|
PR PELVIC RING FRACTURE UNI/BIL
|
Professional
|
Both
|
$3,110.00
|
|
|
Service Code
|
HCPCS G0413
|
| Min. Negotiated Rate |
$238.26 |
| Max. Negotiated Rate |
$2,177.00 |
| Rate for Payer: Aetna Commercial |
$1,405.97
|
| Rate for Payer: Aetna Medicare |
$1,049.23
|
| Rate for Payer: BCBS Complete |
$718.37
|
| Rate for Payer: BCBS MAPPO |
$1,049.23
|
| Rate for Payer: BCBS Trust/PPO |
$238.26
|
| Rate for Payer: BCN Commercial |
$1,557.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,049.23
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Cofinity Commercial |
$1,510.89
|
| Rate for Payer: Cofinity Commercial |
$1,405.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,049.23
|
| Rate for Payer: Healthscope Commercial |
$1,259.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,259.08
|
| Rate for Payer: Meridian Medicaid |
$718.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.69
|
| Rate for Payer: PACE SWMI |
$1,049.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,049.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$684.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,177.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,627.95
|
| Rate for Payer: Priority Health Medicare |
$1,049.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,627.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.71
|
|
|
PR PELVIC RING FX TREAT INT FIX
|
Professional
|
Both
|
$3,073.00
|
|
|
Service Code
|
HCPCS G0414
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$2,151.10 |
| Rate for Payer: Aetna Commercial |
$1,325.07
|
| Rate for Payer: Aetna Medicare |
$988.86
|
| Rate for Payer: BCBS Complete |
$677.88
|
| Rate for Payer: BCBS MAPPO |
$988.86
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$1,469.46
|
| Rate for Payer: BCN Medicare Advantage |
$988.86
|
| Rate for Payer: Cash Price |
$2,458.40
|
| Rate for Payer: Cash Price |
$2,458.40
|
| Rate for Payer: Cofinity Commercial |
$1,325.07
|
| Rate for Payer: Cofinity Commercial |
$1,423.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$988.86
|
| Rate for Payer: Healthscope Commercial |
$1,186.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,186.63
|
| Rate for Payer: Meridian Medicaid |
$677.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,038.30
|
| Rate for Payer: PACE SWMI |
$988.86
|
| Rate for Payer: PHP Medicare Advantage |
$988.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,151.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,535.53
|
| Rate for Payer: Priority Health Medicare |
$988.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,535.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,018.53
|
|
|
PR PENG BENZATHINE/PROCAINE INJ
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS J0558
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$22.57 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare |
$15.67
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$15.67
|
| Rate for Payer: BCBS Trust/PPO |
$17.90
|
| Rate for Payer: BCN Commercial |
$14.68
|
| Rate for Payer: BCN Medicare Advantage |
$15.67
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$22.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.67
|
| Rate for Payer: Healthscope Commercial |
$18.81
|
| Rate for Payer: Healthscope Whirlpool |
$18.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.46
|
| Rate for Payer: PACE SWMI |
$15.67
|
| Rate for Payer: PHP Medicare Advantage |
$15.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
| Rate for Payer: Priority Health Medicare |
$15.67
|
| Rate for Payer: UHC Medicare Advantage |
$16.14
|
|
|
PR PENICILLIN G BENZATHINE INJ
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J0561
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$29.04 |
| Rate for Payer: Aetna Commercial |
$27.03
|
| Rate for Payer: Aetna Medicare |
$20.17
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$20.17
|
| Rate for Payer: BCBS Trust/PPO |
$21.19
|
| Rate for Payer: BCN Commercial |
$16.84
|
| Rate for Payer: BCN Medicare Advantage |
$20.17
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$27.03
|
| Rate for Payer: Cofinity Commercial |
$29.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.17
|
| Rate for Payer: Healthscope Commercial |
$24.20
|
| Rate for Payer: Healthscope Whirlpool |
$24.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.18
|
| Rate for Payer: PACE SWMI |
$20.17
|
| Rate for Payer: PHP Medicare Advantage |
$20.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
| Rate for Payer: Priority Health Medicare |
$20.17
|
| Rate for Payer: UHC Medicare Advantage |
$20.77
|
|
|
PR PENILE PLETHYSMOGRAPHY
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 54240
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$680.45 |
| Rate for Payer: Aetna Commercial |
$138.68
|
| Rate for Payer: Aetna Medicare |
$103.49
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$103.49
|
| Rate for Payer: BCBS Trust/PPO |
$680.45
|
| Rate for Payer: BCN Commercial |
$155.89
|
| Rate for Payer: BCN Medicare Advantage |
$103.49
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Cofinity Commercial |
$149.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.49
|
| Rate for Payer: Healthscope Commercial |
$124.19
|
| Rate for Payer: Healthscope Whirlpool |
$124.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.66
|
| Rate for Payer: PACE SWMI |
$103.49
|
| Rate for Payer: PHP Medicare Advantage |
$103.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.37
|
| Rate for Payer: Priority Health Medicare |
$103.49
|
| Rate for Payer: Priority Health Narrow Network |
$172.37
|
| Rate for Payer: UHC Medicare Advantage |
$106.59
|
|
|
PR PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR
|
Professional
|
Both
|
$5,098.00
|
|
|
Service Code
|
HCPCS 54304
|
| Min. Negotiated Rate |
$316.45 |
| Max. Negotiated Rate |
$3,568.60 |
| Rate for Payer: Aetna Commercial |
$978.00
|
| Rate for Payer: Aetna Medicare |
$729.85
|
| Rate for Payer: BCBS Complete |
$499.63
|
| Rate for Payer: BCBS MAPPO |
$729.85
|
| Rate for Payer: BCBS Trust/PPO |
$316.45
|
| Rate for Payer: BCN Commercial |
$1,078.02
|
| Rate for Payer: BCN Medicare Advantage |
$729.85
|
| Rate for Payer: Cash Price |
$4,078.40
|
| Rate for Payer: Cash Price |
$4,078.40
|
| Rate for Payer: Cofinity Commercial |
$978.00
|
| Rate for Payer: Cofinity Commercial |
$1,050.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$729.85
|
| Rate for Payer: Healthscope Commercial |
$875.82
|
| Rate for Payer: Healthscope Whirlpool |
$875.82
|
| Rate for Payer: Meridian Medicaid |
$499.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$766.34
|
| Rate for Payer: PACE SWMI |
$729.85
|
| Rate for Payer: PHP Medicare Advantage |
$729.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,568.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,192.03
|
| Rate for Payer: Priority Health Medicare |
$729.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,192.03
|
| Rate for Payer: UHC Medicare Advantage |
$751.75
|
|
|
PR PENIS STRAIGHTENING CHORDEE
|
Professional
|
Both
|
$1,309.68
|
|
|
Service Code
|
HCPCS 54300
|
| Min. Negotiated Rate |
$311.17 |
| Max. Negotiated Rate |
$1,029.92 |
| Rate for Payer: Aetna Commercial |
$843.77
|
| Rate for Payer: Aetna Medicare |
$629.68
|
| Rate for Payer: BCBS Complete |
$432.10
|
| Rate for Payer: BCBS MAPPO |
$629.68
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$931.42
|
| Rate for Payer: BCN Medicare Advantage |
$629.68
|
| Rate for Payer: Cash Price |
$1,047.74
|
| Rate for Payer: Cash Price |
$1,047.74
|
| Rate for Payer: Cofinity Commercial |
$906.74
|
| Rate for Payer: Cofinity Commercial |
$843.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.68
|
| Rate for Payer: Healthscope Commercial |
$755.62
|
| Rate for Payer: Healthscope Whirlpool |
$755.62
|
| Rate for Payer: Meridian Medicaid |
$432.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$661.16
|
| Rate for Payer: PACE SWMI |
$629.68
|
| Rate for Payer: PHP Medicare Advantage |
$629.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$916.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,029.92
|
| Rate for Payer: Priority Health Medicare |
$629.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,029.92
|
| Rate for Payer: UHC Medicare Advantage |
$648.57
|
|
|
PR PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH
|
Professional
|
Both
|
$186.00
|
|
|
Service Code
|
HCPCS 94642
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$217.66 |
| Rate for Payer: Aetna Commercial |
$46.35
|
| Rate for Payer: BCBS Complete |
$18.94
|
| Rate for Payer: BCBS Trust/PPO |
$217.66
|
| Rate for Payer: BCN Commercial |
$177.14
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Meridian Medicaid |
$18.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.14
|
| Rate for Payer: Priority Health Narrow Network |
$56.14
|
|
|
PR PERCUTANEOUS TX MALAR AREA FRACTURE
|
Professional
|
Both
|
$898.00
|
|
|
Service Code
|
HCPCS 21355
|
| Min. Negotiated Rate |
$32.75 |
| Max. Negotiated Rate |
$661.18 |
| Rate for Payer: Aetna Commercial |
$432.81
|
| Rate for Payer: Aetna Medicare |
$322.99
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$322.99
|
| Rate for Payer: BCBS Trust/PPO |
$32.75
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$322.99
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cofinity Commercial |
$465.11
|
| Rate for Payer: Cofinity Commercial |
$432.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.99
|
| Rate for Payer: Healthscope Commercial |
$387.59
|
| Rate for Payer: Healthscope Whirlpool |
$387.59
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$339.14
|
| Rate for Payer: PACE SWMI |
$322.99
|
| Rate for Payer: PHP Medicare Advantage |
$322.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.05
|
| Rate for Payer: Priority Health Medicare |
$322.99
|
| Rate for Payer: Priority Health Narrow Network |
$506.05
|
| Rate for Payer: UHC Medicare Advantage |
$332.68
|
|
|
PR PERCUTANEOUS VERTEBROPLASTY EA ADDL THRC/LMBR
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 22522
|
| Min. Negotiated Rate |
$282.00 |
| Max. Negotiated Rate |
$493.50 |
| Rate for Payer: BCBS Complete |
$282.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.50
|
|
|
PR PERCUTANEOUS VERTEBROPLASTY LUMBAR W/WO BNE BX
|
Professional
|
Both
|
$5,631.00
|
|
|
Service Code
|
HCPCS 22521
|
| Min. Negotiated Rate |
$2,252.40 |
| Max. Negotiated Rate |
$3,941.70 |
| Rate for Payer: BCBS Complete |
$2,252.40
|
| Rate for Payer: Cash Price |
$4,504.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,941.70
|
|
|
PR PERCUTANEOUS VERTEBROPLSTY THORACIC W/WO BONE BX
|
Professional
|
Both
|
$7,687.00
|
|
|
Service Code
|
HCPCS 22520
|
| Min. Negotiated Rate |
$3,074.80 |
| Max. Negotiated Rate |
$5,380.90 |
| Rate for Payer: BCBS Complete |
$3,074.80
|
| Rate for Payer: Cash Price |
$6,149.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,380.90
|
|
|
PR PERCUT DILATN RENAL TRACT
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 50395
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$238.00 |
| Rate for Payer: BCBS Complete |
$136.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.00
|
|
|
PR PERCUT INSERT KIDNEY CATH/DRAIN
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 50392
|
| Min. Negotiated Rate |
$143.20 |
| Max. Negotiated Rate |
$250.60 |
| Rate for Payer: BCBS Complete |
$143.20
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.60
|
|
|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, EA ADD
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
HCPCS 22525
|
| Min. Negotiated Rate |
$198.00 |
| Max. Negotiated Rate |
$346.50 |
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.50
|
|
|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, LUMBAR
|
Professional
|
Both
|
$1,054.00
|
|
|
Service Code
|
HCPCS 22524
|
| Min. Negotiated Rate |
$421.60 |
| Max. Negotiated Rate |
$737.80 |
| Rate for Payer: BCBS Complete |
$421.60
|
| Rate for Payer: Cash Price |
$843.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.80
|
|
|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, THOR
|
Professional
|
Both
|
$1,119.00
|
|
|
Service Code
|
HCPCS 22523
|
| Min. Negotiated Rate |
$447.60 |
| Max. Negotiated Rate |
$783.30 |
| Rate for Payer: BCBS Complete |
$447.60
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.30
|
|
|
PR PEREYRA PX W/ANTERIOR COLPORRHAPHY
|
Professional
|
Both
|
$2,170.00
|
|
|
Service Code
|
HCPCS 57289
|
| Min. Negotiated Rate |
$510.56 |
| Max. Negotiated Rate |
$2,673.73 |
| Rate for Payer: Aetna Commercial |
$1,054.49
|
| Rate for Payer: Aetna Medicare |
$786.93
|
| Rate for Payer: BCBS Complete |
$536.09
|
| Rate for Payer: BCBS MAPPO |
$786.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,673.73
|
| Rate for Payer: BCN Commercial |
$1,165.98
|
| Rate for Payer: BCN Medicare Advantage |
$786.93
|
| Rate for Payer: Cash Price |
$1,736.00
|
| Rate for Payer: Cash Price |
$1,736.00
|
| Rate for Payer: Cofinity Commercial |
$1,054.49
|
| Rate for Payer: Cofinity Commercial |
$1,133.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$786.93
|
| Rate for Payer: Healthscope Commercial |
$944.32
|
| Rate for Payer: Healthscope Whirlpool |
$944.32
|
| Rate for Payer: Meridian Medicaid |
$536.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$826.28
|
| Rate for Payer: PACE SWMI |
$786.93
|
| Rate for Payer: PHP Medicare Advantage |
$786.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,519.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,129.59
|
| Rate for Payer: Priority Health Medicare |
$786.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,129.59
|
| Rate for Payer: UHC Medicare Advantage |
$810.54
|
|
|
PR PERICARDIOCENTESIS INITIAL
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 33010
|
| Min. Negotiated Rate |
$176.80 |
| Max. Negotiated Rate |
$309.40 |
| Rate for Payer: BCBS Complete |
$176.80
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.40
|
|
|
PR PERICARDIOCENTESIS SUBSEQUENT
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 33011
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: BCBS Complete |
$176.40
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.70
|
|
|
PR PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 33016
|
| Min. Negotiated Rate |
$146.33 |
| Max. Negotiated Rate |
$1,116.83 |
| Rate for Payer: Aetna Commercial |
$308.60
|
| Rate for Payer: Aetna Medicare |
$230.30
|
| Rate for Payer: BCBS Complete |
$153.65
|
| Rate for Payer: BCBS MAPPO |
$230.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,116.83
|
| Rate for Payer: BCN Commercial |
$335.23
|
| Rate for Payer: BCN Medicare Advantage |
$230.30
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$331.63
|
| Rate for Payer: Cofinity Commercial |
$308.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.30
|
| Rate for Payer: Healthscope Commercial |
$276.36
|
| Rate for Payer: Healthscope Whirlpool |
$276.36
|
| Rate for Payer: Meridian Medicaid |
$153.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$241.82
|
| Rate for Payer: PACE SWMI |
$230.30
|
| Rate for Payer: PHP Medicare Advantage |
$230.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.93
|
| Rate for Payer: Priority Health Medicare |
$230.30
|
| Rate for Payer: Priority Health Narrow Network |
$364.93
|
| Rate for Payer: UHC Medicare Advantage |
$237.21
|
|
|
PR PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY
|
Professional
|
Both
|
$2,605.00
|
|
|
Service Code
|
HCPCS 33020
|
| Min. Negotiated Rate |
$519.08 |
| Max. Negotiated Rate |
$1,823.50 |
| Rate for Payer: Aetna Commercial |
$1,089.14
|
| Rate for Payer: Aetna Medicare |
$812.79
|
| Rate for Payer: BCBS Complete |
$545.03
|
| Rate for Payer: BCBS MAPPO |
$812.79
|
| Rate for Payer: BCBS Trust/PPO |
$745.96
|
| Rate for Payer: BCN Commercial |
$1,188.47
|
| Rate for Payer: BCN Medicare Advantage |
$812.79
|
| Rate for Payer: Cash Price |
$2,084.00
|
| Rate for Payer: Cash Price |
$2,084.00
|
| Rate for Payer: Cofinity Commercial |
$1,170.42
|
| Rate for Payer: Cofinity Commercial |
$1,089.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.79
|
| Rate for Payer: Healthscope Commercial |
$975.35
|
| Rate for Payer: Healthscope Whirlpool |
$975.35
|
| Rate for Payer: Meridian Medicaid |
$545.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.43
|
| Rate for Payer: PACE SWMI |
$812.79
|
| Rate for Payer: PHP Medicare Advantage |
$812.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,823.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,293.73
|
| Rate for Payer: Priority Health Medicare |
$812.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,293.73
|
| Rate for Payer: UHC Medicare Advantage |
$837.17
|
|
|
PR PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE
|
Professional
|
Both
|
$2,110.00
|
|
|
Service Code
|
HCPCS 19371
|
| Min. Negotiated Rate |
$456.46 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$937.73
|
| Rate for Payer: Aetna Medicare |
$699.80
|
| Rate for Payer: BCBS Complete |
$479.28
|
| Rate for Payer: BCBS MAPPO |
$699.80
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$1,043.82
|
| Rate for Payer: BCN Medicare Advantage |
$699.80
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cofinity Commercial |
$1,007.71
|
| Rate for Payer: Cofinity Commercial |
$937.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.80
|
| Rate for Payer: Healthscope Commercial |
$839.76
|
| Rate for Payer: Healthscope Whirlpool |
$839.76
|
| Rate for Payer: Meridian Medicaid |
$479.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$734.79
|
| Rate for Payer: PACE SWMI |
$699.80
|
| Rate for Payer: PHP Medicare Advantage |
$699.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$877.98
|
| Rate for Payer: Priority Health Medicare |
$699.80
|
| Rate for Payer: Priority Health Narrow Network |
$877.98
|
| Rate for Payer: UHC Medicare Advantage |
$720.79
|
|
|
PR PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX
|
Professional
|
Both
|
$898.00
|
|
|
Service Code
|
HCPCS 56810
|
| Min. Negotiated Rate |
$175.94 |
| Max. Negotiated Rate |
$1,892.90 |
| Rate for Payer: Aetna Commercial |
$360.47
|
| Rate for Payer: Aetna Medicare |
$269.01
|
| Rate for Payer: BCBS Complete |
$184.74
|
| Rate for Payer: BCBS MAPPO |
$269.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,892.90
|
| Rate for Payer: BCN Commercial |
$399.25
|
| Rate for Payer: BCN Medicare Advantage |
$269.01
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cofinity Commercial |
$387.37
|
| Rate for Payer: Cofinity Commercial |
$360.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.01
|
| Rate for Payer: Healthscope Commercial |
$322.81
|
| Rate for Payer: Healthscope Whirlpool |
$322.81
|
| Rate for Payer: Meridian Medicaid |
$184.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$282.46
|
| Rate for Payer: PACE SWMI |
$269.01
|
| Rate for Payer: PHP Medicare Advantage |
$269.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.79
|
| Rate for Payer: Priority Health Medicare |
$269.01
|
| Rate for Payer: Priority Health Narrow Network |
$386.79
|
| Rate for Payer: UHC Medicare Advantage |
$277.08
|
|
|
PR PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 99391
|
| Min. Negotiated Rate |
$61.21 |
| Max. Negotiated Rate |
$193.36 |
| Rate for Payer: Aetna Commercial |
$71.14
|
| Rate for Payer: BCBS Complete |
$64.27
|
| Rate for Payer: BCBS Trust/PPO |
$193.36
|
| Rate for Payer: BCN Commercial |
$141.72
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Meridian Medicaid |
$64.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.81
|
| Rate for Payer: Priority Health Narrow Network |
$139.81
|
|
