|
PR EXC ILEOANAL RSVR W/ILEOSTOMY
|
Professional
|
Both
|
$3,352.00
|
|
|
Service Code
|
HCPCS 45136
|
| Min. Negotiated Rate |
$1,042.64 |
| Max. Negotiated Rate |
$3,224.30 |
| Rate for Payer: Aetna Commercial |
$2,159.03
|
| Rate for Payer: Aetna Medicare |
$1,611.22
|
| Rate for Payer: BCBS Complete |
$1,094.77
|
| Rate for Payer: BCBS MAPPO |
$1,611.22
|
| Rate for Payer: BCN Commercial |
$2,646.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,611.22
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cofinity Commercial |
$2,320.16
|
| Rate for Payer: Cofinity Commercial |
$2,159.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,611.22
|
| Rate for Payer: Healthscope Commercial |
$1,933.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,933.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,691.78
|
| Rate for Payer: Meridian Medicaid |
$1,094.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,772.34
|
| Rate for Payer: Nomi Health Commercial |
$1,933.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,514.00
|
| Rate for Payer: PACE SWMI |
$1,611.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,611.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,042.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,224.30
|
| Rate for Payer: Priority Health Medicare |
$1,611.22
|
| Rate for Payer: Priority Health Narrow Network |
$3,224.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,611.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,162.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,611.22
|
| Rate for Payer: UHC Exchange |
$3,162.57
|
| Rate for Payer: UHC Medicaid |
$1,042.64
|
| Rate for Payer: UHCCP DNSP |
$1,611.22
|
| Rate for Payer: UHCCP Medicaid |
$1,042.64
|
|
|
PR EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,524.00
|
|
|
Service Code
|
HCPCS 33120
|
| Min. Negotiated Rate |
$1,244.56 |
| Max. Negotiated Rate |
$3,737.69 |
| Rate for Payer: Aetna Commercial |
$2,622.96
|
| Rate for Payer: Aetna Medicare |
$1,957.43
|
| Rate for Payer: BCBS Complete |
$1,306.79
|
| Rate for Payer: BCBS MAPPO |
$1,957.43
|
| Rate for Payer: BCN Commercial |
$3,072.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,957.43
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cash Price |
$3,619.20
|
| Rate for Payer: Cofinity Commercial |
$2,818.70
|
| Rate for Payer: Cofinity Commercial |
$2,622.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,957.43
|
| Rate for Payer: Healthscope Commercial |
$2,348.92
|
| Rate for Payer: Healthscope Whirlpool |
$2,348.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,055.30
|
| Rate for Payer: Meridian Medicaid |
$1,306.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,153.17
|
| Rate for Payer: Nomi Health Commercial |
$2,348.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,393.00
|
| Rate for Payer: PACE SWMI |
$1,957.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,957.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,244.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,303.60
|
| Rate for Payer: Priority Health Medicare |
$1,957.43
|
| Rate for Payer: Priority Health Narrow Network |
$3,303.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,957.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,737.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,957.43
|
| Rate for Payer: UHC Exchange |
$3,737.69
|
| Rate for Payer: UHC Medicaid |
$1,244.56
|
| Rate for Payer: UHCCP DNSP |
$1,957.43
|
| Rate for Payer: UHCCP Medicaid |
$1,244.56
|
|
|
PR EXCIS CHEST WALL TUMOR/RIBS
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 19260
|
| Min. Negotiated Rate |
$933.20 |
| Max. Negotiated Rate |
$1,749.75 |
| Rate for Payer: BCBS Complete |
$933.20
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,749.75
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,285.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,231.66 |
| Rate for Payer: Aetna Commercial |
$873.47
|
| Rate for Payer: Aetna Medicare |
$651.84
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS MAPPO |
$651.84
|
| Rate for Payer: BCN Commercial |
$1,074.64
|
| Rate for Payer: BCN Medicare Advantage |
$651.84
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cash Price |
$1,028.00
|
| Rate for Payer: Cofinity Commercial |
$873.47
|
| Rate for Payer: Cofinity Commercial |
$938.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.84
|
| Rate for Payer: Healthscope Commercial |
$782.21
|
| Rate for Payer: Healthscope Whirlpool |
$782.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.43
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$717.02
|
| Rate for Payer: Nomi Health Commercial |
$782.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.75
|
| Rate for Payer: PACE SWMI |
$651.84
|
| Rate for Payer: PHP Medicare Advantage |
$651.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$983.58
|
| Rate for Payer: Priority Health Medicare |
$651.84
|
| Rate for Payer: Priority Health Narrow Network |
$983.58
|
| Rate for Payer: Railroad Medicare Medicare |
$651.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,231.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$651.84
|
| Rate for Payer: UHC Exchange |
$1,231.66
|
| Rate for Payer: UHC Medicaid |
$423.66
|
| Rate for Payer: UHCCP DNSP |
$651.84
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,666.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$542.72 |
| Max. Negotiated Rate |
$1,588.22 |
| Rate for Payer: Aetna Commercial |
$1,110.18
|
| Rate for Payer: Aetna Medicare |
$828.49
|
| Rate for Payer: BCBS Complete |
$569.86
|
| Rate for Payer: BCBS MAPPO |
$828.49
|
| Rate for Payer: BCN Commercial |
$1,412.78
|
| Rate for Payer: BCN Medicare Advantage |
$828.49
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cofinity Commercial |
$1,193.03
|
| Rate for Payer: Cofinity Commercial |
$1,110.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$828.49
|
| Rate for Payer: Healthscope Commercial |
$994.19
|
| Rate for Payer: Healthscope Whirlpool |
$994.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$869.91
|
| Rate for Payer: Meridian Medicaid |
$569.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$911.34
|
| Rate for Payer: Nomi Health Commercial |
$994.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,249.50
|
| Rate for Payer: PACE SWMI |
$828.49
|
| Rate for Payer: PHP Medicare Advantage |
$828.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,293.05
|
| Rate for Payer: Priority Health Medicare |
$828.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,293.05
|
| Rate for Payer: Railroad Medicare Medicare |
$828.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,588.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$828.49
|
| Rate for Payer: UHC Exchange |
$1,588.22
|
| Rate for Payer: UHC Medicaid |
$542.72
|
| Rate for Payer: UHCCP DNSP |
$828.49
|
| Rate for Payer: UHCCP Medicaid |
$542.72
|
|
|
PR EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$3,453.00
|
|
|
Service Code
|
HCPCS 15946
|
| Min. Negotiated Rate |
$931.45 |
| Max. Negotiated Rate |
$2,858.61 |
| Rate for Payer: Aetna Commercial |
$1,925.71
|
| Rate for Payer: Aetna Medicare |
$1,437.10
|
| Rate for Payer: BCBS Complete |
$978.02
|
| Rate for Payer: BCBS MAPPO |
$1,437.10
|
| Rate for Payer: BCN Commercial |
$2,410.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,437.10
|
| Rate for Payer: Cash Price |
$2,762.40
|
| Rate for Payer: Cash Price |
$2,762.40
|
| Rate for Payer: Cofinity Commercial |
$2,069.42
|
| Rate for Payer: Cofinity Commercial |
$1,925.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,437.10
|
| Rate for Payer: Healthscope Commercial |
$1,724.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,724.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,508.95
|
| Rate for Payer: Meridian Medicaid |
$978.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,580.81
|
| Rate for Payer: Nomi Health Commercial |
$1,724.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,589.75
|
| Rate for Payer: PACE SWMI |
$1,437.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,437.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,205.98
|
| Rate for Payer: Priority Health Medicare |
$1,437.10
|
| Rate for Payer: Priority Health Narrow Network |
$2,205.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,437.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,858.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,437.10
|
| Rate for Payer: UHC Exchange |
$2,858.61
|
| Rate for Payer: UHC Medicaid |
$931.45
|
| Rate for Payer: UHCCP DNSP |
$1,437.10
|
| Rate for Payer: UHCCP Medicaid |
$931.45
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$552.31 |
| Max. Negotiated Rate |
$1,597.58 |
| Rate for Payer: Aetna Commercial |
$1,128.45
|
| Rate for Payer: Aetna Medicare |
$842.13
|
| Rate for Payer: BCBS Complete |
$579.93
|
| Rate for Payer: BCBS MAPPO |
$842.13
|
| Rate for Payer: BCN Commercial |
$1,432.20
|
| Rate for Payer: BCN Medicare Advantage |
$842.13
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,212.67
|
| Rate for Payer: Cofinity Commercial |
$1,128.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$842.13
|
| Rate for Payer: Healthscope Commercial |
$1,010.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,010.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$884.24
|
| Rate for Payer: Meridian Medicaid |
$579.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$926.34
|
| Rate for Payer: Nomi Health Commercial |
$1,010.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,248.00
|
| Rate for Payer: PACE SWMI |
$842.13
|
| Rate for Payer: PHP Medicare Advantage |
$842.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,310.83
|
| Rate for Payer: Priority Health Medicare |
$842.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,310.83
|
| Rate for Payer: Railroad Medicare Medicare |
$842.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,597.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$842.13
|
| Rate for Payer: UHC Exchange |
$1,597.58
|
| Rate for Payer: UHC Medicaid |
$552.31
|
| Rate for Payer: UHCCP DNSP |
$842.13
|
| Rate for Payer: UHCCP Medicaid |
$552.31
|
|
|
PR EXCISION 1ST &/CERVICAL RIB
|
Professional
|
Both
|
$1,238.00
|
|
|
Service Code
|
HCPCS 21615
|
| Min. Negotiated Rate |
$371.47 |
| Max. Negotiated Rate |
$1,095.54 |
| Rate for Payer: Aetna Commercial |
$776.89
|
| Rate for Payer: Aetna Medicare |
$579.77
|
| Rate for Payer: BCBS Complete |
$390.04
|
| Rate for Payer: BCBS MAPPO |
$579.77
|
| Rate for Payer: BCN Commercial |
$935.71
|
| Rate for Payer: BCN Medicare Advantage |
$579.77
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cash Price |
$990.40
|
| Rate for Payer: Cofinity Commercial |
$834.87
|
| Rate for Payer: Cofinity Commercial |
$776.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.77
|
| Rate for Payer: Healthscope Commercial |
$695.72
|
| Rate for Payer: Healthscope Whirlpool |
$695.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.76
|
| Rate for Payer: Meridian Medicaid |
$390.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$637.75
|
| Rate for Payer: Nomi Health Commercial |
$695.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$928.50
|
| Rate for Payer: PACE SWMI |
$579.77
|
| Rate for Payer: PHP Medicare Advantage |
$579.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,000.24
|
| Rate for Payer: Priority Health Medicare |
$579.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,000.24
|
| Rate for Payer: Railroad Medicare Medicare |
$579.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,095.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$579.77
|
| Rate for Payer: UHC Exchange |
$1,095.54
|
| Rate for Payer: UHC Medicaid |
$371.47
|
| Rate for Payer: UHCCP DNSP |
$579.77
|
| Rate for Payer: UHCCP Medicaid |
$371.47
|
|
|
PR EXCISION AMPULLA VATER
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 48148
|
| Min. Negotiated Rate |
$751.25 |
| Max. Negotiated Rate |
$2,291.11 |
| Rate for Payer: Aetna Commercial |
$1,569.90
|
| Rate for Payer: Aetna Medicare |
$1,171.57
|
| Rate for Payer: BCBS Complete |
$788.81
|
| Rate for Payer: BCBS MAPPO |
$1,171.57
|
| Rate for Payer: BCN Commercial |
$1,880.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.57
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,687.06
|
| Rate for Payer: Cofinity Commercial |
$1,569.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.57
|
| Rate for Payer: Healthscope Commercial |
$1,405.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,230.15
|
| Rate for Payer: Meridian Medicaid |
$788.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,288.73
|
| Rate for Payer: Nomi Health Commercial |
$1,405.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,426.50
|
| Rate for Payer: PACE SWMI |
$1,171.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,291.11
|
| Rate for Payer: Priority Health Medicare |
$1,171.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,291.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,171.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,229.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,171.57
|
| Rate for Payer: UHC Exchange |
$2,229.83
|
| Rate for Payer: UHC Medicaid |
$751.25
|
| Rate for Payer: UHCCP DNSP |
$1,171.57
|
| Rate for Payer: UHCCP Medicaid |
$751.25
|
|
|
PR EXCISION AURAL POLYP
|
Professional
|
Both
|
$387.00
|
|
|
Service Code
|
HCPCS 69540
|
| Min. Negotiated Rate |
$76.68 |
| Max. Negotiated Rate |
$290.25 |
| Rate for Payer: Aetna Commercial |
$153.60
|
| Rate for Payer: Aetna Medicare |
$114.63
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$114.63
|
| Rate for Payer: BCN Commercial |
$194.71
|
| Rate for Payer: BCN Medicare Advantage |
$114.63
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cofinity Commercial |
$165.07
|
| Rate for Payer: Cofinity Commercial |
$153.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.63
|
| Rate for Payer: Healthscope Commercial |
$137.56
|
| Rate for Payer: Healthscope Whirlpool |
$137.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.36
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.09
|
| Rate for Payer: Nomi Health Commercial |
$137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.25
|
| Rate for Payer: PACE SWMI |
$114.63
|
| Rate for Payer: PHP Medicare Advantage |
$114.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$192.39
|
| Rate for Payer: Priority Health Medicare |
$114.63
|
| Rate for Payer: Priority Health Narrow Network |
$192.39
|
| Rate for Payer: Railroad Medicare Medicare |
$114.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.63
|
| Rate for Payer: UHC Exchange |
$213.32
|
| Rate for Payer: UHC Medicaid |
$76.68
|
| Rate for Payer: UHCCP DNSP |
$114.63
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
|
|
PR EXCISION BARTHOLINS GLAND OR CYST
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 56740
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$717.75 |
| Rate for Payer: Aetna Commercial |
$373.06
|
| Rate for Payer: Aetna Medicare |
$278.40
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCBS MAPPO |
$278.40
|
| Rate for Payer: BCN Commercial |
$471.59
|
| Rate for Payer: BCN Medicare Advantage |
$278.40
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$400.90
|
| Rate for Payer: Cofinity Commercial |
$373.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.40
|
| Rate for Payer: Healthscope Commercial |
$334.08
|
| Rate for Payer: Healthscope Whirlpool |
$334.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.32
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.24
|
| Rate for Payer: Nomi Health Commercial |
$334.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$717.75
|
| Rate for Payer: PACE SWMI |
$278.40
|
| Rate for Payer: PHP Medicare Advantage |
$278.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$477.61
|
| Rate for Payer: Priority Health Medicare |
$278.40
|
| Rate for Payer: Priority Health Narrow Network |
$477.61
|
| Rate for Payer: Railroad Medicare Medicare |
$278.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$542.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.40
|
| Rate for Payer: UHC Exchange |
$542.74
|
| Rate for Payer: UHC Medicaid |
$180.41
|
| Rate for Payer: UHCCP DNSP |
$278.40
|
| Rate for Payer: UHCCP Medicaid |
$180.41
|
|
|
PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT
|
Professional
|
Both
|
$1,005.00
|
|
|
Service Code
|
HCPCS 21040
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$753.75 |
| Rate for Payer: Aetna Commercial |
$437.48
|
| Rate for Payer: Aetna Medicare |
$326.48
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$326.48
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: BCN Medicare Advantage |
$326.48
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cofinity Commercial |
$470.13
|
| Rate for Payer: Cofinity Commercial |
$437.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.48
|
| Rate for Payer: Healthscope Commercial |
$391.78
|
| Rate for Payer: Healthscope Whirlpool |
$391.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$342.80
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.13
|
| Rate for Payer: Nomi Health Commercial |
$391.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.75
|
| Rate for Payer: PACE SWMI |
$326.48
|
| Rate for Payer: PHP Medicare Advantage |
$326.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$588.75
|
| Rate for Payer: Priority Health Medicare |
$326.48
|
| Rate for Payer: Priority Health Narrow Network |
$588.75
|
| Rate for Payer: Railroad Medicare Medicare |
$326.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$669.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.48
|
| Rate for Payer: UHC Exchange |
$669.29
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP DNSP |
$326.48
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
|
|
PR EXCISION BONE CYST/BENIGN TUMOR DEEP
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 27066
|
| Min. Negotiated Rate |
$483.72 |
| Max. Negotiated Rate |
$1,415.18 |
| Rate for Payer: Aetna Commercial |
$992.38
|
| Rate for Payer: Aetna Medicare |
$740.58
|
| Rate for Payer: BCBS Complete |
$507.91
|
| Rate for Payer: BCBS MAPPO |
$740.58
|
| Rate for Payer: BCN Commercial |
$1,248.94
|
| Rate for Payer: BCN Medicare Advantage |
$740.58
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cofinity Commercial |
$992.38
|
| Rate for Payer: Cofinity Commercial |
$1,066.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.58
|
| Rate for Payer: Healthscope Commercial |
$888.70
|
| Rate for Payer: Healthscope Whirlpool |
$888.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.61
|
| Rate for Payer: Meridian Medicaid |
$507.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$814.64
|
| Rate for Payer: Nomi Health Commercial |
$888.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,156.50
|
| Rate for Payer: PACE SWMI |
$740.58
|
| Rate for Payer: PHP Medicare Advantage |
$740.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,335.08
|
| Rate for Payer: Priority Health Medicare |
$740.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,335.08
|
| Rate for Payer: Railroad Medicare Medicare |
$740.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,415.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$740.58
|
| Rate for Payer: UHC Exchange |
$1,415.18
|
| Rate for Payer: UHC Medicaid |
$483.72
|
| Rate for Payer: UHCCP DNSP |
$740.58
|
| Rate for Payer: UHCCP Medicaid |
$483.72
|
|
|
PR EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL
|
Professional
|
Both
|
$932.00
|
|
|
Service Code
|
HCPCS 27065
|
| Min. Negotiated Rate |
$324.19 |
| Max. Negotiated Rate |
$903.58 |
| Rate for Payer: Aetna Commercial |
$659.87
|
| Rate for Payer: Aetna Medicare |
$492.44
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$492.44
|
| Rate for Payer: BCN Commercial |
$804.24
|
| Rate for Payer: BCN Medicare Advantage |
$492.44
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cash Price |
$745.60
|
| Rate for Payer: Cofinity Commercial |
$709.11
|
| Rate for Payer: Cofinity Commercial |
$659.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.44
|
| Rate for Payer: Healthscope Commercial |
$590.93
|
| Rate for Payer: Healthscope Whirlpool |
$590.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.06
|
| Rate for Payer: Meridian Medicaid |
$340.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$541.68
|
| Rate for Payer: Nomi Health Commercial |
$590.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$699.00
|
| Rate for Payer: PACE SWMI |
$492.44
|
| Rate for Payer: PHP Medicare Advantage |
$492.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$859.72
|
| Rate for Payer: Priority Health Medicare |
$492.44
|
| Rate for Payer: Priority Health Narrow Network |
$859.72
|
| Rate for Payer: Railroad Medicare Medicare |
$492.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$903.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$492.44
|
| Rate for Payer: UHC Exchange |
$903.58
|
| Rate for Payer: UHC Medicaid |
$324.19
|
| Rate for Payer: UHCCP DNSP |
$492.44
|
| Rate for Payer: UHCCP Medicaid |
$324.19
|
|
|
PR EXCISION BONE MANDIBLE
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 21025
|
| Min. Negotiated Rate |
$391.28 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$801.40
|
| Rate for Payer: Aetna Medicare |
$598.06
|
| Rate for Payer: BCBS Complete |
$410.84
|
| Rate for Payer: BCBS MAPPO |
$598.06
|
| Rate for Payer: BCN Commercial |
$1,009.90
|
| Rate for Payer: BCN Medicare Advantage |
$598.06
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cofinity Commercial |
$861.21
|
| Rate for Payer: Cofinity Commercial |
$801.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.06
|
| Rate for Payer: Healthscope Commercial |
$717.67
|
| Rate for Payer: Healthscope Whirlpool |
$717.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.96
|
| Rate for Payer: Meridian Medicaid |
$410.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$657.87
|
| Rate for Payer: Nomi Health Commercial |
$717.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,233.00
|
| Rate for Payer: PACE SWMI |
$598.06
|
| Rate for Payer: PHP Medicare Advantage |
$598.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,079.57
|
| Rate for Payer: Priority Health Medicare |
$598.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,079.57
|
| Rate for Payer: Railroad Medicare Medicare |
$598.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,203.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$598.06
|
| Rate for Payer: UHC Exchange |
$1,203.12
|
| Rate for Payer: UHC Medicaid |
$391.28
|
| Rate for Payer: UHCCP DNSP |
$598.06
|
| Rate for Payer: UHCCP Medicaid |
$391.28
|
|
|
PR EXCISION CHALAZION MULTIPLE SAME LID
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 67801
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$228.66 |
| Rate for Payer: Aetna Commercial |
$143.54
|
| Rate for Payer: Aetna Medicare |
$107.12
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCBS MAPPO |
$107.12
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$107.12
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$154.25
|
| Rate for Payer: Cofinity Commercial |
$143.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.12
|
| Rate for Payer: Healthscope Commercial |
$128.54
|
| Rate for Payer: Healthscope Whirlpool |
$128.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.48
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.83
|
| Rate for Payer: Nomi Health Commercial |
$128.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PACE SWMI |
$107.12
|
| Rate for Payer: PHP Medicare Advantage |
$107.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$228.66
|
| Rate for Payer: Priority Health Medicare |
$107.12
|
| Rate for Payer: Priority Health Narrow Network |
$228.66
|
| Rate for Payer: Railroad Medicare Medicare |
$107.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$225.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.12
|
| Rate for Payer: UHC Exchange |
$225.78
|
| Rate for Payer: UHC Medicaid |
$70.29
|
| Rate for Payer: UHCCP DNSP |
$107.12
|
| Rate for Payer: UHCCP Medicaid |
$70.29
|
|
|
PR EXCISION CHALAZION SINGLE
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 67800
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$178.49 |
| Rate for Payer: Aetna Commercial |
$112.64
|
| Rate for Payer: Aetna Medicare |
$84.06
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$84.06
|
| Rate for Payer: BCN Commercial |
$120.17
|
| Rate for Payer: BCN Medicare Advantage |
$84.06
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$121.05
|
| Rate for Payer: Cofinity Commercial |
$112.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$100.87
|
| Rate for Payer: Healthscope Whirlpool |
$100.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.26
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.47
|
| Rate for Payer: Nomi Health Commercial |
$100.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: PACE SWMI |
$84.06
|
| Rate for Payer: PHP Medicare Advantage |
$84.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$178.49
|
| Rate for Payer: Priority Health Medicare |
$84.06
|
| Rate for Payer: Priority Health Narrow Network |
$178.49
|
| Rate for Payer: Railroad Medicare Medicare |
$84.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.06
|
| Rate for Payer: UHC Exchange |
$175.31
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP DNSP |
$84.06
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR EXCISION CHEST WALL TUMOR INCLUDING RIBS
|
Professional
|
Both
|
$2,512.00
|
|
|
Service Code
|
HCPCS 21601
|
| Min. Negotiated Rate |
$708.86 |
| Max. Negotiated Rate |
$2,080.14 |
| Rate for Payer: Aetna Commercial |
$1,470.38
|
| Rate for Payer: Aetna Medicare |
$1,097.30
|
| Rate for Payer: BCBS Complete |
$744.30
|
| Rate for Payer: BCBS MAPPO |
$1,097.30
|
| Rate for Payer: BCN Commercial |
$1,716.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,097.30
|
| Rate for Payer: Cash Price |
$2,009.60
|
| Rate for Payer: Cash Price |
$2,009.60
|
| Rate for Payer: Cofinity Commercial |
$1,580.11
|
| Rate for Payer: Cofinity Commercial |
$1,470.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,097.30
|
| Rate for Payer: Healthscope Commercial |
$1,316.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,316.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,152.16
|
| Rate for Payer: Meridian Medicaid |
$744.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,207.03
|
| Rate for Payer: Nomi Health Commercial |
$1,316.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,884.00
|
| Rate for Payer: PACE SWMI |
$1,097.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,097.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$708.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,834.93
|
| Rate for Payer: Priority Health Medicare |
$1,097.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,834.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,097.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,080.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,097.30
|
| Rate for Payer: UHC Exchange |
$2,080.14
|
| Rate for Payer: UHC Medicaid |
$708.86
|
| Rate for Payer: UHCCP DNSP |
$1,097.30
|
| Rate for Payer: UHCCP Medicaid |
$708.86
|
|
|
PR EXCISION CHOLEDOCHAL CYST
|
Professional
|
Both
|
$2,376.00
|
|
|
Service Code
|
HCPCS 47715
|
| Min. Negotiated Rate |
$799.60 |
| Max. Negotiated Rate |
$2,436.13 |
| Rate for Payer: Aetna Commercial |
$1,670.06
|
| Rate for Payer: Aetna Medicare |
$1,246.31
|
| Rate for Payer: BCBS Complete |
$839.58
|
| Rate for Payer: BCBS MAPPO |
$1,246.31
|
| Rate for Payer: BCN Commercial |
$1,999.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,246.31
|
| Rate for Payer: Cash Price |
$1,900.80
|
| Rate for Payer: Cash Price |
$1,900.80
|
| Rate for Payer: Cofinity Commercial |
$1,794.69
|
| Rate for Payer: Cofinity Commercial |
$1,670.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,246.31
|
| Rate for Payer: Healthscope Commercial |
$1,495.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,495.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,308.63
|
| Rate for Payer: Meridian Medicaid |
$839.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,370.94
|
| Rate for Payer: Nomi Health Commercial |
$1,495.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,782.00
|
| Rate for Payer: PACE SWMI |
$1,246.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,246.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$799.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,436.13
|
| Rate for Payer: Priority Health Medicare |
$1,246.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,436.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,246.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,375.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,246.31
|
| Rate for Payer: UHC Exchange |
$2,375.55
|
| Rate for Payer: UHC Medicaid |
$799.60
|
| Rate for Payer: UHCCP DNSP |
$1,246.31
|
| Rate for Payer: UHCCP Medicaid |
$799.60
|
|
|
PR EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC
|
Professional
|
Both
|
$3,858.00
|
|
|
Service Code
|
HCPCS 21603
|
| Min. Negotiated Rate |
$1,066.28 |
| Max. Negotiated Rate |
$3,079.43 |
| Rate for Payer: Aetna Commercial |
$2,200.92
|
| Rate for Payer: Aetna Medicare |
$1,642.48
|
| Rate for Payer: BCBS Complete |
$1,119.59
|
| Rate for Payer: BCBS MAPPO |
$1,642.48
|
| Rate for Payer: BCN Commercial |
$2,508.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,642.48
|
| Rate for Payer: Cash Price |
$3,086.40
|
| Rate for Payer: Cash Price |
$3,086.40
|
| Rate for Payer: Cofinity Commercial |
$2,365.17
|
| Rate for Payer: Cofinity Commercial |
$2,200.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,642.48
|
| Rate for Payer: Healthscope Commercial |
$1,970.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,970.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,724.60
|
| Rate for Payer: Meridian Medicaid |
$1,119.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,806.73
|
| Rate for Payer: Nomi Health Commercial |
$1,970.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,893.50
|
| Rate for Payer: PACE SWMI |
$1,642.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,642.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,066.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,681.87
|
| Rate for Payer: Priority Health Medicare |
$1,642.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,681.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,642.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,079.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,642.48
|
| Rate for Payer: UHC Exchange |
$3,079.43
|
| Rate for Payer: UHC Medicaid |
$1,066.28
|
| Rate for Payer: UHCCP DNSP |
$1,642.48
|
| Rate for Payer: UHCCP Medicaid |
$1,066.28
|
|
|
PR EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC
|
Professional
|
Both
|
$3,219.00
|
|
|
Service Code
|
HCPCS 21602
|
| Min. Negotiated Rate |
$975.11 |
| Max. Negotiated Rate |
$2,778.35 |
| Rate for Payer: Aetna Commercial |
$2,006.32
|
| Rate for Payer: Aetna Medicare |
$1,497.25
|
| Rate for Payer: BCBS Complete |
$1,023.87
|
| Rate for Payer: BCBS MAPPO |
$1,497.25
|
| Rate for Payer: BCN Commercial |
$2,313.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,497.25
|
| Rate for Payer: Cash Price |
$2,575.20
|
| Rate for Payer: Cash Price |
$2,575.20
|
| Rate for Payer: Cofinity Commercial |
$2,156.04
|
| Rate for Payer: Cofinity Commercial |
$2,006.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,497.25
|
| Rate for Payer: Healthscope Commercial |
$1,796.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,796.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,572.11
|
| Rate for Payer: Meridian Medicaid |
$1,023.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,646.97
|
| Rate for Payer: Nomi Health Commercial |
$1,796.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,414.25
|
| Rate for Payer: PACE SWMI |
$1,497.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,497.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$975.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,473.20
|
| Rate for Payer: Priority Health Medicare |
$1,497.25
|
| Rate for Payer: Priority Health Narrow Network |
$2,473.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,497.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,778.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,497.25
|
| Rate for Payer: UHC Exchange |
$2,778.35
|
| Rate for Payer: UHC Medicaid |
$975.11
|
| Rate for Payer: UHCCP DNSP |
$1,497.25
|
| Rate for Payer: UHCCP Medicaid |
$975.11
|
|
|
PR EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 27635
|
| Min. Negotiated Rate |
$348.04 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna Commercial |
$711.63
|
| Rate for Payer: Aetna Medicare |
$531.07
|
| Rate for Payer: BCBS Complete |
$365.44
|
| Rate for Payer: BCBS MAPPO |
$531.07
|
| Rate for Payer: BCN Commercial |
$879.93
|
| Rate for Payer: BCN Medicare Advantage |
$531.07
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$764.74
|
| Rate for Payer: Cofinity Commercial |
$711.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.07
|
| Rate for Payer: Healthscope Commercial |
$637.28
|
| Rate for Payer: Healthscope Whirlpool |
$637.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.62
|
| Rate for Payer: Meridian Medicaid |
$365.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$584.18
|
| Rate for Payer: Nomi Health Commercial |
$637.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,608.00
|
| Rate for Payer: PACE SWMI |
$531.07
|
| Rate for Payer: PHP Medicare Advantage |
$531.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$940.62
|
| Rate for Payer: Priority Health Medicare |
$531.07
|
| Rate for Payer: Priority Health Narrow Network |
$940.62
|
| Rate for Payer: Railroad Medicare Medicare |
$531.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,013.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$531.07
|
| Rate for Payer: UHC Exchange |
$1,013.72
|
| Rate for Payer: UHC Medicaid |
$348.04
|
| Rate for Payer: UHCCP DNSP |
$531.07
|
| Rate for Payer: UHCCP Medicaid |
$348.04
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES
|
Professional
|
Both
|
$1,670.00
|
|
|
Service Code
|
HCPCS 25130
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,252.50 |
| Rate for Payer: Aetna Commercial |
$557.49
|
| Rate for Payer: Aetna Medicare |
$416.04
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$416.04
|
| Rate for Payer: BCN Commercial |
$699.66
|
| Rate for Payer: BCN Medicare Advantage |
$416.04
|
| Rate for Payer: Cash Price |
$1,336.00
|
| Rate for Payer: Cash Price |
$1,336.00
|
| Rate for Payer: Cofinity Commercial |
$599.10
|
| Rate for Payer: Cofinity Commercial |
$557.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.04
|
| Rate for Payer: Healthscope Commercial |
$499.25
|
| Rate for Payer: Healthscope Whirlpool |
$499.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.84
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.64
|
| Rate for Payer: Nomi Health Commercial |
$499.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,252.50
|
| Rate for Payer: PACE SWMI |
$416.04
|
| Rate for Payer: PHP Medicare Advantage |
$416.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$747.92
|
| Rate for Payer: Priority Health Medicare |
$416.04
|
| Rate for Payer: Priority Health Narrow Network |
$747.92
|
| Rate for Payer: Railroad Medicare Medicare |
$416.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$775.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.04
|
| Rate for Payer: UHC Exchange |
$775.78
|
| Rate for Payer: UHC Medicaid |
$274.77
|
| Rate for Payer: UHCCP DNSP |
$416.04
|
| Rate for Payer: UHCCP Medicaid |
$274.77
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 27355
|
| Min. Negotiated Rate |
$368.28 |
| Max. Negotiated Rate |
$1,767.00 |
| Rate for Payer: Aetna Commercial |
$752.76
|
| Rate for Payer: Aetna Medicare |
$561.76
|
| Rate for Payer: BCBS Complete |
$386.69
|
| Rate for Payer: BCBS MAPPO |
$561.76
|
| Rate for Payer: BCN Commercial |
$935.21
|
| Rate for Payer: BCN Medicare Advantage |
$561.76
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cofinity Commercial |
$808.93
|
| Rate for Payer: Cofinity Commercial |
$752.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.76
|
| Rate for Payer: Healthscope Commercial |
$674.11
|
| Rate for Payer: Healthscope Whirlpool |
$674.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.85
|
| Rate for Payer: Meridian Medicaid |
$386.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.94
|
| Rate for Payer: Nomi Health Commercial |
$674.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,767.00
|
| Rate for Payer: PACE SWMI |
$561.76
|
| Rate for Payer: PHP Medicare Advantage |
$561.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$999.72
|
| Rate for Payer: Priority Health Medicare |
$561.76
|
| Rate for Payer: Priority Health Narrow Network |
$999.72
|
| Rate for Payer: Railroad Medicare Medicare |
$561.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,053.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.76
|
| Rate for Payer: UHC Exchange |
$1,053.62
|
| Rate for Payer: UHC Medicaid |
$368.28
|
| Rate for Payer: UHCCP DNSP |
$561.76
|
| Rate for Payer: UHCCP Medicaid |
$368.28
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION
|
Professional
|
Both
|
$1,102.00
|
|
|
Service Code
|
HCPCS 27358
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$826.50 |
| Rate for Payer: Aetna Commercial |
$316.94
|
| Rate for Payer: Aetna Medicare |
$236.52
|
| Rate for Payer: BCBS Complete |
$158.34
|
| Rate for Payer: BCBS MAPPO |
$236.52
|
| Rate for Payer: BCN Commercial |
$408.34
|
| Rate for Payer: BCN Medicare Advantage |
$236.52
|
| Rate for Payer: Cash Price |
$881.60
|
| Rate for Payer: Cash Price |
$881.60
|
| Rate for Payer: Cofinity Commercial |
$340.59
|
| Rate for Payer: Cofinity Commercial |
$316.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.52
|
| Rate for Payer: Healthscope Commercial |
$283.82
|
| Rate for Payer: Healthscope Whirlpool |
$283.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.35
|
| Rate for Payer: Meridian Medicaid |
$158.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$260.17
|
| Rate for Payer: Nomi Health Commercial |
$283.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$826.50
|
| Rate for Payer: PACE SWMI |
$236.52
|
| Rate for Payer: PHP Medicare Advantage |
$236.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$436.51
|
| Rate for Payer: Priority Health Medicare |
$236.52
|
| Rate for Payer: Priority Health Narrow Network |
$436.51
|
| Rate for Payer: Railroad Medicare Medicare |
$236.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$491.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.52
|
| Rate for Payer: UHC Exchange |
$491.55
|
| Rate for Payer: UHC Medicaid |
$150.80
|
| Rate for Payer: UHCCP DNSP |
$236.52
|
| Rate for Payer: UHCCP Medicaid |
$150.80
|
|
