|
PR HOME SLEEP TEST/TYPE 3 PORTA
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS G0399
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$1,157.51 |
| Rate for Payer: Aetna Commercial |
$187.42
|
| Rate for Payer: Aetna Medicare |
$177.50
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,157.51
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.80
|
| Rate for Payer: Priority Health Narrow Network |
$58.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.52
|
| Rate for Payer: UHC Exchange |
$218.52
|
|
|
PR HOME SLEEP TEST/TYPE 4 PORTA
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS G0400
|
| Min. Negotiated Rate |
$64.23 |
| Max. Negotiated Rate |
$1,317.05 |
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: Aetna Medicare |
$104.50
|
| Rate for Payer: Aetna Medicare |
$177.50
|
| Rate for Payer: Aetna Medicare |
$73.00
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: BCBS Complete |
$58.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.23
|
| Rate for Payer: Priority Health Narrow Network |
$64.23
|
| Rate for Payer: Priority Health Narrow Network |
$64.23
|
| Rate for Payer: Priority Health Narrow Network |
$64.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.29
|
| Rate for Payer: UHC Exchange |
$195.29
|
| Rate for Payer: UHC Exchange |
$195.29
|
| Rate for Payer: UHC Exchange |
$195.29
|
|
|
PR HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 94005
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$130.48 |
| Rate for Payer: Aetna Commercial |
$100.62
|
| Rate for Payer: Aetna Medicare |
$95.50
|
| Rate for Payer: BCBS Complete |
$76.40
|
| Rate for Payer: BCN Commercial |
$130.48
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.13
|
| Rate for Payer: Priority Health Narrow Network |
$122.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.90
|
| Rate for Payer: UHC Exchange |
$94.90
|
|
|
PR HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 99343
|
| Min. Negotiated Rate |
$95.60 |
| Max. Negotiated Rate |
$155.35 |
| Rate for Payer: Aetna Medicare |
$119.50
|
| Rate for Payer: BCBS Complete |
$95.60
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
|
|
PR HOPD MNTL HLT, 15-29 MIN
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS C7900
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR HOPD MNTL HLT, 30-60 MIN
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS C7901
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR HOPD MNTL HLT, EA ADDL
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS C7902
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR HOSPICE CARE SUPERVISION
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS G0182
|
| Min. Negotiated Rate |
$19.02 |
| Max. Negotiated Rate |
$151.49 |
| Rate for Payer: Aetna Commercial |
$104.90
|
| Rate for Payer: Aetna Medicare |
$95.50
|
| Rate for Payer: BCBS Complete |
$76.40
|
| Rate for Payer: BCBS Trust/PPO |
$19.02
|
| Rate for Payer: BCN Commercial |
$151.49
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.57
|
| Rate for Payer: Priority Health Narrow Network |
$141.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.40
|
| Rate for Payer: UHC Exchange |
$109.40
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 99236
|
| Min. Negotiated Rate |
$131.42 |
| Max. Negotiated Rate |
$1,191.84 |
| Rate for Payer: Aetna Commercial |
$211.34
|
| Rate for Payer: Aetna Medicare |
$196.00
|
| Rate for Payer: BCBS Complete |
$137.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.84
|
| Rate for Payer: BCN Commercial |
$301.51
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Meridian Medicaid |
$137.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$277.31
|
| Rate for Payer: Priority Health Narrow Network |
$277.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$235.86
|
| Rate for Payer: UHC Exchange |
$235.86
|
| Rate for Payer: UHCCP Medicaid |
$131.42
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 99235
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$230.17 |
| Rate for Payer: Aetna Commercial |
$164.50
|
| Rate for Payer: Aetna Medicare |
$158.00
|
| Rate for Payer: BCBS Complete |
$105.57
|
| Rate for Payer: BCBS Trust/PPO |
$218.72
|
| Rate for Payer: BCN Commercial |
$230.17
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Meridian Medicaid |
$105.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.24
|
| Rate for Payer: Priority Health Narrow Network |
$212.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$189.87
|
| Rate for Payer: UHC Exchange |
$189.87
|
| Rate for Payer: UHCCP Medicaid |
$100.54
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 99234
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$1,631.92 |
| Rate for Payer: Aetna Commercial |
$129.57
|
| Rate for Payer: Aetna Medicare |
$120.50
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.92
|
| Rate for Payer: BCN Commercial |
$142.69
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.13
|
| Rate for Payer: Priority Health Narrow Network |
$130.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.20
|
| Rate for Payer: UHC Exchange |
$145.20
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 99239
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$1,216.15 |
| Rate for Payer: Aetna Commercial |
$104.19
|
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$76.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,216.15
|
| Rate for Payer: BCN Commercial |
$165.66
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Meridian Medicaid |
$76.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.57
|
| Rate for Payer: Priority Health Narrow Network |
$152.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.23
|
| Rate for Payer: UHC Exchange |
$110.23
|
| Rate for Payer: UHCCP Medicaid |
$72.85
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 99238
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$255.17 |
| Rate for Payer: Aetna Commercial |
$70.69
|
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS Trust/PPO |
$255.17
|
| Rate for Payer: BCN Commercial |
$116.79
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.14
|
| Rate for Payer: Priority Health Narrow Network |
$108.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.19
|
| Rate for Payer: UHC Exchange |
$75.19
|
| Rate for Payer: UHCCP Medicaid |
$51.55
|
|
|
PR HO W/O JOINTS CF
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS L3919
|
| Min. Negotiated Rate |
$101.20 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna Commercial |
$148.45
|
| Rate for Payer: Aetna Medicare |
$126.50
|
| Rate for Payer: BCBS Complete |
$101.20
|
| Rate for Payer: BCN Commercial |
$234.03
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.90
|
| Rate for Payer: UHC Exchange |
$133.90
|
|
|
PR HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 46258
|
| Min. Negotiated Rate |
$313.96 |
| Max. Negotiated Rate |
$1,432.75 |
| Rate for Payer: Aetna Commercial |
$640.84
|
| Rate for Payer: Aetna Medicare |
$591.00
|
| Rate for Payer: BCBS Complete |
$329.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,432.75
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Meridian Medicaid |
$329.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.82
|
| Rate for Payer: Priority Health Narrow Network |
$872.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$536.08
|
| Rate for Payer: UHC Exchange |
$536.08
|
| Rate for Payer: UHCCP Medicaid |
$313.96
|
|
|
PR HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY
|
Professional
|
Both
|
$1,775.00
|
|
|
Service Code
|
HCPCS 46262
|
| Min. Negotiated Rate |
$236.15 |
| Max. Negotiated Rate |
$1,153.75 |
| Rate for Payer: Aetna Commercial |
$748.16
|
| Rate for Payer: Aetna Medicare |
$887.50
|
| Rate for Payer: BCBS Complete |
$400.78
|
| Rate for Payer: BCBS Trust/PPO |
$236.15
|
| Rate for Payer: BCN Commercial |
$862.52
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Meridian Medicaid |
$400.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,057.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,057.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$637.86
|
| Rate for Payer: UHC Exchange |
$637.86
|
| Rate for Payer: UHCCP Medicaid |
$381.70
|
|
|
PR HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU
|
Professional
|
Both
|
$1,732.00
|
|
|
Service Code
|
HCPCS 46261
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$1,125.80 |
| Rate for Payer: Aetna Commercial |
$701.89
|
| Rate for Payer: Aetna Medicare |
$866.00
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$776.51
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.11
|
| Rate for Payer: Priority Health Narrow Network |
$961.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$612.10
|
| Rate for Payer: UHC Exchange |
$612.10
|
| Rate for Payer: UHCCP Medicaid |
$345.06
|
|
|
PR HYALGAN SUPARTZ VISCO-3 DOSE
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS J7321
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$196.95 |
| Rate for Payer: Aetna Commercial |
$75.29
|
| Rate for Payer: Aetna Medicare |
$151.50
|
| Rate for Payer: BCBS Complete |
$121.20
|
| Rate for Payer: BCBS Trust/PPO |
$64.00
|
| Rate for Payer: BCN Commercial |
$76.58
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.48
|
| Rate for Payer: UHC Exchange |
$75.48
|
|
|
PR HYDROCORTISONE SODIUM SUCC I
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1720
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$19.85 |
| Rate for Payer: Aetna Commercial |
$18.38
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS Trust/PPO |
$16.18
|
| Rate for Payer: BCN Commercial |
$16.11
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.85
|
| Rate for Payer: UHC Exchange |
$19.85
|
|
|
PR HYDROMORPHONE INJECTION
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J1170
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna Commercial |
$4.73
|
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.40
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.70
|
| Rate for Payer: UHC Exchange |
$2.70
|
|
|
PR HYDROXYPROGESTERONE CAPROATE
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS J1725
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.95
|
|
|
PR HYDROXYZINE HCL INJECTION
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS J3410
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$14.50 |
| Rate for Payer: Aetna Commercial |
$10.21
|
| Rate for Payer: Aetna Medicare |
$7.50
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS Trust/PPO |
$5.95
|
| Rate for Payer: BCN Commercial |
$7.98
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.50
|
| Rate for Payer: UHC Exchange |
$14.50
|
|
|
PR HYMENOTOMY SIMPLE INCISION
|
Professional
|
Both
|
$156.00
|
|
|
Service Code
|
HCPCS 56442
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$2,246.86 |
| Rate for Payer: Aetna Commercial |
$55.11
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,246.86
|
| Rate for Payer: BCN Commercial |
$69.39
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.93
|
| Rate for Payer: Priority Health Narrow Network |
$70.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.53
|
| Rate for Payer: UHC Exchange |
$54.53
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
PR HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL
|
Professional
|
Both
|
$8,489.00
|
|
|
Service Code
|
HCPCS 61548
|
| Min. Negotiated Rate |
$712.15 |
| Max. Negotiated Rate |
$5,517.85 |
| Rate for Payer: Aetna Commercial |
$2,027.19
|
| Rate for Payer: Aetna Medicare |
$4,244.50
|
| Rate for Payer: BCBS Complete |
$1,068.83
|
| Rate for Payer: BCBS Trust/PPO |
$712.15
|
| Rate for Payer: BCN Commercial |
$3,198.48
|
| Rate for Payer: Cash Price |
$6,791.20
|
| Rate for Payer: Cash Price |
$6,791.20
|
| Rate for Payer: Meridian Medicaid |
$1,068.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,517.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,708.79
|
| Rate for Payer: Priority Health Narrow Network |
$2,708.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,817.98
|
| Rate for Payer: UHC Exchange |
$1,817.98
|
| Rate for Payer: UHCCP Medicaid |
$1,017.93
|
|
|
PR HYSTERORRHAPHY RUPTURED UTERUS
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 59350
|
| Min. Negotiated Rate |
$177.64 |
| Max. Negotiated Rate |
$852.80 |
| Rate for Payer: Aetna Commercial |
$307.58
|
| Rate for Payer: Aetna Medicare |
$656.00
|
| Rate for Payer: BCBS Complete |
$186.52
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$407.56
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Meridian Medicaid |
$186.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.37
|
| Rate for Payer: Priority Health Narrow Network |
$389.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.09
|
| Rate for Payer: UHC Exchange |
$322.09
|
| Rate for Payer: UHCCP Medicaid |
$177.64
|
|
