|
PR BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL
|
Professional
|
Both
|
$3,232.00
|
|
|
Service Code
|
HCPCS 35634
|
| Min. Negotiated Rate |
$1,292.80 |
| Max. Negotiated Rate |
$2,452.68 |
| Rate for Payer: Aetna Commercial |
$2,282.36
|
| Rate for Payer: Aetna Medicare |
$1,703.25
|
| Rate for Payer: BCBS Complete |
$1,292.80
|
| Rate for Payer: BCBS MAPPO |
$1,703.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,703.25
|
| Rate for Payer: Cash Price |
$2,585.60
|
| Rate for Payer: Cash Price |
$2,585.60
|
| Rate for Payer: Cofinity Commercial |
$2,452.68
|
| Rate for Payer: Cofinity Commercial |
$2,282.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,703.25
|
| Rate for Payer: Healthscope Commercial |
$2,043.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,043.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,788.41
|
| Rate for Payer: Nomi Health Commercial |
$2,043.90
|
| Rate for Payer: PACE SWMI |
$1,703.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,703.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,100.80
|
| Rate for Payer: Priority Health Medicare |
$1,703.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,703.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,703.25
|
| Rate for Payer: UHCCP DNSP |
$1,703.25
|
|
|
PR BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE
|
Professional
|
Both
|
$4,760.00
|
|
|
Service Code
|
HCPCS 35626
|
| Min. Negotiated Rate |
$1,526.93 |
| Max. Negotiated Rate |
$3,094.00 |
| Rate for Payer: Aetna Commercial |
$2,046.09
|
| Rate for Payer: Aetna Medicare |
$1,526.93
|
| Rate for Payer: BCBS Complete |
$1,904.00
|
| Rate for Payer: BCBS MAPPO |
$1,526.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,526.93
|
| Rate for Payer: Cash Price |
$3,808.00
|
| Rate for Payer: Cash Price |
$3,808.00
|
| Rate for Payer: Cofinity Commercial |
$2,198.78
|
| Rate for Payer: Cofinity Commercial |
$2,046.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,526.93
|
| Rate for Payer: Healthscope Commercial |
$1,832.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,832.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,603.28
|
| Rate for Payer: Nomi Health Commercial |
$1,832.32
|
| Rate for Payer: PACE SWMI |
$1,526.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,526.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,094.00
|
| Rate for Payer: Priority Health Medicare |
$1,526.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,526.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,526.93
|
| Rate for Payer: UHCCP DNSP |
$1,526.93
|
|
|
PR BYPASS W/VEIN AORTOBI-ILIAC
|
Professional
|
Both
|
$6,403.00
|
|
|
Service Code
|
HCPCS 35538
|
| Min. Negotiated Rate |
$2,250.68 |
| Max. Negotiated Rate |
$4,161.95 |
| Rate for Payer: Aetna Commercial |
$3,015.91
|
| Rate for Payer: Aetna Medicare |
$2,250.68
|
| Rate for Payer: BCBS Complete |
$2,561.20
|
| Rate for Payer: BCBS MAPPO |
$2,250.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,250.68
|
| Rate for Payer: Cash Price |
$5,122.40
|
| Rate for Payer: Cash Price |
$5,122.40
|
| Rate for Payer: Cofinity Commercial |
$3,240.98
|
| Rate for Payer: Cofinity Commercial |
$3,015.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,250.68
|
| Rate for Payer: Healthscope Commercial |
$2,700.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,700.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,363.21
|
| Rate for Payer: Nomi Health Commercial |
$2,700.82
|
| Rate for Payer: PACE SWMI |
$2,250.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,250.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,161.95
|
| Rate for Payer: Priority Health Medicare |
$2,250.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,250.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,250.68
|
| Rate for Payer: UHCCP DNSP |
$2,250.68
|
|
|
PR BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC
|
Professional
|
Both
|
$4,277.00
|
|
|
Service Code
|
HCPCS 35531
|
| Min. Negotiated Rate |
$1,710.80 |
| Max. Negotiated Rate |
$2,780.05 |
| Rate for Payer: Aetna Commercial |
$2,517.79
|
| Rate for Payer: Aetna Medicare |
$1,878.95
|
| Rate for Payer: BCBS Complete |
$1,710.80
|
| Rate for Payer: BCBS MAPPO |
$1,878.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,878.95
|
| Rate for Payer: Cash Price |
$3,421.60
|
| Rate for Payer: Cash Price |
$3,421.60
|
| Rate for Payer: Cofinity Commercial |
$2,705.69
|
| Rate for Payer: Cofinity Commercial |
$2,517.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,878.95
|
| Rate for Payer: Healthscope Commercial |
$2,254.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,254.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,972.90
|
| Rate for Payer: Nomi Health Commercial |
$2,254.74
|
| Rate for Payer: PACE SWMI |
$1,878.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,878.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.05
|
| Rate for Payer: Priority Health Medicare |
$1,878.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,878.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,878.95
|
| Rate for Payer: UHCCP DNSP |
$1,878.95
|
|
|
PR BYPASS W/VEIN AORTOILIAC
|
Professional
|
Both
|
$4,403.00
|
|
|
Service Code
|
HCPCS 35537
|
| Min. Negotiated Rate |
$1,761.20 |
| Max. Negotiated Rate |
$2,891.69 |
| Rate for Payer: Aetna Commercial |
$2,690.88
|
| Rate for Payer: Aetna Medicare |
$2,008.12
|
| Rate for Payer: BCBS Complete |
$1,761.20
|
| Rate for Payer: BCBS MAPPO |
$2,008.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,008.12
|
| Rate for Payer: Cash Price |
$3,522.40
|
| Rate for Payer: Cash Price |
$3,522.40
|
| Rate for Payer: Cofinity Commercial |
$2,891.69
|
| Rate for Payer: Cofinity Commercial |
$2,690.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,008.12
|
| Rate for Payer: Healthscope Commercial |
$2,409.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,409.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,108.53
|
| Rate for Payer: Nomi Health Commercial |
$2,409.74
|
| Rate for Payer: PACE SWMI |
$2,008.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,008.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,861.95
|
| Rate for Payer: Priority Health Medicare |
$2,008.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,008.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,008.12
|
| Rate for Payer: UHCCP DNSP |
$2,008.12
|
|
|
PR BYPASS W/VEIN AORTOSUBCLAV/CAROTID/INNOMINATE
|
Professional
|
Both
|
$3,677.00
|
|
|
Service Code
|
HCPCS 35526
|
| Min. Negotiated Rate |
$1,470.80 |
| Max. Negotiated Rate |
$2,390.05 |
| Rate for Payer: Aetna Commercial |
$2,214.14
|
| Rate for Payer: Aetna Medicare |
$1,652.34
|
| Rate for Payer: BCBS Complete |
$1,470.80
|
| Rate for Payer: BCBS MAPPO |
$1,652.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,652.34
|
| Rate for Payer: Cash Price |
$2,941.60
|
| Rate for Payer: Cash Price |
$2,941.60
|
| Rate for Payer: Cofinity Commercial |
$2,379.37
|
| Rate for Payer: Cofinity Commercial |
$2,214.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,652.34
|
| Rate for Payer: Healthscope Commercial |
$1,982.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,982.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,734.96
|
| Rate for Payer: Nomi Health Commercial |
$1,982.81
|
| Rate for Payer: PACE SWMI |
$1,652.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,652.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,390.05
|
| Rate for Payer: Priority Health Medicare |
$1,652.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,652.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,652.34
|
| Rate for Payer: UHCCP DNSP |
$1,652.34
|
|
|
PR BYPASS W/VEIN AXILLARY-BRACHIAL
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 35522
|
| Min. Negotiated Rate |
$964.00 |
| Max. Negotiated Rate |
$1,623.12 |
| Rate for Payer: Aetna Commercial |
$1,510.41
|
| Rate for Payer: Aetna Medicare |
$1,127.17
|
| Rate for Payer: BCBS Complete |
$964.00
|
| Rate for Payer: BCBS MAPPO |
$1,127.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,127.17
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$1,623.12
|
| Rate for Payer: Cofinity Commercial |
$1,510.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,127.17
|
| Rate for Payer: Healthscope Commercial |
$1,352.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,352.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,183.53
|
| Rate for Payer: Nomi Health Commercial |
$1,352.60
|
| Rate for Payer: PACE SWMI |
$1,127.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,127.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.50
|
| Rate for Payer: Priority Health Medicare |
$1,127.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,127.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,127.17
|
| Rate for Payer: UHCCP DNSP |
$1,127.17
|
|
|
PR BYPASS W/VEIN BRACHIAL-BRACHIAL
|
Professional
|
Both
|
$4,190.00
|
|
|
Service Code
|
HCPCS 35525
|
| Min. Negotiated Rate |
$1,060.26 |
| Max. Negotiated Rate |
$2,723.50 |
| Rate for Payer: Aetna Commercial |
$1,420.75
|
| Rate for Payer: Aetna Medicare |
$1,060.26
|
| Rate for Payer: BCBS Complete |
$1,676.00
|
| Rate for Payer: BCBS MAPPO |
$1,060.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,060.26
|
| Rate for Payer: Cash Price |
$3,352.00
|
| Rate for Payer: Cash Price |
$3,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,526.77
|
| Rate for Payer: Cofinity Commercial |
$1,420.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,060.26
|
| Rate for Payer: Healthscope Commercial |
$1,272.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,272.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,113.27
|
| Rate for Payer: Nomi Health Commercial |
$1,272.31
|
| Rate for Payer: PACE SWMI |
$1,060.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,060.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,723.50
|
| Rate for Payer: Priority Health Medicare |
$1,060.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,060.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,060.26
|
| Rate for Payer: UHCCP DNSP |
$1,060.26
|
|
|
PR BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL
|
Professional
|
Both
|
$2,535.00
|
|
|
Service Code
|
HCPCS 35523
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$1,706.07 |
| Rate for Payer: Aetna Commercial |
$1,587.59
|
| Rate for Payer: Aetna Medicare |
$1,184.77
|
| Rate for Payer: BCBS Complete |
$1,014.00
|
| Rate for Payer: BCBS MAPPO |
$1,184.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.77
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cofinity Commercial |
$1,706.07
|
| Rate for Payer: Cofinity Commercial |
$1,587.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.77
|
| Rate for Payer: Healthscope Commercial |
$1,421.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,421.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,244.01
|
| Rate for Payer: Nomi Health Commercial |
$1,421.72
|
| Rate for Payer: PACE SWMI |
$1,184.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,647.75
|
| Rate for Payer: Priority Health Medicare |
$1,184.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,184.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,184.77
|
| Rate for Payer: UHCCP DNSP |
$1,184.77
|
|
|
PR BYPASS W/VEIN CAROTID-BRACHIAL
|
Professional
|
Both
|
$2,597.00
|
|
|
Service Code
|
HCPCS 35510
|
| Min. Negotiated Rate |
$1,038.80 |
| Max. Negotiated Rate |
$1,705.75 |
| Rate for Payer: Aetna Commercial |
$1,587.30
|
| Rate for Payer: Aetna Medicare |
$1,184.55
|
| Rate for Payer: BCBS Complete |
$1,038.80
|
| Rate for Payer: BCBS MAPPO |
$1,184.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.55
|
| Rate for Payer: Cash Price |
$2,077.60
|
| Rate for Payer: Cash Price |
$2,077.60
|
| Rate for Payer: Cofinity Commercial |
$1,705.75
|
| Rate for Payer: Cofinity Commercial |
$1,587.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.55
|
| Rate for Payer: Healthscope Commercial |
$1,421.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,421.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.78
|
| Rate for Payer: Nomi Health Commercial |
$1,421.46
|
| Rate for Payer: PACE SWMI |
$1,184.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,688.05
|
| Rate for Payer: Priority Health Medicare |
$1,184.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,184.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,184.55
|
| Rate for Payer: UHCCP DNSP |
$1,184.55
|
|
|
PR BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID
|
Professional
|
Both
|
$2,668.00
|
|
|
Service Code
|
HCPCS 35506
|
| Min. Negotiated Rate |
$1,067.20 |
| Max. Negotiated Rate |
$1,769.26 |
| Rate for Payer: Aetna Commercial |
$1,646.39
|
| Rate for Payer: Aetna Medicare |
$1,228.65
|
| Rate for Payer: BCBS Complete |
$1,067.20
|
| Rate for Payer: BCBS MAPPO |
$1,228.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,228.65
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,769.26
|
| Rate for Payer: Cofinity Commercial |
$1,646.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,228.65
|
| Rate for Payer: Healthscope Commercial |
$1,474.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,474.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,290.08
|
| Rate for Payer: Nomi Health Commercial |
$1,474.38
|
| Rate for Payer: PACE SWMI |
$1,228.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,228.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,734.20
|
| Rate for Payer: Priority Health Medicare |
$1,228.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,228.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,228.65
|
| Rate for Payer: UHCCP DNSP |
$1,228.65
|
|
|
PR BYPASS W/VEIN COMMON-IPSILATERAL CAROTID
|
Professional
|
Both
|
$3,083.00
|
|
|
Service Code
|
HCPCS 35501
|
| Min. Negotiated Rate |
$1,233.20 |
| Max. Negotiated Rate |
$2,023.70 |
| Rate for Payer: Aetna Commercial |
$1,883.17
|
| Rate for Payer: Aetna Medicare |
$1,405.35
|
| Rate for Payer: BCBS Complete |
$1,233.20
|
| Rate for Payer: BCBS MAPPO |
$1,405.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,405.35
|
| Rate for Payer: Cash Price |
$2,466.40
|
| Rate for Payer: Cash Price |
$2,466.40
|
| Rate for Payer: Cofinity Commercial |
$2,023.70
|
| Rate for Payer: Cofinity Commercial |
$1,883.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,405.35
|
| Rate for Payer: Healthscope Commercial |
$1,686.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,686.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,475.62
|
| Rate for Payer: Nomi Health Commercial |
$1,686.42
|
| Rate for Payer: PACE SWMI |
$1,405.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,405.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.95
|
| Rate for Payer: Priority Health Medicare |
$1,405.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,405.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,405.35
|
| Rate for Payer: UHCCP DNSP |
$1,405.35
|
|
|
PR BYPASS W/VEIN FEMORAL-FEMORAL
|
Professional
|
Both
|
$2,413.00
|
|
|
Service Code
|
HCPCS 35558
|
| Min. Negotiated Rate |
$965.20 |
| Max. Negotiated Rate |
$1,686.63 |
| Rate for Payer: Aetna Commercial |
$1,569.50
|
| Rate for Payer: Aetna Medicare |
$1,171.27
|
| Rate for Payer: BCBS Complete |
$965.20
|
| Rate for Payer: BCBS MAPPO |
$1,171.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.27
|
| Rate for Payer: Cash Price |
$1,930.40
|
| Rate for Payer: Cash Price |
$1,930.40
|
| Rate for Payer: Cofinity Commercial |
$1,686.63
|
| Rate for Payer: Cofinity Commercial |
$1,569.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.27
|
| Rate for Payer: Healthscope Commercial |
$1,405.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,229.83
|
| Rate for Payer: Nomi Health Commercial |
$1,405.52
|
| Rate for Payer: PACE SWMI |
$1,171.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,568.45
|
| Rate for Payer: Priority Health Medicare |
$1,171.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,171.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,171.27
|
| Rate for Payer: UHCCP DNSP |
$1,171.27
|
|
|
PR BYPASS W/VEIN FEMORAL-POPLITEAL
|
Professional
|
Both
|
$2,750.00
|
|
|
Service Code
|
HCPCS 35556
|
| Min. Negotiated Rate |
$1,100.00 |
| Max. Negotiated Rate |
$1,923.62 |
| Rate for Payer: Aetna Commercial |
$1,790.04
|
| Rate for Payer: Aetna Medicare |
$1,335.85
|
| Rate for Payer: BCBS Complete |
$1,100.00
|
| Rate for Payer: BCBS MAPPO |
$1,335.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,335.85
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,923.62
|
| Rate for Payer: Cofinity Commercial |
$1,790.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,335.85
|
| Rate for Payer: Healthscope Commercial |
$1,603.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,603.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,402.64
|
| Rate for Payer: Nomi Health Commercial |
$1,603.02
|
| Rate for Payer: PACE SWMI |
$1,335.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,335.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.50
|
| Rate for Payer: Priority Health Medicare |
$1,335.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,335.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,335.85
|
| Rate for Payer: UHCCP DNSP |
$1,335.85
|
|
|
PR BYPASS W/VEIN HEPATORENAL
|
Professional
|
Both
|
$3,934.00
|
|
|
Service Code
|
HCPCS 35535
|
| Min. Negotiated Rate |
$1,573.60 |
| Max. Negotiated Rate |
$2,640.44 |
| Rate for Payer: Aetna Commercial |
$2,457.08
|
| Rate for Payer: Aetna Medicare |
$1,833.64
|
| Rate for Payer: BCBS Complete |
$1,573.60
|
| Rate for Payer: BCBS MAPPO |
$1,833.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,833.64
|
| Rate for Payer: Cash Price |
$3,147.20
|
| Rate for Payer: Cash Price |
$3,147.20
|
| Rate for Payer: Cofinity Commercial |
$2,640.44
|
| Rate for Payer: Cofinity Commercial |
$2,457.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,833.64
|
| Rate for Payer: Healthscope Commercial |
$2,200.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,200.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,925.32
|
| Rate for Payer: Nomi Health Commercial |
$2,200.37
|
| Rate for Payer: PACE SWMI |
$1,833.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,833.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,557.10
|
| Rate for Payer: Priority Health Medicare |
$1,833.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,833.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,833.64
|
| Rate for Payer: UHCCP DNSP |
$1,833.64
|
|
|
PR BYPASS W/VEIN ILIOFEMORAL
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS 35565
|
| Min. Negotiated Rate |
$1,040.40 |
| Max. Negotiated Rate |
$1,808.91 |
| Rate for Payer: Aetna Commercial |
$1,683.29
|
| Rate for Payer: Aetna Medicare |
$1,256.19
|
| Rate for Payer: BCBS Complete |
$1,040.40
|
| Rate for Payer: BCBS MAPPO |
$1,256.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,256.19
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Cofinity Commercial |
$1,808.91
|
| Rate for Payer: Cofinity Commercial |
$1,683.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,256.19
|
| Rate for Payer: Healthscope Commercial |
$1,507.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,507.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.00
|
| Rate for Payer: Nomi Health Commercial |
$1,507.43
|
| Rate for Payer: PACE SWMI |
$1,256.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,256.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,690.65
|
| Rate for Payer: Priority Health Medicare |
$1,256.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,256.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,256.19
|
| Rate for Payer: UHCCP DNSP |
$1,256.19
|
|
|
PR BYPASS W/VEIN ILIOILIAC
|
Professional
|
Both
|
$2,815.00
|
|
|
Service Code
|
HCPCS 35563
|
| Min. Negotiated Rate |
$1,126.00 |
| Max. Negotiated Rate |
$1,837.53 |
| Rate for Payer: Aetna Commercial |
$1,709.92
|
| Rate for Payer: Aetna Medicare |
$1,276.06
|
| Rate for Payer: BCBS Complete |
$1,126.00
|
| Rate for Payer: BCBS MAPPO |
$1,276.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,276.06
|
| Rate for Payer: Cash Price |
$2,252.00
|
| Rate for Payer: Cash Price |
$2,252.00
|
| Rate for Payer: Cofinity Commercial |
$1,837.53
|
| Rate for Payer: Cofinity Commercial |
$1,709.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,276.06
|
| Rate for Payer: Healthscope Commercial |
$1,531.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,531.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.86
|
| Rate for Payer: Nomi Health Commercial |
$1,531.27
|
| Rate for Payer: PACE SWMI |
$1,276.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,276.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,829.75
|
| Rate for Payer: Priority Health Medicare |
$1,276.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,276.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,276.06
|
| Rate for Payer: UHCCP DNSP |
$1,276.06
|
|
|
PR BYPASS W/VEIN SPLENORENAL
|
Professional
|
Both
|
$4,905.00
|
|
|
Service Code
|
HCPCS 35536
|
| Min. Negotiated Rate |
$1,628.75 |
| Max. Negotiated Rate |
$3,188.25 |
| Rate for Payer: Aetna Commercial |
$2,182.53
|
| Rate for Payer: Aetna Medicare |
$1,628.75
|
| Rate for Payer: BCBS Complete |
$1,962.00
|
| Rate for Payer: BCBS MAPPO |
$1,628.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,628.75
|
| Rate for Payer: Cash Price |
$3,924.00
|
| Rate for Payer: Cash Price |
$3,924.00
|
| Rate for Payer: Cofinity Commercial |
$2,345.40
|
| Rate for Payer: Cofinity Commercial |
$2,182.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,628.75
|
| Rate for Payer: Healthscope Commercial |
$1,954.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,954.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,710.19
|
| Rate for Payer: Nomi Health Commercial |
$1,954.50
|
| Rate for Payer: PACE SWMI |
$1,628.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,628.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,188.25
|
| Rate for Payer: Priority Health Medicare |
$1,628.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,628.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,628.75
|
| Rate for Payer: UHCCP DNSP |
$1,628.75
|
|
|
PR BYPASS W/VEIN SUBCLAVIAN-BRACHIAL
|
Professional
|
Both
|
$2,544.00
|
|
|
Service Code
|
HCPCS 35512
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$1,673.06 |
| Rate for Payer: Aetna Commercial |
$1,556.88
|
| Rate for Payer: Aetna Medicare |
$1,161.85
|
| Rate for Payer: BCBS Complete |
$1,017.60
|
| Rate for Payer: BCBS MAPPO |
$1,161.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,161.85
|
| Rate for Payer: Cash Price |
$2,035.20
|
| Rate for Payer: Cash Price |
$2,035.20
|
| Rate for Payer: Cofinity Commercial |
$1,673.06
|
| Rate for Payer: Cofinity Commercial |
$1,556.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,161.85
|
| Rate for Payer: Healthscope Commercial |
$1,394.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,394.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,219.94
|
| Rate for Payer: Nomi Health Commercial |
$1,394.22
|
| Rate for Payer: PACE SWMI |
$1,161.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,161.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.60
|
| Rate for Payer: Priority Health Medicare |
$1,161.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,161.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,161.85
|
| Rate for Payer: UHCCP DNSP |
$1,161.85
|
|
|
PR BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN
|
Professional
|
Both
|
$4,185.00
|
|
|
Service Code
|
HCPCS 35511
|
| Min. Negotiated Rate |
$1,079.75 |
| Max. Negotiated Rate |
$2,720.25 |
| Rate for Payer: Aetna Commercial |
$1,446.87
|
| Rate for Payer: Aetna Medicare |
$1,079.75
|
| Rate for Payer: BCBS Complete |
$1,674.00
|
| Rate for Payer: BCBS MAPPO |
$1,079.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,079.75
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cash Price |
$3,348.00
|
| Rate for Payer: Cofinity Commercial |
$1,554.84
|
| Rate for Payer: Cofinity Commercial |
$1,446.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,079.75
|
| Rate for Payer: Healthscope Commercial |
$1,295.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,295.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,133.74
|
| Rate for Payer: Nomi Health Commercial |
$1,295.70
|
| Rate for Payer: PACE SWMI |
$1,079.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,079.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,720.25
|
| Rate for Payer: Priority Health Medicare |
$1,079.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,079.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,079.75
|
| Rate for Payer: UHCCP DNSP |
$1,079.75
|
|
|
PR BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 35682
|
| Min. Negotiated Rate |
$282.40 |
| Max. Negotiated Rate |
$487.44 |
| Rate for Payer: Aetna Commercial |
$453.59
|
| Rate for Payer: Aetna Medicare |
$338.50
|
| Rate for Payer: BCBS Complete |
$282.40
|
| Rate for Payer: BCBS MAPPO |
$338.50
|
| Rate for Payer: BCN Medicare Advantage |
$338.50
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$487.44
|
| Rate for Payer: Cofinity Commercial |
$453.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.50
|
| Rate for Payer: Healthscope Commercial |
$406.20
|
| Rate for Payer: Healthscope Whirlpool |
$406.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.43
|
| Rate for Payer: Nomi Health Commercial |
$406.20
|
| Rate for Payer: PACE SWMI |
$338.50
|
| Rate for Payer: PHP Medicare Advantage |
$338.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health Medicare |
$338.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.50
|
| Rate for Payer: UHC Medicare Advantage |
$338.50
|
| Rate for Payer: UHCCP DNSP |
$338.50
|
|
|
PR BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION
|
Professional
|
Both
|
$866.00
|
|
|
Service Code
|
HCPCS 35683
|
| Min. Negotiated Rate |
$346.40 |
| Max. Negotiated Rate |
$568.87 |
| Rate for Payer: Aetna Commercial |
$529.37
|
| Rate for Payer: Aetna Medicare |
$395.05
|
| Rate for Payer: BCBS Complete |
$346.40
|
| Rate for Payer: BCBS MAPPO |
$395.05
|
| Rate for Payer: BCN Medicare Advantage |
$395.05
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$568.87
|
| Rate for Payer: Cofinity Commercial |
$529.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.05
|
| Rate for Payer: Healthscope Commercial |
$474.06
|
| Rate for Payer: Healthscope Whirlpool |
$474.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.80
|
| Rate for Payer: Nomi Health Commercial |
$474.06
|
| Rate for Payer: PACE SWMI |
$395.05
|
| Rate for Payer: PHP Medicare Advantage |
$395.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.90
|
| Rate for Payer: Priority Health Medicare |
$395.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.05
|
| Rate for Payer: UHC Medicare Advantage |
$395.05
|
| Rate for Payer: UHCCP DNSP |
$395.05
|
|
|
PR BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL
|
Professional
|
Both
|
$4,830.00
|
|
|
Service Code
|
HCPCS 35566
|
| Min. Negotiated Rate |
$1,592.84 |
| Max. Negotiated Rate |
$3,139.50 |
| Rate for Payer: Aetna Commercial |
$2,134.41
|
| Rate for Payer: Aetna Medicare |
$1,592.84
|
| Rate for Payer: BCBS Complete |
$1,932.00
|
| Rate for Payer: BCBS MAPPO |
$1,592.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,592.84
|
| Rate for Payer: Cash Price |
$3,864.00
|
| Rate for Payer: Cash Price |
$3,864.00
|
| Rate for Payer: Cofinity Commercial |
$2,293.69
|
| Rate for Payer: Cofinity Commercial |
$2,134.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,592.84
|
| Rate for Payer: Healthscope Commercial |
$1,911.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,911.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,672.48
|
| Rate for Payer: Nomi Health Commercial |
$1,911.41
|
| Rate for Payer: PACE SWMI |
$1,592.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,592.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,139.50
|
| Rate for Payer: Priority Health Medicare |
$1,592.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,592.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,592.84
|
| Rate for Payer: UHCCP DNSP |
$1,592.84
|
|
|
PR BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC
|
Professional
|
Both
|
$1,964.00
|
|
|
Service Code
|
HCPCS 33891
|
| Min. Negotiated Rate |
$785.60 |
| Max. Negotiated Rate |
$1,337.03 |
| Rate for Payer: Aetna Commercial |
$1,244.18
|
| Rate for Payer: Aetna Medicare |
$928.49
|
| Rate for Payer: BCBS Complete |
$785.60
|
| Rate for Payer: BCBS MAPPO |
$928.49
|
| Rate for Payer: BCN Medicare Advantage |
$928.49
|
| Rate for Payer: Cash Price |
$1,571.20
|
| Rate for Payer: Cash Price |
$1,571.20
|
| Rate for Payer: Cofinity Commercial |
$1,337.03
|
| Rate for Payer: Cofinity Commercial |
$1,244.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$928.49
|
| Rate for Payer: Healthscope Commercial |
$1,114.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,114.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.91
|
| Rate for Payer: Nomi Health Commercial |
$1,114.19
|
| Rate for Payer: PACE SWMI |
$928.49
|
| Rate for Payer: PHP Medicare Advantage |
$928.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.60
|
| Rate for Payer: Priority Health Medicare |
$928.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$928.49
|
| Rate for Payer: UHC Medicare Advantage |
$928.49
|
| Rate for Payer: UHCCP DNSP |
$928.49
|
|
|
PR BYP OTH/THN VEIN AORTOBIFEMORAL
|
Professional
|
Both
|
$5,782.00
|
|
|
Service Code
|
HCPCS 35646
|
| Min. Negotiated Rate |
$1,632.04 |
| Max. Negotiated Rate |
$3,758.30 |
| Rate for Payer: Aetna Commercial |
$2,186.93
|
| Rate for Payer: Aetna Medicare |
$1,632.04
|
| Rate for Payer: BCBS Complete |
$2,312.80
|
| Rate for Payer: BCBS MAPPO |
$1,632.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,632.04
|
| Rate for Payer: Cash Price |
$4,625.60
|
| Rate for Payer: Cash Price |
$4,625.60
|
| Rate for Payer: Cofinity Commercial |
$2,350.14
|
| Rate for Payer: Cofinity Commercial |
$2,186.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,632.04
|
| Rate for Payer: Healthscope Commercial |
$1,958.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,958.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,713.64
|
| Rate for Payer: Nomi Health Commercial |
$1,958.45
|
| Rate for Payer: PACE SWMI |
$1,632.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,632.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,758.30
|
| Rate for Payer: Priority Health Medicare |
$1,632.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,632.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,632.04
|
| Rate for Payer: UHCCP DNSP |
$1,632.04
|
|
