|
PR CRNEC/CRNOT DRG INTRACRANIAL ABSC INFRATENTORIAL
|
Professional
|
Both
|
$4,357.00
|
|
|
Service Code
|
HCPCS 61321
|
| Min. Negotiated Rate |
$431.09 |
| Max. Negotiated Rate |
$3,678.46 |
| Rate for Payer: Aetna Commercial |
$2,747.11
|
| Rate for Payer: Aetna Medicare |
$2,178.50
|
| Rate for Payer: BCBS Complete |
$1,452.61
|
| Rate for Payer: BCBS Trust/PPO |
$431.09
|
| Rate for Payer: BCN Commercial |
$3,133.89
|
| Rate for Payer: Cash Price |
$3,485.60
|
| Rate for Payer: Cash Price |
$3,485.60
|
| Rate for Payer: Meridian Medicaid |
$1,452.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,832.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,678.46
|
| Rate for Payer: Priority Health Narrow Network |
$3,678.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,450.52
|
| Rate for Payer: UHC Exchange |
$2,450.52
|
| Rate for Payer: UHCCP Medicaid |
$1,383.44
|
|
|
PR CRNEC/CRNOT DRG INTRACRANIAL ABSC SUPRATENTORIAL
|
Professional
|
Both
|
$6,842.00
|
|
|
Service Code
|
HCPCS 61320
|
| Min. Negotiated Rate |
$495.02 |
| Max. Negotiated Rate |
$4,447.30 |
| Rate for Payer: Aetna Commercial |
$2,452.91
|
| Rate for Payer: Aetna Medicare |
$3,421.00
|
| Rate for Payer: BCBS Complete |
$1,296.95
|
| Rate for Payer: BCBS Trust/PPO |
$495.02
|
| Rate for Payer: BCN Commercial |
$3,871.00
|
| Rate for Payer: Cash Price |
$5,473.60
|
| Rate for Payer: Cash Price |
$5,473.60
|
| Rate for Payer: Meridian Medicaid |
$1,296.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,235.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,447.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,278.07
|
| Rate for Payer: Priority Health Narrow Network |
$3,278.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,212.52
|
| Rate for Payer: UHC Exchange |
$2,212.52
|
| Rate for Payer: UHCCP Medicaid |
$1,235.19
|
|
|
PR CRNEC/CRNOT HMTMA INFRATENTORIAL INTRACEREBELLAR
|
Professional
|
Both
|
$7,040.00
|
|
|
Service Code
|
HCPCS 61315
|
| Min. Negotiated Rate |
$1,127.39 |
| Max. Negotiated Rate |
$4,576.00 |
| Rate for Payer: Aetna Commercial |
$2,670.81
|
| Rate for Payer: Aetna Medicare |
$3,520.00
|
| Rate for Payer: BCBS Complete |
$1,413.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.39
|
| Rate for Payer: BCN Commercial |
$4,232.33
|
| Rate for Payer: Cash Price |
$5,632.00
|
| Rate for Payer: Cash Price |
$5,632.00
|
| Rate for Payer: Meridian Medicaid |
$1,413.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,346.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,576.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,584.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,584.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,401.42
|
| Rate for Payer: UHC Exchange |
$2,401.42
|
| Rate for Payer: UHCCP Medicaid |
$1,346.16
|
|
|
PR CRNEC/CRNOT HMTMA INFRATENTORIAL XDRL/SDRL
|
Professional
|
Both
|
$5,612.00
|
|
|
Service Code
|
HCPCS 61314
|
| Min. Negotiated Rate |
$1,064.00 |
| Max. Negotiated Rate |
$3,730.66 |
| Rate for Payer: Aetna Commercial |
$2,364.24
|
| Rate for Payer: Aetna Medicare |
$2,806.00
|
| Rate for Payer: BCBS Complete |
$1,250.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,064.00
|
| Rate for Payer: BCN Commercial |
$3,730.66
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Meridian Medicaid |
$1,250.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,190.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,647.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,163.76
|
| Rate for Payer: Priority Health Narrow Network |
$3,163.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,110.42
|
| Rate for Payer: UHC Exchange |
$2,110.42
|
| Rate for Payer: UHCCP Medicaid |
$1,190.67
|
|
|
PR CRNEC/CRNOT HMTMA SUPRATENTORIAL INTRACEREBRAL
|
Professional
|
Both
|
$4,171.00
|
|
|
Service Code
|
HCPCS 61313
|
| Min. Negotiated Rate |
$1,065.58 |
| Max. Negotiated Rate |
$4,059.46 |
| Rate for Payer: Aetna Commercial |
$2,561.06
|
| Rate for Payer: Aetna Medicare |
$2,085.50
|
| Rate for Payer: BCBS Complete |
$1,359.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.58
|
| Rate for Payer: BCN Commercial |
$4,059.46
|
| Rate for Payer: Cash Price |
$3,336.80
|
| Rate for Payer: Cash Price |
$3,336.80
|
| Rate for Payer: Meridian Medicaid |
$1,359.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,294.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,711.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,441.87
|
| Rate for Payer: Priority Health Narrow Network |
$3,441.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,289.91
|
| Rate for Payer: UHC Exchange |
$2,289.91
|
| Rate for Payer: UHCCP Medicaid |
$1,294.40
|
|
|
PR CRNEC/CRNOT HMTMA SUPRATENTORIAL XDRL/SUBDURAL
|
Professional
|
Both
|
$7,129.00
|
|
|
Service Code
|
HCPCS 61312
|
| Min. Negotiated Rate |
$831.54 |
| Max. Negotiated Rate |
$4,633.85 |
| Rate for Payer: Aetna Commercial |
$2,679.75
|
| Rate for Payer: Aetna Medicare |
$3,564.50
|
| Rate for Payer: BCBS Complete |
$1,413.47
|
| Rate for Payer: BCBS Trust/PPO |
$831.54
|
| Rate for Payer: BCN Commercial |
$4,233.69
|
| Rate for Payer: Cash Price |
$5,703.20
|
| Rate for Payer: Cash Price |
$5,703.20
|
| Rate for Payer: Meridian Medicaid |
$1,413.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,346.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,633.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,582.34
|
| Rate for Payer: Priority Health Narrow Network |
$3,582.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,414.32
|
| Rate for Payer: UHC Exchange |
$2,414.32
|
| Rate for Payer: UHCCP Medicaid |
$1,346.16
|
|
|
PR CRNEC/CRNOT W/WO DURAPLASTY WITH LOBECTOMY
|
Professional
|
Both
|
$8,807.00
|
|
|
Service Code
|
HCPCS 61323
|
| Min. Negotiated Rate |
$679.39 |
| Max. Negotiated Rate |
$5,724.55 |
| Rate for Payer: Aetna Commercial |
$3,089.39
|
| Rate for Payer: Aetna Medicare |
$4,403.50
|
| Rate for Payer: BCBS Complete |
$1,618.77
|
| Rate for Payer: BCBS Trust/PPO |
$679.39
|
| Rate for Payer: BCN Commercial |
$4,887.22
|
| Rate for Payer: Cash Price |
$7,045.60
|
| Rate for Payer: Cash Price |
$7,045.60
|
| Rate for Payer: Meridian Medicaid |
$1,618.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,541.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,724.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,134.56
|
| Rate for Payer: Priority Health Narrow Network |
$4,134.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,765.76
|
| Rate for Payer: UHC Exchange |
$2,765.76
|
| Rate for Payer: UHCCP Medicaid |
$1,541.69
|
|
|
PR CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA
|
Professional
|
Both
|
$8,419.00
|
|
|
Service Code
|
HCPCS 61518
|
| Min. Negotiated Rate |
$1,142.71 |
| Max. Negotiated Rate |
$5,660.06 |
| Rate for Payer: Aetna Commercial |
$3,575.97
|
| Rate for Payer: Aetna Medicare |
$4,209.50
|
| Rate for Payer: BCBS Complete |
$1,890.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,142.71
|
| Rate for Payer: BCN Commercial |
$5,660.06
|
| Rate for Payer: Cash Price |
$6,735.20
|
| Rate for Payer: Cash Price |
$6,735.20
|
| Rate for Payer: Meridian Medicaid |
$1,890.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,800.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,472.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,792.57
|
| Rate for Payer: Priority Health Narrow Network |
$4,792.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,206.40
|
| Rate for Payer: UHC Exchange |
$3,206.40
|
| Rate for Payer: UHCCP Medicaid |
$1,800.92
|
|
|
PR CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA
|
Professional
|
Both
|
$7,858.00
|
|
|
Service Code
|
HCPCS 61530
|
| Min. Negotiated Rate |
$1,728.07 |
| Max. Negotiated Rate |
$6,271.56 |
| Rate for Payer: Aetna Commercial |
$3,972.92
|
| Rate for Payer: Aetna Medicare |
$3,929.00
|
| Rate for Payer: BCBS Complete |
$2,092.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,728.07
|
| Rate for Payer: BCN Commercial |
$6,271.56
|
| Rate for Payer: Cash Price |
$6,286.40
|
| Rate for Payer: Cash Price |
$6,286.40
|
| Rate for Payer: Meridian Medicaid |
$2,092.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,992.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,107.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,300.44
|
| Rate for Payer: Priority Health Narrow Network |
$5,300.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,569.71
|
| Rate for Payer: UHC Exchange |
$3,569.71
|
| Rate for Payer: UHCCP Medicaid |
$1,992.40
|
|
|
PR CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA
|
Professional
|
Both
|
$8,718.00
|
|
|
Service Code
|
HCPCS 61519
|
| Min. Negotiated Rate |
$1,169.66 |
| Max. Negotiated Rate |
$6,020.71 |
| Rate for Payer: Aetna Commercial |
$3,807.82
|
| Rate for Payer: Aetna Medicare |
$4,359.00
|
| Rate for Payer: BCBS Complete |
$2,008.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,169.66
|
| Rate for Payer: BCN Commercial |
$6,020.71
|
| Rate for Payer: Cash Price |
$6,974.40
|
| Rate for Payer: Cash Price |
$6,974.40
|
| Rate for Payer: Meridian Medicaid |
$2,008.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,912.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,666.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,079.20
|
| Rate for Payer: Priority Health Narrow Network |
$5,079.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,441.76
|
| Rate for Payer: UHC Exchange |
$3,441.76
|
| Rate for Payer: UHCCP Medicaid |
$1,912.95
|
|
|
PR CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS
|
Professional
|
Both
|
$6,227.00
|
|
|
Service Code
|
HCPCS 61522
|
| Min. Negotiated Rate |
$581.66 |
| Max. Negotiated Rate |
$4,475.71 |
| Rate for Payer: Aetna Commercial |
$2,828.40
|
| Rate for Payer: Aetna Medicare |
$3,113.50
|
| Rate for Payer: BCBS Complete |
$1,495.77
|
| Rate for Payer: BCBS Trust/PPO |
$581.66
|
| Rate for Payer: BCN Commercial |
$4,475.71
|
| Rate for Payer: Cash Price |
$4,981.60
|
| Rate for Payer: Cash Price |
$4,981.60
|
| Rate for Payer: Meridian Medicaid |
$1,495.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,424.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,047.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,787.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,787.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,542.15
|
| Rate for Payer: UHC Exchange |
$2,542.15
|
| Rate for Payer: UHCCP Medicaid |
$1,424.54
|
|
|
PR CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST
|
Professional
|
Both
|
$7,109.00
|
|
|
Service Code
|
HCPCS 61524
|
| Min. Negotiated Rate |
$322.26 |
| Max. Negotiated Rate |
$4,620.85 |
| Rate for Payer: Aetna Commercial |
$2,693.85
|
| Rate for Payer: Aetna Medicare |
$3,554.50
|
| Rate for Payer: BCBS Complete |
$1,425.54
|
| Rate for Payer: BCBS Trust/PPO |
$322.26
|
| Rate for Payer: BCN Commercial |
$3,075.74
|
| Rate for Payer: Cash Price |
$5,687.20
|
| Rate for Payer: Cash Price |
$5,687.20
|
| Rate for Payer: Meridian Medicaid |
$1,425.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,357.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,620.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,610.20
|
| Rate for Payer: Priority Health Narrow Network |
$3,610.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,407.25
|
| Rate for Payer: UHC Exchange |
$2,407.25
|
| Rate for Payer: UHCCP Medicaid |
$1,357.66
|
|
|
PR CRNEC SOPL EXPLORATION/DECOMPRESSION CRANIAL NRV
|
Professional
|
Both
|
$7,844.00
|
|
|
Service Code
|
HCPCS 61458
|
| Min. Negotiated Rate |
$861.66 |
| Max. Negotiated Rate |
$5,098.60 |
| Rate for Payer: Aetna Commercial |
$2,603.51
|
| Rate for Payer: Aetna Medicare |
$3,922.00
|
| Rate for Payer: BCBS Complete |
$1,380.14
|
| Rate for Payer: BCBS Trust/PPO |
$861.66
|
| Rate for Payer: BCN Commercial |
$4,127.93
|
| Rate for Payer: Cash Price |
$6,275.20
|
| Rate for Payer: Cash Price |
$6,275.20
|
| Rate for Payer: Meridian Medicaid |
$1,380.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,314.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,098.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,482.82
|
| Rate for Payer: Priority Health Narrow Network |
$3,482.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,330.76
|
| Rate for Payer: UHC Exchange |
$2,330.76
|
| Rate for Payer: UHCCP Medicaid |
$1,314.42
|
|
|
PR CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION
|
Professional
|
Both
|
$6,713.00
|
|
|
Service Code
|
HCPCS 61450
|
| Min. Negotiated Rate |
$732.75 |
| Max. Negotiated Rate |
$4,363.45 |
| Rate for Payer: Aetna Commercial |
$2,481.54
|
| Rate for Payer: Aetna Medicare |
$3,356.50
|
| Rate for Payer: BCBS Complete |
$1,313.05
|
| Rate for Payer: BCBS Trust/PPO |
$732.75
|
| Rate for Payer: BCN Commercial |
$2,831.40
|
| Rate for Payer: Cash Price |
$5,370.40
|
| Rate for Payer: Cash Price |
$5,370.40
|
| Rate for Payer: Meridian Medicaid |
$1,313.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,250.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,363.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,325.28
|
| Rate for Payer: Priority Health Narrow Network |
$3,325.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,224.16
|
| Rate for Payer: UHC Exchange |
$2,224.16
|
| Rate for Payer: UHCCP Medicaid |
$1,250.52
|
|
|
PR CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD
|
Professional
|
Both
|
$4,610.00
|
|
|
Service Code
|
HCPCS 61343
|
| Min. Negotiated Rate |
$230.87 |
| Max. Negotiated Rate |
$4,491.99 |
| Rate for Payer: Aetna Commercial |
$2,837.46
|
| Rate for Payer: Aetna Medicare |
$2,305.00
|
| Rate for Payer: BCBS Complete |
$1,496.67
|
| Rate for Payer: BCBS Trust/PPO |
$230.87
|
| Rate for Payer: BCN Commercial |
$4,491.99
|
| Rate for Payer: Cash Price |
$3,688.00
|
| Rate for Payer: Cash Price |
$3,688.00
|
| Rate for Payer: Meridian Medicaid |
$1,496.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,425.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,996.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,792.76
|
| Rate for Payer: Priority Health Narrow Network |
$3,792.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,555.14
|
| Rate for Payer: UHC Exchange |
$2,555.14
|
| Rate for Payer: UHCCP Medicaid |
$1,425.40
|
|
|
PR CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM
|
Professional
|
Both
|
$8,071.00
|
|
|
Service Code
|
HCPCS 61526
|
| Min. Negotiated Rate |
$811.47 |
| Max. Negotiated Rate |
$5,723.54 |
| Rate for Payer: Aetna Commercial |
$4,323.75
|
| Rate for Payer: Aetna Medicare |
$4,035.50
|
| Rate for Payer: BCBS Complete |
$2,257.52
|
| Rate for Payer: BCBS Trust/PPO |
$811.47
|
| Rate for Payer: BCN Commercial |
$4,908.76
|
| Rate for Payer: Cash Price |
$6,456.80
|
| Rate for Payer: Cash Price |
$6,456.80
|
| Rate for Payer: Meridian Medicaid |
$2,257.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,150.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,246.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,723.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,723.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,205.95
|
| Rate for Payer: UHC Exchange |
$4,205.95
|
| Rate for Payer: UHCCP Medicaid |
$2,150.02
|
|
|
PR CRNEC TREPH BONE FLAP CRNOT EXC BRAIN ABSC STTL
|
Professional
|
Both
|
$4,023.00
|
|
|
Service Code
|
HCPCS 61514
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$3,926.59 |
| Rate for Payer: Aetna Commercial |
$2,471.98
|
| Rate for Payer: Aetna Medicare |
$2,011.50
|
| Rate for Payer: BCBS Complete |
$1,312.60
|
| Rate for Payer: BCBS Trust/PPO |
$137.36
|
| Rate for Payer: BCN Commercial |
$3,926.59
|
| Rate for Payer: Cash Price |
$3,218.40
|
| Rate for Payer: Cash Price |
$3,218.40
|
| Rate for Payer: Meridian Medicaid |
$1,312.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,250.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,614.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,316.75
|
| Rate for Payer: Priority Health Narrow Network |
$3,316.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,208.48
|
| Rate for Payer: UHC Exchange |
$2,208.48
|
| Rate for Payer: UHCCP Medicaid |
$1,250.10
|
|
|
PR CRNEC TREPH BONE FLAP CRNOT EXC BRAIN TUMOR STTL
|
Professional
|
Both
|
$4,604.00
|
|
|
Service Code
|
HCPCS 61510
|
| Min. Negotiated Rate |
$455.92 |
| Max. Negotiated Rate |
$4,506.22 |
| Rate for Payer: Aetna Commercial |
$2,837.36
|
| Rate for Payer: Aetna Medicare |
$2,302.00
|
| Rate for Payer: BCBS Complete |
$1,507.85
|
| Rate for Payer: BCBS Trust/PPO |
$455.92
|
| Rate for Payer: BCN Commercial |
$4,506.22
|
| Rate for Payer: Cash Price |
$3,683.20
|
| Rate for Payer: Cash Price |
$3,683.20
|
| Rate for Payer: Meridian Medicaid |
$1,507.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,436.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,992.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,816.64
|
| Rate for Payer: Priority Health Narrow Network |
$3,816.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,524.39
|
| Rate for Payer: UHC Exchange |
$2,524.39
|
| Rate for Payer: UHCCP Medicaid |
$1,436.05
|
|
|
PR CRNEC TREPH BONE FLAP CRNOT EXC/FENEST CYST STTL
|
Professional
|
Both
|
$7,117.00
|
|
|
Service Code
|
HCPCS 61516
|
| Min. Negotiated Rate |
$108.83 |
| Max. Negotiated Rate |
$4,626.05 |
| Rate for Payer: Aetna Commercial |
$2,419.47
|
| Rate for Payer: Aetna Medicare |
$3,558.50
|
| Rate for Payer: BCBS Complete |
$1,279.95
|
| Rate for Payer: BCBS Trust/PPO |
$108.83
|
| Rate for Payer: BCN Commercial |
$3,832.35
|
| Rate for Payer: Cash Price |
$5,693.60
|
| Rate for Payer: Cash Price |
$5,693.60
|
| Rate for Payer: Meridian Medicaid |
$1,279.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,219.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,626.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,249.64
|
| Rate for Payer: Priority Health Narrow Network |
$3,249.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,144.59
|
| Rate for Payer: UHC Exchange |
$2,144.59
|
| Rate for Payer: UHCCP Medicaid |
$1,219.00
|
|
|
PR CRNEC TREPH BONE FLAP CRNOT EXC MENINGIOMA STTL
|
Professional
|
Both
|
$5,385.00
|
|
|
Service Code
|
HCPCS 61512
|
| Min. Negotiated Rate |
$223.47 |
| Max. Negotiated Rate |
$5,220.76 |
| Rate for Payer: Aetna Commercial |
$3,299.75
|
| Rate for Payer: Aetna Medicare |
$2,692.50
|
| Rate for Payer: BCBS Complete |
$1,742.68
|
| Rate for Payer: BCBS Trust/PPO |
$223.47
|
| Rate for Payer: BCN Commercial |
$5,220.76
|
| Rate for Payer: Cash Price |
$4,308.00
|
| Rate for Payer: Cash Price |
$4,308.00
|
| Rate for Payer: Meridian Medicaid |
$1,742.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,659.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,413.23
|
| Rate for Payer: Priority Health Narrow Network |
$4,413.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,971.74
|
| Rate for Payer: UHC Exchange |
$2,971.74
|
| Rate for Payer: UHCCP Medicaid |
$1,659.70
|
|
|
PR CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL
|
Professional
|
Both
|
$10,436.00
|
|
|
Service Code
|
HCPCS 61521
|
| Min. Negotiated Rate |
$1,168.07 |
| Max. Negotiated Rate |
$6,783.40 |
| Rate for Payer: Aetna Commercial |
$4,087.42
|
| Rate for Payer: Aetna Medicare |
$5,218.00
|
| Rate for Payer: BCBS Complete |
$2,156.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: BCN Commercial |
$6,470.19
|
| Rate for Payer: Cash Price |
$8,348.80
|
| Rate for Payer: Cash Price |
$8,348.80
|
| Rate for Payer: Meridian Medicaid |
$2,156.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,053.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,783.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,486.41
|
| Rate for Payer: Priority Health Narrow Network |
$5,486.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,710.26
|
| Rate for Payer: UHC Exchange |
$3,710.26
|
| Rate for Payer: UHCCP Medicaid |
$2,053.96
|
|
|
PR CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM
|
Professional
|
Both
|
$8,727.00
|
|
|
Service Code
|
HCPCS 61520
|
| Min. Negotiated Rate |
$1,140.60 |
| Max. Negotiated Rate |
$7,615.22 |
| Rate for Payer: Aetna Commercial |
$4,834.96
|
| Rate for Payer: Aetna Medicare |
$4,363.50
|
| Rate for Payer: BCBS Complete |
$2,531.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.60
|
| Rate for Payer: BCN Commercial |
$7,615.22
|
| Rate for Payer: Cash Price |
$6,981.60
|
| Rate for Payer: Cash Price |
$6,981.60
|
| Rate for Payer: Meridian Medicaid |
$2,531.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,410.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,672.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,398.04
|
| Rate for Payer: Priority Health Narrow Network |
$6,398.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,402.84
|
| Rate for Payer: UHC Exchange |
$4,402.84
|
| Rate for Payer: UHCCP Medicaid |
$2,410.52
|
|
|
PR CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF
|
Professional
|
Both
|
$2,767.00
|
|
|
Service Code
|
HCPCS 36825
|
| Min. Negotiated Rate |
$496.50 |
| Max. Negotiated Rate |
$1,798.55 |
| Rate for Payer: Aetna Commercial |
$1,067.63
|
| Rate for Payer: Aetna Medicare |
$1,383.50
|
| Rate for Payer: BCBS Complete |
$521.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.86
|
| Rate for Payer: BCN Commercial |
$1,135.69
|
| Rate for Payer: Cash Price |
$2,213.60
|
| Rate for Payer: Cash Price |
$2,213.60
|
| Rate for Payer: Meridian Medicaid |
$521.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,798.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,240.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,240.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,051.71
|
| Rate for Payer: UHC Exchange |
$1,051.71
|
| Rate for Payer: UHCCP Medicaid |
$496.50
|
|
|
PR CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF
|
Professional
|
Both
|
$1,380.00
|
|
|
Service Code
|
HCPCS 36830
|
| Min. Negotiated Rate |
$418.12 |
| Max. Negotiated Rate |
$1,041.31 |
| Rate for Payer: Aetna Commercial |
$894.72
|
| Rate for Payer: Aetna Medicare |
$690.00
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS Trust/PPO |
$967.85
|
| Rate for Payer: BCN Commercial |
$953.41
|
| Rate for Payer: Cash Price |
$1,104.00
|
| Rate for Payer: Cash Price |
$1,104.00
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,041.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,041.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$865.31
|
| Rate for Payer: UHC Exchange |
$865.31
|
| Rate for Payer: UHCCP Medicaid |
$418.12
|
|
|
PR CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 35686
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$1,316.52 |
| Rate for Payer: Aetna Commercial |
$216.51
|
| Rate for Payer: Aetna Medicare |
$171.00
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.52
|
| Rate for Payer: BCN Commercial |
$228.22
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.90
|
| Rate for Payer: Priority Health Narrow Network |
$248.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$226.19
|
| Rate for Payer: UHC Exchange |
$226.19
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
