|
PR CRANIECTOMY FOR OSTEOMYELITIS
|
Professional
|
Both
|
$5,521.00
|
|
|
Service Code
|
HCPCS 61501
|
| Min. Negotiated Rate |
$673.51 |
| Max. Negotiated Rate |
$4,140.75 |
| Rate for Payer: Aetna Commercial |
$1,399.51
|
| Rate for Payer: Aetna Medicare |
$1,044.41
|
| Rate for Payer: BCBS Complete |
$707.19
|
| Rate for Payer: BCBS MAPPO |
$1,044.41
|
| Rate for Payer: BCN Commercial |
$2,374.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,044.41
|
| Rate for Payer: Cash Price |
$4,416.80
|
| Rate for Payer: Cash Price |
$4,416.80
|
| Rate for Payer: Cofinity Commercial |
$1,503.95
|
| Rate for Payer: Cofinity Commercial |
$1,399.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,044.41
|
| Rate for Payer: Healthscope Commercial |
$1,253.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,253.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,096.63
|
| Rate for Payer: Meridian Medicaid |
$707.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,148.85
|
| Rate for Payer: Nomi Health Commercial |
$1,253.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,140.75
|
| Rate for Payer: PACE SWMI |
$1,044.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,044.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,996.62
|
| Rate for Payer: Priority Health Medicare |
$1,044.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,996.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,044.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,000.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,044.41
|
| Rate for Payer: UHC Exchange |
$2,000.60
|
| Rate for Payer: UHC Medicaid |
$673.51
|
| Rate for Payer: UHCCP DNSP |
$1,044.41
|
| Rate for Payer: UHCCP Medicaid |
$673.51
|
|
|
PR CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NRV
|
Professional
|
Both
|
$6,490.00
|
|
|
Service Code
|
HCPCS 61460
|
| Min. Negotiated Rate |
$1,306.12 |
| Max. Negotiated Rate |
$4,867.50 |
| Rate for Payer: Aetna Commercial |
$2,740.98
|
| Rate for Payer: Aetna Medicare |
$2,045.51
|
| Rate for Payer: BCBS Complete |
$1,371.43
|
| Rate for Payer: BCBS MAPPO |
$2,045.51
|
| Rate for Payer: BCN Commercial |
$4,430.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,045.51
|
| Rate for Payer: Cash Price |
$5,192.00
|
| Rate for Payer: Cash Price |
$5,192.00
|
| Rate for Payer: Cofinity Commercial |
$2,945.53
|
| Rate for Payer: Cofinity Commercial |
$2,740.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,045.51
|
| Rate for Payer: Healthscope Commercial |
$2,454.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,454.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,147.79
|
| Rate for Payer: Meridian Medicaid |
$1,371.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,250.06
|
| Rate for Payer: Nomi Health Commercial |
$2,454.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,867.50
|
| Rate for Payer: PACE SWMI |
$2,045.51
|
| Rate for Payer: PHP Medicare Advantage |
$2,045.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,306.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,724.86
|
| Rate for Payer: Priority Health Medicare |
$2,045.51
|
| Rate for Payer: Priority Health Narrow Network |
$3,724.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,045.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,715.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,045.51
|
| Rate for Payer: UHC Exchange |
$3,715.74
|
| Rate for Payer: UHC Medicaid |
$1,306.12
|
| Rate for Payer: UHCCP DNSP |
$2,045.51
|
| Rate for Payer: UHCCP Medicaid |
$1,306.12
|
|
|
PR CRANIECTOMY W/EXCISION TUMOR/OTH BONE LESION SKL
|
Professional
|
Both
|
$2,821.00
|
|
|
Service Code
|
HCPCS 61500
|
| Min. Negotiated Rate |
$764.46 |
| Max. Negotiated Rate |
$2,714.74 |
| Rate for Payer: Aetna Commercial |
$1,593.25
|
| Rate for Payer: Aetna Medicare |
$1,188.99
|
| Rate for Payer: BCBS Complete |
$802.68
|
| Rate for Payer: BCBS MAPPO |
$1,188.99
|
| Rate for Payer: BCN Commercial |
$2,714.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,188.99
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cofinity Commercial |
$1,712.15
|
| Rate for Payer: Cofinity Commercial |
$1,593.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,188.99
|
| Rate for Payer: Healthscope Commercial |
$1,426.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,426.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,248.44
|
| Rate for Payer: Meridian Medicaid |
$802.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,307.89
|
| Rate for Payer: Nomi Health Commercial |
$1,426.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,115.75
|
| Rate for Payer: PACE SWMI |
$1,188.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,188.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$764.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,282.34
|
| Rate for Payer: Priority Health Medicare |
$1,188.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,282.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,188.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,308.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,188.99
|
| Rate for Payer: UHC Exchange |
$2,308.42
|
| Rate for Payer: UHC Medicaid |
$764.46
|
| Rate for Payer: UHCCP DNSP |
$1,188.99
|
| Rate for Payer: UHCCP Medicaid |
$764.46
|
|
|
PR CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ
|
Professional
|
Both
|
$5,471.00
|
|
|
Service Code
|
HCPCS 61580
|
| Min. Negotiated Rate |
$1,414.75 |
| Max. Negotiated Rate |
$4,329.30 |
| Rate for Payer: Aetna Commercial |
$2,913.04
|
| Rate for Payer: Aetna Medicare |
$2,173.91
|
| Rate for Payer: BCBS Complete |
$1,485.49
|
| Rate for Payer: BCBS MAPPO |
$2,173.91
|
| Rate for Payer: BCN Commercial |
$3,727.39
|
| Rate for Payer: BCN Medicare Advantage |
$2,173.91
|
| Rate for Payer: Cash Price |
$4,376.80
|
| Rate for Payer: Cash Price |
$4,376.80
|
| Rate for Payer: Cofinity Commercial |
$3,130.43
|
| Rate for Payer: Cofinity Commercial |
$2,913.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,173.91
|
| Rate for Payer: Healthscope Commercial |
$2,608.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,608.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,282.61
|
| Rate for Payer: Meridian Medicaid |
$1,485.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,391.30
|
| Rate for Payer: Nomi Health Commercial |
$2,608.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,103.25
|
| Rate for Payer: PACE SWMI |
$2,173.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,173.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,414.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,329.30
|
| Rate for Payer: Priority Health Medicare |
$2,173.91
|
| Rate for Payer: Priority Health Narrow Network |
$4,329.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2,173.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,272.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,173.91
|
| Rate for Payer: UHC Exchange |
$4,272.07
|
| Rate for Payer: UHC Medicaid |
$1,414.75
|
| Rate for Payer: UHCCP DNSP |
$2,173.91
|
| Rate for Payer: UHCCP Medicaid |
$1,414.75
|
|
|
PR CRANIOPLASTY SKULL DEFECT <5 CM DIAMETER
|
Professional
|
Both
|
$5,502.00
|
|
|
Service Code
|
HCPCS 62140
|
| Min. Negotiated Rate |
$624.30 |
| Max. Negotiated Rate |
$4,126.50 |
| Rate for Payer: Aetna Commercial |
$1,300.34
|
| Rate for Payer: Aetna Medicare |
$970.40
|
| Rate for Payer: BCBS Complete |
$655.51
|
| Rate for Payer: BCBS MAPPO |
$970.40
|
| Rate for Payer: BCN Commercial |
$2,154.04
|
| Rate for Payer: BCN Medicare Advantage |
$970.40
|
| Rate for Payer: Cash Price |
$4,401.60
|
| Rate for Payer: Cash Price |
$4,401.60
|
| Rate for Payer: Cofinity Commercial |
$1,397.38
|
| Rate for Payer: Cofinity Commercial |
$1,300.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$970.40
|
| Rate for Payer: Healthscope Commercial |
$1,164.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,164.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,018.92
|
| Rate for Payer: Meridian Medicaid |
$655.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,067.44
|
| Rate for Payer: Nomi Health Commercial |
$1,164.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,126.50
|
| Rate for Payer: PACE SWMI |
$970.40
|
| Rate for Payer: PHP Medicare Advantage |
$970.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,810.96
|
| Rate for Payer: Priority Health Medicare |
$970.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,810.96
|
| Rate for Payer: Railroad Medicare Medicare |
$970.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,801.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$970.40
|
| Rate for Payer: UHC Exchange |
$1,801.70
|
| Rate for Payer: UHC Medicaid |
$624.30
|
| Rate for Payer: UHCCP DNSP |
$970.40
|
| Rate for Payer: UHCCP Medicaid |
$624.30
|
|
|
PR CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER
|
Professional
|
Both
|
$6,553.00
|
|
|
Service Code
|
HCPCS 62141
|
| Min. Negotiated Rate |
$711.42 |
| Max. Negotiated Rate |
$4,914.75 |
| Rate for Payer: Aetna Commercial |
$1,483.57
|
| Rate for Payer: Aetna Medicare |
$1,107.14
|
| Rate for Payer: BCBS Complete |
$746.99
|
| Rate for Payer: BCBS MAPPO |
$1,107.14
|
| Rate for Payer: BCN Commercial |
$2,415.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,107.14
|
| Rate for Payer: Cash Price |
$5,242.40
|
| Rate for Payer: Cash Price |
$5,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,594.28
|
| Rate for Payer: Cofinity Commercial |
$1,483.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,107.14
|
| Rate for Payer: Healthscope Commercial |
$1,328.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,328.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,162.50
|
| Rate for Payer: Meridian Medicaid |
$746.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,217.85
|
| Rate for Payer: Nomi Health Commercial |
$1,328.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,914.75
|
| Rate for Payer: PACE SWMI |
$1,107.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,107.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,030.75
|
| Rate for Payer: Priority Health Medicare |
$1,107.14
|
| Rate for Payer: Priority Health Narrow Network |
$2,030.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,107.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,005.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,107.14
|
| Rate for Payer: UHC Exchange |
$2,005.99
|
| Rate for Payer: UHC Medicaid |
$711.42
|
| Rate for Payer: UHCCP DNSP |
$1,107.14
|
| Rate for Payer: UHCCP Medicaid |
$711.42
|
|
|
PR CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG
|
Professional
|
Both
|
$6,166.00
|
|
|
Service Code
|
HCPCS 62145
|
| Min. Negotiated Rate |
$871.17 |
| Max. Negotiated Rate |
$4,624.50 |
| Rate for Payer: Aetna Commercial |
$1,822.41
|
| Rate for Payer: Aetna Medicare |
$1,360.01
|
| Rate for Payer: BCBS Complete |
$914.73
|
| Rate for Payer: BCBS MAPPO |
$1,360.01
|
| Rate for Payer: BCN Commercial |
$2,137.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,360.01
|
| Rate for Payer: Cash Price |
$4,932.80
|
| Rate for Payer: Cash Price |
$4,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,958.41
|
| Rate for Payer: Cofinity Commercial |
$1,822.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,360.01
|
| Rate for Payer: Healthscope Commercial |
$1,632.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,632.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,428.01
|
| Rate for Payer: Meridian Medicaid |
$914.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,496.01
|
| Rate for Payer: Nomi Health Commercial |
$1,632.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,624.50
|
| Rate for Payer: PACE SWMI |
$1,360.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,360.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$871.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,483.06
|
| Rate for Payer: Priority Health Medicare |
$1,360.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,483.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,360.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,506.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,360.01
|
| Rate for Payer: UHC Exchange |
$2,506.17
|
| Rate for Payer: UHC Medicaid |
$871.17
|
| Rate for Payer: UHCCP DNSP |
$1,360.01
|
| Rate for Payer: UHCCP Medicaid |
$871.17
|
|
|
PR CRANIOPLASTY W/AUTOGRAFT <5 CM DIAMETER
|
Professional
|
Both
|
$6,568.00
|
|
|
Service Code
|
HCPCS 62146
|
| Min. Negotiated Rate |
$792.79 |
| Max. Negotiated Rate |
$4,926.00 |
| Rate for Payer: Aetna Commercial |
$1,655.18
|
| Rate for Payer: Aetna Medicare |
$1,235.21
|
| Rate for Payer: BCBS Complete |
$832.43
|
| Rate for Payer: BCBS MAPPO |
$1,235.21
|
| Rate for Payer: BCN Commercial |
$2,643.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,235.21
|
| Rate for Payer: Cash Price |
$5,254.40
|
| Rate for Payer: Cash Price |
$5,254.40
|
| Rate for Payer: Cofinity Commercial |
$1,778.70
|
| Rate for Payer: Cofinity Commercial |
$1,655.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,235.21
|
| Rate for Payer: Healthscope Commercial |
$1,482.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,482.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,296.97
|
| Rate for Payer: Meridian Medicaid |
$832.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,358.73
|
| Rate for Payer: Nomi Health Commercial |
$1,482.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,926.00
|
| Rate for Payer: PACE SWMI |
$1,235.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,235.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$792.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,222.78
|
| Rate for Payer: Priority Health Medicare |
$1,235.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,222.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,235.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,989.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,235.21
|
| Rate for Payer: UHC Exchange |
$1,989.15
|
| Rate for Payer: UHC Medicaid |
$792.79
|
| Rate for Payer: UHCCP DNSP |
$1,235.21
|
| Rate for Payer: UHCCP Medicaid |
$792.79
|
|
|
PR CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER
|
Professional
|
Both
|
$7,515.00
|
|
|
Service Code
|
HCPCS 62147
|
| Min. Negotiated Rate |
$868.83 |
| Max. Negotiated Rate |
$5,636.25 |
| Rate for Payer: Aetna Commercial |
$1,821.17
|
| Rate for Payer: Aetna Medicare |
$1,359.08
|
| Rate for Payer: BCBS Complete |
$912.27
|
| Rate for Payer: BCBS MAPPO |
$1,359.08
|
| Rate for Payer: BCN Commercial |
$3,007.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,359.08
|
| Rate for Payer: Cash Price |
$6,012.00
|
| Rate for Payer: Cash Price |
$6,012.00
|
| Rate for Payer: Cofinity Commercial |
$1,957.08
|
| Rate for Payer: Cofinity Commercial |
$1,821.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,359.08
|
| Rate for Payer: Healthscope Commercial |
$1,630.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,630.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,427.03
|
| Rate for Payer: Meridian Medicaid |
$912.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,494.99
|
| Rate for Payer: Nomi Health Commercial |
$1,630.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,636.25
|
| Rate for Payer: PACE SWMI |
$1,359.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,359.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$868.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,528.75
|
| Rate for Payer: Priority Health Medicare |
$1,359.08
|
| Rate for Payer: Priority Health Narrow Network |
$2,528.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,359.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,503.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,359.08
|
| Rate for Payer: UHC Exchange |
$2,503.13
|
| Rate for Payer: UHC Medicaid |
$868.83
|
| Rate for Payer: UHCCP DNSP |
$1,359.08
|
| Rate for Payer: UHCCP Medicaid |
$868.83
|
|
|
PR CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG
|
Professional
|
Both
|
$8,102.00
|
|
|
Service Code
|
HCPCS 61540
|
| Min. Negotiated Rate |
$1,348.08 |
| Max. Negotiated Rate |
$6,076.50 |
| Rate for Payer: Aetna Commercial |
$2,830.75
|
| Rate for Payer: Aetna Medicare |
$2,112.50
|
| Rate for Payer: BCBS Complete |
$1,415.48
|
| Rate for Payer: BCBS MAPPO |
$2,112.50
|
| Rate for Payer: BCN Commercial |
$3,311.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,112.50
|
| Rate for Payer: Cash Price |
$6,481.60
|
| Rate for Payer: Cash Price |
$6,481.60
|
| Rate for Payer: Cofinity Commercial |
$3,042.00
|
| Rate for Payer: Cofinity Commercial |
$2,830.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,112.50
|
| Rate for Payer: Healthscope Commercial |
$2,535.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,535.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,218.12
|
| Rate for Payer: Meridian Medicaid |
$1,415.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,323.75
|
| Rate for Payer: Nomi Health Commercial |
$2,535.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,076.50
|
| Rate for Payer: PACE SWMI |
$2,112.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,112.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,348.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,846.33
|
| Rate for Payer: Priority Health Medicare |
$2,112.50
|
| Rate for Payer: Priority Health Narrow Network |
$3,846.33
|
| Rate for Payer: Railroad Medicare Medicare |
$2,112.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,847.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,112.50
|
| Rate for Payer: UHC Exchange |
$3,847.26
|
| Rate for Payer: UHC Medicaid |
$1,348.08
|
| Rate for Payer: UHCCP DNSP |
$2,112.50
|
| Rate for Payer: UHCCP Medicaid |
$1,348.08
|
|
|
PR CRANIOTOMY EXCISION CRANIOPHARYNGIOMA
|
Professional
|
Both
|
$6,897.00
|
|
|
Service Code
|
HCPCS 61545
|
| Min. Negotiated Rate |
$1,956.83 |
| Max. Negotiated Rate |
$6,687.78 |
| Rate for Payer: Aetna Commercial |
$4,115.05
|
| Rate for Payer: Aetna Medicare |
$3,070.93
|
| Rate for Payer: BCBS Complete |
$2,054.67
|
| Rate for Payer: BCBS MAPPO |
$3,070.93
|
| Rate for Payer: BCN Commercial |
$6,687.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,070.93
|
| Rate for Payer: Cash Price |
$5,517.60
|
| Rate for Payer: Cash Price |
$5,517.60
|
| Rate for Payer: Cofinity Commercial |
$4,422.14
|
| Rate for Payer: Cofinity Commercial |
$4,115.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,070.93
|
| Rate for Payer: Healthscope Commercial |
$3,685.12
|
| Rate for Payer: Healthscope Whirlpool |
$3,685.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,224.48
|
| Rate for Payer: Meridian Medicaid |
$2,054.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,378.02
|
| Rate for Payer: Nomi Health Commercial |
$3,685.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,172.75
|
| Rate for Payer: PACE SWMI |
$3,070.93
|
| Rate for Payer: PHP Medicare Advantage |
$3,070.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,956.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,622.58
|
| Rate for Payer: Priority Health Medicare |
$3,070.93
|
| Rate for Payer: Priority Health Narrow Network |
$5,622.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3,070.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,644.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,070.93
|
| Rate for Payer: UHC Exchange |
$5,644.06
|
| Rate for Payer: UHC Medicaid |
$1,956.83
|
| Rate for Payer: UHCCP DNSP |
$3,070.93
|
| Rate for Payer: UHCCP Medicaid |
$1,956.83
|
|
|
PR CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE
|
Professional
|
Both
|
$5,780.00
|
|
|
Service Code
|
HCPCS 62121
|
| Min. Negotiated Rate |
$913.98 |
| Max. Negotiated Rate |
$4,335.00 |
| Rate for Payer: Aetna Commercial |
$1,898.28
|
| Rate for Payer: Aetna Medicare |
$1,416.63
|
| Rate for Payer: BCBS Complete |
$959.68
|
| Rate for Payer: BCBS MAPPO |
$1,416.63
|
| Rate for Payer: BCN Commercial |
$2,333.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,416.63
|
| Rate for Payer: Cash Price |
$4,624.00
|
| Rate for Payer: Cash Price |
$4,624.00
|
| Rate for Payer: Cofinity Commercial |
$2,039.95
|
| Rate for Payer: Cofinity Commercial |
$1,898.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,416.63
|
| Rate for Payer: Healthscope Commercial |
$1,699.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,699.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,487.46
|
| Rate for Payer: Meridian Medicaid |
$959.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,558.29
|
| Rate for Payer: Nomi Health Commercial |
$1,699.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,335.00
|
| Rate for Payer: PACE SWMI |
$1,416.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,416.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$913.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,710.37
|
| Rate for Payer: Priority Health Medicare |
$1,416.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,710.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,416.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,738.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,416.63
|
| Rate for Payer: UHC Exchange |
$2,738.27
|
| Rate for Payer: UHC Medicaid |
$913.98
|
| Rate for Payer: UHCCP DNSP |
$1,416.63
|
| Rate for Payer: UHCCP Medicaid |
$913.98
|
|
|
PR CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY
|
Professional
|
Both
|
$7,279.00
|
|
|
Service Code
|
HCPCS 61537
|
| Min. Negotiated Rate |
$1,501.86 |
| Max. Negotiated Rate |
$5,459.25 |
| Rate for Payer: Aetna Commercial |
$3,164.77
|
| Rate for Payer: Aetna Medicare |
$2,361.77
|
| Rate for Payer: BCBS Complete |
$1,576.95
|
| Rate for Payer: BCBS MAPPO |
$2,361.77
|
| Rate for Payer: BCN Commercial |
$3,729.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,361.77
|
| Rate for Payer: Cash Price |
$5,823.20
|
| Rate for Payer: Cash Price |
$5,823.20
|
| Rate for Payer: Cofinity Commercial |
$3,400.95
|
| Rate for Payer: Cofinity Commercial |
$3,164.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,361.77
|
| Rate for Payer: Healthscope Commercial |
$2,834.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,834.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,479.86
|
| Rate for Payer: Meridian Medicaid |
$1,576.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,597.95
|
| Rate for Payer: Nomi Health Commercial |
$2,834.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,459.25
|
| Rate for Payer: PACE SWMI |
$2,361.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,361.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,501.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,332.18
|
| Rate for Payer: Priority Health Medicare |
$2,361.77
|
| Rate for Payer: Priority Health Narrow Network |
$4,332.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,361.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,364.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,361.77
|
| Rate for Payer: UHC Exchange |
$4,364.58
|
| Rate for Payer: UHC Medicaid |
$1,501.86
|
| Rate for Payer: UHCCP DNSP |
$2,361.77
|
| Rate for Payer: UHCCP Medicaid |
$1,501.86
|
|
|
PR CRICOPHARYNGEAL MYOTOMY
|
Professional
|
Both
|
$2,353.00
|
|
|
Service Code
|
HCPCS 43030
|
| Min. Negotiated Rate |
$297.56 |
| Max. Negotiated Rate |
$1,764.75 |
| Rate for Payer: Aetna Commercial |
$612.98
|
| Rate for Payer: Aetna Medicare |
$457.45
|
| Rate for Payer: BCBS Complete |
$312.44
|
| Rate for Payer: BCBS MAPPO |
$457.45
|
| Rate for Payer: BCN Commercial |
$792.29
|
| Rate for Payer: BCN Medicare Advantage |
$457.45
|
| Rate for Payer: Cash Price |
$1,882.40
|
| Rate for Payer: Cash Price |
$1,882.40
|
| Rate for Payer: Cofinity Commercial |
$658.73
|
| Rate for Payer: Cofinity Commercial |
$612.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.45
|
| Rate for Payer: Healthscope Commercial |
$548.94
|
| Rate for Payer: Healthscope Whirlpool |
$548.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$480.32
|
| Rate for Payer: Meridian Medicaid |
$312.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$503.19
|
| Rate for Payer: Nomi Health Commercial |
$548.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,764.75
|
| Rate for Payer: PACE SWMI |
$457.45
|
| Rate for Payer: PHP Medicare Advantage |
$457.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$965.35
|
| Rate for Payer: Priority Health Medicare |
$457.45
|
| Rate for Payer: Priority Health Narrow Network |
$965.35
|
| Rate for Payer: Railroad Medicare Medicare |
$457.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$904.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.45
|
| Rate for Payer: UHC Exchange |
$904.37
|
| Rate for Payer: UHC Medicaid |
$297.56
|
| Rate for Payer: UHCCP DNSP |
$457.45
|
| Rate for Payer: UHCCP Medicaid |
$297.56
|
|
|
PR CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 99292
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$133.57
|
| Rate for Payer: Aetna Medicare |
$99.68
|
| Rate for Payer: BCBS Complete |
$67.09
|
| Rate for Payer: BCBS MAPPO |
$99.68
|
| Rate for Payer: BCN Commercial |
$158.36
|
| Rate for Payer: BCN Medicare Advantage |
$99.68
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$143.54
|
| Rate for Payer: Cofinity Commercial |
$133.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.68
|
| Rate for Payer: Healthscope Commercial |
$109.65
|
| Rate for Payer: Healthscope Whirlpool |
$109.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.66
|
| Rate for Payer: Meridian Medicaid |
$67.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.65
|
| Rate for Payer: Nomi Health Commercial |
$119.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$99.68
|
| Rate for Payer: PHP Medicare Advantage |
$99.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$142.44
|
| Rate for Payer: Priority Health Medicare |
$99.68
|
| Rate for Payer: Priority Health Narrow Network |
$142.44
|
| Rate for Payer: Railroad Medicare Medicare |
$99.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.68
|
| Rate for Payer: UHC Exchange |
$158.88
|
| Rate for Payer: UHC Medicaid |
$63.90
|
| Rate for Payer: UHCCP DNSP |
$99.68
|
| Rate for Payer: UHCCP Medicaid |
$63.90
|
|
|
PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 99291
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$414.84 |
| Rate for Payer: Aetna Commercial |
$265.52
|
| Rate for Payer: Aetna Medicare |
$198.15
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$198.15
|
| Rate for Payer: BCN Commercial |
$316.71
|
| Rate for Payer: BCN Medicare Advantage |
$198.15
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$285.34
|
| Rate for Payer: Cofinity Commercial |
$265.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.15
|
| Rate for Payer: Healthscope Commercial |
$217.97
|
| Rate for Payer: Healthscope Whirlpool |
$217.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.06
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.97
|
| Rate for Payer: Nomi Health Commercial |
$237.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.50
|
| Rate for Payer: PACE SWMI |
$198.15
|
| Rate for Payer: PHP Medicare Advantage |
$198.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$414.84
|
| Rate for Payer: Priority Health Medicare |
$198.15
|
| Rate for Payer: Priority Health Narrow Network |
$414.84
|
| Rate for Payer: Railroad Medicare Medicare |
$198.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.15
|
| Rate for Payer: UHC Exchange |
$315.79
|
| Rate for Payer: UHC Medicaid |
$126.95
|
| Rate for Payer: UHCCP DNSP |
$198.15
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
|
|
PR CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN
|
Professional
|
Both
|
$599.00
|
|
|
Service Code
|
HCPCS 99466
|
| Min. Negotiated Rate |
$200.13 |
| Max. Negotiated Rate |
$449.25 |
| Rate for Payer: Aetna Commercial |
$268.17
|
| Rate for Payer: Aetna Medicare |
$200.13
|
| Rate for Payer: BCBS Complete |
$239.60
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCN Commercial |
$340.62
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cofinity Commercial |
$268.17
|
| Rate for Payer: Cofinity Commercial |
$288.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Healthscope Commercial |
$220.14
|
| Rate for Payer: Healthscope Whirlpool |
$220.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.14
|
| Rate for Payer: Nomi Health Commercial |
$240.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$449.25
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$306.39
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health Narrow Network |
$306.39
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$338.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$200.13
|
| Rate for Payer: UHC Exchange |
$338.24
|
| Rate for Payer: UHCCP DNSP |
$200.13
|
|
|
PR CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 99467
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$134.62
|
| Rate for Payer: Aetna Medicare |
$100.46
|
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: BCBS MAPPO |
$100.46
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$100.46
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cofinity Commercial |
$144.66
|
| Rate for Payer: Cofinity Commercial |
$134.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.46
|
| Rate for Payer: Healthscope Commercial |
$110.51
|
| Rate for Payer: Healthscope Whirlpool |
$110.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.51
|
| Rate for Payer: Nomi Health Commercial |
$120.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: PACE SWMI |
$100.46
|
| Rate for Payer: PHP Medicare Advantage |
$100.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$153.65
|
| Rate for Payer: Priority Health Medicare |
$100.46
|
| Rate for Payer: Priority Health Narrow Network |
$153.65
|
| Rate for Payer: Railroad Medicare Medicare |
$100.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.46
|
| Rate for Payer: UHC Exchange |
$169.59
|
| Rate for Payer: UHCCP DNSP |
$100.46
|
|
|
PR CRNEC/CRNOT DCMPRV W/WO DURAPLASTY W/O LOBECTOMY
|
Professional
|
Both
|
$5,169.00
|
|
|
Service Code
|
HCPCS 61322
|
| Min. Negotiated Rate |
$1,469.06 |
| Max. Negotiated Rate |
$4,207.24 |
| Rate for Payer: Aetna Commercial |
$3,084.13
|
| Rate for Payer: Aetna Medicare |
$2,301.59
|
| Rate for Payer: BCBS Complete |
$1,542.51
|
| Rate for Payer: BCBS MAPPO |
$2,301.59
|
| Rate for Payer: BCN Commercial |
$3,622.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,301.59
|
| Rate for Payer: Cash Price |
$4,135.20
|
| Rate for Payer: Cash Price |
$4,135.20
|
| Rate for Payer: Cofinity Commercial |
$3,314.29
|
| Rate for Payer: Cofinity Commercial |
$3,084.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,301.59
|
| Rate for Payer: Healthscope Commercial |
$2,761.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,761.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,416.67
|
| Rate for Payer: Meridian Medicaid |
$1,542.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,531.75
|
| Rate for Payer: Nomi Health Commercial |
$2,761.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,876.75
|
| Rate for Payer: PACE SWMI |
$2,301.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,301.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,469.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,207.24
|
| Rate for Payer: Priority Health Medicare |
$2,301.59
|
| Rate for Payer: Priority Health Narrow Network |
$4,207.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,301.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,198.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,301.59
|
| Rate for Payer: UHC Exchange |
$4,198.03
|
| Rate for Payer: UHC Medicaid |
$1,469.06
|
| Rate for Payer: UHCCP DNSP |
$2,301.59
|
| Rate for Payer: UHCCP Medicaid |
$1,469.06
|
|
|
PR CRNEC/CRNOT DRG INTRACRANIAL ABSC INFRATENTORIAL
|
Professional
|
Both
|
$4,488.00
|
|
|
Service Code
|
HCPCS 61321
|
| Min. Negotiated Rate |
$1,319.54 |
| Max. Negotiated Rate |
$3,756.69 |
| Rate for Payer: Aetna Commercial |
$2,769.02
|
| Rate for Payer: Aetna Medicare |
$2,066.43
|
| Rate for Payer: BCBS Complete |
$1,385.52
|
| Rate for Payer: BCBS MAPPO |
$2,066.43
|
| Rate for Payer: BCN Commercial |
$3,234.39
|
| Rate for Payer: BCN Medicare Advantage |
$2,066.43
|
| Rate for Payer: Cash Price |
$3,590.40
|
| Rate for Payer: Cash Price |
$3,590.40
|
| Rate for Payer: Cofinity Commercial |
$2,975.66
|
| Rate for Payer: Cofinity Commercial |
$2,769.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,066.43
|
| Rate for Payer: Healthscope Commercial |
$2,479.72
|
| Rate for Payer: Healthscope Whirlpool |
$2,479.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,169.75
|
| Rate for Payer: Meridian Medicaid |
$1,385.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,273.07
|
| Rate for Payer: Nomi Health Commercial |
$2,479.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,366.00
|
| Rate for Payer: PACE SWMI |
$2,066.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,066.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,319.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,756.69
|
| Rate for Payer: Priority Health Medicare |
$2,066.43
|
| Rate for Payer: Priority Health Narrow Network |
$3,756.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,066.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,752.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,066.43
|
| Rate for Payer: UHC Exchange |
$3,752.85
|
| Rate for Payer: UHC Medicaid |
$1,319.54
|
| Rate for Payer: UHCCP DNSP |
$2,066.43
|
| Rate for Payer: UHCCP Medicaid |
$1,319.54
|
|
|
PR CRNEC/CRNOT DRG INTRACRANIAL ABSC SUPRATENTORIAL
|
Professional
|
Both
|
$7,047.00
|
|
|
Service Code
|
HCPCS 61320
|
| Min. Negotiated Rate |
$1,171.71 |
| Max. Negotiated Rate |
$5,285.25 |
| Rate for Payer: Aetna Commercial |
$2,459.26
|
| Rate for Payer: Aetna Medicare |
$1,835.27
|
| Rate for Payer: BCBS Complete |
$1,230.30
|
| Rate for Payer: BCBS MAPPO |
$1,835.27
|
| Rate for Payer: BCN Commercial |
$3,989.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,835.27
|
| Rate for Payer: Cash Price |
$5,637.60
|
| Rate for Payer: Cash Price |
$5,637.60
|
| Rate for Payer: Cofinity Commercial |
$2,642.79
|
| Rate for Payer: Cofinity Commercial |
$2,459.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,835.27
|
| Rate for Payer: Healthscope Commercial |
$2,202.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,202.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,927.03
|
| Rate for Payer: Meridian Medicaid |
$1,230.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,018.80
|
| Rate for Payer: Nomi Health Commercial |
$2,202.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,285.25
|
| Rate for Payer: PACE SWMI |
$1,835.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,835.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,354.11
|
| Rate for Payer: Priority Health Medicare |
$1,835.27
|
| Rate for Payer: Priority Health Narrow Network |
$3,354.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,835.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,350.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,835.27
|
| Rate for Payer: UHC Exchange |
$3,350.70
|
| Rate for Payer: UHC Medicaid |
$1,171.71
|
| Rate for Payer: UHCCP DNSP |
$1,835.27
|
| Rate for Payer: UHCCP Medicaid |
$1,171.71
|
|
|
PR CRNEC/CRNOT HMTMA INFRATENTORIAL INTRACEREBELLAR
|
Professional
|
Both
|
$7,251.00
|
|
|
Service Code
|
HCPCS 61315
|
| Min. Negotiated Rate |
$1,286.31 |
| Max. Negotiated Rate |
$5,438.25 |
| Rate for Payer: Aetna Commercial |
$2,698.45
|
| Rate for Payer: Aetna Medicare |
$2,013.77
|
| Rate for Payer: BCBS Complete |
$1,350.63
|
| Rate for Payer: BCBS MAPPO |
$2,013.77
|
| Rate for Payer: BCN Commercial |
$4,347.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,013.77
|
| Rate for Payer: Cash Price |
$5,800.80
|
| Rate for Payer: Cash Price |
$5,800.80
|
| Rate for Payer: Cofinity Commercial |
$2,899.83
|
| Rate for Payer: Cofinity Commercial |
$2,698.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,013.77
|
| Rate for Payer: Healthscope Commercial |
$2,416.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,416.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,114.46
|
| Rate for Payer: Meridian Medicaid |
$1,350.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,215.15
|
| Rate for Payer: Nomi Health Commercial |
$2,416.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,438.25
|
| Rate for Payer: PACE SWMI |
$2,013.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,013.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,286.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,655.46
|
| Rate for Payer: Priority Health Medicare |
$2,013.77
|
| Rate for Payer: Priority Health Narrow Network |
$3,655.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,013.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,644.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,013.77
|
| Rate for Payer: UHC Exchange |
$3,644.87
|
| Rate for Payer: UHC Medicaid |
$1,286.31
|
| Rate for Payer: UHCCP DNSP |
$2,013.77
|
| Rate for Payer: UHCCP Medicaid |
$1,286.31
|
|
|
PR CRNEC/CRNOT HMTMA INFRATENTORIAL XDRL/SDRL
|
Professional
|
Both
|
$5,780.00
|
|
|
Service Code
|
HCPCS 61314
|
| Min. Negotiated Rate |
$1,140.83 |
| Max. Negotiated Rate |
$4,335.00 |
| Rate for Payer: Aetna Commercial |
$2,389.64
|
| Rate for Payer: Aetna Medicare |
$1,783.31
|
| Rate for Payer: BCBS Complete |
$1,197.87
|
| Rate for Payer: BCBS MAPPO |
$1,783.31
|
| Rate for Payer: BCN Commercial |
$3,845.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,783.31
|
| Rate for Payer: Cash Price |
$4,624.00
|
| Rate for Payer: Cash Price |
$4,624.00
|
| Rate for Payer: Cofinity Commercial |
$2,567.97
|
| Rate for Payer: Cofinity Commercial |
$2,389.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,783.31
|
| Rate for Payer: Healthscope Commercial |
$2,139.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,139.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,872.48
|
| Rate for Payer: Meridian Medicaid |
$1,197.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,961.64
|
| Rate for Payer: Nomi Health Commercial |
$2,139.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,335.00
|
| Rate for Payer: PACE SWMI |
$1,783.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,783.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,140.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,233.23
|
| Rate for Payer: Priority Health Medicare |
$1,783.31
|
| Rate for Payer: Priority Health Narrow Network |
$3,233.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,783.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,219.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,783.31
|
| Rate for Payer: UHC Exchange |
$3,219.70
|
| Rate for Payer: UHC Medicaid |
$1,140.83
|
| Rate for Payer: UHCCP DNSP |
$1,783.31
|
| Rate for Payer: UHCCP Medicaid |
$1,140.83
|
|
|
PR CRNEC/CRNOT HMTMA SUPRATENTORIAL INTRACEREBRAL
|
Professional
|
Both
|
$4,296.00
|
|
|
Service Code
|
HCPCS 61313
|
| Min. Negotiated Rate |
$1,242.00 |
| Max. Negotiated Rate |
$4,180.82 |
| Rate for Payer: Aetna Commercial |
$2,600.56
|
| Rate for Payer: Aetna Medicare |
$1,940.72
|
| Rate for Payer: BCBS Complete |
$1,304.10
|
| Rate for Payer: BCBS MAPPO |
$1,940.72
|
| Rate for Payer: BCN Commercial |
$4,180.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,940.72
|
| Rate for Payer: Cash Price |
$3,436.80
|
| Rate for Payer: Cash Price |
$3,436.80
|
| Rate for Payer: Cofinity Commercial |
$2,794.64
|
| Rate for Payer: Cofinity Commercial |
$2,600.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,940.72
|
| Rate for Payer: Healthscope Commercial |
$2,328.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,328.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,037.76
|
| Rate for Payer: Meridian Medicaid |
$1,304.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,134.79
|
| Rate for Payer: Nomi Health Commercial |
$2,328.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,222.00
|
| Rate for Payer: PACE SWMI |
$1,940.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,940.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,242.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,514.92
|
| Rate for Payer: Priority Health Medicare |
$1,940.72
|
| Rate for Payer: Priority Health Narrow Network |
$3,514.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,940.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,493.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,940.72
|
| Rate for Payer: UHC Exchange |
$3,493.80
|
| Rate for Payer: UHC Medicaid |
$1,242.00
|
| Rate for Payer: UHCCP DNSP |
$1,940.72
|
| Rate for Payer: UHCCP Medicaid |
$1,242.00
|
|
|
PR CRNEC/CRNOT HMTMA SUPRATENTORIAL XDRL/SUBDURAL
|
Professional
|
Both
|
$7,343.00
|
|
|
Service Code
|
HCPCS 61312
|
| Min. Negotiated Rate |
$1,278.64 |
| Max. Negotiated Rate |
$5,507.25 |
| Rate for Payer: Aetna Commercial |
$2,687.08
|
| Rate for Payer: Aetna Medicare |
$2,005.28
|
| Rate for Payer: BCBS Complete |
$1,342.57
|
| Rate for Payer: BCBS MAPPO |
$2,005.28
|
| Rate for Payer: BCN Commercial |
$4,347.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,005.28
|
| Rate for Payer: Cash Price |
$5,874.40
|
| Rate for Payer: Cash Price |
$5,874.40
|
| Rate for Payer: Cofinity Commercial |
$2,887.60
|
| Rate for Payer: Cofinity Commercial |
$2,687.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,005.28
|
| Rate for Payer: Healthscope Commercial |
$2,406.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,406.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,105.54
|
| Rate for Payer: Meridian Medicaid |
$1,342.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,205.81
|
| Rate for Payer: Nomi Health Commercial |
$2,406.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,507.25
|
| Rate for Payer: PACE SWMI |
$2,005.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,005.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,278.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,655.46
|
| Rate for Payer: Priority Health Medicare |
$2,005.28
|
| Rate for Payer: Priority Health Narrow Network |
$3,655.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,005.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,665.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,005.28
|
| Rate for Payer: UHC Exchange |
$3,665.31
|
| Rate for Payer: UHC Medicaid |
$1,278.64
|
| Rate for Payer: UHCCP DNSP |
$2,005.28
|
| Rate for Payer: UHCCP Medicaid |
$1,278.64
|
|
