|
PR CYSTOSTOMY CYSTOTOMY W/DRAINAGE
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 51040
|
| Min. Negotiated Rate |
$188.72 |
| Max. Negotiated Rate |
$3,051.99 |
| Rate for Payer: Aetna Commercial |
$370.57
|
| Rate for Payer: Aetna Medicare |
$273.00
|
| Rate for Payer: BCBS Complete |
$198.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,051.99
|
| Rate for Payer: BCN Commercial |
$422.22
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Meridian Medicaid |
$198.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.69
|
| Rate for Payer: Priority Health Narrow Network |
$468.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$345.83
|
| Rate for Payer: UHC Exchange |
$345.83
|
| Rate for Payer: UHCCP Medicaid |
$188.72
|
|
|
PR CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL
|
Professional
|
Both
|
$2,450.00
|
|
|
Service Code
|
HCPCS 51020
|
| Min. Negotiated Rate |
$303.10 |
| Max. Negotiated Rate |
$3,049.88 |
| Rate for Payer: Aetna Commercial |
$601.20
|
| Rate for Payer: Aetna Medicare |
$1,225.00
|
| Rate for Payer: BCBS Complete |
$318.26
|
| Rate for Payer: BCBS Trust/PPO |
$3,049.88
|
| Rate for Payer: BCN Commercial |
$680.73
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Meridian Medicaid |
$318.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,592.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.16
|
| Rate for Payer: Priority Health Narrow Network |
$754.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$560.30
|
| Rate for Payer: UHC Exchange |
$560.30
|
| Rate for Payer: UHCCP Medicaid |
$303.10
|
|
|
PR CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE
|
Professional
|
Both
|
$2,002.00
|
|
|
Service Code
|
HCPCS 51525
|
| Min. Negotiated Rate |
$548.48 |
| Max. Negotiated Rate |
$3,181.95 |
| Rate for Payer: Aetna Commercial |
$1,103.89
|
| Rate for Payer: Aetna Medicare |
$1,001.00
|
| Rate for Payer: BCBS Complete |
$575.90
|
| Rate for Payer: BCBS Trust/PPO |
$3,181.95
|
| Rate for Payer: BCN Commercial |
$1,239.29
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Meridian Medicaid |
$575.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,301.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,362.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,362.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,036.29
|
| Rate for Payer: UHC Exchange |
$1,036.29
|
| Rate for Payer: UHCCP Medicaid |
$548.48
|
|
|
PR CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 51535
|
| Min. Negotiated Rate |
$499.49 |
| Max. Negotiated Rate |
$3,177.20 |
| Rate for Payer: Aetna Commercial |
$1,001.20
|
| Rate for Payer: Aetna Medicare |
$864.50
|
| Rate for Payer: BCBS Complete |
$524.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,177.20
|
| Rate for Payer: BCN Commercial |
$1,124.45
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Meridian Medicaid |
$524.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$928.94
|
| Rate for Payer: UHC Exchange |
$928.94
|
| Rate for Payer: UHCCP Medicaid |
$499.49
|
|
|
PR CYSTOTOMY EXCISION BLADDER TUMOR
|
Professional
|
Both
|
$1,390.00
|
|
|
Service Code
|
HCPCS 51530
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$2,404.29 |
| Rate for Payer: Aetna Commercial |
$988.36
|
| Rate for Payer: Aetna Medicare |
$695.00
|
| Rate for Payer: BCBS Complete |
$517.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,404.29
|
| Rate for Payer: BCN Commercial |
$1,110.28
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Meridian Medicaid |
$517.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$903.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,224.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$932.26
|
| Rate for Payer: UHC Exchange |
$932.26
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
|
|
PR CYSTOTOMY SIMPLE EXCISION VESICAL NECK
|
Professional
|
Both
|
$1,228.00
|
|
|
Service Code
|
HCPCS 51520
|
| Min. Negotiated Rate |
$383.19 |
| Max. Negotiated Rate |
$3,020.82 |
| Rate for Payer: Aetna Commercial |
$763.07
|
| Rate for Payer: Aetna Medicare |
$614.00
|
| Rate for Payer: BCBS Complete |
$402.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.82
|
| Rate for Payer: BCN Commercial |
$861.05
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Meridian Medicaid |
$402.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$951.22
|
| Rate for Payer: Priority Health Narrow Network |
$951.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.70
|
| Rate for Payer: UHC Exchange |
$704.70
|
| Rate for Payer: UHCCP Medicaid |
$383.19
|
|
|
PR CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 51065
|
| Min. Negotiated Rate |
$373.39 |
| Max. Negotiated Rate |
$2,864.97 |
| Rate for Payer: Aetna Commercial |
$743.33
|
| Rate for Payer: Aetna Medicare |
$984.50
|
| Rate for Payer: BCBS Complete |
$392.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,864.97
|
| Rate for Payer: BCN Commercial |
$839.06
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Meridian Medicaid |
$392.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.26
|
| Rate for Payer: Priority Health Narrow Network |
$927.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$694.03
|
| Rate for Payer: UHC Exchange |
$694.03
|
| Rate for Payer: UHCCP Medicaid |
$373.39
|
|
|
PR CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX
|
Professional
|
Both
|
$1,032.00
|
|
|
Service Code
|
HCPCS 51045
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$3,133.88 |
| Rate for Payer: Aetna Commercial |
$645.19
|
| Rate for Payer: Aetna Medicare |
$516.00
|
| Rate for Payer: BCBS Complete |
$332.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,133.88
|
| Rate for Payer: BCN Commercial |
$728.13
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Meridian Medicaid |
$332.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.84
|
| Rate for Payer: Priority Health Narrow Network |
$797.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$570.95
|
| Rate for Payer: UHC Exchange |
$570.95
|
| Rate for Payer: UHCCP Medicaid |
$316.52
|
|
|
PR CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
HCPCS 52356
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$651.90 |
| Rate for Payer: Aetna Commercial |
$532.71
|
| Rate for Payer: Aetna Medicare |
$424.00
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS Trust/PPO |
$478.11
|
| Rate for Payer: BCN Commercial |
$591.79
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.90
|
| Rate for Payer: Priority Health Narrow Network |
$651.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$499.26
|
| Rate for Payer: UHC Exchange |
$499.26
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
|
|
PR CYSTOURETHROSCOPY
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 52000
|
| Min. Negotiated Rate |
$50.91 |
| Max. Negotiated Rate |
$1,840.07 |
| Rate for Payer: Aetna Commercial |
$102.99
|
| Rate for Payer: Aetna Medicare |
$235.00
|
| Rate for Payer: BCBS Complete |
$53.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.07
|
| Rate for Payer: BCN Commercial |
$352.33
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Meridian Medicaid |
$53.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.75
|
| Rate for Payer: Priority Health Narrow Network |
$126.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.32
|
| Rate for Payer: UHC Exchange |
$151.32
|
| Rate for Payer: UHCCP Medicaid |
$50.91
|
|
|
PR CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 52287
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$1,222.49 |
| Rate for Payer: Aetna Commercial |
$217.02
|
| Rate for Payer: Aetna Medicare |
$352.50
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,222.49
|
| Rate for Payer: BCN Commercial |
$570.29
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.76
|
| Rate for Payer: Priority Health Narrow Network |
$265.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$205.92
|
| Rate for Payer: UHC Exchange |
$205.92
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 52282
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$1,714.86 |
| Rate for Payer: Aetna Commercial |
$429.33
|
| Rate for Payer: Aetna Medicare |
$325.00
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,714.86
|
| Rate for Payer: BCN Commercial |
$479.88
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.41
|
| Rate for Payer: Priority Health Narrow Network |
$529.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$409.66
|
| Rate for Payer: UHC Exchange |
$409.66
|
| Rate for Payer: UHCCP Medicaid |
$213.00
|
|
|
PR CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 52250
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$4,966.55 |
| Rate for Payer: Aetna Commercial |
$305.69
|
| Rate for Payer: Aetna Medicare |
$250.00
|
| Rate for Payer: BCBS Complete |
$159.01
|
| Rate for Payer: BCBS Trust/PPO |
$4,966.55
|
| Rate for Payer: BCN Commercial |
$341.58
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Meridian Medicaid |
$159.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$375.49
|
| Rate for Payer: Priority Health Narrow Network |
$375.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$294.88
|
| Rate for Payer: UHC Exchange |
$294.88
|
| Rate for Payer: UHCCP Medicaid |
$151.44
|
|
|
PR CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME
|
Professional
|
Both
|
$639.00
|
|
|
Service Code
|
HCPCS 52285
|
| Min. Negotiated Rate |
$125.03 |
| Max. Negotiated Rate |
$1,483.99 |
| Rate for Payer: Aetna Commercial |
$250.61
|
| Rate for Payer: Aetna Medicare |
$319.50
|
| Rate for Payer: BCBS Complete |
$131.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,483.99
|
| Rate for Payer: BCN Commercial |
$513.12
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Meridian Medicaid |
$131.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$415.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.91
|
| Rate for Payer: Priority Health Narrow Network |
$308.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.44
|
| Rate for Payer: UHC Exchange |
$236.44
|
| Rate for Payer: UHCCP Medicaid |
$125.03
|
|
|
PR CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM
|
Professional
|
Both
|
$1,167.00
|
|
|
Service Code
|
HCPCS 52235
|
| Min. Negotiated Rate |
$182.12 |
| Max. Negotiated Rate |
$3,767.31 |
| Rate for Payer: Aetna Commercial |
$368.99
|
| Rate for Payer: Aetna Medicare |
$583.50
|
| Rate for Payer: BCBS Complete |
$191.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,767.31
|
| Rate for Payer: BCN Commercial |
$411.47
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Cash Price |
$933.60
|
| Rate for Payer: Meridian Medicaid |
$191.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.25
|
| Rate for Payer: Priority Health Narrow Network |
$453.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$351.38
|
| Rate for Payer: UHC Exchange |
$351.38
|
| Rate for Payer: UHCCP Medicaid |
$182.12
|
|
|
PR CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 52240
|
| Min. Negotiated Rate |
$247.08 |
| Max. Negotiated Rate |
$4,858.78 |
| Rate for Payer: Aetna Commercial |
$501.54
|
| Rate for Payer: Aetna Medicare |
$1,121.50
|
| Rate for Payer: BCBS Complete |
$259.43
|
| Rate for Payer: BCBS Trust/PPO |
$4,858.78
|
| Rate for Payer: BCN Commercial |
$558.56
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Meridian Medicaid |
$259.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.15
|
| Rate for Payer: Priority Health Narrow Network |
$615.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$615.22
|
| Rate for Payer: UHC Exchange |
$615.22
|
| Rate for Payer: UHCCP Medicaid |
$247.08
|
|
|
PR CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH
|
Professional
|
Both
|
$395.00
|
|
|
Service Code
|
HCPCS 52260
|
| Min. Negotiated Rate |
$133.34 |
| Max. Negotiated Rate |
$1,421.13 |
| Rate for Payer: Aetna Commercial |
$269.31
|
| Rate for Payer: Aetna Medicare |
$197.50
|
| Rate for Payer: BCBS Complete |
$140.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,421.13
|
| Rate for Payer: BCN Commercial |
$418.29
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Meridian Medicaid |
$140.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.28
|
| Rate for Payer: Priority Health Narrow Network |
$331.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.59
|
| Rate for Payer: UHC Exchange |
$254.59
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
|
|
PR CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA
|
Professional
|
Both
|
$638.00
|
|
|
Service Code
|
HCPCS 52265
|
| Min. Negotiated Rate |
$103.09 |
| Max. Negotiated Rate |
$5,029.94 |
| Rate for Payer: Aetna Commercial |
$208.09
|
| Rate for Payer: Aetna Medicare |
$319.00
|
| Rate for Payer: BCBS Complete |
$108.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,029.94
|
| Rate for Payer: BCN Commercial |
$549.27
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Meridian Medicaid |
$108.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.18
|
| Rate for Payer: Priority Health Narrow Network |
$256.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$194.94
|
| Rate for Payer: UHC Exchange |
$194.94
|
| Rate for Payer: UHCCP Medicaid |
$103.09
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY
|
Professional
|
Both
|
$1,121.00
|
|
|
Service Code
|
HCPCS 52276
|
| Min. Negotiated Rate |
$167.21 |
| Max. Negotiated Rate |
$2,759.84 |
| Rate for Payer: Aetna Commercial |
$338.51
|
| Rate for Payer: Aetna Medicare |
$560.50
|
| Rate for Payer: BCBS Complete |
$175.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,759.84
|
| Rate for Payer: BCN Commercial |
$376.77
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Cash Price |
$896.80
|
| Rate for Payer: Meridian Medicaid |
$175.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.90
|
| Rate for Payer: Priority Health Narrow Network |
$414.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.59
|
| Rate for Payer: UHC Exchange |
$323.59
|
| Rate for Payer: UHCCP Medicaid |
$167.21
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 52270
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$4,237.49 |
| Rate for Payer: Aetna Commercial |
$233.02
|
| Rate for Payer: Aetna Medicare |
$358.00
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS Trust/PPO |
$4,237.49
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$285.47
|
| Rate for Payer: Priority Health Narrow Network |
$285.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$220.81
|
| Rate for Payer: UHC Exchange |
$220.81
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE
|
Professional
|
Both
|
$977.00
|
|
|
Service Code
|
HCPCS 52275
|
| Min. Negotiated Rate |
$157.41 |
| Max. Negotiated Rate |
$5,563.53 |
| Rate for Payer: Aetna Commercial |
$317.31
|
| Rate for Payer: Aetna Medicare |
$488.50
|
| Rate for Payer: BCBS Complete |
$165.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,563.53
|
| Rate for Payer: BCN Commercial |
$790.68
|
| Rate for Payer: Cash Price |
$781.60
|
| Rate for Payer: Cash Price |
$781.60
|
| Rate for Payer: Meridian Medicaid |
$165.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$635.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.86
|
| Rate for Payer: Priority Health Narrow Network |
$389.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.55
|
| Rate for Payer: UHC Exchange |
$302.55
|
| Rate for Payer: UHCCP Medicaid |
$157.41
|
|
|
PR CYSTOURETHROSCOPY WITH BIOPSY
|
Professional
|
Both
|
$748.00
|
|
|
Service Code
|
HCPCS 52204
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$1,981.65 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna Medicare |
$374.00
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,981.65
|
| Rate for Payer: BCN Commercial |
$554.65
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.15
|
| Rate for Payer: Priority Health Narrow Network |
$223.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.18
|
| Rate for Payer: UHC Exchange |
$171.18
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
|
|
PR CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS
|
Professional
|
Both
|
$1,426.00
|
|
|
Service Code
|
HCPCS 52320
|
| Min. Negotiated Rate |
$155.92 |
| Max. Negotiated Rate |
$926.90 |
| Rate for Payer: Aetna Commercial |
$315.24
|
| Rate for Payer: Aetna Medicare |
$713.00
|
| Rate for Payer: BCBS Complete |
$163.72
|
| Rate for Payer: BCBS Trust/PPO |
$454.34
|
| Rate for Payer: BCN Commercial |
$350.87
|
| Rate for Payer: Cash Price |
$1,140.80
|
| Rate for Payer: Cash Price |
$1,140.80
|
| Rate for Payer: Meridian Medicaid |
$163.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$926.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.13
|
| Rate for Payer: Priority Health Narrow Network |
$386.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.51
|
| Rate for Payer: UHC Exchange |
$300.51
|
| Rate for Payer: UHCCP Medicaid |
$155.92
|
|
|
PR CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE
|
Professional
|
Both
|
$416.00
|
|
|
Service Code
|
HCPCS 52283
|
| Min. Negotiated Rate |
$128.23 |
| Max. Negotiated Rate |
$606.49 |
| Rate for Payer: Aetna Commercial |
$258.19
|
| Rate for Payer: Aetna Medicare |
$208.00
|
| Rate for Payer: BCBS Complete |
$134.64
|
| Rate for Payer: BCBS Trust/PPO |
$606.49
|
| Rate for Payer: BCN Commercial |
$517.51
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Meridian Medicaid |
$134.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.90
|
| Rate for Payer: Priority Health Narrow Network |
$316.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.00
|
| Rate for Payer: UHC Exchange |
$244.00
|
| Rate for Payer: UHCCP Medicaid |
$128.23
|
|
|
PR CYSTOURETHROSCOPY W/URETERAL CATHETERIZATION
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 52005
|
| Min. Negotiated Rate |
$84.77 |
| Max. Negotiated Rate |
$2,077.80 |
| Rate for Payer: Aetna Commercial |
$169.08
|
| Rate for Payer: Aetna Medicare |
$279.50
|
| Rate for Payer: BCBS Complete |
$89.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.80
|
| Rate for Payer: BCN Commercial |
$489.65
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Meridian Medicaid |
$89.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.38
|
| Rate for Payer: Priority Health Narrow Network |
$210.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.98
|
| Rate for Payer: UHC Exchange |
$160.98
|
| Rate for Payer: UHCCP Medicaid |
$84.77
|
|
