|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 46601
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$375.62 |
| Rate for Payer: Aetna Commercial |
$126.71
|
| Rate for Payer: Aetna Medicare |
$136.00
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS Trust/PPO |
$375.62
|
| Rate for Payer: BCN Commercial |
$218.93
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Meridian Medicaid |
$62.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.06
|
| Rate for Payer: Priority Health Narrow Network |
$167.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.19
|
| Rate for Payer: UHC Exchange |
$123.19
|
| Rate for Payer: UHCCP Medicaid |
$59.85
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
HCPCS 46607
|
| Min. Negotiated Rate |
$79.02 |
| Max. Negotiated Rate |
$1,451.24 |
| Rate for Payer: Aetna Commercial |
$170.74
|
| Rate for Payer: Aetna Medicare |
$144.00
|
| Rate for Payer: BCBS Complete |
$82.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,451.24
|
| Rate for Payer: BCN Commercial |
$302.98
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Meridian Medicaid |
$82.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.93
|
| Rate for Payer: Priority Health Narrow Network |
$221.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$166.43
|
| Rate for Payer: UHC Exchange |
$166.43
|
| Rate for Payer: UHCCP Medicaid |
$79.02
|
|
|
PR ANOSCOPY W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 46606
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$3,172.97 |
| Rate for Payer: Aetna Commercial |
$100.54
|
| Rate for Payer: Aetna Medicare |
$183.50
|
| Rate for Payer: BCBS Complete |
$50.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,172.97
|
| Rate for Payer: BCN Commercial |
$414.40
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Meridian Medicaid |
$50.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.83
|
| Rate for Payer: Priority Health Narrow Network |
$134.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.84
|
| Rate for Payer: UHC Exchange |
$90.84
|
| Rate for Payer: UHCCP Medicaid |
$48.56
|
|
|
PR ANOSCOPY W/DILATION
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
HCPCS 46604
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$2,787.84 |
| Rate for Payer: Aetna Commercial |
$86.80
|
| Rate for Payer: Aetna Medicare |
$503.00
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,787.84
|
| Rate for Payer: BCN Commercial |
$967.58
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.13
|
| Rate for Payer: Priority Health Narrow Network |
$118.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.18
|
| Rate for Payer: UHC Exchange |
$79.18
|
| Rate for Payer: UHCCP Medicaid |
$42.17
|
|
|
PR ANOSCOPY W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 46608
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$432.96 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: Aetna Medicare |
$178.00
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$432.96
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.53
|
| Rate for Payer: Priority Health Narrow Network |
$151.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.84
|
| Rate for Payer: UHC Exchange |
$96.84
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
|
|
PR ANOSCOPY W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 46610
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$410.00 |
| Rate for Payer: Aetna Commercial |
$106.52
|
| Rate for Payer: Aetna Medicare |
$287.00
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$410.00
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.18
|
| Rate for Payer: Priority Health Narrow Network |
$143.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.25
|
| Rate for Payer: UHC Exchange |
$97.25
|
| Rate for Payer: UHCCP Medicaid |
$51.55
|
|
|
PR ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 46611
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$2,682.71 |
| Rate for Payer: Aetna Commercial |
$106.48
|
| Rate for Payer: Aetna Medicare |
$287.00
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,682.71
|
| Rate for Payer: BCN Commercial |
$329.36
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.77
|
| Rate for Payer: Priority Health Narrow Network |
$143.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.11
|
| Rate for Payer: UHC Exchange |
$98.11
|
| Rate for Payer: UHCCP Medicaid |
$51.55
|
|
|
PR ANOSC RMVL MULT TUMORS CAUTERY/SNARE
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 46612
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$494.54 |
| Rate for Payer: Aetna Commercial |
$127.63
|
| Rate for Payer: Aetna Medicare |
$335.00
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS Trust/PPO |
$316.98
|
| Rate for Payer: BCN Commercial |
$494.54
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.62
|
| Rate for Payer: Priority Health Narrow Network |
$170.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.65
|
| Rate for Payer: UHC Exchange |
$115.65
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Facility
|
OP
|
$322.00
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$209.30 |
| Max. Negotiated Rate |
$4,164.76 |
| Rate for Payer: Aetna Commercial |
$289.80
|
| Rate for Payer: Aetna Medicare |
$2,686.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: ASR ASR |
$312.34
|
| Rate for Payer: ASR Commercial |
$312.34
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$263.69
|
| Rate for Payer: BCN Commercial |
$249.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$302.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$322.00
|
| Rate for Payer: Healthscope Whirlpool |
$312.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,686.94
|
| Rate for Payer: Mclaren Commercial |
$289.80
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.70
|
| Rate for Payer: Nomi Health Commercial |
$264.04
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$2,955.63
|
| Rate for Payer: PHP Medicaid |
$1,440.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.14
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$225.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$4,164.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP DNSP |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 45990
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$1,244.67 |
| Rate for Payer: Aetna Commercial |
$140.68
|
| Rate for Payer: Aetna Medicare |
$161.00
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.67
|
| Rate for Payer: BCN Commercial |
$151.98
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.53
|
| Rate for Payer: Priority Health Narrow Network |
$188.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.80
|
| Rate for Payer: UHC Exchange |
$130.80
|
| Rate for Payer: UHCCP Medicaid |
$68.16
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$1,244.67 |
| Rate for Payer: Aetna Commercial |
$140.68
|
| Rate for Payer: Aetna Medicare |
$161.00
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.67
|
| Rate for Payer: BCN Commercial |
$151.98
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.53
|
| Rate for Payer: Priority Health Narrow Network |
$188.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.80
|
| Rate for Payer: UHC Exchange |
$130.80
|
| Rate for Payer: UHCCP Medicaid |
$68.16
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Facility
|
IP
|
$322.00
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$209.30 |
| Max. Negotiated Rate |
$322.00 |
| Rate for Payer: Aetna Commercial |
$289.80
|
| Rate for Payer: ASR ASR |
$312.34
|
| Rate for Payer: ASR Commercial |
$312.34
|
| Rate for Payer: BCBS Trust/PPO |
$262.40
|
| Rate for Payer: BCN Commercial |
$249.65
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$302.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Healthscope Commercial |
$322.00
|
| Rate for Payer: Healthscope Whirlpool |
$312.34
|
| Rate for Payer: Mclaren Commercial |
$289.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.70
|
| Rate for Payer: Nomi Health Commercial |
$264.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.36
|
|
|
PR ANTEPARTUM CARE ONLY 4-6 VISITS
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 59425
|
| Min. Negotiated Rate |
$94.57 |
| Max. Negotiated Rate |
$973.77 |
| Rate for Payer: Aetna Commercial |
$479.68
|
| Rate for Payer: Aetna Medicare |
$578.00
|
| Rate for Payer: BCBS Complete |
$423.03
|
| Rate for Payer: BCBS Trust/PPO |
$94.57
|
| Rate for Payer: BCN Commercial |
$973.77
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Meridian Medicaid |
$423.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.42
|
| Rate for Payer: Priority Health Narrow Network |
$606.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$418.65
|
| Rate for Payer: UHC Exchange |
$418.65
|
| Rate for Payer: UHCCP Medicaid |
$402.89
|
|
|
PR ANTEPARTUM CARE ONLY 7/> VISITS
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 59426
|
| Min. Negotiated Rate |
$55.47 |
| Max. Negotiated Rate |
$1,391.08 |
| Rate for Payer: Aetna Commercial |
$878.78
|
| Rate for Payer: Aetna Medicare |
$794.50
|
| Rate for Payer: BCBS Complete |
$777.43
|
| Rate for Payer: BCBS Trust/PPO |
$55.47
|
| Rate for Payer: BCN Commercial |
$1,391.08
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Meridian Medicaid |
$777.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,113.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$741.87
|
| Rate for Payer: UHC Exchange |
$741.87
|
| Rate for Payer: UHCCP Medicaid |
$740.41
|
|
|
PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 57240
|
| Min. Negotiated Rate |
$394.05 |
| Max. Negotiated Rate |
$2,162.33 |
| Rate for Payer: Aetna Commercial |
$727.57
|
| Rate for Payer: Aetna Medicare |
$776.50
|
| Rate for Payer: BCBS Complete |
$413.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,162.33
|
| Rate for Payer: BCN Commercial |
$899.66
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Meridian Medicaid |
$413.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,009.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$918.18
|
| Rate for Payer: Priority Health Narrow Network |
$918.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.47
|
| Rate for Payer: UHC Exchange |
$765.47
|
| Rate for Payer: UHCCP Medicaid |
$394.05
|
|
|
PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,881.00
|
|
|
Service Code
|
HCPCS 22845
|
| Min. Negotiated Rate |
$92.54 |
| Max. Negotiated Rate |
$2,522.65 |
| Rate for Payer: Aetna Commercial |
$979.87
|
| Rate for Payer: Aetna Medicare |
$1,940.50
|
| Rate for Payer: BCBS Complete |
$487.56
|
| Rate for Payer: BCBS Trust/PPO |
$92.54
|
| Rate for Payer: BCN Commercial |
$1,164.39
|
| Rate for Payer: Cash Price |
$3,104.80
|
| Rate for Payer: Cash Price |
$3,104.80
|
| Rate for Payer: Meridian Medicaid |
$487.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,522.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,105.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,105.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$884.52
|
| Rate for Payer: UHC Exchange |
$884.52
|
| Rate for Payer: UHCCP Medicaid |
$464.34
|
|
|
PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$4,270.00
|
|
|
Service Code
|
HCPCS 22846
|
| Min. Negotiated Rate |
$62.83 |
| Max. Negotiated Rate |
$2,775.50 |
| Rate for Payer: Aetna Commercial |
$1,018.33
|
| Rate for Payer: Aetna Medicare |
$2,135.00
|
| Rate for Payer: BCBS Complete |
$507.91
|
| Rate for Payer: BCBS Trust/PPO |
$62.83
|
| Rate for Payer: BCN Commercial |
$1,211.74
|
| Rate for Payer: Cash Price |
$3,416.00
|
| Rate for Payer: Cash Price |
$3,416.00
|
| Rate for Payer: Meridian Medicaid |
$507.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,775.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,150.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$917.65
|
| Rate for Payer: UHC Exchange |
$917.65
|
| Rate for Payer: UHCCP Medicaid |
$483.72
|
|
|
PR ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,779.00
|
|
|
Service Code
|
HCPCS 22847
|
| Min. Negotiated Rate |
$111.22 |
| Max. Negotiated Rate |
$2,456.35 |
| Rate for Payer: Aetna Commercial |
$1,078.87
|
| Rate for Payer: Aetna Medicare |
$1,889.50
|
| Rate for Payer: BCBS Complete |
$533.85
|
| Rate for Payer: BCBS Trust/PPO |
$111.22
|
| Rate for Payer: BCN Commercial |
$1,158.16
|
| Rate for Payer: Cash Price |
$3,023.20
|
| Rate for Payer: Cash Price |
$3,023.20
|
| Rate for Payer: Meridian Medicaid |
$533.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,456.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,207.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,207.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,046.36
|
| Rate for Payer: UHC Exchange |
$1,046.36
|
| Rate for Payer: UHCCP Medicaid |
$508.43
|
|
|
PR ANTERIOR TIBIAL TUBERCLEPLASTY
|
Professional
|
Both
|
$2,577.00
|
|
|
Service Code
|
HCPCS 27418
|
| Min. Negotiated Rate |
$532.07 |
| Max. Negotiated Rate |
$1,675.05 |
| Rate for Payer: Aetna Commercial |
$1,109.69
|
| Rate for Payer: Aetna Medicare |
$1,288.50
|
| Rate for Payer: BCBS Complete |
$558.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,136.90
|
| Rate for Payer: BCN Commercial |
$1,343.56
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Meridian Medicaid |
$558.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$532.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,675.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,268.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,268.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$954.20
|
| Rate for Payer: UHC Exchange |
$954.20
|
| Rate for Payer: UHCCP Medicaid |
$532.07
|
|
|
PR ANTICOAG MGMT, EACH SUBSEQ 90 DAYS
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 99364
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$61.10 |
| Rate for Payer: Aetna Medicare |
$47.00
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
|
|
PR ANTICOAG MGMT, INITIAL 90 DAYS
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 99363
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$134.55 |
| Rate for Payer: Aetna Medicare |
$103.50
|
| Rate for Payer: BCBS Complete |
$82.80
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.55
|
|
|
PR ANTICOAGULANT MGMT FOR PT TAKING WARFARIN
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 93793
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$39.09 |
| Rate for Payer: Aetna Commercial |
$12.40
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.09
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.01
|
| Rate for Payer: Priority Health Narrow Network |
$16.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.98
|
| Rate for Payer: UHC Exchange |
$12.98
|
|
|
PR ANT VESICOURETHROPEXY/URETHROPEXY SMPL
|
Professional
|
Both
|
$2,459.00
|
|
|
Service Code
|
HCPCS 51840
|
| Min. Negotiated Rate |
$445.17 |
| Max. Negotiated Rate |
$5,391.30 |
| Rate for Payer: Aetna Commercial |
$888.00
|
| Rate for Payer: Aetna Medicare |
$1,229.50
|
| Rate for Payer: BCBS Complete |
$467.43
|
| Rate for Payer: BCBS Trust/PPO |
$5,391.30
|
| Rate for Payer: BCN Commercial |
$1,010.58
|
| Rate for Payer: Cash Price |
$1,967.20
|
| Rate for Payer: Cash Price |
$1,967.20
|
| Rate for Payer: Meridian Medicaid |
$467.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,111.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$776.16
|
| Rate for Payer: UHC Exchange |
$776.16
|
| Rate for Payer: UHCCP Medicaid |
$445.17
|
|
|
PR AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS
|
Professional
|
Both
|
$1,940.00
|
|
|
Service Code
|
HCPCS 33866
|
| Min. Negotiated Rate |
$573.21 |
| Max. Negotiated Rate |
$1,429.55 |
| Rate for Payer: Aetna Commercial |
$1,243.44
|
| Rate for Payer: Aetna Medicare |
$970.00
|
| Rate for Payer: BCBS Complete |
$603.40
|
| Rate for Payer: BCBS Trust/PPO |
$573.21
|
| Rate for Payer: BCN Commercial |
$1,314.55
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Cash Price |
$1,552.00
|
| Rate for Payer: Meridian Medicaid |
$603.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,429.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,429.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,380.75
|
| Rate for Payer: UHC Exchange |
$1,380.75
|
| Rate for Payer: UHCCP Medicaid |
$574.67
|
|
|
PR AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX
|
Professional
|
Both
|
$1,864.00
|
|
|
Service Code
|
HCPCS 33800
|
| Min. Negotiated Rate |
$623.66 |
| Max. Negotiated Rate |
$1,550.79 |
| Rate for Payer: Aetna Commercial |
$1,324.10
|
| Rate for Payer: Aetna Medicare |
$932.00
|
| Rate for Payer: BCBS Complete |
$654.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,416.90
|
| Rate for Payer: BCN Commercial |
$1,417.16
|
| Rate for Payer: Cash Price |
$1,491.20
|
| Rate for Payer: Cash Price |
$1,491.20
|
| Rate for Payer: Meridian Medicaid |
$654.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,550.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,279.26
|
| Rate for Payer: UHC Exchange |
$1,279.26
|
| Rate for Payer: UHCCP Medicaid |
$623.66
|
|
