|
PR LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 31511
|
| Min. Negotiated Rate |
$131.37 |
| Max. Negotiated Rate |
$1,223.54 |
| Rate for Payer: Aetna Commercial |
$176.04
|
| Rate for Payer: Aetna Medicare |
$131.37
|
| Rate for Payer: BCBS Complete |
$223.60
|
| Rate for Payer: BCBS MAPPO |
$131.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,223.54
|
| Rate for Payer: BCN Commercial |
$309.82
|
| Rate for Payer: BCN Medicare Advantage |
$131.37
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cofinity Commercial |
$189.17
|
| Rate for Payer: Cofinity Commercial |
$176.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.37
|
| Rate for Payer: Healthscope Commercial |
$157.64
|
| Rate for Payer: Healthscope Whirlpool |
$157.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.94
|
| Rate for Payer: PACE SWMI |
$131.37
|
| Rate for Payer: PHP Medicare Advantage |
$131.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.76
|
| Rate for Payer: Priority Health Medicare |
$131.37
|
| Rate for Payer: Priority Health Narrow Network |
$184.76
|
| Rate for Payer: UHC Medicare Advantage |
$135.31
|
|
|
PR LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE
|
Professional
|
Both
|
$931.00
|
|
|
Service Code
|
HCPCS 31536
|
| Min. Negotiated Rate |
$133.34 |
| Max. Negotiated Rate |
$987.92 |
| Rate for Payer: Aetna Commercial |
$276.71
|
| Rate for Payer: Aetna Medicare |
$206.50
|
| Rate for Payer: BCBS Complete |
$140.01
|
| Rate for Payer: BCBS MAPPO |
$206.50
|
| Rate for Payer: BCBS Trust/PPO |
$987.92
|
| Rate for Payer: BCN Commercial |
$305.43
|
| Rate for Payer: BCN Medicare Advantage |
$206.50
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Cofinity Commercial |
$276.71
|
| Rate for Payer: Cofinity Commercial |
$297.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.50
|
| Rate for Payer: Healthscope Commercial |
$247.80
|
| Rate for Payer: Healthscope Whirlpool |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$140.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$216.82
|
| Rate for Payer: PACE SWMI |
$206.50
|
| Rate for Payer: PHP Medicare Advantage |
$206.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$651.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.41
|
| Rate for Payer: Priority Health Medicare |
$206.50
|
| Rate for Payer: Priority Health Narrow Network |
$289.41
|
| Rate for Payer: UHC Medicare Advantage |
$212.70
|
|
|
PR LARYNGOSCOPY W/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 31530
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$1,856.45 |
| Rate for Payer: Aetna Commercial |
$261.96
|
| Rate for Payer: Aetna Medicare |
$195.49
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$195.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,856.45
|
| Rate for Payer: BCN Commercial |
$288.81
|
| Rate for Payer: BCN Medicare Advantage |
$195.49
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$281.51
|
| Rate for Payer: Cofinity Commercial |
$261.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.49
|
| Rate for Payer: Healthscope Commercial |
$234.59
|
| Rate for Payer: Healthscope Whirlpool |
$234.59
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.26
|
| Rate for Payer: PACE SWMI |
$195.49
|
| Rate for Payer: PHP Medicare Advantage |
$195.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.65
|
| Rate for Payer: Priority Health Medicare |
$195.49
|
| Rate for Payer: Priority Health Narrow Network |
$273.65
|
| Rate for Payer: UHC Medicare Advantage |
$201.35
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 31515
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$146.49
|
| Rate for Payer: Aetna Medicare |
$109.32
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$109.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$316.66
|
| Rate for Payer: BCN Medicare Advantage |
$109.32
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$157.42
|
| Rate for Payer: Cofinity Commercial |
$146.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.32
|
| Rate for Payer: Healthscope Commercial |
$131.18
|
| Rate for Payer: Healthscope Whirlpool |
$131.18
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$114.79
|
| Rate for Payer: PACE SWMI |
$109.32
|
| Rate for Payer: PHP Medicare Advantage |
$109.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.74
|
| Rate for Payer: Priority Health Medicare |
$109.32
|
| Rate for Payer: Priority Health Narrow Network |
$153.74
|
| Rate for Payer: UHC Medicare Advantage |
$112.60
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 31529
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$1,150.11 |
| Rate for Payer: Aetna Commercial |
$210.93
|
| Rate for Payer: Aetna Medicare |
$157.41
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$157.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,150.11
|
| Rate for Payer: BCN Commercial |
$233.10
|
| Rate for Payer: BCN Medicare Advantage |
$157.41
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$226.67
|
| Rate for Payer: Cofinity Commercial |
$210.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.41
|
| Rate for Payer: Healthscope Commercial |
$188.89
|
| Rate for Payer: Healthscope Whirlpool |
$188.89
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.28
|
| Rate for Payer: PACE SWMI |
$157.41
|
| Rate for Payer: PHP Medicare Advantage |
$157.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.87
|
| Rate for Payer: Priority Health Medicare |
$157.41
|
| Rate for Payer: Priority Health Narrow Network |
$220.87
|
| Rate for Payer: UHC Medicare Advantage |
$162.13
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 31525
|
| Min. Negotiated Rate |
$102.03 |
| Max. Negotiated Rate |
$1,289.05 |
| Rate for Payer: Aetna Commercial |
$209.48
|
| Rate for Payer: Aetna Medicare |
$156.33
|
| Rate for Payer: BCBS Complete |
$107.13
|
| Rate for Payer: BCBS MAPPO |
$156.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.05
|
| Rate for Payer: BCN Commercial |
$367.97
|
| Rate for Payer: BCN Medicare Advantage |
$156.33
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$225.12
|
| Rate for Payer: Cofinity Commercial |
$209.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.33
|
| Rate for Payer: Healthscope Commercial |
$187.60
|
| Rate for Payer: Healthscope Whirlpool |
$187.60
|
| Rate for Payer: Meridian Medicaid |
$107.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$164.15
|
| Rate for Payer: PACE SWMI |
$156.33
|
| Rate for Payer: PHP Medicare Advantage |
$156.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$219.49
|
| Rate for Payer: Priority Health Medicare |
$156.33
|
| Rate for Payer: Priority Health Narrow Network |
$219.49
|
| Rate for Payer: UHC Medicare Advantage |
$161.02
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 31528
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$1,317.05 |
| Rate for Payer: Aetna Commercial |
$189.66
|
| Rate for Payer: Aetna Medicare |
$141.54
|
| Rate for Payer: BCBS Complete |
$96.39
|
| Rate for Payer: BCBS MAPPO |
$141.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| Rate for Payer: BCN Commercial |
$209.64
|
| Rate for Payer: BCN Medicare Advantage |
$141.54
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cofinity Commercial |
$203.82
|
| Rate for Payer: Cofinity Commercial |
$189.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.54
|
| Rate for Payer: Healthscope Commercial |
$169.85
|
| Rate for Payer: Healthscope Whirlpool |
$169.85
|
| Rate for Payer: Meridian Medicaid |
$96.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.62
|
| Rate for Payer: PACE SWMI |
$141.54
|
| Rate for Payer: PHP Medicare Advantage |
$141.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.65
|
| Rate for Payer: Priority Health Medicare |
$141.54
|
| Rate for Payer: Priority Health Narrow Network |
$198.65
|
| Rate for Payer: UHC Medicare Advantage |
$145.79
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 31526
|
| Min. Negotiated Rate |
$99.90 |
| Max. Negotiated Rate |
$1,251.54 |
| Rate for Payer: Aetna Commercial |
$205.93
|
| Rate for Payer: Aetna Medicare |
$153.68
|
| Rate for Payer: BCBS Complete |
$104.90
|
| Rate for Payer: BCBS MAPPO |
$153.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.54
|
| Rate for Payer: BCN Commercial |
$227.73
|
| Rate for Payer: BCN Medicare Advantage |
$153.68
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$221.30
|
| Rate for Payer: Cofinity Commercial |
$205.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.68
|
| Rate for Payer: Healthscope Commercial |
$184.42
|
| Rate for Payer: Healthscope Whirlpool |
$184.42
|
| Rate for Payer: Meridian Medicaid |
$104.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.36
|
| Rate for Payer: PACE SWMI |
$153.68
|
| Rate for Payer: PHP Medicare Advantage |
$153.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.77
|
| Rate for Payer: Priority Health Medicare |
$153.68
|
| Rate for Payer: Priority Health Narrow Network |
$215.77
|
| Rate for Payer: UHC Medicare Advantage |
$158.29
|
|
|
PR LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY
|
Professional
|
Both
|
$2,226.00
|
|
|
Service Code
|
HCPCS 31300
|
| Min. Negotiated Rate |
$801.31 |
| Max. Negotiated Rate |
$1,841.33 |
| Rate for Payer: Aetna Commercial |
$1,640.03
|
| Rate for Payer: Aetna Medicare |
$1,223.90
|
| Rate for Payer: BCBS Complete |
$841.38
|
| Rate for Payer: BCBS MAPPO |
$1,223.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,537.35
|
| Rate for Payer: BCN Commercial |
$1,841.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,223.90
|
| Rate for Payer: Cash Price |
$1,780.80
|
| Rate for Payer: Cash Price |
$1,780.80
|
| Rate for Payer: Cofinity Commercial |
$1,762.42
|
| Rate for Payer: Cofinity Commercial |
$1,640.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,223.90
|
| Rate for Payer: Healthscope Commercial |
$1,468.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,468.68
|
| Rate for Payer: Meridian Medicaid |
$841.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,285.10
|
| Rate for Payer: PACE SWMI |
$1,223.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,223.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,744.75
|
| Rate for Payer: Priority Health Medicare |
$1,223.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,744.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,260.62
|
|
|
PR LASER CO2 - FULL FACE
|
Professional
|
Both
|
$2,750.00
|
|
|
Service Code
|
HCPCS 00263
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,100.00 |
| Max. Negotiated Rate |
$1,925.00 |
| Rate for Payer: BCBS Complete |
$1,100.00
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.00
|
|
|
PR LASER CO2 - ONE AREA
|
Professional
|
Both
|
$1,750.00
|
|
|
Service Code
|
HCPCS 00181
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$1,225.00 |
| Rate for Payer: BCBS Complete |
$700.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,225.00
|
|
|
PR LASER CO2 - TWO AREAS
|
Professional
|
Both
|
$2,250.00
|
|
|
Service Code
|
HCPCS 00182
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: BCBS Complete |
$900.00
|
| Rate for Payer: Cash Price |
$1,800.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,575.00
|
|
|
PR LASER ENUCLEATION PROSTATE W/MORCELLATION
|
Professional
|
Both
|
$1,675.00
|
|
|
Service Code
|
HCPCS 52649
|
| Min. Negotiated Rate |
$524.83 |
| Max. Negotiated Rate |
$1,315.77 |
| Rate for Payer: Aetna Commercial |
$1,079.10
|
| Rate for Payer: Aetna Medicare |
$805.30
|
| Rate for Payer: BCBS Complete |
$551.07
|
| Rate for Payer: BCBS MAPPO |
$805.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.05
|
| Rate for Payer: BCN Commercial |
$1,189.93
|
| Rate for Payer: BCN Medicare Advantage |
$805.30
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cofinity Commercial |
$1,079.10
|
| Rate for Payer: Cofinity Commercial |
$1,159.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.30
|
| Rate for Payer: Healthscope Commercial |
$966.36
|
| Rate for Payer: Healthscope Whirlpool |
$966.36
|
| Rate for Payer: Meridian Medicaid |
$551.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$845.56
|
| Rate for Payer: PACE SWMI |
$805.30
|
| Rate for Payer: PHP Medicare Advantage |
$805.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$524.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,172.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,315.77
|
| Rate for Payer: Priority Health Medicare |
$805.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,315.77
|
| Rate for Payer: UHC Medicare Advantage |
$829.46
|
|
|
PR LASER VAPORIZATION OF PROSTATE FOR URINE FLOW
|
Professional
|
Both
|
$3,242.78
|
|
|
Service Code
|
HCPCS 52648
|
| Min. Negotiated Rate |
$441.34 |
| Max. Negotiated Rate |
$2,363.74 |
| Rate for Payer: Aetna Commercial |
$905.52
|
| Rate for Payer: Aetna Medicare |
$675.76
|
| Rate for Payer: BCBS Complete |
$463.41
|
| Rate for Payer: BCBS MAPPO |
$675.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,272.67
|
| Rate for Payer: BCN Commercial |
$2,363.74
|
| Rate for Payer: BCN Medicare Advantage |
$675.76
|
| Rate for Payer: Cash Price |
$2,594.22
|
| Rate for Payer: Cash Price |
$2,594.22
|
| Rate for Payer: Cofinity Commercial |
$905.52
|
| Rate for Payer: Cofinity Commercial |
$973.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.76
|
| Rate for Payer: Healthscope Commercial |
$810.91
|
| Rate for Payer: Healthscope Whirlpool |
$810.91
|
| Rate for Payer: Meridian Medicaid |
$463.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$709.55
|
| Rate for Payer: PACE SWMI |
$675.76
|
| Rate for Payer: PHP Medicare Advantage |
$675.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,269.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,104.48
|
| Rate for Payer: Priority Health Medicare |
$675.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,104.48
|
| Rate for Payer: UHC Medicare Advantage |
$696.03
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 27425
|
| Min. Negotiated Rate |
$297.35 |
| Max. Negotiated Rate |
$1,208.75 |
| Rate for Payer: Aetna Commercial |
$599.77
|
| Rate for Payer: Aetna Medicare |
$447.59
|
| Rate for Payer: BCBS Complete |
$312.22
|
| Rate for Payer: BCBS MAPPO |
$447.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.75
|
| Rate for Payer: BCN Commercial |
$741.46
|
| Rate for Payer: BCN Medicare Advantage |
$447.59
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$644.53
|
| Rate for Payer: Cofinity Commercial |
$599.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.59
|
| Rate for Payer: Healthscope Commercial |
$537.11
|
| Rate for Payer: Healthscope Whirlpool |
$537.11
|
| Rate for Payer: Meridian Medicaid |
$312.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$469.97
|
| Rate for Payer: PACE SWMI |
$447.59
|
| Rate for Payer: PHP Medicare Advantage |
$447.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,164.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.68
|
| Rate for Payer: Priority Health Medicare |
$447.59
|
| Rate for Payer: Priority Health Narrow Network |
$703.68
|
| Rate for Payer: UHC Medicare Advantage |
$461.02
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Facility
|
IP
|
$1,664.00
|
|
|
Service Code
|
CPT 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$1,164.80 |
| Max. Negotiated Rate |
$1,664.00 |
| Rate for Payer: Aetna Commercial |
$1,497.60
|
| Rate for Payer: ASR ASR |
$1,614.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.10
|
| Rate for Payer: BCN Commercial |
$1,290.10
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,564.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,331.20
|
| Rate for Payer: Healthscope Commercial |
$1,664.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,614.08
|
| Rate for Payer: Mclaren Commercial |
$1,497.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,414.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,164.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,464.32
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$297.35 |
| Max. Negotiated Rate |
$1,208.75 |
| Rate for Payer: Aetna Commercial |
$599.77
|
| Rate for Payer: Aetna Medicare |
$447.59
|
| Rate for Payer: BCBS Complete |
$312.22
|
| Rate for Payer: BCBS MAPPO |
$447.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.75
|
| Rate for Payer: BCN Commercial |
$741.46
|
| Rate for Payer: BCN Medicare Advantage |
$447.59
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$644.53
|
| Rate for Payer: Cofinity Commercial |
$599.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.59
|
| Rate for Payer: Healthscope Commercial |
$537.11
|
| Rate for Payer: Healthscope Whirlpool |
$537.11
|
| Rate for Payer: Meridian Medicaid |
$312.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$469.97
|
| Rate for Payer: PACE SWMI |
$447.59
|
| Rate for Payer: PHP Medicare Advantage |
$447.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,164.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.68
|
| Rate for Payer: Priority Health Medicare |
$447.59
|
| Rate for Payer: Priority Health Narrow Network |
$703.68
|
| Rate for Payer: UHC Medicare Advantage |
$461.02
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Facility
|
OP
|
$1,664.00
|
|
|
Service Code
|
CPT 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$1,164.80 |
| Max. Negotiated Rate |
$3,596.44 |
| Rate for Payer: Aetna Commercial |
$1,497.60
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$1,614.08
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.10
|
| Rate for Payer: BCN Commercial |
$1,290.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,564.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,331.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,664.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,614.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$1,497.60
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,414.40
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,164.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,514.24
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,181.44
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,464.32
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PR LATISSE
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 00267
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$71.60 |
| Max. Negotiated Rate |
$125.30 |
| Rate for Payer: BCBS Complete |
$71.60
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
|
|
PR LAVAGE CANNULATION MAXILLARY SINUS
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 31000
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$694.71 |
| Rate for Payer: Aetna Commercial |
$143.54
|
| Rate for Payer: Aetna Medicare |
$107.12
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS MAPPO |
$107.12
|
| Rate for Payer: BCBS Trust/PPO |
$694.71
|
| Rate for Payer: BCN Commercial |
$274.15
|
| Rate for Payer: BCN Medicare Advantage |
$107.12
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$154.25
|
| Rate for Payer: Cofinity Commercial |
$143.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.12
|
| Rate for Payer: Healthscope Commercial |
$128.54
|
| Rate for Payer: Healthscope Whirlpool |
$128.54
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.48
|
| Rate for Payer: PACE SWMI |
$107.12
|
| Rate for Payer: PHP Medicare Advantage |
$107.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.74
|
| Rate for Payer: Priority Health Medicare |
$107.12
|
| Rate for Payer: Priority Health Narrow Network |
$153.74
|
| Rate for Payer: UHC Medicare Advantage |
$110.33
|
|
|
PR LAVAGE CANNULATION SPHENOID SINUS
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 31002
|
| Min. Negotiated Rate |
$121.62 |
| Max. Negotiated Rate |
$689.96 |
| Rate for Payer: Aetna Commercial |
$248.68
|
| Rate for Payer: Aetna Medicare |
$185.58
|
| Rate for Payer: BCBS Complete |
$127.70
|
| Rate for Payer: BCBS MAPPO |
$185.58
|
| Rate for Payer: BCBS Trust/PPO |
$689.96
|
| Rate for Payer: BCN Commercial |
$282.46
|
| Rate for Payer: BCN Medicare Advantage |
$185.58
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$267.24
|
| Rate for Payer: Cofinity Commercial |
$248.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.58
|
| Rate for Payer: Healthscope Commercial |
$222.70
|
| Rate for Payer: Healthscope Whirlpool |
$222.70
|
| Rate for Payer: Meridian Medicaid |
$127.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$194.86
|
| Rate for Payer: PACE SWMI |
$185.58
|
| Rate for Payer: PHP Medicare Advantage |
$185.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.64
|
| Rate for Payer: Priority Health Medicare |
$185.58
|
| Rate for Payer: Priority Health Narrow Network |
$267.64
|
| Rate for Payer: UHC Medicare Advantage |
$191.15
|
|
|
PR LEFT HEART CATH BY TRANSEPTAL PUNCTURE
|
Professional
|
Both
|
$433.00
|
|
|
Service Code
|
HCPCS 93462
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$548.90 |
| Rate for Payer: Aetna Commercial |
$273.98
|
| Rate for Payer: Aetna Medicare |
$204.46
|
| Rate for Payer: BCBS Complete |
$135.53
|
| Rate for Payer: BCBS MAPPO |
$204.46
|
| Rate for Payer: BCBS Trust/PPO |
$548.90
|
| Rate for Payer: BCN Commercial |
$298.58
|
| Rate for Payer: BCN Medicare Advantage |
$204.46
|
| Rate for Payer: Cash Price |
$346.40
|
| Rate for Payer: Cash Price |
$346.40
|
| Rate for Payer: Cofinity Commercial |
$273.98
|
| Rate for Payer: Cofinity Commercial |
$294.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.46
|
| Rate for Payer: Healthscope Commercial |
$245.35
|
| Rate for Payer: Healthscope Whirlpool |
$245.35
|
| Rate for Payer: Meridian Medicaid |
$135.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$214.68
|
| Rate for Payer: PACE SWMI |
$204.46
|
| Rate for Payer: PHP Medicare Advantage |
$204.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.92
|
| Rate for Payer: Priority Health Medicare |
$204.46
|
| Rate for Payer: Priority Health Narrow Network |
$288.92
|
| Rate for Payer: UHC Medicare Advantage |
$210.59
|
|
|
PR LENGTHENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,322.00
|
|
|
Service Code
|
HCPCS 26476
|
| Min. Negotiated Rate |
$418.12 |
| Max. Negotiated Rate |
$1,727.54 |
| Rate for Payer: Aetna Commercial |
$842.18
|
| Rate for Payer: Aetna Medicare |
$628.49
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS MAPPO |
$628.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,727.54
|
| Rate for Payer: BCN Commercial |
$959.76
|
| Rate for Payer: BCN Medicare Advantage |
$628.49
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cofinity Commercial |
$905.03
|
| Rate for Payer: Cofinity Commercial |
$842.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.49
|
| Rate for Payer: Healthscope Commercial |
$754.19
|
| Rate for Payer: Healthscope Whirlpool |
$754.19
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$659.91
|
| Rate for Payer: PACE SWMI |
$628.49
|
| Rate for Payer: PHP Medicare Advantage |
$628.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,002.91
|
| Rate for Payer: Priority Health Medicare |
$628.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,002.91
|
| Rate for Payer: UHC Medicare Advantage |
$647.34
|
|
|
PR LENGTHENING TENDON FLEXOR HAND/FINGER EACH
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 26478
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,400.00 |
| Rate for Payer: Aetna Commercial |
$869.79
|
| Rate for Payer: Aetna Medicare |
$649.10
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS MAPPO |
$649.10
|
| Rate for Payer: BCBS Trust/PPO |
$878.03
|
| Rate for Payer: BCN Commercial |
$989.08
|
| Rate for Payer: BCN Medicare Advantage |
$649.10
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Commercial |
$934.70
|
| Rate for Payer: Cofinity Commercial |
$869.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$649.10
|
| Rate for Payer: Healthscope Commercial |
$778.92
|
| Rate for Payer: Healthscope Whirlpool |
$778.92
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$681.56
|
| Rate for Payer: PACE SWMI |
$649.10
|
| Rate for Payer: PHP Medicare Advantage |
$649.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.56
|
| Rate for Payer: Priority Health Medicare |
$649.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.56
|
| Rate for Payer: UHC Medicare Advantage |
$668.57
|
|
|
PR LESION <15
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 00074
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
|
