|
PR ETONOGESTREL IMPLANT SYSTEM
|
Professional
|
Both
|
$1,404.00
|
|
|
Service Code
|
HCPCS J7307
|
| Min. Negotiated Rate |
$1,053.00 |
| Max. Negotiated Rate |
$1,351.89 |
| Rate for Payer: Aetna Commercial |
$1,092.48
|
| Rate for Payer: BCBS Complete |
$1,351.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,295.81
|
| Rate for Payer: BCN Commercial |
$1,235.28
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Cash Price |
$1,123.20
|
| Rate for Payer: Meridian Medicaid |
$1,351.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,287.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,275.36
|
| Rate for Payer: UHC Exchange |
$1,275.36
|
| Rate for Payer: UHC Medicaid |
$1,287.51
|
| Rate for Payer: UHCCP Medicaid |
$1,287.51
|
|
|
PR EUFLEXXA INJ PER DOSE
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS J7323
|
| Min. Negotiated Rate |
$105.46 |
| Max. Negotiated Rate |
$228.00 |
| Rate for Payer: Aetna Commercial |
$141.48
|
| Rate for Payer: Aetna Medicare |
$105.58
|
| Rate for Payer: BCBS MAPPO |
$105.58
|
| Rate for Payer: BCBS Trust/PPO |
$107.45
|
| Rate for Payer: BCN Commercial |
$137.68
|
| Rate for Payer: BCN Medicare Advantage |
$105.58
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cofinity Commercial |
$152.04
|
| Rate for Payer: Cofinity Commercial |
$141.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.58
|
| Rate for Payer: Healthscope Commercial |
$126.70
|
| Rate for Payer: Healthscope Whirlpool |
$126.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.14
|
| Rate for Payer: Nomi Health Commercial |
$126.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.00
|
| Rate for Payer: PACE SWMI |
$105.58
|
| Rate for Payer: PHP Medicare Advantage |
$105.58
|
| Rate for Payer: Priority Health Medicare |
$105.58
|
| Rate for Payer: Railroad Medicare Medicare |
$105.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$105.58
|
| Rate for Payer: UHC Exchange |
$105.46
|
| Rate for Payer: UHCCP DNSP |
$105.58
|
|
|
PR EVACUATION SUBUNGUAL HEMATOMA
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 11740
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$40.11
|
| Rate for Payer: Aetna Medicare |
$29.93
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$38.88
|
| Rate for Payer: BCN Medicare Advantage |
$29.93
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$43.10
|
| Rate for Payer: Cofinity Commercial |
$40.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.93
|
| Rate for Payer: Healthscope Commercial |
$35.92
|
| Rate for Payer: Healthscope Whirlpool |
$35.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.43
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.92
|
| Rate for Payer: Nomi Health Commercial |
$35.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$29.93
|
| Rate for Payer: PHP Medicare Advantage |
$29.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$45.12
|
| Rate for Payer: Priority Health Medicare |
$29.93
|
| Rate for Payer: Priority Health Narrow Network |
$45.12
|
| Rate for Payer: Railroad Medicare Medicare |
$29.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.93
|
| Rate for Payer: UHC Exchange |
$53.85
|
| Rate for Payer: UHC Medicaid |
$20.02
|
| Rate for Payer: UHCCP DNSP |
$29.93
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
|
|
PR EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 92626
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Aetna Commercial |
$78.70
|
| Rate for Payer: Aetna Medicare |
$58.73
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$58.73
|
| Rate for Payer: BCN Commercial |
$110.55
|
| Rate for Payer: BCN Medicare Advantage |
$58.73
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$84.57
|
| Rate for Payer: Cofinity Commercial |
$78.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.73
|
| Rate for Payer: Healthscope Commercial |
$70.48
|
| Rate for Payer: Healthscope Whirlpool |
$70.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.67
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.60
|
| Rate for Payer: Nomi Health Commercial |
$70.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE SWMI |
$58.73
|
| Rate for Payer: PHP Medicare Advantage |
$58.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$101.95
|
| Rate for Payer: Priority Health Medicare |
$58.73
|
| Rate for Payer: Priority Health Narrow Network |
$101.95
|
| Rate for Payer: Railroad Medicare Medicare |
$58.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.73
|
| Rate for Payer: UHC Exchange |
$122.52
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP DNSP |
$58.73
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
PR EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 92627
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$13.77
|
| Rate for Payer: BCN Commercial |
$25.90
|
| Rate for Payer: BCN Medicare Advantage |
$13.77
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$19.83
|
| Rate for Payer: Cofinity Commercial |
$18.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.77
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Healthscope Whirlpool |
$16.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.46
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.15
|
| Rate for Payer: Nomi Health Commercial |
$16.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: PACE SWMI |
$13.77
|
| Rate for Payer: PHP Medicare Advantage |
$13.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.88
|
| Rate for Payer: Priority Health Medicare |
$13.77
|
| Rate for Payer: Priority Health Narrow Network |
$23.88
|
| Rate for Payer: Railroad Medicare Medicare |
$13.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.77
|
| Rate for Payer: UHC Exchange |
$28.79
|
| Rate for Payer: UHC Medicaid |
$8.95
|
| Rate for Payer: UHCCP DNSP |
$13.77
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 92620
|
| Min. Negotiated Rate |
$62.98 |
| Max. Negotiated Rate |
$131.57 |
| Rate for Payer: Aetna Commercial |
$84.39
|
| Rate for Payer: Aetna Medicare |
$62.98
|
| Rate for Payer: BCBS Complete |
$69.20
|
| Rate for Payer: BCBS MAPPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$118.03
|
| Rate for Payer: BCN Medicare Advantage |
$62.98
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$84.39
|
| Rate for Payer: Cofinity Commercial |
$90.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.98
|
| Rate for Payer: Healthscope Commercial |
$75.58
|
| Rate for Payer: Healthscope Whirlpool |
$75.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.28
|
| Rate for Payer: Nomi Health Commercial |
$75.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: PACE SWMI |
$62.98
|
| Rate for Payer: PHP Medicare Advantage |
$62.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$108.84
|
| Rate for Payer: Priority Health Medicare |
$62.98
|
| Rate for Payer: Priority Health Narrow Network |
$108.84
|
| Rate for Payer: Railroad Medicare Medicare |
$62.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.98
|
| Rate for Payer: UHC Exchange |
$131.57
|
| Rate for Payer: UHCCP DNSP |
$62.98
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 92621
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna Medicare |
$14.74
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS MAPPO |
$14.74
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: BCN Medicare Advantage |
$14.74
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$21.23
|
| Rate for Payer: Cofinity Commercial |
$19.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$17.69
|
| Rate for Payer: Healthscope Whirlpool |
$17.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.21
|
| Rate for Payer: Nomi Health Commercial |
$17.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: PACE SWMI |
$14.74
|
| Rate for Payer: PHP Medicare Advantage |
$14.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$25.71
|
| Rate for Payer: Priority Health Medicare |
$14.74
|
| Rate for Payer: Priority Health Narrow Network |
$25.71
|
| Rate for Payer: Railroad Medicare Medicare |
$14.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.74
|
| Rate for Payer: UHC Exchange |
$30.49
|
| Rate for Payer: UHCCP DNSP |
$14.74
|
|
|
PR EVAL OF ORTHOTIC/PROSTH USE, EA 15 MIN
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 97762
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
|
|
PR EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 92523
|
| Min. Negotiated Rate |
$217.99 |
| Max. Negotiated Rate |
$344.11 |
| Rate for Payer: Aetna Commercial |
$292.11
|
| Rate for Payer: Aetna Medicare |
$217.99
|
| Rate for Payer: BCBS MAPPO |
$217.99
|
| Rate for Payer: BCN Commercial |
$344.11
|
| Rate for Payer: BCN Medicare Advantage |
$217.99
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$313.91
|
| Rate for Payer: Cofinity Commercial |
$292.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.99
|
| Rate for Payer: Healthscope Commercial |
$261.59
|
| Rate for Payer: Healthscope Whirlpool |
$261.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.79
|
| Rate for Payer: Nomi Health Commercial |
$261.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
| Rate for Payer: PACE SWMI |
$217.99
|
| Rate for Payer: PHP Medicare Advantage |
$217.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$317.33
|
| Rate for Payer: Priority Health Medicare |
$217.99
|
| Rate for Payer: Priority Health Narrow Network |
$317.33
|
| Rate for Payer: Railroad Medicare Medicare |
$217.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$307.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$217.99
|
| Rate for Payer: UHC Exchange |
$307.77
|
| Rate for Payer: UHCCP DNSP |
$217.99
|
|
|
PR EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 92628
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
|
|
PR EVALUATION HEARING AID CANDIDACY EA ADDL 15 MIN
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 92629
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$55.50 |
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.50
|
|
|
PR EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 92521
|
| Min. Negotiated Rate |
$128.26 |
| Max. Negotiated Rate |
$201.18 |
| Rate for Payer: Aetna Commercial |
$171.87
|
| Rate for Payer: Aetna Medicare |
$128.26
|
| Rate for Payer: BCBS MAPPO |
$128.26
|
| Rate for Payer: BCN Commercial |
$201.18
|
| Rate for Payer: BCN Medicare Advantage |
$128.26
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$184.69
|
| Rate for Payer: Cofinity Commercial |
$171.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.26
|
| Rate for Payer: Healthscope Commercial |
$153.91
|
| Rate for Payer: Healthscope Whirlpool |
$153.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.09
|
| Rate for Payer: Nomi Health Commercial |
$153.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.75
|
| Rate for Payer: PACE SWMI |
$128.26
|
| Rate for Payer: PHP Medicare Advantage |
$128.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$185.53
|
| Rate for Payer: Priority Health Medicare |
$128.26
|
| Rate for Payer: Priority Health Narrow Network |
$185.53
|
| Rate for Payer: Railroad Medicare Medicare |
$128.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.26
|
| Rate for Payer: UHC Exchange |
$179.69
|
| Rate for Payer: UHCCP DNSP |
$128.26
|
|
|
PR EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 92522
|
| Min. Negotiated Rate |
$108.03 |
| Max. Negotiated Rate |
$167.32 |
| Rate for Payer: Aetna Commercial |
$144.76
|
| Rate for Payer: Aetna Medicare |
$108.03
|
| Rate for Payer: BCBS MAPPO |
$108.03
|
| Rate for Payer: BCN Commercial |
$167.32
|
| Rate for Payer: BCN Medicare Advantage |
$108.03
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$144.76
|
| Rate for Payer: Cofinity Commercial |
$155.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.03
|
| Rate for Payer: Healthscope Commercial |
$129.64
|
| Rate for Payer: Healthscope Whirlpool |
$129.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.83
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: PACE SWMI |
$108.03
|
| Rate for Payer: PHP Medicare Advantage |
$108.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$154.30
|
| Rate for Payer: Priority Health Medicare |
$108.03
|
| Rate for Payer: Priority Health Narrow Network |
$154.30
|
| Rate for Payer: Railroad Medicare Medicare |
$108.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$108.03
|
| Rate for Payer: UHC Exchange |
$147.09
|
| Rate for Payer: UHCCP DNSP |
$108.03
|
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST
|
Professional
|
Both
|
$1,138.00
|
|
|
Service Code
|
HCPCS 61650
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$1,018.55 |
| Rate for Payer: Aetna Commercial |
$709.13
|
| Rate for Payer: Aetna Medicare |
$529.20
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCBS MAPPO |
$529.20
|
| Rate for Payer: BCN Commercial |
$876.95
|
| Rate for Payer: BCN Medicare Advantage |
$529.20
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$762.05
|
| Rate for Payer: Cofinity Commercial |
$709.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.20
|
| Rate for Payer: Healthscope Commercial |
$635.04
|
| Rate for Payer: Healthscope Whirlpool |
$635.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.66
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$582.12
|
| Rate for Payer: Nomi Health Commercial |
$635.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$853.50
|
| Rate for Payer: PACE SWMI |
$529.20
|
| Rate for Payer: PHP Medicare Advantage |
$529.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,018.55
|
| Rate for Payer: Priority Health Medicare |
$529.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,018.55
|
| Rate for Payer: Railroad Medicare Medicare |
$529.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,015.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$529.20
|
| Rate for Payer: UHC Exchange |
$1,015.67
|
| Rate for Payer: UHC Medicaid |
$333.77
|
| Rate for Payer: UHCCP DNSP |
$529.20
|
| Rate for Payer: UHCCP Medicaid |
$333.77
|
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL
|
Professional
|
Both
|
$484.00
|
|
|
Service Code
|
HCPCS 61651
|
| Min. Negotiated Rate |
$142.71 |
| Max. Negotiated Rate |
$434.96 |
| Rate for Payer: Aetna Commercial |
$303.15
|
| Rate for Payer: Aetna Medicare |
$226.23
|
| Rate for Payer: BCBS Complete |
$149.85
|
| Rate for Payer: BCBS MAPPO |
$226.23
|
| Rate for Payer: BCN Commercial |
$374.49
|
| Rate for Payer: BCN Medicare Advantage |
$226.23
|
| Rate for Payer: Cash Price |
$387.20
|
| Rate for Payer: Cash Price |
$387.20
|
| Rate for Payer: Cofinity Commercial |
$325.77
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.23
|
| Rate for Payer: Healthscope Commercial |
$271.48
|
| Rate for Payer: Healthscope Whirlpool |
$271.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.54
|
| Rate for Payer: Meridian Medicaid |
$149.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.85
|
| Rate for Payer: Nomi Health Commercial |
$271.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.00
|
| Rate for Payer: PACE SWMI |
$226.23
|
| Rate for Payer: PHP Medicare Advantage |
$226.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$434.96
|
| Rate for Payer: Priority Health Medicare |
$226.23
|
| Rate for Payer: Priority Health Narrow Network |
$434.96
|
| Rate for Payer: Railroad Medicare Medicare |
$226.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$434.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.23
|
| Rate for Payer: UHC Exchange |
$434.77
|
| Rate for Payer: UHC Medicaid |
$142.71
|
| Rate for Payer: UHCCP DNSP |
$226.23
|
| Rate for Payer: UHCCP Medicaid |
$142.71
|
|
|
PR EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE
|
Professional
|
Both
|
$458.00
|
|
|
Service Code
|
HCPCS 34808
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$361.05 |
| Rate for Payer: Aetna Commercial |
$247.91
|
| Rate for Payer: Aetna Medicare |
$185.01
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS MAPPO |
$185.01
|
| Rate for Payer: BCN Commercial |
$294.31
|
| Rate for Payer: BCN Medicare Advantage |
$185.01
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cofinity Commercial |
$266.41
|
| Rate for Payer: Cofinity Commercial |
$247.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.01
|
| Rate for Payer: Healthscope Commercial |
$222.01
|
| Rate for Payer: Healthscope Whirlpool |
$222.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.26
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.51
|
| Rate for Payer: Nomi Health Commercial |
$222.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.50
|
| Rate for Payer: PACE SWMI |
$185.01
|
| Rate for Payer: PHP Medicare Advantage |
$185.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$316.49
|
| Rate for Payer: Priority Health Medicare |
$185.01
|
| Rate for Payer: Priority Health Narrow Network |
$316.49
|
| Rate for Payer: Railroad Medicare Medicare |
$185.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$361.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.01
|
| Rate for Payer: UHC Exchange |
$361.05
|
| Rate for Payer: UHC Medicaid |
$115.87
|
| Rate for Payer: UHCCP DNSP |
$185.01
|
| Rate for Payer: UHCCP Medicaid |
$115.87
|
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT
|
Professional
|
Both
|
$2,666.00
|
|
|
Service Code
|
HCPCS 34701
|
| Min. Negotiated Rate |
$711.63 |
| Max. Negotiated Rate |
$2,232.99 |
| Rate for Payer: Aetna Commercial |
$1,511.14
|
| Rate for Payer: Aetna Medicare |
$1,127.72
|
| Rate for Payer: BCBS Complete |
$747.21
|
| Rate for Payer: BCBS MAPPO |
$1,127.72
|
| Rate for Payer: BCN Commercial |
$1,805.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,127.72
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cofinity Commercial |
$1,623.92
|
| Rate for Payer: Cofinity Commercial |
$1,511.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,127.72
|
| Rate for Payer: Healthscope Commercial |
$1,353.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,353.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.11
|
| Rate for Payer: Meridian Medicaid |
$747.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,240.49
|
| Rate for Payer: Nomi Health Commercial |
$1,353.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,999.50
|
| Rate for Payer: PACE SWMI |
$1,127.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,127.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,941.24
|
| Rate for Payer: Priority Health Medicare |
$1,127.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,941.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,127.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,232.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,127.72
|
| Rate for Payer: UHC Exchange |
$2,232.99
|
| Rate for Payer: UHC Medicaid |
$711.63
|
| Rate for Payer: UHCCP DNSP |
$1,127.72
|
| Rate for Payer: UHCCP Medicaid |
$711.63
|
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT
|
Professional
|
Both
|
$4,030.00
|
|
|
Service Code
|
HCPCS 34702
|
| Min. Negotiated Rate |
$1,037.95 |
| Max. Negotiated Rate |
$3,337.11 |
| Rate for Payer: Aetna Commercial |
$2,214.86
|
| Rate for Payer: Aetna Medicare |
$1,652.88
|
| Rate for Payer: BCBS Complete |
$1,089.85
|
| Rate for Payer: BCBS MAPPO |
$1,652.88
|
| Rate for Payer: BCN Commercial |
$2,617.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,652.88
|
| Rate for Payer: Cash Price |
$3,224.00
|
| Rate for Payer: Cash Price |
$3,224.00
|
| Rate for Payer: Cofinity Commercial |
$2,380.15
|
| Rate for Payer: Cofinity Commercial |
$2,214.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,652.88
|
| Rate for Payer: Healthscope Commercial |
$1,983.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,983.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,735.52
|
| Rate for Payer: Meridian Medicaid |
$1,089.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,818.17
|
| Rate for Payer: Nomi Health Commercial |
$1,983.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,022.50
|
| Rate for Payer: PACE SWMI |
$1,652.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,652.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,037.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,814.67
|
| Rate for Payer: Priority Health Medicare |
$1,652.88
|
| Rate for Payer: Priority Health Narrow Network |
$2,814.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,652.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,337.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,652.88
|
| Rate for Payer: UHC Exchange |
$3,337.11
|
| Rate for Payer: UHC Medicaid |
$1,037.95
|
| Rate for Payer: UHCCP DNSP |
$1,652.88
|
| Rate for Payer: UHCCP Medicaid |
$1,037.95
|
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT
|
Professional
|
Both
|
$3,261.00
|
|
|
Service Code
|
HCPCS 34705
|
| Min. Negotiated Rate |
$876.71 |
| Max. Negotiated Rate |
$2,752.26 |
| Rate for Payer: Aetna Commercial |
$1,864.03
|
| Rate for Payer: Aetna Medicare |
$1,391.07
|
| Rate for Payer: BCBS Complete |
$920.55
|
| Rate for Payer: BCBS MAPPO |
$1,391.07
|
| Rate for Payer: BCN Commercial |
$2,222.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,391.07
|
| Rate for Payer: Cash Price |
$2,608.80
|
| Rate for Payer: Cash Price |
$2,608.80
|
| Rate for Payer: Cofinity Commercial |
$2,003.14
|
| Rate for Payer: Cofinity Commercial |
$1,864.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,391.07
|
| Rate for Payer: Healthscope Commercial |
$1,669.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,669.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,460.62
|
| Rate for Payer: Meridian Medicaid |
$920.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,530.18
|
| Rate for Payer: Nomi Health Commercial |
$1,669.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,445.75
|
| Rate for Payer: PACE SWMI |
$1,391.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,391.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,390.54
|
| Rate for Payer: Priority Health Medicare |
$1,391.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,390.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,391.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,752.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,391.07
|
| Rate for Payer: UHC Exchange |
$2,752.26
|
| Rate for Payer: UHC Medicaid |
$876.71
|
| Rate for Payer: UHCCP DNSP |
$1,391.07
|
| Rate for Payer: UHCCP Medicaid |
$876.71
|
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT
|
Professional
|
Both
|
$4,985.00
|
|
|
Service Code
|
HCPCS 34706
|
| Min. Negotiated Rate |
$1,307.82 |
| Max. Negotiated Rate |
$4,152.60 |
| Rate for Payer: Aetna Commercial |
$2,786.99
|
| Rate for Payer: Aetna Medicare |
$2,079.84
|
| Rate for Payer: BCBS Complete |
$1,373.21
|
| Rate for Payer: BCBS MAPPO |
$2,079.84
|
| Rate for Payer: BCN Commercial |
$3,319.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,079.84
|
| Rate for Payer: Cash Price |
$3,988.00
|
| Rate for Payer: Cash Price |
$3,988.00
|
| Rate for Payer: Cofinity Commercial |
$2,994.97
|
| Rate for Payer: Cofinity Commercial |
$2,786.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,079.84
|
| Rate for Payer: Healthscope Commercial |
$2,495.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,495.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,183.83
|
| Rate for Payer: Meridian Medicaid |
$1,373.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,287.82
|
| Rate for Payer: Nomi Health Commercial |
$2,495.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,738.75
|
| Rate for Payer: PACE SWMI |
$2,079.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,079.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,307.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,569.20
|
| Rate for Payer: Priority Health Medicare |
$2,079.84
|
| Rate for Payer: Priority Health Narrow Network |
$3,569.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,079.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,152.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,079.84
|
| Rate for Payer: UHC Exchange |
$4,152.60
|
| Rate for Payer: UHC Medicaid |
$1,307.82
|
| Rate for Payer: UHCCP DNSP |
$2,079.84
|
| Rate for Payer: UHCCP Medicaid |
$1,307.82
|
|
|
PR EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT
|
Professional
|
Both
|
$3,005.00
|
|
|
Service Code
|
HCPCS 34703
|
| Min. Negotiated Rate |
$789.38 |
| Max. Negotiated Rate |
$2,465.16 |
| Rate for Payer: Aetna Commercial |
$1,677.83
|
| Rate for Payer: Aetna Medicare |
$1,252.11
|
| Rate for Payer: BCBS Complete |
$828.85
|
| Rate for Payer: BCBS MAPPO |
$1,252.11
|
| Rate for Payer: BCN Commercial |
$2,000.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,252.11
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cash Price |
$2,404.00
|
| Rate for Payer: Cofinity Commercial |
$1,803.04
|
| Rate for Payer: Cofinity Commercial |
$1,677.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,252.11
|
| Rate for Payer: Healthscope Commercial |
$1,502.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,502.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,314.72
|
| Rate for Payer: Meridian Medicaid |
$828.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,377.32
|
| Rate for Payer: Nomi Health Commercial |
$1,502.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,253.75
|
| Rate for Payer: PACE SWMI |
$1,252.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,252.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,151.17
|
| Rate for Payer: Priority Health Medicare |
$1,252.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,151.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,252.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,465.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,252.11
|
| Rate for Payer: UHC Exchange |
$2,465.16
|
| Rate for Payer: UHC Medicaid |
$789.38
|
| Rate for Payer: UHCCP DNSP |
$1,252.11
|
| Rate for Payer: UHCCP Medicaid |
$789.38
|
|
|
PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT
|
Professional
|
Both
|
$2,486.00
|
|
|
Service Code
|
HCPCS 34707
|
| Min. Negotiated Rate |
$670.10 |
| Max. Negotiated Rate |
$2,084.83 |
| Rate for Payer: Aetna Commercial |
$1,422.62
|
| Rate for Payer: Aetna Medicare |
$1,061.66
|
| Rate for Payer: BCBS Complete |
$703.61
|
| Rate for Payer: BCBS MAPPO |
$1,061.66
|
| Rate for Payer: BCN Commercial |
$1,696.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,061.66
|
| Rate for Payer: Cash Price |
$1,988.80
|
| Rate for Payer: Cash Price |
$1,988.80
|
| Rate for Payer: Cofinity Commercial |
$1,528.79
|
| Rate for Payer: Cofinity Commercial |
$1,422.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,061.66
|
| Rate for Payer: Healthscope Commercial |
$1,273.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,273.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,114.74
|
| Rate for Payer: Meridian Medicaid |
$703.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,167.83
|
| Rate for Payer: Nomi Health Commercial |
$1,273.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,864.50
|
| Rate for Payer: PACE SWMI |
$1,061.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,061.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$670.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,823.96
|
| Rate for Payer: Priority Health Medicare |
$1,061.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,823.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,061.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,084.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,061.66
|
| Rate for Payer: UHC Exchange |
$2,084.83
|
| Rate for Payer: UHC Medicaid |
$670.10
|
| Rate for Payer: UHCCP DNSP |
$1,061.66
|
| Rate for Payer: UHCCP Medicaid |
$670.10
|
|
|
PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT
|
Professional
|
Both
|
$4,016.00
|
|
|
Service Code
|
HCPCS 34708
|
| Min. Negotiated Rate |
$1,051.79 |
| Max. Negotiated Rate |
$3,333.14 |
| Rate for Payer: Aetna Commercial |
$2,244.58
|
| Rate for Payer: Aetna Medicare |
$1,675.06
|
| Rate for Payer: BCBS Complete |
$1,104.38
|
| Rate for Payer: BCBS MAPPO |
$1,675.06
|
| Rate for Payer: BCN Commercial |
$2,652.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,675.06
|
| Rate for Payer: Cash Price |
$3,212.80
|
| Rate for Payer: Cash Price |
$3,212.80
|
| Rate for Payer: Cofinity Commercial |
$2,244.58
|
| Rate for Payer: Cofinity Commercial |
$2,412.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,675.06
|
| Rate for Payer: Healthscope Commercial |
$2,010.07
|
| Rate for Payer: Healthscope Whirlpool |
$2,010.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,758.81
|
| Rate for Payer: Meridian Medicaid |
$1,104.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,842.57
|
| Rate for Payer: Nomi Health Commercial |
$2,010.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,012.00
|
| Rate for Payer: PACE SWMI |
$1,675.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,675.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,051.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,852.15
|
| Rate for Payer: Priority Health Medicare |
$1,675.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,852.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,675.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,333.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,675.06
|
| Rate for Payer: UHC Exchange |
$3,333.14
|
| Rate for Payer: UHC Medicaid |
$1,051.79
|
| Rate for Payer: UHCCP DNSP |
$1,675.06
|
| Rate for Payer: UHCCP Medicaid |
$1,051.79
|
|
|
PR EVASC RPR ILAC ART BIFUR ENDGRFT CATHJ RS&I UNI
|
Professional
|
Both
|
$988.00
|
|
|
Service Code
|
HCPCS 0254T
|
| Min. Negotiated Rate |
$395.20 |
| Max. Negotiated Rate |
$741.00 |
| Rate for Payer: BCBS Complete |
$395.20
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.00
|
|
|
PR EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI
|
Professional
|
Both
|
$2,227.00
|
|
|
Service Code
|
HCPCS 34718
|
| Min. Negotiated Rate |
$709.50 |
| Max. Negotiated Rate |
$2,230.58 |
| Rate for Payer: Aetna Commercial |
$1,509.22
|
| Rate for Payer: Aetna Medicare |
$1,126.28
|
| Rate for Payer: BCBS Complete |
$744.98
|
| Rate for Payer: BCBS MAPPO |
$1,126.28
|
| Rate for Payer: BCN Commercial |
$1,801.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,126.28
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cofinity Commercial |
$1,621.84
|
| Rate for Payer: Cofinity Commercial |
$1,509.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,126.28
|
| Rate for Payer: Healthscope Commercial |
$1,351.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,351.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,182.59
|
| Rate for Payer: Meridian Medicaid |
$744.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,238.91
|
| Rate for Payer: Nomi Health Commercial |
$1,351.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,670.25
|
| Rate for Payer: PACE SWMI |
$1,126.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,126.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,937.50
|
| Rate for Payer: Priority Health Medicare |
$1,126.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,937.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,126.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,230.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,126.28
|
| Rate for Payer: UHC Exchange |
$2,230.58
|
| Rate for Payer: UHC Medicaid |
$709.50
|
| Rate for Payer: UHCCP DNSP |
$1,126.28
|
| Rate for Payer: UHCCP Medicaid |
$709.50
|
|
