|
PR CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY
|
Professional
|
Both
|
$2,478.00
|
|
|
Service Code
|
HCPCS 28299
|
| Min. Negotiated Rate |
$359.33 |
| Max. Negotiated Rate |
$1,858.50 |
| Rate for Payer: Aetna Commercial |
$735.57
|
| Rate for Payer: Aetna Medicare |
$548.93
|
| Rate for Payer: BCBS Complete |
$377.30
|
| Rate for Payer: BCBS MAPPO |
$548.93
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: BCN Medicare Advantage |
$548.93
|
| Rate for Payer: Cash Price |
$1,982.40
|
| Rate for Payer: Cash Price |
$1,982.40
|
| Rate for Payer: Cofinity Commercial |
$790.46
|
| Rate for Payer: Cofinity Commercial |
$735.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.93
|
| Rate for Payer: Healthscope Commercial |
$658.72
|
| Rate for Payer: Healthscope Whirlpool |
$658.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$576.38
|
| Rate for Payer: Meridian Medicaid |
$377.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$603.82
|
| Rate for Payer: Nomi Health Commercial |
$658.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,858.50
|
| Rate for Payer: PACE SWMI |
$548.93
|
| Rate for Payer: PHP Medicare Advantage |
$548.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$967.25
|
| Rate for Payer: Priority Health Medicare |
$548.93
|
| Rate for Payer: Priority Health Narrow Network |
$967.25
|
| Rate for Payer: Railroad Medicare Medicare |
$548.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,019.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$548.93
|
| Rate for Payer: UHC Exchange |
$1,019.95
|
| Rate for Payer: UHC Medicaid |
$359.33
|
| Rate for Payer: UHCCP DNSP |
$548.93
|
| Rate for Payer: UHCCP Medicaid |
$359.33
|
|
|
PR CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD
|
Professional
|
Both
|
$3,087.00
|
|
|
Service Code
|
HCPCS 67912
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$2,315.25 |
| Rate for Payer: Aetna Commercial |
$549.27
|
| Rate for Payer: Aetna Medicare |
$409.90
|
| Rate for Payer: BCBS Complete |
$283.81
|
| Rate for Payer: BCBS MAPPO |
$409.90
|
| Rate for Payer: BCN Commercial |
$719.59
|
| Rate for Payer: BCN Medicare Advantage |
$409.90
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cofinity Commercial |
$590.26
|
| Rate for Payer: Cofinity Commercial |
$549.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.90
|
| Rate for Payer: Healthscope Commercial |
$491.88
|
| Rate for Payer: Healthscope Whirlpool |
$491.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.39
|
| Rate for Payer: Meridian Medicaid |
$283.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.89
|
| Rate for Payer: Nomi Health Commercial |
$491.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,315.25
|
| Rate for Payer: PACE SWMI |
$409.90
|
| Rate for Payer: PHP Medicare Advantage |
$409.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$842.88
|
| Rate for Payer: Priority Health Medicare |
$409.90
|
| Rate for Payer: Priority Health Narrow Network |
$842.88
|
| Rate for Payer: Railroad Medicare Medicare |
$409.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$828.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$409.90
|
| Rate for Payer: UHC Exchange |
$828.99
|
| Rate for Payer: UHC Medicaid |
$270.30
|
| Rate for Payer: UHCCP DNSP |
$409.90
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
|
|
PR CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS
|
Professional
|
Both
|
$3,267.00
|
|
|
Service Code
|
HCPCS 44055
|
| Min. Negotiated Rate |
$878.63 |
| Max. Negotiated Rate |
$2,727.38 |
| Rate for Payer: Aetna Commercial |
$1,844.22
|
| Rate for Payer: Aetna Medicare |
$1,376.28
|
| Rate for Payer: BCBS Complete |
$922.56
|
| Rate for Payer: BCBS MAPPO |
$1,376.28
|
| Rate for Payer: BCN Commercial |
$2,238.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,376.28
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cash Price |
$2,613.60
|
| Rate for Payer: Cofinity Commercial |
$1,981.84
|
| Rate for Payer: Cofinity Commercial |
$1,844.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,376.28
|
| Rate for Payer: Healthscope Commercial |
$1,651.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,651.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,445.09
|
| Rate for Payer: Meridian Medicaid |
$922.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,513.91
|
| Rate for Payer: Nomi Health Commercial |
$1,651.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.25
|
| Rate for Payer: PACE SWMI |
$1,376.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,376.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,727.38
|
| Rate for Payer: Priority Health Medicare |
$1,376.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,727.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,376.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,663.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,376.28
|
| Rate for Payer: UHC Exchange |
$2,663.49
|
| Rate for Payer: UHC Medicaid |
$878.63
|
| Rate for Payer: UHCCP DNSP |
$1,376.28
|
| Rate for Payer: UHCCP Medicaid |
$878.63
|
|
|
PR COSMETIC CORRECTION OF INVERTED NIPPLES
|
Professional
|
Both
|
$1,803.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$721.20 |
| Max. Negotiated Rate |
$1,352.25 |
| Rate for Payer: BCBS Complete |
$721.20
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,352.25
|
|
|
PR COSMETIC SCLEROTHERAPY
|
Professional
|
Both
|
$300.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
|
|
PR COSMETIC SCLEROTHERAPY/LASER
|
Professional
|
Both
|
$263.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
PR COSMETIC SCLEROTHERAPY/LASER/F/U TREATMENT
|
Professional
|
Both
|
$79.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
|
|
PR COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG
|
Professional
|
Both
|
$6,444.00
|
|
|
Service Code
|
HCPCS 63064
|
| Min. Negotiated Rate |
$1,075.01 |
| Max. Negotiated Rate |
$4,833.00 |
| Rate for Payer: Aetna Commercial |
$2,251.32
|
| Rate for Payer: Aetna Medicare |
$1,680.09
|
| Rate for Payer: BCBS Complete |
$1,128.76
|
| Rate for Payer: BCBS MAPPO |
$1,680.09
|
| Rate for Payer: BCN Commercial |
$2,939.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,680.09
|
| Rate for Payer: Cash Price |
$5,155.20
|
| Rate for Payer: Cash Price |
$5,155.20
|
| Rate for Payer: Cofinity Commercial |
$2,251.32
|
| Rate for Payer: Cofinity Commercial |
$2,419.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,680.09
|
| Rate for Payer: Healthscope Commercial |
$2,016.11
|
| Rate for Payer: Healthscope Whirlpool |
$2,016.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,764.09
|
| Rate for Payer: Meridian Medicaid |
$1,128.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,848.10
|
| Rate for Payer: Nomi Health Commercial |
$2,016.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,833.00
|
| Rate for Payer: PACE SWMI |
$1,680.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,680.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,108.30
|
| Rate for Payer: Priority Health Medicare |
$1,680.09
|
| Rate for Payer: Priority Health Narrow Network |
$3,108.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,680.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,145.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,680.09
|
| Rate for Payer: UHC Exchange |
$3,145.29
|
| Rate for Payer: UHC Medicaid |
$1,075.01
|
| Rate for Payer: UHCCP DNSP |
$1,680.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.01
|
|
|
PR COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG
|
Professional
|
Both
|
$2,209.00
|
|
|
Service Code
|
HCPCS 63066
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$1,656.75 |
| Rate for Payer: Aetna Commercial |
$254.89
|
| Rate for Payer: Aetna Medicare |
$190.22
|
| Rate for Payer: BCBS Complete |
$125.70
|
| Rate for Payer: BCBS MAPPO |
$190.22
|
| Rate for Payer: BCN Commercial |
$339.18
|
| Rate for Payer: BCN Medicare Advantage |
$190.22
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cofinity Commercial |
$273.92
|
| Rate for Payer: Cofinity Commercial |
$254.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.22
|
| Rate for Payer: Healthscope Commercial |
$228.26
|
| Rate for Payer: Healthscope Whirlpool |
$228.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.73
|
| Rate for Payer: Meridian Medicaid |
$125.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.24
|
| Rate for Payer: Nomi Health Commercial |
$228.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.75
|
| Rate for Payer: PACE SWMI |
$190.22
|
| Rate for Payer: PHP Medicare Advantage |
$190.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$358.61
|
| Rate for Payer: Priority Health Medicare |
$190.22
|
| Rate for Payer: Priority Health Narrow Network |
$358.61
|
| Rate for Payer: Railroad Medicare Medicare |
$190.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$190.22
|
| Rate for Payer: UHC Exchange |
$366.81
|
| Rate for Payer: UHC Medicaid |
$119.71
|
| Rate for Payer: UHCCP DNSP |
$190.22
|
| Rate for Payer: UHCCP Medicaid |
$119.71
|
|
|
PR COUDE TIP URINARY CATHETER
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS A4352
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$11.20 |
| Rate for Payer: Aetna Commercial |
$10.43
|
| Rate for Payer: Aetna Medicare |
$7.78
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$7.78
|
| Rate for Payer: BCN Commercial |
$7.45
|
| Rate for Payer: BCN Medicare Advantage |
$7.78
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$10.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.78
|
| Rate for Payer: Healthscope Commercial |
$9.34
|
| Rate for Payer: Healthscope Whirlpool |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.56
|
| Rate for Payer: Nomi Health Commercial |
$9.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: PACE SWMI |
$7.78
|
| Rate for Payer: PHP Medicare Advantage |
$7.78
|
| Rate for Payer: Priority Health Medicare |
$7.78
|
| Rate for Payer: Railroad Medicare Medicare |
$7.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.78
|
| Rate for Payer: UHC Exchange |
$2.54
|
| Rate for Payer: UHCCP DNSP |
$7.78
|
|
|
PR COUNSEL IMMUNE <21 16-30 M
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS G0314
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
|
|
PR COUNSEL IMMUNE <21 5-15 M
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS G0315
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR CPAP VENTILATION CPAP INITIATION&MGMT
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 94660
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$43.09
|
| Rate for Payer: Aetna Medicare |
$32.16
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCBS MAPPO |
$32.16
|
| Rate for Payer: BCN Commercial |
$54.28
|
| Rate for Payer: BCN Medicare Advantage |
$32.16
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$46.31
|
| Rate for Payer: Cofinity Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.16
|
| Rate for Payer: Healthscope Commercial |
$38.59
|
| Rate for Payer: Healthscope Whirlpool |
$38.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.77
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$38.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.00
|
| Rate for Payer: PACE SWMI |
$32.16
|
| Rate for Payer: PHP Medicare Advantage |
$32.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.06
|
| Rate for Payer: Priority Health Medicare |
$32.16
|
| Rate for Payer: Priority Health Narrow Network |
$50.06
|
| Rate for Payer: Railroad Medicare Medicare |
$32.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.16
|
| Rate for Payer: UHC Exchange |
$62.00
|
| Rate for Payer: UHC Medicaid |
$20.66
|
| Rate for Payer: UHCCP DNSP |
$32.16
|
| Rate for Payer: UHCCP Medicaid |
$20.66
|
|
|
PR CPLX CHRONIC CARE MGMT SVC EA ADDL 30 MIN CAL MO
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 99489
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$79.19 |
| Rate for Payer: Aetna Commercial |
$58.10
|
| Rate for Payer: Aetna Medicare |
$43.36
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$43.36
|
| Rate for Payer: BCN Commercial |
$79.19
|
| Rate for Payer: BCN Medicare Advantage |
$43.36
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$62.44
|
| Rate for Payer: Cofinity Commercial |
$58.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.36
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Healthscope Whirlpool |
$47.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.53
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.70
|
| Rate for Payer: Nomi Health Commercial |
$52.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE SWMI |
$43.36
|
| Rate for Payer: PHP Medicare Advantage |
$43.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.40
|
| Rate for Payer: Priority Health Medicare |
$43.36
|
| Rate for Payer: Priority Health Narrow Network |
$65.40
|
| Rate for Payer: Railroad Medicare Medicare |
$43.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.36
|
| Rate for Payer: UHC Exchange |
$36.54
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP DNSP |
$43.36
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ
|
Professional
|
Both
|
$10,611.00
|
|
|
Service Code
|
HCPCS 61698
|
| Min. Negotiated Rate |
$2,787.96 |
| Max. Negotiated Rate |
$9,661.21 |
| Rate for Payer: Aetna Commercial |
$5,890.02
|
| Rate for Payer: Aetna Medicare |
$4,395.54
|
| Rate for Payer: BCBS Complete |
$2,927.36
|
| Rate for Payer: BCBS MAPPO |
$4,395.54
|
| Rate for Payer: BCN Commercial |
$9,661.21
|
| Rate for Payer: BCN Medicare Advantage |
$4,395.54
|
| Rate for Payer: Cash Price |
$8,488.80
|
| Rate for Payer: Cash Price |
$8,488.80
|
| Rate for Payer: Cofinity Commercial |
$6,329.58
|
| Rate for Payer: Cofinity Commercial |
$5,890.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,395.54
|
| Rate for Payer: Healthscope Commercial |
$5,274.65
|
| Rate for Payer: Healthscope Whirlpool |
$5,274.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,615.32
|
| Rate for Payer: Meridian Medicaid |
$2,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,835.09
|
| Rate for Payer: Nomi Health Commercial |
$5,274.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,958.25
|
| Rate for Payer: PACE SWMI |
$4,395.54
|
| Rate for Payer: PHP Medicare Advantage |
$4,395.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,787.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,122.41
|
| Rate for Payer: Priority Health Medicare |
$4,395.54
|
| Rate for Payer: Priority Health Narrow Network |
$8,122.41
|
| Rate for Payer: Railroad Medicare Medicare |
$4,395.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,461.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,395.54
|
| Rate for Payer: UHC Exchange |
$8,461.50
|
| Rate for Payer: UHC Medicaid |
$2,787.96
|
| Rate for Payer: UHCCP DNSP |
$4,395.54
|
| Rate for Payer: UHCCP Medicaid |
$2,787.96
|
|
|
PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
HCPCS 0055T
|
| Min. Negotiated Rate |
$146.69 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Commercial |
$210.14
|
| Rate for Payer: BCBS Complete |
$154.02
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Meridian Medicaid |
$154.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$311.16
|
| Rate for Payer: UHC Exchange |
$311.16
|
| Rate for Payer: UHC Medicaid |
$146.69
|
| Rate for Payer: UHCCP Medicaid |
$146.69
|
|
|
PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 0054T
|
| Min. Negotiated Rate |
$91.75 |
| Max. Negotiated Rate |
$277.22 |
| Rate for Payer: Aetna Commercial |
$179.20
|
| Rate for Payer: BCBS Complete |
$96.34
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Meridian Medicaid |
$96.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.22
|
| Rate for Payer: UHC Exchange |
$277.22
|
| Rate for Payer: UHC Medicaid |
$91.75
|
| Rate for Payer: UHCCP Medicaid |
$91.75
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 20985
|
| Min. Negotiated Rate |
$79.02 |
| Max. Negotiated Rate |
$259.56 |
| Rate for Payer: Aetna Commercial |
$165.93
|
| Rate for Payer: Aetna Medicare |
$123.83
|
| Rate for Payer: BCBS Complete |
$82.97
|
| Rate for Payer: BCBS MAPPO |
$123.83
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$123.83
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$178.32
|
| Rate for Payer: Cofinity Commercial |
$165.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.83
|
| Rate for Payer: Healthscope Commercial |
$148.60
|
| Rate for Payer: Healthscope Whirlpool |
$148.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.02
|
| Rate for Payer: Meridian Medicaid |
$82.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.21
|
| Rate for Payer: Nomi Health Commercial |
$148.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.25
|
| Rate for Payer: PACE SWMI |
$123.83
|
| Rate for Payer: PHP Medicare Advantage |
$123.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$230.50
|
| Rate for Payer: Priority Health Medicare |
$123.83
|
| Rate for Payer: Priority Health Narrow Network |
$230.50
|
| Rate for Payer: Railroad Medicare Medicare |
$123.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.83
|
| Rate for Payer: UHC Exchange |
$259.56
|
| Rate for Payer: UHC Medicaid |
$79.02
|
| Rate for Payer: UHCCP DNSP |
$123.83
|
| Rate for Payer: UHCCP Medicaid |
$79.02
|
|
|
PR CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT
|
Professional
|
Both
|
$7,513.00
|
|
|
Service Code
|
HCPCS 61582
|
| Min. Negotiated Rate |
$1,962.58 |
| Max. Negotiated Rate |
$6,335.54 |
| Rate for Payer: Aetna Commercial |
$4,029.35
|
| Rate for Payer: Aetna Medicare |
$3,006.98
|
| Rate for Payer: BCBS Complete |
$2,060.71
|
| Rate for Payer: BCBS MAPPO |
$3,006.98
|
| Rate for Payer: BCN Commercial |
$6,335.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,006.98
|
| Rate for Payer: Cash Price |
$6,010.40
|
| Rate for Payer: Cash Price |
$6,010.40
|
| Rate for Payer: Cofinity Commercial |
$4,330.05
|
| Rate for Payer: Cofinity Commercial |
$4,029.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,006.98
|
| Rate for Payer: Healthscope Commercial |
$3,608.38
|
| Rate for Payer: Healthscope Whirlpool |
$3,608.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,157.33
|
| Rate for Payer: Meridian Medicaid |
$2,060.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,307.68
|
| Rate for Payer: Nomi Health Commercial |
$3,608.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,634.75
|
| Rate for Payer: PACE SWMI |
$3,006.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,006.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,962.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,326.45
|
| Rate for Payer: Priority Health Medicare |
$3,006.98
|
| Rate for Payer: Priority Health Narrow Network |
$5,326.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,006.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,354.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,006.98
|
| Rate for Payer: UHC Exchange |
$5,354.68
|
| Rate for Payer: UHC Medicaid |
$1,962.58
|
| Rate for Payer: UHCCP DNSP |
$3,006.98
|
| Rate for Payer: UHCCP Medicaid |
$1,962.58
|
|
|
PR CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE
|
Professional
|
Both
|
$8,207.00
|
|
|
Service Code
|
HCPCS 61583
|
| Min. Negotiated Rate |
$1,864.39 |
| Max. Negotiated Rate |
$6,155.25 |
| Rate for Payer: Aetna Commercial |
$3,871.53
|
| Rate for Payer: Aetna Medicare |
$2,889.20
|
| Rate for Payer: BCBS Complete |
$1,957.61
|
| Rate for Payer: BCBS MAPPO |
$2,889.20
|
| Rate for Payer: BCN Commercial |
$6,122.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,889.20
|
| Rate for Payer: Cash Price |
$6,565.60
|
| Rate for Payer: Cash Price |
$6,565.60
|
| Rate for Payer: Cofinity Commercial |
$4,160.45
|
| Rate for Payer: Cofinity Commercial |
$3,871.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,889.20
|
| Rate for Payer: Healthscope Commercial |
$3,467.04
|
| Rate for Payer: Healthscope Whirlpool |
$3,467.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,033.66
|
| Rate for Payer: Meridian Medicaid |
$1,957.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,178.12
|
| Rate for Payer: Nomi Health Commercial |
$3,467.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,155.25
|
| Rate for Payer: PACE SWMI |
$2,889.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,889.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,147.15
|
| Rate for Payer: Priority Health Medicare |
$2,889.20
|
| Rate for Payer: Priority Health Narrow Network |
$5,147.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,889.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,063.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,889.20
|
| Rate for Payer: UHC Exchange |
$5,063.90
|
| Rate for Payer: UHC Medicaid |
$1,864.39
|
| Rate for Payer: UHCCP DNSP |
$2,889.20
|
| Rate for Payer: UHCCP Medicaid |
$1,864.39
|
|
|
PR CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP
|
Professional
|
Both
|
$3,489.00
|
|
|
Service Code
|
HCPCS 61557
|
| Min. Negotiated Rate |
$1,066.92 |
| Max. Negotiated Rate |
$3,563.01 |
| Rate for Payer: Aetna Commercial |
$2,228.17
|
| Rate for Payer: Aetna Medicare |
$1,662.81
|
| Rate for Payer: BCBS Complete |
$1,120.27
|
| Rate for Payer: BCBS MAPPO |
$1,662.81
|
| Rate for Payer: BCN Commercial |
$3,563.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,662.81
|
| Rate for Payer: Cash Price |
$2,791.20
|
| Rate for Payer: Cash Price |
$2,791.20
|
| Rate for Payer: Cofinity Commercial |
$2,394.45
|
| Rate for Payer: Cofinity Commercial |
$2,228.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,662.81
|
| Rate for Payer: Healthscope Commercial |
$1,995.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,995.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,745.95
|
| Rate for Payer: Meridian Medicaid |
$1,120.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,829.09
|
| Rate for Payer: Nomi Health Commercial |
$1,995.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,616.75
|
| Rate for Payer: PACE SWMI |
$1,662.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,662.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,066.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,995.52
|
| Rate for Payer: Priority Health Medicare |
$1,662.81
|
| Rate for Payer: Priority Health Narrow Network |
$2,995.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,662.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,959.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,662.81
|
| Rate for Payer: UHC Exchange |
$2,959.43
|
| Rate for Payer: UHC Medicaid |
$1,066.92
|
| Rate for Payer: UHCCP DNSP |
$1,662.81
|
| Rate for Payer: UHCCP Medicaid |
$1,066.92
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN
|
Professional
|
Both
|
$9,676.00
|
|
|
Service Code
|
HCPCS 61570
|
| Min. Negotiated Rate |
$1,168.94 |
| Max. Negotiated Rate |
$7,257.00 |
| Rate for Payer: Aetna Commercial |
$2,448.90
|
| Rate for Payer: Aetna Medicare |
$1,827.54
|
| Rate for Payer: BCBS Complete |
$1,227.39
|
| Rate for Payer: BCBS MAPPO |
$1,827.54
|
| Rate for Payer: BCN Commercial |
$3,942.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,827.54
|
| Rate for Payer: Cash Price |
$7,740.80
|
| Rate for Payer: Cash Price |
$7,740.80
|
| Rate for Payer: Cofinity Commercial |
$2,631.66
|
| Rate for Payer: Cofinity Commercial |
$2,448.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,827.54
|
| Rate for Payer: Healthscope Commercial |
$2,193.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,193.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,918.92
|
| Rate for Payer: Meridian Medicaid |
$1,227.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,010.29
|
| Rate for Payer: Nomi Health Commercial |
$2,193.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,257.00
|
| Rate for Payer: PACE SWMI |
$1,827.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,827.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,168.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,314.20
|
| Rate for Payer: Priority Health Medicare |
$1,827.54
|
| Rate for Payer: Priority Health Narrow Network |
$3,314.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,827.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,293.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,827.54
|
| Rate for Payer: UHC Exchange |
$3,293.59
|
| Rate for Payer: UHC Medicaid |
$1,168.94
|
| Rate for Payer: UHCCP DNSP |
$1,827.54
|
| Rate for Payer: UHCCP Medicaid |
$1,168.94
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL
|
Professional
|
Both
|
$4,314.00
|
|
|
Service Code
|
HCPCS 61305
|
| Min. Negotiated Rate |
$1,249.88 |
| Max. Negotiated Rate |
$3,549.03 |
| Rate for Payer: Aetna Commercial |
$2,620.75
|
| Rate for Payer: Aetna Medicare |
$1,955.78
|
| Rate for Payer: BCBS Complete |
$1,312.37
|
| Rate for Payer: BCBS MAPPO |
$1,955.78
|
| Rate for Payer: BCN Commercial |
$3,055.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,955.78
|
| Rate for Payer: Cash Price |
$3,451.20
|
| Rate for Payer: Cash Price |
$3,451.20
|
| Rate for Payer: Cofinity Commercial |
$2,816.32
|
| Rate for Payer: Cofinity Commercial |
$2,620.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,955.78
|
| Rate for Payer: Healthscope Commercial |
$2,346.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,346.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,053.57
|
| Rate for Payer: Meridian Medicaid |
$1,312.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,151.36
|
| Rate for Payer: Nomi Health Commercial |
$2,346.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,235.50
|
| Rate for Payer: PACE SWMI |
$1,955.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,955.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,249.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,549.03
|
| Rate for Payer: Priority Health Medicare |
$1,955.78
|
| Rate for Payer: Priority Health Narrow Network |
$3,549.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,955.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,538.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,955.78
|
| Rate for Payer: UHC Exchange |
$3,538.38
|
| Rate for Payer: UHC Medicaid |
$1,249.88
|
| Rate for Payer: UHCCP DNSP |
$1,955.78
|
| Rate for Payer: UHCCP Medicaid |
$1,249.88
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL
|
Professional
|
Both
|
$5,627.00
|
|
|
Service Code
|
HCPCS 61304
|
| Min. Negotiated Rate |
$1,026.02 |
| Max. Negotiated Rate |
$4,220.25 |
| Rate for Payer: Aetna Commercial |
$2,149.37
|
| Rate for Payer: Aetna Medicare |
$1,604.01
|
| Rate for Payer: BCBS Complete |
$1,077.32
|
| Rate for Payer: BCBS MAPPO |
$1,604.01
|
| Rate for Payer: BCN Commercial |
$3,454.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,604.01
|
| Rate for Payer: Cash Price |
$4,501.60
|
| Rate for Payer: Cash Price |
$4,501.60
|
| Rate for Payer: Cofinity Commercial |
$2,309.77
|
| Rate for Payer: Cofinity Commercial |
$2,149.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,604.01
|
| Rate for Payer: Healthscope Commercial |
$1,924.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,924.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,684.21
|
| Rate for Payer: Meridian Medicaid |
$1,077.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,764.41
|
| Rate for Payer: Nomi Health Commercial |
$1,924.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,220.25
|
| Rate for Payer: PACE SWMI |
$1,604.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,604.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,026.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,904.13
|
| Rate for Payer: Priority Health Medicare |
$1,604.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,604.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,894.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,604.01
|
| Rate for Payer: UHC Exchange |
$2,894.30
|
| Rate for Payer: UHC Medicaid |
$1,026.02
|
| Rate for Payer: UHCCP DNSP |
$1,604.01
|
| Rate for Payer: UHCCP Medicaid |
$1,026.02
|
|
|
PR CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN
|
Professional
|
Both
|
$9,252.00
|
|
|
Service Code
|
HCPCS 61571
|
| Min. Negotiated Rate |
$1,239.45 |
| Max. Negotiated Rate |
$6,939.00 |
| Rate for Payer: Aetna Commercial |
$2,599.04
|
| Rate for Payer: Aetna Medicare |
$1,939.58
|
| Rate for Payer: BCBS Complete |
$1,301.42
|
| Rate for Payer: BCBS MAPPO |
$1,939.58
|
| Rate for Payer: BCN Commercial |
$3,035.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,939.58
|
| Rate for Payer: Cash Price |
$7,401.60
|
| Rate for Payer: Cash Price |
$7,401.60
|
| Rate for Payer: Cofinity Commercial |
$2,793.00
|
| Rate for Payer: Cofinity Commercial |
$2,599.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,939.58
|
| Rate for Payer: Healthscope Commercial |
$2,327.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,327.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,036.56
|
| Rate for Payer: Meridian Medicaid |
$1,301.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,133.54
|
| Rate for Payer: Nomi Health Commercial |
$2,327.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,939.00
|
| Rate for Payer: PACE SWMI |
$1,939.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,939.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,239.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,525.32
|
| Rate for Payer: Priority Health Medicare |
$1,939.58
|
| Rate for Payer: Priority Health Narrow Network |
$3,525.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,939.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,509.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,939.58
|
| Rate for Payer: UHC Exchange |
$3,509.95
|
| Rate for Payer: UHC Medicaid |
$1,239.45
|
| Rate for Payer: UHCCP DNSP |
$1,939.58
|
| Rate for Payer: UHCCP Medicaid |
$1,239.45
|
|
