|
PR REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA
|
Professional
|
Both
|
$157.00
|
|
|
Service Code
|
HCPCS 15851
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$272.27 |
| Rate for Payer: Aetna Commercial |
$85.18
|
| Rate for Payer: Aetna Medicare |
$63.57
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$63.57
|
| Rate for Payer: BCBS Trust/PPO |
$272.27
|
| Rate for Payer: BCN Commercial |
$82.58
|
| Rate for Payer: BCN Medicare Advantage |
$63.57
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cofinity Commercial |
$85.18
|
| Rate for Payer: Cofinity Commercial |
$91.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.57
|
| Rate for Payer: Healthscope Commercial |
$76.28
|
| Rate for Payer: Healthscope Whirlpool |
$76.28
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.75
|
| Rate for Payer: PACE SWMI |
$63.57
|
| Rate for Payer: PHP Medicare Advantage |
$63.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.33
|
| Rate for Payer: Priority Health Medicare |
$63.57
|
| Rate for Payer: Priority Health Narrow Network |
$79.33
|
| Rate for Payer: UHC Medicare Advantage |
$65.48
|
|
|
PR REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 15850
|
| Min. Negotiated Rate |
$88.80 |
| Max. Negotiated Rate |
$155.40 |
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.40
|
|
|
PR REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 11971
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$807.78 |
| Rate for Payer: Aetna Commercial |
$721.62
|
| Rate for Payer: Aetna Medicare |
$538.52
|
| Rate for Payer: BCBS Complete |
$373.28
|
| Rate for Payer: BCBS MAPPO |
$538.52
|
| Rate for Payer: BCBS Trust/PPO |
$394.67
|
| Rate for Payer: BCN Commercial |
$807.78
|
| Rate for Payer: BCN Medicare Advantage |
$538.52
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$721.62
|
| Rate for Payer: Cofinity Commercial |
$775.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.52
|
| Rate for Payer: Healthscope Commercial |
$646.22
|
| Rate for Payer: Healthscope Whirlpool |
$646.22
|
| Rate for Payer: Meridian Medicaid |
$373.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$565.45
|
| Rate for Payer: PACE SWMI |
$538.52
|
| Rate for Payer: PHP Medicare Advantage |
$538.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.45
|
| Rate for Payer: Priority Health Medicare |
$538.52
|
| Rate for Payer: Priority Health Narrow Network |
$679.45
|
| Rate for Payer: UHC Medicare Advantage |
$554.68
|
|
|
PR REMOVAL TUNNELED INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 49422
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$906.56 |
| Rate for Payer: Aetna Commercial |
$293.94
|
| Rate for Payer: Aetna Medicare |
$219.36
|
| Rate for Payer: BCBS Complete |
$147.16
|
| Rate for Payer: BCBS MAPPO |
$219.36
|
| Rate for Payer: BCBS Trust/PPO |
$906.56
|
| Rate for Payer: BCN Commercial |
$320.09
|
| Rate for Payer: BCN Medicare Advantage |
$219.36
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$315.88
|
| Rate for Payer: Cofinity Commercial |
$293.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.36
|
| Rate for Payer: Healthscope Commercial |
$263.23
|
| Rate for Payer: Healthscope Whirlpool |
$263.23
|
| Rate for Payer: Meridian Medicaid |
$147.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.33
|
| Rate for Payer: PACE SWMI |
$219.36
|
| Rate for Payer: PHP Medicare Advantage |
$219.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.12
|
| Rate for Payer: Priority Health Medicare |
$219.36
|
| Rate for Payer: Priority Health Narrow Network |
$385.12
|
| Rate for Payer: UHC Medicare Advantage |
$225.94
|
|
|
PR REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE
|
Professional
|
Both
|
$3,314.00
|
|
|
Service Code
|
HCPCS 33977
|
| Min. Negotiated Rate |
$107.24 |
| Max. Negotiated Rate |
$2,319.80 |
| Rate for Payer: Aetna Commercial |
$1,476.67
|
| Rate for Payer: Aetna Medicare |
$1,101.99
|
| Rate for Payer: BCBS Complete |
$736.26
|
| Rate for Payer: BCBS MAPPO |
$1,101.99
|
| Rate for Payer: BCBS Trust/PPO |
$107.24
|
| Rate for Payer: BCN Commercial |
$1,602.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.99
|
| Rate for Payer: Cash Price |
$2,651.20
|
| Rate for Payer: Cash Price |
$2,651.20
|
| Rate for Payer: Cofinity Commercial |
$1,586.87
|
| Rate for Payer: Cofinity Commercial |
$1,476.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.99
|
| Rate for Payer: Healthscope Commercial |
$1,322.39
|
| Rate for Payer: Healthscope Whirlpool |
$1,322.39
|
| Rate for Payer: Meridian Medicaid |
$736.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,157.09
|
| Rate for Payer: PACE SWMI |
$1,101.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,319.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,744.82
|
| Rate for Payer: Priority Health Medicare |
$1,101.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,744.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,135.05
|
|
|
PR REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST
|
Professional
|
Both
|
$1,325.00
|
|
|
Service Code
|
HCPCS 25251
|
| Min. Negotiated Rate |
$466.90 |
| Max. Negotiated Rate |
$2,000.67 |
| Rate for Payer: Aetna Commercial |
$952.95
|
| Rate for Payer: Aetna Medicare |
$711.16
|
| Rate for Payer: BCBS Complete |
$490.24
|
| Rate for Payer: BCBS MAPPO |
$711.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,000.67
|
| Rate for Payer: BCN Commercial |
$1,061.41
|
| Rate for Payer: BCN Medicare Advantage |
$711.16
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cofinity Commercial |
$1,024.07
|
| Rate for Payer: Cofinity Commercial |
$952.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.16
|
| Rate for Payer: Healthscope Commercial |
$853.39
|
| Rate for Payer: Healthscope Whirlpool |
$853.39
|
| Rate for Payer: Meridian Medicaid |
$490.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$746.72
|
| Rate for Payer: PACE SWMI |
$711.16
|
| Rate for Payer: PHP Medicare Advantage |
$711.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$927.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.13
|
| Rate for Payer: Priority Health Medicare |
$711.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.13
|
| Rate for Payer: UHC Medicare Advantage |
$732.49
|
|
|
PR REMOVE BILE DUCT STONE, PERCUT
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 47630
|
| Min. Negotiated Rate |
$354.40 |
| Max. Negotiated Rate |
$620.20 |
| Rate for Payer: BCBS Complete |
$354.40
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.20
|
|
|
PR REMOVE DEEP SHOULDER FOREIGN BODY
|
Professional
|
Both
|
$1,019.00
|
|
|
Service Code
|
HCPCS 23331
|
| Min. Negotiated Rate |
$407.60 |
| Max. Negotiated Rate |
$713.30 |
| Rate for Payer: BCBS Complete |
$407.60
|
| Rate for Payer: Cash Price |
$815.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.30
|
|
|
PR REMOVE NAIL BED/FINGER TIP
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 11752
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$364.00 |
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.00
|
|
|
PR REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL
|
Professional
|
Both
|
$2,052.00
|
|
|
Service Code
|
HCPCS 50385
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,060.90 |
| Rate for Payer: Aetna Commercial |
$282.31
|
| Rate for Payer: Aetna Medicare |
$210.68
|
| Rate for Payer: BCBS Complete |
$141.12
|
| Rate for Payer: BCBS MAPPO |
$210.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,060.90
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: BCN Medicare Advantage |
$210.68
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cofinity Commercial |
$303.38
|
| Rate for Payer: Cofinity Commercial |
$282.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.68
|
| Rate for Payer: Healthscope Commercial |
$252.82
|
| Rate for Payer: Healthscope Whirlpool |
$252.82
|
| Rate for Payer: Meridian Medicaid |
$141.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$221.21
|
| Rate for Payer: PACE SWMI |
$210.68
|
| Rate for Payer: PHP Medicare Advantage |
$210.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,436.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$342.05
|
| Rate for Payer: Priority Health Medicare |
$210.68
|
| Rate for Payer: Priority Health Narrow Network |
$342.05
|
| Rate for Payer: UHC Medicare Advantage |
$217.00
|
|
|
PR REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,886.00
|
|
|
Service Code
|
HCPCS 53446
|
| Min. Negotiated Rate |
$410.24 |
| Max. Negotiated Rate |
$1,320.20 |
| Rate for Payer: Aetna Commercial |
$839.93
|
| Rate for Payer: Aetna Medicare |
$626.81
|
| Rate for Payer: BCBS Complete |
$430.75
|
| Rate for Payer: BCBS MAPPO |
$626.81
|
| Rate for Payer: BCBS Trust/PPO |
$437.96
|
| Rate for Payer: BCN Commercial |
$928.00
|
| Rate for Payer: BCN Medicare Advantage |
$626.81
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$902.61
|
| Rate for Payer: Cofinity Commercial |
$839.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.81
|
| Rate for Payer: Healthscope Commercial |
$752.17
|
| Rate for Payer: Healthscope Whirlpool |
$752.17
|
| Rate for Payer: Meridian Medicaid |
$430.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$658.15
|
| Rate for Payer: PACE SWMI |
$626.81
|
| Rate for Payer: PHP Medicare Advantage |
$626.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,026.14
|
| Rate for Payer: Priority Health Medicare |
$626.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,026.14
|
| Rate for Payer: UHC Medicare Advantage |
$645.61
|
|
|
PR REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD
|
Professional
|
Both
|
$688.00
|
|
|
Service Code
|
HCPCS 33227
|
| Min. Negotiated Rate |
$213.64 |
| Max. Negotiated Rate |
$1,104.68 |
| Rate for Payer: Aetna Commercial |
$445.31
|
| Rate for Payer: Aetna Medicare |
$332.32
|
| Rate for Payer: BCBS Complete |
$224.32
|
| Rate for Payer: BCBS MAPPO |
$332.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.68
|
| Rate for Payer: BCN Commercial |
$490.63
|
| Rate for Payer: BCN Medicare Advantage |
$332.32
|
| Rate for Payer: Cash Price |
$550.40
|
| Rate for Payer: Cash Price |
$550.40
|
| Rate for Payer: Cofinity Commercial |
$478.54
|
| Rate for Payer: Cofinity Commercial |
$445.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.32
|
| Rate for Payer: Healthscope Commercial |
$398.78
|
| Rate for Payer: Healthscope Whirlpool |
$398.78
|
| Rate for Payer: Meridian Medicaid |
$224.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$348.94
|
| Rate for Payer: PACE SWMI |
$332.32
|
| Rate for Payer: PHP Medicare Advantage |
$332.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$481.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.09
|
| Rate for Payer: Priority Health Medicare |
$332.32
|
| Rate for Payer: Priority Health Narrow Network |
$534.09
|
| Rate for Payer: UHC Medicare Advantage |
$342.29
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS
|
Professional
|
Both
|
$713.00
|
|
|
Service Code
|
HCPCS 33228
|
| Min. Negotiated Rate |
$223.01 |
| Max. Negotiated Rate |
$864.30 |
| Rate for Payer: Aetna Commercial |
$464.90
|
| Rate for Payer: Aetna Medicare |
$346.94
|
| Rate for Payer: BCBS Complete |
$234.16
|
| Rate for Payer: BCBS MAPPO |
$346.94
|
| Rate for Payer: BCBS Trust/PPO |
$864.30
|
| Rate for Payer: BCN Commercial |
$512.14
|
| Rate for Payer: BCN Medicare Advantage |
$346.94
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Cofinity Commercial |
$499.59
|
| Rate for Payer: Cofinity Commercial |
$464.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.94
|
| Rate for Payer: Healthscope Commercial |
$416.33
|
| Rate for Payer: Healthscope Whirlpool |
$416.33
|
| Rate for Payer: Meridian Medicaid |
$234.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$364.29
|
| Rate for Payer: PACE SWMI |
$346.94
|
| Rate for Payer: PHP Medicare Advantage |
$346.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.49
|
| Rate for Payer: Priority Health Medicare |
$346.94
|
| Rate for Payer: Priority Health Narrow Network |
$557.49
|
| Rate for Payer: UHC Medicare Advantage |
$357.35
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS 33229
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$1,010.11 |
| Rate for Payer: Aetna Commercial |
$491.34
|
| Rate for Payer: Aetna Medicare |
$366.67
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$366.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.11
|
| Rate for Payer: BCN Commercial |
$541.46
|
| Rate for Payer: BCN Medicare Advantage |
$366.67
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$491.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.67
|
| Rate for Payer: Healthscope Commercial |
$440.00
|
| Rate for Payer: Healthscope Whirlpool |
$440.00
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.00
|
| Rate for Payer: PACE SWMI |
$366.67
|
| Rate for Payer: PHP Medicare Advantage |
$366.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$396.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.41
|
| Rate for Payer: Priority Health Medicare |
$366.67
|
| Rate for Payer: Priority Health Narrow Network |
$589.41
|
| Rate for Payer: UHC Medicare Advantage |
$377.67
|
|
|
PR REMV TISSUE FOR GRAFT OTHR
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 20926
|
| Min. Negotiated Rate |
$321.20 |
| Max. Negotiated Rate |
$562.10 |
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.10
|
|
|
PR RENAL ANGIO, CARDIAC CATH
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS G0275
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
|
|
PR RENAL BIOPSY SURG EXPOSURE KIDNEY
|
Professional
|
Both
|
$1,666.00
|
|
|
Service Code
|
HCPCS 50205
|
| Min. Negotiated Rate |
$483.72 |
| Max. Negotiated Rate |
$2,575.99 |
| Rate for Payer: Aetna Commercial |
$1,003.53
|
| Rate for Payer: Aetna Medicare |
$748.90
|
| Rate for Payer: BCBS Complete |
$507.91
|
| Rate for Payer: BCBS MAPPO |
$748.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,575.99
|
| Rate for Payer: BCN Commercial |
$1,101.48
|
| Rate for Payer: BCN Medicare Advantage |
$748.90
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cofinity Commercial |
$1,003.53
|
| Rate for Payer: Cofinity Commercial |
$1,078.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.90
|
| Rate for Payer: Healthscope Commercial |
$898.68
|
| Rate for Payer: Healthscope Whirlpool |
$898.68
|
| Rate for Payer: Meridian Medicaid |
$507.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$786.34
|
| Rate for Payer: PACE SWMI |
$748.90
|
| Rate for Payer: PHP Medicare Advantage |
$748.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$483.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,166.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,217.97
|
| Rate for Payer: Priority Health Medicare |
$748.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,217.97
|
| Rate for Payer: UHC Medicare Advantage |
$771.37
|
|
|
PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$712.00
|
|
|
Service Code
|
HCPCS 50551
|
| Min. Negotiated Rate |
$184.46 |
| Max. Negotiated Rate |
$3,748.82 |
| Rate for Payer: Aetna Commercial |
$383.37
|
| Rate for Payer: Aetna Medicare |
$286.10
|
| Rate for Payer: BCBS Complete |
$193.68
|
| Rate for Payer: BCBS MAPPO |
$286.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,748.82
|
| Rate for Payer: BCN Commercial |
$522.88
|
| Rate for Payer: BCN Medicare Advantage |
$286.10
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cofinity Commercial |
$411.98
|
| Rate for Payer: Cofinity Commercial |
$383.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.10
|
| Rate for Payer: Healthscope Commercial |
$343.32
|
| Rate for Payer: Healthscope Whirlpool |
$343.32
|
| Rate for Payer: Meridian Medicaid |
$193.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$300.40
|
| Rate for Payer: PACE SWMI |
$286.10
|
| Rate for Payer: PHP Medicare Advantage |
$286.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.71
|
| Rate for Payer: Priority Health Medicare |
$286.10
|
| Rate for Payer: Priority Health Narrow Network |
$464.71
|
| Rate for Payer: UHC Medicare Advantage |
$294.68
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY
|
Professional
|
Both
|
$769.00
|
|
|
Service Code
|
HCPCS 50555
|
| Min. Negotiated Rate |
$214.07 |
| Max. Negotiated Rate |
$4,030.40 |
| Rate for Payer: Aetna Commercial |
$444.21
|
| Rate for Payer: Aetna Medicare |
$331.50
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$331.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,030.40
|
| Rate for Payer: BCN Commercial |
$595.70
|
| Rate for Payer: BCN Medicare Advantage |
$331.50
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cofinity Commercial |
$444.21
|
| Rate for Payer: Cofinity Commercial |
$477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.50
|
| Rate for Payer: Healthscope Commercial |
$397.80
|
| Rate for Payer: Healthscope Whirlpool |
$397.80
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$348.08
|
| Rate for Payer: PACE SWMI |
$331.50
|
| Rate for Payer: PHP Medicare Advantage |
$331.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$538.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$538.20
|
| Rate for Payer: Priority Health Medicare |
$331.50
|
| Rate for Payer: Priority Health Narrow Network |
$538.20
|
| Rate for Payer: UHC Medicare Advantage |
$341.44
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI
|
Professional
|
Both
|
$815.00
|
|
|
Service Code
|
HCPCS 50557
|
| Min. Negotiated Rate |
$216.83 |
| Max. Negotiated Rate |
$4,171.46 |
| Rate for Payer: Aetna Commercial |
$450.03
|
| Rate for Payer: Aetna Medicare |
$335.84
|
| Rate for Payer: BCBS Complete |
$227.67
|
| Rate for Payer: BCBS MAPPO |
$335.84
|
| Rate for Payer: BCBS Trust/PPO |
$4,171.46
|
| Rate for Payer: BCN Commercial |
$606.45
|
| Rate for Payer: BCN Medicare Advantage |
$335.84
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cofinity Commercial |
$483.61
|
| Rate for Payer: Cofinity Commercial |
$450.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.84
|
| Rate for Payer: Healthscope Commercial |
$403.01
|
| Rate for Payer: Healthscope Whirlpool |
$403.01
|
| Rate for Payer: Meridian Medicaid |
$227.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$352.63
|
| Rate for Payer: PACE SWMI |
$335.84
|
| Rate for Payer: PHP Medicare Advantage |
$335.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$545.22
|
| Rate for Payer: Priority Health Medicare |
$335.84
|
| Rate for Payer: Priority Health Narrow Network |
$545.22
|
| Rate for Payer: UHC Medicare Advantage |
$345.92
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 50561
|
| Min. Negotiated Rate |
$247.72 |
| Max. Negotiated Rate |
$687.57 |
| Rate for Payer: Aetna Commercial |
$513.18
|
| Rate for Payer: Aetna Medicare |
$382.97
|
| Rate for Payer: BCBS Complete |
$260.11
|
| Rate for Payer: BCBS MAPPO |
$382.97
|
| Rate for Payer: BCBS Trust/PPO |
$287.92
|
| Rate for Payer: BCN Commercial |
$687.57
|
| Rate for Payer: BCN Medicare Advantage |
$382.97
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$551.48
|
| Rate for Payer: Cofinity Commercial |
$513.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.97
|
| Rate for Payer: Healthscope Commercial |
$459.56
|
| Rate for Payer: Healthscope Whirlpool |
$459.56
|
| Rate for Payer: Meridian Medicaid |
$260.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$402.12
|
| Rate for Payer: PACE SWMI |
$382.97
|
| Rate for Payer: PHP Medicare Advantage |
$382.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$621.41
|
| Rate for Payer: Priority Health Medicare |
$382.97
|
| Rate for Payer: Priority Health Narrow Network |
$621.41
|
| Rate for Payer: UHC Medicare Advantage |
$394.46
|
|
|
PR RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA
|
Professional
|
Both
|
$712.00
|
|
|
Service Code
|
HCPCS 50553
|
| Min. Negotiated Rate |
$197.24 |
| Max. Negotiated Rate |
$3,834.93 |
| Rate for Payer: Aetna Commercial |
$409.73
|
| Rate for Payer: Aetna Medicare |
$305.77
|
| Rate for Payer: BCBS Complete |
$207.10
|
| Rate for Payer: BCBS MAPPO |
$305.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,834.93
|
| Rate for Payer: BCN Commercial |
$560.51
|
| Rate for Payer: BCN Medicare Advantage |
$305.77
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cofinity Commercial |
$409.73
|
| Rate for Payer: Cofinity Commercial |
$440.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.77
|
| Rate for Payer: Healthscope Commercial |
$366.92
|
| Rate for Payer: Healthscope Whirlpool |
$366.92
|
| Rate for Payer: Meridian Medicaid |
$207.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$321.06
|
| Rate for Payer: PACE SWMI |
$305.77
|
| Rate for Payer: PHP Medicare Advantage |
$305.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.58
|
| Rate for Payer: Priority Health Medicare |
$305.77
|
| Rate for Payer: Priority Health Narrow Network |
$496.58
|
| Rate for Payer: UHC Medicare Advantage |
$314.94
|
|
|
PR RENAL NDSC NEPHROTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 50570
|
| Min. Negotiated Rate |
$308.21 |
| Max. Negotiated Rate |
$773.26 |
| Rate for Payer: Aetna Commercial |
$638.95
|
| Rate for Payer: Aetna Medicare |
$476.83
|
| Rate for Payer: BCBS Complete |
$323.62
|
| Rate for Payer: BCBS MAPPO |
$476.83
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCN Commercial |
$699.30
|
| Rate for Payer: BCN Medicare Advantage |
$476.83
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cofinity Commercial |
$686.64
|
| Rate for Payer: Cofinity Commercial |
$638.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.83
|
| Rate for Payer: Healthscope Commercial |
$572.20
|
| Rate for Payer: Healthscope Whirlpool |
$572.20
|
| Rate for Payer: Meridian Medicaid |
$323.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.67
|
| Rate for Payer: PACE SWMI |
$476.83
|
| Rate for Payer: PHP Medicare Advantage |
$476.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$654.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$773.26
|
| Rate for Payer: Priority Health Medicare |
$476.83
|
| Rate for Payer: Priority Health Narrow Network |
$773.26
|
| Rate for Payer: UHC Medicare Advantage |
$491.13
|
|
|
PR REOPENING RECENT LAPAROTOMY
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 49002
|
| Min. Negotiated Rate |
$611.24 |
| Max. Negotiated Rate |
$1,827.41 |
| Rate for Payer: Aetna Commercial |
$1,387.89
|
| Rate for Payer: Aetna Medicare |
$1,035.74
|
| Rate for Payer: BCBS Complete |
$698.68
|
| Rate for Payer: BCBS MAPPO |
$1,035.74
|
| Rate for Payer: BCBS Trust/PPO |
$611.24
|
| Rate for Payer: BCN Commercial |
$1,518.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.74
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cofinity Commercial |
$1,491.47
|
| Rate for Payer: Cofinity Commercial |
$1,387.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.74
|
| Rate for Payer: Healthscope Commercial |
$1,242.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,242.89
|
| Rate for Payer: Meridian Medicaid |
$698.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,087.53
|
| Rate for Payer: PACE SWMI |
$1,035.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$665.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,459.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,827.41
|
| Rate for Payer: Priority Health Medicare |
$1,035.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,827.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,066.81
|
|
|
PR REPAIR ANAL FISTULA W/FIBRIN GLUE
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 46706
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$316.32 |
| Rate for Payer: Aetna Commercial |
$236.91
|
| Rate for Payer: Aetna Medicare |
$176.80
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$176.80
|
| Rate for Payer: BCBS Trust/PPO |
$169.58
|
| Rate for Payer: BCN Commercial |
$262.91
|
| Rate for Payer: BCN Medicare Advantage |
$176.80
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$254.59
|
| Rate for Payer: Cofinity Commercial |
$236.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.80
|
| Rate for Payer: Healthscope Commercial |
$212.16
|
| Rate for Payer: Healthscope Whirlpool |
$212.16
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.64
|
| Rate for Payer: PACE SWMI |
$176.80
|
| Rate for Payer: PHP Medicare Advantage |
$176.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.32
|
| Rate for Payer: Priority Health Medicare |
$176.80
|
| Rate for Payer: Priority Health Narrow Network |
$316.32
|
| Rate for Payer: UHC Medicare Advantage |
$182.10
|
|
