|
PR DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 69020
|
| Min. Negotiated Rate |
$92.66 |
| Max. Negotiated Rate |
$346.96 |
| Rate for Payer: Aetna Commercial |
$158.84
|
| Rate for Payer: Aetna Medicare |
$190.00
|
| Rate for Payer: BCBS Complete |
$97.29
|
| Rate for Payer: BCBS Trust/PPO |
$282.64
|
| Rate for Payer: BCN Commercial |
$346.96
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Meridian Medicaid |
$97.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.05
|
| Rate for Payer: Priority Health Narrow Network |
$212.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.39
|
| Rate for Payer: UHC Exchange |
$155.39
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA COMP
|
Professional
|
Both
|
$385.00
|
|
|
Service Code
|
HCPCS 69005
|
| Min. Negotiated Rate |
$104.37 |
| Max. Negotiated Rate |
$5,834.02 |
| Rate for Payer: Aetna Commercial |
$177.45
|
| Rate for Payer: Aetna Medicare |
$192.50
|
| Rate for Payer: BCBS Complete |
$109.59
|
| Rate for Payer: BCBS Trust/PPO |
$5,834.02
|
| Rate for Payer: BCN Commercial |
$323.02
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Meridian Medicaid |
$109.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.84
|
| Rate for Payer: Priority Health Narrow Network |
$237.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.26
|
| Rate for Payer: UHC Exchange |
$174.26
|
| Rate for Payer: UHCCP Medicaid |
$104.37
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 69000
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$5,524.43 |
| Rate for Payer: Aetna Commercial |
$136.46
|
| Rate for Payer: Aetna Medicare |
$158.50
|
| Rate for Payer: BCBS Complete |
$84.99
|
| Rate for Payer: BCBS Trust/PPO |
$5,524.43
|
| Rate for Payer: BCN Commercial |
$275.12
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Meridian Medicaid |
$84.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.82
|
| Rate for Payer: Priority Health Narrow Network |
$184.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.28
|
| Rate for Payer: UHC Exchange |
$129.28
|
| Rate for Payer: UHCCP Medicaid |
$80.94
|
|
|
PR DRAINAGE FINGER ABSCESS COMPLICATED
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 26011
|
| Min. Negotiated Rate |
$120.98 |
| Max. Negotiated Rate |
$712.98 |
| Rate for Payer: Aetna Commercial |
$245.87
|
| Rate for Payer: Aetna Medicare |
$405.50
|
| Rate for Payer: BCBS Complete |
$127.03
|
| Rate for Payer: BCBS Trust/PPO |
$452.09
|
| Rate for Payer: BCN Commercial |
$712.98
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Meridian Medicaid |
$127.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.49
|
| Rate for Payer: Priority Health Narrow Network |
$286.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$205.80
|
| Rate for Payer: UHC Exchange |
$205.80
|
| Rate for Payer: UHCCP Medicaid |
$120.98
|
|
|
PR DRAINAGE FINGER ABSCESS SIMPLE
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 26010
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$509.69 |
| Rate for Payer: Aetna Commercial |
$184.30
|
| Rate for Payer: Aetna Medicare |
$288.00
|
| Rate for Payer: BCBS Complete |
$96.39
|
| Rate for Payer: BCBS Trust/PPO |
$348.51
|
| Rate for Payer: BCN Commercial |
$509.69
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Meridian Medicaid |
$96.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.82
|
| Rate for Payer: Priority Health Narrow Network |
$218.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.75
|
| Rate for Payer: UHC Exchange |
$149.75
|
| Rate for Payer: UHCCP Medicaid |
$91.80
|
|
|
PR DRAINAGE OF PALMAR BURSA MULTIPLE BURSA
|
Professional
|
Both
|
$3,178.00
|
|
|
Service Code
|
HCPCS 26030
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$2,065.70 |
| Rate for Payer: Aetna Commercial |
$651.70
|
| Rate for Payer: Aetna Medicare |
$1,589.00
|
| Rate for Payer: BCBS Complete |
$339.95
|
| Rate for Payer: BCBS Trust/PPO |
$104.00
|
| Rate for Payer: BCN Commercial |
$727.15
|
| Rate for Payer: Cash Price |
$2,542.40
|
| Rate for Payer: Cash Price |
$2,542.40
|
| Rate for Payer: Meridian Medicaid |
$339.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,065.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.32
|
| Rate for Payer: Priority Health Narrow Network |
$765.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$552.24
|
| Rate for Payer: UHC Exchange |
$552.24
|
| Rate for Payer: UHCCP Medicaid |
$323.76
|
|
|
PR DRAINAGE OF PALMAR BURSA SINGLE BURSA
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 26025
|
| Min. Negotiated Rate |
$84.90 |
| Max. Negotiated Rate |
$885.95 |
| Rate for Payer: Aetna Commercial |
$560.79
|
| Rate for Payer: Aetna Medicare |
$681.50
|
| Rate for Payer: BCBS Complete |
$289.18
|
| Rate for Payer: BCBS Trust/PPO |
$84.90
|
| Rate for Payer: BCN Commercial |
$621.60
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Meridian Medicaid |
$289.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$653.37
|
| Rate for Payer: Priority Health Narrow Network |
$653.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$466.74
|
| Rate for Payer: UHC Exchange |
$466.74
|
| Rate for Payer: UHCCP Medicaid |
$275.41
|
|
|
PR DRAINAGE OF RETROPERITONEAL ABSCESS OPEN
|
Professional
|
Both
|
$2,249.00
|
|
|
Service Code
|
HCPCS 49060
|
| Min. Negotiated Rate |
$709.29 |
| Max. Negotiated Rate |
$1,957.42 |
| Rate for Payer: Aetna Commercial |
$1,480.16
|
| Rate for Payer: Aetna Medicare |
$1,124.50
|
| Rate for Payer: BCBS Complete |
$744.75
|
| Rate for Payer: BCBS Trust/PPO |
$798.26
|
| Rate for Payer: BCN Commercial |
$1,595.04
|
| Rate for Payer: Cash Price |
$1,799.20
|
| Rate for Payer: Cash Price |
$1,799.20
|
| Rate for Payer: Meridian Medicaid |
$744.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,461.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,957.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,957.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,344.50
|
| Rate for Payer: UHC Exchange |
$1,344.50
|
| Rate for Payer: UHCCP Medicaid |
$709.29
|
|
|
PR DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Professional
|
Both
|
$1,725.00
|
|
|
Service Code
|
HCPCS 58822
|
| Min. Negotiated Rate |
$280.53 |
| Max. Negotiated Rate |
$1,121.25 |
| Rate for Payer: Aetna Commercial |
$854.23
|
| Rate for Payer: Aetna Medicare |
$862.50
|
| Rate for Payer: BCBS Complete |
$481.30
|
| Rate for Payer: BCBS Trust/PPO |
$280.53
|
| Rate for Payer: BCN Commercial |
$1,050.17
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Meridian Medicaid |
$481.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,121.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,070.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,070.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$831.73
|
| Rate for Payer: UHC Exchange |
$831.73
|
| Rate for Payer: UHCCP Medicaid |
$458.38
|
|
|
PR DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN
|
Professional
|
Both
|
$897.00
|
|
|
Service Code
|
HCPCS 58820
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$583.05 |
| Rate for Payer: Aetna Commercial |
$398.40
|
| Rate for Payer: Aetna Medicare |
$448.50
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$500.41
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.43
|
| Rate for Payer: Priority Health Narrow Network |
$510.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$354.38
|
| Rate for Payer: UHC Exchange |
$354.38
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
|
|
PR DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL
|
Professional
|
Both
|
$1,612.00
|
|
|
Service Code
|
HCPCS 58805
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,047.80 |
| Rate for Payer: Aetna Commercial |
$506.69
|
| Rate for Payer: Aetna Medicare |
$806.00
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS Trust/PPO |
$275.77
|
| Rate for Payer: BCN Commercial |
$630.89
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.87
|
| Rate for Payer: Priority Health Narrow Network |
$643.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$461.13
|
| Rate for Payer: UHC Exchange |
$461.13
|
| Rate for Payer: UHCCP Medicaid |
$274.77
|
|
|
PR DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR
|
Professional
|
Both
|
$993.00
|
|
|
Service Code
|
HCPCS 58800
|
| Min. Negotiated Rate |
$203.63 |
| Max. Negotiated Rate |
$645.45 |
| Rate for Payer: Aetna Commercial |
$373.31
|
| Rate for Payer: Aetna Medicare |
$496.50
|
| Rate for Payer: BCBS Complete |
$213.81
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: BCN Commercial |
$535.10
|
| Rate for Payer: Cash Price |
$794.40
|
| Rate for Payer: Cash Price |
$794.40
|
| Rate for Payer: Meridian Medicaid |
$213.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$645.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.71
|
| Rate for Payer: Priority Health Narrow Network |
$474.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.33
|
| Rate for Payer: UHC Exchange |
$340.33
|
| Rate for Payer: UHCCP Medicaid |
$203.63
|
|
|
PR DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN
|
Professional
|
Both
|
$2,828.00
|
|
|
Service Code
|
HCPCS 49020
|
| Min. Negotiated Rate |
$537.81 |
| Max. Negotiated Rate |
$2,851.12 |
| Rate for Payer: Aetna Commercial |
$2,149.64
|
| Rate for Payer: Aetna Medicare |
$1,414.00
|
| Rate for Payer: BCBS Complete |
$1,073.74
|
| Rate for Payer: BCBS Trust/PPO |
$537.81
|
| Rate for Payer: BCN Commercial |
$2,320.24
|
| Rate for Payer: Cash Price |
$2,262.40
|
| Rate for Payer: Cash Price |
$2,262.40
|
| Rate for Payer: Meridian Medicaid |
$1,073.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,022.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,838.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,851.12
|
| Rate for Payer: Priority Health Narrow Network |
$2,851.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,922.30
|
| Rate for Payer: UHC Exchange |
$1,922.30
|
| Rate for Payer: UHCCP Medicaid |
$1,022.61
|
|
|
PR DRAINAGE SCROTAL WALL ABSCESS
|
Professional
|
Both
|
$399.00
|
|
|
Service Code
|
HCPCS 55100
|
| Min. Negotiated Rate |
$108.84 |
| Max. Negotiated Rate |
$1,199.77 |
| Rate for Payer: Aetna Commercial |
$212.60
|
| Rate for Payer: Aetna Medicare |
$199.50
|
| Rate for Payer: BCBS Complete |
$114.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,199.77
|
| Rate for Payer: BCN Commercial |
$336.70
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Meridian Medicaid |
$114.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.03
|
| Rate for Payer: Priority Health Narrow Network |
$270.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$194.35
|
| Rate for Payer: UHC Exchange |
$194.35
|
| Rate for Payer: UHCCP Medicaid |
$108.84
|
|
|
PR DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN
|
Professional
|
Both
|
$2,224.00
|
|
|
Service Code
|
HCPCS 49040
|
| Min. Negotiated Rate |
$640.83 |
| Max. Negotiated Rate |
$1,796.35 |
| Rate for Payer: Aetna Commercial |
$1,356.51
|
| Rate for Payer: Aetna Medicare |
$1,112.00
|
| Rate for Payer: BCBS Complete |
$679.22
|
| Rate for Payer: BCBS Trust/PPO |
$640.83
|
| Rate for Payer: BCN Commercial |
$1,465.54
|
| Rate for Payer: Cash Price |
$1,779.20
|
| Rate for Payer: Cash Price |
$1,779.20
|
| Rate for Payer: Meridian Medicaid |
$679.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$646.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,445.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,796.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,796.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,206.74
|
| Rate for Payer: UHC Exchange |
$1,206.74
|
| Rate for Payer: UHCCP Medicaid |
$646.88
|
|
|
PR DRAINAGE TENDON SHEATH DIGIT&/PALM EACH
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 26020
|
| Min. Negotiated Rate |
$366.15 |
| Max. Negotiated Rate |
$865.57 |
| Rate for Payer: Aetna Commercial |
$737.75
|
| Rate for Payer: Aetna Medicare |
$382.50
|
| Rate for Payer: BCBS Complete |
$384.46
|
| Rate for Payer: BCBS Trust/PPO |
$663.49
|
| Rate for Payer: BCN Commercial |
$823.43
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Meridian Medicaid |
$384.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$865.57
|
| Rate for Payer: Priority Health Narrow Network |
$865.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.14
|
| Rate for Payer: UHC Exchange |
$479.14
|
| Rate for Payer: UHCCP Medicaid |
$366.15
|
|
|
PR DRESSING CHANGE UNDER ANESTHESIA
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 15852
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$50.88
|
| Rate for Payer: Aetna Medicare |
$85.00
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$450.00
|
| Rate for Payer: BCN Commercial |
$66.95
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.05
|
| Rate for Payer: Priority Health Narrow Network |
$60.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.37
|
| Rate for Payer: UHC Exchange |
$51.37
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 41800
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$2,059.31 |
| Rate for Payer: Aetna Commercial |
$204.22
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,059.31
|
| Rate for Payer: BCN Commercial |
$429.55
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.01
|
| Rate for Payer: Priority Health Narrow Network |
$278.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.41
|
| Rate for Payer: UHC Exchange |
$157.41
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR DRG ABSC CST HMTMA VESTIBULE MOUTH COMP
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 40801
|
| Min. Negotiated Rate |
$130.36 |
| Max. Negotiated Rate |
$1,779.31 |
| Rate for Payer: Aetna Commercial |
$262.87
|
| Rate for Payer: Aetna Medicare |
$316.00
|
| Rate for Payer: BCBS Complete |
$136.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.31
|
| Rate for Payer: BCN Commercial |
$425.15
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Meridian Medicaid |
$136.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$356.76
|
| Rate for Payer: Priority Health Narrow Network |
$356.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.18
|
| Rate for Payer: UHC Exchange |
$260.18
|
| Rate for Payer: UHCCP Medicaid |
$130.36
|
|
|
PR DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV
|
Professional
|
Both
|
$1,058.00
|
|
|
Service Code
|
HCPCS 38305
|
| Min. Negotiated Rate |
$322.06 |
| Max. Negotiated Rate |
$998.62 |
| Rate for Payer: Aetna Commercial |
$608.51
|
| Rate for Payer: Aetna Medicare |
$529.00
|
| Rate for Payer: BCBS Complete |
$338.16
|
| Rate for Payer: BCBS Trust/PPO |
$565.81
|
| Rate for Payer: BCN Commercial |
$725.20
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Meridian Medicaid |
$338.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$687.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$998.62
|
| Rate for Payer: Priority Health Narrow Network |
$998.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$511.83
|
| Rate for Payer: UHC Exchange |
$511.83
|
| Rate for Payer: UHCCP Medicaid |
$322.06
|
|
|
PR DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 38300
|
| Min. Negotiated Rate |
$136.75 |
| Max. Negotiated Rate |
$604.38 |
| Rate for Payer: Aetna Commercial |
$255.68
|
| Rate for Payer: Aetna Medicare |
$227.50
|
| Rate for Payer: BCBS Complete |
$143.59
|
| Rate for Payer: BCBS Trust/PPO |
$604.38
|
| Rate for Payer: BCN Commercial |
$498.94
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Meridian Medicaid |
$143.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.42
|
| Rate for Payer: Priority Health Narrow Network |
$423.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$200.73
|
| Rate for Payer: UHC Exchange |
$200.73
|
| Rate for Payer: UHCCP Medicaid |
$136.75
|
|
|
PR DRG OF SKENE'S GLAND ABSCESS OR CYST
|
Professional
|
Both
|
$615.00
|
|
|
Service Code
|
HCPCS 53060
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Aetna Commercial |
$213.39
|
| Rate for Payer: Aetna Medicare |
$307.50
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$277.56
|
| Rate for Payer: Cash Price |
$492.00
|
| Rate for Payer: Cash Price |
$492.00
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.30
|
| Rate for Payer: Priority Health Narrow Network |
$266.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.35
|
| Rate for Payer: UHC Exchange |
$190.35
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 16030
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$569.29 |
| Rate for Payer: Aetna Commercial |
$141.99
|
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCBS Trust/PPO |
$569.29
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.36
|
| Rate for Payer: Priority Health Narrow Network |
$178.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.32
|
| Rate for Payer: UHC Exchange |
$140.32
|
| Rate for Payer: UHCCP Medicaid |
$85.20
|
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 16025
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$2,369.57 |
| Rate for Payer: Aetna Commercial |
$119.21
|
| Rate for Payer: Aetna Medicare |
$125.50
|
| Rate for Payer: BCBS Complete |
$74.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,369.57
|
| Rate for Payer: BCN Commercial |
$228.70
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Meridian Medicaid |
$74.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.81
|
| Rate for Payer: Priority Health Narrow Network |
$150.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.38
|
| Rate for Payer: UHC Exchange |
$123.38
|
| Rate for Payer: UHCCP Medicaid |
$71.14
|
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 16020
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$3,995.58 |
| Rate for Payer: Aetna Commercial |
$59.06
|
| Rate for Payer: Aetna Medicare |
$69.00
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,995.58
|
| Rate for Payer: BCN Commercial |
$125.10
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.85
|
| Rate for Payer: Priority Health Narrow Network |
$75.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.38
|
| Rate for Payer: UHC Exchange |
$59.38
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
|
