|
PR CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE
|
Professional
|
Both
|
$5,612.00
|
|
|
Service Code
|
HCPCS 62121
|
| Min. Negotiated Rate |
$1,495.12 |
| Max. Negotiated Rate |
$3,647.80 |
| Rate for Payer: Aetna Commercial |
$2,003.46
|
| Rate for Payer: Aetna Medicare |
$1,495.12
|
| Rate for Payer: BCBS Complete |
$2,244.80
|
| Rate for Payer: BCBS MAPPO |
$1,495.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,495.12
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cofinity Commercial |
$2,152.97
|
| Rate for Payer: Cofinity Commercial |
$2,003.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,495.12
|
| Rate for Payer: Healthscope Commercial |
$1,794.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,794.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,569.88
|
| Rate for Payer: Nomi Health Commercial |
$1,794.14
|
| Rate for Payer: PACE SWMI |
$1,495.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,495.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,647.80
|
| Rate for Payer: Priority Health Medicare |
$1,495.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,495.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,495.12
|
| Rate for Payer: UHCCP DNSP |
$1,495.12
|
|
|
PR CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY
|
Professional
|
Both
|
$7,067.00
|
|
|
Service Code
|
HCPCS 61537
|
| Min. Negotiated Rate |
$2,439.18 |
| Max. Negotiated Rate |
$4,593.55 |
| Rate for Payer: Aetna Commercial |
$3,268.50
|
| Rate for Payer: Aetna Medicare |
$2,439.18
|
| Rate for Payer: BCBS Complete |
$2,826.80
|
| Rate for Payer: BCBS MAPPO |
$2,439.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,439.18
|
| Rate for Payer: Cash Price |
$5,653.60
|
| Rate for Payer: Cash Price |
$5,653.60
|
| Rate for Payer: Cofinity Commercial |
$3,512.42
|
| Rate for Payer: Cofinity Commercial |
$3,268.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,439.18
|
| Rate for Payer: Healthscope Commercial |
$2,927.02
|
| Rate for Payer: Healthscope Whirlpool |
$2,927.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,561.14
|
| Rate for Payer: Nomi Health Commercial |
$2,927.02
|
| Rate for Payer: PACE SWMI |
$2,439.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,439.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,593.55
|
| Rate for Payer: Priority Health Medicare |
$2,439.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,439.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,439.18
|
| Rate for Payer: UHCCP DNSP |
$2,439.18
|
|
|
PR CRICOPHARYNGEAL MYOTOMY
|
Professional
|
Both
|
$2,284.00
|
|
|
Service Code
|
HCPCS 43030
|
| Min. Negotiated Rate |
$502.34 |
| Max. Negotiated Rate |
$1,484.60 |
| Rate for Payer: Aetna Commercial |
$673.14
|
| Rate for Payer: Aetna Medicare |
$502.34
|
| Rate for Payer: BCBS Complete |
$913.60
|
| Rate for Payer: BCBS MAPPO |
$502.34
|
| Rate for Payer: BCN Medicare Advantage |
$502.34
|
| Rate for Payer: Cash Price |
$1,827.20
|
| Rate for Payer: Cash Price |
$1,827.20
|
| Rate for Payer: Cofinity Commercial |
$723.37
|
| Rate for Payer: Cofinity Commercial |
$673.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.34
|
| Rate for Payer: Healthscope Commercial |
$602.81
|
| Rate for Payer: Healthscope Whirlpool |
$602.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.46
|
| Rate for Payer: Nomi Health Commercial |
$602.81
|
| Rate for Payer: PACE SWMI |
$502.34
|
| Rate for Payer: PHP Medicare Advantage |
$502.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,484.60
|
| Rate for Payer: Priority Health Medicare |
$502.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.34
|
| Rate for Payer: UHC Medicare Advantage |
$502.34
|
| Rate for Payer: UHCCP DNSP |
$502.34
|
|
|
PR CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 99292
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$146.82 |
| Rate for Payer: Aetna Commercial |
$136.63
|
| Rate for Payer: Aetna Medicare |
$101.96
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS MAPPO |
$101.96
|
| Rate for Payer: BCN Medicare Advantage |
$101.96
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$146.82
|
| Rate for Payer: Cofinity Commercial |
$136.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.96
|
| Rate for Payer: Healthscope Commercial |
$112.16
|
| Rate for Payer: Healthscope Whirlpool |
$112.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.06
|
| Rate for Payer: Nomi Health Commercial |
$122.35
|
| Rate for Payer: PACE SWMI |
$101.96
|
| Rate for Payer: PHP Medicare Advantage |
$101.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health Medicare |
$101.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.96
|
| Rate for Payer: UHC Medicare Advantage |
$101.96
|
| Rate for Payer: UHCCP DNSP |
$101.96
|
|
|
PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN
|
Professional
|
Both
|
$476.00
|
|
|
Service Code
|
HCPCS 99291
|
| Min. Negotiated Rate |
$190.40 |
| Max. Negotiated Rate |
$309.40 |
| Rate for Payer: Aetna Commercial |
$273.49
|
| Rate for Payer: Aetna Medicare |
$204.10
|
| Rate for Payer: BCBS Complete |
$190.40
|
| Rate for Payer: BCBS MAPPO |
$204.10
|
| Rate for Payer: BCN Medicare Advantage |
$204.10
|
| Rate for Payer: Cash Price |
$380.80
|
| Rate for Payer: Cash Price |
$380.80
|
| Rate for Payer: Cofinity Commercial |
$293.90
|
| Rate for Payer: Cofinity Commercial |
$273.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.10
|
| Rate for Payer: Healthscope Commercial |
$224.51
|
| Rate for Payer: Healthscope Whirlpool |
$224.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.31
|
| Rate for Payer: Nomi Health Commercial |
$244.92
|
| Rate for Payer: PACE SWMI |
$204.10
|
| Rate for Payer: PHP Medicare Advantage |
$204.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.40
|
| Rate for Payer: Priority Health Medicare |
$204.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.10
|
| Rate for Payer: UHC Medicare Advantage |
$204.10
|
| Rate for Payer: UHCCP DNSP |
$204.10
|
|
|
PR CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN
|
Professional
|
Both
|
$582.00
|
|
|
Service Code
|
HCPCS 99466
|
| Min. Negotiated Rate |
$218.15 |
| Max. Negotiated Rate |
$378.30 |
| Rate for Payer: Aetna Commercial |
$292.32
|
| Rate for Payer: Aetna Medicare |
$218.15
|
| Rate for Payer: BCBS Complete |
$232.80
|
| Rate for Payer: BCBS MAPPO |
$218.15
|
| Rate for Payer: BCN Medicare Advantage |
$218.15
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cofinity Commercial |
$314.14
|
| Rate for Payer: Cofinity Commercial |
$292.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.15
|
| Rate for Payer: Healthscope Commercial |
$239.97
|
| Rate for Payer: Healthscope Whirlpool |
$239.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.06
|
| Rate for Payer: Nomi Health Commercial |
$261.78
|
| Rate for Payer: PACE SWMI |
$218.15
|
| Rate for Payer: PHP Medicare Advantage |
$218.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.30
|
| Rate for Payer: Priority Health Medicare |
$218.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.15
|
| Rate for Payer: UHC Medicare Advantage |
$218.15
|
| Rate for Payer: UHCCP DNSP |
$218.15
|
|
|
PR CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 99467
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$157.95 |
| Rate for Payer: Aetna Commercial |
$146.52
|
| Rate for Payer: Aetna Medicare |
$109.34
|
| Rate for Payer: BCBS Complete |
$97.20
|
| Rate for Payer: BCBS MAPPO |
$109.34
|
| Rate for Payer: BCN Medicare Advantage |
$109.34
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$157.45
|
| Rate for Payer: Cofinity Commercial |
$146.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.34
|
| Rate for Payer: Healthscope Commercial |
$120.27
|
| Rate for Payer: Healthscope Whirlpool |
$120.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.81
|
| Rate for Payer: Nomi Health Commercial |
$131.21
|
| Rate for Payer: PACE SWMI |
$109.34
|
| Rate for Payer: PHP Medicare Advantage |
$109.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health Medicare |
$109.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.34
|
| Rate for Payer: UHC Medicare Advantage |
$109.34
|
| Rate for Payer: UHCCP DNSP |
$109.34
|
|
|
PR CRNEC/CRNOT DCMPRV W/WO DURAPLASTY W/O LOBECTOMY
|
Professional
|
Both
|
$5,018.00
|
|
|
Service Code
|
HCPCS 61322
|
| Min. Negotiated Rate |
$2,007.20 |
| Max. Negotiated Rate |
$3,399.48 |
| Rate for Payer: Aetna Commercial |
$3,163.41
|
| Rate for Payer: Aetna Medicare |
$2,360.75
|
| Rate for Payer: BCBS Complete |
$2,007.20
|
| Rate for Payer: BCBS MAPPO |
$2,360.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,360.75
|
| Rate for Payer: Cash Price |
$4,014.40
|
| Rate for Payer: Cash Price |
$4,014.40
|
| Rate for Payer: Cofinity Commercial |
$3,399.48
|
| Rate for Payer: Cofinity Commercial |
$3,163.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,360.75
|
| Rate for Payer: Healthscope Commercial |
$2,832.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,832.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,478.79
|
| Rate for Payer: Nomi Health Commercial |
$2,832.90
|
| Rate for Payer: PACE SWMI |
$2,360.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,360.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,261.70
|
| Rate for Payer: Priority Health Medicare |
$2,360.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,360.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,360.75
|
| Rate for Payer: UHCCP DNSP |
$2,360.75
|
|
|
PR CRNEC/CRNOT DRG INTRACRANIAL ABSC INFRATENTORIAL
|
Professional
|
Both
|
$4,357.00
|
|
|
Service Code
|
HCPCS 61321
|
| Min. Negotiated Rate |
$1,742.80 |
| Max. Negotiated Rate |
$3,035.89 |
| Rate for Payer: Aetna Commercial |
$2,825.07
|
| Rate for Payer: Aetna Medicare |
$2,108.26
|
| Rate for Payer: BCBS Complete |
$1,742.80
|
| Rate for Payer: BCBS MAPPO |
$2,108.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,108.26
|
| Rate for Payer: Cash Price |
$3,485.60
|
| Rate for Payer: Cash Price |
$3,485.60
|
| Rate for Payer: Cofinity Commercial |
$3,035.89
|
| Rate for Payer: Cofinity Commercial |
$2,825.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,108.26
|
| Rate for Payer: Healthscope Commercial |
$2,529.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,529.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,213.67
|
| Rate for Payer: Nomi Health Commercial |
$2,529.91
|
| Rate for Payer: PACE SWMI |
$2,108.26
|
| Rate for Payer: PHP Medicare Advantage |
$2,108.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,832.05
|
| Rate for Payer: Priority Health Medicare |
$2,108.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,108.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,108.26
|
| Rate for Payer: UHCCP DNSP |
$2,108.26
|
|
|
PR CRNEC/CRNOT DRG INTRACRANIAL ABSC SUPRATENTORIAL
|
Professional
|
Both
|
$6,842.00
|
|
|
Service Code
|
HCPCS 61320
|
| Min. Negotiated Rate |
$1,882.26 |
| Max. Negotiated Rate |
$4,447.30 |
| Rate for Payer: Aetna Commercial |
$2,522.23
|
| Rate for Payer: Aetna Medicare |
$1,882.26
|
| Rate for Payer: BCBS Complete |
$2,736.80
|
| Rate for Payer: BCBS MAPPO |
$1,882.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,882.26
|
| Rate for Payer: Cash Price |
$5,473.60
|
| Rate for Payer: Cash Price |
$5,473.60
|
| Rate for Payer: Cofinity Commercial |
$2,710.45
|
| Rate for Payer: Cofinity Commercial |
$2,522.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,882.26
|
| Rate for Payer: Healthscope Commercial |
$2,258.71
|
| Rate for Payer: Healthscope Whirlpool |
$2,258.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,976.37
|
| Rate for Payer: Nomi Health Commercial |
$2,258.71
|
| Rate for Payer: PACE SWMI |
$1,882.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,882.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,447.30
|
| Rate for Payer: Priority Health Medicare |
$1,882.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,882.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,882.26
|
| Rate for Payer: UHCCP DNSP |
$1,882.26
|
|
|
PR CRNEC/CRNOT HMTMA INFRATENTORIAL INTRACEREBELLAR
|
Professional
|
Both
|
$7,040.00
|
|
|
Service Code
|
HCPCS 61315
|
| Min. Negotiated Rate |
$2,050.68 |
| Max. Negotiated Rate |
$4,576.00 |
| Rate for Payer: Aetna Commercial |
$2,747.91
|
| Rate for Payer: Aetna Medicare |
$2,050.68
|
| Rate for Payer: BCBS Complete |
$2,816.00
|
| Rate for Payer: BCBS MAPPO |
$2,050.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,050.68
|
| Rate for Payer: Cash Price |
$5,632.00
|
| Rate for Payer: Cash Price |
$5,632.00
|
| Rate for Payer: Cofinity Commercial |
$2,952.98
|
| Rate for Payer: Cofinity Commercial |
$2,747.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,050.68
|
| Rate for Payer: Healthscope Commercial |
$2,460.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,460.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,153.21
|
| Rate for Payer: Nomi Health Commercial |
$2,460.82
|
| Rate for Payer: PACE SWMI |
$2,050.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,050.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,576.00
|
| Rate for Payer: Priority Health Medicare |
$2,050.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,050.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,050.68
|
| Rate for Payer: UHCCP DNSP |
$2,050.68
|
|
|
PR CRNEC/CRNOT HMTMA INFRATENTORIAL XDRL/SDRL
|
Professional
|
Both
|
$5,612.00
|
|
|
Service Code
|
HCPCS 61314
|
| Min. Negotiated Rate |
$1,810.79 |
| Max. Negotiated Rate |
$3,647.80 |
| Rate for Payer: Aetna Commercial |
$2,426.46
|
| Rate for Payer: Aetna Medicare |
$1,810.79
|
| Rate for Payer: BCBS Complete |
$2,244.80
|
| Rate for Payer: BCBS MAPPO |
$1,810.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.79
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cofinity Commercial |
$2,607.54
|
| Rate for Payer: Cofinity Commercial |
$2,426.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.79
|
| Rate for Payer: Healthscope Commercial |
$2,172.95
|
| Rate for Payer: Healthscope Whirlpool |
$2,172.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,901.33
|
| Rate for Payer: Nomi Health Commercial |
$2,172.95
|
| Rate for Payer: PACE SWMI |
$1,810.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,647.80
|
| Rate for Payer: Priority Health Medicare |
$1,810.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,810.79
|
| Rate for Payer: UHCCP DNSP |
$1,810.79
|
|
|
PR CRNEC/CRNOT HMTMA SUPRATENTORIAL INTRACEREBRAL
|
Professional
|
Both
|
$4,171.00
|
|
|
Service Code
|
HCPCS 61313
|
| Min. Negotiated Rate |
$1,668.40 |
| Max. Negotiated Rate |
$2,835.35 |
| Rate for Payer: Aetna Commercial |
$2,638.45
|
| Rate for Payer: Aetna Medicare |
$1,968.99
|
| Rate for Payer: BCBS Complete |
$1,668.40
|
| Rate for Payer: BCBS MAPPO |
$1,968.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,968.99
|
| Rate for Payer: Cash Price |
$3,336.80
|
| Rate for Payer: Cash Price |
$3,336.80
|
| Rate for Payer: Cofinity Commercial |
$2,835.35
|
| Rate for Payer: Cofinity Commercial |
$2,638.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,968.99
|
| Rate for Payer: Healthscope Commercial |
$2,362.79
|
| Rate for Payer: Healthscope Whirlpool |
$2,362.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,067.44
|
| Rate for Payer: Nomi Health Commercial |
$2,362.79
|
| Rate for Payer: PACE SWMI |
$1,968.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,968.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,711.15
|
| Rate for Payer: Priority Health Medicare |
$1,968.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,968.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,968.99
|
| Rate for Payer: UHCCP DNSP |
$1,968.99
|
|
|
PR CRNEC/CRNOT HMTMA SUPRATENTORIAL XDRL/SUBDURAL
|
Professional
|
Both
|
$7,129.00
|
|
|
Service Code
|
HCPCS 61312
|
| Min. Negotiated Rate |
$2,053.45 |
| Max. Negotiated Rate |
$4,633.85 |
| Rate for Payer: Aetna Commercial |
$2,751.62
|
| Rate for Payer: Aetna Medicare |
$2,053.45
|
| Rate for Payer: BCBS Complete |
$2,851.60
|
| Rate for Payer: BCBS MAPPO |
$2,053.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,053.45
|
| Rate for Payer: Cash Price |
$5,703.20
|
| Rate for Payer: Cash Price |
$5,703.20
|
| Rate for Payer: Cofinity Commercial |
$2,956.97
|
| Rate for Payer: Cofinity Commercial |
$2,751.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,053.45
|
| Rate for Payer: Healthscope Commercial |
$2,464.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,464.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,156.12
|
| Rate for Payer: Nomi Health Commercial |
$2,464.14
|
| Rate for Payer: PACE SWMI |
$2,053.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,053.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,633.85
|
| Rate for Payer: Priority Health Medicare |
$2,053.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,053.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,053.45
|
| Rate for Payer: UHCCP DNSP |
$2,053.45
|
|
|
PR CRNEC/CRNOT W/WO DURAPLASTY WITH LOBECTOMY
|
Professional
|
Both
|
$8,807.00
|
|
|
Service Code
|
HCPCS 61323
|
| Min. Negotiated Rate |
$2,353.13 |
| Max. Negotiated Rate |
$5,724.55 |
| Rate for Payer: Aetna Commercial |
$3,153.19
|
| Rate for Payer: Aetna Medicare |
$2,353.13
|
| Rate for Payer: BCBS Complete |
$3,522.80
|
| Rate for Payer: BCBS MAPPO |
$2,353.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,353.13
|
| Rate for Payer: Cash Price |
$7,045.60
|
| Rate for Payer: Cash Price |
$7,045.60
|
| Rate for Payer: Cofinity Commercial |
$3,388.51
|
| Rate for Payer: Cofinity Commercial |
$3,153.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,353.13
|
| Rate for Payer: Healthscope Commercial |
$2,823.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,823.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,470.79
|
| Rate for Payer: Nomi Health Commercial |
$2,823.76
|
| Rate for Payer: PACE SWMI |
$2,353.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,353.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,724.55
|
| Rate for Payer: Priority Health Medicare |
$2,353.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,353.13
|
| Rate for Payer: UHC Medicare Advantage |
$2,353.13
|
| Rate for Payer: UHCCP DNSP |
$2,353.13
|
|
|
PR CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA
|
Professional
|
Both
|
$8,419.00
|
|
|
Service Code
|
HCPCS 61518
|
| Min. Negotiated Rate |
$2,744.38 |
| Max. Negotiated Rate |
$5,472.35 |
| Rate for Payer: Aetna Commercial |
$3,677.47
|
| Rate for Payer: Aetna Medicare |
$2,744.38
|
| Rate for Payer: BCBS Complete |
$3,367.60
|
| Rate for Payer: BCBS MAPPO |
$2,744.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,744.38
|
| Rate for Payer: Cash Price |
$6,735.20
|
| Rate for Payer: Cash Price |
$6,735.20
|
| Rate for Payer: Cofinity Commercial |
$3,951.91
|
| Rate for Payer: Cofinity Commercial |
$3,677.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,744.38
|
| Rate for Payer: Healthscope Commercial |
$3,293.26
|
| Rate for Payer: Healthscope Whirlpool |
$3,293.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,881.60
|
| Rate for Payer: Nomi Health Commercial |
$3,293.26
|
| Rate for Payer: PACE SWMI |
$2,744.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,744.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,472.35
|
| Rate for Payer: Priority Health Medicare |
$2,744.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,744.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,744.38
|
| Rate for Payer: UHCCP DNSP |
$2,744.38
|
|
|
PR CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA
|
Professional
|
Both
|
$7,858.00
|
|
|
Service Code
|
HCPCS 61530
|
| Min. Negotiated Rate |
$3,046.30 |
| Max. Negotiated Rate |
$5,107.70 |
| Rate for Payer: Aetna Commercial |
$4,082.04
|
| Rate for Payer: Aetna Medicare |
$3,046.30
|
| Rate for Payer: BCBS Complete |
$3,143.20
|
| Rate for Payer: BCBS MAPPO |
$3,046.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,046.30
|
| Rate for Payer: Cash Price |
$6,286.40
|
| Rate for Payer: Cash Price |
$6,286.40
|
| Rate for Payer: Cofinity Commercial |
$4,386.67
|
| Rate for Payer: Cofinity Commercial |
$4,082.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,046.30
|
| Rate for Payer: Healthscope Commercial |
$3,655.56
|
| Rate for Payer: Healthscope Whirlpool |
$3,655.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,198.61
|
| Rate for Payer: Nomi Health Commercial |
$3,655.56
|
| Rate for Payer: PACE SWMI |
$3,046.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,046.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,107.70
|
| Rate for Payer: Priority Health Medicare |
$3,046.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,046.30
|
| Rate for Payer: UHC Medicare Advantage |
$3,046.30
|
| Rate for Payer: UHCCP DNSP |
$3,046.30
|
|
|
PR CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA
|
Professional
|
Both
|
$8,718.00
|
|
|
Service Code
|
HCPCS 61519
|
| Min. Negotiated Rate |
$2,921.61 |
| Max. Negotiated Rate |
$5,666.70 |
| Rate for Payer: Aetna Commercial |
$3,914.96
|
| Rate for Payer: Aetna Medicare |
$2,921.61
|
| Rate for Payer: BCBS Complete |
$3,487.20
|
| Rate for Payer: BCBS MAPPO |
$2,921.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,921.61
|
| Rate for Payer: Cash Price |
$6,974.40
|
| Rate for Payer: Cash Price |
$6,974.40
|
| Rate for Payer: Cofinity Commercial |
$4,207.12
|
| Rate for Payer: Cofinity Commercial |
$3,914.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,921.61
|
| Rate for Payer: Healthscope Commercial |
$3,505.93
|
| Rate for Payer: Healthscope Whirlpool |
$3,505.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,067.69
|
| Rate for Payer: Nomi Health Commercial |
$3,505.93
|
| Rate for Payer: PACE SWMI |
$2,921.61
|
| Rate for Payer: PHP Medicare Advantage |
$2,921.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,666.70
|
| Rate for Payer: Priority Health Medicare |
$2,921.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,921.61
|
| Rate for Payer: UHC Medicare Advantage |
$2,921.61
|
| Rate for Payer: UHCCP DNSP |
$2,921.61
|
|
|
PR CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS
|
Professional
|
Both
|
$6,227.00
|
|
|
Service Code
|
HCPCS 61522
|
| Min. Negotiated Rate |
$2,171.51 |
| Max. Negotiated Rate |
$4,047.55 |
| Rate for Payer: Aetna Commercial |
$2,909.82
|
| Rate for Payer: Aetna Medicare |
$2,171.51
|
| Rate for Payer: BCBS Complete |
$2,490.80
|
| Rate for Payer: BCBS MAPPO |
$2,171.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,171.51
|
| Rate for Payer: Cash Price |
$4,981.60
|
| Rate for Payer: Cash Price |
$4,981.60
|
| Rate for Payer: Cofinity Commercial |
$3,126.97
|
| Rate for Payer: Cofinity Commercial |
$2,909.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,171.51
|
| Rate for Payer: Healthscope Commercial |
$2,605.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,605.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,280.09
|
| Rate for Payer: Nomi Health Commercial |
$2,605.81
|
| Rate for Payer: PACE SWMI |
$2,171.51
|
| Rate for Payer: PHP Medicare Advantage |
$2,171.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,047.55
|
| Rate for Payer: Priority Health Medicare |
$2,171.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,171.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,171.51
|
| Rate for Payer: UHCCP DNSP |
$2,171.51
|
|
|
PR CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST
|
Professional
|
Both
|
$7,109.00
|
|
|
Service Code
|
HCPCS 61524
|
| Min. Negotiated Rate |
$2,068.47 |
| Max. Negotiated Rate |
$4,620.85 |
| Rate for Payer: Aetna Commercial |
$2,771.75
|
| Rate for Payer: Aetna Medicare |
$2,068.47
|
| Rate for Payer: BCBS Complete |
$2,843.60
|
| Rate for Payer: BCBS MAPPO |
$2,068.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,068.47
|
| Rate for Payer: Cash Price |
$5,687.20
|
| Rate for Payer: Cash Price |
$5,687.20
|
| Rate for Payer: Cofinity Commercial |
$2,978.60
|
| Rate for Payer: Cofinity Commercial |
$2,771.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,068.47
|
| Rate for Payer: Healthscope Commercial |
$2,482.16
|
| Rate for Payer: Healthscope Whirlpool |
$2,482.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,171.89
|
| Rate for Payer: Nomi Health Commercial |
$2,482.16
|
| Rate for Payer: PACE SWMI |
$2,068.47
|
| Rate for Payer: PHP Medicare Advantage |
$2,068.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,620.85
|
| Rate for Payer: Priority Health Medicare |
$2,068.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,068.47
|
| Rate for Payer: UHC Medicare Advantage |
$2,068.47
|
| Rate for Payer: UHCCP DNSP |
$2,068.47
|
|
|
PR CRNEC SOPL EXPLORATION/DECOMPRESSION CRANIAL NRV
|
Professional
|
Both
|
$7,844.00
|
|
|
Service Code
|
HCPCS 61458
|
| Min. Negotiated Rate |
$2,001.73 |
| Max. Negotiated Rate |
$5,098.60 |
| Rate for Payer: Aetna Commercial |
$2,682.32
|
| Rate for Payer: Aetna Medicare |
$2,001.73
|
| Rate for Payer: BCBS Complete |
$3,137.60
|
| Rate for Payer: BCBS MAPPO |
$2,001.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,001.73
|
| Rate for Payer: Cash Price |
$6,275.20
|
| Rate for Payer: Cash Price |
$6,275.20
|
| Rate for Payer: Cofinity Commercial |
$2,882.49
|
| Rate for Payer: Cofinity Commercial |
$2,682.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,001.73
|
| Rate for Payer: Healthscope Commercial |
$2,402.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,402.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,101.82
|
| Rate for Payer: Nomi Health Commercial |
$2,402.08
|
| Rate for Payer: PACE SWMI |
$2,001.73
|
| Rate for Payer: PHP Medicare Advantage |
$2,001.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,098.60
|
| Rate for Payer: Priority Health Medicare |
$2,001.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,001.73
|
| Rate for Payer: UHC Medicare Advantage |
$2,001.73
|
| Rate for Payer: UHCCP DNSP |
$2,001.73
|
|
|
PR CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION
|
Professional
|
Both
|
$6,713.00
|
|
|
Service Code
|
HCPCS 61450
|
| Min. Negotiated Rate |
$1,906.37 |
| Max. Negotiated Rate |
$4,363.45 |
| Rate for Payer: Aetna Commercial |
$2,554.54
|
| Rate for Payer: Aetna Medicare |
$1,906.37
|
| Rate for Payer: BCBS Complete |
$2,685.20
|
| Rate for Payer: BCBS MAPPO |
$1,906.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,906.37
|
| Rate for Payer: Cash Price |
$5,370.40
|
| Rate for Payer: Cash Price |
$5,370.40
|
| Rate for Payer: Cofinity Commercial |
$2,745.17
|
| Rate for Payer: Cofinity Commercial |
$2,554.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,906.37
|
| Rate for Payer: Healthscope Commercial |
$2,287.64
|
| Rate for Payer: Healthscope Whirlpool |
$2,287.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,001.69
|
| Rate for Payer: Nomi Health Commercial |
$2,287.64
|
| Rate for Payer: PACE SWMI |
$1,906.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,906.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,363.45
|
| Rate for Payer: Priority Health Medicare |
$1,906.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,906.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,906.37
|
| Rate for Payer: UHCCP DNSP |
$1,906.37
|
|
|
PR CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD
|
Professional
|
Both
|
$4,610.00
|
|
|
Service Code
|
HCPCS 61343
|
| Min. Negotiated Rate |
$1,844.00 |
| Max. Negotiated Rate |
$3,127.68 |
| Rate for Payer: Aetna Commercial |
$2,910.48
|
| Rate for Payer: Aetna Medicare |
$2,172.00
|
| Rate for Payer: BCBS Complete |
$1,844.00
|
| Rate for Payer: BCBS MAPPO |
$2,172.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,172.00
|
| Rate for Payer: Cash Price |
$3,688.00
|
| Rate for Payer: Cash Price |
$3,688.00
|
| Rate for Payer: Cofinity Commercial |
$3,127.68
|
| Rate for Payer: Cofinity Commercial |
$2,910.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,172.00
|
| Rate for Payer: Healthscope Commercial |
$2,606.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,606.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,280.60
|
| Rate for Payer: Nomi Health Commercial |
$2,606.40
|
| Rate for Payer: PACE SWMI |
$2,172.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,172.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,996.50
|
| Rate for Payer: Priority Health Medicare |
$2,172.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,172.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,172.00
|
| Rate for Payer: UHCCP DNSP |
$2,172.00
|
|
|
PR CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM
|
Professional
|
Both
|
$8,071.00
|
|
|
Service Code
|
HCPCS 61526
|
| Min. Negotiated Rate |
$3,228.40 |
| Max. Negotiated Rate |
$5,246.15 |
| Rate for Payer: Aetna Commercial |
$4,366.56
|
| Rate for Payer: Aetna Medicare |
$3,258.63
|
| Rate for Payer: BCBS Complete |
$3,228.40
|
| Rate for Payer: BCBS MAPPO |
$3,258.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,258.63
|
| Rate for Payer: Cash Price |
$6,456.80
|
| Rate for Payer: Cash Price |
$6,456.80
|
| Rate for Payer: Cofinity Commercial |
$4,692.43
|
| Rate for Payer: Cofinity Commercial |
$4,366.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,258.63
|
| Rate for Payer: Healthscope Commercial |
$3,910.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,910.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,421.56
|
| Rate for Payer: Nomi Health Commercial |
$3,910.36
|
| Rate for Payer: PACE SWMI |
$3,258.63
|
| Rate for Payer: PHP Medicare Advantage |
$3,258.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,246.15
|
| Rate for Payer: Priority Health Medicare |
$3,258.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,258.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,258.63
|
| Rate for Payer: UHCCP DNSP |
$3,258.63
|
|
|
PR CRNEC TREPH BONE FLAP CRNOT EXC BRAIN ABSC STTL
|
Professional
|
Both
|
$4,023.00
|
|
|
Service Code
|
HCPCS 61514
|
| Min. Negotiated Rate |
$1,609.20 |
| Max. Negotiated Rate |
$2,739.99 |
| Rate for Payer: Aetna Commercial |
$2,549.71
|
| Rate for Payer: Aetna Medicare |
$1,902.77
|
| Rate for Payer: BCBS Complete |
$1,609.20
|
| Rate for Payer: BCBS MAPPO |
$1,902.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,902.77
|
| Rate for Payer: Cash Price |
$3,218.40
|
| Rate for Payer: Cash Price |
$3,218.40
|
| Rate for Payer: Cofinity Commercial |
$2,739.99
|
| Rate for Payer: Cofinity Commercial |
$2,549.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,902.77
|
| Rate for Payer: Healthscope Commercial |
$2,283.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,283.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,997.91
|
| Rate for Payer: Nomi Health Commercial |
$2,283.32
|
| Rate for Payer: PACE SWMI |
$1,902.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,902.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,614.95
|
| Rate for Payer: Priority Health Medicare |
$1,902.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,902.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,902.77
|
| Rate for Payer: UHCCP DNSP |
$1,902.77
|
|
