|
PR CV STRS TST XERS&/RX CONT ECG I&R ONLY
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 93018
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Aetna Commercial |
$17.98
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCN Commercial |
$20.92
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$19.32
|
| Rate for Payer: Cofinity Commercial |
$17.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$16.10
|
| Rate for Payer: Healthscope Whirlpool |
$16.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.76
|
| Rate for Payer: Nomi Health Commercial |
$16.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.25
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.89
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health Narrow Network |
$19.89
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.42
|
| Rate for Payer: UHC Exchange |
$23.86
|
| Rate for Payer: UHC Medicaid |
$8.73
|
| Rate for Payer: UHCCP DNSP |
$13.42
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
|
|
PR CV STRS TST XERS&/RX CONT ECG SUPVJ ONLY W/O I&R
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 93016
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$87.00 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$20.26
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$20.26
|
| Rate for Payer: BCN Commercial |
$30.87
|
| Rate for Payer: BCN Medicare Advantage |
$20.26
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$29.17
|
| Rate for Payer: Cofinity Commercial |
$27.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.26
|
| Rate for Payer: Healthscope Commercial |
$24.31
|
| Rate for Payer: Healthscope Whirlpool |
$24.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.27
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.29
|
| Rate for Payer: Nomi Health Commercial |
$24.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.00
|
| Rate for Payer: PACE SWMI |
$20.26
|
| Rate for Payer: PHP Medicare Advantage |
$20.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$29.34
|
| Rate for Payer: Priority Health Medicare |
$20.26
|
| Rate for Payer: Priority Health Narrow Network |
$29.34
|
| Rate for Payer: Railroad Medicare Medicare |
$20.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.26
|
| Rate for Payer: UHC Exchange |
$35.81
|
| Rate for Payer: UHC Medicaid |
$13.21
|
| Rate for Payer: UHCCP DNSP |
$20.26
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
|
|
PR CV STRS TST XERS&/RX CONT ECG TRCG ONLY W/O I&R
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 93017
|
| Min. Negotiated Rate |
$35.82 |
| Max. Negotiated Rate |
$87.00 |
| Rate for Payer: Aetna Commercial |
$48.00
|
| Rate for Payer: Aetna Medicare |
$35.82
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: BCBS MAPPO |
$35.82
|
| Rate for Payer: BCN Commercial |
$57.27
|
| Rate for Payer: BCN Medicare Advantage |
$35.82
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$51.58
|
| Rate for Payer: Cofinity Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.82
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Healthscope Whirlpool |
$42.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.40
|
| Rate for Payer: Nomi Health Commercial |
$42.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.00
|
| Rate for Payer: PACE SWMI |
$35.82
|
| Rate for Payer: PHP Medicare Advantage |
$35.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$54.43
|
| Rate for Payer: Priority Health Medicare |
$35.82
|
| Rate for Payer: Priority Health Narrow Network |
$54.43
|
| Rate for Payer: Railroad Medicare Medicare |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.82
|
| Rate for Payer: UHC Exchange |
$50.55
|
| Rate for Payer: UHCCP DNSP |
$35.82
|
|
|
PR CYSTECTOMY COMPLETE SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,895.00
|
|
|
Service Code
|
HCPCS 51570
|
| Min. Negotiated Rate |
$831.77 |
| Max. Negotiated Rate |
$2,612.07 |
| Rate for Payer: Aetna Commercial |
$1,733.30
|
| Rate for Payer: Aetna Medicare |
$1,293.51
|
| Rate for Payer: BCBS Complete |
$873.36
|
| Rate for Payer: BCBS MAPPO |
$1,293.51
|
| Rate for Payer: BCN Commercial |
$2,187.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,293.51
|
| Rate for Payer: Cash Price |
$2,316.00
|
| Rate for Payer: Cash Price |
$2,316.00
|
| Rate for Payer: Cofinity Commercial |
$1,862.65
|
| Rate for Payer: Cofinity Commercial |
$1,733.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,293.51
|
| Rate for Payer: Healthscope Commercial |
$1,552.21
|
| Rate for Payer: Healthscope Whirlpool |
$1,552.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,358.19
|
| Rate for Payer: Meridian Medicaid |
$873.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,422.86
|
| Rate for Payer: Nomi Health Commercial |
$1,552.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,171.25
|
| Rate for Payer: PACE SWMI |
$1,293.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,293.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$831.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,383.04
|
| Rate for Payer: Priority Health Medicare |
$1,293.51
|
| Rate for Payer: Priority Health Narrow Network |
$2,383.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,293.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,612.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,293.51
|
| Rate for Payer: UHC Exchange |
$2,612.07
|
| Rate for Payer: UHC Medicaid |
$831.77
|
| Rate for Payer: UHCCP DNSP |
$1,293.51
|
| Rate for Payer: UHCCP Medicaid |
$831.77
|
|
|
PR CYSTECTOMY PARTIAL COMPLICATED
|
Professional
|
Both
|
$7,985.00
|
|
|
Service Code
|
HCPCS 51555
|
| Min. Negotiated Rate |
$720.15 |
| Max. Negotiated Rate |
$5,988.75 |
| Rate for Payer: Aetna Commercial |
$1,499.66
|
| Rate for Payer: Aetna Medicare |
$1,119.15
|
| Rate for Payer: BCBS Complete |
$756.16
|
| Rate for Payer: BCBS MAPPO |
$1,119.15
|
| Rate for Payer: BCN Commercial |
$1,878.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.15
|
| Rate for Payer: Cash Price |
$6,388.00
|
| Rate for Payer: Cash Price |
$6,388.00
|
| Rate for Payer: Cofinity Commercial |
$1,611.58
|
| Rate for Payer: Cofinity Commercial |
$1,499.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.15
|
| Rate for Payer: Healthscope Commercial |
$1,342.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,342.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,175.11
|
| Rate for Payer: Meridian Medicaid |
$756.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,231.07
|
| Rate for Payer: Nomi Health Commercial |
$1,342.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,988.75
|
| Rate for Payer: PACE SWMI |
$1,119.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$720.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,046.71
|
| Rate for Payer: Priority Health Medicare |
$1,119.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,046.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,119.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,240.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,119.15
|
| Rate for Payer: UHC Exchange |
$2,240.74
|
| Rate for Payer: UHC Medicaid |
$720.15
|
| Rate for Payer: UHCCP DNSP |
$1,119.15
|
| Rate for Payer: UHCCP Medicaid |
$720.15
|
|
|
PR CYSTECTOMY PARTIAL SIMPLE
|
Professional
|
Both
|
$1,591.00
|
|
|
Service Code
|
HCPCS 51550
|
| Min. Negotiated Rate |
$555.72 |
| Max. Negotiated Rate |
$1,702.22 |
| Rate for Payer: Aetna Commercial |
$1,155.62
|
| Rate for Payer: Aetna Medicare |
$862.40
|
| Rate for Payer: BCBS Complete |
$583.51
|
| Rate for Payer: BCBS MAPPO |
$862.40
|
| Rate for Payer: BCN Commercial |
$1,438.67
|
| Rate for Payer: BCN Medicare Advantage |
$862.40
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cofinity Commercial |
$1,241.86
|
| Rate for Payer: Cofinity Commercial |
$1,155.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.40
|
| Rate for Payer: Healthscope Commercial |
$1,034.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,034.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.52
|
| Rate for Payer: Meridian Medicaid |
$583.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$948.64
|
| Rate for Payer: Nomi Health Commercial |
$1,034.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,193.25
|
| Rate for Payer: PACE SWMI |
$862.40
|
| Rate for Payer: PHP Medicare Advantage |
$862.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,567.18
|
| Rate for Payer: Priority Health Medicare |
$862.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,567.18
|
| Rate for Payer: Railroad Medicare Medicare |
$862.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,702.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$862.40
|
| Rate for Payer: UHC Exchange |
$1,702.22
|
| Rate for Payer: UHC Medicaid |
$555.72
|
| Rate for Payer: UHCCP DNSP |
$862.40
|
| Rate for Payer: UHCCP Medicaid |
$555.72
|
|
|
PR CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY
|
Professional
|
Both
|
$3,910.00
|
|
|
Service Code
|
HCPCS 51575
|
| Min. Negotiated Rate |
$1,026.23 |
| Max. Negotiated Rate |
$3,229.13 |
| Rate for Payer: Aetna Commercial |
$2,139.95
|
| Rate for Payer: Aetna Medicare |
$1,596.98
|
| Rate for Payer: BCBS Complete |
$1,077.54
|
| Rate for Payer: BCBS MAPPO |
$1,596.98
|
| Rate for Payer: BCN Commercial |
$2,695.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,596.98
|
| Rate for Payer: Cash Price |
$3,128.00
|
| Rate for Payer: Cash Price |
$3,128.00
|
| Rate for Payer: Cofinity Commercial |
$2,299.65
|
| Rate for Payer: Cofinity Commercial |
$2,139.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,596.98
|
| Rate for Payer: Healthscope Commercial |
$1,916.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,916.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,676.83
|
| Rate for Payer: Meridian Medicaid |
$1,077.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,756.68
|
| Rate for Payer: Nomi Health Commercial |
$1,916.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,932.50
|
| Rate for Payer: PACE SWMI |
$1,596.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,596.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,026.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,936.36
|
| Rate for Payer: Priority Health Medicare |
$1,596.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,936.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,596.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,229.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,596.98
|
| Rate for Payer: UHC Exchange |
$3,229.13
|
| Rate for Payer: UHC Medicaid |
$1,026.23
|
| Rate for Payer: UHCCP DNSP |
$1,596.98
|
| Rate for Payer: UHCCP Medicaid |
$1,026.23
|
|
|
PR CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 52281
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$597.00 |
| Rate for Payer: Aetna Commercial |
$181.05
|
| Rate for Payer: Aetna Medicare |
$135.11
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$135.11
|
| Rate for Payer: BCN Commercial |
$226.08
|
| Rate for Payer: BCN Medicare Advantage |
$135.11
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$194.56
|
| Rate for Payer: Cofinity Commercial |
$181.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.11
|
| Rate for Payer: Healthscope Commercial |
$162.13
|
| Rate for Payer: Healthscope Whirlpool |
$162.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.87
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.62
|
| Rate for Payer: Nomi Health Commercial |
$162.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$597.00
|
| Rate for Payer: PACE SWMI |
$135.11
|
| Rate for Payer: PHP Medicare Advantage |
$135.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$246.27
|
| Rate for Payer: Priority Health Medicare |
$135.11
|
| Rate for Payer: Priority Health Narrow Network |
$246.27
|
| Rate for Payer: Railroad Medicare Medicare |
$135.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.11
|
| Rate for Payer: UHC Exchange |
$267.46
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP DNSP |
$135.11
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR CYSTO FRAGMENTATION URETERAL STONE
|
Professional
|
Both
|
$685.00
|
|
|
Service Code
|
HCPCS 52325
|
| Min. Negotiated Rate |
$179.56 |
| Max. Negotiated Rate |
$566.18 |
| Rate for Payer: Aetna Commercial |
$375.39
|
| Rate for Payer: Aetna Medicare |
$280.14
|
| Rate for Payer: BCBS Complete |
$188.54
|
| Rate for Payer: BCBS MAPPO |
$280.14
|
| Rate for Payer: BCN Commercial |
$472.08
|
| Rate for Payer: BCN Medicare Advantage |
$280.14
|
| Rate for Payer: Cash Price |
$548.00
|
| Rate for Payer: Cash Price |
$548.00
|
| Rate for Payer: Cofinity Commercial |
$403.40
|
| Rate for Payer: Cofinity Commercial |
$375.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.14
|
| Rate for Payer: Healthscope Commercial |
$336.17
|
| Rate for Payer: Healthscope Whirlpool |
$336.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.15
|
| Rate for Payer: Meridian Medicaid |
$188.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.15
|
| Rate for Payer: Nomi Health Commercial |
$336.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.75
|
| Rate for Payer: PACE SWMI |
$280.14
|
| Rate for Payer: PHP Medicare Advantage |
$280.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$514.25
|
| Rate for Payer: Priority Health Medicare |
$280.14
|
| Rate for Payer: Priority Health Narrow Network |
$514.25
|
| Rate for Payer: Railroad Medicare Medicare |
$280.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$566.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$280.14
|
| Rate for Payer: UHC Exchange |
$566.18
|
| Rate for Payer: UHC Medicaid |
$179.56
|
| Rate for Payer: UHCCP DNSP |
$280.14
|
| Rate for Payer: UHCCP Medicaid |
$179.56
|
|
|
PR CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 52305
|
| Min. Negotiated Rate |
$156.13 |
| Max. Negotiated Rate |
$493.52 |
| Rate for Payer: Aetna Commercial |
$326.04
|
| Rate for Payer: Aetna Medicare |
$243.31
|
| Rate for Payer: BCBS Complete |
$163.94
|
| Rate for Payer: BCBS MAPPO |
$243.31
|
| Rate for Payer: BCN Commercial |
$410.33
|
| Rate for Payer: BCN Medicare Advantage |
$243.31
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$350.37
|
| Rate for Payer: Cofinity Commercial |
$326.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.31
|
| Rate for Payer: Healthscope Commercial |
$291.97
|
| Rate for Payer: Healthscope Whirlpool |
$291.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.48
|
| Rate for Payer: Meridian Medicaid |
$163.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$267.64
|
| Rate for Payer: Nomi Health Commercial |
$291.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.25
|
| Rate for Payer: PACE SWMI |
$243.31
|
| Rate for Payer: PHP Medicare Advantage |
$243.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$447.00
|
| Rate for Payer: Priority Health Medicare |
$243.31
|
| Rate for Payer: Priority Health Narrow Network |
$447.00
|
| Rate for Payer: Railroad Medicare Medicare |
$243.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$493.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$243.31
|
| Rate for Payer: UHC Exchange |
$493.52
|
| Rate for Payer: UHC Medicaid |
$156.13
|
| Rate for Payer: UHCCP DNSP |
$243.31
|
| Rate for Payer: UHCCP Medicaid |
$156.13
|
|
|
PR CYSTO INSJ PERM ADJTBL TRANSPROSTATIC 1 IMPLANT
|
Professional
|
Both
|
$2,315.00
|
|
|
Service Code
|
HCPCS 52441
|
| Min. Negotiated Rate |
$117.36 |
| Max. Negotiated Rate |
$1,736.25 |
| Rate for Payer: Aetna Commercial |
$244.98
|
| Rate for Payer: Aetna Medicare |
$182.82
|
| Rate for Payer: BCBS Complete |
$123.23
|
| Rate for Payer: BCBS MAPPO |
$182.82
|
| Rate for Payer: BCN Commercial |
$310.74
|
| Rate for Payer: BCN Medicare Advantage |
$182.82
|
| Rate for Payer: Cash Price |
$1,852.00
|
| Rate for Payer: Cash Price |
$1,852.00
|
| Rate for Payer: Cofinity Commercial |
$263.26
|
| Rate for Payer: Cofinity Commercial |
$244.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.82
|
| Rate for Payer: Healthscope Commercial |
$219.38
|
| Rate for Payer: Healthscope Whirlpool |
$219.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.96
|
| Rate for Payer: Meridian Medicaid |
$123.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$201.10
|
| Rate for Payer: Nomi Health Commercial |
$219.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,736.25
|
| Rate for Payer: PACE SWMI |
$182.82
|
| Rate for Payer: PHP Medicare Advantage |
$182.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$338.49
|
| Rate for Payer: Priority Health Medicare |
$182.82
|
| Rate for Payer: Priority Health Narrow Network |
$338.49
|
| Rate for Payer: Railroad Medicare Medicare |
$182.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$372.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$182.82
|
| Rate for Payer: UHC Exchange |
$372.60
|
| Rate for Payer: UHC Medicaid |
$117.36
|
| Rate for Payer: UHCCP DNSP |
$182.82
|
| Rate for Payer: UHCCP Medicaid |
$117.36
|
|
|
PR CYSTO INSJ PERM ADJTBL TRANSPROSTATIC IMPLANT EA
|
Professional
|
Both
|
$1,772.00
|
|
|
Service Code
|
HCPCS 52442
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$1,329.00 |
| Rate for Payer: Aetna Commercial |
$59.01
|
| Rate for Payer: Aetna Medicare |
$44.04
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: BCBS MAPPO |
$44.04
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: BCN Medicare Advantage |
$44.04
|
| Rate for Payer: Cash Price |
$1,417.60
|
| Rate for Payer: Cash Price |
$1,417.60
|
| Rate for Payer: Cofinity Commercial |
$63.42
|
| Rate for Payer: Cofinity Commercial |
$59.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.04
|
| Rate for Payer: Healthscope Commercial |
$52.85
|
| Rate for Payer: Healthscope Whirlpool |
$52.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.24
|
| Rate for Payer: Meridian Medicaid |
$29.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.44
|
| Rate for Payer: Nomi Health Commercial |
$52.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,329.00
|
| Rate for Payer: PACE SWMI |
$44.04
|
| Rate for Payer: PHP Medicare Advantage |
$44.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$81.91
|
| Rate for Payer: Priority Health Medicare |
$44.04
|
| Rate for Payer: Priority Health Narrow Network |
$81.91
|
| Rate for Payer: Railroad Medicare Medicare |
$44.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.04
|
| Rate for Payer: UHC Exchange |
$89.85
|
| Rate for Payer: UHC Medicaid |
$28.12
|
| Rate for Payer: UHCCP DNSP |
$44.04
|
| Rate for Payer: UHCCP Medicaid |
$28.12
|
|
|
PR CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR
|
Professional
|
Both
|
$972.00
|
|
|
Service Code
|
HCPCS 52334
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Aetna Commercial |
$216.79
|
| Rate for Payer: Aetna Medicare |
$161.78
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$161.78
|
| Rate for Payer: BCN Commercial |
$271.90
|
| Rate for Payer: BCN Medicare Advantage |
$161.78
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cofinity Commercial |
$232.96
|
| Rate for Payer: Cofinity Commercial |
$216.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.78
|
| Rate for Payer: Healthscope Commercial |
$194.14
|
| Rate for Payer: Healthscope Whirlpool |
$194.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.87
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$177.96
|
| Rate for Payer: Nomi Health Commercial |
$194.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.00
|
| Rate for Payer: PACE SWMI |
$161.78
|
| Rate for Payer: PHP Medicare Advantage |
$161.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$296.18
|
| Rate for Payer: Priority Health Medicare |
$161.78
|
| Rate for Payer: Priority Health Narrow Network |
$296.18
|
| Rate for Payer: Railroad Medicare Medicare |
$161.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.78
|
| Rate for Payer: UHC Exchange |
$322.86
|
| Rate for Payer: UHC Medicaid |
$104.16
|
| Rate for Payer: UHCCP DNSP |
$161.78
|
| Rate for Payer: UHCCP Medicaid |
$104.16
|
|
|
PR CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS
|
Professional
|
Both
|
$1,069.00
|
|
|
Service Code
|
HCPCS 51050
|
| Min. Negotiated Rate |
$276.69 |
| Max. Negotiated Rate |
$828.78 |
| Rate for Payer: Aetna Commercial |
$570.84
|
| Rate for Payer: Aetna Medicare |
$426.00
|
| Rate for Payer: BCBS Complete |
$290.52
|
| Rate for Payer: BCBS MAPPO |
$426.00
|
| Rate for Payer: BCN Commercial |
$712.11
|
| Rate for Payer: BCN Medicare Advantage |
$426.00
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cofinity Commercial |
$613.44
|
| Rate for Payer: Cofinity Commercial |
$570.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.00
|
| Rate for Payer: Healthscope Commercial |
$511.20
|
| Rate for Payer: Healthscope Whirlpool |
$511.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.30
|
| Rate for Payer: Meridian Medicaid |
$290.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.60
|
| Rate for Payer: Nomi Health Commercial |
$511.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.75
|
| Rate for Payer: PACE SWMI |
$426.00
|
| Rate for Payer: PHP Medicare Advantage |
$426.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$775.71
|
| Rate for Payer: Priority Health Medicare |
$426.00
|
| Rate for Payer: Priority Health Narrow Network |
$775.71
|
| Rate for Payer: Railroad Medicare Medicare |
$426.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$828.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$426.00
|
| Rate for Payer: UHC Exchange |
$828.78
|
| Rate for Payer: UHC Medicaid |
$276.69
|
| Rate for Payer: UHCCP DNSP |
$426.00
|
| Rate for Payer: UHCCP Medicaid |
$276.69
|
|
|
PR CYSTO MANJ W/O RMVL URETERAL STONE
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 52330
|
| Min. Negotiated Rate |
$147.40 |
| Max. Negotiated Rate |
$811.50 |
| Rate for Payer: Aetna Commercial |
$307.85
|
| Rate for Payer: Aetna Medicare |
$229.74
|
| Rate for Payer: BCBS Complete |
$154.77
|
| Rate for Payer: BCBS MAPPO |
$229.74
|
| Rate for Payer: BCN Commercial |
$388.92
|
| Rate for Payer: BCN Medicare Advantage |
$229.74
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$330.83
|
| Rate for Payer: Cofinity Commercial |
$307.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.74
|
| Rate for Payer: Healthscope Commercial |
$275.69
|
| Rate for Payer: Healthscope Whirlpool |
$275.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.23
|
| Rate for Payer: Meridian Medicaid |
$154.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$252.71
|
| Rate for Payer: Nomi Health Commercial |
$275.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$811.50
|
| Rate for Payer: PACE SWMI |
$229.74
|
| Rate for Payer: PHP Medicare Advantage |
$229.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$423.67
|
| Rate for Payer: Priority Health Medicare |
$229.74
|
| Rate for Payer: Priority Health Narrow Network |
$423.67
|
| Rate for Payer: Railroad Medicare Medicare |
$229.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$466.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$229.74
|
| Rate for Payer: UHC Exchange |
$466.55
|
| Rate for Payer: UHC Medicaid |
$147.40
|
| Rate for Payer: UHCCP DNSP |
$229.74
|
| Rate for Payer: UHCCP Medicaid |
$147.40
|
|
|
PR CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION
|
Professional
|
Both
|
$785.00
|
|
|
Service Code
|
HCPCS 52354
|
| Min. Negotiated Rate |
$233.66 |
| Max. Negotiated Rate |
$738.72 |
| Rate for Payer: Aetna Commercial |
$488.51
|
| Rate for Payer: Aetna Medicare |
$364.56
|
| Rate for Payer: BCBS Complete |
$245.34
|
| Rate for Payer: BCBS MAPPO |
$364.56
|
| Rate for Payer: BCN Commercial |
$616.01
|
| Rate for Payer: BCN Medicare Advantage |
$364.56
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cofinity Commercial |
$524.97
|
| Rate for Payer: Cofinity Commercial |
$488.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.56
|
| Rate for Payer: Healthscope Commercial |
$437.47
|
| Rate for Payer: Healthscope Whirlpool |
$437.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.79
|
| Rate for Payer: Meridian Medicaid |
$245.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$401.02
|
| Rate for Payer: Nomi Health Commercial |
$437.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$588.75
|
| Rate for Payer: PACE SWMI |
$364.56
|
| Rate for Payer: PHP Medicare Advantage |
$364.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$671.03
|
| Rate for Payer: Priority Health Medicare |
$364.56
|
| Rate for Payer: Priority Health Narrow Network |
$671.03
|
| Rate for Payer: Railroad Medicare Medicare |
$364.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$738.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$364.56
|
| Rate for Payer: UHC Exchange |
$738.72
|
| Rate for Payer: UHC Medicaid |
$233.66
|
| Rate for Payer: UHCCP DNSP |
$364.56
|
| Rate for Payer: UHCCP Medicaid |
$233.66
|
|
|
PR CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR
|
Professional
|
Both
|
$1,496.00
|
|
|
Service Code
|
HCPCS 52355
|
| Min. Negotiated Rate |
$261.35 |
| Max. Negotiated Rate |
$1,122.00 |
| Rate for Payer: Aetna Commercial |
$546.51
|
| Rate for Payer: Aetna Medicare |
$407.84
|
| Rate for Payer: BCBS Complete |
$274.42
|
| Rate for Payer: BCBS MAPPO |
$407.84
|
| Rate for Payer: BCN Commercial |
$690.20
|
| Rate for Payer: BCN Medicare Advantage |
$407.84
|
| Rate for Payer: Cash Price |
$1,196.80
|
| Rate for Payer: Cash Price |
$1,196.80
|
| Rate for Payer: Cofinity Commercial |
$587.29
|
| Rate for Payer: Cofinity Commercial |
$546.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.84
|
| Rate for Payer: Healthscope Commercial |
$489.41
|
| Rate for Payer: Healthscope Whirlpool |
$489.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.23
|
| Rate for Payer: Meridian Medicaid |
$274.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$448.62
|
| Rate for Payer: Nomi Health Commercial |
$489.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,122.00
|
| Rate for Payer: PACE SWMI |
$407.84
|
| Rate for Payer: PHP Medicare Advantage |
$407.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$751.85
|
| Rate for Payer: Priority Health Medicare |
$407.84
|
| Rate for Payer: Priority Health Narrow Network |
$751.85
|
| Rate for Payer: Railroad Medicare Medicare |
$407.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$828.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$407.84
|
| Rate for Payer: UHC Exchange |
$828.01
|
| Rate for Payer: UHC Medicaid |
$261.35
|
| Rate for Payer: UHCCP DNSP |
$407.84
|
| Rate for Payer: UHCCP Medicaid |
$261.35
|
|
|
PR CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED
|
Professional
|
Both
|
$3,293.00
|
|
|
Service Code
|
HCPCS 51865
|
| Min. Negotiated Rate |
$516.53 |
| Max. Negotiated Rate |
$2,469.75 |
| Rate for Payer: Aetna Commercial |
$1,072.31
|
| Rate for Payer: Aetna Medicare |
$800.23
|
| Rate for Payer: BCBS Complete |
$542.36
|
| Rate for Payer: BCBS MAPPO |
$800.23
|
| Rate for Payer: BCN Commercial |
$1,337.08
|
| Rate for Payer: BCN Medicare Advantage |
$800.23
|
| Rate for Payer: Cash Price |
$2,634.40
|
| Rate for Payer: Cash Price |
$2,634.40
|
| Rate for Payer: Cofinity Commercial |
$1,152.33
|
| Rate for Payer: Cofinity Commercial |
$1,072.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.23
|
| Rate for Payer: Healthscope Commercial |
$960.28
|
| Rate for Payer: Healthscope Whirlpool |
$960.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.24
|
| Rate for Payer: Meridian Medicaid |
$542.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$880.25
|
| Rate for Payer: Nomi Health Commercial |
$960.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,469.75
|
| Rate for Payer: PACE SWMI |
$800.23
|
| Rate for Payer: PHP Medicare Advantage |
$800.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,456.51
|
| Rate for Payer: Priority Health Medicare |
$800.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,456.51
|
| Rate for Payer: Railroad Medicare Medicare |
$800.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,587.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$800.23
|
| Rate for Payer: UHC Exchange |
$1,587.72
|
| Rate for Payer: UHC Medicaid |
$516.53
|
| Rate for Payer: UHCCP DNSP |
$800.23
|
| Rate for Payer: UHCCP Medicaid |
$516.53
|
|
|
PR CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE
|
Professional
|
Both
|
$2,521.00
|
|
|
Service Code
|
HCPCS 51860
|
| Min. Negotiated Rate |
$434.95 |
| Max. Negotiated Rate |
$1,890.75 |
| Rate for Payer: Aetna Commercial |
$901.53
|
| Rate for Payer: Aetna Medicare |
$672.78
|
| Rate for Payer: BCBS Complete |
$456.70
|
| Rate for Payer: BCBS MAPPO |
$672.78
|
| Rate for Payer: BCN Commercial |
$1,114.98
|
| Rate for Payer: BCN Medicare Advantage |
$672.78
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cofinity Commercial |
$968.80
|
| Rate for Payer: Cofinity Commercial |
$901.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.78
|
| Rate for Payer: Healthscope Commercial |
$807.34
|
| Rate for Payer: Healthscope Whirlpool |
$807.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$706.42
|
| Rate for Payer: Meridian Medicaid |
$456.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$740.06
|
| Rate for Payer: Nomi Health Commercial |
$807.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,890.75
|
| Rate for Payer: PACE SWMI |
$672.78
|
| Rate for Payer: PHP Medicare Advantage |
$672.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,214.58
|
| Rate for Payer: Priority Health Medicare |
$672.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,214.58
|
| Rate for Payer: Railroad Medicare Medicare |
$672.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,315.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$672.78
|
| Rate for Payer: UHC Exchange |
$1,315.28
|
| Rate for Payer: UHC Medicaid |
$434.95
|
| Rate for Payer: UHCCP DNSP |
$672.78
|
| Rate for Payer: UHCCP Medicaid |
$434.95
|
|
|
PR CYSTOSTOMY CYSTOTOMY W/DRAINAGE
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 51040
|
| Min. Negotiated Rate |
$174.02 |
| Max. Negotiated Rate |
$505.91 |
| Rate for Payer: Aetna Commercial |
$356.32
|
| Rate for Payer: Aetna Medicare |
$265.91
|
| Rate for Payer: BCBS Complete |
$182.72
|
| Rate for Payer: BCBS MAPPO |
$265.91
|
| Rate for Payer: BCN Commercial |
$441.21
|
| Rate for Payer: BCN Medicare Advantage |
$265.91
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$382.91
|
| Rate for Payer: Cofinity Commercial |
$356.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.91
|
| Rate for Payer: Healthscope Commercial |
$319.09
|
| Rate for Payer: Healthscope Whirlpool |
$319.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.21
|
| Rate for Payer: Meridian Medicaid |
$182.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$292.50
|
| Rate for Payer: Nomi Health Commercial |
$319.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.50
|
| Rate for Payer: PACE SWMI |
$265.91
|
| Rate for Payer: PHP Medicare Advantage |
$265.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$480.62
|
| Rate for Payer: Priority Health Medicare |
$265.91
|
| Rate for Payer: Priority Health Narrow Network |
$480.62
|
| Rate for Payer: Railroad Medicare Medicare |
$265.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$505.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$265.91
|
| Rate for Payer: UHC Exchange |
$505.91
|
| Rate for Payer: UHC Medicaid |
$174.02
|
| Rate for Payer: UHCCP DNSP |
$265.91
|
| Rate for Payer: UHCCP Medicaid |
$174.02
|
|
|
PR CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL
|
Professional
|
Both
|
$2,524.00
|
|
|
Service Code
|
HCPCS 51020
|
| Min. Negotiated Rate |
$277.75 |
| Max. Negotiated Rate |
$1,893.00 |
| Rate for Payer: Aetna Commercial |
$571.54
|
| Rate for Payer: Aetna Medicare |
$426.52
|
| Rate for Payer: BCBS Complete |
$291.64
|
| Rate for Payer: BCBS MAPPO |
$426.52
|
| Rate for Payer: BCN Commercial |
$708.63
|
| Rate for Payer: BCN Medicare Advantage |
$426.52
|
| Rate for Payer: Cash Price |
$2,019.20
|
| Rate for Payer: Cash Price |
$2,019.20
|
| Rate for Payer: Cofinity Commercial |
$614.19
|
| Rate for Payer: Cofinity Commercial |
$571.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.52
|
| Rate for Payer: Healthscope Commercial |
$511.82
|
| Rate for Payer: Healthscope Whirlpool |
$511.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.85
|
| Rate for Payer: Meridian Medicaid |
$291.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$469.17
|
| Rate for Payer: Nomi Health Commercial |
$511.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,893.00
|
| Rate for Payer: PACE SWMI |
$426.52
|
| Rate for Payer: PHP Medicare Advantage |
$426.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$771.92
|
| Rate for Payer: Priority Health Medicare |
$426.52
|
| Rate for Payer: Priority Health Narrow Network |
$771.92
|
| Rate for Payer: Railroad Medicare Medicare |
$426.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$426.52
|
| Rate for Payer: UHC Exchange |
$821.94
|
| Rate for Payer: UHC Medicaid |
$277.75
|
| Rate for Payer: UHCCP DNSP |
$426.52
|
| Rate for Payer: UHCCP Medicaid |
$277.75
|
|
|
PR CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 51525
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$1,546.50 |
| Rate for Payer: Aetna Commercial |
$1,023.84
|
| Rate for Payer: Aetna Medicare |
$764.06
|
| Rate for Payer: BCBS Complete |
$517.75
|
| Rate for Payer: BCBS MAPPO |
$764.06
|
| Rate for Payer: BCN Commercial |
$1,282.31
|
| Rate for Payer: BCN Medicare Advantage |
$764.06
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$1,100.25
|
| Rate for Payer: Cofinity Commercial |
$1,023.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$764.06
|
| Rate for Payer: Healthscope Commercial |
$916.87
|
| Rate for Payer: Healthscope Whirlpool |
$916.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$802.26
|
| Rate for Payer: Meridian Medicaid |
$517.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$840.47
|
| Rate for Payer: Nomi Health Commercial |
$916.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,546.50
|
| Rate for Payer: PACE SWMI |
$764.06
|
| Rate for Payer: PHP Medicare Advantage |
$764.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,396.84
|
| Rate for Payer: Priority Health Medicare |
$764.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,396.84
|
| Rate for Payer: Railroad Medicare Medicare |
$764.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,517.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$764.06
|
| Rate for Payer: UHC Exchange |
$1,517.40
|
| Rate for Payer: UHC Medicaid |
$493.10
|
| Rate for Payer: UHCCP DNSP |
$764.06
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
|
|
PR CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE
|
Professional
|
Both
|
$1,781.00
|
|
|
Service Code
|
HCPCS 51535
|
| Min. Negotiated Rate |
$449.22 |
| Max. Negotiated Rate |
$1,377.80 |
| Rate for Payer: Aetna Commercial |
$931.39
|
| Rate for Payer: Aetna Medicare |
$695.07
|
| Rate for Payer: BCBS Complete |
$471.68
|
| Rate for Payer: BCBS MAPPO |
$695.07
|
| Rate for Payer: BCN Commercial |
$1,167.77
|
| Rate for Payer: BCN Medicare Advantage |
$695.07
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cash Price |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$931.39
|
| Rate for Payer: Cofinity Commercial |
$1,000.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.07
|
| Rate for Payer: Healthscope Commercial |
$834.08
|
| Rate for Payer: Healthscope Whirlpool |
$834.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.82
|
| Rate for Payer: Meridian Medicaid |
$471.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.58
|
| Rate for Payer: Nomi Health Commercial |
$834.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,335.75
|
| Rate for Payer: PACE SWMI |
$695.07
|
| Rate for Payer: PHP Medicare Advantage |
$695.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,272.08
|
| Rate for Payer: Priority Health Medicare |
$695.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,272.08
|
| Rate for Payer: Railroad Medicare Medicare |
$695.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,377.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$695.07
|
| Rate for Payer: UHC Exchange |
$1,377.80
|
| Rate for Payer: UHC Medicaid |
$449.22
|
| Rate for Payer: UHCCP DNSP |
$695.07
|
| Rate for Payer: UHCCP Medicaid |
$449.22
|
|
|
PR CYSTOTOMY EXCISION BLADDER TUMOR
|
Professional
|
Both
|
$1,432.00
|
|
|
Service Code
|
HCPCS 51530
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,359.34 |
| Rate for Payer: Aetna Commercial |
$920.69
|
| Rate for Payer: Aetna Medicare |
$687.08
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$687.08
|
| Rate for Payer: BCN Commercial |
$1,152.83
|
| Rate for Payer: BCN Medicare Advantage |
$687.08
|
| Rate for Payer: Cash Price |
$1,145.60
|
| Rate for Payer: Cash Price |
$1,145.60
|
| Rate for Payer: Cofinity Commercial |
$989.40
|
| Rate for Payer: Cofinity Commercial |
$920.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.08
|
| Rate for Payer: Healthscope Commercial |
$824.50
|
| Rate for Payer: Healthscope Whirlpool |
$824.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.43
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$755.79
|
| Rate for Payer: Nomi Health Commercial |
$824.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.00
|
| Rate for Payer: PACE SWMI |
$687.08
|
| Rate for Payer: PHP Medicare Advantage |
$687.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,255.80
|
| Rate for Payer: Priority Health Medicare |
$687.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,255.80
|
| Rate for Payer: Railroad Medicare Medicare |
$687.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,359.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$687.08
|
| Rate for Payer: UHC Exchange |
$1,359.34
|
| Rate for Payer: UHC Medicaid |
$444.11
|
| Rate for Payer: UHCCP DNSP |
$687.08
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
|
|
PR CYSTOTOMY SIMPLE EXCISION VESICAL NECK
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 51520
|
| Min. Negotiated Rate |
$347.19 |
| Max. Negotiated Rate |
$1,047.22 |
| Rate for Payer: Aetna Commercial |
$717.29
|
| Rate for Payer: Aetna Medicare |
$535.29
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS MAPPO |
$535.29
|
| Rate for Payer: BCN Commercial |
$895.87
|
| Rate for Payer: BCN Medicare Advantage |
$535.29
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$770.82
|
| Rate for Payer: Cofinity Commercial |
$717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.29
|
| Rate for Payer: Healthscope Commercial |
$642.35
|
| Rate for Payer: Healthscope Whirlpool |
$642.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.05
|
| Rate for Payer: Meridian Medicaid |
$364.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$588.82
|
| Rate for Payer: Nomi Health Commercial |
$642.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$948.75
|
| Rate for Payer: PACE SWMI |
$535.29
|
| Rate for Payer: PHP Medicare Advantage |
$535.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$975.89
|
| Rate for Payer: Priority Health Medicare |
$535.29
|
| Rate for Payer: Priority Health Narrow Network |
$975.89
|
| Rate for Payer: Railroad Medicare Medicare |
$535.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,047.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$535.29
|
| Rate for Payer: UHC Exchange |
$1,047.22
|
| Rate for Payer: UHC Medicaid |
$347.19
|
| Rate for Payer: UHCCP DNSP |
$535.29
|
| Rate for Payer: UHCCP Medicaid |
$347.19
|
|
