|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$310.13 |
| Max. Negotiated Rate |
$2,501.50 |
| Rate for Payer: Aetna Commercial |
$635.94
|
| Rate for Payer: Aetna Medicare |
$474.58
|
| Rate for Payer: BCBS Complete |
$325.64
|
| Rate for Payer: BCBS MAPPO |
$474.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$474.58
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$683.40
|
| Rate for Payer: Cofinity Commercial |
$635.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.58
|
| Rate for Payer: Healthscope Commercial |
$569.50
|
| Rate for Payer: Healthscope Whirlpool |
$569.50
|
| Rate for Payer: Meridian Medicaid |
$325.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$498.31
|
| Rate for Payer: PACE SWMI |
$474.58
|
| Rate for Payer: PHP Medicare Advantage |
$474.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,107.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.39
|
| Rate for Payer: Priority Health Medicare |
$474.58
|
| Rate for Payer: Priority Health Narrow Network |
$851.39
|
| Rate for Payer: UHC Medicare Advantage |
$488.82
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$2,489.35 |
| Rate for Payer: Aetna Commercial |
$468.25
|
| Rate for Payer: Aetna Medicare |
$349.44
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS MAPPO |
$349.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$349.44
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$503.19
|
| Rate for Payer: Cofinity Commercial |
$468.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.44
|
| Rate for Payer: Healthscope Commercial |
$419.33
|
| Rate for Payer: Healthscope Whirlpool |
$419.33
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$366.91
|
| Rate for Payer: PACE SWMI |
$349.44
|
| Rate for Payer: PHP Medicare Advantage |
$349.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.37
|
| Rate for Payer: Priority Health Medicare |
$349.44
|
| Rate for Payer: Priority Health Narrow Network |
$627.37
|
| Rate for Payer: UHC Medicare Advantage |
$359.92
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$2,489.35 |
| Rate for Payer: Aetna Commercial |
$468.25
|
| Rate for Payer: Aetna Medicare |
$349.44
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS MAPPO |
$349.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$349.44
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$468.25
|
| Rate for Payer: Cofinity Commercial |
$503.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.44
|
| Rate for Payer: Healthscope Commercial |
$419.33
|
| Rate for Payer: Healthscope Whirlpool |
$419.33
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$366.91
|
| Rate for Payer: PACE SWMI |
$349.44
|
| Rate for Payer: PHP Medicare Advantage |
$349.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.37
|
| Rate for Payer: Priority Health Medicare |
$349.44
|
| Rate for Payer: Priority Health Narrow Network |
$627.37
|
| Rate for Payer: UHC Medicare Advantage |
$359.92
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,076.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$753.20 |
| Max. Negotiated Rate |
$3,119.72 |
| Rate for Payer: Aetna Commercial |
$968.40
|
| Rate for Payer: Aetna Medicare |
$2,495.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: ASR ASR |
$1,043.72
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$834.22
|
| Rate for Payer: BCN Commercial |
$834.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$1,011.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$1,076.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,043.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,495.78
|
| Rate for Payer: Mclaren Commercial |
$968.40
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.60
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$2,745.36
|
| Rate for Payer: PHP Medicaid |
$1,365.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$979.16
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$763.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$946.88
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: VA VA |
$2,495.78
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,076.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$753.20 |
| Max. Negotiated Rate |
$1,076.00 |
| Rate for Payer: Aetna Commercial |
$968.40
|
| Rate for Payer: ASR ASR |
$1,043.72
|
| Rate for Payer: BCBS Trust/PPO |
$834.22
|
| Rate for Payer: BCN Commercial |
$834.22
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$1,011.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.80
|
| Rate for Payer: Healthscope Commercial |
$1,076.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,043.72
|
| Rate for Payer: Mclaren Commercial |
$968.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$946.88
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
OP
|
$1,107.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$774.90 |
| Max. Negotiated Rate |
$3,119.72 |
| Rate for Payer: Aetna Commercial |
$996.30
|
| Rate for Payer: Aetna Medicare |
$2,495.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: ASR ASR |
$1,073.79
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$858.26
|
| Rate for Payer: BCN Commercial |
$858.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cofinity Commercial |
$1,040.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$1,107.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,073.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,495.78
|
| Rate for Payer: Mclaren Commercial |
$996.30
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$940.95
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$2,745.36
|
| Rate for Payer: PHP Medicaid |
$1,365.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,007.37
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$785.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$974.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: VA VA |
$2,495.78
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,107.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$205.12 |
| Max. Negotiated Rate |
$1,253.13 |
| Rate for Payer: Aetna Commercial |
$419.39
|
| Rate for Payer: Aetna Medicare |
$312.98
|
| Rate for Payer: BCBS Complete |
$215.38
|
| Rate for Payer: BCBS MAPPO |
$312.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.13
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$312.98
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cofinity Commercial |
$450.69
|
| Rate for Payer: Cofinity Commercial |
$419.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.98
|
| Rate for Payer: Healthscope Commercial |
$375.58
|
| Rate for Payer: Healthscope Whirlpool |
$375.58
|
| Rate for Payer: Meridian Medicaid |
$215.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$328.63
|
| Rate for Payer: PACE SWMI |
$312.98
|
| Rate for Payer: PHP Medicare Advantage |
$312.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$563.28
|
| Rate for Payer: Priority Health Medicare |
$312.98
|
| Rate for Payer: Priority Health Narrow Network |
$563.28
|
| Rate for Payer: UHC Medicare Advantage |
$322.37
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
IP
|
$1,107.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$774.90 |
| Max. Negotiated Rate |
$1,107.00 |
| Rate for Payer: Aetna Commercial |
$996.30
|
| Rate for Payer: ASR ASR |
$1,073.79
|
| Rate for Payer: BCBS Trust/PPO |
$858.26
|
| Rate for Payer: BCN Commercial |
$858.26
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cofinity Commercial |
$1,040.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.60
|
| Rate for Payer: Healthscope Commercial |
$1,107.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,073.79
|
| Rate for Payer: Mclaren Commercial |
$996.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$940.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$974.16
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,107.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$205.12 |
| Max. Negotiated Rate |
$1,253.13 |
| Rate for Payer: Aetna Commercial |
$419.39
|
| Rate for Payer: Aetna Medicare |
$312.98
|
| Rate for Payer: BCBS Complete |
$215.38
|
| Rate for Payer: BCBS MAPPO |
$312.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.13
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$312.98
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cofinity Commercial |
$419.39
|
| Rate for Payer: Cofinity Commercial |
$450.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.98
|
| Rate for Payer: Healthscope Commercial |
$375.58
|
| Rate for Payer: Healthscope Whirlpool |
$375.58
|
| Rate for Payer: Meridian Medicaid |
$215.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$328.63
|
| Rate for Payer: PACE SWMI |
$312.98
|
| Rate for Payer: PHP Medicare Advantage |
$312.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$563.28
|
| Rate for Payer: Priority Health Medicare |
$312.98
|
| Rate for Payer: Priority Health Narrow Network |
$563.28
|
| Rate for Payer: UHC Medicare Advantage |
$322.37
|
|
|
PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 46257
|
| Min. Negotiated Rate |
$267.95 |
| Max. Negotiated Rate |
$1,554.26 |
| Rate for Payer: Aetna Commercial |
$545.58
|
| Rate for Payer: Aetna Medicare |
$407.15
|
| Rate for Payer: BCBS Complete |
$281.35
|
| Rate for Payer: BCBS MAPPO |
$407.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,554.26
|
| Rate for Payer: BCN Commercial |
$610.36
|
| Rate for Payer: BCN Medicare Advantage |
$407.15
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$586.30
|
| Rate for Payer: Cofinity Commercial |
$545.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.15
|
| Rate for Payer: Healthscope Commercial |
$488.58
|
| Rate for Payer: Healthscope Whirlpool |
$488.58
|
| Rate for Payer: Meridian Medicaid |
$281.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$427.51
|
| Rate for Payer: PACE SWMI |
$407.15
|
| Rate for Payer: PHP Medicare Advantage |
$407.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$734.38
|
| Rate for Payer: Priority Health Medicare |
$407.15
|
| Rate for Payer: Priority Health Narrow Network |
$734.38
|
| Rate for Payer: UHC Medicare Advantage |
$419.36
|
|
|
PR HEMORRHOIDOPEXY STAPLING
|
Professional
|
Both
|
$633.00
|
|
|
Service Code
|
HCPCS 46947
|
| Min. Negotiated Rate |
$250.91 |
| Max. Negotiated Rate |
$2,172.37 |
| Rate for Payer: Aetna Commercial |
$514.18
|
| Rate for Payer: Aetna Medicare |
$383.72
|
| Rate for Payer: BCBS Complete |
$263.46
|
| Rate for Payer: BCBS MAPPO |
$383.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,172.37
|
| Rate for Payer: BCN Commercial |
$570.29
|
| Rate for Payer: BCN Medicare Advantage |
$383.72
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cofinity Commercial |
$552.56
|
| Rate for Payer: Cofinity Commercial |
$514.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.72
|
| Rate for Payer: Healthscope Commercial |
$460.46
|
| Rate for Payer: Healthscope Whirlpool |
$460.46
|
| Rate for Payer: Meridian Medicaid |
$263.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$402.91
|
| Rate for Payer: PACE SWMI |
$383.72
|
| Rate for Payer: PHP Medicare Advantage |
$383.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.16
|
| Rate for Payer: Priority Health Medicare |
$383.72
|
| Rate for Payer: Priority Health Narrow Network |
$686.16
|
| Rate for Payer: UHC Medicare Advantage |
$395.23
|
|
|
PR HEPATECTOMY RESCJ PARTIAL LOBECTOMY
|
Professional
|
Both
|
$4,542.00
|
|
|
Service Code
|
HCPCS 47120
|
| Min. Negotiated Rate |
$1,489.08 |
| Max. Negotiated Rate |
$4,093.47 |
| Rate for Payer: Aetna Commercial |
$3,108.38
|
| Rate for Payer: Aetna Medicare |
$2,319.69
|
| Rate for Payer: BCBS Complete |
$1,563.53
|
| Rate for Payer: BCBS MAPPO |
$2,319.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,491.46
|
| Rate for Payer: BCN Commercial |
$3,402.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,319.69
|
| Rate for Payer: Cash Price |
$3,633.60
|
| Rate for Payer: Cash Price |
$3,633.60
|
| Rate for Payer: Cofinity Commercial |
$3,108.38
|
| Rate for Payer: Cofinity Commercial |
$3,340.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,319.69
|
| Rate for Payer: Healthscope Commercial |
$2,783.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,783.63
|
| Rate for Payer: Meridian Medicaid |
$1,563.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,435.67
|
| Rate for Payer: PACE SWMI |
$2,319.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,319.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,489.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,179.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,093.47
|
| Rate for Payer: Priority Health Medicare |
$2,319.69
|
| Rate for Payer: Priority Health Narrow Network |
$4,093.47
|
| Rate for Payer: UHC Medicare Advantage |
$2,389.28
|
|
|
PR HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY
|
Professional
|
Both
|
$6,038.00
|
|
|
Service Code
|
HCPCS 47130
|
| Min. Negotiated Rate |
$2,100.18 |
| Max. Negotiated Rate |
$5,780.36 |
| Rate for Payer: Aetna Commercial |
$4,402.85
|
| Rate for Payer: Aetna Medicare |
$3,285.71
|
| Rate for Payer: BCBS Complete |
$2,205.19
|
| Rate for Payer: BCBS MAPPO |
$3,285.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.86
|
| Rate for Payer: BCN Commercial |
$4,804.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,285.71
|
| Rate for Payer: Cash Price |
$4,830.40
|
| Rate for Payer: Cash Price |
$4,830.40
|
| Rate for Payer: Cofinity Commercial |
$4,731.42
|
| Rate for Payer: Cofinity Commercial |
$4,402.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,285.71
|
| Rate for Payer: Healthscope Commercial |
$3,942.85
|
| Rate for Payer: Healthscope Whirlpool |
$3,942.85
|
| Rate for Payer: Meridian Medicaid |
$2,205.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,450.00
|
| Rate for Payer: PACE SWMI |
$3,285.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,285.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,100.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,226.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,780.36
|
| Rate for Payer: Priority Health Medicare |
$3,285.71
|
| Rate for Payer: Priority Health Narrow Network |
$5,780.36
|
| Rate for Payer: UHC Medicare Advantage |
$3,384.28
|
|
|
PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 90636
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$134.53 |
| Rate for Payer: Aetna Commercial |
$123.57
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS Trust/PPO |
$134.53
|
| Rate for Payer: BCN Commercial |
$134.53
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
|
|
PR HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES
|
Professional
|
Both
|
$2,199.00
|
|
|
Service Code
|
HCPCS 47010
|
| Min. Negotiated Rate |
$241.96 |
| Max. Negotiated Rate |
$2,131.40 |
| Rate for Payer: Aetna Commercial |
$1,613.19
|
| Rate for Payer: Aetna Medicare |
$1,203.87
|
| Rate for Payer: BCBS Complete |
$814.54
|
| Rate for Payer: BCBS MAPPO |
$1,203.87
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$1,771.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,203.87
|
| Rate for Payer: Cash Price |
$1,759.20
|
| Rate for Payer: Cash Price |
$1,759.20
|
| Rate for Payer: Cofinity Commercial |
$1,733.57
|
| Rate for Payer: Cofinity Commercial |
$1,613.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,203.87
|
| Rate for Payer: Healthscope Commercial |
$1,444.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,444.64
|
| Rate for Payer: Meridian Medicaid |
$814.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,264.06
|
| Rate for Payer: PACE SWMI |
$1,203.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,203.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,131.40
|
| Rate for Payer: Priority Health Medicare |
$1,203.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,131.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,239.99
|
|
|
PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 90633
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$38.42
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$31.32
|
| Rate for Payer: BCN Commercial |
$31.32
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
|
|
PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 90632
|
| Min. Negotiated Rate |
$35.20 |
| Max. Negotiated Rate |
$103.47 |
| Rate for Payer: Aetna Commercial |
$96.28
|
| Rate for Payer: Aetna Medicare |
$71.85
|
| Rate for Payer: BCBS Complete |
$35.20
|
| Rate for Payer: BCBS MAPPO |
$71.85
|
| Rate for Payer: BCBS Trust/PPO |
$72.34
|
| Rate for Payer: BCN Commercial |
$73.37
|
| Rate for Payer: BCN Medicare Advantage |
$71.85
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$103.47
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.85
|
| Rate for Payer: Healthscope Commercial |
$86.22
|
| Rate for Payer: Healthscope Whirlpool |
$86.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.45
|
| Rate for Payer: PACE SWMI |
$71.85
|
| Rate for Payer: PHP Medicare Advantage |
$71.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: Priority Health Medicare |
$71.85
|
| Rate for Payer: UHC Medicare Advantage |
$74.01
|
|
|
PR HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 90743
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$106.34 |
| Rate for Payer: Aetna Commercial |
$98.95
|
| Rate for Payer: Aetna Medicare |
$73.85
|
| Rate for Payer: BCBS Complete |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$73.85
|
| Rate for Payer: BCBS Trust/PPO |
$76.66
|
| Rate for Payer: BCN Commercial |
$65.05
|
| Rate for Payer: BCN Medicare Advantage |
$73.85
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$98.95
|
| Rate for Payer: Cofinity Commercial |
$106.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.85
|
| Rate for Payer: Healthscope Commercial |
$88.62
|
| Rate for Payer: Healthscope Whirlpool |
$88.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.54
|
| Rate for Payer: PACE SWMI |
$73.85
|
| Rate for Payer: PHP Medicare Advantage |
$73.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.70
|
| Rate for Payer: Priority Health Medicare |
$73.85
|
| Rate for Payer: UHC Medicare Advantage |
$76.06
|
|
|
PR HEPB VACCINE ADULT 2/4 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 90739
|
| Min. Negotiated Rate |
$128.00 |
| Max. Negotiated Rate |
$230.81 |
| Rate for Payer: Aetna Commercial |
$214.78
|
| Rate for Payer: Aetna Medicare |
$160.28
|
| Rate for Payer: BCBS Complete |
$128.00
|
| Rate for Payer: BCBS MAPPO |
$160.28
|
| Rate for Payer: BCBS Trust/PPO |
$166.39
|
| Rate for Payer: BCN Commercial |
$132.46
|
| Rate for Payer: BCN Medicare Advantage |
$160.28
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$214.78
|
| Rate for Payer: Cofinity Commercial |
$230.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.28
|
| Rate for Payer: Healthscope Commercial |
$192.34
|
| Rate for Payer: Healthscope Whirlpool |
$192.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$168.30
|
| Rate for Payer: PACE SWMI |
$160.28
|
| Rate for Payer: PHP Medicare Advantage |
$160.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.00
|
| Rate for Payer: Priority Health Medicare |
$160.28
|
| Rate for Payer: UHC Medicare Advantage |
$165.09
|
|
|
PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 90746
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$101.34 |
| Rate for Payer: Aetna Commercial |
$94.30
|
| Rate for Payer: Aetna Medicare |
$70.38
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS MAPPO |
$70.38
|
| Rate for Payer: BCBS Trust/PPO |
$73.05
|
| Rate for Payer: BCN Commercial |
$65.05
|
| Rate for Payer: BCN Medicare Advantage |
$70.38
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$94.30
|
| Rate for Payer: Cofinity Commercial |
$101.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.38
|
| Rate for Payer: Healthscope Commercial |
$84.45
|
| Rate for Payer: Healthscope Whirlpool |
$84.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.89
|
| Rate for Payer: PACE SWMI |
$70.38
|
| Rate for Payer: PHP Medicare Advantage |
$70.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.70
|
| Rate for Payer: Priority Health Medicare |
$70.38
|
| Rate for Payer: UHC Medicare Advantage |
$72.49
|
|
|
PR HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS 90744
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$43.05 |
| Rate for Payer: Aetna Commercial |
$40.06
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$29.90
|
| Rate for Payer: BCBS Trust/PPO |
$31.03
|
| Rate for Payer: BCN Commercial |
$25.88
|
| Rate for Payer: BCN Medicare Advantage |
$29.90
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$40.06
|
| Rate for Payer: Cofinity Commercial |
$43.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.90
|
| Rate for Payer: Healthscope Commercial |
$35.87
|
| Rate for Payer: Healthscope Whirlpool |
$35.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.39
|
| Rate for Payer: PACE SWMI |
$29.90
|
| Rate for Payer: PHP Medicare Advantage |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
| Rate for Payer: Priority Health Medicare |
$29.90
|
| Rate for Payer: UHC Medicare Advantage |
$30.79
|
|
|
PR HFO FLEXION GLOVE PRE OTS
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS L3912
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$91.04 |
| Rate for Payer: Aetna Commercial |
$57.75
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCN Commercial |
$91.04
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.90
|
|
|
PR HFO NONTORSION JNTS PRE CST
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS L3929
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$78.93 |
| Rate for Payer: Aetna Commercial |
$50.06
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCN Commercial |
$78.93
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
|
|
PR HFO W/JOINT(S) CF
|
Professional
|
Both
|
$294.00
|
|
|
Service Code
|
HCPCS L3921
|
| Min. Negotiated Rate |
$117.60 |
| Max. Negotiated Rate |
$277.59 |
| Rate for Payer: Aetna Commercial |
$176.08
|
| Rate for Payer: BCBS Complete |
$117.60
|
| Rate for Payer: BCN Commercial |
$277.59
|
| Rate for Payer: Cash Price |
$235.20
|
| Rate for Payer: Cash Price |
$235.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.80
|
|
|
PR HFO W/O JOINTS CF
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS L3913
|
| Min. Negotiated Rate |
$99.20 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna Commercial |
$148.45
|
| Rate for Payer: BCBS Complete |
$99.20
|
| Rate for Payer: BCN Commercial |
$234.03
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.60
|
|
