|
PR CORF RELATED SERV 15 MINS EA
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS G0409
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$35.86 |
| Rate for Payer: Aetna Commercial |
$29.52
|
| Rate for Payer: Aetna Medicare |
$22.03
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$22.03
|
| Rate for Payer: BCN Commercial |
$35.86
|
| Rate for Payer: BCN Medicare Advantage |
$22.03
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$26.44
|
| Rate for Payer: Healthscope Whirlpool |
$26.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.23
|
| Rate for Payer: Nomi Health Commercial |
$26.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: PACE SWMI |
$22.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.03
|
| Rate for Payer: Priority Health Medicare |
$22.03
|
| Rate for Payer: Railroad Medicare Medicare |
$22.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.03
|
| Rate for Payer: UHC Exchange |
$19.72
|
| Rate for Payer: UHCCP DNSP |
$22.03
|
|
|
PR CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT
|
Professional
|
Both
|
$4,167.00
|
|
|
Service Code
|
HCPCS 33510
|
| Min. Negotiated Rate |
$1,157.23 |
| Max. Negotiated Rate |
$3,448.51 |
| Rate for Payer: Aetna Commercial |
$2,433.84
|
| Rate for Payer: Aetna Medicare |
$1,816.30
|
| Rate for Payer: BCBS Complete |
$1,215.09
|
| Rate for Payer: BCBS MAPPO |
$1,816.30
|
| Rate for Payer: BCN Commercial |
$2,842.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,816.30
|
| Rate for Payer: Cash Price |
$3,333.60
|
| Rate for Payer: Cash Price |
$3,333.60
|
| Rate for Payer: Cofinity Commercial |
$2,615.47
|
| Rate for Payer: Cofinity Commercial |
$2,433.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,816.30
|
| Rate for Payer: Healthscope Commercial |
$2,179.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,179.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,907.12
|
| Rate for Payer: Meridian Medicaid |
$1,215.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,997.93
|
| Rate for Payer: Nomi Health Commercial |
$2,179.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,125.25
|
| Rate for Payer: PACE SWMI |
$1,816.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,816.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,157.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,057.26
|
| Rate for Payer: Priority Health Medicare |
$1,816.30
|
| Rate for Payer: Priority Health Narrow Network |
$3,057.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,816.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,448.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,816.30
|
| Rate for Payer: UHC Exchange |
$3,448.51
|
| Rate for Payer: UHC Medicaid |
$1,157.23
|
| Rate for Payer: UHCCP DNSP |
$1,816.30
|
| Rate for Payer: UHCCP Medicaid |
$1,157.23
|
|
|
PR CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$4,577.00
|
|
|
Service Code
|
HCPCS 33511
|
| Min. Negotiated Rate |
$1,272.04 |
| Max. Negotiated Rate |
$3,785.49 |
| Rate for Payer: Aetna Commercial |
$2,675.86
|
| Rate for Payer: Aetna Medicare |
$1,996.91
|
| Rate for Payer: BCBS Complete |
$1,335.64
|
| Rate for Payer: BCBS MAPPO |
$1,996.91
|
| Rate for Payer: BCN Commercial |
$3,122.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,996.91
|
| Rate for Payer: Cash Price |
$3,661.60
|
| Rate for Payer: Cash Price |
$3,661.60
|
| Rate for Payer: Cofinity Commercial |
$2,875.55
|
| Rate for Payer: Cofinity Commercial |
$2,675.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,996.91
|
| Rate for Payer: Healthscope Commercial |
$2,396.29
|
| Rate for Payer: Healthscope Whirlpool |
$2,396.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,096.76
|
| Rate for Payer: Meridian Medicaid |
$1,335.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,196.60
|
| Rate for Payer: Nomi Health Commercial |
$2,396.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,432.75
|
| Rate for Payer: PACE SWMI |
$1,996.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,996.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,272.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,358.22
|
| Rate for Payer: Priority Health Medicare |
$1,996.91
|
| Rate for Payer: Priority Health Narrow Network |
$3,358.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,996.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,785.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,996.91
|
| Rate for Payer: UHC Exchange |
$3,785.49
|
| Rate for Payer: UHC Medicaid |
$1,272.04
|
| Rate for Payer: UHCCP DNSP |
$1,996.91
|
| Rate for Payer: UHCCP Medicaid |
$1,272.04
|
|
|
PR CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$10,215.00
|
|
|
Service Code
|
HCPCS 33512
|
| Min. Negotiated Rate |
$1,440.09 |
| Max. Negotiated Rate |
$7,661.25 |
| Rate for Payer: Aetna Commercial |
$3,031.44
|
| Rate for Payer: Aetna Medicare |
$2,262.27
|
| Rate for Payer: BCBS Complete |
$1,512.09
|
| Rate for Payer: BCBS MAPPO |
$2,262.27
|
| Rate for Payer: BCN Commercial |
$3,553.09
|
| Rate for Payer: BCN Medicare Advantage |
$2,262.27
|
| Rate for Payer: Cash Price |
$8,172.00
|
| Rate for Payer: Cash Price |
$8,172.00
|
| Rate for Payer: Cofinity Commercial |
$3,257.67
|
| Rate for Payer: Cofinity Commercial |
$3,031.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,262.27
|
| Rate for Payer: Healthscope Commercial |
$2,714.72
|
| Rate for Payer: Healthscope Whirlpool |
$2,714.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,375.38
|
| Rate for Payer: Meridian Medicaid |
$1,512.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,488.50
|
| Rate for Payer: Nomi Health Commercial |
$2,714.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,661.25
|
| Rate for Payer: PACE SWMI |
$2,262.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,262.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,820.90
|
| Rate for Payer: Priority Health Medicare |
$2,262.27
|
| Rate for Payer: Priority Health Narrow Network |
$3,820.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,262.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,312.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,262.27
|
| Rate for Payer: UHC Exchange |
$4,312.82
|
| Rate for Payer: UHC Medicaid |
$1,440.09
|
| Rate for Payer: UHCCP DNSP |
$2,262.27
|
| Rate for Payer: UHCCP Medicaid |
$1,440.09
|
|
|
PR CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS
|
Professional
|
Both
|
$10,424.00
|
|
|
Service Code
|
HCPCS 33513
|
| Min. Negotiated Rate |
$1,469.06 |
| Max. Negotiated Rate |
$7,818.00 |
| Rate for Payer: Aetna Commercial |
$3,094.64
|
| Rate for Payer: Aetna Medicare |
$2,309.43
|
| Rate for Payer: BCBS Complete |
$1,542.51
|
| Rate for Payer: BCBS MAPPO |
$2,309.43
|
| Rate for Payer: BCN Commercial |
$3,630.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,309.43
|
| Rate for Payer: Cash Price |
$8,339.20
|
| Rate for Payer: Cash Price |
$8,339.20
|
| Rate for Payer: Cofinity Commercial |
$3,325.58
|
| Rate for Payer: Cofinity Commercial |
$3,094.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,309.43
|
| Rate for Payer: Healthscope Commercial |
$2,771.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,771.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,424.90
|
| Rate for Payer: Meridian Medicaid |
$1,542.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,540.37
|
| Rate for Payer: Nomi Health Commercial |
$2,771.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,818.00
|
| Rate for Payer: PACE SWMI |
$2,309.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,309.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,469.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,903.91
|
| Rate for Payer: Priority Health Medicare |
$2,309.43
|
| Rate for Payer: Priority Health Narrow Network |
$3,903.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,309.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,428.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,309.43
|
| Rate for Payer: UHC Exchange |
$4,428.00
|
| Rate for Payer: UHC Medicaid |
$1,469.06
|
| Rate for Payer: UHCCP DNSP |
$2,309.43
|
| Rate for Payer: UHCCP Medicaid |
$1,469.06
|
|
|
PR CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT
|
Professional
|
Both
|
$11,723.00
|
|
|
Service Code
|
HCPCS 33516
|
| Min. Negotiated Rate |
$1,619.65 |
| Max. Negotiated Rate |
$8,792.25 |
| Rate for Payer: Aetna Commercial |
$3,408.91
|
| Rate for Payer: Aetna Medicare |
$2,543.96
|
| Rate for Payer: BCBS Complete |
$1,700.63
|
| Rate for Payer: BCBS MAPPO |
$2,543.96
|
| Rate for Payer: BCN Commercial |
$3,953.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,543.96
|
| Rate for Payer: Cash Price |
$9,378.40
|
| Rate for Payer: Cash Price |
$9,378.40
|
| Rate for Payer: Cofinity Commercial |
$3,663.30
|
| Rate for Payer: Cofinity Commercial |
$3,408.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,543.96
|
| Rate for Payer: Healthscope Commercial |
$3,052.75
|
| Rate for Payer: Healthscope Whirlpool |
$3,052.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,671.16
|
| Rate for Payer: Meridian Medicaid |
$1,700.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,798.36
|
| Rate for Payer: Nomi Health Commercial |
$3,052.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,792.25
|
| Rate for Payer: PACE SWMI |
$2,543.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,543.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,619.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,251.46
|
| Rate for Payer: Priority Health Medicare |
$2,543.96
|
| Rate for Payer: Priority Health Narrow Network |
$4,251.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,543.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,830.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,543.96
|
| Rate for Payer: UHC Exchange |
$4,830.24
|
| Rate for Payer: UHC Medicaid |
$1,619.65
|
| Rate for Payer: UHCCP DNSP |
$2,543.96
|
| Rate for Payer: UHCCP Medicaid |
$1,619.65
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 33517
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$621.00 |
| Rate for Payer: Aetna Commercial |
$230.52
|
| Rate for Payer: Aetna Medicare |
$172.03
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$172.03
|
| Rate for Payer: BCN Commercial |
$272.89
|
| Rate for Payer: BCN Medicare Advantage |
$172.03
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cofinity Commercial |
$247.72
|
| Rate for Payer: Cofinity Commercial |
$230.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.03
|
| Rate for Payer: Healthscope Commercial |
$206.44
|
| Rate for Payer: Healthscope Whirlpool |
$206.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.63
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.23
|
| Rate for Payer: Nomi Health Commercial |
$206.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.00
|
| Rate for Payer: PACE SWMI |
$172.03
|
| Rate for Payer: PHP Medicare Advantage |
$172.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$293.46
|
| Rate for Payer: Priority Health Medicare |
$172.03
|
| Rate for Payer: Priority Health Narrow Network |
$293.46
|
| Rate for Payer: Railroad Medicare Medicare |
$172.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$172.03
|
| Rate for Payer: UHC Exchange |
$336.12
|
| Rate for Payer: UHC Medicaid |
$108.63
|
| Rate for Payer: UHCCP DNSP |
$172.03
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 33518
|
| Min. Negotiated Rate |
$238.35 |
| Max. Negotiated Rate |
$1,023.75 |
| Rate for Payer: Aetna Commercial |
$505.82
|
| Rate for Payer: Aetna Medicare |
$377.48
|
| Rate for Payer: BCBS Complete |
$250.27
|
| Rate for Payer: BCBS MAPPO |
$377.48
|
| Rate for Payer: BCN Commercial |
$600.57
|
| Rate for Payer: BCN Medicare Advantage |
$377.48
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cofinity Commercial |
$543.57
|
| Rate for Payer: Cofinity Commercial |
$505.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.48
|
| Rate for Payer: Healthscope Commercial |
$452.98
|
| Rate for Payer: Healthscope Whirlpool |
$452.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$396.35
|
| Rate for Payer: Meridian Medicaid |
$250.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$415.23
|
| Rate for Payer: Nomi Health Commercial |
$452.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,023.75
|
| Rate for Payer: PACE SWMI |
$377.48
|
| Rate for Payer: PHP Medicare Advantage |
$377.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$645.83
|
| Rate for Payer: Priority Health Medicare |
$377.48
|
| Rate for Payer: Priority Health Narrow Network |
$645.83
|
| Rate for Payer: Railroad Medicare Medicare |
$377.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$738.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$377.48
|
| Rate for Payer: UHC Exchange |
$738.46
|
| Rate for Payer: UHC Medicaid |
$238.35
|
| Rate for Payer: UHCCP DNSP |
$377.48
|
| Rate for Payer: UHCCP Medicaid |
$238.35
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN
|
Professional
|
Both
|
$1,988.00
|
|
|
Service Code
|
HCPCS 33519
|
| Min. Negotiated Rate |
$315.03 |
| Max. Negotiated Rate |
$1,491.00 |
| Rate for Payer: Aetna Commercial |
$668.57
|
| Rate for Payer: Aetna Medicare |
$498.93
|
| Rate for Payer: BCBS Complete |
$330.78
|
| Rate for Payer: BCBS MAPPO |
$498.93
|
| Rate for Payer: BCN Commercial |
$792.29
|
| Rate for Payer: BCN Medicare Advantage |
$498.93
|
| Rate for Payer: Cash Price |
$1,590.40
|
| Rate for Payer: Cash Price |
$1,590.40
|
| Rate for Payer: Cofinity Commercial |
$718.46
|
| Rate for Payer: Cofinity Commercial |
$668.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.93
|
| Rate for Payer: Healthscope Commercial |
$598.72
|
| Rate for Payer: Healthscope Whirlpool |
$598.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.88
|
| Rate for Payer: Meridian Medicaid |
$330.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$548.82
|
| Rate for Payer: Nomi Health Commercial |
$598.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.00
|
| Rate for Payer: PACE SWMI |
$498.93
|
| Rate for Payer: PHP Medicare Advantage |
$498.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$852.00
|
| Rate for Payer: Priority Health Medicare |
$498.93
|
| Rate for Payer: Priority Health Narrow Network |
$852.00
|
| Rate for Payer: Railroad Medicare Medicare |
$498.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$976.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$498.93
|
| Rate for Payer: UHC Exchange |
$976.28
|
| Rate for Payer: UHC Medicaid |
$315.03
|
| Rate for Payer: UHCCP DNSP |
$498.93
|
| Rate for Payer: UHCCP Medicaid |
$315.03
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN
|
Professional
|
Both
|
$2,669.00
|
|
|
Service Code
|
HCPCS 33521
|
| Min. Negotiated Rate |
$378.29 |
| Max. Negotiated Rate |
$2,001.75 |
| Rate for Payer: Aetna Commercial |
$802.85
|
| Rate for Payer: Aetna Medicare |
$599.14
|
| Rate for Payer: BCBS Complete |
$397.20
|
| Rate for Payer: BCBS MAPPO |
$599.14
|
| Rate for Payer: BCN Commercial |
$951.15
|
| Rate for Payer: BCN Medicare Advantage |
$599.14
|
| Rate for Payer: Cash Price |
$2,135.20
|
| Rate for Payer: Cash Price |
$2,135.20
|
| Rate for Payer: Cofinity Commercial |
$862.76
|
| Rate for Payer: Cofinity Commercial |
$802.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.14
|
| Rate for Payer: Healthscope Commercial |
$718.97
|
| Rate for Payer: Healthscope Whirlpool |
$718.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.10
|
| Rate for Payer: Meridian Medicaid |
$397.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$659.05
|
| Rate for Payer: Nomi Health Commercial |
$718.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,001.75
|
| Rate for Payer: PACE SWMI |
$599.14
|
| Rate for Payer: PHP Medicare Advantage |
$599.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,022.84
|
| Rate for Payer: Priority Health Medicare |
$599.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,022.84
|
| Rate for Payer: Railroad Medicare Medicare |
$599.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,172.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$599.14
|
| Rate for Payer: UHC Exchange |
$1,172.27
|
| Rate for Payer: UHC Medicaid |
$378.29
|
| Rate for Payer: UHCCP DNSP |
$599.14
|
| Rate for Payer: UHCCP Medicaid |
$378.29
|
|
|
PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN
|
Professional
|
Both
|
$3,391.00
|
|
|
Service Code
|
HCPCS 33522
|
| Min. Negotiated Rate |
$424.30 |
| Max. Negotiated Rate |
$2,543.25 |
| Rate for Payer: Aetna Commercial |
$900.47
|
| Rate for Payer: Aetna Medicare |
$671.99
|
| Rate for Payer: BCBS Complete |
$445.51
|
| Rate for Payer: BCBS MAPPO |
$671.99
|
| Rate for Payer: BCN Commercial |
$1,068.17
|
| Rate for Payer: BCN Medicare Advantage |
$671.99
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cofinity Commercial |
$967.67
|
| Rate for Payer: Cofinity Commercial |
$900.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.99
|
| Rate for Payer: Healthscope Commercial |
$806.39
|
| Rate for Payer: Healthscope Whirlpool |
$806.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.59
|
| Rate for Payer: Meridian Medicaid |
$445.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$739.19
|
| Rate for Payer: Nomi Health Commercial |
$806.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,543.25
|
| Rate for Payer: PACE SWMI |
$671.99
|
| Rate for Payer: PHP Medicare Advantage |
$671.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$424.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,148.68
|
| Rate for Payer: Priority Health Medicare |
$671.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.68
|
| Rate for Payer: Railroad Medicare Medicare |
$671.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,313.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$671.99
|
| Rate for Payer: UHC Exchange |
$1,313.86
|
| Rate for Payer: UHC Medicaid |
$424.30
|
| Rate for Payer: UHCCP DNSP |
$671.99
|
| Rate for Payer: UHCCP Medicaid |
$424.30
|
|
|
PR CORONARY ENDARTERCOMY OPEN ANY METHOD
|
Professional
|
Both
|
$1,334.00
|
|
|
Service Code
|
HCPCS 33572
|
| Min. Negotiated Rate |
$133.55 |
| Max. Negotiated Rate |
$1,000.50 |
| Rate for Payer: Aetna Commercial |
$283.42
|
| Rate for Payer: Aetna Medicare |
$211.51
|
| Rate for Payer: BCBS Complete |
$140.23
|
| Rate for Payer: BCBS MAPPO |
$211.51
|
| Rate for Payer: BCN Commercial |
$335.14
|
| Rate for Payer: BCN Medicare Advantage |
$211.51
|
| Rate for Payer: Cash Price |
$1,067.20
|
| Rate for Payer: Cash Price |
$1,067.20
|
| Rate for Payer: Cofinity Commercial |
$304.57
|
| Rate for Payer: Cofinity Commercial |
$283.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.51
|
| Rate for Payer: Healthscope Commercial |
$253.81
|
| Rate for Payer: Healthscope Whirlpool |
$253.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.09
|
| Rate for Payer: Meridian Medicaid |
$140.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$232.66
|
| Rate for Payer: Nomi Health Commercial |
$253.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.50
|
| Rate for Payer: PACE SWMI |
$211.51
|
| Rate for Payer: PHP Medicare Advantage |
$211.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$360.40
|
| Rate for Payer: Priority Health Medicare |
$211.51
|
| Rate for Payer: Priority Health Narrow Network |
$360.40
|
| Rate for Payer: Railroad Medicare Medicare |
$211.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$412.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$211.51
|
| Rate for Payer: UHC Exchange |
$412.85
|
| Rate for Payer: UHC Medicaid |
$133.55
|
| Rate for Payer: UHCCP DNSP |
$211.51
|
| Rate for Payer: UHCCP Medicaid |
$133.55
|
|
|
PR CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 54430
|
| Min. Negotiated Rate |
$370.83 |
| Max. Negotiated Rate |
$1,447.50 |
| Rate for Payer: Aetna Commercial |
$766.65
|
| Rate for Payer: Aetna Medicare |
$572.13
|
| Rate for Payer: BCBS Complete |
$389.37
|
| Rate for Payer: BCBS MAPPO |
$572.13
|
| Rate for Payer: BCN Commercial |
$960.10
|
| Rate for Payer: BCN Medicare Advantage |
$572.13
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$823.87
|
| Rate for Payer: Cofinity Commercial |
$766.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.13
|
| Rate for Payer: Healthscope Commercial |
$686.56
|
| Rate for Payer: Healthscope Whirlpool |
$686.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.74
|
| Rate for Payer: Meridian Medicaid |
$389.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$629.34
|
| Rate for Payer: Nomi Health Commercial |
$686.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,447.50
|
| Rate for Payer: PACE SWMI |
$572.13
|
| Rate for Payer: PHP Medicare Advantage |
$572.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$370.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,045.87
|
| Rate for Payer: Priority Health Medicare |
$572.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,045.87
|
| Rate for Payer: Railroad Medicare Medicare |
$572.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,125.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$572.13
|
| Rate for Payer: UHC Exchange |
$1,125.78
|
| Rate for Payer: UHC Medicaid |
$370.83
|
| Rate for Payer: UHCCP DNSP |
$572.13
|
| Rate for Payer: UHCCP Medicaid |
$370.83
|
|
|
PR CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 54435
|
| Min. Negotiated Rate |
$244.74 |
| Max. Negotiated Rate |
$728.87 |
| Rate for Payer: Aetna Commercial |
$503.69
|
| Rate for Payer: Aetna Medicare |
$375.89
|
| Rate for Payer: BCBS Complete |
$256.98
|
| Rate for Payer: BCBS MAPPO |
$375.89
|
| Rate for Payer: BCN Commercial |
$625.47
|
| Rate for Payer: BCN Medicare Advantage |
$375.89
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cofinity Commercial |
$541.28
|
| Rate for Payer: Cofinity Commercial |
$503.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.89
|
| Rate for Payer: Healthscope Commercial |
$451.07
|
| Rate for Payer: Healthscope Whirlpool |
$451.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.68
|
| Rate for Payer: Meridian Medicaid |
$256.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$413.48
|
| Rate for Payer: Nomi Health Commercial |
$451.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$582.00
|
| Rate for Payer: PACE SWMI |
$375.89
|
| Rate for Payer: PHP Medicare Advantage |
$375.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$681.33
|
| Rate for Payer: Priority Health Medicare |
$375.89
|
| Rate for Payer: Priority Health Narrow Network |
$681.33
|
| Rate for Payer: Railroad Medicare Medicare |
$375.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$728.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$375.89
|
| Rate for Payer: UHC Exchange |
$728.87
|
| Rate for Payer: UHC Medicaid |
$244.74
|
| Rate for Payer: UHCCP DNSP |
$375.89
|
| Rate for Payer: UHCCP Medicaid |
$244.74
|
|
|
PR CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 54420
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$1,241.75 |
| Rate for Payer: Aetna Commercial |
$840.37
|
| Rate for Payer: Aetna Medicare |
$627.14
|
| Rate for Payer: BCBS Complete |
$426.06
|
| Rate for Payer: BCBS MAPPO |
$627.14
|
| Rate for Payer: BCN Commercial |
$1,053.23
|
| Rate for Payer: BCN Medicare Advantage |
$627.14
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$840.37
|
| Rate for Payer: Cofinity Commercial |
$903.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.14
|
| Rate for Payer: Healthscope Commercial |
$752.57
|
| Rate for Payer: Healthscope Whirlpool |
$752.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.50
|
| Rate for Payer: Meridian Medicaid |
$426.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$689.85
|
| Rate for Payer: Nomi Health Commercial |
$752.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.00
|
| Rate for Payer: PACE SWMI |
$627.14
|
| Rate for Payer: PHP Medicare Advantage |
$627.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,147.31
|
| Rate for Payer: Priority Health Medicare |
$627.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,147.31
|
| Rate for Payer: Railroad Medicare Medicare |
$627.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,241.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$627.14
|
| Rate for Payer: UHC Exchange |
$1,241.75
|
| Rate for Payer: UHC Medicaid |
$405.77
|
| Rate for Payer: UHCCP DNSP |
$627.14
|
| Rate for Payer: UHCCP Medicaid |
$405.77
|
|
|
PR CORRECT BUNION,SIMPLE
|
Professional
|
Both
|
$1,426.00
|
|
|
Service Code
|
HCPCS 28290
|
| Min. Negotiated Rate |
$570.40 |
| Max. Negotiated Rate |
$1,069.50 |
| Rate for Payer: BCBS Complete |
$570.40
|
| Rate for Payer: Cash Price |
$1,140.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,069.50
|
|
|
PR CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE
|
Professional
|
Both
|
$966.00
|
|
|
Service Code
|
HCPCS 28286
|
| Min. Negotiated Rate |
$177.22 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Aetna Commercial |
$361.68
|
| Rate for Payer: Aetna Medicare |
$269.91
|
| Rate for Payer: BCBS Complete |
$186.08
|
| Rate for Payer: BCBS MAPPO |
$269.91
|
| Rate for Payer: BCN Commercial |
$449.18
|
| Rate for Payer: BCN Medicare Advantage |
$269.91
|
| Rate for Payer: Cash Price |
$772.80
|
| Rate for Payer: Cash Price |
$772.80
|
| Rate for Payer: Cofinity Commercial |
$388.67
|
| Rate for Payer: Cofinity Commercial |
$361.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.91
|
| Rate for Payer: Healthscope Commercial |
$323.89
|
| Rate for Payer: Healthscope Whirlpool |
$323.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$283.41
|
| Rate for Payer: Meridian Medicaid |
$186.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$296.90
|
| Rate for Payer: Nomi Health Commercial |
$323.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$724.50
|
| Rate for Payer: PACE SWMI |
$269.91
|
| Rate for Payer: PHP Medicare Advantage |
$269.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$480.17
|
| Rate for Payer: Priority Health Medicare |
$269.91
|
| Rate for Payer: Priority Health Narrow Network |
$480.17
|
| Rate for Payer: Railroad Medicare Medicare |
$269.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$518.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$269.91
|
| Rate for Payer: UHC Exchange |
$518.99
|
| Rate for Payer: UHC Medicaid |
$177.22
|
| Rate for Payer: UHCCP DNSP |
$269.91
|
| Rate for Payer: UHCCP Medicaid |
$177.22
|
|
|
PR CORRECTION HAMMERTOE
|
Professional
|
Both
|
$985.00
|
|
|
Service Code
|
HCPCS 28285
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$738.75 |
| Rate for Payer: Aetna Commercial |
$480.91
|
| Rate for Payer: Aetna Medicare |
$358.89
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS MAPPO |
$358.89
|
| Rate for Payer: BCN Commercial |
$649.92
|
| Rate for Payer: BCN Medicare Advantage |
$358.89
|
| Rate for Payer: Cash Price |
$788.00
|
| Rate for Payer: Cash Price |
$788.00
|
| Rate for Payer: Cofinity Commercial |
$516.80
|
| Rate for Payer: Cofinity Commercial |
$480.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.89
|
| Rate for Payer: Healthscope Commercial |
$430.67
|
| Rate for Payer: Healthscope Whirlpool |
$430.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.83
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$394.78
|
| Rate for Payer: Nomi Health Commercial |
$430.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$738.75
|
| Rate for Payer: PACE SWMI |
$358.89
|
| Rate for Payer: PHP Medicare Advantage |
$358.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$632.41
|
| Rate for Payer: Priority Health Medicare |
$358.89
|
| Rate for Payer: Priority Health Narrow Network |
$632.41
|
| Rate for Payer: Railroad Medicare Medicare |
$358.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$661.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$358.89
|
| Rate for Payer: UHC Exchange |
$661.55
|
| Rate for Payer: UHC Medicaid |
$236.43
|
| Rate for Payer: UHCCP DNSP |
$358.89
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
|
|
PR CORRECTION INVERTED NIPPLES
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 19355
|
| Min. Negotiated Rate |
$358.48 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$734.88
|
| Rate for Payer: Aetna Medicare |
$548.42
|
| Rate for Payer: BCBS Complete |
$376.40
|
| Rate for Payer: BCBS MAPPO |
$548.42
|
| Rate for Payer: BCN Commercial |
$935.21
|
| Rate for Payer: BCN Medicare Advantage |
$548.42
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$789.72
|
| Rate for Payer: Cofinity Commercial |
$734.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.42
|
| Rate for Payer: Healthscope Commercial |
$658.10
|
| Rate for Payer: Healthscope Whirlpool |
$658.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$575.84
|
| Rate for Payer: Meridian Medicaid |
$376.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$603.26
|
| Rate for Payer: Nomi Health Commercial |
$658.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.75
|
| Rate for Payer: PACE SWMI |
$548.42
|
| Rate for Payer: PHP Medicare Advantage |
$548.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$855.96
|
| Rate for Payer: Priority Health Medicare |
$548.42
|
| Rate for Payer: Priority Health Narrow Network |
$855.96
|
| Rate for Payer: Railroad Medicare Medicare |
$548.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$548.42
|
| Rate for Payer: UHC Exchange |
$1,081.32
|
| Rate for Payer: UHC Medicaid |
$358.48
|
| Rate for Payer: UHCCP DNSP |
$548.42
|
| Rate for Payer: UHCCP Medicaid |
$358.48
|
|
|
PR CORRECTION TRICHIASIS EPILATION FORCEPS ONLY
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 67820
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$111.00 |
| Rate for Payer: Aetna Commercial |
$24.70
|
| Rate for Payer: Aetna Medicare |
$18.43
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS MAPPO |
$18.43
|
| Rate for Payer: BCN Commercial |
$25.92
|
| Rate for Payer: BCN Medicare Advantage |
$18.43
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$26.54
|
| Rate for Payer: Cofinity Commercial |
$24.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.43
|
| Rate for Payer: Healthscope Commercial |
$22.12
|
| Rate for Payer: Healthscope Whirlpool |
$22.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.35
|
| Rate for Payer: Meridian Medicaid |
$12.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.27
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.00
|
| Rate for Payer: PACE SWMI |
$18.43
|
| Rate for Payer: PHP Medicare Advantage |
$18.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.50
|
| Rate for Payer: Priority Health Medicare |
$18.43
|
| Rate for Payer: Priority Health Narrow Network |
$38.50
|
| Rate for Payer: Railroad Medicare Medicare |
$18.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.43
|
| Rate for Payer: UHC Exchange |
$47.78
|
| Rate for Payer: UHC Medicaid |
$12.14
|
| Rate for Payer: UHCCP DNSP |
$18.43
|
| Rate for Payer: UHCCP Medicaid |
$12.14
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT
|
Professional
|
Both
|
$2,308.00
|
|
|
Service Code
|
HCPCS 28296
|
| Min. Negotiated Rate |
$308.85 |
| Max. Negotiated Rate |
$1,731.00 |
| Rate for Payer: Aetna Commercial |
$631.76
|
| Rate for Payer: Aetna Medicare |
$471.46
|
| Rate for Payer: BCBS Complete |
$324.29
|
| Rate for Payer: BCBS MAPPO |
$471.46
|
| Rate for Payer: BCN Commercial |
$782.32
|
| Rate for Payer: BCN Medicare Advantage |
$471.46
|
| Rate for Payer: Cash Price |
$1,846.40
|
| Rate for Payer: Cash Price |
$1,846.40
|
| Rate for Payer: Cofinity Commercial |
$678.90
|
| Rate for Payer: Cofinity Commercial |
$631.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.46
|
| Rate for Payer: Healthscope Commercial |
$565.75
|
| Rate for Payer: Healthscope Whirlpool |
$565.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.03
|
| Rate for Payer: Meridian Medicaid |
$324.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$518.61
|
| Rate for Payer: Nomi Health Commercial |
$565.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,731.00
|
| Rate for Payer: PACE SWMI |
$471.46
|
| Rate for Payer: PHP Medicare Advantage |
$471.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$836.28
|
| Rate for Payer: Priority Health Medicare |
$471.46
|
| Rate for Payer: Priority Health Narrow Network |
$836.28
|
| Rate for Payer: Railroad Medicare Medicare |
$471.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$899.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$471.46
|
| Rate for Payer: UHC Exchange |
$899.01
|
| Rate for Payer: UHC Medicaid |
$308.85
|
| Rate for Payer: UHCCP DNSP |
$471.46
|
| Rate for Payer: UHCCP Medicaid |
$308.85
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS
|
Professional
|
Both
|
$2,037.00
|
|
|
Service Code
|
HCPCS 28297
|
| Min. Negotiated Rate |
$358.27 |
| Max. Negotiated Rate |
$1,527.75 |
| Rate for Payer: Aetna Commercial |
$733.42
|
| Rate for Payer: Aetna Medicare |
$547.33
|
| Rate for Payer: BCBS Complete |
$376.18
|
| Rate for Payer: BCBS MAPPO |
$547.33
|
| Rate for Payer: BCN Commercial |
$907.82
|
| Rate for Payer: BCN Medicare Advantage |
$547.33
|
| Rate for Payer: Cash Price |
$1,629.60
|
| Rate for Payer: Cash Price |
$1,629.60
|
| Rate for Payer: Cofinity Commercial |
$788.16
|
| Rate for Payer: Cofinity Commercial |
$733.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.33
|
| Rate for Payer: Healthscope Commercial |
$656.80
|
| Rate for Payer: Healthscope Whirlpool |
$656.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.70
|
| Rate for Payer: Meridian Medicaid |
$376.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.06
|
| Rate for Payer: Nomi Health Commercial |
$656.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.75
|
| Rate for Payer: PACE SWMI |
$547.33
|
| Rate for Payer: PHP Medicare Advantage |
$547.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$970.44
|
| Rate for Payer: Priority Health Medicare |
$547.33
|
| Rate for Payer: Priority Health Narrow Network |
$970.44
|
| Rate for Payer: Railroad Medicare Medicare |
$547.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.33
|
| Rate for Payer: UHC Exchange |
$1,055.12
|
| Rate for Payer: UHC Medicaid |
$358.27
|
| Rate for Payer: UHCCP DNSP |
$547.33
|
| Rate for Payer: UHCCP Medicaid |
$358.27
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC PROX METAR OSTEOT
|
Professional
|
Both
|
$1,693.00
|
|
|
Service Code
|
HCPCS 28295
|
| Min. Negotiated Rate |
$358.91 |
| Max. Negotiated Rate |
$1,269.75 |
| Rate for Payer: Aetna Commercial |
$732.90
|
| Rate for Payer: Aetna Medicare |
$546.94
|
| Rate for Payer: BCBS Complete |
$376.86
|
| Rate for Payer: BCBS MAPPO |
$546.94
|
| Rate for Payer: BCN Commercial |
$908.82
|
| Rate for Payer: BCN Medicare Advantage |
$546.94
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$787.59
|
| Rate for Payer: Cofinity Commercial |
$732.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.94
|
| Rate for Payer: Healthscope Commercial |
$656.33
|
| Rate for Payer: Healthscope Whirlpool |
$656.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.29
|
| Rate for Payer: Meridian Medicaid |
$376.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$601.63
|
| Rate for Payer: Nomi Health Commercial |
$656.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,269.75
|
| Rate for Payer: PACE SWMI |
$546.94
|
| Rate for Payer: PHP Medicare Advantage |
$546.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$971.49
|
| Rate for Payer: Priority Health Medicare |
$546.94
|
| Rate for Payer: Priority Health Narrow Network |
$971.49
|
| Rate for Payer: Railroad Medicare Medicare |
$546.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$979.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$546.94
|
| Rate for Payer: UHC Exchange |
$979.32
|
| Rate for Payer: UHC Medicaid |
$358.91
|
| Rate for Payer: UHCCP DNSP |
$546.94
|
| Rate for Payer: UHCCP Medicaid |
$358.91
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT
|
Professional
|
Both
|
$1,968.00
|
|
|
Service Code
|
HCPCS 28298
|
| Min. Negotiated Rate |
$308.21 |
| Max. Negotiated Rate |
$1,476.00 |
| Rate for Payer: Aetna Commercial |
$630.30
|
| Rate for Payer: Aetna Medicare |
$470.37
|
| Rate for Payer: BCBS Complete |
$323.62
|
| Rate for Payer: BCBS MAPPO |
$470.37
|
| Rate for Payer: BCN Commercial |
$769.38
|
| Rate for Payer: BCN Medicare Advantage |
$470.37
|
| Rate for Payer: Cash Price |
$1,574.40
|
| Rate for Payer: Cash Price |
$1,574.40
|
| Rate for Payer: Cofinity Commercial |
$677.33
|
| Rate for Payer: Cofinity Commercial |
$630.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.37
|
| Rate for Payer: Healthscope Commercial |
$564.44
|
| Rate for Payer: Healthscope Whirlpool |
$564.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.89
|
| Rate for Payer: Meridian Medicaid |
$323.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.41
|
| Rate for Payer: Nomi Health Commercial |
$564.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.00
|
| Rate for Payer: PACE SWMI |
$470.37
|
| Rate for Payer: PHP Medicare Advantage |
$470.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$822.44
|
| Rate for Payer: Priority Health Medicare |
$470.37
|
| Rate for Payer: Priority Health Narrow Network |
$822.44
|
| Rate for Payer: Railroad Medicare Medicare |
$470.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$869.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$470.37
|
| Rate for Payer: UHC Exchange |
$869.81
|
| Rate for Payer: UHC Medicaid |
$308.21
|
| Rate for Payer: UHCCP DNSP |
$470.37
|
| Rate for Payer: UHCCP Medicaid |
$308.21
|
|
|
PR CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE
|
Professional
|
Both
|
$1,833.00
|
|
|
Service Code
|
HCPCS 28292
|
| Min. Negotiated Rate |
$293.30 |
| Max. Negotiated Rate |
$1,374.75 |
| Rate for Payer: Aetna Commercial |
$598.46
|
| Rate for Payer: Aetna Medicare |
$446.61
|
| Rate for Payer: BCBS Complete |
$307.96
|
| Rate for Payer: BCBS MAPPO |
$446.61
|
| Rate for Payer: BCN Commercial |
$740.00
|
| Rate for Payer: BCN Medicare Advantage |
$446.61
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Cofinity Commercial |
$643.12
|
| Rate for Payer: Cofinity Commercial |
$598.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.61
|
| Rate for Payer: Healthscope Commercial |
$535.93
|
| Rate for Payer: Healthscope Whirlpool |
$535.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$468.94
|
| Rate for Payer: Meridian Medicaid |
$307.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.27
|
| Rate for Payer: Nomi Health Commercial |
$535.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.75
|
| Rate for Payer: PACE SWMI |
$446.61
|
| Rate for Payer: PHP Medicare Advantage |
$446.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$791.04
|
| Rate for Payer: Priority Health Medicare |
$446.61
|
| Rate for Payer: Priority Health Narrow Network |
$791.04
|
| Rate for Payer: Railroad Medicare Medicare |
$446.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$843.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$446.61
|
| Rate for Payer: UHC Exchange |
$843.90
|
| Rate for Payer: UHC Medicaid |
$293.30
|
| Rate for Payer: UHCCP DNSP |
$446.61
|
| Rate for Payer: UHCCP Medicaid |
$293.30
|
|
