|
PR OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 28531
|
| Min. Negotiated Rate |
$117.58 |
| Max. Negotiated Rate |
$486.56 |
| Rate for Payer: Aetna Commercial |
$234.78
|
| Rate for Payer: Aetna Medicare |
$175.21
|
| Rate for Payer: BCBS Complete |
$123.46
|
| Rate for Payer: BCBS MAPPO |
$175.21
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$478.42
|
| Rate for Payer: BCN Medicare Advantage |
$175.21
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$234.78
|
| Rate for Payer: Cofinity Commercial |
$252.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.21
|
| Rate for Payer: Healthscope Commercial |
$210.25
|
| Rate for Payer: Healthscope Whirlpool |
$210.25
|
| Rate for Payer: Meridian Medicaid |
$123.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$183.97
|
| Rate for Payer: PACE SWMI |
$175.21
|
| Rate for Payer: PHP Medicare Advantage |
$175.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.24
|
| Rate for Payer: Priority Health Medicare |
$175.21
|
| Rate for Payer: Priority Health Narrow Network |
$275.24
|
| Rate for Payer: UHC Medicare Advantage |
$180.47
|
|
|
PR OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 23530
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$1,682.10 |
| Rate for Payer: Aetna Commercial |
$763.48
|
| Rate for Payer: Aetna Medicare |
$569.76
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$569.76
|
| Rate for Payer: BCBS Trust/PPO |
$414.72
|
| Rate for Payer: BCN Commercial |
$852.74
|
| Rate for Payer: BCN Medicare Advantage |
$569.76
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cofinity Commercial |
$820.45
|
| Rate for Payer: Cofinity Commercial |
$763.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$569.76
|
| Rate for Payer: Healthscope Commercial |
$683.71
|
| Rate for Payer: Healthscope Whirlpool |
$683.71
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$598.25
|
| Rate for Payer: PACE SWMI |
$569.76
|
| Rate for Payer: PHP Medicare Advantage |
$569.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$891.08
|
| Rate for Payer: Priority Health Medicare |
$569.76
|
| Rate for Payer: Priority Health Narrow Network |
$891.08
|
| Rate for Payer: UHC Medicare Advantage |
$586.85
|
|
|
PR OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION
|
Professional
|
Both
|
$984.00
|
|
|
Service Code
|
HCPCS 21825
|
| Min. Negotiated Rate |
$355.28 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$726.03
|
| Rate for Payer: Aetna Medicare |
$541.81
|
| Rate for Payer: BCBS Complete |
$373.04
|
| Rate for Payer: BCBS MAPPO |
$541.81
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$804.85
|
| Rate for Payer: BCN Medicare Advantage |
$541.81
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cash Price |
$787.20
|
| Rate for Payer: Cofinity Commercial |
$780.21
|
| Rate for Payer: Cofinity Commercial |
$726.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$541.81
|
| Rate for Payer: Healthscope Commercial |
$650.17
|
| Rate for Payer: Healthscope Whirlpool |
$650.17
|
| Rate for Payer: Meridian Medicaid |
$373.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$568.90
|
| Rate for Payer: PACE SWMI |
$541.81
|
| Rate for Payer: PHP Medicare Advantage |
$541.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$688.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$841.04
|
| Rate for Payer: Priority Health Medicare |
$541.81
|
| Rate for Payer: Priority Health Narrow Network |
$841.04
|
| Rate for Payer: UHC Medicare Advantage |
$558.06
|
|
|
PR OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 28465
|
| Min. Negotiated Rate |
$414.92 |
| Max. Negotiated Rate |
$1,078.00 |
| Rate for Payer: Aetna Commercial |
$833.02
|
| Rate for Payer: Aetna Medicare |
$621.66
|
| Rate for Payer: BCBS Complete |
$435.67
|
| Rate for Payer: BCBS MAPPO |
$621.66
|
| Rate for Payer: BCBS Trust/PPO |
$524.60
|
| Rate for Payer: BCN Commercial |
$931.42
|
| Rate for Payer: BCN Medicare Advantage |
$621.66
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cofinity Commercial |
$895.19
|
| Rate for Payer: Cofinity Commercial |
$833.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.66
|
| Rate for Payer: Healthscope Commercial |
$745.99
|
| Rate for Payer: Healthscope Whirlpool |
$745.99
|
| Rate for Payer: Meridian Medicaid |
$435.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$652.74
|
| Rate for Payer: PACE SWMI |
$621.66
|
| Rate for Payer: PHP Medicare Advantage |
$621.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,078.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$973.30
|
| Rate for Payer: Priority Health Medicare |
$621.66
|
| Rate for Payer: Priority Health Narrow Network |
$973.30
|
| Rate for Payer: UHC Medicare Advantage |
$640.31
|
|
|
PR OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,731.00
|
|
|
Service Code
|
HCPCS 27535
|
| Min. Negotiated Rate |
$533.05 |
| Max. Negotiated Rate |
$1,911.70 |
| Rate for Payer: Aetna Commercial |
$1,185.74
|
| Rate for Payer: Aetna Medicare |
$884.88
|
| Rate for Payer: BCBS Complete |
$604.75
|
| Rate for Payer: BCBS MAPPO |
$884.88
|
| Rate for Payer: BCBS Trust/PPO |
$533.05
|
| Rate for Payer: BCN Commercial |
$1,313.07
|
| Rate for Payer: BCN Medicare Advantage |
$884.88
|
| Rate for Payer: Cash Price |
$2,184.80
|
| Rate for Payer: Cash Price |
$2,184.80
|
| Rate for Payer: Cofinity Commercial |
$1,274.23
|
| Rate for Payer: Cofinity Commercial |
$1,185.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.88
|
| Rate for Payer: Healthscope Commercial |
$1,061.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,061.86
|
| Rate for Payer: Meridian Medicaid |
$604.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$929.12
|
| Rate for Payer: PACE SWMI |
$884.88
|
| Rate for Payer: PHP Medicare Advantage |
$884.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,911.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,372.12
|
| Rate for Payer: Priority Health Medicare |
$884.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,372.12
|
| Rate for Payer: UHC Medicare Advantage |
$911.43
|
|
|
PR OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC
|
Professional
|
Both
|
$2,067.00
|
|
|
Service Code
|
HCPCS 25685
|
| Min. Negotiated Rate |
$476.91 |
| Max. Negotiated Rate |
$1,614.48 |
| Rate for Payer: Aetna Commercial |
$973.93
|
| Rate for Payer: Aetna Medicare |
$726.81
|
| Rate for Payer: BCBS Complete |
$500.76
|
| Rate for Payer: BCBS MAPPO |
$726.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.48
|
| Rate for Payer: BCN Commercial |
$1,084.38
|
| Rate for Payer: BCN Medicare Advantage |
$726.81
|
| Rate for Payer: Cash Price |
$1,653.60
|
| Rate for Payer: Cash Price |
$1,653.60
|
| Rate for Payer: Cofinity Commercial |
$973.93
|
| Rate for Payer: Cofinity Commercial |
$1,046.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$726.81
|
| Rate for Payer: Healthscope Commercial |
$872.17
|
| Rate for Payer: Healthscope Whirlpool |
$872.17
|
| Rate for Payer: Meridian Medicaid |
$500.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$763.15
|
| Rate for Payer: PACE SWMI |
$726.81
|
| Rate for Payer: PHP Medicare Advantage |
$726.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,133.14
|
| Rate for Payer: Priority Health Medicare |
$726.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,133.14
|
| Rate for Payer: UHC Medicare Advantage |
$748.61
|
|
|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP
|
Professional
|
Both
|
$4,086.00
|
|
|
Service Code
|
HCPCS 27823
|
| Min. Negotiated Rate |
$634.95 |
| Max. Negotiated Rate |
$3,182.48 |
| Rate for Payer: Aetna Commercial |
$1,297.48
|
| Rate for Payer: Aetna Medicare |
$968.27
|
| Rate for Payer: BCBS Complete |
$666.70
|
| Rate for Payer: BCBS MAPPO |
$968.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,182.48
|
| Rate for Payer: BCN Commercial |
$1,447.95
|
| Rate for Payer: BCN Medicare Advantage |
$968.27
|
| Rate for Payer: Cash Price |
$3,268.80
|
| Rate for Payer: Cash Price |
$3,268.80
|
| Rate for Payer: Cofinity Commercial |
$1,297.48
|
| Rate for Payer: Cofinity Commercial |
$1,394.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$968.27
|
| Rate for Payer: Healthscope Commercial |
$1,161.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.92
|
| Rate for Payer: Meridian Medicaid |
$666.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,016.68
|
| Rate for Payer: PACE SWMI |
$968.27
|
| Rate for Payer: PHP Medicare Advantage |
$968.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,860.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,513.06
|
| Rate for Payer: Priority Health Medicare |
$968.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,513.06
|
| Rate for Payer: UHC Medicare Advantage |
$997.32
|
|
|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP
|
Professional
|
Both
|
$3,468.00
|
|
|
Service Code
|
HCPCS 27822
|
| Min. Negotiated Rate |
$564.02 |
| Max. Negotiated Rate |
$3,847.61 |
| Rate for Payer: Aetna Commercial |
$1,150.51
|
| Rate for Payer: Aetna Medicare |
$858.59
|
| Rate for Payer: BCBS Complete |
$592.22
|
| Rate for Payer: BCBS MAPPO |
$858.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,847.61
|
| Rate for Payer: BCN Commercial |
$1,287.17
|
| Rate for Payer: BCN Medicare Advantage |
$858.59
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cofinity Commercial |
$1,150.51
|
| Rate for Payer: Cofinity Commercial |
$1,236.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.59
|
| Rate for Payer: Healthscope Commercial |
$1,030.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,030.31
|
| Rate for Payer: Meridian Medicaid |
$592.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$901.52
|
| Rate for Payer: PACE SWMI |
$858.59
|
| Rate for Payer: PHP Medicare Advantage |
$858.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,427.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,345.05
|
| Rate for Payer: Priority Health Medicare |
$858.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,345.05
|
| Rate for Payer: UHC Medicare Advantage |
$884.35
|
|
|
PR OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST
|
Professional
|
Both
|
$205.00
|
|
|
Service Code
|
HCPCS 92004
|
| Min. Negotiated Rate |
$59.00 |
| Max. Negotiated Rate |
$1,175.47 |
| Rate for Payer: Aetna Commercial |
$122.25
|
| Rate for Payer: Aetna Medicare |
$91.23
|
| Rate for Payer: BCBS Complete |
$61.95
|
| Rate for Payer: BCBS MAPPO |
$91.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,175.47
|
| Rate for Payer: BCN Commercial |
$159.06
|
| Rate for Payer: BCN Medicare Advantage |
$91.23
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cofinity Commercial |
$122.25
|
| Rate for Payer: Cofinity Commercial |
$131.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.23
|
| Rate for Payer: Healthscope Commercial |
$109.48
|
| Rate for Payer: Healthscope Whirlpool |
$109.48
|
| Rate for Payer: Meridian Medicaid |
$61.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.79
|
| Rate for Payer: PACE SWMI |
$91.23
|
| Rate for Payer: PHP Medicare Advantage |
$91.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.21
|
| Rate for Payer: Priority Health Medicare |
$91.23
|
| Rate for Payer: Priority Health Narrow Network |
$111.21
|
| Rate for Payer: UHC Medicare Advantage |
$93.97
|
|
|
PR OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 92014
|
| Min. Negotiated Rate |
$47.50 |
| Max. Negotiated Rate |
$1,611.32 |
| Rate for Payer: Aetna Commercial |
$98.70
|
| Rate for Payer: Aetna Medicare |
$73.66
|
| Rate for Payer: BCBS Complete |
$49.88
|
| Rate for Payer: BCBS MAPPO |
$73.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.32
|
| Rate for Payer: BCN Commercial |
$134.35
|
| Rate for Payer: BCN Medicare Advantage |
$73.66
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$106.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.66
|
| Rate for Payer: Healthscope Commercial |
$88.39
|
| Rate for Payer: Healthscope Whirlpool |
$88.39
|
| Rate for Payer: Meridian Medicaid |
$49.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.34
|
| Rate for Payer: PACE SWMI |
$73.66
|
| Rate for Payer: PHP Medicare Advantage |
$73.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.93
|
| Rate for Payer: Priority Health Medicare |
$73.66
|
| Rate for Payer: Priority Health Narrow Network |
$89.93
|
| Rate for Payer: UHC Medicare Advantage |
$75.87
|
|
|
PR OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 92012
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$1,213.51 |
| Rate for Payer: Aetna Commercial |
$65.66
|
| Rate for Payer: Aetna Medicare |
$49.00
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$49.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,213.51
|
| Rate for Payer: BCN Commercial |
$95.65
|
| Rate for Payer: BCN Medicare Advantage |
$49.00
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$65.66
|
| Rate for Payer: Cofinity Commercial |
$70.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.00
|
| Rate for Payer: Healthscope Commercial |
$58.80
|
| Rate for Payer: Healthscope Whirlpool |
$58.80
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.45
|
| Rate for Payer: PACE SWMI |
$49.00
|
| Rate for Payer: PHP Medicare Advantage |
$49.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.82
|
| Rate for Payer: Priority Health Medicare |
$49.00
|
| Rate for Payer: Priority Health Narrow Network |
$59.82
|
| Rate for Payer: UHC Medicare Advantage |
$50.47
|
|
|
PR OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT
|
Professional
|
Both
|
$109.00
|
|
|
Service Code
|
HCPCS 92002
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$902.86 |
| Rate for Payer: Aetna Commercial |
$59.55
|
| Rate for Payer: Aetna Medicare |
$44.44
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS MAPPO |
$44.44
|
| Rate for Payer: BCBS Trust/PPO |
$902.86
|
| Rate for Payer: BCN Commercial |
$90.99
|
| Rate for Payer: BCN Medicare Advantage |
$44.44
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cofinity Commercial |
$63.99
|
| Rate for Payer: Cofinity Commercial |
$59.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.44
|
| Rate for Payer: Healthscope Commercial |
$53.33
|
| Rate for Payer: Healthscope Whirlpool |
$53.33
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.66
|
| Rate for Payer: PACE SWMI |
$44.44
|
| Rate for Payer: PHP Medicare Advantage |
$44.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.20
|
| Rate for Payer: Priority Health Medicare |
$44.44
|
| Rate for Payer: Priority Health Narrow Network |
$54.20
|
| Rate for Payer: UHC Medicare Advantage |
$45.77
|
|
|
PR OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 92018
|
| Min. Negotiated Rate |
$87.54 |
| Max. Negotiated Rate |
$7,723.22 |
| Rate for Payer: Aetna Commercial |
$179.63
|
| Rate for Payer: Aetna Medicare |
$134.05
|
| Rate for Payer: BCBS Complete |
$91.92
|
| Rate for Payer: BCBS MAPPO |
$134.05
|
| Rate for Payer: BCBS Trust/PPO |
$7,723.22
|
| Rate for Payer: BCN Commercial |
$146.17
|
| Rate for Payer: BCN Medicare Advantage |
$134.05
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$179.63
|
| Rate for Payer: Cofinity Commercial |
$193.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.05
|
| Rate for Payer: Healthscope Commercial |
$160.86
|
| Rate for Payer: Healthscope Whirlpool |
$160.86
|
| Rate for Payer: Meridian Medicaid |
$91.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.75
|
| Rate for Payer: PACE SWMI |
$134.05
|
| Rate for Payer: PHP Medicare Advantage |
$134.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.80
|
| Rate for Payer: Priority Health Medicare |
$134.05
|
| Rate for Payer: Priority Health Narrow Network |
$163.80
|
| Rate for Payer: UHC Medicare Advantage |
$138.07
|
|
|
PR OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 92019
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$1,793.58 |
| Rate for Payer: Aetna Commercial |
$92.88
|
| Rate for Payer: Aetna Medicare |
$69.31
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$69.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.58
|
| Rate for Payer: BCN Commercial |
$75.59
|
| Rate for Payer: BCN Medicare Advantage |
$69.31
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$99.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.31
|
| Rate for Payer: Healthscope Commercial |
$83.17
|
| Rate for Payer: Healthscope Whirlpool |
$83.17
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.78
|
| Rate for Payer: PACE SWMI |
$69.31
|
| Rate for Payer: PHP Medicare Advantage |
$69.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.71
|
| Rate for Payer: Priority Health Medicare |
$69.31
|
| Rate for Payer: Priority Health Narrow Network |
$84.71
|
| Rate for Payer: UHC Medicare Advantage |
$71.39
|
|
|
PR OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ
|
Professional
|
Both
|
$772.00
|
|
|
Service Code
|
HCPCS 34716
|
| Min. Negotiated Rate |
$231.53 |
| Max. Negotiated Rate |
$1,773.50 |
| Rate for Payer: Aetna Commercial |
$490.41
|
| Rate for Payer: Aetna Medicare |
$365.98
|
| Rate for Payer: BCBS Complete |
$243.11
|
| Rate for Payer: BCBS MAPPO |
$365.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.50
|
| Rate for Payer: BCN Commercial |
$530.22
|
| Rate for Payer: BCN Medicare Advantage |
$365.98
|
| Rate for Payer: Cash Price |
$617.60
|
| Rate for Payer: Cash Price |
$617.60
|
| Rate for Payer: Cofinity Commercial |
$527.01
|
| Rate for Payer: Cofinity Commercial |
$490.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.98
|
| Rate for Payer: Healthscope Commercial |
$439.18
|
| Rate for Payer: Healthscope Whirlpool |
$439.18
|
| Rate for Payer: Meridian Medicaid |
$243.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.28
|
| Rate for Payer: PACE SWMI |
$365.98
|
| Rate for Payer: PHP Medicare Advantage |
$365.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$540.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$577.18
|
| Rate for Payer: Priority Health Medicare |
$365.98
|
| Rate for Payer: Priority Health Narrow Network |
$577.18
|
| Rate for Payer: UHC Medicare Advantage |
$376.96
|
|
|
PR OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 34834
|
| Min. Negotiated Rate |
$80.30 |
| Max. Negotiated Rate |
$1,323.92 |
| Rate for Payer: Aetna Commercial |
$171.53
|
| Rate for Payer: Aetna Medicare |
$128.01
|
| Rate for Payer: BCBS Complete |
$84.32
|
| Rate for Payer: BCBS MAPPO |
$128.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,323.92
|
| Rate for Payer: BCN Commercial |
$184.23
|
| Rate for Payer: BCN Medicare Advantage |
$128.01
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$171.53
|
| Rate for Payer: Cofinity Commercial |
$184.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.01
|
| Rate for Payer: Healthscope Commercial |
$153.61
|
| Rate for Payer: Healthscope Whirlpool |
$153.61
|
| Rate for Payer: Meridian Medicaid |
$84.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.41
|
| Rate for Payer: PACE SWMI |
$128.01
|
| Rate for Payer: PHP Medicare Advantage |
$128.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.54
|
| Rate for Payer: Priority Health Medicare |
$128.01
|
| Rate for Payer: Priority Health Narrow Network |
$200.54
|
| Rate for Payer: UHC Medicare Advantage |
$131.85
|
|
|
PR OPN FEM ART EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$1,242.00
|
|
|
Service Code
|
HCPCS 34812
|
| Min. Negotiated Rate |
$128.01 |
| Max. Negotiated Rate |
$869.40 |
| Rate for Payer: Aetna Commercial |
$271.82
|
| Rate for Payer: Aetna Medicare |
$202.85
|
| Rate for Payer: BCBS Complete |
$134.41
|
| Rate for Payer: BCBS MAPPO |
$202.85
|
| Rate for Payer: BCBS Trust/PPO |
$498.72
|
| Rate for Payer: BCN Commercial |
$292.72
|
| Rate for Payer: BCN Medicare Advantage |
$202.85
|
| Rate for Payer: Cash Price |
$993.60
|
| Rate for Payer: Cash Price |
$993.60
|
| Rate for Payer: Cofinity Commercial |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$271.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.85
|
| Rate for Payer: Healthscope Commercial |
$243.42
|
| Rate for Payer: Healthscope Whirlpool |
$243.42
|
| Rate for Payer: Meridian Medicaid |
$134.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.99
|
| Rate for Payer: PACE SWMI |
$202.85
|
| Rate for Payer: PHP Medicare Advantage |
$202.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.64
|
| Rate for Payer: Priority Health Medicare |
$202.85
|
| Rate for Payer: Priority Health Narrow Network |
$318.64
|
| Rate for Payer: UHC Medicare Advantage |
$208.94
|
|
|
PR OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH
|
Professional
|
Both
|
$557.00
|
|
|
Service Code
|
HCPCS 34714
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$1,553.20 |
| Rate for Payer: Aetna Commercial |
$355.25
|
| Rate for Payer: Aetna Medicare |
$265.11
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS MAPPO |
$265.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,553.20
|
| Rate for Payer: BCN Commercial |
$383.62
|
| Rate for Payer: BCN Medicare Advantage |
$265.11
|
| Rate for Payer: Cash Price |
$445.60
|
| Rate for Payer: Cash Price |
$445.60
|
| Rate for Payer: Cofinity Commercial |
$355.25
|
| Rate for Payer: Cofinity Commercial |
$381.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.11
|
| Rate for Payer: Healthscope Commercial |
$318.13
|
| Rate for Payer: Healthscope Whirlpool |
$318.13
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$278.37
|
| Rate for Payer: PACE SWMI |
$265.11
|
| Rate for Payer: PHP Medicare Advantage |
$265.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$417.58
|
| Rate for Payer: Priority Health Medicare |
$265.11
|
| Rate for Payer: Priority Health Narrow Network |
$417.58
|
| Rate for Payer: UHC Medicare Advantage |
$273.06
|
|
|
PR OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP
|
Professional
|
Both
|
$2,188.00
|
|
|
Service Code
|
HCPCS 34833
|
| Min. Negotiated Rate |
$244.10 |
| Max. Negotiated Rate |
$1,531.60 |
| Rate for Payer: Aetna Commercial |
$519.75
|
| Rate for Payer: Aetna Medicare |
$387.87
|
| Rate for Payer: BCBS Complete |
$256.30
|
| Rate for Payer: BCBS MAPPO |
$387.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,407.92
|
| Rate for Payer: BCN Commercial |
$557.58
|
| Rate for Payer: BCN Medicare Advantage |
$387.87
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cofinity Commercial |
$558.53
|
| Rate for Payer: Cofinity Commercial |
$519.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.87
|
| Rate for Payer: Healthscope Commercial |
$465.44
|
| Rate for Payer: Healthscope Whirlpool |
$465.44
|
| Rate for Payer: Meridian Medicaid |
$256.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$407.26
|
| Rate for Payer: PACE SWMI |
$387.87
|
| Rate for Payer: PHP Medicare Advantage |
$387.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,531.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.96
|
| Rate for Payer: Priority Health Medicare |
$387.87
|
| Rate for Payer: Priority Health Narrow Network |
$606.96
|
| Rate for Payer: UHC Medicare Advantage |
$399.51
|
|
|
PR OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH
|
Professional
|
Both
|
$4,718.00
|
|
|
Service Code
|
HCPCS 34830
|
| Min. Negotiated Rate |
$841.05 |
| Max. Negotiated Rate |
$3,302.60 |
| Rate for Payer: Aetna Commercial |
$2,331.89
|
| Rate for Payer: Aetna Medicare |
$1,740.22
|
| Rate for Payer: BCBS Complete |
$1,154.03
|
| Rate for Payer: BCBS MAPPO |
$1,740.22
|
| Rate for Payer: BCBS Trust/PPO |
$841.05
|
| Rate for Payer: BCN Commercial |
$2,510.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,740.22
|
| Rate for Payer: Cash Price |
$3,774.40
|
| Rate for Payer: Cash Price |
$3,774.40
|
| Rate for Payer: Cofinity Commercial |
$2,505.92
|
| Rate for Payer: Cofinity Commercial |
$2,331.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,740.22
|
| Rate for Payer: Healthscope Commercial |
$2,088.26
|
| Rate for Payer: Healthscope Whirlpool |
$2,088.26
|
| Rate for Payer: Meridian Medicaid |
$1,154.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,827.23
|
| Rate for Payer: PACE SWMI |
$1,740.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,740.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,099.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,302.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,733.19
|
| Rate for Payer: Priority Health Medicare |
$1,740.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,733.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.43
|
|
|
PR OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH
|
Professional
|
Both
|
$3,997.00
|
|
|
Service Code
|
HCPCS 34831
|
| Min. Negotiated Rate |
$953.05 |
| Max. Negotiated Rate |
$2,988.53 |
| Rate for Payer: Aetna Commercial |
$2,546.52
|
| Rate for Payer: Aetna Medicare |
$1,900.39
|
| Rate for Payer: BCBS Complete |
$1,262.06
|
| Rate for Payer: BCBS MAPPO |
$1,900.39
|
| Rate for Payer: BCBS Trust/PPO |
$953.05
|
| Rate for Payer: BCN Commercial |
$2,745.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,900.39
|
| Rate for Payer: Cash Price |
$3,197.60
|
| Rate for Payer: Cash Price |
$3,197.60
|
| Rate for Payer: Cofinity Commercial |
$2,546.52
|
| Rate for Payer: Cofinity Commercial |
$2,736.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,900.39
|
| Rate for Payer: Healthscope Commercial |
$2,280.47
|
| Rate for Payer: Healthscope Whirlpool |
$2,280.47
|
| Rate for Payer: Meridian Medicaid |
$1,262.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,995.41
|
| Rate for Payer: PACE SWMI |
$1,900.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,900.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,201.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,988.53
|
| Rate for Payer: Priority Health Medicare |
$1,900.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,988.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,957.40
|
|
|
PR OPN SUBCLA CRTD ART TRPOS NCK INC ULAT
|
Professional
|
Both
|
$3,137.00
|
|
|
Service Code
|
HCPCS 33889
|
| Min. Negotiated Rate |
$494.59 |
| Max. Negotiated Rate |
$2,852.29 |
| Rate for Payer: Aetna Commercial |
$1,050.28
|
| Rate for Payer: Aetna Medicare |
$783.79
|
| Rate for Payer: BCBS Complete |
$519.32
|
| Rate for Payer: BCBS MAPPO |
$783.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,852.29
|
| Rate for Payer: BCN Commercial |
$1,130.80
|
| Rate for Payer: BCN Medicare Advantage |
$783.79
|
| Rate for Payer: Cash Price |
$2,509.60
|
| Rate for Payer: Cash Price |
$2,509.60
|
| Rate for Payer: Cofinity Commercial |
$1,128.66
|
| Rate for Payer: Cofinity Commercial |
$1,050.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$783.79
|
| Rate for Payer: Healthscope Commercial |
$940.55
|
| Rate for Payer: Healthscope Whirlpool |
$940.55
|
| Rate for Payer: Meridian Medicaid |
$519.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$822.98
|
| Rate for Payer: PACE SWMI |
$783.79
|
| Rate for Payer: PHP Medicare Advantage |
$783.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.95
|
| Rate for Payer: Priority Health Medicare |
$783.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,230.95
|
| Rate for Payer: UHC Medicare Advantage |
$807.30
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
IP
|
$72.72
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$50.90 |
| Max. Negotiated Rate |
$72.72 |
| Rate for Payer: Aetna Commercial |
$65.45
|
| Rate for Payer: Aetna Commercial |
$69.40
|
| Rate for Payer: Aetna Commercial |
$85.92
|
| Rate for Payer: ASR ASR |
$74.80
|
| Rate for Payer: ASR ASR |
$70.54
|
| Rate for Payer: ASR ASR |
$92.61
|
| Rate for Payer: BCBS Trust/PPO |
$74.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.78
|
| Rate for Payer: BCBS Trust/PPO |
$56.38
|
| Rate for Payer: BCN Commercial |
$74.02
|
| Rate for Payer: BCN Commercial |
$59.78
|
| Rate for Payer: BCN Commercial |
$56.38
|
| Rate for Payer: Cash Price |
$58.17
|
| Rate for Payer: Cash Price |
$61.69
|
| Rate for Payer: Cash Price |
$76.38
|
| Rate for Payer: Cofinity Commercial |
$72.48
|
| Rate for Payer: Cofinity Commercial |
$68.36
|
| Rate for Payer: Cofinity Commercial |
$89.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.38
|
| Rate for Payer: Healthscope Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$72.72
|
| Rate for Payer: Healthscope Whirlpool |
$74.80
|
| Rate for Payer: Healthscope Whirlpool |
$70.54
|
| Rate for Payer: Healthscope Whirlpool |
$92.61
|
| Rate for Payer: Mclaren Commercial |
$69.40
|
| Rate for Payer: Mclaren Commercial |
$65.45
|
| Rate for Payer: Mclaren Commercial |
$85.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.01
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
IP
|
$119.34
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$83.54 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Aetna Commercial |
$107.41
|
| Rate for Payer: Aetna Commercial |
$41.52
|
| Rate for Payer: Aetna Commercial |
$49.09
|
| Rate for Payer: Aetna Commercial |
$69.40
|
| Rate for Payer: Aetna Commercial |
$64.44
|
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: Aetna Commercial |
$85.92
|
| Rate for Payer: Aetna Commercial |
$61.67
|
| Rate for Payer: Aetna Commercial |
$65.45
|
| Rate for Payer: ASR ASR |
$52.90
|
| Rate for Payer: ASR ASR |
$115.76
|
| Rate for Payer: ASR ASR |
$92.61
|
| Rate for Payer: ASR ASR |
$80.45
|
| Rate for Payer: ASR ASR |
$74.80
|
| Rate for Payer: ASR ASR |
$44.75
|
| Rate for Payer: ASR ASR |
$70.54
|
| Rate for Payer: ASR ASR |
$69.45
|
| Rate for Payer: ASR ASR |
$66.46
|
| Rate for Payer: BCBS Trust/PPO |
$56.38
|
| Rate for Payer: BCBS Trust/PPO |
$53.12
|
| Rate for Payer: BCBS Trust/PPO |
$64.30
|
| Rate for Payer: BCBS Trust/PPO |
$55.51
|
| Rate for Payer: BCBS Trust/PPO |
$92.52
|
| Rate for Payer: BCBS Trust/PPO |
$74.02
|
| Rate for Payer: BCBS Trust/PPO |
$35.76
|
| Rate for Payer: BCBS Trust/PPO |
$42.28
|
| Rate for Payer: BCBS Trust/PPO |
$59.78
|
| Rate for Payer: BCN Commercial |
$64.30
|
| Rate for Payer: BCN Commercial |
$92.52
|
| Rate for Payer: BCN Commercial |
$35.76
|
| Rate for Payer: BCN Commercial |
$42.28
|
| Rate for Payer: BCN Commercial |
$53.12
|
| Rate for Payer: BCN Commercial |
$55.51
|
| Rate for Payer: BCN Commercial |
$56.38
|
| Rate for Payer: BCN Commercial |
$59.78
|
| Rate for Payer: BCN Commercial |
$74.02
|
| Rate for Payer: Cash Price |
$36.91
|
| Rate for Payer: Cash Price |
$61.69
|
| Rate for Payer: Cash Price |
$76.38
|
| Rate for Payer: Cash Price |
$54.82
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$57.28
|
| Rate for Payer: Cash Price |
$58.17
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cash Price |
$66.35
|
| Rate for Payer: Cofinity Commercial |
$68.36
|
| Rate for Payer: Cofinity Commercial |
$51.27
|
| Rate for Payer: Cofinity Commercial |
$43.36
|
| Rate for Payer: Cofinity Commercial |
$112.18
|
| Rate for Payer: Cofinity Commercial |
$64.41
|
| Rate for Payer: Cofinity Commercial |
$72.48
|
| Rate for Payer: Cofinity Commercial |
$89.74
|
| Rate for Payer: Cofinity Commercial |
$67.30
|
| Rate for Payer: Cofinity Commercial |
$77.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Healthscope Commercial |
$82.94
|
| Rate for Payer: Healthscope Commercial |
$68.52
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Healthscope Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$46.13
|
| Rate for Payer: Healthscope Commercial |
$54.54
|
| Rate for Payer: Healthscope Commercial |
$72.72
|
| Rate for Payer: Healthscope Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$119.34
|
| Rate for Payer: Healthscope Whirlpool |
$80.45
|
| Rate for Payer: Healthscope Whirlpool |
$66.46
|
| Rate for Payer: Healthscope Whirlpool |
$92.61
|
| Rate for Payer: Healthscope Whirlpool |
$74.80
|
| Rate for Payer: Healthscope Whirlpool |
$115.76
|
| Rate for Payer: Healthscope Whirlpool |
$69.45
|
| Rate for Payer: Healthscope Whirlpool |
$52.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.75
|
| Rate for Payer: Healthscope Whirlpool |
$70.54
|
| Rate for Payer: Mclaren Commercial |
$64.44
|
| Rate for Payer: Mclaren Commercial |
$65.45
|
| Rate for Payer: Mclaren Commercial |
$49.09
|
| Rate for Payer: Mclaren Commercial |
$41.52
|
| Rate for Payer: Mclaren Commercial |
$74.65
|
| Rate for Payer: Mclaren Commercial |
$69.40
|
| Rate for Payer: Mclaren Commercial |
$61.67
|
| Rate for Payer: Mclaren Commercial |
$107.41
|
| Rate for Payer: Mclaren Commercial |
$85.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.99
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$119.34
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$83.54 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Aetna Commercial |
$107.41
|
| Rate for Payer: Aetna Commercial |
$65.45
|
| Rate for Payer: ASR ASR |
$115.76
|
| Rate for Payer: ASR ASR |
$70.54
|
| Rate for Payer: BCBS Trust/PPO |
$56.38
|
| Rate for Payer: BCBS Trust/PPO |
$92.52
|
| Rate for Payer: BCN Commercial |
$56.38
|
| Rate for Payer: BCN Commercial |
$92.52
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cash Price |
$58.17
|
| Rate for Payer: Cofinity Commercial |
$68.36
|
| Rate for Payer: Cofinity Commercial |
$112.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$119.34
|
| Rate for Payer: Healthscope Commercial |
$72.72
|
| Rate for Payer: Healthscope Whirlpool |
$115.76
|
| Rate for Payer: Healthscope Whirlpool |
$70.54
|
| Rate for Payer: Mclaren Commercial |
$65.45
|
| Rate for Payer: Mclaren Commercial |
$107.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.99
|
|
