|
PR CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX
|
Professional
|
Both
|
$2,550.00
|
|
|
Service Code
|
HCPCS 33025
|
| Min. Negotiated Rate |
$488.41 |
| Max. Negotiated Rate |
$1,657.50 |
| Rate for Payer: Aetna Commercial |
$1,030.99
|
| Rate for Payer: Aetna Medicare |
$1,275.00
|
| Rate for Payer: BCBS Complete |
$512.83
|
| Rate for Payer: BCBS Trust/PPO |
$724.83
|
| Rate for Payer: BCN Commercial |
$1,108.32
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Meridian Medicaid |
$512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,213.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,213.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.53
|
| Rate for Payer: UHC Exchange |
$1,034.53
|
| Rate for Payer: UHCCP Medicaid |
$488.41
|
|
|
PR CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM
|
Professional
|
Both
|
$4,365.00
|
|
|
Service Code
|
HCPCS 63740
|
| Min. Negotiated Rate |
$254.64 |
| Max. Negotiated Rate |
$2,837.25 |
| Rate for Payer: Aetna Commercial |
$1,267.15
|
| Rate for Payer: Aetna Medicare |
$2,182.50
|
| Rate for Payer: BCBS Complete |
$681.02
|
| Rate for Payer: BCBS Trust/PPO |
$254.64
|
| Rate for Payer: BCN Commercial |
$1,611.53
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Meridian Medicaid |
$681.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$648.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,837.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,720.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,720.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,082.14
|
| Rate for Payer: UHC Exchange |
$1,082.14
|
| Rate for Payer: UHCCP Medicaid |
$648.59
|
|
|
PR CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 63741
|
| Min. Negotiated Rate |
$248.83 |
| Max. Negotiated Rate |
$1,561.95 |
| Rate for Payer: Aetna Commercial |
$868.81
|
| Rate for Payer: Aetna Medicare |
$1,201.50
|
| Rate for Payer: BCBS Complete |
$462.28
|
| Rate for Payer: BCBS Trust/PPO |
$248.83
|
| Rate for Payer: BCN Commercial |
$1,017.92
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Meridian Medicaid |
$462.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,561.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,187.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,187.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.52
|
| Rate for Payer: UHC Exchange |
$693.52
|
| Rate for Payer: UHCCP Medicaid |
$440.27
|
|
|
PR CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH
|
Professional
|
Both
|
$5,855.00
|
|
|
Service Code
|
HCPCS 62192
|
| Min. Negotiated Rate |
$478.64 |
| Max. Negotiated Rate |
$3,805.75 |
| Rate for Payer: Aetna Commercial |
$1,267.26
|
| Rate for Payer: Aetna Medicare |
$2,927.50
|
| Rate for Payer: BCBS Complete |
$682.80
|
| Rate for Payer: BCBS Trust/PPO |
$478.64
|
| Rate for Payer: BCN Commercial |
$2,002.62
|
| Rate for Payer: Cash Price |
$4,684.00
|
| Rate for Payer: Cash Price |
$4,684.00
|
| Rate for Payer: Meridian Medicaid |
$682.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,805.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,731.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,731.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,117.15
|
| Rate for Payer: UHC Exchange |
$1,117.15
|
| Rate for Payer: UHCCP Medicaid |
$650.29
|
|
|
PR CRTJ SHUNT VENTRICULO-ATR-JUG-AUR
|
Professional
|
Both
|
$5,065.00
|
|
|
Service Code
|
HCPCS 62220
|
| Min. Negotiated Rate |
$635.38 |
| Max. Negotiated Rate |
$3,292.25 |
| Rate for Payer: Aetna Commercial |
$1,269.68
|
| Rate for Payer: Aetna Medicare |
$2,532.50
|
| Rate for Payer: BCBS Complete |
$667.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.32
|
| Rate for Payer: BCN Commercial |
$1,984.31
|
| Rate for Payer: Cash Price |
$4,052.00
|
| Rate for Payer: Cash Price |
$4,052.00
|
| Rate for Payer: Meridian Medicaid |
$667.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$635.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,292.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,691.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,691.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,165.61
|
| Rate for Payer: UHC Exchange |
$1,165.61
|
| Rate for Payer: UHCCP Medicaid |
$635.38
|
|
|
PR CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS
|
Professional
|
Both
|
$5,051.00
|
|
|
Service Code
|
HCPCS 62223
|
| Min. Negotiated Rate |
$672.87 |
| Max. Negotiated Rate |
$3,283.15 |
| Rate for Payer: Aetna Commercial |
$1,340.52
|
| Rate for Payer: Aetna Medicare |
$2,525.50
|
| Rate for Payer: BCBS Complete |
$706.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.56
|
| Rate for Payer: BCN Commercial |
$2,125.99
|
| Rate for Payer: Cash Price |
$4,040.80
|
| Rate for Payer: Cash Price |
$4,040.80
|
| Rate for Payer: Meridian Medicaid |
$706.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$672.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,283.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,794.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,794.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,203.46
|
| Rate for Payer: UHC Exchange |
$1,203.46
|
| Rate for Payer: UHCCP Medicaid |
$672.87
|
|
|
PR CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA
|
Professional
|
Both
|
$7,247.00
|
|
|
Service Code
|
HCPCS 62100
|
| Min. Negotiated Rate |
$1,019.84 |
| Max. Negotiated Rate |
$4,710.55 |
| Rate for Payer: Aetna Commercial |
$2,017.87
|
| Rate for Payer: Aetna Medicare |
$3,623.50
|
| Rate for Payer: BCBS Complete |
$1,070.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.41
|
| Rate for Payer: BCN Commercial |
$3,210.01
|
| Rate for Payer: Cash Price |
$5,797.60
|
| Rate for Payer: Cash Price |
$5,797.60
|
| Rate for Payer: Meridian Medicaid |
$1,070.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,019.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,710.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,719.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,719.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,864.13
|
| Rate for Payer: UHC Exchange |
$1,864.13
|
| Rate for Payer: UHCCP Medicaid |
$1,019.84
|
|
|
PR CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI
|
Professional
|
Both
|
$2,068.00
|
|
|
Service Code
|
HCPCS 55873
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$8,449.24 |
| Rate for Payer: Aetna Commercial |
$980.44
|
| Rate for Payer: Aetna Medicare |
$1,034.00
|
| Rate for Payer: BCBS Complete |
$514.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,980.07
|
| Rate for Payer: BCN Commercial |
$8,449.24
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Meridian Medicaid |
$514.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,216.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,216.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,035.84
|
| Rate for Payer: UHC Exchange |
$1,035.84
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
|
|
PR CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 17340
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$145.43 |
| Rate for Payer: Aetna Commercial |
$52.87
|
| Rate for Payer: Aetna Medicare |
$51.50
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$76.72
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.37
|
| Rate for Payer: Priority Health Narrow Network |
$66.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.92
|
| Rate for Payer: UHC Exchange |
$49.92
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
|
|
PR CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC
|
Professional
|
Both
|
$4,560.00
|
|
|
Service Code
|
HCPCS 51595
|
| Min. Negotiated Rate |
$1,387.06 |
| Max. Negotiated Rate |
$3,447.52 |
| Rate for Payer: Aetna Commercial |
$2,809.09
|
| Rate for Payer: Aetna Medicare |
$2,280.00
|
| Rate for Payer: BCBS Complete |
$1,456.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,019.16
|
| Rate for Payer: BCN Commercial |
$3,131.45
|
| Rate for Payer: Cash Price |
$3,648.00
|
| Rate for Payer: Cash Price |
$3,648.00
|
| Rate for Payer: Meridian Medicaid |
$1,456.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,387.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,964.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,447.52
|
| Rate for Payer: Priority Health Narrow Network |
$3,447.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,656.09
|
| Rate for Payer: UHC Exchange |
$2,656.09
|
| Rate for Payer: UHCCP Medicaid |
$1,387.06
|
|
|
PR CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR
|
Professional
|
Both
|
$4,906.00
|
|
|
Service Code
|
HCPCS 51596
|
| Min. Negotiated Rate |
$1,498.46 |
| Max. Negotiated Rate |
$3,715.42 |
| Rate for Payer: Aetna Commercial |
$3,025.03
|
| Rate for Payer: Aetna Medicare |
$2,453.00
|
| Rate for Payer: BCBS Complete |
$1,573.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.80
|
| Rate for Payer: BCN Commercial |
$3,380.67
|
| Rate for Payer: Cash Price |
$3,924.80
|
| Rate for Payer: Cash Price |
$3,924.80
|
| Rate for Payer: Meridian Medicaid |
$1,573.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,498.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,188.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,715.42
|
| Rate for Payer: Priority Health Narrow Network |
$3,715.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,853.83
|
| Rate for Payer: UHC Exchange |
$2,853.83
|
| Rate for Payer: UHCCP Medicaid |
$1,498.46
|
|
|
PR CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST
|
Professional
|
Both
|
$4,911.00
|
|
|
Service Code
|
HCPCS 51590
|
| Min. Negotiated Rate |
$1,226.24 |
| Max. Negotiated Rate |
$3,192.15 |
| Rate for Payer: Aetna Commercial |
$2,483.67
|
| Rate for Payer: Aetna Medicare |
$2,455.50
|
| Rate for Payer: BCBS Complete |
$1,287.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,561.73
|
| Rate for Payer: BCN Commercial |
$2,767.38
|
| Rate for Payer: Cash Price |
$3,928.80
|
| Rate for Payer: Cash Price |
$3,928.80
|
| Rate for Payer: Meridian Medicaid |
$1,287.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,226.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,192.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,045.41
|
| Rate for Payer: Priority Health Narrow Network |
$3,045.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,340.46
|
| Rate for Payer: UHC Exchange |
$2,340.46
|
| Rate for Payer: UHCCP Medicaid |
$1,226.24
|
|
|
PR CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 51565
|
| Min. Negotiated Rate |
$820.90 |
| Max. Negotiated Rate |
$2,039.33 |
| Rate for Payer: Aetna Commercial |
$1,654.05
|
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: BCBS Complete |
$861.94
|
| Rate for Payer: BCN Commercial |
$1,851.60
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Meridian Medicaid |
$861.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,039.33
|
| Rate for Payer: Priority Health Narrow Network |
$2,039.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,551.72
|
| Rate for Payer: UHC Exchange |
$1,551.72
|
| Rate for Payer: UHCCP Medicaid |
$820.90
|
|
|
PR CSTOPLASTY/CSTOURTP PLSTC ANY
|
Professional
|
Both
|
$1,135.00
|
|
|
Service Code
|
HCPCS 51800
|
| Min. Negotiated Rate |
$567.50 |
| Max. Negotiated Rate |
$3,574.48 |
| Rate for Payer: Aetna Commercial |
$1,338.27
|
| Rate for Payer: Aetna Medicare |
$567.50
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,574.48
|
| Rate for Payer: BCN Commercial |
$1,493.39
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,645.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,645.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,258.28
|
| Rate for Payer: UHC Exchange |
$1,258.28
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
|
|
PR CSTOURTP W/UNI/BI URTRONEOCSTOST
|
Professional
|
Both
|
$2,417.00
|
|
|
Service Code
|
HCPCS 51820
|
| Min. Negotiated Rate |
$692.89 |
| Max. Negotiated Rate |
$4,989.27 |
| Rate for Payer: Aetna Commercial |
$1,392.31
|
| Rate for Payer: Aetna Medicare |
$1,208.50
|
| Rate for Payer: BCBS Complete |
$727.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,989.27
|
| Rate for Payer: BCN Commercial |
$1,561.33
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Meridian Medicaid |
$727.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,720.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,720.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,276.75
|
| Rate for Payer: UHC Exchange |
$1,276.75
|
| Rate for Payer: UHCCP Medicaid |
$692.89
|
|
|
PR CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$937.00
|
|
|
Service Code
|
HCPCS 42972
|
| Min. Negotiated Rate |
$252.53 |
| Max. Negotiated Rate |
$915.17 |
| Rate for Payer: Aetna Commercial |
$670.67
|
| Rate for Payer: Aetna Medicare |
$468.50
|
| Rate for Payer: BCBS Complete |
$343.53
|
| Rate for Payer: BCBS Trust/PPO |
$252.53
|
| Rate for Payer: BCN Commercial |
$745.24
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Meridian Medicaid |
$343.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$609.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$915.17
|
| Rate for Payer: Priority Health Narrow Network |
$915.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$626.54
|
| Rate for Payer: UHC Exchange |
$626.54
|
| Rate for Payer: UHCCP Medicaid |
$327.17
|
|
|
PR CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS
|
Professional
|
Both
|
$749.00
|
|
|
Service Code
|
HCPCS 42970
|
| Min. Negotiated Rate |
$265.82 |
| Max. Negotiated Rate |
$743.96 |
| Rate for Payer: Aetna Commercial |
$542.75
|
| Rate for Payer: Aetna Medicare |
$374.50
|
| Rate for Payer: BCBS Complete |
$279.11
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$604.99
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Meridian Medicaid |
$279.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$743.96
|
| Rate for Payer: Priority Health Narrow Network |
$743.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.21
|
| Rate for Payer: UHC Exchange |
$479.21
|
| Rate for Payer: UHCCP Medicaid |
$265.82
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 30905
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$835.24 |
| Rate for Payer: Aetna Commercial |
$136.69
|
| Rate for Payer: Aetna Medicare |
$287.50
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS Trust/PPO |
$835.24
|
| Rate for Payer: BCN Commercial |
$519.95
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.46
|
| Rate for Payer: Priority Health Narrow Network |
$146.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.34
|
| Rate for Payer: UHC Exchange |
$119.34
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ
|
Professional
|
Both
|
$599.00
|
|
|
Service Code
|
HCPCS 30906
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$907.62 |
| Rate for Payer: Aetna Commercial |
$174.23
|
| Rate for Payer: Aetna Medicare |
$299.50
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS Trust/PPO |
$907.62
|
| Rate for Payer: BCN Commercial |
$551.23
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.53
|
| Rate for Payer: Priority Health Narrow Network |
$183.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$154.88
|
| Rate for Payer: UHC Exchange |
$154.88
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ
|
Professional
|
Both
|
$780.00
|
|
|
Service Code
|
HCPCS 42961
|
| Min. Negotiated Rate |
$269.96 |
| Max. Negotiated Rate |
$758.87 |
| Rate for Payer: Aetna Commercial |
$551.09
|
| Rate for Payer: Aetna Medicare |
$390.00
|
| Rate for Payer: BCBS Complete |
$284.71
|
| Rate for Payer: BCBS Trust/PPO |
$269.96
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: Cash Price |
$624.00
|
| Rate for Payer: Cash Price |
$624.00
|
| Rate for Payer: Meridian Medicaid |
$284.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$507.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$758.87
|
| Rate for Payer: Priority Health Narrow Network |
$758.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$510.61
|
| Rate for Payer: UHC Exchange |
$510.61
|
| Rate for Payer: UHCCP Medicaid |
$271.15
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$1,901.00
|
|
|
Service Code
|
HCPCS 42962
|
| Min. Negotiated Rate |
$334.20 |
| Max. Negotiated Rate |
$1,235.65 |
| Rate for Payer: Aetna Commercial |
$682.74
|
| Rate for Payer: Aetna Medicare |
$950.50
|
| Rate for Payer: BCBS Complete |
$350.91
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$763.31
|
| Rate for Payer: Cash Price |
$1,520.80
|
| Rate for Payer: Cash Price |
$1,520.80
|
| Rate for Payer: Meridian Medicaid |
$350.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$934.26
|
| Rate for Payer: Priority Health Narrow Network |
$934.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$632.74
|
| Rate for Payer: UHC Exchange |
$632.74
|
| Rate for Payer: UHCCP Medicaid |
$334.20
|
|
|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS
|
Professional
|
Both
|
$539.00
|
|
|
Service Code
|
HCPCS 95929
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$350.35 |
| Rate for Payer: Aetna Commercial |
$260.29
|
| Rate for Payer: Aetna Medicare |
$269.50
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS Trust/PPO |
$111.47
|
| Rate for Payer: BCN Commercial |
$349.40
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Cash Price |
$431.20
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.48
|
| Rate for Payer: Priority Health Narrow Network |
$104.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.03
|
| Rate for Payer: UHC Exchange |
$223.03
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 95928
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$344.03 |
| Rate for Payer: Aetna Commercial |
$253.19
|
| Rate for Payer: Aetna Commercial |
$253.19
|
| Rate for Payer: Aetna Medicare |
$248.50
|
| Rate for Payer: Aetna Medicare |
$170.00
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCN Commercial |
$344.03
|
| Rate for Payer: BCN Commercial |
$344.03
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.94
|
| Rate for Payer: Priority Health Narrow Network |
$104.94
|
| Rate for Payer: Priority Health Narrow Network |
$104.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.74
|
| Rate for Payer: UHC Exchange |
$210.74
|
| Rate for Payer: UHC Exchange |
$210.74
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
| Rate for Payer: UHCCP Medicaid |
$49.20
|
|
|
PR CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 95939
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$797.04 |
| Rate for Payer: Aetna Commercial |
$578.57
|
| Rate for Payer: Aetna Medicare |
$164.00
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS Trust/PPO |
$596.45
|
| Rate for Payer: BCN Commercial |
$797.04
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.96
|
| Rate for Payer: Priority Health Narrow Network |
$156.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$510.55
|
| Rate for Payer: UHC Exchange |
$510.55
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
|
|
PR CURETTAGE POSTPARTUM
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 59160
|
| Min. Negotiated Rate |
$120.77 |
| Max. Negotiated Rate |
$516.15 |
| Rate for Payer: Aetna Commercial |
$203.67
|
| Rate for Payer: Aetna Medicare |
$273.00
|
| Rate for Payer: BCBS Complete |
$126.81
|
| Rate for Payer: BCBS Trust/PPO |
$516.15
|
| Rate for Payer: BCN Commercial |
$405.60
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Meridian Medicaid |
$126.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.41
|
| Rate for Payer: Priority Health Narrow Network |
$266.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.58
|
| Rate for Payer: UHC Exchange |
$203.58
|
| Rate for Payer: UHCCP Medicaid |
$120.77
|
|
