|
PR EXPLORATION PENETRATING WOUND SPX CHEST
|
Professional
|
Both
|
$1,148.00
|
|
|
Service Code
|
HCPCS 20101
|
| Min. Negotiated Rate |
$134.83 |
| Max. Negotiated Rate |
$5,215.40 |
| Rate for Payer: Aetna Commercial |
$282.53
|
| Rate for Payer: Aetna Medicare |
$574.00
|
| Rate for Payer: BCBS Complete |
$141.57
|
| Rate for Payer: BCBS Trust/PPO |
$5,215.40
|
| Rate for Payer: BCN Commercial |
$857.63
|
| Rate for Payer: Cash Price |
$918.40
|
| Rate for Payer: Cash Price |
$918.40
|
| Rate for Payer: Meridian Medicaid |
$141.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.58
|
| Rate for Payer: Priority Health Narrow Network |
$320.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.32
|
| Rate for Payer: UHC Exchange |
$236.32
|
| Rate for Payer: UHCCP Medicaid |
$134.83
|
|
|
PR EXPLORATION PENETRATING WOUND SPX EXTREMITY
|
Professional
|
Both
|
$1,817.00
|
|
|
Service Code
|
HCPCS 20103
|
| Min. Negotiated Rate |
$221.95 |
| Max. Negotiated Rate |
$2,940.00 |
| Rate for Payer: Aetna Commercial |
$461.03
|
| Rate for Payer: Aetna Medicare |
$908.50
|
| Rate for Payer: BCBS Complete |
$233.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,940.00
|
| Rate for Payer: BCN Commercial |
$828.31
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Meridian Medicaid |
$233.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,181.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$528.19
|
| Rate for Payer: Priority Health Narrow Network |
$528.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$406.20
|
| Rate for Payer: UHC Exchange |
$406.20
|
| Rate for Payer: UHCCP Medicaid |
$221.95
|
|
|
PR EXPLORATION PENETRATING WOUND SPX NECK
|
Professional
|
Both
|
$1,939.00
|
|
|
Service Code
|
HCPCS 20100
|
| Min. Negotiated Rate |
$384.89 |
| Max. Negotiated Rate |
$5,215.40 |
| Rate for Payer: Aetna Commercial |
$810.47
|
| Rate for Payer: Aetna Medicare |
$969.50
|
| Rate for Payer: BCBS Complete |
$404.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,215.40
|
| Rate for Payer: BCN Commercial |
$872.77
|
| Rate for Payer: Cash Price |
$1,551.20
|
| Rate for Payer: Cash Price |
$1,551.20
|
| Rate for Payer: Meridian Medicaid |
$404.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$915.44
|
| Rate for Payer: Priority Health Narrow Network |
$915.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$699.84
|
| Rate for Payer: UHC Exchange |
$699.84
|
| Rate for Payer: UHCCP Medicaid |
$384.89
|
|
|
PR EXPLORATION POPLITEAL ARTERY
|
Professional
|
Both
|
$1,079.00
|
|
|
Service Code
|
HCPCS 35741
|
| Min. Negotiated Rate |
$431.60 |
| Max. Negotiated Rate |
$701.35 |
| Rate for Payer: Aetna Medicare |
$539.50
|
| Rate for Payer: BCBS Complete |
$431.60
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.35
|
|
|
PR EXPLORATION SPINAL FUSION
|
Professional
|
Both
|
$5,175.00
|
|
|
Service Code
|
HCPCS 22830
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$3,363.75 |
| Rate for Payer: Aetna Commercial |
$1,097.19
|
| Rate for Payer: Aetna Medicare |
$2,587.50
|
| Rate for Payer: BCBS Complete |
$563.82
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$1,209.96
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Cash Price |
$4,140.00
|
| Rate for Payer: Meridian Medicaid |
$563.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,363.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$931.39
|
| Rate for Payer: UHC Exchange |
$931.39
|
| Rate for Payer: UHCCP Medicaid |
$536.97
|
|
|
PR EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX
|
Professional
|
Both
|
$2,353.00
|
|
|
Service Code
|
HCPCS 49000
|
| Min. Negotiated Rate |
$495.44 |
| Max. Negotiated Rate |
$1,529.45 |
| Rate for Payer: Aetna Commercial |
$1,035.31
|
| Rate for Payer: Aetna Medicare |
$1,176.50
|
| Rate for Payer: BCBS Complete |
$520.21
|
| Rate for Payer: BCBS Trust/PPO |
$576.90
|
| Rate for Payer: BCN Commercial |
$1,122.01
|
| Rate for Payer: Cash Price |
$1,882.40
|
| Rate for Payer: Cash Price |
$1,882.40
|
| Rate for Payer: Meridian Medicaid |
$520.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,529.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,378.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,378.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$930.39
|
| Rate for Payer: UHC Exchange |
$930.39
|
| Rate for Payer: UHCCP Medicaid |
$495.44
|
|
|
PR EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK
|
Professional
|
Both
|
$2,034.00
|
|
|
Service Code
|
HCPCS 20102
|
| Min. Negotiated Rate |
$164.86 |
| Max. Negotiated Rate |
$1,322.10 |
| Rate for Payer: Aetna Commercial |
$342.28
|
| Rate for Payer: Aetna Medicare |
$1,017.00
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,322.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.34
|
| Rate for Payer: Priority Health Narrow Network |
$392.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.07
|
| Rate for Payer: UHC Exchange |
$292.07
|
| Rate for Payer: UHCCP Medicaid |
$164.86
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD
|
Professional
|
Both
|
$2,353.00
|
|
|
Service Code
|
HCPCS 35840
|
| Min. Negotiated Rate |
$777.45 |
| Max. Negotiated Rate |
$1,925.21 |
| Rate for Payer: Aetna Commercial |
$1,617.90
|
| Rate for Payer: Aetna Medicare |
$1,176.50
|
| Rate for Payer: BCBS Complete |
$816.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.11
|
| Rate for Payer: BCN Commercial |
$1,757.78
|
| Rate for Payer: Cash Price |
$1,882.40
|
| Rate for Payer: Cash Price |
$1,882.40
|
| Rate for Payer: Meridian Medicaid |
$816.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,529.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,925.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,925.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$827.40
|
| Rate for Payer: UHC Exchange |
$827.40
|
| Rate for Payer: UHCCP Medicaid |
$777.45
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ CH
|
Professional
|
Both
|
$5,591.00
|
|
|
Service Code
|
HCPCS 35820
|
| Min. Negotiated Rate |
$1,168.60 |
| Max. Negotiated Rate |
$3,634.15 |
| Rate for Payer: Aetna Commercial |
$2,700.88
|
| Rate for Payer: Aetna Medicare |
$2,795.50
|
| Rate for Payer: BCBS Complete |
$1,330.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.60
|
| Rate for Payer: BCN Commercial |
$2,883.69
|
| Rate for Payer: Cash Price |
$4,472.80
|
| Rate for Payer: Cash Price |
$4,472.80
|
| Rate for Payer: Meridian Medicaid |
$1,330.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,267.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,634.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,148.93
|
| Rate for Payer: Priority Health Narrow Network |
$3,148.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,594.03
|
| Rate for Payer: UHC Exchange |
$2,594.03
|
| Rate for Payer: UHCCP Medicaid |
$1,267.14
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 35800
|
| Min. Negotiated Rate |
$469.24 |
| Max. Negotiated Rate |
$1,162.56 |
| Rate for Payer: Aetna Commercial |
$965.79
|
| Rate for Payer: Aetna Medicare |
$756.50
|
| Rate for Payer: BCBS Complete |
$492.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.18
|
| Rate for Payer: BCN Commercial |
$1,062.38
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Meridian Medicaid |
$492.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,162.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,162.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$630.78
|
| Rate for Payer: UHC Exchange |
$630.78
|
| Rate for Payer: UHCCP Medicaid |
$469.24
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR
|
Professional
|
Both
|
$1,524.00
|
|
|
Service Code
|
HCPCS 35860
|
| Min. Negotiated Rate |
$531.44 |
| Max. Negotiated Rate |
$1,318.92 |
| Rate for Payer: Aetna Commercial |
$1,122.58
|
| Rate for Payer: Aetna Medicare |
$762.00
|
| Rate for Payer: BCBS Complete |
$558.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.45
|
| Rate for Payer: BCN Commercial |
$1,204.10
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Meridian Medicaid |
$558.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,318.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,318.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$537.04
|
| Rate for Payer: UHC Exchange |
$537.04
|
| Rate for Payer: UHCCP Medicaid |
$531.44
|
|
|
PR EXPL RETROPERITONEUM W/WO BX SPX
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 49010
|
| Min. Negotiated Rate |
$588.53 |
| Max. Negotiated Rate |
$1,647.20 |
| Rate for Payer: Aetna Commercial |
$1,245.48
|
| Rate for Payer: Aetna Medicare |
$1,016.00
|
| Rate for Payer: BCBS Complete |
$623.09
|
| Rate for Payer: BCBS Trust/PPO |
$588.53
|
| Rate for Payer: BCN Commercial |
$1,340.45
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Meridian Medicaid |
$623.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,647.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,647.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,157.26
|
| Rate for Payer: UHC Exchange |
$1,157.26
|
| Rate for Payer: UHCCP Medicaid |
$593.42
|
|
|
PR EXPL RPR & PRESACRAL DRG RECTAL INJURY
|
Professional
|
Both
|
$3,078.00
|
|
|
Service Code
|
HCPCS 45562
|
| Min. Negotiated Rate |
$753.59 |
| Max. Negotiated Rate |
$2,095.24 |
| Rate for Payer: Aetna Commercial |
$1,516.85
|
| Rate for Payer: Aetna Medicare |
$1,539.00
|
| Rate for Payer: BCBS Complete |
$791.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.03
|
| Rate for Payer: BCN Commercial |
$1,652.71
|
| Rate for Payer: Cash Price |
$2,462.40
|
| Rate for Payer: Cash Price |
$2,462.40
|
| Rate for Payer: Meridian Medicaid |
$791.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$753.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,000.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,095.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,095.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,337.83
|
| Rate for Payer: UHC Exchange |
$1,337.83
|
| Rate for Payer: UHCCP Medicaid |
$753.59
|
|
|
PR EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL
|
Professional
|
Both
|
$1,299.00
|
|
|
Service Code
|
HCPCS 54560
|
| Min. Negotiated Rate |
$440.91 |
| Max. Negotiated Rate |
$3,980.21 |
| Rate for Payer: Aetna Commercial |
$882.98
|
| Rate for Payer: Aetna Medicare |
$649.50
|
| Rate for Payer: BCBS Complete |
$462.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,980.21
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Meridian Medicaid |
$462.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,095.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,095.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$805.95
|
| Rate for Payer: UHC Exchange |
$805.95
|
| Rate for Payer: UHCCP Medicaid |
$440.91
|
|
|
PR EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 54550
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$2,742.41 |
| Rate for Payer: Aetna Commercial |
$630.77
|
| Rate for Payer: Aetna Medicare |
$464.00
|
| Rate for Payer: BCBS Complete |
$332.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,742.41
|
| Rate for Payer: BCN Commercial |
$711.03
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Meridian Medicaid |
$332.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$786.66
|
| Rate for Payer: Priority Health Narrow Network |
$786.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$587.32
|
| Rate for Payer: UHC Exchange |
$587.32
|
| Rate for Payer: UHCCP Medicaid |
$316.52
|
|
|
PR EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST
|
Professional
|
Both
|
$820.00
|
|
|
Service Code
|
HCPCS 25248
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,918.26 |
| Rate for Payer: Aetna Commercial |
$558.31
|
| Rate for Payer: Aetna Medicare |
$410.00
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.26
|
| Rate for Payer: BCN Commercial |
$615.74
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$662.53
|
| Rate for Payer: Priority Health Narrow Network |
$662.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$492.77
|
| Rate for Payer: UHC Exchange |
$492.77
|
| Rate for Payer: UHCCP Medicaid |
$274.77
|
|
|
PR EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST
|
Professional
|
Both
|
$1,673.00
|
|
|
Service Code
|
HCPCS 55860
|
| Min. Negotiated Rate |
$558.91 |
| Max. Negotiated Rate |
$2,253.73 |
| Rate for Payer: Aetna Commercial |
$1,124.18
|
| Rate for Payer: Aetna Medicare |
$836.50
|
| Rate for Payer: BCBS Complete |
$586.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,253.73
|
| Rate for Payer: BCN Commercial |
$1,260.78
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Meridian Medicaid |
$586.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,388.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,388.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,057.61
|
| Rate for Payer: UHC Exchange |
$1,057.61
|
| Rate for Payer: UHCCP Medicaid |
$558.91
|
|
|
PR EXPRESS FACIAL REFINEMENT OR RELAXATION
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 00126
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
|
|
PR EXT ECG > 48HR TO 21 DAY RCRD W/CONECT INTL RCRD
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS 0296T
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$122.85 |
| Rate for Payer: Aetna Medicare |
$94.50
|
| Rate for Payer: BCBS Complete |
$75.60
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.85
|
|
|
PR EXT ECG > 48HR TO 21 DAY REVIEW AND INTERPRETATN
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 0298T
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
|
|
PR EXTENDED ABDOMINOPLASTY
|
Professional
|
Both
|
$5,304.00
|
|
|
Service Code
|
HCPCS 00366
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,121.60 |
| Max. Negotiated Rate |
$3,447.60 |
| Rate for Payer: Aetna Medicare |
$2,652.00
|
| Rate for Payer: BCBS Complete |
$2,121.60
|
| Rate for Payer: Cash Price |
$4,243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,447.60
|
|
|
PR EXTENDED VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 92083
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,352.98 |
| Rate for Payer: Aetna Commercial |
$66.10
|
| Rate for Payer: Aetna Medicare |
$58.50
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.98
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.37
|
| Rate for Payer: Priority Health Narrow Network |
$45.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.25
|
| Rate for Payer: UHC Exchange |
$83.25
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
|
|
PR EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 59412
|
| Min. Negotiated Rate |
$95.36 |
| Max. Negotiated Rate |
$279.47 |
| Rate for Payer: Aetna Commercial |
$112.32
|
| Rate for Payer: Aetna Medicare |
$145.00
|
| Rate for Payer: BCBS Complete |
$100.13
|
| Rate for Payer: BCBS Trust/PPO |
$279.47
|
| Rate for Payer: BCN Commercial |
$150.03
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Meridian Medicaid |
$100.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.92
|
| Rate for Payer: Priority Health Narrow Network |
$143.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.23
|
| Rate for Payer: UHC Exchange |
$119.23
|
| Rate for Payer: UHCCP Medicaid |
$95.36
|
|
|
PR EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN
|
Professional
|
Both
|
$3,081.00
|
|
|
Service Code
|
HCPCS 48510
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$2,002.65 |
| Rate for Payer: Aetna Commercial |
$1,486.24
|
| Rate for Payer: Aetna Medicare |
$1,540.50
|
| Rate for Payer: BCBS Complete |
$741.40
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,605.31
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Meridian Medicaid |
$741.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,002.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,967.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,967.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,293.88
|
| Rate for Payer: UHC Exchange |
$1,293.88
|
| Rate for Payer: UHCCP Medicaid |
$706.10
|
|
|
PR EXTERNAL ECG REC>48HR<7D RECORDING
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93242
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$526.19 |
| Rate for Payer: Aetna Commercial |
$18.91
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.95
|
| Rate for Payer: Priority Health Narrow Network |
$16.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.01
|
| Rate for Payer: UHC Exchange |
$20.01
|
|
