|
PR CLSD TX PELVIC RING FX W/MANIPULATION W/ANES
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 27198
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$2,080.97 |
| Rate for Payer: Aetna Commercial |
$423.91
|
| Rate for Payer: Aetna Medicare |
$229.50
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,080.97
|
| Rate for Payer: BCN Commercial |
$461.32
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.42
|
| Rate for Payer: Priority Health Narrow Network |
$483.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$375.47
|
| Rate for Payer: UHC Exchange |
$375.47
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR CLSD TX PELVIC RING FX W/O MANIPULATION
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 27197
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$1,831.62 |
| Rate for Payer: Aetna Commercial |
$174.74
|
| Rate for Payer: Aetna Medicare |
$118.00
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.62
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.58
|
| Rate for Payer: Priority Health Narrow Network |
$205.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$146.29
|
| Rate for Payer: UHC Exchange |
$146.29
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 23655
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$670.15 |
| Rate for Payer: Aetna Commercial |
$542.19
|
| Rate for Payer: Aetna Medicare |
$515.50
|
| Rate for Payer: BCBS Complete |
$283.82
|
| Rate for Payer: BCBS Trust/PPO |
$372.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Meridian Medicaid |
$283.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.16
|
| Rate for Payer: Priority Health Narrow Network |
$641.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.62
|
| Rate for Payer: UHC Exchange |
$431.62
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 23650
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$498.94 |
| Rate for Payer: Aetna Commercial |
$390.39
|
| Rate for Payer: Aetna Medicare |
$347.00
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS Trust/PPO |
$328.60
|
| Rate for Payer: BCN Commercial |
$498.94
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$478.33
|
| Rate for Payer: Priority Health Narrow Network |
$478.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.90
|
| Rate for Payer: UHC Exchange |
$302.90
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR CLSR ANAL FSTL W/RCT ADVMNT FLAP
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 46288
|
| Min. Negotiated Rate |
$362.53 |
| Max. Negotiated Rate |
$2,458.18 |
| Rate for Payer: Aetna Commercial |
$741.11
|
| Rate for Payer: Aetna Medicare |
$839.00
|
| Rate for Payer: BCBS Complete |
$380.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.18
|
| Rate for Payer: BCN Commercial |
$818.53
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Meridian Medicaid |
$380.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,007.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,007.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$628.38
|
| Rate for Payer: UHC Exchange |
$628.38
|
| Rate for Payer: UHCCP Medicaid |
$362.53
|
|
|
PR CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA
|
Professional
|
Both
|
$1,872.00
|
|
|
Service Code
|
HCPCS 32810
|
| Min. Negotiated Rate |
$573.18 |
| Max. Negotiated Rate |
$1,299.88 |
| Rate for Payer: Aetna Commercial |
$1,159.79
|
| Rate for Payer: Aetna Medicare |
$936.00
|
| Rate for Payer: BCBS Complete |
$601.84
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,299.88
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Meridian Medicaid |
$601.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,242.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,242.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,059.18
|
| Rate for Payer: UHC Exchange |
$1,059.18
|
| Rate for Payer: UHCCP Medicaid |
$573.18
|
|
|
PR CLSR ENTEROENTERIC/ENTEROCOLIC FSTL
|
Professional
|
Both
|
$2,579.00
|
|
|
Service Code
|
HCPCS 44650
|
| Min. Negotiated Rate |
$245.13 |
| Max. Negotiated Rate |
$2,561.78 |
| Rate for Payer: Aetna Commercial |
$1,939.64
|
| Rate for Payer: Aetna Medicare |
$1,289.50
|
| Rate for Payer: BCBS Complete |
$962.59
|
| Rate for Payer: BCBS Trust/PPO |
$245.13
|
| Rate for Payer: BCN Commercial |
$2,089.58
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Meridian Medicaid |
$962.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$916.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,676.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,561.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,561.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,769.16
|
| Rate for Payer: UHC Exchange |
$1,769.16
|
| Rate for Payer: UHCCP Medicaid |
$916.75
|
|
|
PR CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ
|
Professional
|
Both
|
$3,576.00
|
|
|
Service Code
|
HCPCS 44661
|
| Min. Negotiated Rate |
$246.19 |
| Max. Negotiated Rate |
$2,739.56 |
| Rate for Payer: Aetna Commercial |
$2,083.58
|
| Rate for Payer: Aetna Medicare |
$1,788.00
|
| Rate for Payer: BCBS Complete |
$1,034.16
|
| Rate for Payer: BCBS Trust/PPO |
$246.19
|
| Rate for Payer: BCN Commercial |
$2,239.12
|
| Rate for Payer: Cash Price |
$2,860.80
|
| Rate for Payer: Cash Price |
$2,860.80
|
| Rate for Payer: Meridian Medicaid |
$1,034.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$984.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,324.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,739.56
|
| Rate for Payer: Priority Health Narrow Network |
$2,739.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,913.79
|
| Rate for Payer: UHC Exchange |
$1,913.79
|
| Rate for Payer: UHCCP Medicaid |
$984.91
|
|
|
PR CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ
|
Professional
|
Both
|
$2,662.00
|
|
|
Service Code
|
HCPCS 44660
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$2,387.58 |
| Rate for Payer: Aetna Commercial |
$1,795.04
|
| Rate for Payer: Aetna Medicare |
$1,331.00
|
| Rate for Payer: BCBS Complete |
$897.73
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,934.67
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Meridian Medicaid |
$897.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$854.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,730.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,387.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,387.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,680.05
|
| Rate for Payer: UHC Exchange |
$1,680.05
|
| Rate for Payer: UHCCP Medicaid |
$854.98
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL CRV APPR
|
Professional
|
Both
|
$2,693.00
|
|
|
Service Code
|
HCPCS 43420
|
| Min. Negotiated Rate |
$654.12 |
| Max. Negotiated Rate |
$1,826.76 |
| Rate for Payer: Aetna Commercial |
$1,345.37
|
| Rate for Payer: Aetna Medicare |
$1,346.50
|
| Rate for Payer: BCBS Complete |
$686.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,490.95
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Meridian Medicaid |
$686.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,826.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,826.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,236.26
|
| Rate for Payer: UHC Exchange |
$1,236.26
|
| Rate for Payer: UHCCP Medicaid |
$654.12
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,177.00
|
|
|
Service Code
|
HCPCS 43425
|
| Min. Negotiated Rate |
$914.84 |
| Max. Negotiated Rate |
$2,715.05 |
| Rate for Payer: Aetna Commercial |
$1,937.74
|
| Rate for Payer: Aetna Medicare |
$2,088.50
|
| Rate for Payer: BCBS Complete |
$960.58
|
| Rate for Payer: BCBS Trust/PPO |
$986.34
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: Cash Price |
$3,341.60
|
| Rate for Payer: Cash Price |
$3,341.60
|
| Rate for Payer: Meridian Medicaid |
$960.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$914.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,715.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,552.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,552.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,871.29
|
| Rate for Payer: UHC Exchange |
$1,871.29
|
| Rate for Payer: UHCCP Medicaid |
$914.84
|
|
|
PR CLSR LACRIMAL PUNCTUM PLUG EACH
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 68761
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$1,031.77 |
| Rate for Payer: Aetna Commercial |
$152.10
|
| Rate for Payer: Aetna Medicare |
$152.50
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.77
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.13
|
| Rate for Payer: Priority Health Narrow Network |
$204.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$124.25
|
| Rate for Payer: UHC Exchange |
$124.25
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT
|
Professional
|
Both
|
$2,913.00
|
|
|
Service Code
|
HCPCS 44625
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$1,893.45 |
| Rate for Payer: Aetna Commercial |
$1,357.27
|
| Rate for Payer: Aetna Medicare |
$1,456.50
|
| Rate for Payer: BCBS Complete |
$677.44
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$1,467.49
|
| Rate for Payer: Cash Price |
$2,330.40
|
| Rate for Payer: Cash Price |
$2,330.40
|
| Rate for Payer: Meridian Medicaid |
$677.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,893.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,800.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,231.46
|
| Rate for Payer: UHC Exchange |
$1,231.46
|
| Rate for Payer: UHCCP Medicaid |
$645.18
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS
|
Professional
|
Both
|
$2,972.00
|
|
|
Service Code
|
HCPCS 44626
|
| Min. Negotiated Rate |
$205.51 |
| Max. Negotiated Rate |
$2,827.86 |
| Rate for Payer: Aetna Commercial |
$2,151.52
|
| Rate for Payer: Aetna Medicare |
$1,486.00
|
| Rate for Payer: BCBS Complete |
$1,064.12
|
| Rate for Payer: BCBS Trust/PPO |
$205.51
|
| Rate for Payer: BCN Commercial |
$2,311.45
|
| Rate for Payer: Cash Price |
$2,377.60
|
| Rate for Payer: Cash Price |
$2,377.60
|
| Rate for Payer: Meridian Medicaid |
$1,064.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,013.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,931.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,827.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,827.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,955.34
|
| Rate for Payer: UHC Exchange |
$1,955.34
|
| Rate for Payer: UHCCP Medicaid |
$1,013.45
|
|
|
PR CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ
|
Professional
|
Both
|
$1,471.00
|
|
|
Service Code
|
HCPCS 57308
|
| Min. Negotiated Rate |
$427.49 |
| Max. Negotiated Rate |
$1,574.86 |
| Rate for Payer: Aetna Commercial |
$782.21
|
| Rate for Payer: Aetna Medicare |
$735.50
|
| Rate for Payer: BCBS Complete |
$448.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,574.86
|
| Rate for Payer: BCN Commercial |
$970.51
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Meridian Medicaid |
$448.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$992.59
|
| Rate for Payer: Priority Health Narrow Network |
$992.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$727.10
|
| Rate for Payer: UHC Exchange |
$727.10
|
| Rate for Payer: UHCCP Medicaid |
$427.49
|
|
|
PR CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH
|
Professional
|
Both
|
$1,976.00
|
|
|
Service Code
|
HCPCS 57305
|
| Min. Negotiated Rate |
$623.88 |
| Max. Negotiated Rate |
$2,391.09 |
| Rate for Payer: Aetna Commercial |
$1,168.24
|
| Rate for Payer: Aetna Medicare |
$988.00
|
| Rate for Payer: BCBS Complete |
$655.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.09
|
| Rate for Payer: BCN Commercial |
$1,444.05
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Cash Price |
$1,580.80
|
| Rate for Payer: Meridian Medicaid |
$655.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,461.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,461.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.93
|
| Rate for Payer: UHC Exchange |
$1,034.93
|
| Rate for Payer: UHCCP Medicaid |
$623.88
|
|
|
PR CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR
|
Professional
|
Both
|
$1,321.00
|
|
|
Service Code
|
HCPCS 57300
|
| Min. Negotiated Rate |
$393.20 |
| Max. Negotiated Rate |
$2,627.76 |
| Rate for Payer: Aetna Commercial |
$717.48
|
| Rate for Payer: Aetna Medicare |
$660.50
|
| Rate for Payer: BCBS Complete |
$412.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,627.76
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: Cash Price |
$1,056.80
|
| Rate for Payer: Cash Price |
$1,056.80
|
| Rate for Payer: Meridian Medicaid |
$412.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$920.16
|
| Rate for Payer: Priority Health Narrow Network |
$920.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$617.80
|
| Rate for Payer: UHC Exchange |
$617.80
|
| Rate for Payer: UHCCP Medicaid |
$393.20
|
|
|
PR CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 53520
|
| Min. Negotiated Rate |
$256.23 |
| Max. Negotiated Rate |
$894.24 |
| Rate for Payer: Aetna Commercial |
$715.24
|
| Rate for Payer: Aetna Medicare |
$576.50
|
| Rate for Payer: BCBS Complete |
$377.75
|
| Rate for Payer: BCBS Trust/PPO |
$256.23
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Meridian Medicaid |
$377.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.24
|
| Rate for Payer: Priority Health Narrow Network |
$894.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$667.72
|
| Rate for Payer: UHC Exchange |
$667.72
|
| Rate for Payer: UHCCP Medicaid |
$359.76
|
|
|
PR CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL
|
Professional
|
Both
|
$1,103.00
|
|
|
Service Code
|
HCPCS 57311
|
| Min. Negotiated Rate |
$357.41 |
| Max. Negotiated Rate |
$2,101.05 |
| Rate for Payer: Aetna Commercial |
$653.71
|
| Rate for Payer: Aetna Medicare |
$551.50
|
| Rate for Payer: BCBS Complete |
$375.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.05
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Meridian Medicaid |
$375.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$830.88
|
| Rate for Payer: Priority Health Narrow Network |
$830.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.51
|
| Rate for Payer: UHC Exchange |
$620.51
|
| Rate for Payer: UHCCP Medicaid |
$357.41
|
|
|
PR CLSR VESICOVAGINAL FISTUL AABDL APPROACH
|
Professional
|
Both
|
$3,916.00
|
|
|
Service Code
|
HCPCS 51900
|
| Min. Negotiated Rate |
$528.24 |
| Max. Negotiated Rate |
$2,545.40 |
| Rate for Payer: Aetna Commercial |
$1,056.40
|
| Rate for Payer: Aetna Medicare |
$1,958.00
|
| Rate for Payer: BCBS Complete |
$554.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.35
|
| Rate for Payer: BCN Commercial |
$1,187.98
|
| Rate for Payer: Cash Price |
$3,132.80
|
| Rate for Payer: Cash Price |
$3,132.80
|
| Rate for Payer: Meridian Medicaid |
$554.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,545.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,310.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,310.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$979.37
|
| Rate for Payer: UHC Exchange |
$979.37
|
| Rate for Payer: UHCCP Medicaid |
$528.24
|
|
|
PR CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ
|
Professional
|
Both
|
$2,274.00
|
|
|
Service Code
|
HCPCS 27222
|
| Min. Negotiated Rate |
$637.08 |
| Max. Negotiated Rate |
$2,011.24 |
| Rate for Payer: Aetna Commercial |
$1,306.47
|
| Rate for Payer: Aetna Medicare |
$1,137.00
|
| Rate for Payer: BCBS Complete |
$668.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,011.24
|
| Rate for Payer: BCN Commercial |
$1,446.98
|
| Rate for Payer: Cash Price |
$1,819.20
|
| Rate for Payer: Cash Price |
$1,819.20
|
| Rate for Payer: Meridian Medicaid |
$668.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,508.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,126.42
|
| Rate for Payer: UHC Exchange |
$1,126.42
|
| Rate for Payer: UHCCP Medicaid |
$637.08
|
|
|
PR CLTX ACETABULUM HIP/SOCKT FX W/O MANJ
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 27220
|
| Min. Negotiated Rate |
$271.15 |
| Max. Negotiated Rate |
$2,011.24 |
| Rate for Payer: Aetna Commercial |
$550.55
|
| Rate for Payer: Aetna Medicare |
$839.50
|
| Rate for Payer: BCBS Complete |
$284.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,011.24
|
| Rate for Payer: BCN Commercial |
$620.13
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Meridian Medicaid |
$284.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,091.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.69
|
| Rate for Payer: Priority Health Narrow Network |
$642.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.52
|
| Rate for Payer: UHC Exchange |
$590.52
|
| Rate for Payer: UHCCP Medicaid |
$271.15
|
|
|
PR CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ
|
Professional
|
Both
|
$1,414.00
|
|
|
Service Code
|
HCPCS 27842
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$1,704.38 |
| Rate for Payer: Aetna Commercial |
$660.07
|
| Rate for Payer: Aetna Medicare |
$707.00
|
| Rate for Payer: BCBS Complete |
$340.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.38
|
| Rate for Payer: BCN Commercial |
$727.64
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Meridian Medicaid |
$340.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$768.88
|
| Rate for Payer: Priority Health Narrow Network |
$768.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.38
|
| Rate for Payer: UHC Exchange |
$552.38
|
| Rate for Payer: UHCCP Medicaid |
$324.40
|
|
|
PR CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 26742
|
| Min. Negotiated Rate |
$183.81 |
| Max. Negotiated Rate |
$607.75 |
| Rate for Payer: Aetna Commercial |
$448.66
|
| Rate for Payer: Aetna Medicare |
$467.50
|
| Rate for Payer: BCBS Complete |
$235.96
|
| Rate for Payer: BCBS Trust/PPO |
$183.81
|
| Rate for Payer: BCN Commercial |
$562.96
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Meridian Medicaid |
$235.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.25
|
| Rate for Payer: Priority Health Narrow Network |
$531.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.10
|
| Rate for Payer: UHC Exchange |
$367.10
|
| Rate for Payer: UHCCP Medicaid |
$224.72
|
|
|
PR CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 26740
|
| Min. Negotiated Rate |
$150.17 |
| Max. Negotiated Rate |
$410.80 |
| Rate for Payer: Aetna Commercial |
$289.66
|
| Rate for Payer: Aetna Medicare |
$316.00
|
| Rate for Payer: BCBS Complete |
$157.68
|
| Rate for Payer: BCBS Trust/PPO |
$153.74
|
| Rate for Payer: BCN Commercial |
$350.87
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Meridian Medicaid |
$157.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.16
|
| Rate for Payer: Priority Health Narrow Network |
$353.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$225.79
|
| Rate for Payer: UHC Exchange |
$225.79
|
| Rate for Payer: UHCCP Medicaid |
$150.17
|
|
