|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,549.00
|
|
|
Service Code
|
HCPCS 36561
|
| Hospital Charge Code |
36561
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$2,661.75 |
| Rate for Payer: Aetna Commercial |
$398.14
|
| Rate for Payer: Aetna Medicare |
$297.12
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS MAPPO |
$297.12
|
| Rate for Payer: BCN Commercial |
$490.01
|
| Rate for Payer: BCN Medicare Advantage |
$297.12
|
| Rate for Payer: Cash Price |
$2,839.20
|
| Rate for Payer: Cash Price |
$2,839.20
|
| Rate for Payer: Cofinity Commercial |
$427.85
|
| Rate for Payer: Cofinity Commercial |
$398.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.12
|
| Rate for Payer: Healthscope Commercial |
$356.54
|
| Rate for Payer: Healthscope Whirlpool |
$356.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.98
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.83
|
| Rate for Payer: Nomi Health Commercial |
$356.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,661.75
|
| Rate for Payer: PACE SWMI |
$297.12
|
| Rate for Payer: PHP Medicare Advantage |
$297.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$526.95
|
| Rate for Payer: Priority Health Medicare |
$297.12
|
| Rate for Payer: Priority Health Narrow Network |
$526.95
|
| Rate for Payer: Railroad Medicare Medicare |
$297.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.12
|
| Rate for Payer: UHC Exchange |
$595.45
|
| Rate for Payer: UHC Medicaid |
$191.27
|
| Rate for Payer: UHCCP DNSP |
$297.12
|
| Rate for Payer: UHCCP Medicaid |
$191.27
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$3,549.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,661.75 |
| Max. Negotiated Rate |
$3,549.00 |
| Rate for Payer: Aetna Commercial |
$3,194.10
|
| Rate for Payer: ASR ASR |
$3,442.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,914.44
|
| Rate for Payer: BCN Commercial |
$2,914.44
|
| Rate for Payer: Cash Price |
$2,839.20
|
| Rate for Payer: Cofinity Commercial |
$3,336.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,839.20
|
| Rate for Payer: Healthscope Commercial |
$3,442.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,549.00
|
| Rate for Payer: Mclaren Commercial |
$3,194.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,016.65
|
| Rate for Payer: Nomi Health Commercial |
$2,910.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,661.75
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR
|
Professional
|
Both
|
$3,686.00
|
|
|
Service Code
|
HCPCS 36560
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$2,764.50 |
| Rate for Payer: Aetna Commercial |
$483.93
|
| Rate for Payer: Aetna Medicare |
$361.14
|
| Rate for Payer: BCBS Complete |
$244.00
|
| Rate for Payer: BCBS MAPPO |
$361.14
|
| Rate for Payer: BCN Commercial |
$575.17
|
| Rate for Payer: BCN Medicare Advantage |
$361.14
|
| Rate for Payer: Cash Price |
$2,948.80
|
| Rate for Payer: Cash Price |
$2,948.80
|
| Rate for Payer: Cofinity Commercial |
$520.04
|
| Rate for Payer: Cofinity Commercial |
$483.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.14
|
| Rate for Payer: Healthscope Commercial |
$433.37
|
| Rate for Payer: Healthscope Whirlpool |
$433.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$379.20
|
| Rate for Payer: Meridian Medicaid |
$244.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$397.25
|
| Rate for Payer: Nomi Health Commercial |
$433.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,764.50
|
| Rate for Payer: PACE SWMI |
$361.14
|
| Rate for Payer: PHP Medicare Advantage |
$361.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$618.52
|
| Rate for Payer: Priority Health Medicare |
$361.14
|
| Rate for Payer: Priority Health Narrow Network |
$618.52
|
| Rate for Payer: Railroad Medicare Medicare |
$361.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$676.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$361.14
|
| Rate for Payer: UHC Exchange |
$676.58
|
| Rate for Payer: UHC Medicaid |
$232.38
|
| Rate for Payer: UHCCP DNSP |
$361.14
|
| Rate for Payer: UHCCP Medicaid |
$232.38
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PUMP
|
Professional
|
Both
|
$3,697.00
|
|
|
Service Code
|
HCPCS 36563
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$2,772.75 |
| Rate for Payer: Aetna Commercial |
$455.22
|
| Rate for Payer: Aetna Medicare |
$339.72
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS MAPPO |
$339.72
|
| Rate for Payer: BCN Commercial |
$538.32
|
| Rate for Payer: BCN Medicare Advantage |
$339.72
|
| Rate for Payer: Cash Price |
$2,957.60
|
| Rate for Payer: Cash Price |
$2,957.60
|
| Rate for Payer: Cofinity Commercial |
$489.20
|
| Rate for Payer: Cofinity Commercial |
$455.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.72
|
| Rate for Payer: Healthscope Commercial |
$407.66
|
| Rate for Payer: Healthscope Whirlpool |
$407.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.71
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$373.69
|
| Rate for Payer: Nomi Health Commercial |
$407.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,772.75
|
| Rate for Payer: PACE SWMI |
$339.72
|
| Rate for Payer: PHP Medicare Advantage |
$339.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$578.90
|
| Rate for Payer: Priority Health Medicare |
$339.72
|
| Rate for Payer: Priority Health Narrow Network |
$578.90
|
| Rate for Payer: Railroad Medicare Medicare |
$339.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$648.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$339.72
|
| Rate for Payer: UHC Exchange |
$648.25
|
| Rate for Payer: UHC Medicaid |
$218.33
|
| Rate for Payer: UHCCP DNSP |
$339.72
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
|
|
PR INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>
|
Professional
|
Both
|
$2,041.00
|
|
|
Service Code
|
HCPCS 36558
|
| Min. Negotiated Rate |
$148.25 |
| Max. Negotiated Rate |
$1,530.75 |
| Rate for Payer: Aetna Commercial |
$308.04
|
| Rate for Payer: Aetna Medicare |
$229.88
|
| Rate for Payer: BCBS Complete |
$155.66
|
| Rate for Payer: BCBS MAPPO |
$229.88
|
| Rate for Payer: BCN Commercial |
$382.45
|
| Rate for Payer: BCN Medicare Advantage |
$229.88
|
| Rate for Payer: Cash Price |
$1,632.80
|
| Rate for Payer: Cash Price |
$1,632.80
|
| Rate for Payer: Cofinity Commercial |
$331.03
|
| Rate for Payer: Cofinity Commercial |
$308.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.88
|
| Rate for Payer: Healthscope Commercial |
$275.86
|
| Rate for Payer: Healthscope Whirlpool |
$275.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.37
|
| Rate for Payer: Meridian Medicaid |
$155.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$252.87
|
| Rate for Payer: Nomi Health Commercial |
$275.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,530.75
|
| Rate for Payer: PACE SWMI |
$229.88
|
| Rate for Payer: PHP Medicare Advantage |
$229.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$411.27
|
| Rate for Payer: Priority Health Medicare |
$229.88
|
| Rate for Payer: Priority Health Narrow Network |
$411.27
|
| Rate for Payer: Railroad Medicare Medicare |
$229.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$461.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$229.88
|
| Rate for Payer: UHC Exchange |
$461.48
|
| Rate for Payer: UHC Medicaid |
$148.25
|
| Rate for Payer: UHCCP DNSP |
$229.88
|
| Rate for Payer: UHCCP Medicaid |
$148.25
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$1,790.00
|
|
|
Service Code
|
HCPCS 36565
|
| Min. Negotiated Rate |
$199.58 |
| Max. Negotiated Rate |
$1,342.50 |
| Rate for Payer: Aetna Commercial |
$416.69
|
| Rate for Payer: Aetna Medicare |
$310.96
|
| Rate for Payer: BCBS Complete |
$209.56
|
| Rate for Payer: BCBS MAPPO |
$310.96
|
| Rate for Payer: BCN Commercial |
$499.48
|
| Rate for Payer: BCN Medicare Advantage |
$310.96
|
| Rate for Payer: Cash Price |
$1,432.00
|
| Rate for Payer: Cash Price |
$1,432.00
|
| Rate for Payer: Cofinity Commercial |
$447.78
|
| Rate for Payer: Cofinity Commercial |
$416.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.96
|
| Rate for Payer: Healthscope Commercial |
$373.15
|
| Rate for Payer: Healthscope Whirlpool |
$373.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.51
|
| Rate for Payer: Meridian Medicaid |
$209.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.06
|
| Rate for Payer: Nomi Health Commercial |
$373.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,342.50
|
| Rate for Payer: PACE SWMI |
$310.96
|
| Rate for Payer: PHP Medicare Advantage |
$310.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$537.13
|
| Rate for Payer: Priority Health Medicare |
$310.96
|
| Rate for Payer: Priority Health Narrow Network |
$537.13
|
| Rate for Payer: Railroad Medicare Medicare |
$310.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$310.96
|
| Rate for Payer: UHC Exchange |
$595.36
|
| Rate for Payer: UHC Medicaid |
$199.58
|
| Rate for Payer: UHCCP DNSP |
$310.96
|
| Rate for Payer: UHCCP Medicaid |
$199.58
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT
|
Professional
|
Both
|
$2,994.00
|
|
|
Service Code
|
HCPCS 36566
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$2,245.50 |
| Rate for Payer: Aetna Commercial |
$444.01
|
| Rate for Payer: Aetna Medicare |
$331.35
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS MAPPO |
$331.35
|
| Rate for Payer: BCN Commercial |
$527.36
|
| Rate for Payer: BCN Medicare Advantage |
$331.35
|
| Rate for Payer: Cash Price |
$2,395.20
|
| Rate for Payer: Cash Price |
$2,395.20
|
| Rate for Payer: Cofinity Commercial |
$477.14
|
| Rate for Payer: Cofinity Commercial |
$444.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.35
|
| Rate for Payer: Healthscope Commercial |
$397.62
|
| Rate for Payer: Healthscope Whirlpool |
$397.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.92
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$364.49
|
| Rate for Payer: Nomi Health Commercial |
$397.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,245.50
|
| Rate for Payer: PACE SWMI |
$331.35
|
| Rate for Payer: PHP Medicare Advantage |
$331.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$567.11
|
| Rate for Payer: Priority Health Medicare |
$331.35
|
| Rate for Payer: Priority Health Narrow Network |
$567.11
|
| Rate for Payer: Railroad Medicare Medicare |
$331.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$640.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$331.35
|
| Rate for Payer: UHC Exchange |
$640.39
|
| Rate for Payer: UHC Medicaid |
$213.00
|
| Rate for Payer: UHCCP DNSP |
$331.35
|
| Rate for Payer: UHCCP Medicaid |
$213.00
|
|
|
PR INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE
|
Professional
|
Both
|
$2,579.00
|
|
|
Service Code
|
HCPCS 33975
|
| Min. Negotiated Rate |
$751.25 |
| Max. Negotiated Rate |
$2,339.34 |
| Rate for Payer: Aetna Commercial |
$1,594.39
|
| Rate for Payer: Aetna Medicare |
$1,189.84
|
| Rate for Payer: BCBS Complete |
$788.81
|
| Rate for Payer: BCBS MAPPO |
$1,189.84
|
| Rate for Payer: BCN Commercial |
$1,908.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,189.84
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cofinity Commercial |
$1,713.37
|
| Rate for Payer: Cofinity Commercial |
$1,594.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,189.84
|
| Rate for Payer: Healthscope Commercial |
$1,427.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,427.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,249.33
|
| Rate for Payer: Meridian Medicaid |
$788.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,308.82
|
| Rate for Payer: Nomi Health Commercial |
$1,427.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,934.25
|
| Rate for Payer: PACE SWMI |
$1,189.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,189.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,052.63
|
| Rate for Payer: Priority Health Medicare |
$1,189.84
|
| Rate for Payer: Priority Health Narrow Network |
$2,052.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,189.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,339.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,189.84
|
| Rate for Payer: UHC Exchange |
$2,339.34
|
| Rate for Payer: UHC Medicaid |
$751.25
|
| Rate for Payer: UHCCP DNSP |
$1,189.84
|
| Rate for Payer: UHCCP Medicaid |
$751.25
|
|
|
PR INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL
|
Professional
|
Both
|
$1,559.00
|
|
|
Service Code
|
HCPCS 33206
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$1,169.25 |
| Rate for Payer: Aetna Commercial |
$534.85
|
| Rate for Payer: Aetna Medicare |
$399.14
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$399.14
|
| Rate for Payer: BCN Commercial |
$670.78
|
| Rate for Payer: BCN Medicare Advantage |
$399.14
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cofinity Commercial |
$574.76
|
| Rate for Payer: Cofinity Commercial |
$534.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.14
|
| Rate for Payer: Healthscope Commercial |
$478.97
|
| Rate for Payer: Healthscope Whirlpool |
$478.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.10
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.05
|
| Rate for Payer: Nomi Health Commercial |
$478.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,169.25
|
| Rate for Payer: PACE SWMI |
$399.14
|
| Rate for Payer: PHP Medicare Advantage |
$399.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$721.34
|
| Rate for Payer: Priority Health Medicare |
$399.14
|
| Rate for Payer: Priority Health Narrow Network |
$721.34
|
| Rate for Payer: Railroad Medicare Medicare |
$399.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$803.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$399.14
|
| Rate for Payer: UHC Exchange |
$803.74
|
| Rate for Payer: UHC Medicaid |
$256.45
|
| Rate for Payer: UHCCP DNSP |
$399.14
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
|
|
PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 33208
|
| Min. Negotiated Rate |
$290.75 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$608.99
|
| Rate for Payer: Aetna Medicare |
$454.47
|
| Rate for Payer: BCBS Complete |
$305.29
|
| Rate for Payer: BCBS MAPPO |
$454.47
|
| Rate for Payer: BCN Commercial |
$761.91
|
| Rate for Payer: BCN Medicare Advantage |
$454.47
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$654.44
|
| Rate for Payer: Cofinity Commercial |
$608.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.47
|
| Rate for Payer: Healthscope Commercial |
$545.36
|
| Rate for Payer: Healthscope Whirlpool |
$545.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.19
|
| Rate for Payer: Meridian Medicaid |
$305.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$499.92
|
| Rate for Payer: Nomi Health Commercial |
$545.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$454.47
|
| Rate for Payer: PHP Medicare Advantage |
$454.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$819.34
|
| Rate for Payer: Priority Health Medicare |
$454.47
|
| Rate for Payer: Priority Health Narrow Network |
$819.34
|
| Rate for Payer: Railroad Medicare Medicare |
$454.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$924.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$454.47
|
| Rate for Payer: UHC Exchange |
$924.79
|
| Rate for Payer: UHC Medicaid |
$290.75
|
| Rate for Payer: UHCCP DNSP |
$454.47
|
| Rate for Payer: UHCCP Medicaid |
$290.75
|
|
|
PR INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR
|
Professional
|
Both
|
$1,870.00
|
|
|
Service Code
|
HCPCS 33207
|
| Min. Negotiated Rate |
$269.23 |
| Max. Negotiated Rate |
$1,402.50 |
| Rate for Payer: Aetna Commercial |
$563.35
|
| Rate for Payer: Aetna Medicare |
$420.41
|
| Rate for Payer: BCBS Complete |
$282.69
|
| Rate for Payer: BCBS MAPPO |
$420.41
|
| Rate for Payer: BCN Commercial |
$705.64
|
| Rate for Payer: BCN Medicare Advantage |
$420.41
|
| Rate for Payer: Cash Price |
$1,496.00
|
| Rate for Payer: Cash Price |
$1,496.00
|
| Rate for Payer: Cofinity Commercial |
$605.39
|
| Rate for Payer: Cofinity Commercial |
$563.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.41
|
| Rate for Payer: Healthscope Commercial |
$504.49
|
| Rate for Payer: Healthscope Whirlpool |
$504.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.43
|
| Rate for Payer: Meridian Medicaid |
$282.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$462.45
|
| Rate for Payer: Nomi Health Commercial |
$504.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,402.50
|
| Rate for Payer: PACE SWMI |
$420.41
|
| Rate for Payer: PHP Medicare Advantage |
$420.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$758.83
|
| Rate for Payer: Priority Health Medicare |
$420.41
|
| Rate for Payer: Priority Health Narrow Network |
$758.83
|
| Rate for Payer: Railroad Medicare Medicare |
$420.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$850.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.41
|
| Rate for Payer: UHC Exchange |
$850.53
|
| Rate for Payer: UHC Medicaid |
$269.23
|
| Rate for Payer: UHCCP DNSP |
$420.41
|
| Rate for Payer: UHCCP Medicaid |
$269.23
|
|
|
PR INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS
|
Professional
|
Both
|
$1,309.00
|
|
|
Service Code
|
HCPCS 33213
|
| Min. Negotiated Rate |
$193.62 |
| Max. Negotiated Rate |
$981.75 |
| Rate for Payer: Aetna Commercial |
$403.30
|
| Rate for Payer: Aetna Medicare |
$300.97
|
| Rate for Payer: BCBS Complete |
$203.30
|
| Rate for Payer: BCBS MAPPO |
$300.97
|
| Rate for Payer: BCN Commercial |
$498.48
|
| Rate for Payer: BCN Medicare Advantage |
$300.97
|
| Rate for Payer: Cash Price |
$1,047.20
|
| Rate for Payer: Cash Price |
$1,047.20
|
| Rate for Payer: Cofinity Commercial |
$433.40
|
| Rate for Payer: Cofinity Commercial |
$403.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.97
|
| Rate for Payer: Healthscope Commercial |
$361.16
|
| Rate for Payer: Healthscope Whirlpool |
$361.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.02
|
| Rate for Payer: Meridian Medicaid |
$203.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$331.07
|
| Rate for Payer: Nomi Health Commercial |
$361.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$981.75
|
| Rate for Payer: PACE SWMI |
$300.97
|
| Rate for Payer: PHP Medicare Advantage |
$300.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$536.05
|
| Rate for Payer: Priority Health Medicare |
$300.97
|
| Rate for Payer: Priority Health Narrow Network |
$536.05
|
| Rate for Payer: Railroad Medicare Medicare |
$300.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$593.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$300.97
|
| Rate for Payer: UHC Exchange |
$593.43
|
| Rate for Payer: UHC Medicaid |
$193.62
|
| Rate for Payer: UHCCP DNSP |
$300.97
|
| Rate for Payer: UHCCP Medicaid |
$193.62
|
|
|
PR INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS
|
Professional
|
Both
|
$766.00
|
|
|
Service Code
|
HCPCS 33221
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$638.89 |
| Rate for Payer: Aetna Commercial |
$423.37
|
| Rate for Payer: Aetna Medicare |
$315.95
|
| Rate for Payer: BCBS Complete |
$213.36
|
| Rate for Payer: BCBS MAPPO |
$315.95
|
| Rate for Payer: BCN Commercial |
$526.86
|
| Rate for Payer: BCN Medicare Advantage |
$315.95
|
| Rate for Payer: Cash Price |
$612.80
|
| Rate for Payer: Cash Price |
$612.80
|
| Rate for Payer: Cofinity Commercial |
$454.97
|
| Rate for Payer: Cofinity Commercial |
$423.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.95
|
| Rate for Payer: Healthscope Commercial |
$379.14
|
| Rate for Payer: Healthscope Whirlpool |
$379.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.75
|
| Rate for Payer: Meridian Medicaid |
$213.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$347.55
|
| Rate for Payer: Nomi Health Commercial |
$379.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$574.50
|
| Rate for Payer: PACE SWMI |
$315.95
|
| Rate for Payer: PHP Medicare Advantage |
$315.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$566.58
|
| Rate for Payer: Priority Health Medicare |
$315.95
|
| Rate for Payer: Priority Health Narrow Network |
$566.58
|
| Rate for Payer: Railroad Medicare Medicare |
$315.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$315.95
|
| Rate for Payer: UHC Exchange |
$638.89
|
| Rate for Payer: UHC Medicaid |
$203.20
|
| Rate for Payer: UHCCP DNSP |
$315.95
|
| Rate for Payer: UHCCP Medicaid |
$203.20
|
|
|
PR INS PM PLS GEN W/EXIST SINGLE LEAD
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 33212
|
| Min. Negotiated Rate |
$186.38 |
| Max. Negotiated Rate |
$865.50 |
| Rate for Payer: Aetna Commercial |
$387.77
|
| Rate for Payer: Aetna Medicare |
$289.38
|
| Rate for Payer: BCBS Complete |
$195.70
|
| Rate for Payer: BCBS MAPPO |
$289.38
|
| Rate for Payer: BCN Commercial |
$479.06
|
| Rate for Payer: BCN Medicare Advantage |
$289.38
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$416.71
|
| Rate for Payer: Cofinity Commercial |
$387.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.38
|
| Rate for Payer: Healthscope Commercial |
$347.26
|
| Rate for Payer: Healthscope Whirlpool |
$347.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.85
|
| Rate for Payer: Meridian Medicaid |
$195.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.32
|
| Rate for Payer: Nomi Health Commercial |
$347.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$865.50
|
| Rate for Payer: PACE SWMI |
$289.38
|
| Rate for Payer: PHP Medicare Advantage |
$289.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$515.16
|
| Rate for Payer: Priority Health Medicare |
$289.38
|
| Rate for Payer: Priority Health Narrow Network |
$515.16
|
| Rate for Payer: Railroad Medicare Medicare |
$289.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$568.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$289.38
|
| Rate for Payer: UHC Exchange |
$568.11
|
| Rate for Payer: UHC Medicaid |
$186.38
|
| Rate for Payer: UHCCP DNSP |
$289.38
|
| Rate for Payer: UHCCP Medicaid |
$186.38
|
|
|
PR INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD
|
Professional
|
Both
|
$1,211.00
|
|
|
Service Code
|
HCPCS 33270
|
| Min. Negotiated Rate |
$314.39 |
| Max. Negotiated Rate |
$1,003.11 |
| Rate for Payer: Aetna Commercial |
$657.79
|
| Rate for Payer: Aetna Medicare |
$490.89
|
| Rate for Payer: BCBS Complete |
$330.11
|
| Rate for Payer: BCBS MAPPO |
$490.89
|
| Rate for Payer: BCN Commercial |
$824.66
|
| Rate for Payer: BCN Medicare Advantage |
$490.89
|
| Rate for Payer: Cash Price |
$968.80
|
| Rate for Payer: Cash Price |
$968.80
|
| Rate for Payer: Cofinity Commercial |
$706.88
|
| Rate for Payer: Cofinity Commercial |
$657.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.89
|
| Rate for Payer: Healthscope Commercial |
$589.07
|
| Rate for Payer: Healthscope Whirlpool |
$589.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$515.43
|
| Rate for Payer: Meridian Medicaid |
$330.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$539.98
|
| Rate for Payer: Nomi Health Commercial |
$589.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$908.25
|
| Rate for Payer: PACE SWMI |
$490.89
|
| Rate for Payer: PHP Medicare Advantage |
$490.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$886.82
|
| Rate for Payer: Priority Health Medicare |
$490.89
|
| Rate for Payer: Priority Health Narrow Network |
$886.82
|
| Rate for Payer: Railroad Medicare Medicare |
$490.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,003.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$490.89
|
| Rate for Payer: UHC Exchange |
$1,003.11
|
| Rate for Payer: UHC Medicaid |
$314.39
|
| Rate for Payer: UHCCP DNSP |
$490.89
|
| Rate for Payer: UHCCP Medicaid |
$314.39
|
|
|
PR INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN
|
Professional
|
Both
|
$1,025.00
|
|
|
Service Code
|
HCPCS 64590
|
| Min. Negotiated Rate |
$170.19 |
| Max. Negotiated Rate |
$768.75 |
| Rate for Payer: Aetna Commercial |
$352.90
|
| Rate for Payer: Aetna Medicare |
$263.36
|
| Rate for Payer: BCBS Complete |
$178.70
|
| Rate for Payer: BCBS MAPPO |
$263.36
|
| Rate for Payer: BCN Commercial |
$441.71
|
| Rate for Payer: BCN Medicare Advantage |
$263.36
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cofinity Commercial |
$352.90
|
| Rate for Payer: Cofinity Commercial |
$379.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.36
|
| Rate for Payer: Healthscope Commercial |
$316.03
|
| Rate for Payer: Healthscope Whirlpool |
$316.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.53
|
| Rate for Payer: Meridian Medicaid |
$178.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$289.70
|
| Rate for Payer: Nomi Health Commercial |
$316.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$768.75
|
| Rate for Payer: PACE SWMI |
$263.36
|
| Rate for Payer: PHP Medicare Advantage |
$263.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$513.03
|
| Rate for Payer: Priority Health Medicare |
$263.36
|
| Rate for Payer: Priority Health Narrow Network |
$513.03
|
| Rate for Payer: Railroad Medicare Medicare |
$263.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$263.36
|
| Rate for Payer: UHC Exchange |
$280.91
|
| Rate for Payer: UHC Medicaid |
$170.19
|
| Rate for Payer: UHCCP DNSP |
$263.36
|
| Rate for Payer: UHCCP Medicaid |
$170.19
|
|
|
PR INSRT CH WALL RESPIR ELTRD/RA & CONJ PULSE GEN
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 0466T
|
| Min. Negotiated Rate |
$200.00 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: BCBS Complete |
$200.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.00
|
|
|
PR INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY
|
Professional
|
Both
|
$219.00
|
|
|
Service Code
|
HCPCS 32562
|
| Min. Negotiated Rate |
$34.29 |
| Max. Negotiated Rate |
$164.25 |
| Rate for Payer: Aetna Commercial |
$71.76
|
| Rate for Payer: Aetna Medicare |
$53.55
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$53.55
|
| Rate for Payer: BCN Commercial |
$88.14
|
| Rate for Payer: BCN Medicare Advantage |
$53.55
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$71.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.55
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Healthscope Whirlpool |
$64.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.23
|
| Rate for Payer: Meridian Medicaid |
$36.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.91
|
| Rate for Payer: Nomi Health Commercial |
$64.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.25
|
| Rate for Payer: PACE SWMI |
$53.55
|
| Rate for Payer: PHP Medicare Advantage |
$53.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.00
|
| Rate for Payer: Priority Health Medicare |
$53.55
|
| Rate for Payer: Priority Health Narrow Network |
$83.00
|
| Rate for Payer: Railroad Medicare Medicare |
$53.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53.55
|
| Rate for Payer: UHC Exchange |
$107.86
|
| Rate for Payer: UHC Medicaid |
$34.29
|
| Rate for Payer: UHCCP DNSP |
$53.55
|
| Rate for Payer: UHCCP Medicaid |
$34.29
|
|
|
PR INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS
|
Professional
|
Both
|
$469.00
|
|
|
Service Code
|
HCPCS 32560
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$351.75 |
| Rate for Payer: Aetna Commercial |
$91.83
|
| Rate for Payer: Aetna Medicare |
$68.53
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$68.53
|
| Rate for Payer: BCN Commercial |
$111.55
|
| Rate for Payer: BCN Medicare Advantage |
$68.53
|
| Rate for Payer: Cash Price |
$375.20
|
| Rate for Payer: Cash Price |
$375.20
|
| Rate for Payer: Cofinity Commercial |
$98.68
|
| Rate for Payer: Cofinity Commercial |
$91.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.53
|
| Rate for Payer: Healthscope Commercial |
$82.24
|
| Rate for Payer: Healthscope Whirlpool |
$82.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.96
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.38
|
| Rate for Payer: Nomi Health Commercial |
$82.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.75
|
| Rate for Payer: PACE SWMI |
$68.53
|
| Rate for Payer: PHP Medicare Advantage |
$68.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$105.05
|
| Rate for Payer: Priority Health Medicare |
$68.53
|
| Rate for Payer: Priority Health Narrow Network |
$105.05
|
| Rate for Payer: Railroad Medicare Medicare |
$68.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$68.53
|
| Rate for Payer: UHC Exchange |
$138.77
|
| Rate for Payer: UHC Medicaid |
$43.67
|
| Rate for Payer: UHCCP DNSP |
$68.53
|
| Rate for Payer: UHCCP Medicaid |
$43.67
|
|
|
PR INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 32561
|
| Min. Negotiated Rate |
$38.34 |
| Max. Negotiated Rate |
$177.75 |
| Rate for Payer: Aetna Commercial |
$80.31
|
| Rate for Payer: Aetna Medicare |
$59.93
|
| Rate for Payer: BCBS Complete |
$40.26
|
| Rate for Payer: BCBS MAPPO |
$59.93
|
| Rate for Payer: BCN Commercial |
$99.10
|
| Rate for Payer: BCN Medicare Advantage |
$59.93
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$86.30
|
| Rate for Payer: Cofinity Commercial |
$80.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$71.92
|
| Rate for Payer: Healthscope Whirlpool |
$71.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.93
|
| Rate for Payer: Meridian Medicaid |
$40.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.92
|
| Rate for Payer: Nomi Health Commercial |
$71.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: PACE SWMI |
$59.93
|
| Rate for Payer: PHP Medicare Advantage |
$59.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.32
|
| Rate for Payer: Priority Health Medicare |
$59.93
|
| Rate for Payer: Priority Health Narrow Network |
$93.32
|
| Rate for Payer: Railroad Medicare Medicare |
$59.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.93
|
| Rate for Payer: UHC Exchange |
$120.15
|
| Rate for Payer: UHC Medicaid |
$38.34
|
| Rate for Payer: UHCCP DNSP |
$59.93
|
| Rate for Payer: UHCCP Medicaid |
$38.34
|
|
|
PR INSTRUMENT BASED OCULAR SCR BI W/ONSITE ANALYSIS
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 99177
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$8.25 |
| Rate for Payer: Aetna Commercial |
$4.57
|
| Rate for Payer: BCN Commercial |
$7.47
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6.89
|
| Rate for Payer: Priority Health Narrow Network |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.47
|
| Rate for Payer: UHC Exchange |
$5.47
|
|
|
PR INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 99174
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: BCN Commercial |
$9.46
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8.73
|
| Rate for Payer: Priority Health Narrow Network |
$8.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.72
|
| Rate for Payer: UHC Exchange |
$6.72
|
|
|
PR INSULIN INJECTION
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS J1815
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$0.30
|
| Rate for Payer: BCBS Trust/PPO |
$0.04
|
| Rate for Payer: BCN Commercial |
$0.04
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.22
|
| Rate for Payer: UHC Exchange |
$0.22
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT DIRECT
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 48520
|
| Min. Negotiated Rate |
$659.66 |
| Max. Negotiated Rate |
$2,013.83 |
| Rate for Payer: Aetna Commercial |
$1,380.28
|
| Rate for Payer: Aetna Medicare |
$1,030.06
|
| Rate for Payer: BCBS Complete |
$692.64
|
| Rate for Payer: BCBS MAPPO |
$1,030.06
|
| Rate for Payer: BCN Commercial |
$1,652.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,030.06
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cofinity Commercial |
$1,380.28
|
| Rate for Payer: Cofinity Commercial |
$1,483.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,030.06
|
| Rate for Payer: Healthscope Commercial |
$1,236.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,236.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,081.56
|
| Rate for Payer: Meridian Medicaid |
$692.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,133.07
|
| Rate for Payer: Nomi Health Commercial |
$1,236.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,518.75
|
| Rate for Payer: PACE SWMI |
$1,030.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,030.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,013.83
|
| Rate for Payer: Priority Health Medicare |
$1,030.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,013.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,030.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,950.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,030.06
|
| Rate for Payer: UHC Exchange |
$1,950.49
|
| Rate for Payer: UHC Medicaid |
$659.66
|
| Rate for Payer: UHCCP DNSP |
$1,030.06
|
| Rate for Payer: UHCCP Medicaid |
$659.66
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y
|
Professional
|
Both
|
$2,974.00
|
|
|
Service Code
|
HCPCS 48540
|
| Min. Negotiated Rate |
$778.30 |
| Max. Negotiated Rate |
$2,391.24 |
| Rate for Payer: Aetna Commercial |
$1,631.73
|
| Rate for Payer: Aetna Medicare |
$1,217.71
|
| Rate for Payer: BCBS Complete |
$817.22
|
| Rate for Payer: BCBS MAPPO |
$1,217.71
|
| Rate for Payer: BCN Commercial |
$1,962.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,217.71
|
| Rate for Payer: Cash Price |
$2,379.20
|
| Rate for Payer: Cash Price |
$2,379.20
|
| Rate for Payer: Cofinity Commercial |
$1,631.73
|
| Rate for Payer: Cofinity Commercial |
$1,753.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,217.71
|
| Rate for Payer: Healthscope Commercial |
$1,461.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,461.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,278.60
|
| Rate for Payer: Meridian Medicaid |
$817.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,339.48
|
| Rate for Payer: Nomi Health Commercial |
$1,461.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,230.50
|
| Rate for Payer: PACE SWMI |
$1,217.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,217.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,391.24
|
| Rate for Payer: Priority Health Medicare |
$1,217.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,391.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,217.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,342.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,217.71
|
| Rate for Payer: UHC Exchange |
$2,342.42
|
| Rate for Payer: UHC Medicaid |
$778.30
|
| Rate for Payer: UHCCP DNSP |
$1,217.71
|
| Rate for Payer: UHCCP Medicaid |
$778.30
|
|
