|
PR REMOVAL IMPLANT FROM FINGER/HAND
|
Professional
|
Both
|
$1,024.00
|
|
|
Service Code
|
HCPCS 26320
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$716.80 |
| Rate for Payer: Aetna Commercial |
$461.92
|
| Rate for Payer: Aetna Medicare |
$344.72
|
| Rate for Payer: BCBS Complete |
$240.20
|
| Rate for Payer: BCBS MAPPO |
$344.72
|
| Rate for Payer: BCBS Trust/PPO |
$140.00
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$344.72
|
| Rate for Payer: Cash Price |
$819.20
|
| Rate for Payer: Cash Price |
$819.20
|
| Rate for Payer: Cofinity Commercial |
$496.40
|
| Rate for Payer: Cofinity Commercial |
$461.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.72
|
| Rate for Payer: Healthscope Commercial |
$413.66
|
| Rate for Payer: Healthscope Whirlpool |
$413.66
|
| Rate for Payer: Meridian Medicaid |
$240.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$361.96
|
| Rate for Payer: PACE SWMI |
$344.72
|
| Rate for Payer: PHP Medicare Advantage |
$344.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.82
|
| Rate for Payer: Priority Health Medicare |
$344.72
|
| Rate for Payer: Priority Health Narrow Network |
$542.82
|
| Rate for Payer: UHC Medicare Advantage |
$355.06
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 20670
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$188.38
|
| Rate for Payer: Aetna Medicare |
$140.58
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$140.58
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$422.50
|
| Rate for Payer: BCN Medicare Advantage |
$140.58
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$188.38
|
| Rate for Payer: Cofinity Commercial |
$202.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.58
|
| Rate for Payer: Healthscope Commercial |
$168.70
|
| Rate for Payer: Healthscope Whirlpool |
$168.70
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.61
|
| Rate for Payer: PACE SWMI |
$140.58
|
| Rate for Payer: PHP Medicare Advantage |
$140.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.11
|
| Rate for Payer: Priority Health Medicare |
$140.58
|
| Rate for Payer: Priority Health Narrow Network |
$221.11
|
| Rate for Payer: UHC Medicare Advantage |
$144.80
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Facility
|
IP
|
$901.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$630.70 |
| Max. Negotiated Rate |
$901.00 |
| Rate for Payer: Aetna Commercial |
$810.90
|
| Rate for Payer: ASR ASR |
$873.97
|
| Rate for Payer: BCBS Trust/PPO |
$698.55
|
| Rate for Payer: BCN Commercial |
$698.55
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$846.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.80
|
| Rate for Payer: Healthscope Commercial |
$901.00
|
| Rate for Payer: Healthscope Whirlpool |
$873.97
|
| Rate for Payer: Mclaren Commercial |
$810.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.88
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$188.38
|
| Rate for Payer: Aetna Medicare |
$140.58
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$140.58
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$422.50
|
| Rate for Payer: BCN Medicare Advantage |
$140.58
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$188.38
|
| Rate for Payer: Cofinity Commercial |
$202.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.58
|
| Rate for Payer: Healthscope Commercial |
$168.70
|
| Rate for Payer: Healthscope Whirlpool |
$168.70
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.61
|
| Rate for Payer: PACE SWMI |
$140.58
|
| Rate for Payer: PHP Medicare Advantage |
$140.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.11
|
| Rate for Payer: Priority Health Medicare |
$140.58
|
| Rate for Payer: Priority Health Narrow Network |
$221.11
|
| Rate for Payer: UHC Medicare Advantage |
$144.80
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Facility
|
OP
|
$901.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$630.70 |
| Max. Negotiated Rate |
$2,555.18 |
| Rate for Payer: Aetna Commercial |
$810.90
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$873.97
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$698.55
|
| Rate for Payer: BCN Commercial |
$698.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$846.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$901.00
|
| Rate for Payer: Healthscope Whirlpool |
$873.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$810.90
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.85
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,555.18
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,044.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
PR REMOVAL INDWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$1,662.00
|
|
|
Service Code
|
HCPCS 50384
|
| Min. Negotiated Rate |
$140.79 |
| Max. Negotiated Rate |
$3,794.78 |
| Rate for Payer: Aetna Commercial |
$297.69
|
| Rate for Payer: Aetna Medicare |
$222.16
|
| Rate for Payer: BCBS Complete |
$147.83
|
| Rate for Payer: BCBS MAPPO |
$222.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,794.78
|
| Rate for Payer: BCN Commercial |
$1,270.56
|
| Rate for Payer: BCN Medicare Advantage |
$222.16
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Commercial |
$319.91
|
| Rate for Payer: Cofinity Commercial |
$297.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.16
|
| Rate for Payer: Healthscope Commercial |
$266.59
|
| Rate for Payer: Healthscope Whirlpool |
$266.59
|
| Rate for Payer: Meridian Medicaid |
$147.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.27
|
| Rate for Payer: PACE SWMI |
$222.16
|
| Rate for Payer: PHP Medicare Advantage |
$222.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,163.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$358.80
|
| Rate for Payer: Priority Health Medicare |
$222.16
|
| Rate for Payer: Priority Health Narrow Network |
$358.80
|
| Rate for Payer: UHC Medicare Advantage |
$228.82
|
|
|
PR REMOVAL INTACT BREAST IMPLANT
|
Professional
|
Both
|
$1,500.00
|
|
|
Service Code
|
HCPCS 19328
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$1,050.00 |
| Rate for Payer: Aetna Commercial |
$727.93
|
| Rate for Payer: Aetna Medicare |
$543.23
|
| Rate for Payer: BCBS Complete |
$373.72
|
| Rate for Payer: BCBS MAPPO |
$543.23
|
| Rate for Payer: BCBS Trust/PPO |
$14.00
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$543.23
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$782.25
|
| Rate for Payer: Cofinity Commercial |
$727.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.23
|
| Rate for Payer: Healthscope Commercial |
$651.88
|
| Rate for Payer: Healthscope Whirlpool |
$651.88
|
| Rate for Payer: Meridian Medicaid |
$373.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$570.39
|
| Rate for Payer: PACE SWMI |
$543.23
|
| Rate for Payer: PHP Medicare Advantage |
$543.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.15
|
| Rate for Payer: Priority Health Medicare |
$543.23
|
| Rate for Payer: Priority Health Narrow Network |
$683.15
|
| Rate for Payer: UHC Medicare Advantage |
$559.53
|
|
|
PR REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 33968
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$267.85 |
| Rate for Payer: Aetna Commercial |
$44.60
|
| Rate for Payer: Aetna Medicare |
$33.28
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS MAPPO |
$33.28
|
| Rate for Payer: BCBS Trust/PPO |
$267.85
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$33.28
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$44.60
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.28
|
| Rate for Payer: Healthscope Commercial |
$39.94
|
| Rate for Payer: Healthscope Whirlpool |
$39.94
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.94
|
| Rate for Payer: PACE SWMI |
$33.28
|
| Rate for Payer: PHP Medicare Advantage |
$33.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.67
|
| Rate for Payer: Priority Health Medicare |
$33.28
|
| Rate for Payer: Priority Health Narrow Network |
$52.67
|
| Rate for Payer: UHC Medicare Advantage |
$34.28
|
|
|
PR REMOVAL INTRAUTERINE DEVICE IUD
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 58301
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$510.34 |
| Rate for Payer: Aetna Commercial |
$88.12
|
| Rate for Payer: Aetna Medicare |
$65.76
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS MAPPO |
$65.76
|
| Rate for Payer: BCBS Trust/PPO |
$510.34
|
| Rate for Payer: BCN Commercial |
$130.36
|
| Rate for Payer: BCN Medicare Advantage |
$65.76
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$94.69
|
| Rate for Payer: Cofinity Commercial |
$88.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.76
|
| Rate for Payer: Healthscope Commercial |
$78.91
|
| Rate for Payer: Healthscope Whirlpool |
$78.91
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.05
|
| Rate for Payer: PACE SWMI |
$65.76
|
| Rate for Payer: PHP Medicare Advantage |
$65.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.27
|
| Rate for Payer: Priority Health Medicare |
$65.76
|
| Rate for Payer: Priority Health Narrow Network |
$93.27
|
| Rate for Payer: UHC Medicare Advantage |
$67.73
|
|
|
PR REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA
|
Professional
|
Both
|
$5,982.00
|
|
|
Service Code
|
HCPCS 32442
|
| Min. Negotiated Rate |
$640.30 |
| Max. Negotiated Rate |
$4,375.62 |
| Rate for Payer: Aetna Commercial |
$4,034.15
|
| Rate for Payer: Aetna Medicare |
$3,010.56
|
| Rate for Payer: BCBS Complete |
$2,009.05
|
| Rate for Payer: BCBS MAPPO |
$3,010.56
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$4,375.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,010.56
|
| Rate for Payer: Cash Price |
$4,785.60
|
| Rate for Payer: Cash Price |
$4,785.60
|
| Rate for Payer: Cofinity Commercial |
$4,034.15
|
| Rate for Payer: Cofinity Commercial |
$4,335.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,010.56
|
| Rate for Payer: Healthscope Commercial |
$3,612.67
|
| Rate for Payer: Healthscope Whirlpool |
$3,612.67
|
| Rate for Payer: Meridian Medicaid |
$2,009.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,161.09
|
| Rate for Payer: PACE SWMI |
$3,010.56
|
| Rate for Payer: PHP Medicare Advantage |
$3,010.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,913.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,187.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,146.10
|
| Rate for Payer: Priority Health Medicare |
$3,010.56
|
| Rate for Payer: Priority Health Narrow Network |
$4,146.10
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.88
|
|
|
PR REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 11982
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$438.68 |
| Rate for Payer: Aetna Commercial |
$98.30
|
| Rate for Payer: Aetna Medicare |
$73.36
|
| Rate for Payer: BCBS Complete |
$48.75
|
| Rate for Payer: BCBS MAPPO |
$73.36
|
| Rate for Payer: BCBS Trust/PPO |
$438.68
|
| Rate for Payer: BCN Commercial |
$164.69
|
| Rate for Payer: BCN Medicare Advantage |
$73.36
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$98.30
|
| Rate for Payer: Cofinity Commercial |
$105.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.36
|
| Rate for Payer: Healthscope Commercial |
$88.03
|
| Rate for Payer: Healthscope Whirlpool |
$88.03
|
| Rate for Payer: Meridian Medicaid |
$48.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.03
|
| Rate for Payer: PACE SWMI |
$73.36
|
| Rate for Payer: PHP Medicare Advantage |
$73.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.43
|
| Rate for Payer: Priority Health Medicare |
$73.36
|
| Rate for Payer: Priority Health Narrow Network |
$90.43
|
| Rate for Payer: UHC Medicare Advantage |
$75.56
|
|
|
PR REMOVAL OF LUNG PNEUMONECTOMY
|
Professional
|
Both
|
$5,395.00
|
|
|
Service Code
|
HCPCS 32440
|
| Min. Negotiated Rate |
$544.68 |
| Max. Negotiated Rate |
$3,776.50 |
| Rate for Payer: Aetna Commercial |
$2,067.65
|
| Rate for Payer: Aetna Medicare |
$1,543.02
|
| Rate for Payer: BCBS Complete |
$1,037.74
|
| Rate for Payer: BCBS MAPPO |
$1,543.02
|
| Rate for Payer: BCBS Trust/PPO |
$544.68
|
| Rate for Payer: BCN Commercial |
$2,254.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,543.02
|
| Rate for Payer: Cash Price |
$4,316.00
|
| Rate for Payer: Cash Price |
$4,316.00
|
| Rate for Payer: Cofinity Commercial |
$2,221.95
|
| Rate for Payer: Cofinity Commercial |
$2,067.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,543.02
|
| Rate for Payer: Healthscope Commercial |
$1,851.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,851.62
|
| Rate for Payer: Meridian Medicaid |
$1,037.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,620.17
|
| Rate for Payer: PACE SWMI |
$1,543.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,543.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$988.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,776.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.50
|
| Rate for Payer: Priority Health Medicare |
$1,543.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,136.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,589.31
|
|
|
PR REMOVAL OF SUTURES
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS S0630
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$66.04 |
| Rate for Payer: Aetna Commercial |
$27.32
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Trust/PPO |
$66.04
|
| Rate for Payer: BCN Commercial |
$37.93
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
|
|
PR REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 49402
|
| Min. Negotiated Rate |
$546.98 |
| Max. Negotiated Rate |
$2,108.97 |
| Rate for Payer: Aetna Commercial |
$1,137.59
|
| Rate for Payer: Aetna Medicare |
$848.95
|
| Rate for Payer: BCBS Complete |
$574.33
|
| Rate for Payer: BCBS MAPPO |
$848.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.97
|
| Rate for Payer: BCN Commercial |
$1,247.10
|
| Rate for Payer: BCN Medicare Advantage |
$848.95
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cofinity Commercial |
$1,222.49
|
| Rate for Payer: Cofinity Commercial |
$1,137.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.95
|
| Rate for Payer: Healthscope Commercial |
$1,018.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.74
|
| Rate for Payer: Meridian Medicaid |
$574.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$891.40
|
| Rate for Payer: PACE SWMI |
$848.95
|
| Rate for Payer: PHP Medicare Advantage |
$848.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,549.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,500.50
|
| Rate for Payer: Priority Health Medicare |
$848.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,500.50
|
| Rate for Payer: UHC Medicare Advantage |
$874.42
|
|
|
PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 33233
|
| Min. Negotiated Rate |
$147.40 |
| Max. Negotiated Rate |
$702.64 |
| Rate for Payer: Aetna Commercial |
$305.10
|
| Rate for Payer: Aetna Medicare |
$227.69
|
| Rate for Payer: BCBS Complete |
$154.77
|
| Rate for Payer: BCBS MAPPO |
$227.69
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: BCN Medicare Advantage |
$227.69
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cofinity Commercial |
$327.87
|
| Rate for Payer: Cofinity Commercial |
$305.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.69
|
| Rate for Payer: Healthscope Commercial |
$273.23
|
| Rate for Payer: Healthscope Whirlpool |
$273.23
|
| Rate for Payer: Meridian Medicaid |
$154.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$239.07
|
| Rate for Payer: PACE SWMI |
$227.69
|
| Rate for Payer: PHP Medicare Advantage |
$227.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.18
|
| Rate for Payer: Priority Health Medicare |
$227.69
|
| Rate for Payer: Priority Health Narrow Network |
$369.18
|
| Rate for Payer: UHC Medicare Advantage |
$234.52
|
|
|
PR REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ
|
Professional
|
Both
|
$552.00
|
|
|
Service Code
|
HCPCS 33992
|
| Min. Negotiated Rate |
$117.15 |
| Max. Negotiated Rate |
$1,321.81 |
| Rate for Payer: Aetna Commercial |
$246.55
|
| Rate for Payer: Aetna Medicare |
$183.99
|
| Rate for Payer: BCBS Complete |
$123.01
|
| Rate for Payer: BCBS MAPPO |
$183.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.81
|
| Rate for Payer: BCN Commercial |
$267.31
|
| Rate for Payer: BCN Medicare Advantage |
$183.99
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Commercial |
$264.95
|
| Rate for Payer: Cofinity Commercial |
$246.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.99
|
| Rate for Payer: Healthscope Commercial |
$220.79
|
| Rate for Payer: Healthscope Whirlpool |
$220.79
|
| Rate for Payer: Meridian Medicaid |
$123.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$193.19
|
| Rate for Payer: PACE SWMI |
$183.99
|
| Rate for Payer: PHP Medicare Advantage |
$183.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.98
|
| Rate for Payer: Priority Health Medicare |
$183.99
|
| Rate for Payer: Priority Health Narrow Network |
$290.98
|
| Rate for Payer: UHC Medicare Advantage |
$189.51
|
|
|
PR REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$2,061.00
|
|
|
Service Code
|
HCPCS 22850
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$1,442.70 |
| Rate for Payer: Aetna Commercial |
$978.04
|
| Rate for Payer: Aetna Medicare |
$729.88
|
| Rate for Payer: BCBS Complete |
$500.52
|
| Rate for Payer: BCBS MAPPO |
$729.88
|
| Rate for Payer: BCBS Trust/PPO |
$89.99
|
| Rate for Payer: BCN Commercial |
$1,082.91
|
| Rate for Payer: BCN Medicare Advantage |
$729.88
|
| Rate for Payer: Cash Price |
$1,648.80
|
| Rate for Payer: Cash Price |
$1,648.80
|
| Rate for Payer: Cofinity Commercial |
$1,051.03
|
| Rate for Payer: Cofinity Commercial |
$978.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$729.88
|
| Rate for Payer: Healthscope Commercial |
$875.86
|
| Rate for Payer: Healthscope Whirlpool |
$875.86
|
| Rate for Payer: Meridian Medicaid |
$500.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$766.37
|
| Rate for Payer: PACE SWMI |
$729.88
|
| Rate for Payer: PHP Medicare Advantage |
$729.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.60
|
| Rate for Payer: Priority Health Medicare |
$729.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,131.60
|
| Rate for Payer: UHC Medicare Advantage |
$751.78
|
|
|
PR REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$2,188.00
|
|
|
Service Code
|
HCPCS 22852
|
| Min. Negotiated Rate |
$459.65 |
| Max. Negotiated Rate |
$1,531.60 |
| Rate for Payer: Aetna Commercial |
$940.76
|
| Rate for Payer: Aetna Medicare |
$702.06
|
| Rate for Payer: BCBS Complete |
$482.63
|
| Rate for Payer: BCBS MAPPO |
$702.06
|
| Rate for Payer: BCBS Trust/PPO |
$648.97
|
| Rate for Payer: BCN Commercial |
$1,042.35
|
| Rate for Payer: BCN Medicare Advantage |
$702.06
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cofinity Commercial |
$940.76
|
| Rate for Payer: Cofinity Commercial |
$1,010.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.06
|
| Rate for Payer: Healthscope Commercial |
$842.47
|
| Rate for Payer: Healthscope Whirlpool |
$842.47
|
| Rate for Payer: Meridian Medicaid |
$482.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$737.16
|
| Rate for Payer: PACE SWMI |
$702.06
|
| Rate for Payer: PHP Medicare Advantage |
$702.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$459.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,531.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,089.21
|
| Rate for Payer: Priority Health Medicare |
$702.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,089.21
|
| Rate for Payer: UHC Medicare Advantage |
$723.12
|
|
|
PR REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 11008
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$566.30 |
| Rate for Payer: Aetna Commercial |
$363.45
|
| Rate for Payer: Aetna Medicare |
$271.23
|
| Rate for Payer: BCBS Complete |
$180.70
|
| Rate for Payer: BCBS MAPPO |
$271.23
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$394.85
|
| Rate for Payer: BCN Medicare Advantage |
$271.23
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$390.57
|
| Rate for Payer: Cofinity Commercial |
$363.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.23
|
| Rate for Payer: Healthscope Commercial |
$325.48
|
| Rate for Payer: Healthscope Whirlpool |
$325.48
|
| Rate for Payer: Meridian Medicaid |
$180.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$284.79
|
| Rate for Payer: PACE SWMI |
$271.23
|
| Rate for Payer: PHP Medicare Advantage |
$271.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.12
|
| Rate for Payer: Priority Health Medicare |
$271.23
|
| Rate for Payer: Priority Health Narrow Network |
$332.12
|
| Rate for Payer: UHC Medicare Advantage |
$279.37
|
|
|
PR REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM
|
Professional
|
Both
|
$929.00
|
|
|
Service Code
|
HCPCS 23333
|
| Min. Negotiated Rate |
$75.14 |
| Max. Negotiated Rate |
$730.75 |
| Rate for Payer: Aetna Commercial |
$625.20
|
| Rate for Payer: Aetna Medicare |
$466.57
|
| Rate for Payer: BCBS Complete |
$324.07
|
| Rate for Payer: BCBS MAPPO |
$466.57
|
| Rate for Payer: BCBS Trust/PPO |
$75.14
|
| Rate for Payer: BCN Commercial |
$699.30
|
| Rate for Payer: BCN Medicare Advantage |
$466.57
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cofinity Commercial |
$625.20
|
| Rate for Payer: Cofinity Commercial |
$671.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.57
|
| Rate for Payer: Healthscope Commercial |
$559.88
|
| Rate for Payer: Healthscope Whirlpool |
$559.88
|
| Rate for Payer: Meridian Medicaid |
$324.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$489.90
|
| Rate for Payer: PACE SWMI |
$466.57
|
| Rate for Payer: PHP Medicare Advantage |
$466.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$730.75
|
| Rate for Payer: Priority Health Medicare |
$466.57
|
| Rate for Payer: Priority Health Narrow Network |
$730.75
|
| Rate for Payer: UHC Medicare Advantage |
$480.57
|
|
|
PR REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 11200
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$1,422.75 |
| Rate for Payer: Aetna Commercial |
$98.38
|
| Rate for Payer: Aetna Medicare |
$73.42
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS MAPPO |
$73.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.75
|
| Rate for Payer: BCN Commercial |
$107.59
|
| Rate for Payer: BCN Medicare Advantage |
$73.42
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$105.72
|
| Rate for Payer: Cofinity Commercial |
$98.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.42
|
| Rate for Payer: Healthscope Commercial |
$88.10
|
| Rate for Payer: Healthscope Whirlpool |
$88.10
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.09
|
| Rate for Payer: PACE SWMI |
$73.42
|
| Rate for Payer: PHP Medicare Advantage |
$73.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.71
|
| Rate for Payer: Priority Health Medicare |
$73.42
|
| Rate for Payer: Priority Health Narrow Network |
$93.71
|
| Rate for Payer: UHC Medicare Advantage |
$75.62
|
|
|
PR REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 11201
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$106.97 |
| Rate for Payer: Aetna Commercial |
$21.75
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: BCBS MAPPO |
$16.23
|
| Rate for Payer: BCBS Trust/PPO |
$106.97
|
| Rate for Payer: BCN Commercial |
$21.60
|
| Rate for Payer: BCN Medicare Advantage |
$16.23
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$21.75
|
| Rate for Payer: Cofinity Commercial |
$23.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.23
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Healthscope Whirlpool |
$19.48
|
| Rate for Payer: Meridian Medicaid |
$10.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.04
|
| Rate for Payer: PACE SWMI |
$16.23
|
| Rate for Payer: PHP Medicare Advantage |
$16.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.14
|
| Rate for Payer: Priority Health Medicare |
$16.23
|
| Rate for Payer: Priority Health Narrow Network |
$20.14
|
| Rate for Payer: UHC Medicare Advantage |
$16.72
|
|
|
PR REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 33286
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$2,454.48 |
| Rate for Payer: Aetna Commercial |
$114.10
|
| Rate for Payer: Aetna Medicare |
$85.15
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$85.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,454.48
|
| Rate for Payer: BCN Commercial |
$192.54
|
| Rate for Payer: BCN Medicare Advantage |
$85.15
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$122.62
|
| Rate for Payer: Cofinity Commercial |
$114.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.15
|
| Rate for Payer: Healthscope Commercial |
$102.18
|
| Rate for Payer: Healthscope Whirlpool |
$102.18
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.41
|
| Rate for Payer: PACE SWMI |
$85.15
|
| Rate for Payer: PHP Medicare Advantage |
$85.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.65
|
| Rate for Payer: Priority Health Medicare |
$85.15
|
| Rate for Payer: Priority Health Narrow Network |
$135.65
|
| Rate for Payer: UHC Medicare Advantage |
$87.70
|
|
|
PR REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 15854
|
| Min. Negotiated Rate |
$14.93 |
| Max. Negotiated Rate |
$452.03 |
| Rate for Payer: Aetna Commercial |
$20.01
|
| Rate for Payer: Aetna Medicare |
$14.93
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$14.93
|
| Rate for Payer: BCBS Trust/PPO |
$452.03
|
| Rate for Payer: BCN Commercial |
$23.46
|
| Rate for Payer: BCN Medicare Advantage |
$14.93
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$20.01
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.93
|
| Rate for Payer: Healthscope Commercial |
$17.92
|
| Rate for Payer: Healthscope Whirlpool |
$17.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.68
|
| Rate for Payer: PACE SWMI |
$14.93
|
| Rate for Payer: PHP Medicare Advantage |
$14.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.73
|
| Rate for Payer: Priority Health Medicare |
$14.93
|
| Rate for Payer: Priority Health Narrow Network |
$19.73
|
| Rate for Payer: UHC Medicare Advantage |
$15.38
|
|
|
PR REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 15853
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$10,615.31 |
| Rate for Payer: Aetna Commercial |
$14.14
|
| Rate for Payer: Aetna Medicare |
$10.55
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$10.55
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.31
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: BCN Medicare Advantage |
$10.55
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$14.14
|
| Rate for Payer: Cofinity Commercial |
$15.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.55
|
| Rate for Payer: Healthscope Commercial |
$12.66
|
| Rate for Payer: Healthscope Whirlpool |
$12.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.08
|
| Rate for Payer: PACE SWMI |
$10.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.97
|
| Rate for Payer: Priority Health Medicare |
$10.55
|
| Rate for Payer: Priority Health Narrow Network |
$13.97
|
| Rate for Payer: UHC Medicare Advantage |
$10.87
|
|
