|
PR PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH
|
Professional
|
Both
|
$1,057.00
|
|
|
Service Code
|
HCPCS 92921
|
| Min. Negotiated Rate |
$203.06 |
| Max. Negotiated Rate |
$739.90 |
| Rate for Payer: Aetna Commercial |
$300.69
|
| Rate for Payer: BCBS Complete |
$422.80
|
| Rate for Payer: BCBS Trust/PPO |
$388.83
|
| Rate for Payer: BCN Commercial |
$203.06
|
| Rate for Payer: Cash Price |
$845.60
|
| Rate for Payer: Cash Price |
$845.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.00
|
| Rate for Payer: Priority Health Narrow Network |
$249.00
|
|
|
PR PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH
|
Professional
|
Both
|
$1,097.00
|
|
|
Service Code
|
HCPCS 92920
|
| Min. Negotiated Rate |
$329.09 |
| Max. Negotiated Rate |
$3,219.99 |
| Rate for Payer: Aetna Commercial |
$692.63
|
| Rate for Payer: Aetna Medicare |
$516.89
|
| Rate for Payer: BCBS Complete |
$345.54
|
| Rate for Payer: BCBS MAPPO |
$516.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,219.99
|
| Rate for Payer: BCN Commercial |
$752.07
|
| Rate for Payer: BCN Medicare Advantage |
$516.89
|
| Rate for Payer: Cash Price |
$877.60
|
| Rate for Payer: Cash Price |
$877.60
|
| Rate for Payer: Cofinity Commercial |
$744.32
|
| Rate for Payer: Cofinity Commercial |
$692.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.89
|
| Rate for Payer: Healthscope Commercial |
$620.27
|
| Rate for Payer: Healthscope Whirlpool |
$620.27
|
| Rate for Payer: Meridian Medicaid |
$345.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$542.73
|
| Rate for Payer: PACE SWMI |
$516.89
|
| Rate for Payer: PHP Medicare Advantage |
$516.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.74
|
| Rate for Payer: Priority Health Medicare |
$516.89
|
| Rate for Payer: Priority Health Narrow Network |
$727.74
|
| Rate for Payer: UHC Medicare Advantage |
$532.40
|
|
|
PR PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 92938
|
| Min. Negotiated Rate |
$110.00 |
| Max. Negotiated Rate |
$316.80 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: BCBS Trust/PPO |
$151.09
|
| Rate for Payer: BCN Commercial |
$226.15
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.00
|
| Rate for Payer: Priority Health Narrow Network |
$249.00
|
|
|
PR PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL
|
Professional
|
Both
|
$1,219.00
|
|
|
Service Code
|
HCPCS 92937
|
| Min. Negotiated Rate |
$146.34 |
| Max. Negotiated Rate |
$853.30 |
| Rate for Payer: Aetna Commercial |
$771.57
|
| Rate for Payer: Aetna Medicare |
$575.80
|
| Rate for Payer: BCBS Complete |
$384.46
|
| Rate for Payer: BCBS MAPPO |
$575.80
|
| Rate for Payer: BCBS Trust/PPO |
$146.34
|
| Rate for Payer: BCN Commercial |
$837.60
|
| Rate for Payer: BCN Medicare Advantage |
$575.80
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cofinity Commercial |
$829.15
|
| Rate for Payer: Cofinity Commercial |
$771.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.80
|
| Rate for Payer: Healthscope Commercial |
$690.96
|
| Rate for Payer: Healthscope Whirlpool |
$690.96
|
| Rate for Payer: Meridian Medicaid |
$384.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$604.59
|
| Rate for Payer: PACE SWMI |
$575.80
|
| Rate for Payer: PHP Medicare Advantage |
$575.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$810.50
|
| Rate for Payer: Priority Health Medicare |
$575.80
|
| Rate for Payer: Priority Health Narrow Network |
$810.50
|
| Rate for Payer: UHC Medicare Advantage |
$593.07
|
|
|
PR PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
HCPCS 92934
|
| Min. Negotiated Rate |
$82.41 |
| Max. Negotiated Rate |
$854.70 |
| Rate for Payer: Aetna Commercial |
$273.84
|
| Rate for Payer: BCBS Complete |
$488.40
|
| Rate for Payer: BCBS Trust/PPO |
$82.41
|
| Rate for Payer: BCN Commercial |
$253.73
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$310.00
|
| Rate for Payer: Priority Health Narrow Network |
$310.00
|
|
|
PR PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 92929
|
| Min. Negotiated Rate |
$226.41 |
| Max. Negotiated Rate |
$832.30 |
| Rate for Payer: Aetna Commercial |
$352.65
|
| Rate for Payer: BCBS Complete |
$475.60
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$226.41
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.00
|
| Rate for Payer: Priority Health Narrow Network |
$275.00
|
|
|
PR PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH
|
Professional
|
Both
|
$1,220.00
|
|
|
Service Code
|
HCPCS 92928
|
| Min. Negotiated Rate |
$334.41 |
| Max. Negotiated Rate |
$854.00 |
| Rate for Payer: Aetna Commercial |
$772.44
|
| Rate for Payer: Aetna Medicare |
$576.45
|
| Rate for Payer: BCBS Complete |
$384.46
|
| Rate for Payer: BCBS MAPPO |
$576.45
|
| Rate for Payer: BCBS Trust/PPO |
$334.41
|
| Rate for Payer: BCN Commercial |
$838.57
|
| Rate for Payer: BCN Medicare Advantage |
$576.45
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cofinity Commercial |
$830.09
|
| Rate for Payer: Cofinity Commercial |
$772.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$576.45
|
| Rate for Payer: Healthscope Commercial |
$691.74
|
| Rate for Payer: Healthscope Whirlpool |
$691.74
|
| Rate for Payer: Meridian Medicaid |
$384.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$605.27
|
| Rate for Payer: PACE SWMI |
$576.45
|
| Rate for Payer: PHP Medicare Advantage |
$576.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$811.44
|
| Rate for Payer: Priority Health Medicare |
$576.45
|
| Rate for Payer: Priority Health Narrow Network |
$811.44
|
| Rate for Payer: UHC Medicare Advantage |
$593.74
|
|
|
PR PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 92943
|
| Min. Negotiated Rate |
$411.09 |
| Max. Negotiated Rate |
$1,794.11 |
| Rate for Payer: Aetna Commercial |
$867.44
|
| Rate for Payer: Aetna Medicare |
$647.34
|
| Rate for Payer: BCBS Complete |
$431.64
|
| Rate for Payer: BCBS MAPPO |
$647.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,794.11
|
| Rate for Payer: BCN Commercial |
$941.68
|
| Rate for Payer: BCN Medicare Advantage |
$647.34
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cofinity Commercial |
$932.17
|
| Rate for Payer: Cofinity Commercial |
$867.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.34
|
| Rate for Payer: Healthscope Commercial |
$776.81
|
| Rate for Payer: Healthscope Whirlpool |
$776.81
|
| Rate for Payer: Meridian Medicaid |
$431.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$679.71
|
| Rate for Payer: PACE SWMI |
$647.34
|
| Rate for Payer: PHP Medicare Advantage |
$647.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$911.22
|
| Rate for Payer: Priority Health Medicare |
$647.34
|
| Rate for Payer: Priority Health Narrow Network |
$911.22
|
| Rate for Payer: UHC Medicare Advantage |
$666.76
|
|
|
PR PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH
|
Professional
|
Both
|
$1,409.00
|
|
|
Service Code
|
HCPCS 92933
|
| Min. Negotiated Rate |
$128.38 |
| Max. Negotiated Rate |
$986.30 |
| Rate for Payer: Aetna Commercial |
$865.61
|
| Rate for Payer: Aetna Medicare |
$645.98
|
| Rate for Payer: BCBS Complete |
$431.19
|
| Rate for Payer: BCBS MAPPO |
$645.98
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$939.73
|
| Rate for Payer: BCN Medicare Advantage |
$645.98
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Cofinity Commercial |
$930.21
|
| Rate for Payer: Cofinity Commercial |
$865.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$645.98
|
| Rate for Payer: Healthscope Commercial |
$775.18
|
| Rate for Payer: Healthscope Whirlpool |
$775.18
|
| Rate for Payer: Meridian Medicaid |
$431.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$678.28
|
| Rate for Payer: PACE SWMI |
$645.98
|
| Rate for Payer: PHP Medicare Advantage |
$645.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.32
|
| Rate for Payer: Priority Health Medicare |
$645.98
|
| Rate for Payer: Priority Health Narrow Network |
$909.32
|
| Rate for Payer: UHC Medicare Advantage |
$665.36
|
|
|
PR PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL
|
Professional
|
Both
|
$1,371.00
|
|
|
Service Code
|
HCPCS 92941
|
| Min. Negotiated Rate |
$180.15 |
| Max. Negotiated Rate |
$959.70 |
| Rate for Payer: Aetna Commercial |
$866.38
|
| Rate for Payer: Aetna Medicare |
$646.55
|
| Rate for Payer: BCBS Complete |
$431.64
|
| Rate for Payer: BCBS MAPPO |
$646.55
|
| Rate for Payer: BCBS Trust/PPO |
$180.15
|
| Rate for Payer: BCN Commercial |
$940.71
|
| Rate for Payer: BCN Medicare Advantage |
$646.55
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$931.03
|
| Rate for Payer: Cofinity Commercial |
$866.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.55
|
| Rate for Payer: Healthscope Commercial |
$775.86
|
| Rate for Payer: Healthscope Whirlpool |
$775.86
|
| Rate for Payer: Meridian Medicaid |
$431.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$678.88
|
| Rate for Payer: PACE SWMI |
$646.55
|
| Rate for Payer: PHP Medicare Advantage |
$646.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$959.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$910.27
|
| Rate for Payer: Priority Health Medicare |
$646.55
|
| Rate for Payer: Priority Health Narrow Network |
$910.27
|
| Rate for Payer: UHC Medicare Advantage |
$665.95
|
|
|
PR PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX
|
Professional
|
Both
|
$531.00
|
|
|
Service Code
|
HCPCS 37188
|
| Min. Negotiated Rate |
$174.45 |
| Max. Negotiated Rate |
$2,165.33 |
| Rate for Payer: Aetna Commercial |
$367.27
|
| Rate for Payer: Aetna Medicare |
$274.08
|
| Rate for Payer: BCBS Complete |
$183.17
|
| Rate for Payer: BCBS MAPPO |
$274.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,237.28
|
| Rate for Payer: BCN Commercial |
$2,165.33
|
| Rate for Payer: BCN Medicare Advantage |
$274.08
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$394.68
|
| Rate for Payer: Cofinity Commercial |
$367.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.08
|
| Rate for Payer: Healthscope Commercial |
$328.90
|
| Rate for Payer: Healthscope Whirlpool |
$328.90
|
| Rate for Payer: Meridian Medicaid |
$183.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$287.78
|
| Rate for Payer: PACE SWMI |
$274.08
|
| Rate for Payer: PHP Medicare Advantage |
$274.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.15
|
| Rate for Payer: Priority Health Medicare |
$274.08
|
| Rate for Payer: Priority Health Narrow Network |
$435.15
|
| Rate for Payer: UHC Medicare Advantage |
$282.30
|
|
|
PR PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF
|
Professional
|
Both
|
$9,273.00
|
|
|
Service Code
|
HCPCS 43116
|
| Min. Negotiated Rate |
$216.60 |
| Max. Negotiated Rate |
$8,572.64 |
| Rate for Payer: Aetna Commercial |
$6,574.79
|
| Rate for Payer: Aetna Medicare |
$4,906.56
|
| Rate for Payer: BCBS Complete |
$3,268.65
|
| Rate for Payer: BCBS MAPPO |
$4,906.56
|
| Rate for Payer: BCBS Trust/PPO |
$216.60
|
| Rate for Payer: BCN Commercial |
$7,124.91
|
| Rate for Payer: BCN Medicare Advantage |
$4,906.56
|
| Rate for Payer: Cash Price |
$7,418.40
|
| Rate for Payer: Cash Price |
$7,418.40
|
| Rate for Payer: Cofinity Commercial |
$7,065.45
|
| Rate for Payer: Cofinity Commercial |
$6,574.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,906.56
|
| Rate for Payer: Healthscope Commercial |
$5,887.87
|
| Rate for Payer: Healthscope Whirlpool |
$5,887.87
|
| Rate for Payer: Meridian Medicaid |
$3,268.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,151.89
|
| Rate for Payer: PACE SWMI |
$4,906.56
|
| Rate for Payer: PHP Medicare Advantage |
$4,906.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,113.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,491.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,572.64
|
| Rate for Payer: Priority Health Medicare |
$4,906.56
|
| Rate for Payer: Priority Health Narrow Network |
$8,572.64
|
| Rate for Payer: UHC Medicare Advantage |
$5,053.76
|
|
|
PR PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY
|
Professional
|
Both
|
$5,892.00
|
|
|
Service Code
|
HCPCS 43121
|
| Min. Negotiated Rate |
$86.60 |
| Max. Negotiated Rate |
$4,939.55 |
| Rate for Payer: Aetna Commercial |
$3,775.89
|
| Rate for Payer: Aetna Medicare |
$2,817.83
|
| Rate for Payer: BCBS Complete |
$1,887.39
|
| Rate for Payer: BCBS MAPPO |
$2,817.83
|
| Rate for Payer: BCBS Trust/PPO |
$86.60
|
| Rate for Payer: BCN Commercial |
$4,105.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,817.83
|
| Rate for Payer: Cash Price |
$4,713.60
|
| Rate for Payer: Cash Price |
$4,713.60
|
| Rate for Payer: Cofinity Commercial |
$3,775.89
|
| Rate for Payer: Cofinity Commercial |
$4,057.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,817.83
|
| Rate for Payer: Healthscope Commercial |
$3,381.40
|
| Rate for Payer: Healthscope Whirlpool |
$3,381.40
|
| Rate for Payer: Meridian Medicaid |
$1,887.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,958.72
|
| Rate for Payer: PACE SWMI |
$2,817.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,817.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,797.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,124.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,939.55
|
| Rate for Payer: Priority Health Medicare |
$2,817.83
|
| Rate for Payer: Priority Health Narrow Network |
$4,939.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,902.36
|
|
|
PR PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY
|
Professional
|
Both
|
$6,210.00
|
|
|
Service Code
|
HCPCS 43117
|
| Min. Negotiated Rate |
$147.40 |
| Max. Negotiated Rate |
$5,636.31 |
| Rate for Payer: Aetna Commercial |
$4,301.19
|
| Rate for Payer: Aetna Medicare |
$3,209.84
|
| Rate for Payer: BCBS Complete |
$2,154.42
|
| Rate for Payer: BCBS MAPPO |
$3,209.84
|
| Rate for Payer: BCBS Trust/PPO |
$147.40
|
| Rate for Payer: BCN Commercial |
$4,684.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,209.84
|
| Rate for Payer: Cash Price |
$4,968.00
|
| Rate for Payer: Cash Price |
$4,968.00
|
| Rate for Payer: Cofinity Commercial |
$4,622.17
|
| Rate for Payer: Cofinity Commercial |
$4,301.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,209.84
|
| Rate for Payer: Healthscope Commercial |
$3,851.81
|
| Rate for Payer: Healthscope Whirlpool |
$3,851.81
|
| Rate for Payer: Meridian Medicaid |
$2,154.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,370.33
|
| Rate for Payer: PACE SWMI |
$3,209.84
|
| Rate for Payer: PHP Medicare Advantage |
$3,209.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,051.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,347.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,636.31
|
| Rate for Payer: Priority Health Medicare |
$3,209.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,636.31
|
| Rate for Payer: UHC Medicare Advantage |
$3,306.14
|
|
|
PR PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
HCPCS 28122
|
| Min. Negotiated Rate |
$283.29 |
| Max. Negotiated Rate |
$1,020.15 |
| Rate for Payer: Aetna Commercial |
$572.97
|
| Rate for Payer: Aetna Medicare |
$427.59
|
| Rate for Payer: BCBS Complete |
$297.45
|
| Rate for Payer: BCBS MAPPO |
$427.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,020.15
|
| Rate for Payer: BCN Commercial |
$859.58
|
| Rate for Payer: BCN Medicare Advantage |
$427.59
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cofinity Commercial |
$572.97
|
| Rate for Payer: Cofinity Commercial |
$615.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.59
|
| Rate for Payer: Healthscope Commercial |
$513.11
|
| Rate for Payer: Healthscope Whirlpool |
$513.11
|
| Rate for Payer: Meridian Medicaid |
$297.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$448.97
|
| Rate for Payer: PACE SWMI |
$427.59
|
| Rate for Payer: PHP Medicare Advantage |
$427.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$666.91
|
| Rate for Payer: Priority Health Medicare |
$427.59
|
| Rate for Payer: Priority Health Narrow Network |
$666.91
|
| Rate for Payer: UHC Medicare Advantage |
$440.42
|
|
|
PR PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA
|
Professional
|
Both
|
$3,238.00
|
|
|
Service Code
|
HCPCS 27360
|
| Min. Negotiated Rate |
$583.19 |
| Max. Negotiated Rate |
$2,266.60 |
| Rate for Payer: Aetna Commercial |
$1,190.66
|
| Rate for Payer: Aetna Medicare |
$888.55
|
| Rate for Payer: BCBS Complete |
$612.35
|
| Rate for Payer: BCBS MAPPO |
$888.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,958.41
|
| Rate for Payer: BCN Commercial |
$1,331.65
|
| Rate for Payer: BCN Medicare Advantage |
$888.55
|
| Rate for Payer: Cash Price |
$2,590.40
|
| Rate for Payer: Cash Price |
$2,590.40
|
| Rate for Payer: Cofinity Commercial |
$1,190.66
|
| Rate for Payer: Cofinity Commercial |
$1,279.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$888.55
|
| Rate for Payer: Healthscope Commercial |
$1,066.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,066.26
|
| Rate for Payer: Meridian Medicaid |
$612.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$932.98
|
| Rate for Payer: PACE SWMI |
$888.55
|
| Rate for Payer: PHP Medicare Advantage |
$888.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,266.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,391.53
|
| Rate for Payer: Priority Health Medicare |
$888.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,391.53
|
| Rate for Payer: UHC Medicare Advantage |
$915.21
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV
|
Professional
|
Both
|
$1,735.00
|
|
|
Service Code
|
HCPCS 22100
|
| Min. Negotiated Rate |
$617.06 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$1,143.42
|
| Rate for Payer: Aetna Medicare |
$853.30
|
| Rate for Payer: BCBS Complete |
$647.91
|
| Rate for Payer: BCBS MAPPO |
$853.30
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$1,270.07
|
| Rate for Payer: BCN Medicare Advantage |
$853.30
|
| Rate for Payer: Cash Price |
$1,388.00
|
| Rate for Payer: Cash Price |
$1,388.00
|
| Rate for Payer: Cofinity Commercial |
$1,228.75
|
| Rate for Payer: Cofinity Commercial |
$1,143.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.30
|
| Rate for Payer: Healthscope Commercial |
$1,023.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,023.96
|
| Rate for Payer: Meridian Medicaid |
$647.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$895.96
|
| Rate for Payer: PACE SWMI |
$853.30
|
| Rate for Payer: PHP Medicare Advantage |
$853.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$617.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,214.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,327.18
|
| Rate for Payer: Priority Health Medicare |
$853.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,327.18
|
| Rate for Payer: UHC Medicare Advantage |
$878.90
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 22103
|
| Min. Negotiated Rate |
$85.41 |
| Max. Negotiated Rate |
$18,089.98 |
| Rate for Payer: Aetna Commercial |
$180.18
|
| Rate for Payer: Aetna Medicare |
$134.46
|
| Rate for Payer: BCBS Complete |
$89.68
|
| Rate for Payer: BCBS MAPPO |
$134.46
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$134.46
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cofinity Commercial |
$180.18
|
| Rate for Payer: Cofinity Commercial |
$193.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.46
|
| Rate for Payer: Healthscope Commercial |
$161.35
|
| Rate for Payer: Healthscope Whirlpool |
$161.35
|
| Rate for Payer: Meridian Medicaid |
$89.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$141.18
|
| Rate for Payer: PACE SWMI |
$134.46
|
| Rate for Payer: PHP Medicare Advantage |
$134.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.29
|
| Rate for Payer: Priority Health Medicare |
$134.46
|
| Rate for Payer: Priority Health Narrow Network |
$205.29
|
| Rate for Payer: UHC Medicare Advantage |
$138.49
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR
|
Professional
|
Both
|
$2,157.00
|
|
|
Service Code
|
HCPCS 22102
|
| Min. Negotiated Rate |
$497.57 |
| Max. Negotiated Rate |
$18,089.98 |
| Rate for Payer: Aetna Commercial |
$1,028.06
|
| Rate for Payer: Aetna Medicare |
$767.21
|
| Rate for Payer: BCBS Complete |
$522.45
|
| Rate for Payer: BCBS MAPPO |
$767.21
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$1,141.55
|
| Rate for Payer: BCN Medicare Advantage |
$767.21
|
| Rate for Payer: Cash Price |
$1,725.60
|
| Rate for Payer: Cash Price |
$1,725.60
|
| Rate for Payer: Cofinity Commercial |
$1,028.06
|
| Rate for Payer: Cofinity Commercial |
$1,104.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$767.21
|
| Rate for Payer: Healthscope Commercial |
$920.65
|
| Rate for Payer: Healthscope Whirlpool |
$920.65
|
| Rate for Payer: Meridian Medicaid |
$522.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$805.57
|
| Rate for Payer: PACE SWMI |
$767.21
|
| Rate for Payer: PHP Medicare Advantage |
$767.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,192.87
|
| Rate for Payer: Priority Health Medicare |
$767.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,192.87
|
| Rate for Payer: UHC Medicare Advantage |
$790.23
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC
|
Professional
|
Both
|
$2,225.00
|
|
|
Service Code
|
HCPCS 22101
|
| Min. Negotiated Rate |
$116.11 |
| Max. Negotiated Rate |
$1,557.50 |
| Rate for Payer: Aetna Commercial |
$1,151.61
|
| Rate for Payer: Aetna Medicare |
$859.41
|
| Rate for Payer: BCBS Complete |
$597.60
|
| Rate for Payer: BCBS MAPPO |
$859.41
|
| Rate for Payer: BCBS Trust/PPO |
$116.11
|
| Rate for Payer: BCN Commercial |
$1,279.36
|
| Rate for Payer: BCN Medicare Advantage |
$859.41
|
| Rate for Payer: Cash Price |
$1,780.00
|
| Rate for Payer: Cash Price |
$1,780.00
|
| Rate for Payer: Cofinity Commercial |
$1,151.61
|
| Rate for Payer: Cofinity Commercial |
$1,237.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.41
|
| Rate for Payer: Healthscope Commercial |
$1,031.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,031.29
|
| Rate for Payer: Meridian Medicaid |
$597.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$902.38
|
| Rate for Payer: PACE SWMI |
$859.41
|
| Rate for Payer: PHP Medicare Advantage |
$859.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$569.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,557.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.89
|
| Rate for Payer: Priority Health Medicare |
$859.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,336.89
|
| Rate for Payer: UHC Medicare Advantage |
$885.19
|
|
|
PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV
|
Professional
|
Both
|
$3,200.00
|
|
|
Service Code
|
HCPCS 22110
|
| Min. Negotiated Rate |
$687.35 |
| Max. Negotiated Rate |
$18,089.98 |
| Rate for Payer: Aetna Commercial |
$1,414.73
|
| Rate for Payer: Aetna Medicare |
$1,055.77
|
| Rate for Payer: BCBS Complete |
$721.72
|
| Rate for Payer: BCBS MAPPO |
$1,055.77
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$1,721.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,055.77
|
| Rate for Payer: Cash Price |
$2,560.00
|
| Rate for Payer: Cash Price |
$2,560.00
|
| Rate for Payer: Cofinity Commercial |
$1,414.73
|
| Rate for Payer: Cofinity Commercial |
$1,520.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,055.77
|
| Rate for Payer: Healthscope Commercial |
$1,266.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,266.92
|
| Rate for Payer: Meridian Medicaid |
$721.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,108.56
|
| Rate for Payer: PACE SWMI |
$1,055.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,055.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,240.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,634.08
|
| Rate for Payer: Priority Health Medicare |
$1,055.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,634.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,087.44
|
|
|
PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA
|
Professional
|
Both
|
$787.00
|
|
|
Service Code
|
HCPCS 22116
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$4,702.18 |
| Rate for Payer: Aetna Commercial |
$188.74
|
| Rate for Payer: Aetna Medicare |
$140.85
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$140.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,702.18
|
| Rate for Payer: BCN Commercial |
$205.25
|
| Rate for Payer: BCN Medicare Advantage |
$140.85
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cofinity Commercial |
$202.82
|
| Rate for Payer: Cofinity Commercial |
$188.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.85
|
| Rate for Payer: Healthscope Commercial |
$169.02
|
| Rate for Payer: Healthscope Whirlpool |
$169.02
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.89
|
| Rate for Payer: PACE SWMI |
$140.85
|
| Rate for Payer: PHP Medicare Advantage |
$140.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$550.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.48
|
| Rate for Payer: Priority Health Medicare |
$140.85
|
| Rate for Payer: Priority Health Narrow Network |
$214.48
|
| Rate for Payer: UHC Medicare Advantage |
$145.08
|
|
|
PR PRTL HYMENECTOMY/REVJ HYMENAL RING
|
Professional
|
Both
|
$644.00
|
|
|
Service Code
|
HCPCS 56700
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$2,047.16 |
| Rate for Payer: Aetna Commercial |
$268.51
|
| Rate for Payer: Aetna Medicare |
$200.38
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$200.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,047.16
|
| Rate for Payer: BCN Commercial |
$299.56
|
| Rate for Payer: BCN Medicare Advantage |
$200.38
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$288.55
|
| Rate for Payer: Cofinity Commercial |
$268.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.38
|
| Rate for Payer: Healthscope Commercial |
$240.46
|
| Rate for Payer: Healthscope Whirlpool |
$240.46
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.40
|
| Rate for Payer: PACE SWMI |
$200.38
|
| Rate for Payer: PHP Medicare Advantage |
$200.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.21
|
| Rate for Payer: Priority Health Medicare |
$200.38
|
| Rate for Payer: Priority Health Narrow Network |
$290.21
|
| Rate for Payer: UHC Medicare Advantage |
$206.39
|
|
|
PR PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$3,890.00
|
|
|
Service Code
|
HCPCS 60210
|
| Min. Negotiated Rate |
$259.40 |
| Max. Negotiated Rate |
$2,723.00 |
| Rate for Payer: Aetna Commercial |
$939.57
|
| Rate for Payer: Aetna Medicare |
$701.17
|
| Rate for Payer: BCBS Complete |
$477.05
|
| Rate for Payer: BCBS MAPPO |
$701.17
|
| Rate for Payer: BCBS Trust/PPO |
$259.40
|
| Rate for Payer: BCN Commercial |
$1,036.48
|
| Rate for Payer: BCN Medicare Advantage |
$701.17
|
| Rate for Payer: Cash Price |
$3,112.00
|
| Rate for Payer: Cash Price |
$3,112.00
|
| Rate for Payer: Cofinity Commercial |
$939.57
|
| Rate for Payer: Cofinity Commercial |
$1,009.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.17
|
| Rate for Payer: Healthscope Commercial |
$841.40
|
| Rate for Payer: Healthscope Whirlpool |
$841.40
|
| Rate for Payer: Meridian Medicaid |
$477.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$736.23
|
| Rate for Payer: PACE SWMI |
$701.17
|
| Rate for Payer: PHP Medicare Advantage |
$701.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,723.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.54
|
| Rate for Payer: Priority Health Medicare |
$701.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.54
|
| Rate for Payer: UHC Medicare Advantage |
$722.21
|
|
|
PR PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC
|
Professional
|
Both
|
$1,795.00
|
|
|
Service Code
|
HCPCS 60212
|
| Min. Negotiated Rate |
$368.75 |
| Max. Negotiated Rate |
$1,501.71 |
| Rate for Payer: Aetna Commercial |
$1,368.57
|
| Rate for Payer: Aetna Medicare |
$1,021.32
|
| Rate for Payer: BCBS Complete |
$690.41
|
| Rate for Payer: BCBS MAPPO |
$1,021.32
|
| Rate for Payer: BCBS Trust/PPO |
$368.75
|
| Rate for Payer: BCN Commercial |
$1,501.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,021.32
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,470.70
|
| Rate for Payer: Cofinity Commercial |
$1,368.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,021.32
|
| Rate for Payer: Healthscope Commercial |
$1,225.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,225.58
|
| Rate for Payer: Meridian Medicaid |
$690.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,072.39
|
| Rate for Payer: PACE SWMI |
$1,021.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,021.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,256.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,453.96
|
| Rate for Payer: Priority Health Medicare |
$1,021.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,453.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,051.96
|
|
