|
PR BIOPSY VERTEBRAL BODY OPEN THORACIC
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 20250
|
| Min. Negotiated Rate |
$247.08 |
| Max. Negotiated Rate |
$689.07 |
| Rate for Payer: Aetna Commercial |
$507.83
|
| Rate for Payer: Aetna Medicare |
$378.98
|
| Rate for Payer: BCBS Complete |
$259.43
|
| Rate for Payer: BCBS MAPPO |
$378.98
|
| Rate for Payer: BCN Commercial |
$595.09
|
| Rate for Payer: BCN Medicare Advantage |
$378.98
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$545.73
|
| Rate for Payer: Cofinity Commercial |
$507.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.98
|
| Rate for Payer: Healthscope Commercial |
$454.78
|
| Rate for Payer: Healthscope Whirlpool |
$454.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.93
|
| Rate for Payer: Meridian Medicaid |
$259.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.88
|
| Rate for Payer: Nomi Health Commercial |
$454.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.25
|
| Rate for Payer: PACE SWMI |
$378.98
|
| Rate for Payer: PHP Medicare Advantage |
$378.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$636.13
|
| Rate for Payer: Priority Health Medicare |
$378.98
|
| Rate for Payer: Priority Health Narrow Network |
$636.13
|
| Rate for Payer: Railroad Medicare Medicare |
$378.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$689.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.98
|
| Rate for Payer: UHC Exchange |
$689.07
|
| Rate for Payer: UHC Medicaid |
$247.08
|
| Rate for Payer: UHCCP DNSP |
$378.98
|
| Rate for Payer: UHCCP Medicaid |
$247.08
|
|
|
PR BIOPSY VESTIBULE MOUTH
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 40808
|
| Min. Negotiated Rate |
$52.61 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$106.26
|
| Rate for Payer: Aetna Medicare |
$79.30
|
| Rate for Payer: BCBS Complete |
$55.24
|
| Rate for Payer: BCBS MAPPO |
$79.30
|
| Rate for Payer: BCN Commercial |
$135.95
|
| Rate for Payer: BCN Medicare Advantage |
$79.30
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$114.19
|
| Rate for Payer: Cofinity Commercial |
$106.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.30
|
| Rate for Payer: Healthscope Commercial |
$95.16
|
| Rate for Payer: Healthscope Whirlpool |
$95.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.27
|
| Rate for Payer: Meridian Medicaid |
$55.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.23
|
| Rate for Payer: Nomi Health Commercial |
$95.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$79.30
|
| Rate for Payer: PHP Medicare Advantage |
$79.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$165.65
|
| Rate for Payer: Priority Health Medicare |
$79.30
|
| Rate for Payer: Priority Health Narrow Network |
$165.65
|
| Rate for Payer: Railroad Medicare Medicare |
$79.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.30
|
| Rate for Payer: UHC Exchange |
$148.11
|
| Rate for Payer: UHC Medicaid |
$52.61
|
| Rate for Payer: UHCCP DNSP |
$79.30
|
| Rate for Payer: UHCCP Medicaid |
$52.61
|
|
|
PR BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 56605
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$69.34
|
| Rate for Payer: Aetna Medicare |
$51.75
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS MAPPO |
$51.75
|
| Rate for Payer: BCN Commercial |
$69.51
|
| Rate for Payer: BCN Medicare Advantage |
$51.75
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$74.52
|
| Rate for Payer: Cofinity Commercial |
$69.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.75
|
| Rate for Payer: Healthscope Commercial |
$62.10
|
| Rate for Payer: Healthscope Whirlpool |
$62.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.34
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.92
|
| Rate for Payer: Nomi Health Commercial |
$62.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$51.75
|
| Rate for Payer: PHP Medicare Advantage |
$51.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$89.26
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health Narrow Network |
$89.26
|
| Rate for Payer: Railroad Medicare Medicare |
$51.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.75
|
| Rate for Payer: UHC Exchange |
$107.38
|
| Rate for Payer: UHC Medicaid |
$33.02
|
| Rate for Payer: UHCCP DNSP |
$51.75
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
|
|
PR BIOPSY VULVA/PERINEUM EACH ADDL LESION
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 56606
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Aetna Commercial |
$34.02
|
| Rate for Payer: Aetna Medicare |
$25.39
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$25.39
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: BCN Medicare Advantage |
$25.39
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$36.56
|
| Rate for Payer: Cofinity Commercial |
$34.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.39
|
| Rate for Payer: Healthscope Commercial |
$30.47
|
| Rate for Payer: Healthscope Whirlpool |
$30.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.66
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.93
|
| Rate for Payer: Nomi Health Commercial |
$30.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.50
|
| Rate for Payer: PACE SWMI |
$25.39
|
| Rate for Payer: PHP Medicare Advantage |
$25.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.38
|
| Rate for Payer: Priority Health Medicare |
$25.39
|
| Rate for Payer: Priority Health Narrow Network |
$43.38
|
| Rate for Payer: Railroad Medicare Medicare |
$25.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.39
|
| Rate for Payer: UHC Exchange |
$52.83
|
| Rate for Payer: UHC Medicaid |
$16.19
|
| Rate for Payer: UHCCP DNSP |
$25.39
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
|
|
PR BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 33933
|
| Min. Negotiated Rate |
$251.71 |
| Max. Negotiated Rate |
$712.11 |
| Rate for Payer: Aetna Commercial |
$536.72
|
| Rate for Payer: BCBS Complete |
$264.30
|
| Rate for Payer: BCN Commercial |
$633.90
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Meridian Medicaid |
$264.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$684.39
|
| Rate for Payer: Priority Health Narrow Network |
$684.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$712.11
|
| Rate for Payer: UHC Exchange |
$712.11
|
| Rate for Payer: UHC Medicaid |
$251.71
|
| Rate for Payer: UHCCP Medicaid |
$251.71
|
|
|
PR BLADDER INSTILLATION ANTICARCINOGENIC AGENT
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 51720
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$50.96
|
| Rate for Payer: Aetna Medicare |
$38.03
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS MAPPO |
$38.03
|
| Rate for Payer: BCN Commercial |
$51.44
|
| Rate for Payer: BCN Medicare Advantage |
$38.03
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Cofinity Commercial |
$50.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.03
|
| Rate for Payer: Healthscope Commercial |
$45.64
|
| Rate for Payer: Healthscope Whirlpool |
$45.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.93
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.83
|
| Rate for Payer: Nomi Health Commercial |
$45.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: PACE SWMI |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$38.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$71.06
|
| Rate for Payer: Priority Health Medicare |
$38.03
|
| Rate for Payer: Priority Health Narrow Network |
$71.06
|
| Rate for Payer: Railroad Medicare Medicare |
$38.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.03
|
| Rate for Payer: UHC Exchange |
$77.52
|
| Rate for Payer: UHC Medicaid |
$24.28
|
| Rate for Payer: UHCCP DNSP |
$38.03
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
|
PR BLADDER PRESSURE MEASUREMENT DURING FILLING
|
Professional
|
Both
|
$721.00
|
|
|
Service Code
|
HCPCS 51726
|
| Min. Negotiated Rate |
$253.39 |
| Max. Negotiated Rate |
$540.75 |
| Rate for Payer: Aetna Commercial |
$339.54
|
| Rate for Payer: Aetna Medicare |
$253.39
|
| Rate for Payer: BCBS MAPPO |
$253.39
|
| Rate for Payer: BCN Commercial |
$414.32
|
| Rate for Payer: BCN Medicare Advantage |
$253.39
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cofinity Commercial |
$339.54
|
| Rate for Payer: Cofinity Commercial |
$364.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.39
|
| Rate for Payer: Healthscope Commercial |
$304.07
|
| Rate for Payer: Healthscope Whirlpool |
$304.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$278.73
|
| Rate for Payer: Nomi Health Commercial |
$304.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$540.75
|
| Rate for Payer: PACE SWMI |
$253.39
|
| Rate for Payer: PHP Medicare Advantage |
$253.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$451.32
|
| Rate for Payer: Priority Health Medicare |
$253.39
|
| Rate for Payer: Priority Health Narrow Network |
$451.32
|
| Rate for Payer: Railroad Medicare Medicare |
$253.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$482.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$253.39
|
| Rate for Payer: UHC Exchange |
$482.80
|
| Rate for Payer: UHCCP DNSP |
$253.39
|
|
|
PR BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 38206
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$356.25 |
| Rate for Payer: Aetna Commercial |
$89.10
|
| Rate for Payer: Aetna Medicare |
$66.49
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$66.49
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$66.49
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$95.75
|
| Rate for Payer: Cofinity Commercial |
$89.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.49
|
| Rate for Payer: Healthscope Commercial |
$79.79
|
| Rate for Payer: Healthscope Whirlpool |
$79.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.81
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.14
|
| Rate for Payer: Nomi Health Commercial |
$79.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$356.25
|
| Rate for Payer: PACE SWMI |
$66.49
|
| Rate for Payer: PHP Medicare Advantage |
$66.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$161.68
|
| Rate for Payer: Priority Health Medicare |
$66.49
|
| Rate for Payer: Priority Health Narrow Network |
$161.68
|
| Rate for Payer: Railroad Medicare Medicare |
$66.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.49
|
| Rate for Payer: UHC Exchange |
$148.11
|
| Rate for Payer: UHC Medicaid |
$43.03
|
| Rate for Payer: UHCCP DNSP |
$66.49
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
PR BLDR IRRIGATION SMPL LAVAGE &/INSTLJ
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 51700
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$135.75 |
| Rate for Payer: Aetna Commercial |
$34.85
|
| Rate for Payer: Aetna Medicare |
$26.01
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCN Commercial |
$34.95
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$37.45
|
| Rate for Payer: Cofinity Commercial |
$34.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.61
|
| Rate for Payer: Nomi Health Commercial |
$31.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.75
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.28
|
| Rate for Payer: Priority Health Medicare |
$26.01
|
| Rate for Payer: Priority Health Narrow Network |
$48.28
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.01
|
| Rate for Payer: UHC Exchange |
$55.38
|
| Rate for Payer: UHC Medicaid |
$16.61
|
| Rate for Payer: UHCCP DNSP |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
|
|
PR BLEPHAROPLASTY LOWER EYELID W/HERNIATED FAT PAD
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 15821
|
| Min. Negotiated Rate |
$308.42 |
| Max. Negotiated Rate |
$932.10 |
| Rate for Payer: Aetna Commercial |
$623.96
|
| Rate for Payer: Aetna Medicare |
$465.64
|
| Rate for Payer: BCBS Complete |
$323.84
|
| Rate for Payer: BCBS MAPPO |
$465.64
|
| Rate for Payer: BCN Commercial |
$820.67
|
| Rate for Payer: BCN Medicare Advantage |
$465.64
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$670.52
|
| Rate for Payer: Cofinity Commercial |
$623.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.64
|
| Rate for Payer: Healthscope Commercial |
$558.77
|
| Rate for Payer: Healthscope Whirlpool |
$558.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.92
|
| Rate for Payer: Meridian Medicaid |
$323.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$512.20
|
| Rate for Payer: Nomi Health Commercial |
$558.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$465.64
|
| Rate for Payer: PHP Medicare Advantage |
$465.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$751.13
|
| Rate for Payer: Priority Health Medicare |
$465.64
|
| Rate for Payer: Priority Health Narrow Network |
$751.13
|
| Rate for Payer: Railroad Medicare Medicare |
$465.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$932.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$465.64
|
| Rate for Payer: UHC Exchange |
$932.10
|
| Rate for Payer: UHC Medicaid |
$308.42
|
| Rate for Payer: UHCCP DNSP |
$465.64
|
| Rate for Payer: UHCCP Medicaid |
$308.42
|
|
|
PR BLEPHAROPLASTY UPPER EYELID
|
Professional
|
Both
|
$972.00
|
|
|
Service Code
|
HCPCS 15822
|
| Min. Negotiated Rate |
$226.85 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Aetna Commercial |
$457.45
|
| Rate for Payer: Aetna Medicare |
$341.38
|
| Rate for Payer: BCBS Complete |
$238.19
|
| Rate for Payer: BCBS MAPPO |
$341.38
|
| Rate for Payer: BCN Commercial |
$595.09
|
| Rate for Payer: BCN Medicare Advantage |
$341.38
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cofinity Commercial |
$491.59
|
| Rate for Payer: Cofinity Commercial |
$457.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.38
|
| Rate for Payer: Healthscope Commercial |
$409.66
|
| Rate for Payer: Healthscope Whirlpool |
$409.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.45
|
| Rate for Payer: Meridian Medicaid |
$238.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$375.52
|
| Rate for Payer: Nomi Health Commercial |
$409.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.00
|
| Rate for Payer: PACE SWMI |
$341.38
|
| Rate for Payer: PHP Medicare Advantage |
$341.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$544.66
|
| Rate for Payer: Priority Health Medicare |
$341.38
|
| Rate for Payer: Priority Health Narrow Network |
$544.66
|
| Rate for Payer: Railroad Medicare Medicare |
$341.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$672.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$341.38
|
| Rate for Payer: UHC Exchange |
$672.04
|
| Rate for Payer: UHC Medicaid |
$226.85
|
| Rate for Payer: UHCCP DNSP |
$341.38
|
| Rate for Payer: UHCCP Medicaid |
$226.85
|
|
|
PR BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 15823
|
| Min. Negotiated Rate |
$307.15 |
| Max. Negotiated Rate |
$932.26 |
| Rate for Payer: Aetna Commercial |
$620.71
|
| Rate for Payer: Aetna Medicare |
$463.22
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCBS MAPPO |
$463.22
|
| Rate for Payer: BCN Commercial |
$820.67
|
| Rate for Payer: BCN Medicare Advantage |
$463.22
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$667.04
|
| Rate for Payer: Cofinity Commercial |
$620.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.22
|
| Rate for Payer: Healthscope Commercial |
$555.86
|
| Rate for Payer: Healthscope Whirlpool |
$555.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.38
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$509.54
|
| Rate for Payer: Nomi Health Commercial |
$555.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$463.22
|
| Rate for Payer: PHP Medicare Advantage |
$463.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$751.13
|
| Rate for Payer: Priority Health Medicare |
$463.22
|
| Rate for Payer: Priority Health Narrow Network |
$751.13
|
| Rate for Payer: Railroad Medicare Medicare |
$463.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$932.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$463.22
|
| Rate for Payer: UHC Exchange |
$932.26
|
| Rate for Payer: UHC Medicaid |
$307.15
|
| Rate for Payer: UHCCP DNSP |
$463.22
|
| Rate for Payer: UHCCP Medicaid |
$307.15
|
|
|
PR BLEPHAROTOMY DRAINAGE ABSCESS EYELID
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 67700
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: Aetna Commercial |
$131.84
|
| Rate for Payer: Aetna Medicare |
$98.39
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$98.39
|
| Rate for Payer: BCN Commercial |
$173.80
|
| Rate for Payer: BCN Medicare Advantage |
$98.39
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$131.84
|
| Rate for Payer: Cofinity Commercial |
$141.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.39
|
| Rate for Payer: Healthscope Commercial |
$118.07
|
| Rate for Payer: Healthscope Whirlpool |
$118.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.31
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.23
|
| Rate for Payer: Nomi Health Commercial |
$118.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.00
|
| Rate for Payer: PACE SWMI |
$98.39
|
| Rate for Payer: PHP Medicare Advantage |
$98.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.58
|
| Rate for Payer: Priority Health Medicare |
$98.39
|
| Rate for Payer: Priority Health Narrow Network |
$203.58
|
| Rate for Payer: Railroad Medicare Medicare |
$98.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.39
|
| Rate for Payer: UHC Exchange |
$196.52
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP DNSP |
$98.39
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR BLUE TIDAL
|
Professional
|
Both
|
$63.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR BONE GRAFT ANY DONOR AREA MAJOR/LARGE
|
Professional
|
Both
|
$1,291.00
|
|
|
Service Code
|
HCPCS 20902
|
| Min. Negotiated Rate |
$154.21 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Aetna Commercial |
$321.28
|
| Rate for Payer: Aetna Medicare |
$239.76
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCBS MAPPO |
$239.76
|
| Rate for Payer: BCN Commercial |
$409.84
|
| Rate for Payer: BCN Medicare Advantage |
$239.76
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cofinity Commercial |
$345.25
|
| Rate for Payer: Cofinity Commercial |
$321.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.76
|
| Rate for Payer: Healthscope Commercial |
$287.71
|
| Rate for Payer: Healthscope Whirlpool |
$287.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.75
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$263.74
|
| Rate for Payer: Nomi Health Commercial |
$287.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$968.25
|
| Rate for Payer: PACE SWMI |
$239.76
|
| Rate for Payer: PHP Medicare Advantage |
$239.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$438.10
|
| Rate for Payer: Priority Health Medicare |
$239.76
|
| Rate for Payer: Priority Health Narrow Network |
$438.10
|
| Rate for Payer: Railroad Medicare Medicare |
$239.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$497.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$239.76
|
| Rate for Payer: UHC Exchange |
$497.85
|
| Rate for Payer: UHC Medicaid |
$154.21
|
| Rate for Payer: UHCCP DNSP |
$239.76
|
| Rate for Payer: UHCCP Medicaid |
$154.21
|
|
|
PR BONE GRAFT ANY DONOR AREA MINOR/SMALL
|
Professional
|
Both
|
$936.00
|
|
|
Service Code
|
HCPCS 20900
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Aetna Commercial |
$212.60
|
| Rate for Payer: Aetna Medicare |
$158.66
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$158.66
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: BCN Medicare Advantage |
$158.66
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cofinity Commercial |
$228.47
|
| Rate for Payer: Cofinity Commercial |
$212.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.66
|
| Rate for Payer: Healthscope Commercial |
$190.39
|
| Rate for Payer: Healthscope Whirlpool |
$190.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.59
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.53
|
| Rate for Payer: Nomi Health Commercial |
$190.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.00
|
| Rate for Payer: PACE SWMI |
$158.66
|
| Rate for Payer: PHP Medicare Advantage |
$158.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$288.52
|
| Rate for Payer: Priority Health Medicare |
$158.66
|
| Rate for Payer: Priority Health Narrow Network |
$288.52
|
| Rate for Payer: Railroad Medicare Medicare |
$158.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.66
|
| Rate for Payer: UHC Exchange |
$324.96
|
| Rate for Payer: UHC Medicaid |
$102.45
|
| Rate for Payer: UHCCP DNSP |
$158.66
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR
|
Professional
|
Both
|
$4,726.00
|
|
|
Service Code
|
HCPCS 20962
|
| Min. Negotiated Rate |
$1,548.51 |
| Max. Negotiated Rate |
$4,668.92 |
| Rate for Payer: Aetna Commercial |
$3,198.42
|
| Rate for Payer: Aetna Medicare |
$2,386.88
|
| Rate for Payer: BCBS Complete |
$1,625.94
|
| Rate for Payer: BCBS MAPPO |
$2,386.88
|
| Rate for Payer: BCN Commercial |
$4,024.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,386.88
|
| Rate for Payer: Cash Price |
$3,780.80
|
| Rate for Payer: Cash Price |
$3,780.80
|
| Rate for Payer: Cofinity Commercial |
$3,437.11
|
| Rate for Payer: Cofinity Commercial |
$3,198.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,386.88
|
| Rate for Payer: Healthscope Commercial |
$2,864.26
|
| Rate for Payer: Healthscope Whirlpool |
$2,864.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,506.22
|
| Rate for Payer: Meridian Medicaid |
$1,625.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,625.57
|
| Rate for Payer: Nomi Health Commercial |
$2,864.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,544.50
|
| Rate for Payer: PACE SWMI |
$2,386.88
|
| Rate for Payer: PHP Medicare Advantage |
$2,386.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,548.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,301.74
|
| Rate for Payer: Priority Health Medicare |
$2,386.88
|
| Rate for Payer: Priority Health Narrow Network |
$4,301.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,386.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,668.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,386.88
|
| Rate for Payer: UHC Exchange |
$4,668.92
|
| Rate for Payer: UHC Medicaid |
$1,548.51
|
| Rate for Payer: UHCCP DNSP |
$2,386.88
|
| Rate for Payer: UHCCP Medicaid |
$1,548.51
|
|
|
PR BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 20939
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$124.46 |
| Rate for Payer: Aetna Commercial |
$82.88
|
| Rate for Payer: Aetna Medicare |
$61.85
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$61.85
|
| Rate for Payer: BCN Commercial |
$104.58
|
| Rate for Payer: BCN Medicare Advantage |
$61.85
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cofinity Commercial |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$82.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.85
|
| Rate for Payer: Healthscope Commercial |
$74.22
|
| Rate for Payer: Healthscope Whirlpool |
$74.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.94
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.03
|
| Rate for Payer: Nomi Health Commercial |
$74.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
| Rate for Payer: PACE SWMI |
$61.85
|
| Rate for Payer: PHP Medicare Advantage |
$61.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.79
|
| Rate for Payer: Priority Health Medicare |
$61.85
|
| Rate for Payer: Priority Health Narrow Network |
$111.79
|
| Rate for Payer: Railroad Medicare Medicare |
$61.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$124.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.85
|
| Rate for Payer: UHC Exchange |
$124.46
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP DNSP |
$61.85
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
PR BOTOX UNIT
|
Professional
|
Both
|
$13.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
|
|
PR BPG OTH/THN VEIN AORTOBIFEMORAL
|
Professional
|
Both
|
$5,955.00
|
|
|
Service Code
|
HCPCS 35646
|
| Min. Negotiated Rate |
$984.06 |
| Max. Negotiated Rate |
$4,466.25 |
| Rate for Payer: Aetna Commercial |
$2,092.10
|
| Rate for Payer: Aetna Medicare |
$1,561.27
|
| Rate for Payer: BCBS Complete |
$1,033.26
|
| Rate for Payer: BCBS MAPPO |
$1,561.27
|
| Rate for Payer: BCN Commercial |
$2,482.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,561.27
|
| Rate for Payer: Cash Price |
$4,764.00
|
| Rate for Payer: Cash Price |
$4,764.00
|
| Rate for Payer: Cofinity Commercial |
$2,092.10
|
| Rate for Payer: Cofinity Commercial |
$2,248.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,561.27
|
| Rate for Payer: Healthscope Commercial |
$1,873.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,873.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,639.33
|
| Rate for Payer: Meridian Medicaid |
$1,033.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,717.40
|
| Rate for Payer: Nomi Health Commercial |
$1,873.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,466.25
|
| Rate for Payer: PACE SWMI |
$1,561.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,561.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$984.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,669.54
|
| Rate for Payer: Priority Health Medicare |
$1,561.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,669.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,561.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,084.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,561.27
|
| Rate for Payer: UHC Exchange |
$3,084.39
|
| Rate for Payer: UHC Medicaid |
$984.06
|
| Rate for Payer: UHCCP DNSP |
$1,561.27
|
| Rate for Payer: UHCCP Medicaid |
$984.06
|
|
|
PR BPG OTH/THN VEIN AORTOBI-ILIAC
|
Professional
|
Both
|
$5,091.00
|
|
|
Service Code
|
HCPCS 35638
|
| Min. Negotiated Rate |
$1,008.34 |
| Max. Negotiated Rate |
$3,818.25 |
| Rate for Payer: Aetna Commercial |
$2,142.08
|
| Rate for Payer: Aetna Medicare |
$1,598.57
|
| Rate for Payer: BCBS Complete |
$1,058.76
|
| Rate for Payer: BCBS MAPPO |
$1,598.57
|
| Rate for Payer: BCN Commercial |
$2,549.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,598.57
|
| Rate for Payer: Cash Price |
$4,072.80
|
| Rate for Payer: Cash Price |
$4,072.80
|
| Rate for Payer: Cofinity Commercial |
$2,301.94
|
| Rate for Payer: Cofinity Commercial |
$2,142.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,598.57
|
| Rate for Payer: Healthscope Commercial |
$1,918.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,918.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,678.50
|
| Rate for Payer: Meridian Medicaid |
$1,058.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,758.43
|
| Rate for Payer: Nomi Health Commercial |
$1,918.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,818.25
|
| Rate for Payer: PACE SWMI |
$1,598.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,598.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,008.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,741.31
|
| Rate for Payer: Priority Health Medicare |
$1,598.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,741.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,598.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,134.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,598.57
|
| Rate for Payer: UHC Exchange |
$3,134.31
|
| Rate for Payer: UHC Medicaid |
$1,008.34
|
| Rate for Payer: UHCCP DNSP |
$1,598.57
|
| Rate for Payer: UHCCP Medicaid |
$1,008.34
|
|
|
PR BPG OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL
|
Professional
|
Both
|
$5,218.00
|
|
|
Service Code
|
HCPCS 35631
|
| Min. Negotiated Rate |
$1,067.56 |
| Max. Negotiated Rate |
$3,913.50 |
| Rate for Payer: Aetna Commercial |
$2,271.19
|
| Rate for Payer: Aetna Medicare |
$1,694.92
|
| Rate for Payer: BCBS Complete |
$1,120.94
|
| Rate for Payer: BCBS MAPPO |
$1,694.92
|
| Rate for Payer: BCN Commercial |
$2,694.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,694.92
|
| Rate for Payer: Cash Price |
$4,174.40
|
| Rate for Payer: Cash Price |
$4,174.40
|
| Rate for Payer: Cofinity Commercial |
$2,440.68
|
| Rate for Payer: Cofinity Commercial |
$2,271.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,694.92
|
| Rate for Payer: Healthscope Commercial |
$2,033.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,033.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,779.67
|
| Rate for Payer: Meridian Medicaid |
$1,120.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,864.41
|
| Rate for Payer: Nomi Health Commercial |
$2,033.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,913.50
|
| Rate for Payer: PACE SWMI |
$1,694.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,694.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,067.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,897.15
|
| Rate for Payer: Priority Health Medicare |
$1,694.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,897.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,694.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,331.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,694.92
|
| Rate for Payer: UHC Exchange |
$3,331.28
|
| Rate for Payer: UHC Medicaid |
$1,067.56
|
| Rate for Payer: UHCCP DNSP |
$1,694.92
|
| Rate for Payer: UHCCP Medicaid |
$1,067.56
|
|
|
PR BPG OTH/THN VEIN AORTOFEMORAL
|
Professional
|
Both
|
$3,159.00
|
|
|
Service Code
|
HCPCS 35647
|
| Min. Negotiated Rate |
$866.70 |
| Max. Negotiated Rate |
$2,780.92 |
| Rate for Payer: Aetna Commercial |
$1,847.35
|
| Rate for Payer: Aetna Medicare |
$1,378.62
|
| Rate for Payer: BCBS Complete |
$910.03
|
| Rate for Payer: BCBS MAPPO |
$1,378.62
|
| Rate for Payer: BCN Commercial |
$2,240.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,378.62
|
| Rate for Payer: Cash Price |
$2,527.20
|
| Rate for Payer: Cash Price |
$2,527.20
|
| Rate for Payer: Cofinity Commercial |
$1,985.21
|
| Rate for Payer: Cofinity Commercial |
$1,847.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,378.62
|
| Rate for Payer: Healthscope Commercial |
$1,654.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,654.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,447.55
|
| Rate for Payer: Meridian Medicaid |
$910.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,516.48
|
| Rate for Payer: Nomi Health Commercial |
$1,654.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,369.25
|
| Rate for Payer: PACE SWMI |
$1,378.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,378.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$866.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,409.29
|
| Rate for Payer: Priority Health Medicare |
$1,378.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,409.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,378.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,780.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,378.62
|
| Rate for Payer: UHC Exchange |
$2,780.92
|
| Rate for Payer: UHC Medicaid |
$866.70
|
| Rate for Payer: UHCCP DNSP |
$1,378.62
|
| Rate for Payer: UHCCP Medicaid |
$866.70
|
|
|
PR BPG OTH/THN VEIN AORTOILIAC
|
Professional
|
Both
|
$3,744.00
|
|
|
Service Code
|
HCPCS 35637
|
| Min. Negotiated Rate |
$961.48 |
| Max. Negotiated Rate |
$2,988.99 |
| Rate for Payer: Aetna Commercial |
$2,049.78
|
| Rate for Payer: Aetna Medicare |
$1,529.69
|
| Rate for Payer: BCBS Complete |
$1,009.55
|
| Rate for Payer: BCBS MAPPO |
$1,529.69
|
| Rate for Payer: BCN Commercial |
$2,423.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,529.69
|
| Rate for Payer: Cash Price |
$2,995.20
|
| Rate for Payer: Cash Price |
$2,995.20
|
| Rate for Payer: Cofinity Commercial |
$2,202.75
|
| Rate for Payer: Cofinity Commercial |
$2,049.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,529.69
|
| Rate for Payer: Healthscope Commercial |
$1,835.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,835.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,606.17
|
| Rate for Payer: Meridian Medicaid |
$1,009.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,682.66
|
| Rate for Payer: Nomi Health Commercial |
$1,835.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,808.00
|
| Rate for Payer: PACE SWMI |
$1,529.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,529.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$961.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,606.35
|
| Rate for Payer: Priority Health Medicare |
$1,529.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,606.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,529.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,988.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,529.69
|
| Rate for Payer: UHC Exchange |
$2,988.99
|
| Rate for Payer: UHC Medicaid |
$961.48
|
| Rate for Payer: UHCCP DNSP |
$1,529.69
|
| Rate for Payer: UHCCP Medicaid |
$961.48
|
|
|
PR BPG OTH/THN VEIN AORTOSUBCLA/INNOMINATE/CAROTID
|
Professional
|
Both
|
$4,903.00
|
|
|
Service Code
|
HCPCS 35626
|
| Min. Negotiated Rate |
$944.66 |
| Max. Negotiated Rate |
$3,677.25 |
| Rate for Payer: Aetna Commercial |
$1,991.07
|
| Rate for Payer: Aetna Medicare |
$1,485.87
|
| Rate for Payer: BCBS Complete |
$991.89
|
| Rate for Payer: BCBS MAPPO |
$1,485.87
|
| Rate for Payer: BCN Commercial |
$2,338.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,485.87
|
| Rate for Payer: Cash Price |
$3,922.40
|
| Rate for Payer: Cash Price |
$3,922.40
|
| Rate for Payer: Cofinity Commercial |
$2,139.65
|
| Rate for Payer: Cofinity Commercial |
$1,991.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,485.87
|
| Rate for Payer: Healthscope Commercial |
$1,783.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,783.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,560.16
|
| Rate for Payer: Meridian Medicaid |
$991.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,634.46
|
| Rate for Payer: Nomi Health Commercial |
$1,783.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,677.25
|
| Rate for Payer: PACE SWMI |
$1,485.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,485.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$944.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,514.78
|
| Rate for Payer: Priority Health Medicare |
$1,485.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,514.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,485.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,840.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,485.87
|
| Rate for Payer: UHC Exchange |
$2,840.86
|
| Rate for Payer: UHC Medicaid |
$944.66
|
| Rate for Payer: UHCCP DNSP |
$1,485.87
|
| Rate for Payer: UHCCP Medicaid |
$944.66
|
|
