|
PR REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 33273
|
| Min. Negotiated Rate |
$253.26 |
| Max. Negotiated Rate |
$1,148.52 |
| Rate for Payer: Aetna Commercial |
$525.08
|
| Rate for Payer: Aetna Medicare |
$391.85
|
| Rate for Payer: BCBS Complete |
$265.92
|
| Rate for Payer: BCBS MAPPO |
$391.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,148.52
|
| Rate for Payer: BCN Commercial |
$576.15
|
| Rate for Payer: BCN Medicare Advantage |
$391.85
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$525.08
|
| Rate for Payer: Cofinity Commercial |
$564.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.85
|
| Rate for Payer: Healthscope Commercial |
$470.22
|
| Rate for Payer: Healthscope Whirlpool |
$470.22
|
| Rate for Payer: Meridian Medicaid |
$265.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$411.44
|
| Rate for Payer: PACE SWMI |
$391.85
|
| Rate for Payer: PHP Medicare Advantage |
$391.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.18
|
| Rate for Payer: Priority Health Medicare |
$391.85
|
| Rate for Payer: Priority Health Narrow Network |
$627.18
|
| Rate for Payer: UHC Medicare Advantage |
$403.61
|
|
|
PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 62252
|
| Min. Negotiated Rate |
$81.59 |
| Max. Negotiated Rate |
$1,964.75 |
| Rate for Payer: Aetna Commercial |
$109.33
|
| Rate for Payer: Aetna Medicare |
$81.59
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS MAPPO |
$81.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,964.75
|
| Rate for Payer: BCN Commercial |
$170.84
|
| Rate for Payer: BCN Medicare Advantage |
$81.59
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$117.49
|
| Rate for Payer: Cofinity Commercial |
$109.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.59
|
| Rate for Payer: Healthscope Commercial |
$97.91
|
| Rate for Payer: Healthscope Whirlpool |
$97.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.67
|
| Rate for Payer: PACE SWMI |
$81.59
|
| Rate for Payer: PHP Medicare Advantage |
$81.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.70
|
| Rate for Payer: Priority Health Medicare |
$81.59
|
| Rate for Payer: Priority Health Narrow Network |
$142.70
|
| Rate for Payer: UHC Medicare Advantage |
$84.04
|
|
|
PR RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ
|
Professional
|
Both
|
$4,834.00
|
|
|
Service Code
|
HCPCS 32504
|
| Min. Negotiated Rate |
$839.47 |
| Max. Negotiated Rate |
$3,383.80 |
| Rate for Payer: Aetna Commercial |
$2,698.06
|
| Rate for Payer: Aetna Medicare |
$2,013.48
|
| Rate for Payer: BCBS Complete |
$1,349.73
|
| Rate for Payer: BCBS MAPPO |
$2,013.48
|
| Rate for Payer: BCBS Trust/PPO |
$839.47
|
| Rate for Payer: BCN Commercial |
$2,935.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,013.48
|
| Rate for Payer: Cash Price |
$3,867.20
|
| Rate for Payer: Cash Price |
$3,867.20
|
| Rate for Payer: Cofinity Commercial |
$2,899.41
|
| Rate for Payer: Cofinity Commercial |
$2,698.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,013.48
|
| Rate for Payer: Healthscope Commercial |
$2,416.18
|
| Rate for Payer: Healthscope Whirlpool |
$2,416.18
|
| Rate for Payer: Meridian Medicaid |
$1,349.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,114.15
|
| Rate for Payer: PACE SWMI |
$2,013.48
|
| Rate for Payer: PHP Medicare Advantage |
$2,013.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,285.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,383.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,781.05
|
| Rate for Payer: Priority Health Medicare |
$2,013.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,781.05
|
| Rate for Payer: UHC Medicare Advantage |
$2,073.88
|
|
|
PR RESCJ DIAPHRAGM W/COMPLEX REPAIR
|
Professional
|
Both
|
$2,217.00
|
|
|
Service Code
|
HCPCS 39561
|
| Min. Negotiated Rate |
$573.73 |
| Max. Negotiated Rate |
$1,978.34 |
| Rate for Payer: Aetna Commercial |
$1,654.91
|
| Rate for Payer: Aetna Medicare |
$1,235.01
|
| Rate for Payer: BCBS Complete |
$839.36
|
| Rate for Payer: BCBS MAPPO |
$1,235.01
|
| Rate for Payer: BCBS Trust/PPO |
$573.73
|
| Rate for Payer: BCN Commercial |
$1,817.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,235.01
|
| Rate for Payer: Cash Price |
$1,773.60
|
| Rate for Payer: Cash Price |
$1,773.60
|
| Rate for Payer: Cofinity Commercial |
$1,778.41
|
| Rate for Payer: Cofinity Commercial |
$1,654.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,235.01
|
| Rate for Payer: Healthscope Commercial |
$1,482.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,482.01
|
| Rate for Payer: Meridian Medicaid |
$839.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,296.76
|
| Rate for Payer: PACE SWMI |
$1,235.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,235.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$799.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,551.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,978.34
|
| Rate for Payer: Priority Health Medicare |
$1,235.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,978.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,272.06
|
|
|
PR RESCJ DIAPHRAGM W/SIMPLE REPAIR
|
Professional
|
Both
|
$3,604.00
|
|
|
Service Code
|
HCPCS 39560
|
| Min. Negotiated Rate |
$479.70 |
| Max. Negotiated Rate |
$2,522.80 |
| Rate for Payer: Aetna Commercial |
$1,061.72
|
| Rate for Payer: Aetna Medicare |
$792.33
|
| Rate for Payer: BCBS Complete |
$537.88
|
| Rate for Payer: BCBS MAPPO |
$792.33
|
| Rate for Payer: BCBS Trust/PPO |
$479.70
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: BCN Medicare Advantage |
$792.33
|
| Rate for Payer: Cash Price |
$2,883.20
|
| Rate for Payer: Cash Price |
$2,883.20
|
| Rate for Payer: Cofinity Commercial |
$1,140.96
|
| Rate for Payer: Cofinity Commercial |
$1,061.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$792.33
|
| Rate for Payer: Healthscope Commercial |
$950.80
|
| Rate for Payer: Healthscope Whirlpool |
$950.80
|
| Rate for Payer: Meridian Medicaid |
$537.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$831.95
|
| Rate for Payer: PACE SWMI |
$792.33
|
| Rate for Payer: PHP Medicare Advantage |
$792.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,522.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,269.79
|
| Rate for Payer: Priority Health Medicare |
$792.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,269.79
|
| Rate for Payer: UHC Medicare Advantage |
$816.10
|
|
|
PR RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL
|
Professional
|
Both
|
$5,311.00
|
|
|
Service Code
|
HCPCS 61600
|
| Min. Negotiated Rate |
$410.49 |
| Max. Negotiated Rate |
$3,717.70 |
| Rate for Payer: Aetna Commercial |
$2,820.47
|
| Rate for Payer: Aetna Medicare |
$2,104.83
|
| Rate for Payer: BCBS Complete |
$1,429.34
|
| Rate for Payer: BCBS MAPPO |
$2,104.83
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$3,131.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,104.83
|
| Rate for Payer: Cash Price |
$4,248.80
|
| Rate for Payer: Cash Price |
$4,248.80
|
| Rate for Payer: Cofinity Commercial |
$3,030.96
|
| Rate for Payer: Cofinity Commercial |
$2,820.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,104.83
|
| Rate for Payer: Healthscope Commercial |
$2,525.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,525.80
|
| Rate for Payer: Meridian Medicaid |
$1,429.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,210.07
|
| Rate for Payer: PACE SWMI |
$2,104.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,104.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,361.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,717.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,628.93
|
| Rate for Payer: Priority Health Medicare |
$2,104.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,628.93
|
| Rate for Payer: UHC Medicare Advantage |
$2,167.97
|
|
|
PR RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF
|
Professional
|
Both
|
$7,318.00
|
|
|
Service Code
|
HCPCS 61601
|
| Min. Negotiated Rate |
$1,571.73 |
| Max. Negotiated Rate |
$5,122.60 |
| Rate for Payer: Aetna Commercial |
$3,254.28
|
| Rate for Payer: Aetna Medicare |
$2,428.57
|
| Rate for Payer: BCBS Complete |
$1,650.32
|
| Rate for Payer: BCBS MAPPO |
$2,428.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,035.01
|
| Rate for Payer: BCN Commercial |
$4,982.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,428.57
|
| Rate for Payer: Cash Price |
$5,854.40
|
| Rate for Payer: Cash Price |
$5,854.40
|
| Rate for Payer: Cofinity Commercial |
$3,497.14
|
| Rate for Payer: Cofinity Commercial |
$3,254.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,428.57
|
| Rate for Payer: Healthscope Commercial |
$2,914.28
|
| Rate for Payer: Healthscope Whirlpool |
$2,914.28
|
| Rate for Payer: Meridian Medicaid |
$1,650.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,550.00
|
| Rate for Payer: PACE SWMI |
$2,428.57
|
| Rate for Payer: PHP Medicare Advantage |
$2,428.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,571.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,122.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,161.18
|
| Rate for Payer: Priority Health Medicare |
$2,428.57
|
| Rate for Payer: Priority Health Narrow Network |
$4,161.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,501.43
|
|
|
PR RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL
|
Professional
|
Both
|
$6,837.40
|
|
|
Service Code
|
HCPCS 61616
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$6,824.07 |
| Rate for Payer: Aetna Commercial |
$4,477.25
|
| Rate for Payer: Aetna Medicare |
$3,341.23
|
| Rate for Payer: BCBS Complete |
$2,262.22
|
| Rate for Payer: BCBS MAPPO |
$3,341.23
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$6,824.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,341.23
|
| Rate for Payer: Cash Price |
$5,469.92
|
| Rate for Payer: Cash Price |
$5,469.92
|
| Rate for Payer: Cofinity Commercial |
$4,811.37
|
| Rate for Payer: Cofinity Commercial |
$4,477.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,341.23
|
| Rate for Payer: Healthscope Commercial |
$4,009.48
|
| Rate for Payer: Healthscope Whirlpool |
$4,009.48
|
| Rate for Payer: Meridian Medicaid |
$2,262.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,508.29
|
| Rate for Payer: PACE SWMI |
$3,341.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,341.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,154.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,786.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.61
|
| Rate for Payer: Priority Health Medicare |
$3,341.23
|
| Rate for Payer: Priority Health Narrow Network |
$5,699.61
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.47
|
|
|
PR RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL
|
Professional
|
Both
|
$7,083.00
|
|
|
Service Code
|
HCPCS 61615
|
| Min. Negotiated Rate |
$129.96 |
| Max. Negotiated Rate |
$4,958.10 |
| Rate for Payer: Aetna Commercial |
$3,775.97
|
| Rate for Payer: Aetna Medicare |
$2,817.89
|
| Rate for Payer: BCBS Complete |
$1,910.19
|
| Rate for Payer: BCBS MAPPO |
$2,817.89
|
| Rate for Payer: BCBS Trust/PPO |
$129.96
|
| Rate for Payer: BCN Commercial |
$4,161.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,817.89
|
| Rate for Payer: Cash Price |
$5,666.40
|
| Rate for Payer: Cash Price |
$5,666.40
|
| Rate for Payer: Cofinity Commercial |
$3,775.97
|
| Rate for Payer: Cofinity Commercial |
$4,057.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,817.89
|
| Rate for Payer: Healthscope Commercial |
$3,381.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,381.47
|
| Rate for Payer: Meridian Medicaid |
$1,910.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,958.78
|
| Rate for Payer: PACE SWMI |
$2,817.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,817.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,819.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,958.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,821.95
|
| Rate for Payer: Priority Health Medicare |
$2,817.89
|
| Rate for Payer: Priority Health Narrow Network |
$4,821.95
|
| Rate for Payer: UHC Medicare Advantage |
$2,902.43
|
|
|
PR RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL
|
Professional
|
Both
|
$4,631.00
|
|
|
Service Code
|
HCPCS 61605
|
| Min. Negotiated Rate |
$1,385.78 |
| Max. Negotiated Rate |
$3,694.04 |
| Rate for Payer: Aetna Commercial |
$2,870.23
|
| Rate for Payer: Aetna Medicare |
$2,141.96
|
| Rate for Payer: BCBS Complete |
$1,455.07
|
| Rate for Payer: BCBS MAPPO |
$2,141.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.48
|
| Rate for Payer: BCN Commercial |
$3,188.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,141.96
|
| Rate for Payer: Cash Price |
$3,704.80
|
| Rate for Payer: Cash Price |
$3,704.80
|
| Rate for Payer: Cofinity Commercial |
$3,084.42
|
| Rate for Payer: Cofinity Commercial |
$2,870.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,141.96
|
| Rate for Payer: Healthscope Commercial |
$2,570.35
|
| Rate for Payer: Healthscope Whirlpool |
$2,570.35
|
| Rate for Payer: Meridian Medicaid |
$1,455.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,249.06
|
| Rate for Payer: PACE SWMI |
$2,141.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,141.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,385.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,241.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,694.04
|
| Rate for Payer: Priority Health Medicare |
$2,141.96
|
| Rate for Payer: Priority Health Narrow Network |
$3,694.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,206.22
|
|
|
PR RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR
|
Professional
|
Both
|
$10,019.00
|
|
|
Service Code
|
HCPCS 61606
|
| Min. Negotiated Rate |
$202.34 |
| Max. Negotiated Rate |
$7,013.30 |
| Rate for Payer: Aetna Commercial |
$3,915.59
|
| Rate for Payer: Aetna Medicare |
$2,922.08
|
| Rate for Payer: BCBS Complete |
$1,964.32
|
| Rate for Payer: BCBS MAPPO |
$2,922.08
|
| Rate for Payer: BCBS Trust/PPO |
$202.34
|
| Rate for Payer: BCN Commercial |
$5,966.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,922.08
|
| Rate for Payer: Cash Price |
$8,015.20
|
| Rate for Payer: Cash Price |
$8,015.20
|
| Rate for Payer: Cofinity Commercial |
$3,915.59
|
| Rate for Payer: Cofinity Commercial |
$4,207.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,922.08
|
| Rate for Payer: Healthscope Commercial |
$3,506.50
|
| Rate for Payer: Healthscope Whirlpool |
$3,506.50
|
| Rate for Payer: Meridian Medicaid |
$1,964.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,068.18
|
| Rate for Payer: PACE SWMI |
$2,922.08
|
| Rate for Payer: PHP Medicare Advantage |
$2,922.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,870.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,013.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,983.33
|
| Rate for Payer: Priority Health Medicare |
$2,922.08
|
| Rate for Payer: Priority Health Narrow Network |
$4,983.33
|
| Rate for Payer: UHC Medicare Advantage |
$3,009.74
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL
|
Professional
|
Both
|
$10,444.00
|
|
|
Service Code
|
HCPCS 61608
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$7,310.80 |
| Rate for Payer: Aetna Commercial |
$4,413.42
|
| Rate for Payer: Aetna Medicare |
$3,293.60
|
| Rate for Payer: BCBS Complete |
$2,223.30
|
| Rate for Payer: BCBS MAPPO |
$3,293.60
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$6,712.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,293.60
|
| Rate for Payer: Cash Price |
$8,355.20
|
| Rate for Payer: Cash Price |
$8,355.20
|
| Rate for Payer: Cofinity Commercial |
$4,742.78
|
| Rate for Payer: Cofinity Commercial |
$4,413.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,293.60
|
| Rate for Payer: Healthscope Commercial |
$3,952.32
|
| Rate for Payer: Healthscope Whirlpool |
$3,952.32
|
| Rate for Payer: Meridian Medicaid |
$2,223.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,458.28
|
| Rate for Payer: PACE SWMI |
$3,293.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,293.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,117.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,310.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,606.18
|
| Rate for Payer: Priority Health Medicare |
$3,293.60
|
| Rate for Payer: Priority Health Narrow Network |
$5,606.18
|
| Rate for Payer: UHC Medicare Advantage |
$3,392.41
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL
|
Professional
|
Both
|
$5,903.00
|
|
|
Service Code
|
HCPCS 61607
|
| Min. Negotiated Rate |
$156.91 |
| Max. Negotiated Rate |
$4,524.70 |
| Rate for Payer: Aetna Commercial |
$3,545.12
|
| Rate for Payer: Aetna Medicare |
$2,645.61
|
| Rate for Payer: BCBS Complete |
$2,060.49
|
| Rate for Payer: BCBS MAPPO |
$2,645.61
|
| Rate for Payer: BCBS Trust/PPO |
$156.91
|
| Rate for Payer: BCN Commercial |
$3,905.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,645.61
|
| Rate for Payer: Cash Price |
$4,722.40
|
| Rate for Payer: Cash Price |
$4,722.40
|
| Rate for Payer: Cofinity Commercial |
$3,809.68
|
| Rate for Payer: Cofinity Commercial |
$3,545.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,645.61
|
| Rate for Payer: Healthscope Commercial |
$3,174.73
|
| Rate for Payer: Healthscope Whirlpool |
$3,174.73
|
| Rate for Payer: Meridian Medicaid |
$2,060.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,777.89
|
| Rate for Payer: PACE SWMI |
$2,645.61
|
| Rate for Payer: PHP Medicare Advantage |
$2,645.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,962.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,132.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,524.70
|
| Rate for Payer: Priority Health Medicare |
$2,645.61
|
| Rate for Payer: Priority Health Narrow Network |
$4,524.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,724.98
|
|
|
PR RESCJ PALATE/EXTENSIVE RESCJ LESION
|
Professional
|
Both
|
$2,012.00
|
|
|
Service Code
|
HCPCS 42120
|
| Min. Negotiated Rate |
$418.41 |
| Max. Negotiated Rate |
$1,773.92 |
| Rate for Payer: Aetna Commercial |
$1,308.50
|
| Rate for Payer: Aetna Medicare |
$976.49
|
| Rate for Payer: BCBS Complete |
$672.51
|
| Rate for Payer: BCBS MAPPO |
$976.49
|
| Rate for Payer: BCBS Trust/PPO |
$418.41
|
| Rate for Payer: BCN Commercial |
$1,474.34
|
| Rate for Payer: BCN Medicare Advantage |
$976.49
|
| Rate for Payer: Cash Price |
$1,609.60
|
| Rate for Payer: Cash Price |
$1,609.60
|
| Rate for Payer: Cofinity Commercial |
$1,406.15
|
| Rate for Payer: Cofinity Commercial |
$1,308.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$976.49
|
| Rate for Payer: Healthscope Commercial |
$1,171.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,171.79
|
| Rate for Payer: Meridian Medicaid |
$672.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,025.31
|
| Rate for Payer: PACE SWMI |
$976.49
|
| Rate for Payer: PHP Medicare Advantage |
$976.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$640.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,408.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,773.92
|
| Rate for Payer: Priority Health Medicare |
$976.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,773.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.78
|
|
|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD
|
Professional
|
Both
|
$4,839.00
|
|
|
Service Code
|
HCPCS 58951
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$3,387.30 |
| Rate for Payer: Aetna Commercial |
$1,912.01
|
| Rate for Payer: Aetna Medicare |
$1,426.87
|
| Rate for Payer: BCBS Complete |
$972.21
|
| Rate for Payer: BCBS MAPPO |
$1,426.87
|
| Rate for Payer: BCBS Trust/PPO |
$149.51
|
| Rate for Payer: BCN Commercial |
$2,107.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,426.87
|
| Rate for Payer: Cash Price |
$3,871.20
|
| Rate for Payer: Cash Price |
$3,871.20
|
| Rate for Payer: Cofinity Commercial |
$2,054.69
|
| Rate for Payer: Cofinity Commercial |
$1,912.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,426.87
|
| Rate for Payer: Healthscope Commercial |
$1,712.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,712.24
|
| Rate for Payer: Meridian Medicaid |
$972.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,498.21
|
| Rate for Payer: PACE SWMI |
$1,426.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,426.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,387.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,041.41
|
| Rate for Payer: Priority Health Medicare |
$1,426.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,041.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,469.68
|
|
|
PR RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS
|
Professional
|
Both
|
$6,506.00
|
|
|
Service Code
|
HCPCS 48105
|
| Min. Negotiated Rate |
$1,791.76 |
| Max. Negotiated Rate |
$4,941.91 |
| Rate for Payer: Aetna Commercial |
$3,756.56
|
| Rate for Payer: Aetna Medicare |
$2,803.40
|
| Rate for Payer: BCBS Complete |
$1,881.35
|
| Rate for Payer: BCBS MAPPO |
$2,803.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,408.52
|
| Rate for Payer: BCN Commercial |
$4,107.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,803.40
|
| Rate for Payer: Cash Price |
$5,204.80
|
| Rate for Payer: Cash Price |
$5,204.80
|
| Rate for Payer: Cofinity Commercial |
$4,036.90
|
| Rate for Payer: Cofinity Commercial |
$3,756.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,803.40
|
| Rate for Payer: Healthscope Commercial |
$3,364.08
|
| Rate for Payer: Healthscope Whirlpool |
$3,364.08
|
| Rate for Payer: Meridian Medicaid |
$1,881.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,943.57
|
| Rate for Payer: PACE SWMI |
$2,803.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,803.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,791.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,554.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,941.91
|
| Rate for Payer: Priority Health Medicare |
$2,803.40
|
| Rate for Payer: Priority Health Narrow Network |
$4,941.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,887.50
|
|
|
PR RESECJ RECUR OVARIAN/TUBAL/PERITONEAL MALIGNANCY
|
Professional
|
Both
|
$3,260.00
|
|
|
Service Code
|
HCPCS 58957
|
| Min. Negotiated Rate |
$404.15 |
| Max. Negotiated Rate |
$2,319.75 |
| Rate for Payer: Aetna Commercial |
$2,102.71
|
| Rate for Payer: Aetna Medicare |
$1,569.19
|
| Rate for Payer: BCBS Complete |
$1,072.41
|
| Rate for Payer: BCBS MAPPO |
$1,569.19
|
| Rate for Payer: BCBS Trust/PPO |
$404.15
|
| Rate for Payer: BCN Commercial |
$2,319.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,569.19
|
| Rate for Payer: Cash Price |
$2,608.00
|
| Rate for Payer: Cash Price |
$2,608.00
|
| Rate for Payer: Cofinity Commercial |
$2,259.63
|
| Rate for Payer: Cofinity Commercial |
$2,102.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,569.19
|
| Rate for Payer: Healthscope Commercial |
$1,883.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,883.03
|
| Rate for Payer: Meridian Medicaid |
$1,072.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,647.65
|
| Rate for Payer: PACE SWMI |
$1,569.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,569.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,021.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,282.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,247.35
|
| Rate for Payer: Priority Health Medicare |
$1,569.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,247.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,616.27
|
|
|
PR RESEC RECURRENT LARYNX NERVE
|
Professional
|
Both
|
$1,350.00
|
|
|
Service Code
|
HCPCS 31595
|
| Min. Negotiated Rate |
$540.00 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: BCBS Complete |
$540.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
|
|
PR RESECTION CONDYLE DISTAL END PHALANX EACH TOE
|
Professional
|
Both
|
$641.00
|
|
|
Service Code
|
HCPCS 28153
|
| Min. Negotiated Rate |
$170.61 |
| Max. Negotiated Rate |
$988.45 |
| Rate for Payer: Aetna Commercial |
$343.13
|
| Rate for Payer: Aetna Medicare |
$256.07
|
| Rate for Payer: BCBS Complete |
$179.14
|
| Rate for Payer: BCBS MAPPO |
$256.07
|
| Rate for Payer: BCBS Trust/PPO |
$988.45
|
| Rate for Payer: BCN Commercial |
$588.86
|
| Rate for Payer: BCN Medicare Advantage |
$256.07
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cofinity Commercial |
$368.74
|
| Rate for Payer: Cofinity Commercial |
$343.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.07
|
| Rate for Payer: Healthscope Commercial |
$307.28
|
| Rate for Payer: Healthscope Whirlpool |
$307.28
|
| Rate for Payer: Meridian Medicaid |
$179.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$268.87
|
| Rate for Payer: PACE SWMI |
$256.07
|
| Rate for Payer: PHP Medicare Advantage |
$256.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$401.37
|
| Rate for Payer: Priority Health Medicare |
$256.07
|
| Rate for Payer: Priority Health Narrow Network |
$401.37
|
| Rate for Payer: UHC Medicare Advantage |
$263.75
|
|
|
PR RESECTION EXTERNAL CARDIAC TUMOR
|
Professional
|
Both
|
$4,553.00
|
|
|
Service Code
|
HCPCS 33130
|
| Min. Negotiated Rate |
$855.83 |
| Max. Negotiated Rate |
$3,187.10 |
| Rate for Payer: Aetna Commercial |
$1,796.44
|
| Rate for Payer: Aetna Medicare |
$1,340.63
|
| Rate for Payer: BCBS Complete |
$898.62
|
| Rate for Payer: BCBS MAPPO |
$1,340.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.28
|
| Rate for Payer: BCN Commercial |
$1,958.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,340.63
|
| Rate for Payer: Cash Price |
$3,642.40
|
| Rate for Payer: Cash Price |
$3,642.40
|
| Rate for Payer: Cofinity Commercial |
$1,930.51
|
| Rate for Payer: Cofinity Commercial |
$1,796.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,340.63
|
| Rate for Payer: Healthscope Commercial |
$1,608.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,608.76
|
| Rate for Payer: Meridian Medicaid |
$898.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,407.66
|
| Rate for Payer: PACE SWMI |
$1,340.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,340.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,132.09
|
| Rate for Payer: Priority Health Medicare |
$1,340.63
|
| Rate for Payer: Priority Health Narrow Network |
$2,132.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,380.85
|
|
|
PR RESECTION HUMERAL HEAD
|
Professional
|
Both
|
$1,613.00
|
|
|
Service Code
|
HCPCS 23195
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$1,143.34 |
| Rate for Payer: Aetna Commercial |
$982.85
|
| Rate for Payer: Aetna Medicare |
$733.47
|
| Rate for Payer: BCBS Complete |
$508.36
|
| Rate for Payer: BCBS MAPPO |
$733.47
|
| Rate for Payer: BCBS Trust/PPO |
$20.80
|
| Rate for Payer: BCN Commercial |
$1,094.15
|
| Rate for Payer: BCN Medicare Advantage |
$733.47
|
| Rate for Payer: Cash Price |
$1,290.40
|
| Rate for Payer: Cash Price |
$1,290.40
|
| Rate for Payer: Cofinity Commercial |
$1,056.20
|
| Rate for Payer: Cofinity Commercial |
$982.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.47
|
| Rate for Payer: Healthscope Commercial |
$880.16
|
| Rate for Payer: Healthscope Whirlpool |
$880.16
|
| Rate for Payer: Meridian Medicaid |
$508.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$770.14
|
| Rate for Payer: PACE SWMI |
$733.47
|
| Rate for Payer: PHP Medicare Advantage |
$733.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,143.34
|
| Rate for Payer: Priority Health Medicare |
$733.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,143.34
|
| Rate for Payer: UHC Medicare Advantage |
$755.47
|
|
|
PR RESECTION/INCISION SUBVALVULAR TISSUE
|
Professional
|
Both
|
$6,098.00
|
|
|
Service Code
|
HCPCS 33415
|
| Min. Negotiated Rate |
$642.41 |
| Max. Negotiated Rate |
$4,268.60 |
| Rate for Payer: Aetna Commercial |
$2,671.95
|
| Rate for Payer: Aetna Medicare |
$1,993.99
|
| Rate for Payer: BCBS Complete |
$1,333.41
|
| Rate for Payer: BCBS MAPPO |
$1,993.99
|
| Rate for Payer: BCBS Trust/PPO |
$642.41
|
| Rate for Payer: BCN Commercial |
$2,902.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,993.99
|
| Rate for Payer: Cash Price |
$4,878.40
|
| Rate for Payer: Cash Price |
$4,878.40
|
| Rate for Payer: Cofinity Commercial |
$2,871.35
|
| Rate for Payer: Cofinity Commercial |
$2,671.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,993.99
|
| Rate for Payer: Healthscope Commercial |
$2,392.79
|
| Rate for Payer: Healthscope Whirlpool |
$2,392.79
|
| Rate for Payer: Meridian Medicaid |
$1,333.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,093.69
|
| Rate for Payer: PACE SWMI |
$1,993.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,993.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,269.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,268.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,159.29
|
| Rate for Payer: Priority Health Medicare |
$1,993.99
|
| Rate for Payer: Priority Health Narrow Network |
$3,159.29
|
| Rate for Payer: UHC Medicare Advantage |
$2,053.81
|
|
|
PR RESECTION MEDIASTINAL TUMOR
|
Professional
|
Both
|
$5,669.00
|
|
|
Service Code
|
HCPCS 39220
|
| Min. Negotiated Rate |
$718.02 |
| Max. Negotiated Rate |
$3,968.30 |
| Rate for Payer: Aetna Commercial |
$1,498.84
|
| Rate for Payer: Aetna Medicare |
$1,118.54
|
| Rate for Payer: BCBS Complete |
$753.92
|
| Rate for Payer: BCBS MAPPO |
$1,118.54
|
| Rate for Payer: BCBS Trust/PPO |
$735.39
|
| Rate for Payer: BCN Commercial |
$1,639.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,118.54
|
| Rate for Payer: Cash Price |
$4,535.20
|
| Rate for Payer: Cash Price |
$4,535.20
|
| Rate for Payer: Cofinity Commercial |
$1,498.84
|
| Rate for Payer: Cofinity Commercial |
$1,610.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,118.54
|
| Rate for Payer: Healthscope Commercial |
$1,342.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,342.25
|
| Rate for Payer: Meridian Medicaid |
$753.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,174.47
|
| Rate for Payer: PACE SWMI |
$1,118.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,118.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,968.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,784.19
|
| Rate for Payer: Priority Health Medicare |
$1,118.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,784.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,152.10
|
|
|
PR RESECTION OF MEDIASTINAL CYST
|
Professional
|
Both
|
$4,942.00
|
|
|
Service Code
|
HCPCS 39200
|
| Min. Negotiated Rate |
$549.54 |
| Max. Negotiated Rate |
$3,459.40 |
| Rate for Payer: Aetna Commercial |
$1,149.67
|
| Rate for Payer: Aetna Medicare |
$857.96
|
| Rate for Payer: BCBS Complete |
$577.02
|
| Rate for Payer: BCBS MAPPO |
$857.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.79
|
| Rate for Payer: BCN Commercial |
$1,253.95
|
| Rate for Payer: BCN Medicare Advantage |
$857.96
|
| Rate for Payer: Cash Price |
$3,953.60
|
| Rate for Payer: Cash Price |
$3,953.60
|
| Rate for Payer: Cofinity Commercial |
$1,235.46
|
| Rate for Payer: Cofinity Commercial |
$1,149.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$857.96
|
| Rate for Payer: Healthscope Commercial |
$1,029.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,029.55
|
| Rate for Payer: Meridian Medicaid |
$577.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$900.86
|
| Rate for Payer: PACE SWMI |
$857.96
|
| Rate for Payer: PHP Medicare Advantage |
$857.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,459.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,365.01
|
| Rate for Payer: Priority Health Medicare |
$857.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,365.01
|
| Rate for Payer: UHC Medicare Advantage |
$883.70
|
|
|
PR RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 28126
|
| Min. Negotiated Rate |
$162.09 |
| Max. Negotiated Rate |
$1,055.54 |
| Rate for Payer: Aetna Commercial |
$324.01
|
| Rate for Payer: Aetna Medicare |
$241.80
|
| Rate for Payer: BCBS Complete |
$170.19
|
| Rate for Payer: BCBS MAPPO |
$241.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$566.87
|
| Rate for Payer: BCN Medicare Advantage |
$241.80
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cofinity Commercial |
$324.01
|
| Rate for Payer: Cofinity Commercial |
$348.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.80
|
| Rate for Payer: Healthscope Commercial |
$290.16
|
| Rate for Payer: Healthscope Whirlpool |
$290.16
|
| Rate for Payer: Meridian Medicaid |
$170.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$253.89
|
| Rate for Payer: PACE SWMI |
$241.80
|
| Rate for Payer: PHP Medicare Advantage |
$241.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$378.39
|
| Rate for Payer: Priority Health Medicare |
$241.80
|
| Rate for Payer: Priority Health Narrow Network |
$378.39
|
| Rate for Payer: UHC Medicare Advantage |
$249.05
|
|
