|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44365
|
| Min. Negotiated Rate |
$114.81 |
| Max. Negotiated Rate |
$740.68 |
| Rate for Payer: Aetna Commercial |
$241.56
|
| Rate for Payer: Aetna Medicare |
$560.00
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS Trust/PPO |
$740.68
|
| Rate for Payer: BCN Commercial |
$260.46
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.97
|
| Rate for Payer: Priority Health Narrow Network |
$320.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.13
|
| Rate for Payer: UHC Exchange |
$248.13
|
| Rate for Payer: UHCCP Medicaid |
$114.81
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44364
|
| Min. Negotiated Rate |
$128.65 |
| Max. Negotiated Rate |
$728.00 |
| Rate for Payer: Aetna Commercial |
$271.37
|
| Rate for Payer: Aetna Medicare |
$560.00
|
| Rate for Payer: BCBS Complete |
$135.08
|
| Rate for Payer: BCBS Trust/PPO |
$700.00
|
| Rate for Payer: BCN Commercial |
$292.72
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Meridian Medicaid |
$135.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.15
|
| Rate for Payer: Priority Health Narrow Network |
$359.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.35
|
| Rate for Payer: UHC Exchange |
$278.35
|
| Rate for Payer: UHCCP Medicaid |
$128.65
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN
|
Professional
|
Both
|
$2,764.00
|
|
|
Service Code
|
HCPCS 44021
|
| Min. Negotiated Rate |
$626.43 |
| Max. Negotiated Rate |
$1,796.60 |
| Rate for Payer: Aetna Commercial |
$1,316.39
|
| Rate for Payer: Aetna Medicare |
$1,382.00
|
| Rate for Payer: BCBS Complete |
$657.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,724.90
|
| Rate for Payer: BCN Commercial |
$1,418.63
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Meridian Medicaid |
$657.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,737.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,737.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,183.54
|
| Rate for Payer: UHC Exchange |
$1,183.54
|
| Rate for Payer: UHCCP Medicaid |
$626.43
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 44020
|
| Min. Negotiated Rate |
$627.07 |
| Max. Negotiated Rate |
$2,324.52 |
| Rate for Payer: Aetna Commercial |
$1,317.49
|
| Rate for Payer: Aetna Medicare |
$1,473.00
|
| Rate for Payer: BCBS Complete |
$658.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.52
|
| Rate for Payer: BCN Commercial |
$1,420.10
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Meridian Medicaid |
$658.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$627.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,914.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,742.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,742.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,171.24
|
| Rate for Payer: UHC Exchange |
$1,171.24
|
| Rate for Payer: UHCCP Medicaid |
$627.07
|
|
|
PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,992.00
|
|
|
Service Code
|
HCPCS 44128
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$1,294.80 |
| Rate for Payer: Aetna Commercial |
$330.68
|
| Rate for Payer: Aetna Medicare |
$996.00
|
| Rate for Payer: BCBS Complete |
$162.15
|
| Rate for Payer: BCBS Trust/PPO |
$726.94
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Meridian Medicaid |
$162.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,294.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.75
|
| Rate for Payer: Priority Health Narrow Network |
$430.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.66
|
| Rate for Payer: UHC Exchange |
$300.66
|
| Rate for Payer: UHCCP Medicaid |
$154.43
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$5,027.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$240.38 |
| Max. Negotiated Rate |
$5,085.96 |
| Rate for Payer: Aetna Commercial |
$3,863.33
|
| Rate for Payer: Aetna Medicare |
$2,513.50
|
| Rate for Payer: BCBS Complete |
$1,915.34
|
| Rate for Payer: BCBS Trust/PPO |
$240.38
|
| Rate for Payer: BCN Commercial |
$4,149.37
|
| Rate for Payer: Cash Price |
$4,021.60
|
| Rate for Payer: Cash Price |
$4,021.60
|
| Rate for Payer: Meridian Medicaid |
$1,915.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,824.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,267.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,085.96
|
| Rate for Payer: Priority Health Narrow Network |
$5,085.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,449.55
|
| Rate for Payer: UHC Exchange |
$3,449.55
|
| Rate for Payer: UHCCP Medicaid |
$1,824.13
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING
|
Professional
|
Both
|
$4,332.00
|
|
|
Service Code
|
HCPCS 44126
|
| Min. Negotiated Rate |
$1,581.53 |
| Max. Negotiated Rate |
$4,406.43 |
| Rate for Payer: Aetna Commercial |
$3,342.37
|
| Rate for Payer: Aetna Medicare |
$2,166.00
|
| Rate for Payer: BCBS Complete |
$1,660.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.09
|
| Rate for Payer: BCN Commercial |
$3,594.23
|
| Rate for Payer: Cash Price |
$3,465.60
|
| Rate for Payer: Cash Price |
$3,465.60
|
| Rate for Payer: Meridian Medicaid |
$1,660.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,581.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,815.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,406.43
|
| Rate for Payer: Priority Health Narrow Network |
$4,406.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,973.40
|
| Rate for Payer: UHC Exchange |
$2,973.40
|
| Rate for Payer: UHCCP Medicaid |
$1,581.53
|
|
|
PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST
|
Professional
|
Both
|
$3,316.00
|
|
|
Service Code
|
HCPCS 44120
|
| Min. Negotiated Rate |
$236.68 |
| Max. Negotiated Rate |
$2,182.94 |
| Rate for Payer: Aetna Commercial |
$1,649.65
|
| Rate for Payer: Aetna Medicare |
$1,658.00
|
| Rate for Payer: BCBS Complete |
$823.03
|
| Rate for Payer: BCBS Trust/PPO |
$236.68
|
| Rate for Payer: BCN Commercial |
$1,778.29
|
| Rate for Payer: Cash Price |
$2,652.80
|
| Rate for Payer: Cash Price |
$2,652.80
|
| Rate for Payer: Meridian Medicaid |
$823.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$783.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,155.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,182.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,182.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,477.95
|
| Rate for Payer: UHC Exchange |
$1,477.95
|
| Rate for Payer: UHCCP Medicaid |
$783.84
|
|
|
PR EO W/O JOINTS CF
|
Professional
|
Both
|
$270.00
|
|
|
Service Code
|
HCPCS L3702
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$249.53 |
| Rate for Payer: Aetna Commercial |
$158.29
|
| Rate for Payer: Aetna Medicare |
$135.00
|
| Rate for Payer: BCBS Complete |
$108.00
|
| Rate for Payer: BCN Commercial |
$249.53
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.77
|
| Rate for Payer: UHC Exchange |
$142.77
|
|
|
PR EPDRM AGRFT T/A/L EA ADD 100 SQCM/EA 1%INFT/CHLD
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 15111
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$212.16 |
| Rate for Payer: Aetna Commercial |
$111.86
|
| Rate for Payer: Aetna Medicare |
$127.00
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.36
|
| Rate for Payer: Priority Health Narrow Network |
$136.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.82
|
| Rate for Payer: UHC Exchange |
$115.82
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
PR EP EVAL 1/2CHMB PACG CVDFB LDS TSTG OF PULSE GEN
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 93641
|
| Min. Negotiated Rate |
$190.64 |
| Max. Negotiated Rate |
$2,001.73 |
| Rate for Payer: Aetna Commercial |
$765.30
|
| Rate for Payer: Aetna Medicare |
$268.50
|
| Rate for Payer: BCBS Complete |
$200.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,001.73
|
| Rate for Payer: BCN Commercial |
$835.64
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Meridian Medicaid |
$200.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$422.34
|
| Rate for Payer: Priority Health Narrow Network |
$422.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$784.04
|
| Rate for Payer: UHC Exchange |
$784.04
|
| Rate for Payer: UHCCP Medicaid |
$190.64
|
|
|
PR EP EVAL 1/2 CHMB TRANSVNS PAC CVDFB
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 93642
|
| Min. Negotiated Rate |
$156.34 |
| Max. Negotiated Rate |
$2,287.54 |
| Rate for Payer: Aetna Commercial |
$445.35
|
| Rate for Payer: Aetna Medicare |
$867.00
|
| Rate for Payer: BCBS Complete |
$164.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,287.54
|
| Rate for Payer: BCN Commercial |
$481.35
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Meridian Medicaid |
$164.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.65
|
| Rate for Payer: Priority Health Narrow Network |
$344.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$545.45
|
| Rate for Payer: UHC Exchange |
$545.45
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT 1ST 100 SQCM/<
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 15115
|
| Min. Negotiated Rate |
$138.90 |
| Max. Negotiated Rate |
$1,172.34 |
| Rate for Payer: Aetna Commercial |
$751.44
|
| Rate for Payer: Aetna Medicare |
$734.00
|
| Rate for Payer: BCBS Complete |
$473.47
|
| Rate for Payer: BCBS Trust/PPO |
$138.90
|
| Rate for Payer: BCN Commercial |
$1,172.34
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Meridian Medicaid |
$473.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$450.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$954.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.67
|
| Rate for Payer: Priority Health Narrow Network |
$943.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$799.76
|
| Rate for Payer: UHC Exchange |
$799.76
|
| Rate for Payer: UHCCP Medicaid |
$450.92
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT EA 100 SQCM
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 15116
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$281.44 |
| Rate for Payer: Aetna Commercial |
$163.92
|
| Rate for Payer: Aetna Medicare |
$167.00
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS Trust/PPO |
$281.44
|
| Rate for Payer: BCN Commercial |
$225.28
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Meridian Medicaid |
$92.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.57
|
| Rate for Payer: Priority Health Narrow Network |
$185.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.48
|
| Rate for Payer: UHC Exchange |
$162.48
|
| Rate for Payer: UHCCP Medicaid |
$87.97
|
|
|
PR EPIDIDYMECTOMY BILATERAL
|
Professional
|
Both
|
$1,072.00
|
|
|
Service Code
|
HCPCS 54861
|
| Min. Negotiated Rate |
$365.30 |
| Max. Negotiated Rate |
$2,782.03 |
| Rate for Payer: Aetna Commercial |
$728.21
|
| Rate for Payer: Aetna Medicare |
$536.00
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,782.03
|
| Rate for Payer: BCN Commercial |
$821.46
|
| Rate for Payer: Cash Price |
$857.60
|
| Rate for Payer: Cash Price |
$857.60
|
| Rate for Payer: Meridian Medicaid |
$383.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.15
|
| Rate for Payer: Priority Health Narrow Network |
$909.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$677.91
|
| Rate for Payer: UHC Exchange |
$677.91
|
| Rate for Payer: UHCCP Medicaid |
$365.30
|
|
|
PR EPIDIDYMECTOMY UNILATERAL
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 54860
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$1,211.92 |
| Rate for Payer: Aetna Commercial |
$536.30
|
| Rate for Payer: Aetna Medicare |
$378.00
|
| Rate for Payer: BCBS Complete |
$283.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,211.92
|
| Rate for Payer: BCN Commercial |
$606.94
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Meridian Medicaid |
$283.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$671.62
|
| Rate for Payer: Priority Health Narrow Network |
$671.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$501.24
|
| Rate for Payer: UHC Exchange |
$501.24
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
|
|
PR EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
HCPCS 54900
|
| Min. Negotiated Rate |
$513.12 |
| Max. Negotiated Rate |
$2,046.63 |
| Rate for Payer: Aetna Commercial |
$1,027.27
|
| Rate for Payer: Aetna Medicare |
$861.00
|
| Rate for Payer: BCBS Complete |
$538.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,046.63
|
| Rate for Payer: BCN Commercial |
$1,154.74
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Meridian Medicaid |
$538.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.45
|
| Rate for Payer: UHC Exchange |
$918.45
|
| Rate for Payer: UHCCP Medicaid |
$513.12
|
|
|
PR EPIDRM AGRFT T/A/L 1ST 100 SQCM/</1% INFT/CHLD
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 15110
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$1,219.74 |
| Rate for Payer: Aetna Commercial |
$761.36
|
| Rate for Payer: Aetna Medicare |
$804.00
|
| Rate for Payer: BCBS Complete |
$482.63
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,219.74
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Meridian Medicaid |
$482.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$459.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$969.86
|
| Rate for Payer: Priority Health Narrow Network |
$969.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.63
|
| Rate for Payer: UHC Exchange |
$781.63
|
| Rate for Payer: UHCCP Medicaid |
$459.65
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/ULNA
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 25450
|
| Min. Negotiated Rate |
$406.19 |
| Max. Negotiated Rate |
$3,253.04 |
| Rate for Payer: Aetna Commercial |
$824.26
|
| Rate for Payer: Aetna Medicare |
$630.00
|
| Rate for Payer: BCBS Complete |
$426.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.04
|
| Rate for Payer: BCN Commercial |
$913.83
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Meridian Medicaid |
$426.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.24
|
| Rate for Payer: Priority Health Narrow Network |
$961.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$682.94
|
| Rate for Payer: UHC Exchange |
$682.94
|
| Rate for Payer: UHCCP Medicaid |
$406.19
|
|
|
PR EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 27185
|
| Min. Negotiated Rate |
$469.88 |
| Max. Negotiated Rate |
$1,112.88 |
| Rate for Payer: Aetna Commercial |
$958.27
|
| Rate for Payer: Aetna Medicare |
$587.50
|
| Rate for Payer: BCBS Complete |
$493.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,108.37
|
| Rate for Payer: BCN Commercial |
$1,059.45
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Meridian Medicaid |
$493.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,112.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$713.02
|
| Rate for Payer: UHC Exchange |
$713.02
|
| Rate for Payer: UHCCP Medicaid |
$469.88
|
|
|
PR EPISIOTOMY/VAG RPR OTH/THN ATTENDING
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 59300
|
| Min. Negotiated Rate |
$94.57 |
| Max. Negotiated Rate |
$439.02 |
| Rate for Payer: Aetna Commercial |
$160.66
|
| Rate for Payer: Aetna Medicare |
$190.50
|
| Rate for Payer: BCBS Complete |
$99.30
|
| Rate for Payer: BCBS Trust/PPO |
$439.02
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Meridian Medicaid |
$99.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.26
|
| Rate for Payer: Priority Health Narrow Network |
$207.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.39
|
| Rate for Payer: UHC Exchange |
$168.39
|
| Rate for Payer: UHCCP Medicaid |
$94.57
|
|
|
PR EPOETIN ALFA, NON-ESRD
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS J0885
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Commercial |
$9.15
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Trust/PPO |
$6.75
|
| Rate for Payer: BCN Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.05
|
| Rate for Payer: UHC Exchange |
$9.05
|
|
|
PR ERCP,ABLATION TUMOR
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 43272
|
| Min. Negotiated Rate |
$662.00 |
| Max. Negotiated Rate |
$1,075.75 |
| Rate for Payer: Aetna Medicare |
$827.50
|
| Rate for Payer: BCBS Complete |
$662.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
|
|
PR ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 43277
|
| Min. Negotiated Rate |
$237.50 |
| Max. Negotiated Rate |
$947.77 |
| Rate for Payer: Aetna Commercial |
$503.77
|
| Rate for Payer: Aetna Medicare |
$592.50
|
| Rate for Payer: BCBS Complete |
$249.38
|
| Rate for Payer: BCBS Trust/PPO |
$947.77
|
| Rate for Payer: BCN Commercial |
$540.97
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Meridian Medicaid |
$249.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$664.01
|
| Rate for Payer: Priority Health Narrow Network |
$664.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$529.46
|
| Rate for Payer: UHC Exchange |
$529.46
|
| Rate for Payer: UHCCP Medicaid |
$237.50
|
|
|
PR ERCP,BALLOON DIL DUCTS
|
Professional
|
Both
|
$1,672.00
|
|
|
Service Code
|
HCPCS 43271
|
| Min. Negotiated Rate |
$668.80 |
| Max. Negotiated Rate |
$1,086.80 |
| Rate for Payer: Aetna Medicare |
$836.00
|
| Rate for Payer: BCBS Complete |
$668.80
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,086.80
|
|
