|
PR LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC
|
Professional
|
Both
|
$3,865.00
|
|
|
Service Code
|
HCPCS 38562
|
| Min. Negotiated Rate |
$453.26 |
| Max. Negotiated Rate |
$2,705.50 |
| Rate for Payer: Aetna Commercial |
$930.20
|
| Rate for Payer: Aetna Medicare |
$694.18
|
| Rate for Payer: BCBS Complete |
$475.92
|
| Rate for Payer: BCBS MAPPO |
$694.18
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$1,029.16
|
| Rate for Payer: BCN Medicare Advantage |
$694.18
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cofinity Commercial |
$930.20
|
| Rate for Payer: Cofinity Commercial |
$999.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.18
|
| Rate for Payer: Healthscope Commercial |
$833.02
|
| Rate for Payer: Healthscope Whirlpool |
$833.02
|
| Rate for Payer: Meridian Medicaid |
$475.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$728.89
|
| Rate for Payer: PACE SWMI |
$694.18
|
| Rate for Payer: PHP Medicare Advantage |
$694.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,705.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,525.45
|
| Rate for Payer: Priority Health Medicare |
$694.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,525.45
|
| Rate for Payer: UHC Medicare Advantage |
$715.01
|
|
|
PR LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 38564
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$1,942.50 |
| Rate for Payer: Aetna Commercial |
$931.34
|
| Rate for Payer: Aetna Medicare |
$695.03
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS MAPPO |
$695.03
|
| Rate for Payer: BCBS Trust/PPO |
$543.62
|
| Rate for Payer: BCN Commercial |
$1,024.27
|
| Rate for Payer: BCN Medicare Advantage |
$695.03
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$1,000.84
|
| Rate for Payer: Cofinity Commercial |
$931.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.03
|
| Rate for Payer: Healthscope Commercial |
$834.04
|
| Rate for Payer: Healthscope Whirlpool |
$834.04
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$729.78
|
| Rate for Payer: PACE SWMI |
$695.03
|
| Rate for Payer: PHP Medicare Advantage |
$695.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,942.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,518.23
|
| Rate for Payer: Priority Health Medicare |
$695.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,518.23
|
| Rate for Payer: UHC Medicare Advantage |
$715.88
|
|
|
PR LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
HCPCS 25280
|
| Min. Negotiated Rate |
$368.92 |
| Max. Negotiated Rate |
$1,111.60 |
| Rate for Payer: Aetna Commercial |
$748.52
|
| Rate for Payer: Aetna Medicare |
$558.60
|
| Rate for Payer: BCBS Complete |
$387.37
|
| Rate for Payer: BCBS MAPPO |
$558.60
|
| Rate for Payer: BCBS Trust/PPO |
$760.22
|
| Rate for Payer: BCN Commercial |
$837.11
|
| Rate for Payer: BCN Medicare Advantage |
$558.60
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cofinity Commercial |
$804.38
|
| Rate for Payer: Cofinity Commercial |
$748.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.60
|
| Rate for Payer: Healthscope Commercial |
$670.32
|
| Rate for Payer: Healthscope Whirlpool |
$670.32
|
| Rate for Payer: Meridian Medicaid |
$387.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.53
|
| Rate for Payer: PACE SWMI |
$558.60
|
| Rate for Payer: PHP Medicare Advantage |
$558.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,111.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$874.75
|
| Rate for Payer: Priority Health Medicare |
$558.60
|
| Rate for Payer: Priority Health Narrow Network |
$874.75
|
| Rate for Payer: UHC Medicare Advantage |
$575.36
|
|
|
PR LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA
|
Professional
|
Both
|
$1,335.00
|
|
|
Service Code
|
HCPCS 27686
|
| Min. Negotiated Rate |
$344.21 |
| Max. Negotiated Rate |
$2,402.18 |
| Rate for Payer: Aetna Commercial |
$694.29
|
| Rate for Payer: Aetna Medicare |
$518.13
|
| Rate for Payer: BCBS Complete |
$361.42
|
| Rate for Payer: BCBS MAPPO |
$518.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,402.18
|
| Rate for Payer: BCN Commercial |
$773.09
|
| Rate for Payer: BCN Medicare Advantage |
$518.13
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cofinity Commercial |
$746.11
|
| Rate for Payer: Cofinity Commercial |
$694.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.13
|
| Rate for Payer: Healthscope Commercial |
$621.76
|
| Rate for Payer: Healthscope Whirlpool |
$621.76
|
| Rate for Payer: Meridian Medicaid |
$361.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$544.04
|
| Rate for Payer: PACE SWMI |
$518.13
|
| Rate for Payer: PHP Medicare Advantage |
$518.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.86
|
| Rate for Payer: Priority Health Medicare |
$518.13
|
| Rate for Payer: Priority Health Narrow Network |
$807.86
|
| Rate for Payer: UHC Medicare Advantage |
$533.67
|
|
|
PR LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 27685
|
| Min. Negotiated Rate |
$301.82 |
| Max. Negotiated Rate |
$3,119.66 |
| Rate for Payer: Aetna Commercial |
$612.10
|
| Rate for Payer: Aetna Medicare |
$456.79
|
| Rate for Payer: BCBS Complete |
$316.91
|
| Rate for Payer: BCBS MAPPO |
$456.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,119.66
|
| Rate for Payer: BCN Commercial |
$962.69
|
| Rate for Payer: BCN Medicare Advantage |
$456.79
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$657.78
|
| Rate for Payer: Cofinity Commercial |
$612.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$456.79
|
| Rate for Payer: Healthscope Commercial |
$548.15
|
| Rate for Payer: Healthscope Whirlpool |
$548.15
|
| Rate for Payer: Meridian Medicaid |
$316.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$479.63
|
| Rate for Payer: PACE SWMI |
$456.79
|
| Rate for Payer: PHP Medicare Advantage |
$456.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,249.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$713.88
|
| Rate for Payer: Priority Health Medicare |
$456.79
|
| Rate for Payer: Priority Health Narrow Network |
$713.88
|
| Rate for Payer: UHC Medicare Advantage |
$470.49
|
|
|
PR LOCM 250-299MG/ML IODINE,1ML
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS Q9948
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
|
|
PR LORAZEPAM INJECTION
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS J2060
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$4.90 |
| Rate for Payer: Aetna Commercial |
$1.14
|
| Rate for Payer: Aetna Medicare |
$0.85
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$0.85
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Medicare Advantage |
$0.85
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$1.23
|
| Rate for Payer: Cofinity Commercial |
$1.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.85
|
| Rate for Payer: Healthscope Commercial |
$1.02
|
| Rate for Payer: Healthscope Whirlpool |
$1.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.89
|
| Rate for Payer: PACE SWMI |
$0.85
|
| Rate for Payer: PHP Medicare Advantage |
$0.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.90
|
| Rate for Payer: Priority Health Medicare |
$0.85
|
| Rate for Payer: UHC Medicare Advantage |
$0.88
|
|
|
PR LOWER LID BLEPHAROPLASTY
|
Professional
|
Both
|
$1,800.00
|
|
|
Service Code
|
HCPCS 00531
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$720.00 |
| Max. Negotiated Rate |
$1,260.00 |
| Rate for Payer: BCBS Complete |
$720.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.00
|
|
|
PR LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 20979
|
| Min. Negotiated Rate |
$32.07 |
| Max. Negotiated Rate |
$3,247.68 |
| Rate for Payer: Aetna Commercial |
$42.97
|
| Rate for Payer: Aetna Medicare |
$32.07
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$32.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$82.58
|
| Rate for Payer: BCN Medicare Advantage |
$32.07
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$42.97
|
| Rate for Payer: Cofinity Commercial |
$46.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.07
|
| Rate for Payer: Healthscope Commercial |
$38.48
|
| Rate for Payer: Healthscope Whirlpool |
$38.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.67
|
| Rate for Payer: PACE SWMI |
$32.07
|
| Rate for Payer: PHP Medicare Advantage |
$32.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.02
|
| Rate for Payer: Priority Health Medicare |
$32.07
|
| Rate for Payer: Priority Health Narrow Network |
$49.02
|
| Rate for Payer: UHC Medicare Advantage |
$33.03
|
|
|
PR LT COMPRES BAND >=3 <5/YD
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS A6449
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.10 |
| Rate for Payer: Aetna Commercial |
$1.63
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: BCN Commercial |
$1.93
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
|
|
PR LT COMPRES BAND <3/YD
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS A6448
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$2.10 |
| Rate for Payer: Aetna Commercial |
$1.07
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
|
|
PR LT COMPRES BAND >=5/YD
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS A6450
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: Aetna Commercial |
$1.63
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCN Commercial |
$1.93
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
|
|
PR LUX IR ABD/BACK
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 00097
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
|
|
PR LUX IR ARMS
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 00095
|
|
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
|
|
|
PR LUX IR BUTTOCKS
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 00098
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
|
|
PR LUX IR CHEST
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 00094
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
|
|
PR LUX IR FACE & NECK
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 00093
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
|
|
PR LUX IR UP LEGS
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 00096
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
|
|
PR LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 38308
|
| Min. Negotiated Rate |
$302.46 |
| Max. Negotiated Rate |
$1,010.46 |
| Rate for Payer: Aetna Commercial |
$616.21
|
| Rate for Payer: Aetna Medicare |
$459.86
|
| Rate for Payer: BCBS Complete |
$317.58
|
| Rate for Payer: BCBS MAPPO |
$459.86
|
| Rate for Payer: BCBS Trust/PPO |
$635.54
|
| Rate for Payer: BCN Commercial |
$681.71
|
| Rate for Payer: BCN Medicare Advantage |
$459.86
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$662.20
|
| Rate for Payer: Cofinity Commercial |
$616.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.86
|
| Rate for Payer: Healthscope Commercial |
$551.83
|
| Rate for Payer: Healthscope Whirlpool |
$551.83
|
| Rate for Payer: Meridian Medicaid |
$317.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$482.85
|
| Rate for Payer: PACE SWMI |
$459.86
|
| Rate for Payer: PHP Medicare Advantage |
$459.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,010.46
|
| Rate for Payer: Priority Health Medicare |
$459.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,010.46
|
| Rate for Payer: UHC Medicare Advantage |
$473.66
|
|
|
PR LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Professional
|
Both
|
$511.00
|
|
|
Service Code
|
HCPCS 54162
|
| Min. Negotiated Rate |
$128.23 |
| Max. Negotiated Rate |
$1,225.13 |
| Rate for Payer: Aetna Commercial |
$262.13
|
| Rate for Payer: Aetna Medicare |
$195.62
|
| Rate for Payer: BCBS Complete |
$134.64
|
| Rate for Payer: BCBS MAPPO |
$195.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.13
|
| Rate for Payer: BCN Commercial |
$374.33
|
| Rate for Payer: BCN Medicare Advantage |
$195.62
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cofinity Commercial |
$262.13
|
| Rate for Payer: Cofinity Commercial |
$281.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.62
|
| Rate for Payer: Healthscope Commercial |
$234.74
|
| Rate for Payer: Healthscope Whirlpool |
$234.74
|
| Rate for Payer: Meridian Medicaid |
$134.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.40
|
| Rate for Payer: PACE SWMI |
$195.62
|
| Rate for Payer: PHP Medicare Advantage |
$195.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.97
|
| Rate for Payer: Priority Health Medicare |
$195.62
|
| Rate for Payer: Priority Health Narrow Network |
$320.97
|
| Rate for Payer: UHC Medicare Advantage |
$201.49
|
|
|
PR LYSIS INTRANASAL SYNECHIA
|
Professional
|
Both
|
$506.00
|
|
|
Service Code
|
HCPCS 30560
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$805.66 |
| Rate for Payer: Aetna Commercial |
$194.94
|
| Rate for Payer: Aetna Medicare |
$145.48
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$145.48
|
| Rate for Payer: BCBS Trust/PPO |
$805.66
|
| Rate for Payer: BCN Commercial |
$479.88
|
| Rate for Payer: BCN Medicare Advantage |
$145.48
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Cofinity Commercial |
$209.49
|
| Rate for Payer: Cofinity Commercial |
$194.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.48
|
| Rate for Payer: Healthscope Commercial |
$174.58
|
| Rate for Payer: Healthscope Whirlpool |
$174.58
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.75
|
| Rate for Payer: PACE SWMI |
$145.48
|
| Rate for Payer: PHP Medicare Advantage |
$145.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.69
|
| Rate for Payer: Priority Health Medicare |
$145.48
|
| Rate for Payer: Priority Health Narrow Network |
$210.69
|
| Rate for Payer: UHC Medicare Advantage |
$149.84
|
|
|
PR LYSIS LABIAL ADHESIONS
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 56441
|
| Min. Negotiated Rate |
$100.32 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$202.77
|
| Rate for Payer: Aetna Medicare |
$151.32
|
| Rate for Payer: BCBS Complete |
$105.34
|
| Rate for Payer: BCBS MAPPO |
$151.32
|
| Rate for Payer: BCBS Trust/PPO |
$488.15
|
| Rate for Payer: BCN Commercial |
$270.24
|
| Rate for Payer: BCN Medicare Advantage |
$151.32
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$217.90
|
| Rate for Payer: Cofinity Commercial |
$202.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.32
|
| Rate for Payer: Healthscope Commercial |
$181.58
|
| Rate for Payer: Healthscope Whirlpool |
$181.58
|
| Rate for Payer: Meridian Medicaid |
$105.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.89
|
| Rate for Payer: PACE SWMI |
$151.32
|
| Rate for Payer: PHP Medicare Advantage |
$151.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.15
|
| Rate for Payer: Priority Health Medicare |
$151.32
|
| Rate for Payer: Priority Health Narrow Network |
$220.15
|
| Rate for Payer: UHC Medicare Advantage |
$155.86
|
|
|
PR LYSIS OF ADHESIONS SALPINX/OVARY
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 58740
|
| Min. Negotiated Rate |
$207.09 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Aetna Commercial |
$1,200.45
|
| Rate for Payer: Aetna Medicare |
$895.86
|
| Rate for Payer: BCBS Complete |
$608.33
|
| Rate for Payer: BCBS MAPPO |
$895.86
|
| Rate for Payer: BCBS Trust/PPO |
$207.09
|
| Rate for Payer: BCN Commercial |
$1,323.34
|
| Rate for Payer: BCN Medicare Advantage |
$895.86
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cofinity Commercial |
$1,200.45
|
| Rate for Payer: Cofinity Commercial |
$1,290.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.86
|
| Rate for Payer: Healthscope Commercial |
$1,075.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,075.03
|
| Rate for Payer: Meridian Medicaid |
$608.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$940.65
|
| Rate for Payer: PACE SWMI |
$895.86
|
| Rate for Payer: PHP Medicare Advantage |
$895.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,282.04
|
| Rate for Payer: Priority Health Medicare |
$895.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,282.04
|
| Rate for Payer: UHC Medicare Advantage |
$922.74
|
|
|
PR MA/EC CONTRACEPTIVEINJECTION
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS J1056
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.10
|
|
|
PR MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC
|
Professional
|
Both
|
$3,282.00
|
|
|
Service Code
|
HCPCS 32820
|
| Min. Negotiated Rate |
$841.78 |
| Max. Negotiated Rate |
$2,297.40 |
| Rate for Payer: Aetna Commercial |
$1,756.57
|
| Rate for Payer: Aetna Medicare |
$1,310.87
|
| Rate for Payer: BCBS Complete |
$883.87
|
| Rate for Payer: BCBS MAPPO |
$1,310.87
|
| Rate for Payer: BCBS Trust/PPO |
$878.56
|
| Rate for Payer: BCN Commercial |
$1,919.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,310.87
|
| Rate for Payer: Cash Price |
$2,625.60
|
| Rate for Payer: Cash Price |
$2,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,756.57
|
| Rate for Payer: Cofinity Commercial |
$1,887.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,310.87
|
| Rate for Payer: Healthscope Commercial |
$1,573.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,573.04
|
| Rate for Payer: Meridian Medicaid |
$883.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,376.41
|
| Rate for Payer: PACE SWMI |
$1,310.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,310.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,818.84
|
| Rate for Payer: Priority Health Medicare |
$1,310.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,818.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,350.20
|
|
