|
PR OOPHORECTOMY PARTIAL/TOTAL UNI/BI
|
Professional
|
Both
|
$2,764.00
|
|
|
Service Code
|
HCPCS 58940
|
| Min. Negotiated Rate |
$144.75 |
| Max. Negotiated Rate |
$1,934.80 |
| Rate for Payer: Aetna Commercial |
$737.32
|
| Rate for Payer: Aetna Medicare |
$550.24
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS MAPPO |
$550.24
|
| Rate for Payer: BCBS Trust/PPO |
$144.75
|
| Rate for Payer: BCN Commercial |
$818.04
|
| Rate for Payer: BCN Medicare Advantage |
$550.24
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cofinity Commercial |
$792.35
|
| Rate for Payer: Cofinity Commercial |
$737.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.24
|
| Rate for Payer: Healthscope Commercial |
$660.29
|
| Rate for Payer: Healthscope Whirlpool |
$660.29
|
| Rate for Payer: Meridian Medicaid |
$375.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$577.75
|
| Rate for Payer: PACE SWMI |
$550.24
|
| Rate for Payer: PHP Medicare Advantage |
$550.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,934.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$792.51
|
| Rate for Payer: Priority Health Medicare |
$550.24
|
| Rate for Payer: Priority Health Narrow Network |
$792.51
|
| Rate for Payer: UHC Medicare Advantage |
$566.75
|
|
|
PR OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 58943
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$1,713.79 |
| Rate for Payer: Aetna Commercial |
$1,554.44
|
| Rate for Payer: Aetna Medicare |
$1,160.03
|
| Rate for Payer: BCBS Complete |
$810.28
|
| Rate for Payer: BCBS MAPPO |
$1,160.03
|
| Rate for Payer: BCBS Trust/PPO |
$132.60
|
| Rate for Payer: BCN Commercial |
$1,713.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.03
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,554.44
|
| Rate for Payer: Cofinity Commercial |
$1,670.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.03
|
| Rate for Payer: Healthscope Commercial |
$1,392.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,392.04
|
| Rate for Payer: Meridian Medicaid |
$810.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,218.03
|
| Rate for Payer: PACE SWMI |
$1,160.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$771.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,582.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,660.29
|
| Rate for Payer: Priority Health Medicare |
$1,160.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,660.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,194.83
|
|
|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
IP
|
$96.50
|
|
|
Service Code
|
NDC 61314-016-01
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.55 |
| Max. Negotiated Rate |
$96.50 |
| Rate for Payer: Aetna Commercial |
$86.85
|
| Rate for Payer: ASR ASR |
$93.60
|
| Rate for Payer: BCBS Trust/PPO |
$74.82
|
| Rate for Payer: BCN Commercial |
$74.82
|
| Rate for Payer: Cash Price |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$90.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.20
|
| Rate for Payer: Healthscope Commercial |
$96.50
|
| Rate for Payer: Healthscope Whirlpool |
$93.60
|
| Rate for Payer: Mclaren Commercial |
$86.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.92
|
|
|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
IP
|
$116.71
|
|
|
Service Code
|
NDC 24208-730-06
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.70 |
| Max. Negotiated Rate |
$116.71 |
| Rate for Payer: Aetna Commercial |
$105.04
|
| Rate for Payer: ASR ASR |
$113.21
|
| Rate for Payer: BCBS Trust/PPO |
$90.49
|
| Rate for Payer: BCN Commercial |
$90.49
|
| Rate for Payer: Cash Price |
$93.37
|
| Rate for Payer: Cofinity Commercial |
$109.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.37
|
| Rate for Payer: Healthscope Commercial |
$116.71
|
| Rate for Payer: Healthscope Whirlpool |
$113.21
|
| Rate for Payer: Mclaren Commercial |
$105.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.70
|
|
|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
IP
|
$124.84
|
|
|
Service Code
|
NDC 0998-0016-15
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.39 |
| Max. Negotiated Rate |
$124.84 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: ASR ASR |
$121.09
|
| Rate for Payer: BCBS Trust/PPO |
$96.79
|
| Rate for Payer: BCN Commercial |
$96.79
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$117.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.87
|
| Rate for Payer: Healthscope Commercial |
$124.84
|
| Rate for Payer: Healthscope Whirlpool |
$121.09
|
| Rate for Payer: Mclaren Commercial |
$112.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.86
|
|
|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
IP
|
$113.72
|
|
|
Service Code
|
NDC 17478-263-12
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$79.60 |
| Max. Negotiated Rate |
$113.72 |
| Rate for Payer: Aetna Commercial |
$102.35
|
| Rate for Payer: ASR ASR |
$110.31
|
| Rate for Payer: BCBS Trust/PPO |
$88.17
|
| Rate for Payer: BCN Commercial |
$88.17
|
| Rate for Payer: Cash Price |
$90.97
|
| Rate for Payer: Cofinity Commercial |
$106.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.98
|
| Rate for Payer: Healthscope Commercial |
$113.72
|
| Rate for Payer: Healthscope Whirlpool |
$110.31
|
| Rate for Payer: Mclaren Commercial |
$102.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.07
|
|
|
PR OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND
|
Professional
|
Both
|
$2,477.00
|
|
|
Service Code
|
HCPCS 50250
|
| Min. Negotiated Rate |
$770.63 |
| Max. Negotiated Rate |
$4,748.36 |
| Rate for Payer: Aetna Commercial |
$1,589.78
|
| Rate for Payer: Aetna Medicare |
$1,186.40
|
| Rate for Payer: BCBS Complete |
$809.16
|
| Rate for Payer: BCBS MAPPO |
$1,186.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,748.36
|
| Rate for Payer: BCN Commercial |
$1,748.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,981.60
|
| Rate for Payer: Cash Price |
$1,981.60
|
| Rate for Payer: Cofinity Commercial |
$1,708.42
|
| Rate for Payer: Cofinity Commercial |
$1,589.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,186.40
|
| Rate for Payer: Healthscope Commercial |
$1,423.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,423.68
|
| Rate for Payer: Meridian Medicaid |
$809.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,245.72
|
| Rate for Payer: PACE SWMI |
$1,186.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,186.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$770.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,733.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,933.39
|
| Rate for Payer: Priority Health Medicare |
$1,186.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,933.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,221.99
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Facility
|
IP
|
$883.00
|
|
|
Service Code
|
CPT 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$618.10 |
| Max. Negotiated Rate |
$883.00 |
| Rate for Payer: Aetna Commercial |
$794.70
|
| Rate for Payer: ASR ASR |
$856.51
|
| Rate for Payer: BCBS Trust/PPO |
$684.59
|
| Rate for Payer: BCN Commercial |
$684.59
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$830.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Healthscope Commercial |
$883.00
|
| Rate for Payer: Healthscope Whirlpool |
$856.51
|
| Rate for Payer: Mclaren Commercial |
$794.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$750.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$777.04
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 38531
|
| Min. Negotiated Rate |
$287.98 |
| Max. Negotiated Rate |
$970.62 |
| Rate for Payer: Aetna Commercial |
$593.24
|
| Rate for Payer: Aetna Medicare |
$442.72
|
| Rate for Payer: BCBS Complete |
$302.38
|
| Rate for Payer: BCBS MAPPO |
$442.72
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$654.83
|
| Rate for Payer: BCN Medicare Advantage |
$442.72
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$637.52
|
| Rate for Payer: Cofinity Commercial |
$593.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.72
|
| Rate for Payer: Healthscope Commercial |
$531.26
|
| Rate for Payer: Healthscope Whirlpool |
$531.26
|
| Rate for Payer: Meridian Medicaid |
$302.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.86
|
| Rate for Payer: PACE SWMI |
$442.72
|
| Rate for Payer: PHP Medicare Advantage |
$442.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$970.62
|
| Rate for Payer: Priority Health Medicare |
$442.72
|
| Rate for Payer: Priority Health Narrow Network |
$970.62
|
| Rate for Payer: UHC Medicare Advantage |
$456.00
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$287.98 |
| Max. Negotiated Rate |
$970.62 |
| Rate for Payer: Aetna Commercial |
$593.24
|
| Rate for Payer: Aetna Medicare |
$442.72
|
| Rate for Payer: BCBS Complete |
$302.38
|
| Rate for Payer: BCBS MAPPO |
$442.72
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$654.83
|
| Rate for Payer: BCN Medicare Advantage |
$442.72
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$637.52
|
| Rate for Payer: Cofinity Commercial |
$593.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.72
|
| Rate for Payer: Healthscope Commercial |
$531.26
|
| Rate for Payer: Healthscope Whirlpool |
$531.26
|
| Rate for Payer: Meridian Medicaid |
$302.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.86
|
| Rate for Payer: PACE SWMI |
$442.72
|
| Rate for Payer: PHP Medicare Advantage |
$442.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$970.62
|
| Rate for Payer: Priority Health Medicare |
$442.72
|
| Rate for Payer: Priority Health Narrow Network |
$970.62
|
| Rate for Payer: UHC Medicare Advantage |
$456.00
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Facility
|
OP
|
$883.00
|
|
|
Service Code
|
CPT 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$618.10 |
| Max. Negotiated Rate |
$4,235.21 |
| Rate for Payer: Aetna Commercial |
$794.70
|
| Rate for Payer: Aetna Medicare |
$3,388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,235.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,235.21
|
| Rate for Payer: ASR ASR |
$856.51
|
| Rate for Payer: BCBS Complete |
$1,946.16
|
| Rate for Payer: BCBS MAPPO |
$3,388.17
|
| Rate for Payer: BCBS Trust/PPO |
$684.59
|
| Rate for Payer: BCN Commercial |
$684.59
|
| Rate for Payer: BCN Medicare Advantage |
$3,388.17
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$830.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,388.17
|
| Rate for Payer: Healthscope Commercial |
$883.00
|
| Rate for Payer: Healthscope Whirlpool |
$856.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,388.17
|
| Rate for Payer: Mclaren Commercial |
$794.70
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,388.17
|
| Rate for Payer: Meridian Medicaid |
$1,946.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,557.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,896.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$750.55
|
| Rate for Payer: PACE Medicare |
$3,218.76
|
| Rate for Payer: PACE SWMI |
$3,388.17
|
| Rate for Payer: PHP Commercial |
$3,726.99
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,388.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,013.13
|
| Rate for Payer: Priority Health Medicare |
$3,388.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,410.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3,388.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$777.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,489.82
|
| Rate for Payer: VA VA |
$3,388.17
|
|
|
PR OPEN CLOSURE MAJOR BRONCHIAL FISTULA
|
Professional
|
Both
|
$4,688.00
|
|
|
Service Code
|
HCPCS 32815
|
| Min. Negotiated Rate |
$1,282.18 |
| Max. Negotiated Rate |
$4,031.10 |
| Rate for Payer: Aetna Commercial |
$3,704.05
|
| Rate for Payer: Aetna Medicare |
$2,764.22
|
| Rate for Payer: BCBS Complete |
$1,848.02
|
| Rate for Payer: BCBS MAPPO |
$2,764.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.18
|
| Rate for Payer: BCN Commercial |
$4,031.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,764.22
|
| Rate for Payer: Cash Price |
$3,750.40
|
| Rate for Payer: Cash Price |
$3,750.40
|
| Rate for Payer: Cofinity Commercial |
$3,980.48
|
| Rate for Payer: Cofinity Commercial |
$3,704.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,764.22
|
| Rate for Payer: Healthscope Commercial |
$3,317.06
|
| Rate for Payer: Healthscope Whirlpool |
$3,317.06
|
| Rate for Payer: Meridian Medicaid |
$1,848.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,902.43
|
| Rate for Payer: PACE SWMI |
$2,764.22
|
| Rate for Payer: PHP Medicare Advantage |
$2,764.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,760.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,281.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,819.66
|
| Rate for Payer: Priority Health Medicare |
$2,764.22
|
| Rate for Payer: Priority Health Narrow Network |
$3,819.66
|
| Rate for Payer: UHC Medicare Advantage |
$2,847.15
|
|
|
PR OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB
|
Professional
|
Both
|
$1,262.00
|
|
|
Service Code
|
HCPCS 35600
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$1,077.73 |
| Rate for Payer: Aetna Commercial |
$244.94
|
| Rate for Payer: Aetna Medicare |
$182.79
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS MAPPO |
$182.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.73
|
| Rate for Payer: BCN Commercial |
$264.86
|
| Rate for Payer: BCN Medicare Advantage |
$182.79
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cash Price |
$1,009.60
|
| Rate for Payer: Cofinity Commercial |
$244.94
|
| Rate for Payer: Cofinity Commercial |
$263.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.79
|
| Rate for Payer: Healthscope Commercial |
$219.35
|
| Rate for Payer: Healthscope Whirlpool |
$219.35
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$191.93
|
| Rate for Payer: PACE SWMI |
$182.79
|
| Rate for Payer: PHP Medicare Advantage |
$182.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$883.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.32
|
| Rate for Payer: Priority Health Medicare |
$182.79
|
| Rate for Payer: Priority Health Narrow Network |
$288.32
|
| Rate for Payer: UHC Medicare Advantage |
$188.27
|
|
|
PR OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 64568
|
| Min. Negotiated Rate |
$388.30 |
| Max. Negotiated Rate |
$1,330.00 |
| Rate for Payer: Aetna Commercial |
$794.55
|
| Rate for Payer: Aetna Medicare |
$592.95
|
| Rate for Payer: BCBS Complete |
$407.72
|
| Rate for Payer: BCBS MAPPO |
$592.95
|
| Rate for Payer: BCBS Trust/PPO |
$462.79
|
| Rate for Payer: BCN Commercial |
$879.62
|
| Rate for Payer: BCN Medicare Advantage |
$592.95
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cofinity Commercial |
$853.85
|
| Rate for Payer: Cofinity Commercial |
$794.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.95
|
| Rate for Payer: Healthscope Commercial |
$711.54
|
| Rate for Payer: Healthscope Whirlpool |
$711.54
|
| Rate for Payer: Meridian Medicaid |
$407.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$622.60
|
| Rate for Payer: PACE SWMI |
$592.95
|
| Rate for Payer: PHP Medicare Advantage |
$592.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.20
|
| Rate for Payer: Priority Health Medicare |
$592.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.20
|
| Rate for Payer: UHC Medicare Advantage |
$610.74
|
|
|
PR OPEN IMPLANTATION NEA PERIPHERAL NERVE
|
Professional
|
Both
|
$975.00
|
|
|
Service Code
|
HCPCS 64575
|
| Min. Negotiated Rate |
$201.92 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$402.34
|
| Rate for Payer: Aetna Medicare |
$300.25
|
| Rate for Payer: BCBS Complete |
$212.02
|
| Rate for Payer: BCBS MAPPO |
$300.25
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$447.63
|
| Rate for Payer: BCN Medicare Advantage |
$300.25
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cofinity Commercial |
$432.36
|
| Rate for Payer: Cofinity Commercial |
$402.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.25
|
| Rate for Payer: Healthscope Commercial |
$360.30
|
| Rate for Payer: Healthscope Whirlpool |
$360.30
|
| Rate for Payer: Meridian Medicaid |
$212.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$315.26
|
| Rate for Payer: PACE SWMI |
$300.25
|
| Rate for Payer: PHP Medicare Advantage |
$300.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$518.67
|
| Rate for Payer: Priority Health Medicare |
$300.25
|
| Rate for Payer: Priority Health Narrow Network |
$518.67
|
| Rate for Payer: UHC Medicare Advantage |
$309.26
|
|
|
PR OPEN IMPLANTATION NEA SACRAL NERVE
|
Professional
|
Both
|
$1,487.00
|
|
|
Service Code
|
HCPCS 64581
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,101.31 |
| Rate for Payer: Aetna Commercial |
$866.11
|
| Rate for Payer: Aetna Medicare |
$646.35
|
| Rate for Payer: BCBS Complete |
$438.81
|
| Rate for Payer: BCBS MAPPO |
$646.35
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$950.47
|
| Rate for Payer: BCN Medicare Advantage |
$646.35
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cofinity Commercial |
$930.74
|
| Rate for Payer: Cofinity Commercial |
$866.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.35
|
| Rate for Payer: Healthscope Commercial |
$775.62
|
| Rate for Payer: Healthscope Whirlpool |
$775.62
|
| Rate for Payer: Meridian Medicaid |
$438.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$678.67
|
| Rate for Payer: PACE SWMI |
$646.35
|
| Rate for Payer: PHP Medicare Advantage |
$646.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,040.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,101.31
|
| Rate for Payer: Priority Health Medicare |
$646.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,101.31
|
| Rate for Payer: UHC Medicare Advantage |
$665.74
|
|
|
PR OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR
|
Professional
|
Both
|
$1,717.00
|
|
|
Service Code
|
HCPCS 64582
|
| Min. Negotiated Rate |
$368.23 |
| Max. Negotiated Rate |
$1,458.03 |
| Rate for Payer: Aetna Commercial |
$1,141.95
|
| Rate for Payer: Aetna Medicare |
$852.20
|
| Rate for Payer: BCBS Complete |
$562.03
|
| Rate for Payer: BCBS MAPPO |
$852.20
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: BCN Commercial |
$1,258.34
|
| Rate for Payer: BCN Medicare Advantage |
$852.20
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cofinity Commercial |
$1,141.95
|
| Rate for Payer: Cofinity Commercial |
$1,227.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$852.20
|
| Rate for Payer: Healthscope Commercial |
$1,022.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,022.64
|
| Rate for Payer: Meridian Medicaid |
$562.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$894.81
|
| Rate for Payer: PACE SWMI |
$852.20
|
| Rate for Payer: PHP Medicare Advantage |
$852.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,458.03
|
| Rate for Payer: Priority Health Medicare |
$852.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,458.03
|
| Rate for Payer: UHC Medicare Advantage |
$877.77
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL
|
Professional
|
Both
|
$627.00
|
|
|
Service Code
|
HCPCS 37239
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$2,525.00 |
| Rate for Payer: Aetna Commercial |
$197.13
|
| Rate for Payer: Aetna Medicare |
$147.11
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$147.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.39
|
| Rate for Payer: BCN Commercial |
$2,525.00
|
| Rate for Payer: BCN Medicare Advantage |
$147.11
|
| Rate for Payer: Cash Price |
$501.60
|
| Rate for Payer: Cash Price |
$501.60
|
| Rate for Payer: Cofinity Commercial |
$211.84
|
| Rate for Payer: Cofinity Commercial |
$197.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.11
|
| Rate for Payer: Healthscope Commercial |
$176.53
|
| Rate for Payer: Healthscope Whirlpool |
$176.53
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.47
|
| Rate for Payer: PACE SWMI |
$147.11
|
| Rate for Payer: PHP Medicare Advantage |
$147.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.47
|
| Rate for Payer: Priority Health Medicare |
$147.11
|
| Rate for Payer: Priority Health Narrow Network |
$232.47
|
| Rate for Payer: UHC Medicare Advantage |
$151.52
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL
|
Professional
|
Both
|
$498.00
|
|
|
Service Code
|
HCPCS 37237
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$1,902.42 |
| Rate for Payer: Aetna Commercial |
$276.75
|
| Rate for Payer: Aetna Medicare |
$206.53
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$206.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.43
|
| Rate for Payer: BCN Commercial |
$1,902.42
|
| Rate for Payer: BCN Medicare Advantage |
$206.53
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cofinity Commercial |
$297.40
|
| Rate for Payer: Cofinity Commercial |
$276.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.53
|
| Rate for Payer: Healthscope Commercial |
$247.84
|
| Rate for Payer: Healthscope Whirlpool |
$247.84
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$216.86
|
| Rate for Payer: PACE SWMI |
$206.53
|
| Rate for Payer: PHP Medicare Advantage |
$206.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.02
|
| Rate for Payer: Priority Health Medicare |
$206.53
|
| Rate for Payer: Priority Health Narrow Network |
$325.02
|
| Rate for Payer: UHC Medicare Advantage |
$212.73
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL
|
Professional
|
Both
|
$1,187.00
|
|
|
Service Code
|
HCPCS 37236
|
| Min. Negotiated Rate |
$273.49 |
| Max. Negotiated Rate |
$4,048.21 |
| Rate for Payer: Aetna Commercial |
$581.44
|
| Rate for Payer: Aetna Medicare |
$433.91
|
| Rate for Payer: BCBS Complete |
$287.16
|
| Rate for Payer: BCBS MAPPO |
$433.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.84
|
| Rate for Payer: BCN Commercial |
$4,048.21
|
| Rate for Payer: BCN Medicare Advantage |
$433.91
|
| Rate for Payer: Cash Price |
$949.60
|
| Rate for Payer: Cash Price |
$949.60
|
| Rate for Payer: Cofinity Commercial |
$581.44
|
| Rate for Payer: Cofinity Commercial |
$624.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.91
|
| Rate for Payer: Healthscope Commercial |
$520.69
|
| Rate for Payer: Healthscope Whirlpool |
$520.69
|
| Rate for Payer: Meridian Medicaid |
$287.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$455.61
|
| Rate for Payer: PACE SWMI |
$433.91
|
| Rate for Payer: PHP Medicare Advantage |
$433.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$830.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.10
|
| Rate for Payer: Priority Health Medicare |
$433.91
|
| Rate for Payer: Priority Health Narrow Network |
$684.10
|
| Rate for Payer: UHC Medicare Advantage |
$446.93
|
|
|
PR OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 37238
|
| Min. Negotiated Rate |
$190.42 |
| Max. Negotiated Rate |
$5,084.69 |
| Rate for Payer: Aetna Commercial |
$401.12
|
| Rate for Payer: Aetna Medicare |
$299.34
|
| Rate for Payer: BCBS Complete |
$199.94
|
| Rate for Payer: BCBS MAPPO |
$299.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.33
|
| Rate for Payer: BCN Commercial |
$5,084.69
|
| Rate for Payer: BCN Medicare Advantage |
$299.34
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cofinity Commercial |
$431.05
|
| Rate for Payer: Cofinity Commercial |
$401.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.34
|
| Rate for Payer: Healthscope Commercial |
$359.21
|
| Rate for Payer: Healthscope Whirlpool |
$359.21
|
| Rate for Payer: Meridian Medicaid |
$199.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$314.31
|
| Rate for Payer: PACE SWMI |
$299.34
|
| Rate for Payer: PHP Medicare Advantage |
$299.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.45
|
| Rate for Payer: Priority Health Medicare |
$299.34
|
| Rate for Payer: Priority Health Narrow Network |
$473.45
|
| Rate for Payer: UHC Medicare Advantage |
$308.32
|
|
|
PR OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE
|
Professional
|
Both
|
$2,528.00
|
|
|
Service Code
|
HCPCS 25525
|
| Min. Negotiated Rate |
$512.90 |
| Max. Negotiated Rate |
$1,769.60 |
| Rate for Payer: Aetna Commercial |
$1,045.36
|
| Rate for Payer: Aetna Medicare |
$780.12
|
| Rate for Payer: BCBS Complete |
$538.54
|
| Rate for Payer: BCBS MAPPO |
$780.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.84
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: BCN Medicare Advantage |
$780.12
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cofinity Commercial |
$1,123.37
|
| Rate for Payer: Cofinity Commercial |
$1,045.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.12
|
| Rate for Payer: Healthscope Commercial |
$936.14
|
| Rate for Payer: Healthscope Whirlpool |
$936.14
|
| Rate for Payer: Meridian Medicaid |
$538.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$819.13
|
| Rate for Payer: PACE SWMI |
$780.12
|
| Rate for Payer: PHP Medicare Advantage |
$780.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,769.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,218.93
|
| Rate for Payer: Priority Health Medicare |
$780.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,218.93
|
| Rate for Payer: UHC Medicare Advantage |
$803.52
|
|
|
PR OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 25526
|
| Min. Negotiated Rate |
$618.77 |
| Max. Negotiated Rate |
$2,041.90 |
| Rate for Payer: Aetna Commercial |
$1,263.97
|
| Rate for Payer: Aetna Medicare |
$943.26
|
| Rate for Payer: BCBS Complete |
$649.71
|
| Rate for Payer: BCBS MAPPO |
$943.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.05
|
| Rate for Payer: BCN Commercial |
$1,406.91
|
| Rate for Payer: BCN Medicare Advantage |
$943.26
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cofinity Commercial |
$1,263.97
|
| Rate for Payer: Cofinity Commercial |
$1,358.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.26
|
| Rate for Payer: Healthscope Commercial |
$1,131.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,131.91
|
| Rate for Payer: Meridian Medicaid |
$649.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$990.42
|
| Rate for Payer: PACE SWMI |
$943.26
|
| Rate for Payer: PHP Medicare Advantage |
$943.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,041.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,470.16
|
| Rate for Payer: Priority Health Medicare |
$943.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,470.16
|
| Rate for Payer: UHC Medicare Advantage |
$971.56
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF ACUTE
|
Professional
|
Both
|
$2,565.00
|
|
|
Service Code
|
HCPCS 23410
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$1,795.50 |
| Rate for Payer: Aetna Commercial |
$1,084.25
|
| Rate for Payer: Aetna Medicare |
$809.14
|
| Rate for Payer: BCBS Complete |
$556.00
|
| Rate for Payer: BCBS MAPPO |
$809.14
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$1,206.54
|
| Rate for Payer: BCN Medicare Advantage |
$809.14
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Cofinity Commercial |
$1,084.25
|
| Rate for Payer: Cofinity Commercial |
$1,165.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.14
|
| Rate for Payer: Healthscope Commercial |
$970.97
|
| Rate for Payer: Healthscope Whirlpool |
$970.97
|
| Rate for Payer: Meridian Medicaid |
$556.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$849.60
|
| Rate for Payer: PACE SWMI |
$809.14
|
| Rate for Payer: PHP Medicare Advantage |
$809.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,260.79
|
| Rate for Payer: Priority Health Medicare |
$809.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,260.79
|
| Rate for Payer: UHC Medicare Advantage |
$833.41
|
|
|
PR OPEN REPAIR OF ROTATOR CUFF CHRONIC
|
Professional
|
Both
|
$3,058.00
|
|
|
Service Code
|
HCPCS 23412
|
| Min. Negotiated Rate |
$78.96 |
| Max. Negotiated Rate |
$2,140.60 |
| Rate for Payer: Aetna Commercial |
$1,126.55
|
| Rate for Payer: Aetna Medicare |
$840.71
|
| Rate for Payer: BCBS Complete |
$577.91
|
| Rate for Payer: BCBS MAPPO |
$840.71
|
| Rate for Payer: BCBS Trust/PPO |
$78.96
|
| Rate for Payer: BCN Commercial |
$1,379.62
|
| Rate for Payer: BCN Medicare Advantage |
$840.71
|
| Rate for Payer: Cash Price |
$2,446.40
|
| Rate for Payer: Cash Price |
$2,446.40
|
| Rate for Payer: Cofinity Commercial |
$1,126.55
|
| Rate for Payer: Cofinity Commercial |
$1,210.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$840.71
|
| Rate for Payer: Healthscope Commercial |
$1,008.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,008.85
|
| Rate for Payer: Meridian Medicaid |
$577.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$882.75
|
| Rate for Payer: PACE SWMI |
$840.71
|
| Rate for Payer: PHP Medicare Advantage |
$840.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$550.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,309.31
|
| Rate for Payer: Priority Health Medicare |
$840.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,309.31
|
| Rate for Payer: UHC Medicare Advantage |
$865.93
|
|
