|
PR GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 94727
|
| Min. Negotiated Rate |
$41.03 |
| Max. Negotiated Rate |
$251.47 |
| Rate for Payer: Aetna Commercial |
$54.98
|
| Rate for Payer: Aetna Medicare |
$41.03
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: BCBS MAPPO |
$41.03
|
| Rate for Payer: BCBS Trust/PPO |
$251.47
|
| Rate for Payer: BCN Commercial |
$63.53
|
| Rate for Payer: BCN Medicare Advantage |
$41.03
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$54.98
|
| Rate for Payer: Cofinity Commercial |
$59.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.03
|
| Rate for Payer: Healthscope Commercial |
$49.24
|
| Rate for Payer: Healthscope Whirlpool |
$49.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.08
|
| Rate for Payer: PACE SWMI |
$41.03
|
| Rate for Payer: PHP Medicare Advantage |
$41.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.38
|
| Rate for Payer: Priority Health Medicare |
$41.03
|
| Rate for Payer: Priority Health Narrow Network |
$58.38
|
| Rate for Payer: UHC Medicare Advantage |
$42.26
|
|
|
PR GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 43753
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$192.83 |
| Rate for Payer: Aetna Commercial |
$28.89
|
| Rate for Payer: Aetna Medicare |
$21.56
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$21.56
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$31.27
|
| Rate for Payer: BCN Medicare Advantage |
$21.56
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$31.05
|
| Rate for Payer: Cofinity Commercial |
$28.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.56
|
| Rate for Payer: Healthscope Commercial |
$25.87
|
| Rate for Payer: Healthscope Whirlpool |
$25.87
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.64
|
| Rate for Payer: PACE SWMI |
$21.56
|
| Rate for Payer: PHP Medicare Advantage |
$21.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.63
|
| Rate for Payer: Priority Health Medicare |
$21.56
|
| Rate for Payer: Priority Health Narrow Network |
$37.63
|
| Rate for Payer: UHC Medicare Advantage |
$22.21
|
|
|
PR GASTROCNEMIUS RECESSION
|
Professional
|
Both
|
$1,488.00
|
|
|
Service Code
|
HCPCS 27687
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$2,402.71 |
| Rate for Payer: Aetna Commercial |
$596.57
|
| Rate for Payer: Aetna Medicare |
$445.20
|
| Rate for Payer: BCBS Complete |
$308.86
|
| Rate for Payer: BCBS MAPPO |
$445.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,402.71
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: BCN Medicare Advantage |
$445.20
|
| Rate for Payer: Cash Price |
$1,190.40
|
| Rate for Payer: Cash Price |
$1,190.40
|
| Rate for Payer: Cofinity Commercial |
$596.57
|
| Rate for Payer: Cofinity Commercial |
$641.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.20
|
| Rate for Payer: Healthscope Commercial |
$534.24
|
| Rate for Payer: Healthscope Whirlpool |
$534.24
|
| Rate for Payer: Meridian Medicaid |
$308.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$467.46
|
| Rate for Payer: PACE SWMI |
$445.20
|
| Rate for Payer: PHP Medicare Advantage |
$445.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,041.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.01
|
| Rate for Payer: Priority Health Medicare |
$445.20
|
| Rate for Payer: Priority Health Narrow Network |
$696.01
|
| Rate for Payer: UHC Medicare Advantage |
$458.56
|
|
|
PR GASTRODUODENOSTOMY
|
Professional
|
Both
|
$2,437.00
|
|
|
Service Code
|
HCPCS 43810
|
| Min. Negotiated Rate |
$486.56 |
| Max. Negotiated Rate |
$1,786.85 |
| Rate for Payer: Aetna Commercial |
$1,356.99
|
| Rate for Payer: Aetna Medicare |
$1,012.68
|
| Rate for Payer: BCBS Complete |
$683.48
|
| Rate for Payer: BCBS MAPPO |
$1,012.68
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,485.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.68
|
| Rate for Payer: Cash Price |
$1,949.60
|
| Rate for Payer: Cash Price |
$1,949.60
|
| Rate for Payer: Cofinity Commercial |
$1,458.26
|
| Rate for Payer: Cofinity Commercial |
$1,356.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.68
|
| Rate for Payer: Healthscope Commercial |
$1,215.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,215.22
|
| Rate for Payer: Meridian Medicaid |
$683.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,063.31
|
| Rate for Payer: PACE SWMI |
$1,012.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,705.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,786.85
|
| Rate for Payer: Priority Health Medicare |
$1,012.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,786.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,043.06
|
|
|
PR GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 91034
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,518.86 |
| Rate for Payer: Aetna Commercial |
$243.21
|
| Rate for Payer: Aetna Commercial |
$243.21
|
| Rate for Payer: Aetna Medicare |
$181.50
|
| Rate for Payer: Aetna Medicare |
$181.50
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS Complete |
$134.40
|
| Rate for Payer: BCBS MAPPO |
$181.50
|
| Rate for Payer: BCBS MAPPO |
$181.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.86
|
| Rate for Payer: BCN Commercial |
$281.97
|
| Rate for Payer: BCN Commercial |
$281.97
|
| Rate for Payer: BCN Medicare Advantage |
$181.50
|
| Rate for Payer: BCN Medicare Advantage |
$181.50
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$261.36
|
| Rate for Payer: Cofinity Commercial |
$243.21
|
| Rate for Payer: Cofinity Commercial |
$243.21
|
| Rate for Payer: Cofinity Commercial |
$261.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.50
|
| Rate for Payer: Healthscope Commercial |
$217.80
|
| Rate for Payer: Healthscope Commercial |
$217.80
|
| Rate for Payer: Healthscope Whirlpool |
$217.80
|
| Rate for Payer: Healthscope Whirlpool |
$217.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$190.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$190.58
|
| Rate for Payer: PACE SWMI |
$181.50
|
| Rate for Payer: PACE SWMI |
$181.50
|
| Rate for Payer: PHP Medicare Advantage |
$181.50
|
| Rate for Payer: PHP Medicare Advantage |
$181.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.16
|
| Rate for Payer: Priority Health Medicare |
$181.50
|
| Rate for Payer: Priority Health Medicare |
$181.50
|
| Rate for Payer: Priority Health Narrow Network |
$259.16
|
| Rate for Payer: Priority Health Narrow Network |
$259.16
|
| Rate for Payer: UHC Medicare Advantage |
$186.94
|
| Rate for Payer: UHC Medicare Advantage |
$186.94
|
|
|
PR GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 91037
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$963.09 |
| Rate for Payer: Aetna Commercial |
$213.27
|
| Rate for Payer: Aetna Commercial |
$213.27
|
| Rate for Payer: Aetna Medicare |
$159.16
|
| Rate for Payer: Aetna Medicare |
$159.16
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS MAPPO |
$159.16
|
| Rate for Payer: BCBS MAPPO |
$159.16
|
| Rate for Payer: BCBS Trust/PPO |
$963.09
|
| Rate for Payer: BCBS Trust/PPO |
$963.09
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Medicare Advantage |
$159.16
|
| Rate for Payer: BCN Medicare Advantage |
$159.16
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$213.27
|
| Rate for Payer: Cofinity Commercial |
$229.19
|
| Rate for Payer: Cofinity Commercial |
$213.27
|
| Rate for Payer: Cofinity Commercial |
$229.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.16
|
| Rate for Payer: Healthscope Commercial |
$190.99
|
| Rate for Payer: Healthscope Commercial |
$190.99
|
| Rate for Payer: Healthscope Whirlpool |
$190.99
|
| Rate for Payer: Healthscope Whirlpool |
$190.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.12
|
| Rate for Payer: PACE SWMI |
$159.16
|
| Rate for Payer: PACE SWMI |
$159.16
|
| Rate for Payer: PHP Medicare Advantage |
$159.16
|
| Rate for Payer: PHP Medicare Advantage |
$159.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.82
|
| Rate for Payer: Priority Health Medicare |
$159.16
|
| Rate for Payer: Priority Health Medicare |
$159.16
|
| Rate for Payer: Priority Health Narrow Network |
$226.82
|
| Rate for Payer: Priority Health Narrow Network |
$226.82
|
| Rate for Payer: UHC Medicare Advantage |
$163.93
|
| Rate for Payer: UHC Medicare Advantage |
$163.93
|
|
|
PR GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD
|
Professional
|
Both
|
$858.00
|
|
|
Service Code
|
HCPCS 91035
|
| Min. Negotiated Rate |
$343.20 |
| Max. Negotiated Rate |
$976.30 |
| Rate for Payer: Aetna Commercial |
$580.76
|
| Rate for Payer: Aetna Commercial |
$580.76
|
| Rate for Payer: Aetna Medicare |
$433.40
|
| Rate for Payer: Aetna Medicare |
$433.40
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: BCBS Complete |
$343.20
|
| Rate for Payer: BCBS MAPPO |
$433.40
|
| Rate for Payer: BCBS MAPPO |
$433.40
|
| Rate for Payer: BCBS Trust/PPO |
$976.30
|
| Rate for Payer: BCBS Trust/PPO |
$976.30
|
| Rate for Payer: BCN Commercial |
$677.30
|
| Rate for Payer: BCN Commercial |
$677.30
|
| Rate for Payer: BCN Medicare Advantage |
$433.40
|
| Rate for Payer: BCN Medicare Advantage |
$433.40
|
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Cofinity Commercial |
$624.10
|
| Rate for Payer: Cofinity Commercial |
$580.76
|
| Rate for Payer: Cofinity Commercial |
$624.10
|
| Rate for Payer: Cofinity Commercial |
$580.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.40
|
| Rate for Payer: Healthscope Commercial |
$520.08
|
| Rate for Payer: Healthscope Commercial |
$520.08
|
| Rate for Payer: Healthscope Whirlpool |
$520.08
|
| Rate for Payer: Healthscope Whirlpool |
$520.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$455.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$455.07
|
| Rate for Payer: PACE SWMI |
$433.40
|
| Rate for Payer: PACE SWMI |
$433.40
|
| Rate for Payer: PHP Medicare Advantage |
$433.40
|
| Rate for Payer: PHP Medicare Advantage |
$433.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.52
|
| Rate for Payer: Priority Health Medicare |
$433.40
|
| Rate for Payer: Priority Health Medicare |
$433.40
|
| Rate for Payer: Priority Health Narrow Network |
$622.52
|
| Rate for Payer: Priority Health Narrow Network |
$622.52
|
| Rate for Payer: UHC Medicare Advantage |
$446.40
|
| Rate for Payer: UHC Medicare Advantage |
$446.40
|
|
|
PR GASTROJEJUNOSTOMY W/O VAGOTOMY
|
Professional
|
Both
|
$2,570.00
|
|
|
Service Code
|
HCPCS 43820
|
| Min. Negotiated Rate |
$860.09 |
| Max. Negotiated Rate |
$2,359.53 |
| Rate for Payer: Aetna Commercial |
$1,791.81
|
| Rate for Payer: Aetna Medicare |
$1,337.17
|
| Rate for Payer: BCBS Complete |
$903.09
|
| Rate for Payer: BCBS MAPPO |
$1,337.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,050.26
|
| Rate for Payer: BCN Commercial |
$1,961.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,337.17
|
| Rate for Payer: Cash Price |
$2,056.00
|
| Rate for Payer: Cash Price |
$2,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,925.52
|
| Rate for Payer: Cofinity Commercial |
$1,791.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,337.17
|
| Rate for Payer: Healthscope Commercial |
$1,604.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,604.60
|
| Rate for Payer: Meridian Medicaid |
$903.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,404.03
|
| Rate for Payer: PACE SWMI |
$1,337.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,337.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,359.53
|
| Rate for Payer: Priority Health Medicare |
$1,337.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,359.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,377.29
|
|
|
PR GASTROJEJUNOSTOMY W/VAGOTOMY ANY TYPE
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 43825
|
| Min. Negotiated Rate |
$669.36 |
| Max. Negotiated Rate |
$2,304.27 |
| Rate for Payer: Aetna Commercial |
$1,750.04
|
| Rate for Payer: Aetna Medicare |
$1,306.00
|
| Rate for Payer: BCBS Complete |
$880.96
|
| Rate for Payer: BCBS MAPPO |
$1,306.00
|
| Rate for Payer: BCBS Trust/PPO |
$669.36
|
| Rate for Payer: BCN Commercial |
$1,915.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cofinity Commercial |
$1,880.64
|
| Rate for Payer: Cofinity Commercial |
$1,750.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.00
|
| Rate for Payer: Healthscope Commercial |
$1,567.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,567.20
|
| Rate for Payer: Meridian Medicaid |
$880.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,371.30
|
| Rate for Payer: PACE SWMI |
$1,306.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,304.27
|
| Rate for Payer: Priority Health Medicare |
$1,306.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,304.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,345.18
|
|
|
PR GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ
|
Professional
|
Both
|
$2,766.00
|
|
|
Service Code
|
HCPCS 43840
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$2,387.17 |
| Rate for Payer: Aetna Commercial |
$1,813.14
|
| Rate for Payer: Aetna Medicare |
$1,353.09
|
| Rate for Payer: BCBS Complete |
$912.49
|
| Rate for Payer: BCBS MAPPO |
$1,353.09
|
| Rate for Payer: BCBS Trust/PPO |
$75.56
|
| Rate for Payer: BCN Commercial |
$1,984.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,353.09
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cofinity Commercial |
$1,813.14
|
| Rate for Payer: Cofinity Commercial |
$1,948.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.09
|
| Rate for Payer: Healthscope Commercial |
$1,623.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,623.71
|
| Rate for Payer: Meridian Medicaid |
$912.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,420.74
|
| Rate for Payer: PACE SWMI |
$1,353.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,353.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$869.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,936.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,387.17
|
| Rate for Payer: Priority Health Medicare |
$1,353.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,387.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,393.68
|
|
|
PR GASTROSTOMY OPN NEONATAL FEEDING
|
Professional
|
Both
|
$2,090.00
|
|
|
Service Code
|
HCPCS 43831
|
| Min. Negotiated Rate |
$392.99 |
| Max. Negotiated Rate |
$1,463.00 |
| Rate for Payer: Aetna Commercial |
$808.53
|
| Rate for Payer: Aetna Medicare |
$603.38
|
| Rate for Payer: BCBS Complete |
$412.64
|
| Rate for Payer: BCBS MAPPO |
$603.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,286.41
|
| Rate for Payer: BCN Commercial |
$895.74
|
| Rate for Payer: BCN Medicare Advantage |
$603.38
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cofinity Commercial |
$868.87
|
| Rate for Payer: Cofinity Commercial |
$808.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.38
|
| Rate for Payer: Healthscope Commercial |
$724.06
|
| Rate for Payer: Healthscope Whirlpool |
$724.06
|
| Rate for Payer: Meridian Medicaid |
$412.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$633.55
|
| Rate for Payer: PACE SWMI |
$603.38
|
| Rate for Payer: PHP Medicare Advantage |
$603.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,077.75
|
| Rate for Payer: Priority Health Medicare |
$603.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.75
|
| Rate for Payer: UHC Medicare Advantage |
$621.48
|
|
|
PR GASTROSTOMY OPN W/CONSTJ GSTR TUBE
|
Professional
|
Both
|
$2,876.00
|
|
|
Service Code
|
HCPCS 43832
|
| Min. Negotiated Rate |
$670.10 |
| Max. Negotiated Rate |
$2,013.20 |
| Rate for Payer: Aetna Commercial |
$1,390.83
|
| Rate for Payer: Aetna Medicare |
$1,037.93
|
| Rate for Payer: BCBS Complete |
$703.60
|
| Rate for Payer: BCBS MAPPO |
$1,037.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.84
|
| Rate for Payer: BCN Commercial |
$1,523.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.93
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$1,390.83
|
| Rate for Payer: Cofinity Commercial |
$1,494.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.93
|
| Rate for Payer: Healthscope Commercial |
$1,245.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,245.52
|
| Rate for Payer: Meridian Medicaid |
$703.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,089.83
|
| Rate for Payer: PACE SWMI |
$1,037.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$670.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,832.70
|
| Rate for Payer: Priority Health Medicare |
$1,037.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,832.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.07
|
|
|
PR GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX
|
Professional
|
Both
|
$2,090.00
|
|
|
Service Code
|
HCPCS 43830
|
| Min. Negotiated Rate |
$281.06 |
| Max. Negotiated Rate |
$1,463.00 |
| Rate for Payer: Aetna Commercial |
$935.51
|
| Rate for Payer: Aetna Medicare |
$698.14
|
| Rate for Payer: BCBS Complete |
$473.92
|
| Rate for Payer: BCBS MAPPO |
$698.14
|
| Rate for Payer: BCBS Trust/PPO |
$281.06
|
| Rate for Payer: BCN Commercial |
$1,030.14
|
| Rate for Payer: BCN Medicare Advantage |
$698.14
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cofinity Commercial |
$935.51
|
| Rate for Payer: Cofinity Commercial |
$1,005.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.14
|
| Rate for Payer: Healthscope Commercial |
$837.77
|
| Rate for Payer: Healthscope Whirlpool |
$837.77
|
| Rate for Payer: Meridian Medicaid |
$473.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$733.05
|
| Rate for Payer: PACE SWMI |
$698.14
|
| Rate for Payer: PHP Medicare Advantage |
$698.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.44
|
| Rate for Payer: Priority Health Medicare |
$698.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.44
|
| Rate for Payer: UHC Medicare Advantage |
$719.08
|
|
|
PR GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$2,212.00
|
|
|
Service Code
|
HCPCS 43500
|
| Min. Negotiated Rate |
$504.38 |
| Max. Negotiated Rate |
$1,939.39 |
| Rate for Payer: Aetna Commercial |
$1,043.34
|
| Rate for Payer: Aetna Medicare |
$778.61
|
| Rate for Payer: BCBS Complete |
$529.60
|
| Rate for Payer: BCBS MAPPO |
$778.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,939.39
|
| Rate for Payer: BCN Commercial |
$1,144.97
|
| Rate for Payer: BCN Medicare Advantage |
$778.61
|
| Rate for Payer: Cash Price |
$1,769.60
|
| Rate for Payer: Cash Price |
$1,769.60
|
| Rate for Payer: Cofinity Commercial |
$1,121.20
|
| Rate for Payer: Cofinity Commercial |
$1,043.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.61
|
| Rate for Payer: Healthscope Commercial |
$934.33
|
| Rate for Payer: Healthscope Whirlpool |
$934.33
|
| Rate for Payer: Meridian Medicaid |
$529.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$817.54
|
| Rate for Payer: PACE SWMI |
$778.61
|
| Rate for Payer: PHP Medicare Advantage |
$778.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,548.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,377.63
|
| Rate for Payer: Priority Health Medicare |
$778.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,377.63
|
| Rate for Payer: UHC Medicare Advantage |
$801.97
|
|
|
PR GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER
|
Professional
|
Both
|
$3,898.00
|
|
|
Service Code
|
HCPCS 43501
|
| Min. Negotiated Rate |
$864.35 |
| Max. Negotiated Rate |
$2,728.60 |
| Rate for Payer: Aetna Commercial |
$1,795.81
|
| Rate for Payer: Aetna Medicare |
$1,340.16
|
| Rate for Payer: BCBS Complete |
$907.57
|
| Rate for Payer: BCBS MAPPO |
$1,340.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.41
|
| Rate for Payer: BCN Commercial |
$1,964.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,340.16
|
| Rate for Payer: Cash Price |
$3,118.40
|
| Rate for Payer: Cash Price |
$3,118.40
|
| Rate for Payer: Cofinity Commercial |
$1,795.81
|
| Rate for Payer: Cofinity Commercial |
$1,929.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,340.16
|
| Rate for Payer: Healthscope Commercial |
$1,608.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,608.19
|
| Rate for Payer: Meridian Medicaid |
$907.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,407.17
|
| Rate for Payer: PACE SWMI |
$1,340.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,340.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$864.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,728.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,363.66
|
| Rate for Payer: Priority Health Medicare |
$1,340.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,363.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,380.36
|
|
|
PR GEL-ONE
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS J7326
|
| Min. Negotiated Rate |
$506.67 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Aetna Commercial |
$692.41
|
| Rate for Payer: Aetna Medicare |
$516.73
|
| Rate for Payer: BCBS Complete |
$536.00
|
| Rate for Payer: BCBS MAPPO |
$516.73
|
| Rate for Payer: BCBS Trust/PPO |
$506.67
|
| Rate for Payer: BCN Commercial |
$1,159.20
|
| Rate for Payer: BCN Medicare Advantage |
$516.73
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$744.09
|
| Rate for Payer: Cofinity Commercial |
$692.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.73
|
| Rate for Payer: Healthscope Commercial |
$620.07
|
| Rate for Payer: Healthscope Whirlpool |
$620.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$542.56
|
| Rate for Payer: PACE SWMI |
$516.73
|
| Rate for Payer: PHP Medicare Advantage |
$516.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.00
|
| Rate for Payer: Priority Health Medicare |
$516.73
|
| Rate for Payer: UHC Medicare Advantage |
$532.23
|
|
|
PR GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 91112
|
| Min. Negotiated Rate |
$76.80 |
| Max. Negotiated Rate |
$2,415.54 |
| Rate for Payer: Aetna Commercial |
$2,054.03
|
| Rate for Payer: Aetna Medicare |
$1,532.86
|
| Rate for Payer: BCBS Complete |
$76.80
|
| Rate for Payer: BCBS MAPPO |
$1,532.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.20
|
| Rate for Payer: BCN Commercial |
$2,415.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,532.86
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$2,207.32
|
| Rate for Payer: Cofinity Commercial |
$2,054.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,532.86
|
| Rate for Payer: Healthscope Commercial |
$1,839.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,839.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,609.50
|
| Rate for Payer: PACE SWMI |
$1,532.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,532.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,220.11
|
| Rate for Payer: Priority Health Medicare |
$1,532.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,220.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,578.85
|
|
|
PR GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 91110
|
| Min. Negotiated Rate |
$634.40 |
| Max. Negotiated Rate |
$1,110.20 |
| Rate for Payer: Aetna Commercial |
$933.39
|
| Rate for Payer: Aetna Medicare |
$696.56
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$696.56
|
| Rate for Payer: BCBS Trust/PPO |
$910.79
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| Rate for Payer: BCN Medicare Advantage |
$696.56
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$1,003.05
|
| Rate for Payer: Cofinity Commercial |
$933.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.56
|
| Rate for Payer: Healthscope Commercial |
$835.87
|
| Rate for Payer: Healthscope Whirlpool |
$835.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$731.39
|
| Rate for Payer: PACE SWMI |
$696.56
|
| Rate for Payer: PHP Medicare Advantage |
$696.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,002.93
|
| Rate for Payer: Priority Health Medicare |
$696.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,002.93
|
| Rate for Payer: UHC Medicare Advantage |
$717.46
|
|
|
PR GLOSSECTOMY HEMIGLOSSECTOMY
|
Professional
|
Both
|
$2,341.00
|
|
|
Service Code
|
HCPCS 41130
|
| Min. Negotiated Rate |
$761.81 |
| Max. Negotiated Rate |
$2,314.26 |
| Rate for Payer: Aetna Commercial |
$1,709.00
|
| Rate for Payer: Aetna Medicare |
$1,275.37
|
| Rate for Payer: BCBS Complete |
$876.93
|
| Rate for Payer: BCBS MAPPO |
$1,275.37
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,923.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.37
|
| Rate for Payer: Cash Price |
$1,872.80
|
| Rate for Payer: Cash Price |
$1,872.80
|
| Rate for Payer: Cofinity Commercial |
$1,836.53
|
| Rate for Payer: Cofinity Commercial |
$1,709.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.37
|
| Rate for Payer: Healthscope Commercial |
$1,530.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,530.44
|
| Rate for Payer: Meridian Medicaid |
$876.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,339.14
|
| Rate for Payer: PACE SWMI |
$1,275.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,638.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,314.26
|
| Rate for Payer: Priority Health Medicare |
$1,275.37
|
| Rate for Payer: Priority Health Narrow Network |
$2,314.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,313.63
|
|
|
PR GLOSSECTOMY <ONE-HALF TONGUE
|
Professional
|
Both
|
$1,863.00
|
|
|
Service Code
|
HCPCS 41120
|
| Min. Negotiated Rate |
$640.83 |
| Max. Negotiated Rate |
$1,873.88 |
| Rate for Payer: Aetna Commercial |
$1,375.31
|
| Rate for Payer: Aetna Medicare |
$1,026.35
|
| Rate for Payer: BCBS Complete |
$708.97
|
| Rate for Payer: BCBS MAPPO |
$1,026.35
|
| Rate for Payer: BCBS Trust/PPO |
$640.83
|
| Rate for Payer: BCN Commercial |
$1,557.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,026.35
|
| Rate for Payer: Cash Price |
$1,490.40
|
| Rate for Payer: Cash Price |
$1,490.40
|
| Rate for Payer: Cofinity Commercial |
$1,477.94
|
| Rate for Payer: Cofinity Commercial |
$1,375.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,026.35
|
| Rate for Payer: Healthscope Commercial |
$1,231.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,231.62
|
| Rate for Payer: Meridian Medicaid |
$708.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,077.67
|
| Rate for Payer: PACE SWMI |
$1,026.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,026.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,304.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,873.88
|
| Rate for Payer: Priority Health Medicare |
$1,026.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,873.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,057.14
|
|
|
PR GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ
|
Professional
|
Both
|
$3,868.00
|
|
|
Service Code
|
HCPCS 41135
|
| Min. Negotiated Rate |
$438.49 |
| Max. Negotiated Rate |
$3,804.18 |
| Rate for Payer: Aetna Commercial |
$2,829.91
|
| Rate for Payer: Aetna Medicare |
$2,111.87
|
| Rate for Payer: BCBS Complete |
$1,445.23
|
| Rate for Payer: BCBS MAPPO |
$2,111.87
|
| Rate for Payer: BCBS Trust/PPO |
$438.49
|
| Rate for Payer: BCN Commercial |
$3,161.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,111.87
|
| Rate for Payer: Cash Price |
$3,094.40
|
| Rate for Payer: Cash Price |
$3,094.40
|
| Rate for Payer: Cofinity Commercial |
$2,829.91
|
| Rate for Payer: Cofinity Commercial |
$3,041.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,111.87
|
| Rate for Payer: Healthscope Commercial |
$2,534.24
|
| Rate for Payer: Healthscope Whirlpool |
$2,534.24
|
| Rate for Payer: Meridian Medicaid |
$1,445.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,217.46
|
| Rate for Payer: PACE SWMI |
$2,111.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,111.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,376.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,707.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,804.18
|
| Rate for Payer: Priority Health Medicare |
$2,111.87
|
| Rate for Payer: Priority Health Narrow Network |
$3,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,175.23
|
|
|
PR GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ
|
Professional
|
Both
|
$4,018.00
|
|
|
Service Code
|
HCPCS 41150
|
| Min. Negotiated Rate |
$567.92 |
| Max. Negotiated Rate |
$3,862.39 |
| Rate for Payer: Aetna Commercial |
$2,870.03
|
| Rate for Payer: Aetna Medicare |
$2,141.81
|
| Rate for Payer: BCBS Complete |
$1,466.47
|
| Rate for Payer: BCBS MAPPO |
$2,141.81
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCN Commercial |
$3,210.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,141.81
|
| Rate for Payer: Cash Price |
$3,214.40
|
| Rate for Payer: Cash Price |
$3,214.40
|
| Rate for Payer: Cofinity Commercial |
$3,084.21
|
| Rate for Payer: Cofinity Commercial |
$2,870.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,141.81
|
| Rate for Payer: Healthscope Commercial |
$2,570.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,570.17
|
| Rate for Payer: Meridian Medicaid |
$1,466.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,248.90
|
| Rate for Payer: PACE SWMI |
$2,141.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,141.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,396.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,812.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,862.39
|
| Rate for Payer: Priority Health Medicare |
$2,141.81
|
| Rate for Payer: Priority Health Narrow Network |
$3,862.39
|
| Rate for Payer: UHC Medicare Advantage |
$2,206.06
|
|
|
PR GONIOSCOPY SEPARATE PROCEDURE
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 92020
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$1,100.98 |
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: Aetna Medicare |
$19.69
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS MAPPO |
$19.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.98
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$19.69
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$28.35
|
| Rate for Payer: Cofinity Commercial |
$26.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.69
|
| Rate for Payer: Healthscope Commercial |
$23.63
|
| Rate for Payer: Healthscope Whirlpool |
$23.63
|
| Rate for Payer: Meridian Medicaid |
$13.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.67
|
| Rate for Payer: PACE SWMI |
$19.69
|
| Rate for Payer: PHP Medicare Advantage |
$19.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.09
|
| Rate for Payer: Priority Health Medicare |
$19.69
|
| Rate for Payer: Priority Health Narrow Network |
$24.09
|
| Rate for Payer: UHC Medicare Advantage |
$20.28
|
|
|
PR GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA
|
Professional
|
Both
|
$1,670.00
|
|
|
Service Code
|
HCPCS 15760
|
| Min. Negotiated Rate |
$446.66 |
| Max. Negotiated Rate |
$12,622.63 |
| Rate for Payer: Aetna Commercial |
$913.22
|
| Rate for Payer: Aetna Medicare |
$681.51
|
| Rate for Payer: BCBS Complete |
$468.99
|
| Rate for Payer: BCBS MAPPO |
$681.51
|
| Rate for Payer: BCBS Trust/PPO |
$12,622.63
|
| Rate for Payer: BCN Commercial |
$1,239.29
|
| Rate for Payer: BCN Medicare Advantage |
$681.51
|
| Rate for Payer: Cash Price |
$1,336.00
|
| Rate for Payer: Cash Price |
$1,336.00
|
| Rate for Payer: Cofinity Commercial |
$981.37
|
| Rate for Payer: Cofinity Commercial |
$913.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.51
|
| Rate for Payer: Healthscope Commercial |
$817.81
|
| Rate for Payer: Healthscope Whirlpool |
$817.81
|
| Rate for Payer: Meridian Medicaid |
$468.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$715.59
|
| Rate for Payer: PACE SWMI |
$681.51
|
| Rate for Payer: PHP Medicare Advantage |
$681.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$857.84
|
| Rate for Payer: Priority Health Medicare |
$681.51
|
| Rate for Payer: Priority Health Narrow Network |
$857.84
|
| Rate for Payer: UHC Medicare Advantage |
$701.96
|
|
|
PR GRAFT DERMA-FAT-FASCIA
|
Professional
|
Both
|
$1,440.00
|
|
|
Service Code
|
HCPCS 15770
|
| Min. Negotiated Rate |
$432.60 |
| Max. Negotiated Rate |
$12,622.63 |
| Rate for Payer: Aetna Commercial |
$877.89
|
| Rate for Payer: Aetna Medicare |
$655.14
|
| Rate for Payer: BCBS Complete |
$454.23
|
| Rate for Payer: BCBS MAPPO |
$655.14
|
| Rate for Payer: BCBS Trust/PPO |
$12,622.63
|
| Rate for Payer: BCN Commercial |
$982.24
|
| Rate for Payer: BCN Medicare Advantage |
$655.14
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Cofinity Commercial |
$943.40
|
| Rate for Payer: Cofinity Commercial |
$877.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.14
|
| Rate for Payer: Healthscope Commercial |
$786.17
|
| Rate for Payer: Healthscope Whirlpool |
$786.17
|
| Rate for Payer: Meridian Medicaid |
$454.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$687.90
|
| Rate for Payer: PACE SWMI |
$655.14
|
| Rate for Payer: PHP Medicare Advantage |
$655.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$826.18
|
| Rate for Payer: Priority Health Medicare |
$655.14
|
| Rate for Payer: Priority Health Narrow Network |
$826.18
|
| Rate for Payer: UHC Medicare Advantage |
$674.79
|
|
