|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT
|
Professional
|
Both
|
$861.00
|
|
|
Service Code
|
HCPCS 28022
|
| Min. Negotiated Rate |
$200.22 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Aetna Commercial |
$407.69
|
| Rate for Payer: Aetna Medicare |
$304.25
|
| Rate for Payer: BCBS Complete |
$210.23
|
| Rate for Payer: BCBS MAPPO |
$304.25
|
| Rate for Payer: BCN Commercial |
$498.48
|
| Rate for Payer: BCN Medicare Advantage |
$304.25
|
| Rate for Payer: Cash Price |
$688.80
|
| Rate for Payer: Cash Price |
$688.80
|
| Rate for Payer: Cofinity Commercial |
$438.12
|
| Rate for Payer: Cofinity Commercial |
$407.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.25
|
| Rate for Payer: Healthscope Commercial |
$365.10
|
| Rate for Payer: Healthscope Whirlpool |
$365.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.46
|
| Rate for Payer: Meridian Medicaid |
$210.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.68
|
| Rate for Payer: Nomi Health Commercial |
$365.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.75
|
| Rate for Payer: PACE SWMI |
$304.25
|
| Rate for Payer: PHP Medicare Advantage |
$304.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$532.86
|
| Rate for Payer: Priority Health Medicare |
$304.25
|
| Rate for Payer: Priority Health Narrow Network |
$532.86
|
| Rate for Payer: Railroad Medicare Medicare |
$304.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$566.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.25
|
| Rate for Payer: UHC Exchange |
$566.23
|
| Rate for Payer: UHC Medicaid |
$200.22
|
| Rate for Payer: UHCCP DNSP |
$304.25
|
| Rate for Payer: UHCCP Medicaid |
$200.22
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT
|
Professional
|
Both
|
$947.00
|
|
|
Service Code
|
HCPCS 28020
|
| Min. Negotiated Rate |
$223.86 |
| Max. Negotiated Rate |
$710.25 |
| Rate for Payer: Aetna Commercial |
$455.79
|
| Rate for Payer: Aetna Medicare |
$340.14
|
| Rate for Payer: BCBS Complete |
$235.05
|
| Rate for Payer: BCBS MAPPO |
$340.14
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: BCN Medicare Advantage |
$340.14
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$489.80
|
| Rate for Payer: Cofinity Commercial |
$455.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.14
|
| Rate for Payer: Healthscope Commercial |
$408.17
|
| Rate for Payer: Healthscope Whirlpool |
$408.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.15
|
| Rate for Payer: Meridian Medicaid |
$235.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.15
|
| Rate for Payer: Nomi Health Commercial |
$408.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$710.25
|
| Rate for Payer: PACE SWMI |
$340.14
|
| Rate for Payer: PHP Medicare Advantage |
$340.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$588.75
|
| Rate for Payer: Priority Health Medicare |
$340.14
|
| Rate for Payer: Priority Health Narrow Network |
$588.75
|
| Rate for Payer: Railroad Medicare Medicare |
$340.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$626.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.14
|
| Rate for Payer: UHC Exchange |
$626.14
|
| Rate for Payer: UHC Medicaid |
$223.86
|
| Rate for Payer: UHCCP DNSP |
$340.14
|
| Rate for Payer: UHCCP Medicaid |
$223.86
|
|
|
PR ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 25101
|
| Min. Negotiated Rate |
$250.06 |
| Max. Negotiated Rate |
$1,063.50 |
| Rate for Payer: Aetna Commercial |
$506.98
|
| Rate for Payer: Aetna Medicare |
$378.34
|
| Rate for Payer: BCBS Complete |
$262.56
|
| Rate for Payer: BCBS MAPPO |
$378.34
|
| Rate for Payer: BCN Commercial |
$628.95
|
| Rate for Payer: BCN Medicare Advantage |
$378.34
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$544.81
|
| Rate for Payer: Cofinity Commercial |
$506.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.34
|
| Rate for Payer: Healthscope Commercial |
$454.01
|
| Rate for Payer: Healthscope Whirlpool |
$454.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.26
|
| Rate for Payer: Meridian Medicaid |
$262.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.17
|
| Rate for Payer: Nomi Health Commercial |
$454.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,063.50
|
| Rate for Payer: PACE SWMI |
$378.34
|
| Rate for Payer: PHP Medicare Advantage |
$378.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$672.34
|
| Rate for Payer: Priority Health Medicare |
$378.34
|
| Rate for Payer: Priority Health Narrow Network |
$672.34
|
| Rate for Payer: Railroad Medicare Medicare |
$378.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$698.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.34
|
| Rate for Payer: UHC Exchange |
$698.77
|
| Rate for Payer: UHC Medicaid |
$250.06
|
| Rate for Payer: UHCCP DNSP |
$378.34
|
| Rate for Payer: UHCCP Medicaid |
$250.06
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Professional
|
Both
|
$2,864.00
|
|
|
Service Code
|
HCPCS 27335
|
| Min. Negotiated Rate |
$458.59 |
| Max. Negotiated Rate |
$2,148.00 |
| Rate for Payer: Aetna Commercial |
$941.03
|
| Rate for Payer: Aetna Medicare |
$702.26
|
| Rate for Payer: BCBS Complete |
$481.52
|
| Rate for Payer: BCBS MAPPO |
$702.26
|
| Rate for Payer: BCN Commercial |
$1,169.76
|
| Rate for Payer: BCN Medicare Advantage |
$702.26
|
| Rate for Payer: Cash Price |
$2,291.20
|
| Rate for Payer: Cash Price |
$2,291.20
|
| Rate for Payer: Cofinity Commercial |
$941.03
|
| Rate for Payer: Cofinity Commercial |
$1,011.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.26
|
| Rate for Payer: Healthscope Commercial |
$842.71
|
| Rate for Payer: Healthscope Whirlpool |
$842.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.37
|
| Rate for Payer: Meridian Medicaid |
$481.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$772.49
|
| Rate for Payer: Nomi Health Commercial |
$842.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,148.00
|
| Rate for Payer: PACE SWMI |
$702.26
|
| Rate for Payer: PHP Medicare Advantage |
$702.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,250.44
|
| Rate for Payer: Priority Health Medicare |
$702.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,250.44
|
| Rate for Payer: Railroad Medicare Medicare |
$702.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,336.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$702.26
|
| Rate for Payer: UHC Exchange |
$1,336.48
|
| Rate for Payer: UHC Medicaid |
$458.59
|
| Rate for Payer: UHCCP DNSP |
$702.26
|
| Rate for Payer: UHCCP Medicaid |
$458.59
|
|
|
PR ARTIFICIAL INSEMINATION INTRA-CERVICAL
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 58321
|
| Min. Negotiated Rate |
$41.89 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$56.13
|
| Rate for Payer: Aetna Medicare |
$41.89
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS MAPPO |
$41.89
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.89
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cofinity Commercial |
$56.13
|
| Rate for Payer: Cofinity Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.89
|
| Rate for Payer: Healthscope Commercial |
$50.27
|
| Rate for Payer: Healthscope Whirlpool |
$50.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.08
|
| Rate for Payer: Nomi Health Commercial |
$50.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.50
|
| Rate for Payer: PACE SWMI |
$41.89
|
| Rate for Payer: PHP Medicare Advantage |
$41.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.63
|
| Rate for Payer: Priority Health Medicare |
$41.89
|
| Rate for Payer: Priority Health Narrow Network |
$72.63
|
| Rate for Payer: Railroad Medicare Medicare |
$41.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.89
|
| Rate for Payer: UHC Exchange |
$86.04
|
| Rate for Payer: UHCCP DNSP |
$41.89
|
|
|
PR ARTIFICIAL INSEMINATION INTRA-UTERINE
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 58322
|
| Min. Negotiated Rate |
$49.92 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna Commercial |
$66.89
|
| Rate for Payer: Aetna Medicare |
$49.92
|
| Rate for Payer: BCBS Complete |
$100.80
|
| Rate for Payer: BCBS MAPPO |
$49.92
|
| Rate for Payer: BCN Commercial |
$85.15
|
| Rate for Payer: BCN Medicare Advantage |
$49.92
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$71.88
|
| Rate for Payer: Cofinity Commercial |
$66.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.92
|
| Rate for Payer: Healthscope Commercial |
$59.90
|
| Rate for Payer: Healthscope Whirlpool |
$59.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.91
|
| Rate for Payer: Nomi Health Commercial |
$59.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.00
|
| Rate for Payer: PACE SWMI |
$49.92
|
| Rate for Payer: PHP Medicare Advantage |
$49.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$86.24
|
| Rate for Payer: Priority Health Medicare |
$49.92
|
| Rate for Payer: Priority Health Narrow Network |
$86.24
|
| Rate for Payer: Railroad Medicare Medicare |
$49.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.92
|
| Rate for Payer: UHC Exchange |
$104.50
|
| Rate for Payer: UHCCP DNSP |
$49.92
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 36625
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$128.08
|
| Rate for Payer: Aetna Medicare |
$95.58
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$95.58
|
| Rate for Payer: BCN Commercial |
$154.38
|
| Rate for Payer: BCN Medicare Advantage |
$95.58
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$137.64
|
| Rate for Payer: Cofinity Commercial |
$128.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.58
|
| Rate for Payer: Healthscope Commercial |
$114.70
|
| Rate for Payer: Healthscope Whirlpool |
$114.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.36
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.14
|
| Rate for Payer: Nomi Health Commercial |
$114.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$247.50
|
| Rate for Payer: PACE SWMI |
$95.58
|
| Rate for Payer: PHP Medicare Advantage |
$95.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$166.00
|
| Rate for Payer: Priority Health Medicare |
$95.58
|
| Rate for Payer: Priority Health Narrow Network |
$166.00
|
| Rate for Payer: Railroad Medicare Medicare |
$95.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.58
|
| Rate for Payer: UHC Exchange |
$188.77
|
| Rate for Payer: UHC Medicaid |
$60.92
|
| Rate for Payer: UHCCP DNSP |
$95.58
|
| Rate for Payer: UHCCP Medicaid |
$60.92
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 36620
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$54.44
|
| Rate for Payer: Aetna Medicare |
$40.63
|
| Rate for Payer: BCBS Complete |
$27.29
|
| Rate for Payer: BCBS MAPPO |
$40.63
|
| Rate for Payer: BCN Commercial |
$64.24
|
| Rate for Payer: BCN Medicare Advantage |
$40.63
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$58.51
|
| Rate for Payer: Cofinity Commercial |
$54.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.63
|
| Rate for Payer: Healthscope Commercial |
$48.76
|
| Rate for Payer: Healthscope Whirlpool |
$48.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.66
|
| Rate for Payer: Meridian Medicaid |
$27.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.69
|
| Rate for Payer: Nomi Health Commercial |
$48.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$40.63
|
| Rate for Payer: PHP Medicare Advantage |
$40.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.09
|
| Rate for Payer: Priority Health Medicare |
$40.63
|
| Rate for Payer: Priority Health Narrow Network |
$69.09
|
| Rate for Payer: Railroad Medicare Medicare |
$40.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.63
|
| Rate for Payer: UHC Exchange |
$79.36
|
| Rate for Payer: UHC Medicaid |
$25.99
|
| Rate for Payer: UHCCP DNSP |
$40.63
|
| Rate for Payer: UHCCP Medicaid |
$25.99
|
|
|
PR ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 36640
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$431.25 |
| Rate for Payer: Aetna Commercial |
$132.74
|
| Rate for Payer: Aetna Medicare |
$99.06
|
| Rate for Payer: BCBS Complete |
$67.55
|
| Rate for Payer: BCBS MAPPO |
$99.06
|
| Rate for Payer: BCN Commercial |
$173.80
|
| Rate for Payer: BCN Medicare Advantage |
$99.06
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cofinity Commercial |
$142.65
|
| Rate for Payer: Cofinity Commercial |
$132.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.06
|
| Rate for Payer: Healthscope Commercial |
$118.87
|
| Rate for Payer: Healthscope Whirlpool |
$118.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.01
|
| Rate for Payer: Meridian Medicaid |
$67.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.97
|
| Rate for Payer: Nomi Health Commercial |
$118.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$431.25
|
| Rate for Payer: PACE SWMI |
$99.06
|
| Rate for Payer: PHP Medicare Advantage |
$99.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$186.90
|
| Rate for Payer: Priority Health Medicare |
$99.06
|
| Rate for Payer: Priority Health Narrow Network |
$186.90
|
| Rate for Payer: Railroad Medicare Medicare |
$99.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.06
|
| Rate for Payer: UHC Exchange |
$202.19
|
| Rate for Payer: UHC Medicaid |
$64.33
|
| Rate for Payer: UHCCP DNSP |
$99.06
|
| Rate for Payer: UHCCP Medicaid |
$64.33
|
|
|
PR ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 93050
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: Aetna Medicare |
$16.19
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$16.19
|
| Rate for Payer: BCN Commercial |
$24.40
|
| Rate for Payer: BCN Medicare Advantage |
$16.19
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$23.31
|
| Rate for Payer: Cofinity Commercial |
$21.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.19
|
| Rate for Payer: Healthscope Commercial |
$19.43
|
| Rate for Payer: Healthscope Whirlpool |
$19.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.81
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE SWMI |
$16.19
|
| Rate for Payer: PHP Medicare Advantage |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.19
|
| Rate for Payer: Priority Health Medicare |
$16.19
|
| Rate for Payer: Priority Health Narrow Network |
$23.19
|
| Rate for Payer: Railroad Medicare Medicare |
$16.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.19
|
| Rate for Payer: UHC Exchange |
$25.39
|
| Rate for Payer: UHCCP DNSP |
$16.19
|
|
|
PR ARVEN ANAST OPN F/ARM VEIN TRPOS
|
Professional
|
Both
|
$1,570.00
|
|
|
Service Code
|
HCPCS 36820
|
| Min. Negotiated Rate |
$423.23 |
| Max. Negotiated Rate |
$1,304.18 |
| Rate for Payer: Aetna Commercial |
$892.88
|
| Rate for Payer: Aetna Medicare |
$666.33
|
| Rate for Payer: BCBS Complete |
$444.39
|
| Rate for Payer: BCBS MAPPO |
$666.33
|
| Rate for Payer: BCN Commercial |
$1,069.16
|
| Rate for Payer: BCN Medicare Advantage |
$666.33
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cash Price |
$1,256.00
|
| Rate for Payer: Cofinity Commercial |
$959.52
|
| Rate for Payer: Cofinity Commercial |
$892.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.33
|
| Rate for Payer: Healthscope Commercial |
$799.60
|
| Rate for Payer: Healthscope Whirlpool |
$799.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.65
|
| Rate for Payer: Meridian Medicaid |
$444.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$732.96
|
| Rate for Payer: Nomi Health Commercial |
$799.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,177.50
|
| Rate for Payer: PACE SWMI |
$666.33
|
| Rate for Payer: PHP Medicare Advantage |
$666.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,149.75
|
| Rate for Payer: Priority Health Medicare |
$666.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,149.75
|
| Rate for Payer: Railroad Medicare Medicare |
$666.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,304.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$666.33
|
| Rate for Payer: UHC Exchange |
$1,304.18
|
| Rate for Payer: UHC Medicaid |
$423.23
|
| Rate for Payer: UHCCP DNSP |
$666.33
|
| Rate for Payer: UHCCP Medicaid |
$423.23
|
|
|
PR ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS
|
Professional
|
Both
|
$2,508.00
|
|
|
Service Code
|
HCPCS 36819
|
| Min. Negotiated Rate |
$423.23 |
| Max. Negotiated Rate |
$1,881.00 |
| Rate for Payer: Aetna Commercial |
$894.42
|
| Rate for Payer: Aetna Medicare |
$667.48
|
| Rate for Payer: BCBS Complete |
$444.39
|
| Rate for Payer: BCBS MAPPO |
$667.48
|
| Rate for Payer: BCN Commercial |
$1,067.17
|
| Rate for Payer: BCN Medicare Advantage |
$667.48
|
| Rate for Payer: Cash Price |
$2,006.40
|
| Rate for Payer: Cash Price |
$2,006.40
|
| Rate for Payer: Cofinity Commercial |
$961.17
|
| Rate for Payer: Cofinity Commercial |
$894.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.48
|
| Rate for Payer: Healthscope Commercial |
$800.98
|
| Rate for Payer: Healthscope Whirlpool |
$800.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.85
|
| Rate for Payer: Meridian Medicaid |
$444.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$734.23
|
| Rate for Payer: Nomi Health Commercial |
$800.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,881.00
|
| Rate for Payer: PACE SWMI |
$667.48
|
| Rate for Payer: PHP Medicare Advantage |
$667.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,147.62
|
| Rate for Payer: Priority Health Medicare |
$667.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,147.62
|
| Rate for Payer: Railroad Medicare Medicare |
$667.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,309.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$667.48
|
| Rate for Payer: UHC Exchange |
$1,309.70
|
| Rate for Payer: UHC Medicaid |
$423.23
|
| Rate for Payer: UHCCP DNSP |
$667.48
|
| Rate for Payer: UHCCP Medicaid |
$423.23
|
|
|
PR ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS
|
Professional
|
Both
|
$2,069.00
|
|
|
Service Code
|
HCPCS 36818
|
| Min. Negotiated Rate |
$400.87 |
| Max. Negotiated Rate |
$1,551.75 |
| Rate for Payer: Aetna Commercial |
$845.57
|
| Rate for Payer: Aetna Medicare |
$631.02
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS MAPPO |
$631.02
|
| Rate for Payer: BCN Commercial |
$1,009.41
|
| Rate for Payer: BCN Medicare Advantage |
$631.02
|
| Rate for Payer: Cash Price |
$1,655.20
|
| Rate for Payer: Cash Price |
$1,655.20
|
| Rate for Payer: Cofinity Commercial |
$908.67
|
| Rate for Payer: Cofinity Commercial |
$845.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.02
|
| Rate for Payer: Healthscope Commercial |
$757.22
|
| Rate for Payer: Healthscope Whirlpool |
$757.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.57
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.12
|
| Rate for Payer: Nomi Health Commercial |
$757.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,551.75
|
| Rate for Payer: PACE SWMI |
$631.02
|
| Rate for Payer: PHP Medicare Advantage |
$631.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,085.48
|
| Rate for Payer: Priority Health Medicare |
$631.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,085.48
|
| Rate for Payer: Railroad Medicare Medicare |
$631.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,237.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.02
|
| Rate for Payer: UHC Exchange |
$1,237.12
|
| Rate for Payer: UHC Medicaid |
$400.87
|
| Rate for Payer: UHCCP DNSP |
$631.02
|
| Rate for Payer: UHCCP Medicaid |
$400.87
|
|
|
PR ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART
|
Professional
|
Both
|
$8,680.00
|
|
|
Service Code
|
HCPCS 61705
|
| Min. Negotiated Rate |
$1,595.16 |
| Max. Negotiated Rate |
$6,510.00 |
| Rate for Payer: Aetna Commercial |
$3,356.41
|
| Rate for Payer: Aetna Medicare |
$2,504.78
|
| Rate for Payer: BCBS Complete |
$1,674.92
|
| Rate for Payer: BCBS MAPPO |
$2,504.78
|
| Rate for Payer: BCN Commercial |
$3,952.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,504.78
|
| Rate for Payer: Cash Price |
$6,944.00
|
| Rate for Payer: Cash Price |
$6,944.00
|
| Rate for Payer: Cofinity Commercial |
$3,606.88
|
| Rate for Payer: Cofinity Commercial |
$3,356.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,504.78
|
| Rate for Payer: Healthscope Commercial |
$3,005.74
|
| Rate for Payer: Healthscope Whirlpool |
$3,005.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,630.02
|
| Rate for Payer: Meridian Medicaid |
$1,674.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,755.26
|
| Rate for Payer: Nomi Health Commercial |
$3,005.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,510.00
|
| Rate for Payer: PACE SWMI |
$2,504.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,504.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,595.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,591.31
|
| Rate for Payer: Priority Health Medicare |
$2,504.78
|
| Rate for Payer: Priority Health Narrow Network |
$4,591.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2,504.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,604.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,504.78
|
| Rate for Payer: UHC Exchange |
$4,604.25
|
| Rate for Payer: UHC Medicaid |
$1,595.16
|
| Rate for Payer: UHCCP DNSP |
$2,504.78
|
| Rate for Payer: UHCCP Medicaid |
$1,595.16
|
|
|
PR ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 31400
|
| Min. Negotiated Rate |
$595.55 |
| Max. Negotiated Rate |
$1,680.28 |
| Rate for Payer: Aetna Commercial |
$1,202.53
|
| Rate for Payer: Aetna Medicare |
$897.41
|
| Rate for Payer: BCBS Complete |
$625.33
|
| Rate for Payer: BCBS MAPPO |
$897.41
|
| Rate for Payer: BCN Commercial |
$1,524.82
|
| Rate for Payer: BCN Medicare Advantage |
$897.41
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,292.27
|
| Rate for Payer: Cofinity Commercial |
$1,202.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.41
|
| Rate for Payer: Healthscope Commercial |
$1,076.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,076.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$942.28
|
| Rate for Payer: Meridian Medicaid |
$625.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$987.15
|
| Rate for Payer: Nomi Health Commercial |
$1,076.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.50
|
| Rate for Payer: PACE SWMI |
$897.41
|
| Rate for Payer: PHP Medicare Advantage |
$897.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,435.93
|
| Rate for Payer: Priority Health Medicare |
$897.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,435.93
|
| Rate for Payer: Railroad Medicare Medicare |
$897.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,680.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$897.41
|
| Rate for Payer: UHC Exchange |
$1,680.28
|
| Rate for Payer: UHC Medicaid |
$595.55
|
| Rate for Payer: UHCCP DNSP |
$897.41
|
| Rate for Payer: UHCCP Medicaid |
$595.55
|
|
|
PR AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT
|
Professional
|
Both
|
$6,821.00
|
|
|
Service Code
|
HCPCS 33863
|
| Min. Negotiated Rate |
$1,853.10 |
| Max. Negotiated Rate |
$5,636.85 |
| Rate for Payer: Aetna Commercial |
$3,915.01
|
| Rate for Payer: Aetna Medicare |
$2,921.65
|
| Rate for Payer: BCBS Complete |
$1,945.76
|
| Rate for Payer: BCBS MAPPO |
$2,921.65
|
| Rate for Payer: BCN Commercial |
$4,604.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,921.65
|
| Rate for Payer: Cash Price |
$5,456.80
|
| Rate for Payer: Cash Price |
$5,456.80
|
| Rate for Payer: Cofinity Commercial |
$4,207.18
|
| Rate for Payer: Cofinity Commercial |
$3,915.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,921.65
|
| Rate for Payer: Healthscope Commercial |
$3,505.98
|
| Rate for Payer: Healthscope Whirlpool |
$3,505.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,067.73
|
| Rate for Payer: Meridian Medicaid |
$1,945.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,213.82
|
| Rate for Payer: Nomi Health Commercial |
$3,505.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,115.75
|
| Rate for Payer: PACE SWMI |
$2,921.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,921.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,951.91
|
| Rate for Payer: Priority Health Medicare |
$2,921.65
|
| Rate for Payer: Priority Health Narrow Network |
$4,951.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,921.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,636.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,921.65
|
| Rate for Payer: UHC Exchange |
$5,636.85
|
| Rate for Payer: UHC Medicaid |
$1,853.10
|
| Rate for Payer: UHCCP DNSP |
$2,921.65
|
| Rate for Payer: UHCCP Medicaid |
$1,853.10
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION
|
Professional
|
Both
|
$7,339.00
|
|
|
Service Code
|
HCPCS 33858
|
| Min. Negotiated Rate |
$1,998.37 |
| Max. Negotiated Rate |
$6,076.72 |
| Rate for Payer: Aetna Commercial |
$4,222.53
|
| Rate for Payer: Aetna Medicare |
$3,151.14
|
| Rate for Payer: BCBS Complete |
$2,098.29
|
| Rate for Payer: BCBS MAPPO |
$3,151.14
|
| Rate for Payer: BCN Commercial |
$4,969.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.14
|
| Rate for Payer: Cash Price |
$5,871.20
|
| Rate for Payer: Cash Price |
$5,871.20
|
| Rate for Payer: Cofinity Commercial |
$4,537.64
|
| Rate for Payer: Cofinity Commercial |
$4,222.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.14
|
| Rate for Payer: Healthscope Commercial |
$3,781.37
|
| Rate for Payer: Healthscope Whirlpool |
$3,781.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.70
|
| Rate for Payer: Meridian Medicaid |
$2,098.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,466.25
|
| Rate for Payer: Nomi Health Commercial |
$3,781.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,504.25
|
| Rate for Payer: PACE SWMI |
$3,151.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,998.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,343.91
|
| Rate for Payer: Priority Health Medicare |
$3,151.14
|
| Rate for Payer: Priority Health Narrow Network |
$5,343.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,076.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,151.14
|
| Rate for Payer: UHC Exchange |
$6,076.72
|
| Rate for Payer: UHC Medicaid |
$1,998.37
|
| Rate for Payer: UHCCP DNSP |
$3,151.14
|
| Rate for Payer: UHCCP Medicaid |
$1,998.37
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ
|
Professional
|
Both
|
$5,264.00
|
|
|
Service Code
|
HCPCS 33859
|
| Min. Negotiated Rate |
$1,442.44 |
| Max. Negotiated Rate |
$4,359.60 |
| Rate for Payer: Aetna Commercial |
$3,043.58
|
| Rate for Payer: Aetna Medicare |
$2,271.33
|
| Rate for Payer: BCBS Complete |
$1,514.56
|
| Rate for Payer: BCBS MAPPO |
$2,271.33
|
| Rate for Payer: BCN Commercial |
$3,573.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,271.33
|
| Rate for Payer: Cash Price |
$4,211.20
|
| Rate for Payer: Cash Price |
$4,211.20
|
| Rate for Payer: Cofinity Commercial |
$3,043.58
|
| Rate for Payer: Cofinity Commercial |
$3,270.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,271.33
|
| Rate for Payer: Healthscope Commercial |
$2,725.60
|
| Rate for Payer: Healthscope Whirlpool |
$2,725.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,384.90
|
| Rate for Payer: Meridian Medicaid |
$1,514.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,498.46
|
| Rate for Payer: Nomi Health Commercial |
$2,725.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,948.00
|
| Rate for Payer: PACE SWMI |
$2,271.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,271.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,442.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,842.32
|
| Rate for Payer: Priority Health Medicare |
$2,271.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,842.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,271.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,359.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,271.33
|
| Rate for Payer: UHC Exchange |
$4,359.60
|
| Rate for Payer: UHC Medicaid |
$1,442.44
|
| Rate for Payer: UHCCP DNSP |
$2,271.33
|
| Rate for Payer: UHCCP Medicaid |
$1,442.44
|
|
|
PR ASCEND AORTA GRAFT INCL VAVLE SUSPENSION
|
Professional
|
Both
|
$10,357.00
|
|
|
Service Code
|
HCPCS 33860
|
| Min. Negotiated Rate |
$4,142.80 |
| Max. Negotiated Rate |
$7,767.75 |
| Rate for Payer: BCBS Complete |
$4,142.80
|
| Rate for Payer: Cash Price |
$8,285.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,767.75
|
|
|
PR ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL
|
Professional
|
Both
|
$5,385.00
|
|
|
Service Code
|
HCPCS 33864
|
| Min. Negotiated Rate |
$1,891.65 |
| Max. Negotiated Rate |
$5,759.09 |
| Rate for Payer: Aetna Commercial |
$3,996.58
|
| Rate for Payer: Aetna Medicare |
$2,982.52
|
| Rate for Payer: BCBS Complete |
$1,986.23
|
| Rate for Payer: BCBS MAPPO |
$2,982.52
|
| Rate for Payer: BCN Commercial |
$4,706.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,982.52
|
| Rate for Payer: Cash Price |
$4,308.00
|
| Rate for Payer: Cash Price |
$4,308.00
|
| Rate for Payer: Cofinity Commercial |
$4,294.83
|
| Rate for Payer: Cofinity Commercial |
$3,996.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,982.52
|
| Rate for Payer: Healthscope Commercial |
$3,579.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,579.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,131.65
|
| Rate for Payer: Meridian Medicaid |
$1,986.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,280.77
|
| Rate for Payer: Nomi Health Commercial |
$3,579.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,038.75
|
| Rate for Payer: PACE SWMI |
$2,982.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,982.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,891.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,061.69
|
| Rate for Payer: Priority Health Medicare |
$2,982.52
|
| Rate for Payer: Priority Health Narrow Network |
$5,061.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,982.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,759.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,982.52
|
| Rate for Payer: UHC Exchange |
$5,759.09
|
| Rate for Payer: UHC Medicaid |
$1,891.65
|
| Rate for Payer: UHCCP DNSP |
$2,982.52
|
| Rate for Payer: UHCCP Medicaid |
$1,891.65
|
|
|
PR ASPIRATION AND/OR INJECTION THYROID CYST
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 60300
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$125.25 |
| Rate for Payer: Aetna Commercial |
$55.84
|
| Rate for Payer: Aetna Medicare |
$41.67
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.67
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.67
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$55.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.67
|
| Rate for Payer: Healthscope Commercial |
$50.00
|
| Rate for Payer: Healthscope Whirlpool |
$50.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.75
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.84
|
| Rate for Payer: Nomi Health Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.25
|
| Rate for Payer: PACE SWMI |
$41.67
|
| Rate for Payer: PHP Medicare Advantage |
$41.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$77.76
|
| Rate for Payer: Priority Health Medicare |
$41.67
|
| Rate for Payer: Priority Health Narrow Network |
$77.76
|
| Rate for Payer: Railroad Medicare Medicare |
$41.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.67
|
| Rate for Payer: UHC Exchange |
$87.24
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP DNSP |
$41.67
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
|
|
PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 51102
|
| Min. Negotiated Rate |
$80.30 |
| Max. Negotiated Rate |
$257.31 |
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Medicare |
$124.99
|
| Rate for Payer: BCBS Complete |
$84.31
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCN Commercial |
$209.65
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Healthscope Commercial |
$149.99
|
| Rate for Payer: Healthscope Whirlpool |
$149.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Medicaid |
$84.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.49
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$228.38
|
| Rate for Payer: Priority Health Medicare |
$124.99
|
| Rate for Payer: Priority Health Narrow Network |
$228.38
|
| Rate for Payer: Railroad Medicare Medicare |
$124.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.99
|
| Rate for Payer: UHC Exchange |
$257.31
|
| Rate for Payer: UHC Medicaid |
$80.30
|
| Rate for Payer: UHCCP DNSP |
$124.99
|
| Rate for Payer: UHCCP Medicaid |
$80.30
|
|
|
PR ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 51100
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$33.66
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCN Commercial |
$57.76
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Healthscope Whirlpool |
$40.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.03
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.92
|
| Rate for Payer: Priority Health Medicare |
$33.66
|
| Rate for Payer: Priority Health Narrow Network |
$62.92
|
| Rate for Payer: Railroad Medicare Medicare |
$33.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.66
|
| Rate for Payer: UHC Exchange |
$68.99
|
| Rate for Payer: UHC Medicaid |
$21.51
|
| Rate for Payer: UHCCP DNSP |
$33.66
|
| Rate for Payer: UHCCP Medicaid |
$21.51
|
|
|
PR ASPIRATION BLADDER TROCAR/INTRACATHETER
|
Professional
|
Both
|
$399.00
|
|
|
Service Code
|
HCPCS 51101
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Aetna Commercial |
$59.46
|
| Rate for Payer: Aetna Medicare |
$44.37
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$44.37
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$44.37
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Cofinity Commercial |
$59.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.37
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Healthscope Whirlpool |
$53.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.59
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.81
|
| Rate for Payer: Nomi Health Commercial |
$53.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$299.25
|
| Rate for Payer: PACE SWMI |
$44.37
|
| Rate for Payer: PHP Medicare Advantage |
$44.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$82.46
|
| Rate for Payer: Priority Health Medicare |
$44.37
|
| Rate for Payer: Priority Health Narrow Network |
$82.46
|
| Rate for Payer: Railroad Medicare Medicare |
$44.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.37
|
| Rate for Payer: UHC Exchange |
$91.70
|
| Rate for Payer: UHC Medicaid |
$28.33
|
| Rate for Payer: UHCCP DNSP |
$44.37
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 20612
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Aetna Commercial |
$48.47
|
| Rate for Payer: Aetna Medicare |
$36.17
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS MAPPO |
$36.17
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.17
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$52.08
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.17
|
| Rate for Payer: Healthscope Commercial |
$43.40
|
| Rate for Payer: Healthscope Whirlpool |
$43.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.98
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.79
|
| Rate for Payer: Nomi Health Commercial |
$43.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.25
|
| Rate for Payer: PACE SWMI |
$36.17
|
| Rate for Payer: PHP Medicare Advantage |
$36.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.01
|
| Rate for Payer: Priority Health Medicare |
$36.17
|
| Rate for Payer: Priority Health Narrow Network |
$66.01
|
| Rate for Payer: Railroad Medicare Medicare |
$36.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.17
|
| Rate for Payer: UHC Exchange |
$72.59
|
| Rate for Payer: UHC Medicaid |
$23.43
|
| Rate for Payer: UHCCP DNSP |
$36.17
|
| Rate for Payer: UHCCP Medicaid |
$23.43
|
|
