|
PR BYPASS W/VEIN CAROTID-BRACHIAL
|
Professional
|
Both
|
$2,675.00
|
|
|
Service Code
|
HCPCS 35510
|
| Min. Negotiated Rate |
$713.34 |
| Max. Negotiated Rate |
$2,212.25 |
| Rate for Payer: Aetna Commercial |
$1,519.88
|
| Rate for Payer: Aetna Medicare |
$1,134.24
|
| Rate for Payer: BCBS Complete |
$749.01
|
| Rate for Payer: BCBS MAPPO |
$1,134.24
|
| Rate for Payer: BCN Commercial |
$1,797.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,134.24
|
| Rate for Payer: Cash Price |
$2,140.00
|
| Rate for Payer: Cash Price |
$2,140.00
|
| Rate for Payer: Cofinity Commercial |
$1,633.31
|
| Rate for Payer: Cofinity Commercial |
$1,519.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,134.24
|
| Rate for Payer: Healthscope Commercial |
$1,361.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,361.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,190.95
|
| Rate for Payer: Meridian Medicaid |
$749.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,247.66
|
| Rate for Payer: Nomi Health Commercial |
$1,361.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,006.25
|
| Rate for Payer: PACE SWMI |
$1,134.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,134.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,932.68
|
| Rate for Payer: Priority Health Medicare |
$1,134.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,932.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,134.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,212.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,134.24
|
| Rate for Payer: UHC Exchange |
$2,212.25
|
| Rate for Payer: UHC Medicaid |
$713.34
|
| Rate for Payer: UHCCP DNSP |
$1,134.24
|
| Rate for Payer: UHCCP Medicaid |
$713.34
|
|
|
PR BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID
|
Professional
|
Both
|
$2,748.00
|
|
|
Service Code
|
HCPCS 35506
|
| Min. Negotiated Rate |
$739.11 |
| Max. Negotiated Rate |
$2,293.81 |
| Rate for Payer: Aetna Commercial |
$1,575.14
|
| Rate for Payer: Aetna Medicare |
$1,175.48
|
| Rate for Payer: BCBS Complete |
$776.07
|
| Rate for Payer: BCBS MAPPO |
$1,175.48
|
| Rate for Payer: BCN Commercial |
$1,863.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,175.48
|
| Rate for Payer: Cash Price |
$2,198.40
|
| Rate for Payer: Cash Price |
$2,198.40
|
| Rate for Payer: Cofinity Commercial |
$1,692.69
|
| Rate for Payer: Cofinity Commercial |
$1,575.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,175.48
|
| Rate for Payer: Healthscope Commercial |
$1,410.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,410.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,234.25
|
| Rate for Payer: Meridian Medicaid |
$776.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,293.03
|
| Rate for Payer: Nomi Health Commercial |
$1,410.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,061.00
|
| Rate for Payer: PACE SWMI |
$1,175.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,175.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$739.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,003.91
|
| Rate for Payer: Priority Health Medicare |
$1,175.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,003.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,175.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,293.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,175.48
|
| Rate for Payer: UHC Exchange |
$2,293.81
|
| Rate for Payer: UHC Medicaid |
$739.11
|
| Rate for Payer: UHCCP DNSP |
$1,175.48
|
| Rate for Payer: UHCCP Medicaid |
$739.11
|
|
|
PR BYPASS W/VEIN COMMON-IPSILATERAL CAROTID
|
Professional
|
Both
|
$3,175.00
|
|
|
Service Code
|
HCPCS 35501
|
| Min. Negotiated Rate |
$846.25 |
| Max. Negotiated Rate |
$2,630.10 |
| Rate for Payer: Aetna Commercial |
$1,804.12
|
| Rate for Payer: Aetna Medicare |
$1,346.36
|
| Rate for Payer: BCBS Complete |
$888.56
|
| Rate for Payer: BCBS MAPPO |
$1,346.36
|
| Rate for Payer: BCN Commercial |
$2,130.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,346.36
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,938.76
|
| Rate for Payer: Cofinity Commercial |
$1,804.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,346.36
|
| Rate for Payer: Healthscope Commercial |
$1,615.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,615.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,413.68
|
| Rate for Payer: Meridian Medicaid |
$888.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,481.00
|
| Rate for Payer: Nomi Health Commercial |
$1,615.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,381.25
|
| Rate for Payer: PACE SWMI |
$1,346.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,346.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,291.48
|
| Rate for Payer: Priority Health Medicare |
$1,346.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,291.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,346.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,630.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,346.36
|
| Rate for Payer: UHC Exchange |
$2,630.10
|
| Rate for Payer: UHC Medicaid |
$846.25
|
| Rate for Payer: UHCCP DNSP |
$1,346.36
|
| Rate for Payer: UHCCP Medicaid |
$846.25
|
|
|
PR BYPASS W/VEIN FEMORAL-FEMORAL
|
Professional
|
Both
|
$2,485.00
|
|
|
Service Code
|
HCPCS 35558
|
| Min. Negotiated Rate |
$703.54 |
| Max. Negotiated Rate |
$2,206.34 |
| Rate for Payer: Aetna Commercial |
$1,492.44
|
| Rate for Payer: Aetna Medicare |
$1,113.76
|
| Rate for Payer: BCBS Complete |
$738.72
|
| Rate for Payer: BCBS MAPPO |
$1,113.76
|
| Rate for Payer: BCN Commercial |
$1,785.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,113.76
|
| Rate for Payer: Cash Price |
$1,988.00
|
| Rate for Payer: Cash Price |
$1,988.00
|
| Rate for Payer: Cofinity Commercial |
$1,603.81
|
| Rate for Payer: Cofinity Commercial |
$1,492.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,113.76
|
| Rate for Payer: Healthscope Commercial |
$1,336.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,336.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,169.45
|
| Rate for Payer: Meridian Medicaid |
$738.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,225.14
|
| Rate for Payer: Nomi Health Commercial |
$1,336.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,863.75
|
| Rate for Payer: PACE SWMI |
$1,113.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,113.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,920.37
|
| Rate for Payer: Priority Health Medicare |
$1,113.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,920.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,113.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,206.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,113.76
|
| Rate for Payer: UHC Exchange |
$2,206.34
|
| Rate for Payer: UHC Medicaid |
$703.54
|
| Rate for Payer: UHCCP DNSP |
$1,113.76
|
| Rate for Payer: UHCCP Medicaid |
$703.54
|
|
|
PR BYPASS W/VEIN FEMORAL-POPLITEAL
|
Professional
|
Both
|
$2,833.00
|
|
|
Service Code
|
HCPCS 35556
|
| Min. Negotiated Rate |
$804.71 |
| Max. Negotiated Rate |
$2,516.54 |
| Rate for Payer: Aetna Commercial |
$1,709.37
|
| Rate for Payer: Aetna Medicare |
$1,275.65
|
| Rate for Payer: BCBS Complete |
$844.95
|
| Rate for Payer: BCBS MAPPO |
$1,275.65
|
| Rate for Payer: BCN Commercial |
$2,033.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.65
|
| Rate for Payer: Cash Price |
$2,266.40
|
| Rate for Payer: Cash Price |
$2,266.40
|
| Rate for Payer: Cofinity Commercial |
$1,836.94
|
| Rate for Payer: Cofinity Commercial |
$1,709.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.65
|
| Rate for Payer: Healthscope Commercial |
$1,530.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,530.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.43
|
| Rate for Payer: Meridian Medicaid |
$844.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,403.21
|
| Rate for Payer: Nomi Health Commercial |
$1,530.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,124.75
|
| Rate for Payer: PACE SWMI |
$1,275.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$804.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,186.51
|
| Rate for Payer: Priority Health Medicare |
$1,275.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,186.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,275.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,516.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,275.65
|
| Rate for Payer: UHC Exchange |
$2,516.54
|
| Rate for Payer: UHC Medicaid |
$804.71
|
| Rate for Payer: UHCCP DNSP |
$1,275.65
|
| Rate for Payer: UHCCP Medicaid |
$804.71
|
|
|
PR BYPASS W/VEIN HEPATORENAL
|
Professional
|
Both
|
$4,052.00
|
|
|
Service Code
|
HCPCS 35535
|
| Min. Negotiated Rate |
$1,102.06 |
| Max. Negotiated Rate |
$3,431.16 |
| Rate for Payer: Aetna Commercial |
$2,351.08
|
| Rate for Payer: Aetna Medicare |
$1,754.54
|
| Rate for Payer: BCBS Complete |
$1,157.16
|
| Rate for Payer: BCBS MAPPO |
$1,754.54
|
| Rate for Payer: BCN Commercial |
$2,778.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,754.54
|
| Rate for Payer: Cash Price |
$3,241.60
|
| Rate for Payer: Cash Price |
$3,241.60
|
| Rate for Payer: Cofinity Commercial |
$2,526.54
|
| Rate for Payer: Cofinity Commercial |
$2,351.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,754.54
|
| Rate for Payer: Healthscope Commercial |
$2,105.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,105.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,842.27
|
| Rate for Payer: Meridian Medicaid |
$1,157.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,929.99
|
| Rate for Payer: Nomi Health Commercial |
$2,105.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,039.00
|
| Rate for Payer: PACE SWMI |
$1,754.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,754.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,102.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,988.17
|
| Rate for Payer: Priority Health Medicare |
$1,754.54
|
| Rate for Payer: Priority Health Narrow Network |
$2,988.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,754.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,431.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,754.54
|
| Rate for Payer: UHC Exchange |
$3,431.16
|
| Rate for Payer: UHC Medicaid |
$1,102.06
|
| Rate for Payer: UHCCP DNSP |
$1,754.54
|
| Rate for Payer: UHCCP Medicaid |
$1,102.06
|
|
|
PR BYPASS W/VEIN ILIOFEMORAL
|
Professional
|
Both
|
$2,679.00
|
|
|
Service Code
|
HCPCS 35565
|
| Min. Negotiated Rate |
$740.60 |
| Max. Negotiated Rate |
$2,351.75 |
| Rate for Payer: Aetna Commercial |
$1,576.74
|
| Rate for Payer: Aetna Medicare |
$1,176.67
|
| Rate for Payer: BCBS Complete |
$777.63
|
| Rate for Payer: BCBS MAPPO |
$1,176.67
|
| Rate for Payer: BCN Commercial |
$1,912.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,176.67
|
| Rate for Payer: Cash Price |
$2,143.20
|
| Rate for Payer: Cash Price |
$2,143.20
|
| Rate for Payer: Cofinity Commercial |
$1,694.40
|
| Rate for Payer: Cofinity Commercial |
$1,576.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,176.67
|
| Rate for Payer: Healthscope Commercial |
$1,412.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,412.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,235.50
|
| Rate for Payer: Meridian Medicaid |
$777.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,294.34
|
| Rate for Payer: Nomi Health Commercial |
$1,412.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,009.25
|
| Rate for Payer: PACE SWMI |
$1,176.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,176.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,056.39
|
| Rate for Payer: Priority Health Medicare |
$1,176.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,056.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,176.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,351.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,176.67
|
| Rate for Payer: UHC Exchange |
$2,351.75
|
| Rate for Payer: UHC Medicaid |
$740.60
|
| Rate for Payer: UHCCP DNSP |
$1,176.67
|
| Rate for Payer: UHCCP Medicaid |
$740.60
|
|
|
PR BYPASS W/VEIN ILIOILIAC
|
Professional
|
Both
|
$2,899.00
|
|
|
Service Code
|
HCPCS 35563
|
| Min. Negotiated Rate |
$768.08 |
| Max. Negotiated Rate |
$2,380.04 |
| Rate for Payer: Aetna Commercial |
$1,635.55
|
| Rate for Payer: Aetna Medicare |
$1,220.56
|
| Rate for Payer: BCBS Complete |
$806.48
|
| Rate for Payer: BCBS MAPPO |
$1,220.56
|
| Rate for Payer: BCN Commercial |
$1,937.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,220.56
|
| Rate for Payer: Cash Price |
$2,319.20
|
| Rate for Payer: Cash Price |
$2,319.20
|
| Rate for Payer: Cofinity Commercial |
$1,757.61
|
| Rate for Payer: Cofinity Commercial |
$1,635.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,220.56
|
| Rate for Payer: Healthscope Commercial |
$1,464.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,464.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,281.59
|
| Rate for Payer: Meridian Medicaid |
$806.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,342.62
|
| Rate for Payer: Nomi Health Commercial |
$1,464.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,174.25
|
| Rate for Payer: PACE SWMI |
$1,220.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,220.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$768.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,083.16
|
| Rate for Payer: Priority Health Medicare |
$1,220.56
|
| Rate for Payer: Priority Health Narrow Network |
$2,083.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,220.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,380.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,220.56
|
| Rate for Payer: UHC Exchange |
$2,380.04
|
| Rate for Payer: UHC Medicaid |
$768.08
|
| Rate for Payer: UHCCP DNSP |
$1,220.56
|
| Rate for Payer: UHCCP Medicaid |
$768.08
|
|
|
PR BYPASS W/VEIN SPLENORENAL
|
Professional
|
Both
|
$5,052.00
|
|
|
Service Code
|
HCPCS 35536
|
| Min. Negotiated Rate |
$979.16 |
| Max. Negotiated Rate |
$3,789.00 |
| Rate for Payer: Aetna Commercial |
$2,087.76
|
| Rate for Payer: Aetna Medicare |
$1,558.03
|
| Rate for Payer: BCBS Complete |
$1,028.12
|
| Rate for Payer: BCBS MAPPO |
$1,558.03
|
| Rate for Payer: BCN Commercial |
$2,469.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,558.03
|
| Rate for Payer: Cash Price |
$4,041.60
|
| Rate for Payer: Cash Price |
$4,041.60
|
| Rate for Payer: Cofinity Commercial |
$2,243.56
|
| Rate for Payer: Cofinity Commercial |
$2,087.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,558.03
|
| Rate for Payer: Healthscope Commercial |
$1,869.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,869.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,635.93
|
| Rate for Payer: Meridian Medicaid |
$1,028.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,713.83
|
| Rate for Payer: Nomi Health Commercial |
$1,869.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,789.00
|
| Rate for Payer: PACE SWMI |
$1,558.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,558.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$979.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,655.62
|
| Rate for Payer: Priority Health Medicare |
$1,558.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,655.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,558.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,045.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,558.03
|
| Rate for Payer: UHC Exchange |
$3,045.17
|
| Rate for Payer: UHC Medicaid |
$979.16
|
| Rate for Payer: UHCCP DNSP |
$1,558.03
|
| Rate for Payer: UHCCP Medicaid |
$979.16
|
|
|
PR BYPASS W/VEIN SUBCLAVIAN-BRACHIAL
|
Professional
|
Both
|
$2,620.00
|
|
|
Service Code
|
HCPCS 35512
|
| Min. Negotiated Rate |
$699.71 |
| Max. Negotiated Rate |
$2,169.94 |
| Rate for Payer: Aetna Commercial |
$1,490.67
|
| Rate for Payer: Aetna Medicare |
$1,112.44
|
| Rate for Payer: BCBS Complete |
$734.70
|
| Rate for Payer: BCBS MAPPO |
$1,112.44
|
| Rate for Payer: BCN Commercial |
$1,762.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,112.44
|
| Rate for Payer: Cash Price |
$2,096.00
|
| Rate for Payer: Cash Price |
$2,096.00
|
| Rate for Payer: Cofinity Commercial |
$1,601.91
|
| Rate for Payer: Cofinity Commercial |
$1,490.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,112.44
|
| Rate for Payer: Healthscope Commercial |
$1,334.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,334.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,168.06
|
| Rate for Payer: Meridian Medicaid |
$734.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,223.68
|
| Rate for Payer: Nomi Health Commercial |
$1,334.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.00
|
| Rate for Payer: PACE SWMI |
$1,112.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,112.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$699.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,895.73
|
| Rate for Payer: Priority Health Medicare |
$1,112.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,895.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,112.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,169.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,112.44
|
| Rate for Payer: UHC Exchange |
$2,169.94
|
| Rate for Payer: UHC Medicaid |
$699.71
|
| Rate for Payer: UHCCP DNSP |
$1,112.44
|
| Rate for Payer: UHCCP Medicaid |
$699.71
|
|
|
PR BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN
|
Professional
|
Both
|
$4,311.00
|
|
|
Service Code
|
HCPCS 35511
|
| Min. Negotiated Rate |
$650.29 |
| Max. Negotiated Rate |
$3,233.25 |
| Rate for Payer: Aetna Commercial |
$1,385.32
|
| Rate for Payer: Aetna Medicare |
$1,033.82
|
| Rate for Payer: BCBS Complete |
$682.80
|
| Rate for Payer: BCBS MAPPO |
$1,033.82
|
| Rate for Payer: BCN Commercial |
$1,638.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,033.82
|
| Rate for Payer: Cash Price |
$3,448.80
|
| Rate for Payer: Cash Price |
$3,448.80
|
| Rate for Payer: Cofinity Commercial |
$1,488.70
|
| Rate for Payer: Cofinity Commercial |
$1,385.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,033.82
|
| Rate for Payer: Healthscope Commercial |
$1,240.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,240.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,085.51
|
| Rate for Payer: Meridian Medicaid |
$682.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,137.20
|
| Rate for Payer: Nomi Health Commercial |
$1,240.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,233.25
|
| Rate for Payer: PACE SWMI |
$1,033.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,033.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,761.85
|
| Rate for Payer: Priority Health Medicare |
$1,033.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,761.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,033.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,016.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,033.82
|
| Rate for Payer: UHC Exchange |
$2,016.87
|
| Rate for Payer: UHC Medicaid |
$650.29
|
| Rate for Payer: UHCCP DNSP |
$1,033.82
|
| Rate for Payer: UHCCP Medicaid |
$650.29
|
|
|
PR BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 35682
|
| Min. Negotiated Rate |
$201.07 |
| Max. Negotiated Rate |
$638.60 |
| Rate for Payer: Aetna Commercial |
$430.26
|
| Rate for Payer: Aetna Medicare |
$321.09
|
| Rate for Payer: BCBS Complete |
$211.12
|
| Rate for Payer: BCBS MAPPO |
$321.09
|
| Rate for Payer: BCN Commercial |
$511.43
|
| Rate for Payer: BCN Medicare Advantage |
$321.09
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$462.37
|
| Rate for Payer: Cofinity Commercial |
$430.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.09
|
| Rate for Payer: Healthscope Commercial |
$385.31
|
| Rate for Payer: Healthscope Whirlpool |
$385.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.14
|
| Rate for Payer: Meridian Medicaid |
$211.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$353.20
|
| Rate for Payer: Nomi Health Commercial |
$385.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$545.25
|
| Rate for Payer: PACE SWMI |
$321.09
|
| Rate for Payer: PHP Medicare Advantage |
$321.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$549.98
|
| Rate for Payer: Priority Health Medicare |
$321.09
|
| Rate for Payer: Priority Health Narrow Network |
$549.98
|
| Rate for Payer: Railroad Medicare Medicare |
$321.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$321.09
|
| Rate for Payer: UHC Exchange |
$638.60
|
| Rate for Payer: UHC Medicaid |
$201.07
|
| Rate for Payer: UHCCP DNSP |
$321.09
|
| Rate for Payer: UHCCP Medicaid |
$201.07
|
|
|
PR BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION
|
Professional
|
Both
|
$892.00
|
|
|
Service Code
|
HCPCS 35683
|
| Min. Negotiated Rate |
$235.37 |
| Max. Negotiated Rate |
$739.15 |
| Rate for Payer: Aetna Commercial |
$504.18
|
| Rate for Payer: Aetna Medicare |
$376.25
|
| Rate for Payer: BCBS Complete |
$247.14
|
| Rate for Payer: BCBS MAPPO |
$376.25
|
| Rate for Payer: BCN Commercial |
$596.08
|
| Rate for Payer: BCN Medicare Advantage |
$376.25
|
| Rate for Payer: Cash Price |
$713.60
|
| Rate for Payer: Cash Price |
$713.60
|
| Rate for Payer: Cofinity Commercial |
$541.80
|
| Rate for Payer: Cofinity Commercial |
$504.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.25
|
| Rate for Payer: Healthscope Commercial |
$451.50
|
| Rate for Payer: Healthscope Whirlpool |
$451.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.06
|
| Rate for Payer: Meridian Medicaid |
$247.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$413.88
|
| Rate for Payer: Nomi Health Commercial |
$451.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.00
|
| Rate for Payer: PACE SWMI |
$376.25
|
| Rate for Payer: PHP Medicare Advantage |
$376.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$641.02
|
| Rate for Payer: Priority Health Medicare |
$376.25
|
| Rate for Payer: Priority Health Narrow Network |
$641.02
|
| Rate for Payer: Railroad Medicare Medicare |
$376.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$739.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$376.25
|
| Rate for Payer: UHC Exchange |
$739.15
|
| Rate for Payer: UHC Medicaid |
$235.37
|
| Rate for Payer: UHCCP DNSP |
$376.25
|
| Rate for Payer: UHCCP Medicaid |
$235.37
|
|
|
PR BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL
|
Professional
|
Both
|
$4,975.00
|
|
|
Service Code
|
HCPCS 35566
|
| Min. Negotiated Rate |
$957.65 |
| Max. Negotiated Rate |
$3,731.25 |
| Rate for Payer: Aetna Commercial |
$2,037.95
|
| Rate for Payer: Aetna Medicare |
$1,520.86
|
| Rate for Payer: BCBS Complete |
$1,005.53
|
| Rate for Payer: BCBS MAPPO |
$1,520.86
|
| Rate for Payer: BCN Commercial |
$2,420.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,520.86
|
| Rate for Payer: Cash Price |
$3,980.00
|
| Rate for Payer: Cash Price |
$3,980.00
|
| Rate for Payer: Cofinity Commercial |
$2,037.95
|
| Rate for Payer: Cofinity Commercial |
$2,190.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,520.86
|
| Rate for Payer: Healthscope Commercial |
$1,825.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,825.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,596.90
|
| Rate for Payer: Meridian Medicaid |
$1,005.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,672.95
|
| Rate for Payer: Nomi Health Commercial |
$1,825.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,731.25
|
| Rate for Payer: PACE SWMI |
$1,520.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,520.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$957.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,603.14
|
| Rate for Payer: Priority Health Medicare |
$1,520.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,603.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,520.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,005.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,520.86
|
| Rate for Payer: UHC Exchange |
$3,005.82
|
| Rate for Payer: UHC Medicaid |
$957.65
|
| Rate for Payer: UHCCP DNSP |
$1,520.86
|
| Rate for Payer: UHCCP Medicaid |
$957.65
|
|
|
PR BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC
|
Professional
|
Both
|
$2,023.00
|
|
|
Service Code
|
HCPCS 33891
|
| Min. Negotiated Rate |
$809.20 |
| Max. Negotiated Rate |
$1,517.25 |
| Rate for Payer: Aetna Commercial |
$1,300.03
|
| Rate for Payer: BCBS Complete |
$809.20
|
| Rate for Payer: BCN Commercial |
$1,401.32
|
| Rate for Payer: Cash Price |
$1,618.40
|
| Rate for Payer: Cash Price |
$1,618.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,517.25
|
|
|
PR BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL
|
Professional
|
Both
|
$2,882.00
|
|
|
Service Code
|
HCPCS 35570
|
| Min. Negotiated Rate |
$854.98 |
| Max. Negotiated Rate |
$2,651.78 |
| Rate for Payer: Aetna Commercial |
$1,821.30
|
| Rate for Payer: Aetna Medicare |
$1,359.18
|
| Rate for Payer: BCBS Complete |
$897.73
|
| Rate for Payer: BCBS MAPPO |
$1,359.18
|
| Rate for Payer: BCN Commercial |
$2,154.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,359.18
|
| Rate for Payer: Cash Price |
$2,305.60
|
| Rate for Payer: Cash Price |
$2,305.60
|
| Rate for Payer: Cofinity Commercial |
$1,957.22
|
| Rate for Payer: Cofinity Commercial |
$1,821.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,359.18
|
| Rate for Payer: Healthscope Commercial |
$1,631.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,631.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,427.14
|
| Rate for Payer: Meridian Medicaid |
$897.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,495.10
|
| Rate for Payer: Nomi Health Commercial |
$1,631.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,161.50
|
| Rate for Payer: PACE SWMI |
$1,359.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,359.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$854.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,316.64
|
| Rate for Payer: Priority Health Medicare |
$1,359.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,316.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,359.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,651.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,359.18
|
| Rate for Payer: UHC Exchange |
$2,651.78
|
| Rate for Payer: UHC Medicaid |
$854.98
|
| Rate for Payer: UHCCP DNSP |
$1,359.18
|
| Rate for Payer: UHCCP Medicaid |
$854.98
|
|
|
PR BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL
|
Professional
|
Both
|
$5,395.00
|
|
|
Service Code
|
HCPCS 35571
|
| Min. Negotiated Rate |
$765.52 |
| Max. Negotiated Rate |
$4,046.25 |
| Rate for Payer: Aetna Commercial |
$1,627.10
|
| Rate for Payer: Aetna Medicare |
$1,214.25
|
| Rate for Payer: BCBS Complete |
$803.80
|
| Rate for Payer: BCBS MAPPO |
$1,214.25
|
| Rate for Payer: BCN Commercial |
$1,931.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,214.25
|
| Rate for Payer: Cash Price |
$4,316.00
|
| Rate for Payer: Cash Price |
$4,316.00
|
| Rate for Payer: Cofinity Commercial |
$1,748.52
|
| Rate for Payer: Cofinity Commercial |
$1,627.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,214.25
|
| Rate for Payer: Healthscope Commercial |
$1,457.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,457.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,274.96
|
| Rate for Payer: Meridian Medicaid |
$803.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,335.67
|
| Rate for Payer: Nomi Health Commercial |
$1,457.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,046.25
|
| Rate for Payer: PACE SWMI |
$1,214.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,214.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,076.73
|
| Rate for Payer: Priority Health Medicare |
$1,214.25
|
| Rate for Payer: Priority Health Narrow Network |
$2,076.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,214.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,383.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,214.25
|
| Rate for Payer: UHC Exchange |
$2,383.30
|
| Rate for Payer: UHC Medicaid |
$765.52
|
| Rate for Payer: UHCCP DNSP |
$1,214.25
|
| Rate for Payer: UHCCP Medicaid |
$765.52
|
|
|
PR CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,667.00
|
|
|
Service Code
|
HCPCS 33536
|
| Min. Negotiated Rate |
$1,569.17 |
| Max. Negotiated Rate |
$4,713.59 |
| Rate for Payer: Aetna Commercial |
$3,306.89
|
| Rate for Payer: Aetna Medicare |
$2,467.83
|
| Rate for Payer: BCBS Complete |
$1,647.63
|
| Rate for Payer: BCBS MAPPO |
$2,467.83
|
| Rate for Payer: BCN Commercial |
$3,871.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,467.83
|
| Rate for Payer: Cash Price |
$4,533.60
|
| Rate for Payer: Cash Price |
$4,533.60
|
| Rate for Payer: Cofinity Commercial |
$3,553.68
|
| Rate for Payer: Cofinity Commercial |
$3,306.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,467.83
|
| Rate for Payer: Healthscope Commercial |
$2,961.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,961.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,591.22
|
| Rate for Payer: Meridian Medicaid |
$1,647.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,714.61
|
| Rate for Payer: Nomi Health Commercial |
$2,961.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,250.25
|
| Rate for Payer: PACE SWMI |
$2,467.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,467.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,569.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,163.10
|
| Rate for Payer: Priority Health Medicare |
$2,467.83
|
| Rate for Payer: Priority Health Narrow Network |
$4,163.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,467.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,713.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,467.83
|
| Rate for Payer: UHC Exchange |
$4,713.59
|
| Rate for Payer: UHC Medicaid |
$1,569.17
|
| Rate for Payer: UHCCP DNSP |
$2,467.83
|
| Rate for Payer: UHCCP Medicaid |
$1,569.17
|
|
|
PR CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT
|
Professional
|
Both
|
$4,028.00
|
|
|
Service Code
|
HCPCS 33533
|
| Min. Negotiated Rate |
$1,121.02 |
| Max. Negotiated Rate |
$3,334.21 |
| Rate for Payer: Aetna Commercial |
$2,357.38
|
| Rate for Payer: Aetna Medicare |
$1,759.24
|
| Rate for Payer: BCBS Complete |
$1,177.07
|
| Rate for Payer: BCBS MAPPO |
$1,759.24
|
| Rate for Payer: BCN Commercial |
$2,754.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,759.24
|
| Rate for Payer: Cash Price |
$3,222.40
|
| Rate for Payer: Cash Price |
$3,222.40
|
| Rate for Payer: Cofinity Commercial |
$2,533.31
|
| Rate for Payer: Cofinity Commercial |
$2,357.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,759.24
|
| Rate for Payer: Healthscope Commercial |
$2,111.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,111.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,847.20
|
| Rate for Payer: Meridian Medicaid |
$1,177.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,935.16
|
| Rate for Payer: Nomi Health Commercial |
$2,111.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,021.00
|
| Rate for Payer: PACE SWMI |
$1,759.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,759.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,121.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,961.93
|
| Rate for Payer: Priority Health Medicare |
$1,759.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,759.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,334.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,759.24
|
| Rate for Payer: UHC Exchange |
$3,334.21
|
| Rate for Payer: UHC Medicaid |
$1,121.02
|
| Rate for Payer: UHCCP DNSP |
$1,759.24
|
| Rate for Payer: UHCCP Medicaid |
$1,121.02
|
|
|
PR CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,290.00
|
|
|
Service Code
|
HCPCS 33535
|
| Min. Negotiated Rate |
$1,457.56 |
| Max. Negotiated Rate |
$4,373.14 |
| Rate for Payer: Aetna Commercial |
$3,069.81
|
| Rate for Payer: Aetna Medicare |
$2,290.90
|
| Rate for Payer: BCBS Complete |
$1,530.44
|
| Rate for Payer: BCBS MAPPO |
$2,290.90
|
| Rate for Payer: BCN Commercial |
$3,593.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,290.90
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cofinity Commercial |
$3,298.90
|
| Rate for Payer: Cofinity Commercial |
$3,069.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,290.90
|
| Rate for Payer: Healthscope Commercial |
$2,749.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,749.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,405.45
|
| Rate for Payer: Meridian Medicaid |
$1,530.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,519.99
|
| Rate for Payer: Nomi Health Commercial |
$2,749.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,967.50
|
| Rate for Payer: PACE SWMI |
$2,290.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,290.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,457.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,864.82
|
| Rate for Payer: Priority Health Medicare |
$2,290.90
|
| Rate for Payer: Priority Health Narrow Network |
$3,864.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,290.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,373.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,290.90
|
| Rate for Payer: UHC Exchange |
$4,373.14
|
| Rate for Payer: UHC Medicaid |
$1,457.56
|
| Rate for Payer: UHCCP DNSP |
$2,290.90
|
| Rate for Payer: UHCCP Medicaid |
$1,457.56
|
|
|
PR CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS
|
Professional
|
Both
|
$4,740.00
|
|
|
Service Code
|
HCPCS 33534
|
| Min. Negotiated Rate |
$1,314.42 |
| Max. Negotiated Rate |
$3,919.54 |
| Rate for Payer: Aetna Commercial |
$2,765.97
|
| Rate for Payer: Aetna Medicare |
$2,064.16
|
| Rate for Payer: BCBS Complete |
$1,380.14
|
| Rate for Payer: BCBS MAPPO |
$2,064.16
|
| Rate for Payer: BCN Commercial |
$3,235.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,064.16
|
| Rate for Payer: Cash Price |
$3,792.00
|
| Rate for Payer: Cash Price |
$3,792.00
|
| Rate for Payer: Cofinity Commercial |
$2,972.39
|
| Rate for Payer: Cofinity Commercial |
$2,765.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,064.16
|
| Rate for Payer: Healthscope Commercial |
$2,476.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,476.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,167.37
|
| Rate for Payer: Meridian Medicaid |
$1,380.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,270.58
|
| Rate for Payer: Nomi Health Commercial |
$2,476.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,555.00
|
| Rate for Payer: PACE SWMI |
$2,064.16
|
| Rate for Payer: PHP Medicare Advantage |
$2,064.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,314.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,479.24
|
| Rate for Payer: Priority Health Medicare |
$2,064.16
|
| Rate for Payer: Priority Health Narrow Network |
$3,479.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,064.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,919.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,064.16
|
| Rate for Payer: UHC Exchange |
$3,919.54
|
| Rate for Payer: UHC Medicaid |
$1,314.42
|
| Rate for Payer: UHCCP DNSP |
$2,064.16
|
| Rate for Payer: UHCCP Medicaid |
$1,314.42
|
|
|
PR CALIBRATED MICROCAP TUBE
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS A4651
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Aetna Commercial |
$0.03
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCN Commercial |
$1.86
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
|
|
PR CALORIC VESTIBULAR TEST, EACH IRRIGATION, WITH RECORDING
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 92543
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.00
|
|
|
PR CANALITH REPOSITIONING PROCEDURE
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 95992
|
| Min. Negotiated Rate |
$29.41 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Aetna Commercial |
$39.41
|
| Rate for Payer: Aetna Medicare |
$29.41
|
| Rate for Payer: BCBS Complete |
$54.00
|
| Rate for Payer: BCBS MAPPO |
$29.41
|
| Rate for Payer: BCN Commercial |
$52.79
|
| Rate for Payer: BCN Medicare Advantage |
$29.41
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$42.35
|
| Rate for Payer: Cofinity Commercial |
$39.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.41
|
| Rate for Payer: Healthscope Commercial |
$35.29
|
| Rate for Payer: Healthscope Whirlpool |
$35.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.35
|
| Rate for Payer: Nomi Health Commercial |
$35.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$29.41
|
| Rate for Payer: PHP Medicare Advantage |
$29.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.68
|
| Rate for Payer: Priority Health Medicare |
$29.41
|
| Rate for Payer: Priority Health Narrow Network |
$48.68
|
| Rate for Payer: Railroad Medicare Medicare |
$29.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.41
|
| Rate for Payer: UHC Exchange |
$61.37
|
| Rate for Payer: UHCCP DNSP |
$29.41
|
|
|
PR CANTHOPLASTY
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 67950
|
| Min. Negotiated Rate |
$253.47 |
| Max. Negotiated Rate |
$885.00 |
| Rate for Payer: Aetna Commercial |
$513.85
|
| Rate for Payer: Aetna Medicare |
$383.47
|
| Rate for Payer: BCBS Complete |
$266.14
|
| Rate for Payer: BCBS MAPPO |
$383.47
|
| Rate for Payer: BCN Commercial |
$685.22
|
| Rate for Payer: BCN Medicare Advantage |
$383.47
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$552.20
|
| Rate for Payer: Cofinity Commercial |
$513.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.47
|
| Rate for Payer: Healthscope Commercial |
$460.16
|
| Rate for Payer: Healthscope Whirlpool |
$460.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.64
|
| Rate for Payer: Meridian Medicaid |
$266.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$421.82
|
| Rate for Payer: Nomi Health Commercial |
$460.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$885.00
|
| Rate for Payer: PACE SWMI |
$383.47
|
| Rate for Payer: PHP Medicare Advantage |
$383.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$802.63
|
| Rate for Payer: Priority Health Medicare |
$383.47
|
| Rate for Payer: Priority Health Narrow Network |
$802.63
|
| Rate for Payer: Railroad Medicare Medicare |
$383.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$787.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$383.47
|
| Rate for Payer: UHC Exchange |
$787.37
|
| Rate for Payer: UHC Medicaid |
$253.47
|
| Rate for Payer: UHCCP DNSP |
$383.47
|
| Rate for Payer: UHCCP Medicaid |
$253.47
|
|
