
|
| Rate for Payer: Cofinity Commercial |
$531.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.10
|
| Rate for Payer: Healthscope Commercial |
$442.92
|
| Rate for Payer: Healthscope Whirlpool |
$442.92
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$387.56
|
| Rate for Payer: PACE SWMI |
$369.10
|
| Rate for Payer: PHP Medicare Advantage |
$369.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$581.13
|
| Rate for Payer: Priority Health Medicare |
$369.10
|
| Rate for Payer: Priority Health Narrow Network |
$581.13
|
| Rate for Payer: UHC Medicare Advantage |
$380.17
|
|
|
PR EXCISION RADIAL HEAD
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 24130
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$861.70 |
| Rate for Payer: Aetna Commercial |
$678.91
|
| Rate for Payer: Aetna Medicare |
$506.65
|
| Rate for Payer: BCBS Complete |
$350.02
|
| Rate for Payer: BCBS MAPPO |
$506.65
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$760.38
|
| Rate for Payer: BCN Medicare Advantage |
$506.65
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$729.58
|
| Rate for Payer: Cofinity Commercial |
$678.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.65
|
| Rate for Payer: Healthscope Commercial |
$607.98
|
| Rate for Payer: Healthscope Whirlpool |
$607.98
|
| Rate for Payer: Meridian Medicaid |
$350.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$531.98
|
| Rate for Payer: PACE SWMI |
$506.65
|
| Rate for Payer: PHP Medicare Advantage |
$506.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$794.56
|
| Rate for Payer: Priority Health Medicare |
$506.65
|
| Rate for Payer: Priority Health Narrow Network |
$794.56
|
| Rate for Payer: UHC Medicare Advantage |
$521.85
|
|
|
PR EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 67961
|
| Min. Negotiated Rate |
$287.55 |
| Max. Negotiated Rate |
$2,721.27 |
| Rate for Payer: Aetna Commercial |
$578.97
|
| Rate for Payer: Aetna Medicare |
$432.07
|
| Rate for Payer: BCBS Complete |
$301.93
|
| Rate for Payer: BCBS MAPPO |
$432.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,721.27
|
| Rate for Payer: BCN Commercial |
$854.21
|
| Rate for Payer: BCN Medicare Advantage |
$432.07
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$578.97
|
| Rate for Payer: Cofinity Commercial |
$622.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.07
|
| Rate for Payer: Healthscope Commercial |
$518.48
|
| Rate for Payer: Healthscope Whirlpool |
$518.48
|
| Rate for Payer: Meridian Medicaid |
$301.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$453.67
|
| Rate for Payer: PACE SWMI |
$432.07
|
| Rate for Payer: PHP Medicare Advantage |
$432.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$790.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$780.96
|
| Rate for Payer: Priority Health Medicare |
$432.07
|
| Rate for Payer: Priority Health Narrow Network |
$780.96
|
| Rate for Payer: UHC Medicare Advantage |
$445.03
|
|
|
PR EXCISION RIB PARTIAL
|
Professional
|
Both
|
$1,593.00
|
|
|
Service Code
|
HCPCS 21600
|
| Min. Negotiated Rate |
$57.05 |
| Max. Negotiated Rate |
$1,115.10 |
| Rate for Payer: Aetna Commercial |
$743.82
|
| Rate for Payer: Aetna Medicare |
$555.09
|
| Rate for Payer: BCBS Complete |
$384.23
|
| Rate for Payer: BCBS MAPPO |
$555.09
|
| Rate for Payer: BCBS Trust/PPO |
$57.05
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$555.09
|
| Rate for Payer: Cash Price |
$1,274.40
|
| Rate for Payer: Cash Price |
$1,274.40
|
| Rate for Payer: Cofinity Commercial |
$743.82
|
| Rate for Payer: Cofinity Commercial |
$799.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.09
|
| Rate for Payer: Healthscope Commercial |
$666.11
|
| Rate for Payer: Healthscope Whirlpool |
$666.11
|
| Rate for Payer: Meridian Medicaid |
$384.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$582.84
|
| Rate for Payer: PACE SWMI |
$555.09
|
| Rate for Payer: PHP Medicare Advantage |
$555.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.08
|
| Rate for Payer: Priority Health Medicare |
$555.09
|
| Rate for Payer: Priority Health Narrow Network |
$867.08
|
| Rate for Payer: UHC Medicare Advantage |
$571.74
|
|
|
PR EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,151.00
|
|
|
Service Code
|
HCPCS 15931
|
| Min. Negotiated Rate |
$48.31 |
| Max. Negotiated Rate |
$1,034.04 |
| Rate for Payer: Aetna Commercial |
$933.64
|
| Rate for Payer: Aetna Medicare |
$696.75
|
| Rate for Payer: BCBS Complete |
$475.26
|
| Rate for Payer: BCBS MAPPO |
$696.75
|
| Rate for Payer: BCBS Trust/PPO |
$48.31
|
| Rate for Payer: BCN Commercial |
$1,034.04
|
| Rate for Payer: BCN Medicare Advantage |
$696.75
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cofinity Commercial |
$1,003.32
|
| Rate for Payer: Cofinity Commercial |
$933.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.75
|
| Rate for Payer: Healthscope Commercial |
$836.10
|
| Rate for Payer: Healthscope Whirlpool |
$836.10
|
| Rate for Payer: Meridian Medicaid |
$475.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$731.59
|
| Rate for Payer: PACE SWMI |
$696.75
|
| Rate for Payer: PHP Medicare Advantage |
$696.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$805.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$869.75
|
| Rate for Payer: Priority Health Medicare |
$696.75
|
| Rate for Payer: Priority Health Narrow Network |
$869.75
|
| Rate for Payer: UHC Medicare Advantage |
$717.65
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
IP
|
$431.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$301.70 |
| Max. Negotiated Rate |
$431.00 |
| Rate for Payer: Aetna Commercial |
$387.90
|
| Rate for Payer: ASR ASR |
$418.07
|
| Rate for Payer: BCBS Trust/PPO |
$334.15
|
| Rate for Payer: BCN Commercial |
$334.15
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$405.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.80
|
| Rate for Payer: Healthscope Commercial |
$431.00
|
| Rate for Payer: Healthscope Whirlpool |
$418.07
|
| Rate for Payer: Mclaren Commercial |
$387.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$366.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$379.28
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$431.00
|
|
|
Service Code
|
HCPCS 46220
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$1,565.88 |
| Rate for Payer: Aetna Commercial |
$159.26
|
| Rate for Payer: Aetna Medicare |
$118.85
|
| Rate for Payer: BCBS Complete |
$82.30
|
| Rate for Payer: BCBS MAPPO |
$118.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,565.88
|
| Rate for Payer: BCN Commercial |
$370.42
|
| Rate for Payer: BCN Medicare Advantage |
$118.85
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$171.14
|
| Rate for Payer: Cofinity Commercial |
$159.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.85
|
| Rate for Payer: Healthscope Commercial |
$142.62
|
| Rate for Payer: Healthscope Whirlpool |
$142.62
|
| Rate for Payer: Meridian Medicaid |
$82.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.79
|
| Rate for Payer: PACE SWMI |
$118.85
|
| Rate for Payer: PHP Medicare Advantage |
$118.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.02
|
| Rate for Payer: Priority Health Medicare |
$118.85
|
| Rate for Payer: Priority Health Narrow Network |
$214.02
|
| Rate for Payer: UHC Medicare Advantage |
$122.42
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
OP
|
$431.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$301.70 |
| Max. Negotiated Rate |
$1,311.18 |
| Rate for Payer: Aetna Commercial |
$387.90
|
| Rate for Payer: Aetna Medicare |
$1,048.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: ASR ASR |
$418.07
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$334.15
|
| Rate for Payer: BCN Commercial |
$334.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$405.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$431.00
|
| Rate for Payer: Healthscope Whirlpool |
$418.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$387.90
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$366.35
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,153.83
|
| Rate for Payer: PHP Medicaid |
$573.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.21
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$306.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$379.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$431.00
|
|
|
Service Code
|
HCPCS 46220
|
| Hospital Charge Code |
46220
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$1,565.88 |
| Rate for Payer: Aetna Commercial |
$159.26
|
| Rate for Payer: Aetna Medicare |
$118.85
|
| Rate for Payer: BCBS Complete |
$82.30
|
| Rate for Payer: BCBS MAPPO |
$118.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,565.88
|
| Rate for Payer: BCN Commercial |
$370.42
|
| Rate for Payer: BCN Medicare Advantage |
$118.85
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$159.26
|
| Rate for Payer: Cofinity Commercial |
$171.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.85
|
| Rate for Payer: Healthscope Commercial |
$142.62
|
| Rate for Payer: Healthscope Whirlpool |
$142.62
|
| Rate for Payer: Meridian Medicaid |
$82.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.79
|
| Rate for Payer: PACE SWMI |
$118.85
|
| Rate for Payer: PHP Medicare Advantage |
$118.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.02
|
| Rate for Payer: Priority Health Medicare |
$118.85
|
| Rate for Payer: Priority Health Narrow Network |
$214.02
|
| Rate for Payer: UHC Medicare Advantage |
$122.42
|
|
|
PR EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 15830
|
| Min. Negotiated Rate |
$226.01 |
| Max. Negotiated Rate |
$1,820.00 |
| Rate for Payer: Aetna Commercial |
$1,543.05
|
| Rate for Payer: Aetna Medicare |
$1,151.53
|
| Rate for Payer: BCBS Complete |
$787.03
|
| Rate for Payer: BCBS MAPPO |
$1,151.53
|
| Rate for Payer: BCBS Trust/PPO |
$226.01
|
| Rate for Payer: BCN Commercial |
$1,711.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,151.53
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,658.20
|
| Rate for Payer: Cofinity Commercial |
$1,543.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,151.53
|
| Rate for Payer: Healthscope Commercial |
$1,381.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,381.84
|
| Rate for Payer: Meridian Medicaid |
$787.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,209.11
|
| Rate for Payer: PACE SWMI |
$1,151.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,151.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,439.87
|
| Rate for Payer: Priority Health Medicare |
$1,151.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,439.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,186.08
|
|
|
PR EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$663.00
|
|
|
Service Code
|
HCPCS 69145
|
| Min. Negotiated Rate |
$166.35 |
| Max. Negotiated Rate |
$2,204.60 |
| Rate for Payer: Aetna Commercial |
$335.60
|
| Rate for Payer: Aetna Medicare |
$250.45
|
| Rate for Payer: BCBS Complete |
$174.67
|
| Rate for Payer: BCBS MAPPO |
$250.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,204.60
|
| Rate for Payer: BCN Commercial |
$609.38
|
| Rate for Payer: BCN Medicare Advantage |
$250.45
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$360.65
|
| Rate for Payer: Cofinity Commercial |
$335.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.45
|
| Rate for Payer: Healthscope Commercial |
$300.54
|
| Rate for Payer: Healthscope Whirlpool |
$300.54
|
| Rate for Payer: Meridian Medicaid |
$174.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$262.97
|
| Rate for Payer: PACE SWMI |
$250.45
|
| Rate for Payer: PHP Medicare Advantage |
$250.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$366.79
|
| Rate for Payer: Priority Health Medicare |
$250.45
|
| Rate for Payer: Priority Health Narrow Network |
$366.79
|
| Rate for Payer: UHC Medicare Advantage |
$257.96
|
|
|
PR EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY
|
Professional
|
Both
|
$586.00
|
|
|
Service Code
|
HCPCS 54840
|
| Min. Negotiated Rate |
$206.61 |
| Max. Negotiated Rate |
$2,153.88 |
| Rate for Payer: Aetna Commercial |
$422.06
|
| Rate for Payer: Aetna Medicare |
$314.97
|
| Rate for Payer: BCBS Complete |
$216.94
|
| Rate for Payer: BCBS MAPPO |
$314.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,153.88
|
| Rate for Payer: BCN Commercial |
$467.66
|
| Rate for Payer: BCN Medicare Advantage |
$314.97
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cofinity Commercial |
$453.56
|
| Rate for Payer: Cofinity Commercial |
$422.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.97
|
| Rate for Payer: Healthscope Commercial |
$377.96
|
| Rate for Payer: Healthscope Whirlpool |
$377.96
|
| Rate for Payer: Meridian Medicaid |
$216.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$330.72
|
| Rate for Payer: PACE SWMI |
$314.97
|
| Rate for Payer: PHP Medicare Advantage |
$314.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$517.12
|
| Rate for Payer: Priority Health Medicare |
$314.97
|
| Rate for Payer: Priority Health Narrow Network |
$517.12
|
| Rate for Payer: UHC Medicare Advantage |
$324.42
|
|
|
PR EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND
|
Professional
|
Both
|
$2,227.00
|
|
|
Service Code
|
HCPCS 42440
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$1,558.90 |
| Rate for Payer: Aetna Commercial |
$549.48
|
| Rate for Payer: Aetna Medicare |
$410.06
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS MAPPO |
$410.06
|
| Rate for Payer: BCBS Trust/PPO |
$437.96
|
| Rate for Payer: BCN Commercial |
$611.82
|
| Rate for Payer: BCN Medicare Advantage |
$410.06
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cofinity Commercial |
$590.49
|
| Rate for Payer: Cofinity Commercial |
$549.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.06
|
| Rate for Payer: Healthscope Commercial |
$492.07
|
| Rate for Payer: Healthscope Whirlpool |
$492.07
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$430.56
|
| Rate for Payer: PACE SWMI |
$410.06
|
| Rate for Payer: PHP Medicare Advantage |
$410.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$736.15
|
| Rate for Payer: Priority Health Medicare |
$410.06
|
| Rate for Payer: Priority Health Narrow Network |
$736.15
|
| Rate for Payer: UHC Medicare Advantage |
$422.36
|
|
|
PR EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA
|
Professional
|
Both
|
$1,015.00
|
|
|
Service Code
|
HCPCS 30120
|
| Min. Negotiated Rate |
$270.08 |
| Max. Negotiated Rate |
$748.17 |
| Rate for Payer: Aetna Commercial |
$548.45
|
| Rate for Payer: Aetna Medicare |
$409.29
|
| Rate for Payer: BCBS Complete |
$283.58
|
| Rate for Payer: BCBS MAPPO |
$409.29
|
| Rate for Payer: BCBS Trust/PPO |
$589.05
|
| Rate for Payer: BCN Commercial |
$748.17
|
| Rate for Payer: BCN Medicare Advantage |
$409.29
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cofinity Commercial |
$548.45
|
| Rate for Payer: Cofinity Commercial |
$589.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.29
|
| Rate for Payer: Healthscope Commercial |
$491.15
|
| Rate for Payer: Healthscope Whirlpool |
$491.15
|
| Rate for Payer: Meridian Medicaid |
$283.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$429.75
|
| Rate for Payer: PACE SWMI |
$409.29
|
| Rate for Payer: PHP Medicare Advantage |
$409.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$582.97
|
| Rate for Payer: Priority Health Medicare |
$409.29
|
| Rate for Payer: Priority Health Narrow Network |
$582.97
|
| Rate for Payer: UHC Medicare Advantage |
$421.57
|
|
|
PR EXCISION SYNOVIAL CYST POPLITEAL SPACE
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 27345
|
| Min. Negotiated Rate |
$317.37 |
| Max. Negotiated Rate |
$1,594.41 |
| Rate for Payer: Aetna Commercial |
$642.53
|
| Rate for Payer: Aetna Medicare |
$479.50
|
| Rate for Payer: BCBS Complete |
$333.24
|
| Rate for Payer: BCBS MAPPO |
$479.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.41
|
| Rate for Payer: BCN Commercial |
$719.34
|
| Rate for Payer: BCN Medicare Advantage |
$479.50
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cofinity Commercial |
$642.53
|
| Rate for Payer: Cofinity Commercial |
$690.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.50
|
| Rate for Payer: Healthscope Commercial |
$575.40
|
| Rate for Payer: Healthscope Whirlpool |
$575.40
|
| Rate for Payer: Meridian Medicaid |
$333.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$503.48
|
| Rate for Payer: PACE SWMI |
$479.50
|
| Rate for Payer: PHP Medicare Advantage |
$479.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.68
|
| Rate for Payer: Priority Health Medicare |
$479.50
|
| Rate for Payer: Priority Health Narrow Network |
$751.68
|
| Rate for Payer: UHC Medicare Advantage |
$493.88
|
|
|
PR EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 26180
|
| Min. Negotiated Rate |
$146.34 |
| Max. Negotiated Rate |
$872.90 |
| Rate for Payer: Aetna Commercial |
$594.38
|
| Rate for Payer: Aetna Medicare |
$443.57
|
| Rate for Payer: BCBS Complete |
$309.53
|
| Rate for Payer: BCBS MAPPO |
$443.57
|
| Rate for Payer: BCBS Trust/PPO |
$146.34
|
| Rate for Payer: BCN Commercial |
$668.03
|
| Rate for Payer: BCN Medicare Advantage |
$443.57
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cofinity Commercial |
$594.38
|
| Rate for Payer: Cofinity Commercial |
$638.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.57
|
| Rate for Payer: Healthscope Commercial |
$532.28
|
| Rate for Payer: Healthscope Whirlpool |
$532.28
|
| Rate for Payer: Meridian Medicaid |
$309.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$465.75
|
| Rate for Payer: PACE SWMI |
$443.57
|
| Rate for Payer: PHP Medicare Advantage |
$443.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$698.06
|
| Rate for Payer: Priority Health Medicare |
$443.57
|
| Rate for Payer: Priority Health Narrow Network |
$698.06
|
| Rate for Payer: UHC Medicare Advantage |
$456.88
|
|
|
PR EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 26170
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$764.40 |
| Rate for Payer: Aetna Commercial |
$540.37
|
| Rate for Payer: Aetna Medicare |
$403.26
|
| Rate for Payer: BCBS Complete |
$280.91
|
| Rate for Payer: BCBS MAPPO |
$403.26
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$606.94
|
| Rate for Payer: BCN Medicare Advantage |
$403.26
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$580.69
|
| Rate for Payer: Cofinity Commercial |
$540.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.26
|
| Rate for Payer: Healthscope Commercial |
$483.91
|
| Rate for Payer: Healthscope Whirlpool |
$483.91
|
| Rate for Payer: Meridian Medicaid |
$280.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$423.42
|
| Rate for Payer: PACE SWMI |
$403.26
|
| Rate for Payer: PHP Medicare Advantage |
$403.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$634.23
|
| Rate for Payer: Priority Health Medicare |
$403.26
|
| Rate for Payer: Priority Health Narrow Network |
$634.23
|
| Rate for Payer: UHC Medicare Advantage |
$415.36
|
|
|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS
|
Professional
|
Both
|
$2,033.00
|
|
|
Service Code
|
HCPCS 60280
|
| Min. Negotiated Rate |
$293.51 |
| Max. Negotiated Rate |
$3,383.23 |
| Rate for Payer: Aetna Commercial |
$597.28
|
| Rate for Payer: Aetna Medicare |
$445.73
|
| Rate for Payer: BCBS Complete |
$308.19
|
| Rate for Payer: BCBS MAPPO |
$445.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,383.23
|
| Rate for Payer: BCN Commercial |
$668.03
|
| Rate for Payer: BCN Medicare Advantage |
$445.73
|
| Rate for Payer: Cash Price |
$1,626.40
|
| Rate for Payer: Cash Price |
$1,626.40
|
| Rate for Payer: Cofinity Commercial |
$641.85
|
| Rate for Payer: Cofinity Commercial |
$597.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.73
|
| Rate for Payer: Healthscope Commercial |
$534.88
|
| Rate for Payer: Healthscope Whirlpool |
$534.88
|
| Rate for Payer: Meridian Medicaid |
$308.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$468.02
|
| Rate for Payer: PACE SWMI |
$445.73
|
| Rate for Payer: PHP Medicare Advantage |
$445.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.79
|
| Rate for Payer: Priority Health Medicare |
$445.73
|
| Rate for Payer: Priority Health Narrow Network |
$646.79
|
| Rate for Payer: UHC Medicare Advantage |
$459.10
|
|
|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT
|
Professional
|
Both
|
$2,154.00
|
|
|
Service Code
|
HCPCS 60281
|
| Min. Negotiated Rate |
$384.04 |
| Max. Negotiated Rate |
$3,474.63 |
| Rate for Payer: Aetna Commercial |
$787.22
|
| Rate for Payer: Aetna Medicare |
$587.48
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS MAPPO |
$587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,474.63
|
| Rate for Payer: BCN Commercial |
$876.69
|
| Rate for Payer: BCN Medicare Advantage |
$587.48
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cofinity Commercial |
$787.22
|
| Rate for Payer: Cofinity Commercial |
$845.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.48
|
| Rate for Payer: Healthscope Commercial |
$704.98
|
| Rate for Payer: Healthscope Whirlpool |
$704.98
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$616.85
|
| Rate for Payer: PACE SWMI |
$587.48
|
| Rate for Payer: PHP Medicare Advantage |
$587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,507.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$848.82
|
| Rate for Payer: Priority Health Medicare |
$587.48
|
| Rate for Payer: Priority Health Narrow Network |
$848.82
|
| Rate for Payer: UHC Medicare Advantage |
$605.10
|
|
|
PR EXCISION TONSIL TAGS
|
Professional
|
Both
|
$373.00
|
|
|
Service Code
|
HCPCS 42860
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$890.19 |
| Rate for Payer: Aetna Commercial |
$254.25
|
| Rate for Payer: Aetna Medicare |
$189.74
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$189.74
|
| Rate for Payer: BCBS Trust/PPO |
$890.19
|
| Rate for Payer: BCN Commercial |
$286.36
|
| Rate for Payer: BCN Medicare Advantage |
$189.74
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cofinity Commercial |
$273.23
|
| Rate for Payer: Cofinity Commercial |
$254.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.74
|
| Rate for Payer: Healthscope Commercial |
$227.69
|
| Rate for Payer: Healthscope Whirlpool |
$227.69
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.23
|
| Rate for Payer: PACE SWMI |
$189.74
|
| Rate for Payer: PHP Medicare Advantage |
$189.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.55
|
| Rate for Payer: Priority Health Medicare |
$189.74
|
| Rate for Payer: Priority Health Narrow Network |
$344.55
|
| Rate for Payer: UHC Medicare Advantage |
$195.43
|
|
|
PR EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL
|
Professional
|
Both
|
$3,871.00
|
|
|
Service Code
|
HCPCS 31785
|
| Min. Negotiated Rate |
$686.29 |
| Max. Negotiated Rate |
$2,709.70 |
| Rate for Payer: Aetna Commercial |
$1,422.93
|
| Rate for Payer: Aetna Medicare |
$1,061.89
|
| Rate for Payer: BCBS Complete |
$720.60
|
| Rate for Payer: BCBS MAPPO |
$1,061.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.22
|
| Rate for Payer: BCN Commercial |
$1,570.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,061.89
|
| Rate for Payer: Cash Price |
$3,096.80
|
| Rate for Payer: Cash Price |
$3,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,422.93
|
| Rate for Payer: Cofinity Commercial |
$1,529.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,061.89
|
| Rate for Payer: Healthscope Commercial |
$1,274.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,274.27
|
| Rate for Payer: Meridian Medicaid |
$720.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,114.98
|
| Rate for Payer: PACE SWMI |
$1,061.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,061.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,487.77
|
| Rate for Payer: Priority Health Medicare |
$1,061.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,487.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,093.75
|
|
|
PR EXCISION TROCHANTERIC BURSA/CALCIFICATION
|
Professional
|
Both
|
$1,645.00
|
|
|
Service Code
|
HCPCS 27062
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$4,466.25 |
| Rate for Payer: Aetna Commercial |
$601.34
|
| Rate for Payer: Aetna Medicare |
$448.76
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCBS MAPPO |
$448.76
|
| Rate for Payer: BCBS Trust/PPO |
$4,466.25
|
| Rate for Payer: BCN Commercial |
$672.91
|
| Rate for Payer: BCN Medicare Advantage |
$448.76
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cofinity Commercial |
$646.21
|
| Rate for Payer: Cofinity Commercial |
$601.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$448.76
|
| Rate for Payer: Healthscope Commercial |
$538.51
|
| Rate for Payer: Healthscope Whirlpool |
$538.51
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$471.20
|
| Rate for Payer: PACE SWMI |
$448.76
|
| Rate for Payer: PHP Medicare Advantage |
$448.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,151.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.17
|
| Rate for Payer: Priority Health Medicare |
$448.76
|
| Rate for Payer: Priority Health Narrow Network |
$703.17
|
| Rate for Payer: UHC Medicare Advantage |
$462.22
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Facility
|
IP
|
$730.00
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
21931
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$511.00 |
| Max. Negotiated Rate |
$730.00 |
| Rate for Payer: Aetna Commercial |
$657.00
|
| Rate for Payer: ASR ASR |
$708.10
|
| Rate for Payer: BCBS Trust/PPO |
$565.97
|
| Rate for Payer: BCN Commercial |
$565.97
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cofinity Commercial |
$686.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$584.00
|
| Rate for Payer: Healthscope Commercial |
$730.00
|
| Rate for Payer: Healthscope Whirlpool |
$708.10
|
| Rate for Payer: Mclaren Commercial |
$657.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$620.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$642.40
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Professional
|
Both
|
$730.00
|
|
|
Service Code
|
HCPCS 21931
|
| Hospital Charge Code |
21931
|
| Min. Negotiated Rate |
$303.31 |
| Max. Negotiated Rate |
$9,087.30 |
| Rate for Payer: Aetna Commercial |
$623.49
|
| Rate for Payer: Aetna Medicare |
$465.29
|
| Rate for Payer: BCBS Complete |
$318.48
|
| Rate for Payer: BCBS MAPPO |
$465.29
|
| Rate for Payer: BCBS Trust/PPO |
$9,087.30
|
| Rate for Payer: BCN Commercial |
$689.52
|
| Rate for Payer: BCN Medicare Advantage |
$465.29
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cofinity Commercial |
$623.49
|
| Rate for Payer: Cofinity Commercial |
$670.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.29
|
| Rate for Payer: Healthscope Commercial |
$558.35
|
| Rate for Payer: Healthscope Whirlpool |
$558.35
|
| Rate for Payer: Meridian Medicaid |
$318.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$488.55
|
| Rate for Payer: PACE SWMI |
$465.29
|
| Rate for Payer: PHP Medicare Advantage |
$465.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$720.53
|
| Rate for Payer: Priority Health Medicare |
$465.29
|
| Rate for Payer: Priority Health Narrow Network |
$720.53
|
| Rate for Payer: UHC Medicare Advantage |
$479.25
|
|
