|
PR KO IMMOB CANVAS LONG PRE OTS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS L1830
|
| Min. Negotiated Rate |
$33.34 |
| Max. Negotiated Rate |
$129.21 |
| Rate for Payer: Aetna Commercial |
$120.24
|
| Rate for Payer: Aetna Medicare |
$89.73
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$89.73
|
| Rate for Payer: BCN Commercial |
$66.88
|
| Rate for Payer: BCN Medicare Advantage |
$89.73
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$120.24
|
| Rate for Payer: Cofinity Commercial |
$129.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.73
|
| Rate for Payer: Healthscope Commercial |
$107.68
|
| Rate for Payer: Healthscope Whirlpool |
$107.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.70
|
| Rate for Payer: Nomi Health Commercial |
$107.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$89.73
|
| Rate for Payer: PHP Medicare Advantage |
$89.73
|
| Rate for Payer: Priority Health Medicare |
$89.73
|
| Rate for Payer: Railroad Medicare Medicare |
$89.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.73
|
| Rate for Payer: UHC Exchange |
$33.34
|
| Rate for Payer: UHCCP DNSP |
$89.73
|
|
|
PR KYBELLA
|
Professional
|
Both
|
$630.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$252.00 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: BCBS Complete |
$252.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
|
|
PR KYLEENA, 19.5 MG
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS Q9984
|
| Min. Negotiated Rate |
$361.20 |
| Max. Negotiated Rate |
$677.25 |
| Rate for Payer: BCBS Complete |
$361.20
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$677.25
|
|
|
PR KYLEENA, 19.5 MG
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS J7296
|
| Min. Negotiated Rate |
$1,101.70 |
| Max. Negotiated Rate |
$1,351.89 |
| Rate for Payer: Aetna Commercial |
$1,101.70
|
| Rate for Payer: BCBS Complete |
$1,351.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.57
|
| Rate for Payer: BCN Commercial |
$1,236.73
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Meridian Medicaid |
$1,351.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,137.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,287.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,272.44
|
| Rate for Payer: UHC Exchange |
$1,272.44
|
| Rate for Payer: UHC Medicaid |
$1,287.51
|
| Rate for Payer: UHCCP Medicaid |
$1,287.51
|
|
|
PR KYPHECTOMY SINGLE OR TWO SEGMENTS
|
Professional
|
Both
|
$13,314.00
|
|
|
Service Code
|
HCPCS 22818
|
| Min. Negotiated Rate |
$1,219.21 |
| Max. Negotiated Rate |
$9,985.50 |
| Rate for Payer: Aetna Commercial |
$2,538.38
|
| Rate for Payer: Aetna Medicare |
$1,894.31
|
| Rate for Payer: BCBS Complete |
$1,280.17
|
| Rate for Payer: BCBS MAPPO |
$1,894.31
|
| Rate for Payer: BCN Commercial |
$3,230.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,894.31
|
| Rate for Payer: Cash Price |
$10,651.20
|
| Rate for Payer: Cash Price |
$10,651.20
|
| Rate for Payer: Cofinity Commercial |
$2,727.81
|
| Rate for Payer: Cofinity Commercial |
$2,538.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,894.31
|
| Rate for Payer: Healthscope Commercial |
$2,273.17
|
| Rate for Payer: Healthscope Whirlpool |
$2,273.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,989.03
|
| Rate for Payer: Meridian Medicaid |
$1,280.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,083.74
|
| Rate for Payer: Nomi Health Commercial |
$2,273.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,985.50
|
| Rate for Payer: PACE SWMI |
$1,894.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,894.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,219.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,453.74
|
| Rate for Payer: Priority Health Medicare |
$1,894.31
|
| Rate for Payer: Priority Health Narrow Network |
$3,453.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,894.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,819.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,894.31
|
| Rate for Payer: UHC Exchange |
$3,819.49
|
| Rate for Payer: UHC Medicaid |
$1,219.21
|
| Rate for Payer: UHCCP DNSP |
$1,894.31
|
| Rate for Payer: UHCCP Medicaid |
$1,219.21
|
|
|
PR LABYRINTHOTOMY TRANSCANAL
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
HCPCS 69801
|
| Min. Negotiated Rate |
$68.59 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Commercial |
$142.21
|
| Rate for Payer: Aetna Medicare |
$106.13
|
| Rate for Payer: BCBS Complete |
$72.02
|
| Rate for Payer: BCBS MAPPO |
$106.13
|
| Rate for Payer: BCN Commercial |
$186.75
|
| Rate for Payer: BCN Medicare Advantage |
$106.13
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Cofinity Commercial |
$152.83
|
| Rate for Payer: Cofinity Commercial |
$142.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.13
|
| Rate for Payer: Healthscope Commercial |
$127.36
|
| Rate for Payer: Healthscope Whirlpool |
$127.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.44
|
| Rate for Payer: Meridian Medicaid |
$72.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.74
|
| Rate for Payer: Nomi Health Commercial |
$127.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.00
|
| Rate for Payer: PACE SWMI |
$106.13
|
| Rate for Payer: PHP Medicare Advantage |
$106.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$184.52
|
| Rate for Payer: Priority Health Medicare |
$106.13
|
| Rate for Payer: Priority Health Narrow Network |
$184.52
|
| Rate for Payer: Railroad Medicare Medicare |
$106.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.13
|
| Rate for Payer: UHC Exchange |
$216.46
|
| Rate for Payer: UHC Medicaid |
$68.59
|
| Rate for Payer: UHCCP DNSP |
$106.13
|
| Rate for Payer: UHCCP Medicaid |
$68.59
|
|
|
PR LAIV3 VACCINE LIVE FOR INTRANASAL USE
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS 90660
|
| Min. Negotiated Rate |
$24.91 |
| Max. Negotiated Rate |
$53.25 |
| Rate for Payer: Aetna Commercial |
$39.81
|
| Rate for Payer: Aetna Medicare |
$29.71
|
| Rate for Payer: BCBS MAPPO |
$29.71
|
| Rate for Payer: BCBS Trust/PPO |
$26.19
|
| Rate for Payer: BCN Commercial |
$24.91
|
| Rate for Payer: BCN Medicare Advantage |
$29.71
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$42.78
|
| Rate for Payer: Cofinity Commercial |
$39.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$35.65
|
| Rate for Payer: Healthscope Whirlpool |
$35.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.68
|
| Rate for Payer: Nomi Health Commercial |
$35.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.25
|
| Rate for Payer: PACE SWMI |
$29.71
|
| Rate for Payer: PHP Medicare Advantage |
$29.71
|
| Rate for Payer: Priority Health Medicare |
$29.71
|
| Rate for Payer: Railroad Medicare Medicare |
$29.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.71
|
| Rate for Payer: UHC Exchange |
$25.44
|
| Rate for Payer: UHCCP DNSP |
$29.71
|
|
|
PR LAIV4 VACCINE FOR INTRANASAL USE
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 90672
|
| Min. Negotiated Rate |
$23.98 |
| Max. Negotiated Rate |
$27.79 |
| Rate for Payer: Aetna Commercial |
$27.79
|
| Rate for Payer: BCBS Trust/PPO |
$24.50
|
| Rate for Payer: BCN Commercial |
$23.98
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.79
|
| Rate for Payer: UHC Exchange |
$27.79
|
|
|
PR LAM BX/EXC ISPI NEO IDRL IMED CERVICAL
|
Professional
|
Both
|
$8,508.00
|
|
|
Service Code
|
HCPCS 63285
|
| Min. Negotiated Rate |
$1,609.64 |
| Max. Negotiated Rate |
$6,381.00 |
| Rate for Payer: Aetna Commercial |
$3,383.90
|
| Rate for Payer: Aetna Medicare |
$2,525.30
|
| Rate for Payer: BCBS Complete |
$1,690.12
|
| Rate for Payer: BCBS MAPPO |
$2,525.30
|
| Rate for Payer: BCN Commercial |
$4,368.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.30
|
| Rate for Payer: Cash Price |
$6,806.40
|
| Rate for Payer: Cash Price |
$6,806.40
|
| Rate for Payer: Cofinity Commercial |
$3,636.43
|
| Rate for Payer: Cofinity Commercial |
$3,383.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.30
|
| Rate for Payer: Healthscope Commercial |
$3,030.36
|
| Rate for Payer: Healthscope Whirlpool |
$3,030.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,651.57
|
| Rate for Payer: Meridian Medicaid |
$1,690.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,777.83
|
| Rate for Payer: Nomi Health Commercial |
$3,030.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,381.00
|
| Rate for Payer: PACE SWMI |
$2,525.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,609.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,618.49
|
| Rate for Payer: Priority Health Medicare |
$2,525.30
|
| Rate for Payer: Priority Health Narrow Network |
$4,618.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,624.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,525.30
|
| Rate for Payer: UHC Exchange |
$4,624.61
|
| Rate for Payer: UHC Medicaid |
$1,609.64
|
| Rate for Payer: UHCCP DNSP |
$2,525.30
|
| Rate for Payer: UHCCP Medicaid |
$1,609.64
|
|
|
PR LAM BX/EXC ISPI NEO IDRL IMED THORACIC
|
Professional
|
Both
|
$8,526.00
|
|
|
Service Code
|
HCPCS 63286
|
| Min. Negotiated Rate |
$1,590.68 |
| Max. Negotiated Rate |
$6,394.50 |
| Rate for Payer: Aetna Commercial |
$3,343.29
|
| Rate for Payer: Aetna Medicare |
$2,494.99
|
| Rate for Payer: BCBS Complete |
$1,670.21
|
| Rate for Payer: BCBS MAPPO |
$2,494.99
|
| Rate for Payer: BCN Commercial |
$4,318.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,494.99
|
| Rate for Payer: Cash Price |
$6,820.80
|
| Rate for Payer: Cash Price |
$6,820.80
|
| Rate for Payer: Cofinity Commercial |
$3,592.79
|
| Rate for Payer: Cofinity Commercial |
$3,343.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,494.99
|
| Rate for Payer: Healthscope Commercial |
$2,993.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,993.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,619.74
|
| Rate for Payer: Meridian Medicaid |
$1,670.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,744.49
|
| Rate for Payer: Nomi Health Commercial |
$2,993.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,394.50
|
| Rate for Payer: PACE SWMI |
$2,494.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,494.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,590.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,565.85
|
| Rate for Payer: Priority Health Medicare |
$2,494.99
|
| Rate for Payer: Priority Health Narrow Network |
$4,565.85
|
| Rate for Payer: Railroad Medicare Medicare |
$2,494.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,569.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,494.99
|
| Rate for Payer: UHC Exchange |
$4,569.19
|
| Rate for Payer: UHC Medicaid |
$1,590.68
|
| Rate for Payer: UHCCP DNSP |
$2,494.99
|
| Rate for Payer: UHCCP Medicaid |
$1,590.68
|
|
|
PR LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR
|
Professional
|
Both
|
$9,011.00
|
|
|
Service Code
|
HCPCS 63287
|
| Min. Negotiated Rate |
$1,684.19 |
| Max. Negotiated Rate |
$6,758.25 |
| Rate for Payer: Aetna Commercial |
$3,542.65
|
| Rate for Payer: Aetna Medicare |
$2,643.77
|
| Rate for Payer: BCBS Complete |
$1,768.40
|
| Rate for Payer: BCBS MAPPO |
$2,643.77
|
| Rate for Payer: BCN Commercial |
$4,578.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,643.77
|
| Rate for Payer: Cash Price |
$7,208.80
|
| Rate for Payer: Cash Price |
$7,208.80
|
| Rate for Payer: Cofinity Commercial |
$3,807.03
|
| Rate for Payer: Cofinity Commercial |
$3,542.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,643.77
|
| Rate for Payer: Healthscope Commercial |
$3,172.52
|
| Rate for Payer: Healthscope Whirlpool |
$3,172.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,775.96
|
| Rate for Payer: Meridian Medicaid |
$1,768.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,908.15
|
| Rate for Payer: Nomi Health Commercial |
$3,172.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,758.25
|
| Rate for Payer: PACE SWMI |
$2,643.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,643.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,684.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,840.59
|
| Rate for Payer: Priority Health Medicare |
$2,643.77
|
| Rate for Payer: Priority Health Narrow Network |
$4,840.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,643.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,855.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,643.77
|
| Rate for Payer: UHC Exchange |
$4,855.66
|
| Rate for Payer: UHC Medicaid |
$1,684.19
|
| Rate for Payer: UHCCP DNSP |
$2,643.77
|
| Rate for Payer: UHCCP Medicaid |
$1,684.19
|
|
|
PR LAM BX/EXC ISPI NEO IDRL SACRAL
|
Professional
|
Both
|
$6,474.00
|
|
|
Service Code
|
HCPCS 63283
|
| Min. Negotiated Rate |
$1,194.08 |
| Max. Negotiated Rate |
$4,855.50 |
| Rate for Payer: Aetna Commercial |
$2,498.93
|
| Rate for Payer: Aetna Medicare |
$1,864.87
|
| Rate for Payer: BCBS Complete |
$1,253.78
|
| Rate for Payer: BCBS MAPPO |
$1,864.87
|
| Rate for Payer: BCN Commercial |
$2,906.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,864.87
|
| Rate for Payer: Cash Price |
$5,179.20
|
| Rate for Payer: Cash Price |
$5,179.20
|
| Rate for Payer: Cofinity Commercial |
$2,685.41
|
| Rate for Payer: Cofinity Commercial |
$2,498.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,864.87
|
| Rate for Payer: Healthscope Commercial |
$2,237.84
|
| Rate for Payer: Healthscope Whirlpool |
$2,237.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,958.11
|
| Rate for Payer: Meridian Medicaid |
$1,253.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,051.36
|
| Rate for Payer: Nomi Health Commercial |
$2,237.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,855.50
|
| Rate for Payer: PACE SWMI |
$1,864.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,864.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,194.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,376.10
|
| Rate for Payer: Priority Health Medicare |
$1,864.87
|
| Rate for Payer: Priority Health Narrow Network |
$3,376.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,864.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,347.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,864.87
|
| Rate for Payer: UHC Exchange |
$3,347.69
|
| Rate for Payer: UHC Medicaid |
$1,194.08
|
| Rate for Payer: UHCCP DNSP |
$1,864.87
|
| Rate for Payer: UHCCP Medicaid |
$1,194.08
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED CERVICAL
|
Professional
|
Both
|
$7,817.00
|
|
|
Service Code
|
HCPCS 63280
|
| Min. Negotiated Rate |
$1,315.28 |
| Max. Negotiated Rate |
$5,862.75 |
| Rate for Payer: Aetna Commercial |
$2,757.01
|
| Rate for Payer: Aetna Medicare |
$2,057.47
|
| Rate for Payer: BCBS Complete |
$1,381.04
|
| Rate for Payer: BCBS MAPPO |
$2,057.47
|
| Rate for Payer: BCN Commercial |
$3,537.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,057.47
|
| Rate for Payer: Cash Price |
$6,253.60
|
| Rate for Payer: Cash Price |
$6,253.60
|
| Rate for Payer: Cofinity Commercial |
$2,962.76
|
| Rate for Payer: Cofinity Commercial |
$2,757.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,057.47
|
| Rate for Payer: Healthscope Commercial |
$2,468.96
|
| Rate for Payer: Healthscope Whirlpool |
$2,468.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,160.34
|
| Rate for Payer: Meridian Medicaid |
$1,381.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,263.22
|
| Rate for Payer: Nomi Health Commercial |
$2,468.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,862.75
|
| Rate for Payer: PACE SWMI |
$2,057.47
|
| Rate for Payer: PHP Medicare Advantage |
$2,057.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,315.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,740.49
|
| Rate for Payer: Priority Health Medicare |
$2,057.47
|
| Rate for Payer: Priority Health Narrow Network |
$3,740.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,057.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,738.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,057.47
|
| Rate for Payer: UHC Exchange |
$3,738.39
|
| Rate for Payer: UHC Medicaid |
$1,315.28
|
| Rate for Payer: UHCCP DNSP |
$2,057.47
|
| Rate for Payer: UHCCP Medicaid |
$1,315.28
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED LUMBAR
|
Professional
|
Both
|
$8,241.00
|
|
|
Service Code
|
HCPCS 63282
|
| Min. Negotiated Rate |
$1,235.83 |
| Max. Negotiated Rate |
$6,180.75 |
| Rate for Payer: Aetna Commercial |
$2,588.09
|
| Rate for Payer: Aetna Medicare |
$1,931.41
|
| Rate for Payer: BCBS Complete |
$1,297.62
|
| Rate for Payer: BCBS MAPPO |
$1,931.41
|
| Rate for Payer: BCN Commercial |
$3,323.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,931.41
|
| Rate for Payer: Cash Price |
$6,592.80
|
| Rate for Payer: Cash Price |
$6,592.80
|
| Rate for Payer: Cofinity Commercial |
$2,781.23
|
| Rate for Payer: Cofinity Commercial |
$2,588.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,931.41
|
| Rate for Payer: Healthscope Commercial |
$2,317.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,317.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,027.98
|
| Rate for Payer: Meridian Medicaid |
$1,297.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,124.55
|
| Rate for Payer: Nomi Health Commercial |
$2,317.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,180.75
|
| Rate for Payer: PACE SWMI |
$1,931.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,931.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,235.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,513.75
|
| Rate for Payer: Priority Health Medicare |
$1,931.41
|
| Rate for Payer: Priority Health Narrow Network |
$3,513.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,931.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,483.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,931.41
|
| Rate for Payer: UHC Exchange |
$3,483.62
|
| Rate for Payer: UHC Medicaid |
$1,235.83
|
| Rate for Payer: UHCCP DNSP |
$1,931.41
|
| Rate for Payer: UHCCP Medicaid |
$1,235.83
|
|
|
PR LAM BX/EXC ISPI NEO IDRL XMED THORACIC
|
Professional
|
Both
|
$7,655.00
|
|
|
Service Code
|
HCPCS 63281
|
| Min. Negotiated Rate |
$1,305.05 |
| Max. Negotiated Rate |
$5,741.25 |
| Rate for Payer: Aetna Commercial |
$2,735.50
|
| Rate for Payer: Aetna Medicare |
$2,041.42
|
| Rate for Payer: BCBS Complete |
$1,370.30
|
| Rate for Payer: BCBS MAPPO |
$2,041.42
|
| Rate for Payer: BCN Commercial |
$3,512.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,041.42
|
| Rate for Payer: Cash Price |
$6,124.00
|
| Rate for Payer: Cash Price |
$6,124.00
|
| Rate for Payer: Cofinity Commercial |
$2,939.64
|
| Rate for Payer: Cofinity Commercial |
$2,735.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,041.42
|
| Rate for Payer: Healthscope Commercial |
$2,449.70
|
| Rate for Payer: Healthscope Whirlpool |
$2,449.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,143.49
|
| Rate for Payer: Meridian Medicaid |
$1,370.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,245.56
|
| Rate for Payer: Nomi Health Commercial |
$2,449.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,741.25
|
| Rate for Payer: PACE SWMI |
$2,041.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,041.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,305.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,713.31
|
| Rate for Payer: Priority Health Medicare |
$2,041.42
|
| Rate for Payer: Priority Health Narrow Network |
$3,713.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2,041.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,695.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,041.42
|
| Rate for Payer: UHC Exchange |
$3,695.05
|
| Rate for Payer: UHC Medicaid |
$1,305.05
|
| Rate for Payer: UHCCP DNSP |
$2,041.42
|
| Rate for Payer: UHCCP Medicaid |
$1,305.05
|
|
|
PR LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL
|
Professional
|
Both
|
$9,664.00
|
|
|
Service Code
|
HCPCS 63290
|
| Min. Negotiated Rate |
$1,711.88 |
| Max. Negotiated Rate |
$7,248.00 |
| Rate for Payer: Aetna Commercial |
$3,601.68
|
| Rate for Payer: Aetna Medicare |
$2,687.82
|
| Rate for Payer: BCBS Complete |
$1,797.47
|
| Rate for Payer: BCBS MAPPO |
$2,687.82
|
| Rate for Payer: BCN Commercial |
$4,655.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,687.82
|
| Rate for Payer: Cash Price |
$7,731.20
|
| Rate for Payer: Cash Price |
$7,731.20
|
| Rate for Payer: Cofinity Commercial |
$3,870.46
|
| Rate for Payer: Cofinity Commercial |
$3,601.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,687.82
|
| Rate for Payer: Healthscope Commercial |
$3,225.38
|
| Rate for Payer: Healthscope Whirlpool |
$3,225.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,822.21
|
| Rate for Payer: Meridian Medicaid |
$1,797.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,956.60
|
| Rate for Payer: Nomi Health Commercial |
$3,225.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,248.00
|
| Rate for Payer: PACE SWMI |
$2,687.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,687.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,711.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,922.15
|
| Rate for Payer: Priority Health Medicare |
$2,687.82
|
| Rate for Payer: Priority Health Narrow Network |
$4,922.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,687.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,939.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,687.82
|
| Rate for Payer: UHC Exchange |
$4,939.81
|
| Rate for Payer: UHC Medicaid |
$1,711.88
|
| Rate for Payer: UHCCP DNSP |
$2,687.82
|
| Rate for Payer: UHCCP Medicaid |
$1,711.88
|
|
|
PR LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR
|
Professional
|
Both
|
$5,581.00
|
|
|
Service Code
|
HCPCS 63267
|
| Min. Negotiated Rate |
$843.48 |
| Max. Negotiated Rate |
$4,185.75 |
| Rate for Payer: Aetna Commercial |
$1,756.89
|
| Rate for Payer: Aetna Medicare |
$1,311.11
|
| Rate for Payer: BCBS Complete |
$885.65
|
| Rate for Payer: BCBS MAPPO |
$1,311.11
|
| Rate for Payer: BCN Commercial |
$2,296.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,311.11
|
| Rate for Payer: Cash Price |
$4,464.80
|
| Rate for Payer: Cash Price |
$4,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,888.00
|
| Rate for Payer: Cofinity Commercial |
$1,756.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,311.11
|
| Rate for Payer: Healthscope Commercial |
$1,573.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,573.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,376.67
|
| Rate for Payer: Meridian Medicaid |
$885.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,442.22
|
| Rate for Payer: Nomi Health Commercial |
$1,573.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,185.75
|
| Rate for Payer: PACE SWMI |
$1,311.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,311.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$843.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,428.11
|
| Rate for Payer: Priority Health Medicare |
$1,311.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,428.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,311.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,416.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,311.11
|
| Rate for Payer: UHC Exchange |
$2,416.25
|
| Rate for Payer: UHC Medicaid |
$843.48
|
| Rate for Payer: UHCCP DNSP |
$1,311.11
|
| Rate for Payer: UHCCP Medicaid |
$843.48
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL
|
Professional
|
Both
|
$5,994.00
|
|
|
Service Code
|
HCPCS 63265
|
| Min. Negotiated Rate |
$1,029.00 |
| Max. Negotiated Rate |
$4,495.50 |
| Rate for Payer: Aetna Commercial |
$2,151.53
|
| Rate for Payer: Aetna Medicare |
$1,605.62
|
| Rate for Payer: BCBS Complete |
$1,080.45
|
| Rate for Payer: BCBS MAPPO |
$1,605.62
|
| Rate for Payer: BCN Commercial |
$2,784.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,605.62
|
| Rate for Payer: Cash Price |
$4,795.20
|
| Rate for Payer: Cash Price |
$4,795.20
|
| Rate for Payer: Cofinity Commercial |
$2,312.09
|
| Rate for Payer: Cofinity Commercial |
$2,151.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,605.62
|
| Rate for Payer: Healthscope Commercial |
$1,926.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,926.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,685.90
|
| Rate for Payer: Meridian Medicaid |
$1,080.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,766.18
|
| Rate for Payer: Nomi Health Commercial |
$1,926.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,495.50
|
| Rate for Payer: PACE SWMI |
$1,605.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,605.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,029.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,944.04
|
| Rate for Payer: Priority Health Medicare |
$1,605.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,944.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,605.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,944.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,605.62
|
| Rate for Payer: UHC Exchange |
$2,944.48
|
| Rate for Payer: UHC Medicaid |
$1,029.00
|
| Rate for Payer: UHCCP DNSP |
$1,605.62
|
| Rate for Payer: UHCCP Medicaid |
$1,029.00
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL
|
Professional
|
Both
|
$4,735.00
|
|
|
Service Code
|
HCPCS 63268
|
| Min. Negotiated Rate |
$929.53 |
| Max. Negotiated Rate |
$3,551.25 |
| Rate for Payer: Aetna Commercial |
$1,938.94
|
| Rate for Payer: Aetna Medicare |
$1,446.97
|
| Rate for Payer: BCBS Complete |
$976.01
|
| Rate for Payer: BCBS MAPPO |
$1,446.97
|
| Rate for Payer: BCN Commercial |
$2,460.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,446.97
|
| Rate for Payer: Cash Price |
$3,788.00
|
| Rate for Payer: Cash Price |
$3,788.00
|
| Rate for Payer: Cofinity Commercial |
$2,083.64
|
| Rate for Payer: Cofinity Commercial |
$1,938.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,446.97
|
| Rate for Payer: Healthscope Commercial |
$1,736.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,736.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,519.32
|
| Rate for Payer: Meridian Medicaid |
$976.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,591.67
|
| Rate for Payer: Nomi Health Commercial |
$1,736.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,551.25
|
| Rate for Payer: PACE SWMI |
$1,446.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,446.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$929.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,601.04
|
| Rate for Payer: Priority Health Medicare |
$1,446.97
|
| Rate for Payer: Priority Health Narrow Network |
$2,601.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,446.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,493.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,446.97
|
| Rate for Payer: UHC Exchange |
$2,493.33
|
| Rate for Payer: UHC Medicaid |
$929.53
|
| Rate for Payer: UHCCP DNSP |
$1,446.97
|
| Rate for Payer: UHCCP Medicaid |
$929.53
|
|
|
PR LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC
|
Professional
|
Both
|
$6,093.00
|
|
|
Service Code
|
HCPCS 63266
|
| Min. Negotiated Rate |
$1,057.33 |
| Max. Negotiated Rate |
$4,569.75 |
| Rate for Payer: Aetna Commercial |
$2,211.56
|
| Rate for Payer: Aetna Medicare |
$1,650.42
|
| Rate for Payer: BCBS Complete |
$1,110.20
|
| Rate for Payer: BCBS MAPPO |
$1,650.42
|
| Rate for Payer: BCN Commercial |
$2,870.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,650.42
|
| Rate for Payer: Cash Price |
$4,874.40
|
| Rate for Payer: Cash Price |
$4,874.40
|
| Rate for Payer: Cofinity Commercial |
$2,376.60
|
| Rate for Payer: Cofinity Commercial |
$2,211.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,650.42
|
| Rate for Payer: Healthscope Commercial |
$1,980.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,980.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,732.94
|
| Rate for Payer: Meridian Medicaid |
$1,110.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,815.46
|
| Rate for Payer: Nomi Health Commercial |
$1,980.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,569.75
|
| Rate for Payer: PACE SWMI |
$1,650.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,650.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,057.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,034.84
|
| Rate for Payer: Priority Health Medicare |
$1,650.42
|
| Rate for Payer: Priority Health Narrow Network |
$3,034.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,650.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,034.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,650.42
|
| Rate for Payer: UHC Exchange |
$3,034.80
|
| Rate for Payer: UHC Medicaid |
$1,057.33
|
| Rate for Payer: UHCCP DNSP |
$1,650.42
|
| Rate for Payer: UHCCP Medicaid |
$1,057.33
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL
|
Professional
|
Both
|
$6,397.00
|
|
|
Service Code
|
HCPCS 63270
|
| Min. Negotiated Rate |
$1,290.14 |
| Max. Negotiated Rate |
$4,797.75 |
| Rate for Payer: Aetna Commercial |
$2,706.96
|
| Rate for Payer: Aetna Medicare |
$2,020.12
|
| Rate for Payer: BCBS Complete |
$1,354.65
|
| Rate for Payer: BCBS MAPPO |
$2,020.12
|
| Rate for Payer: BCN Commercial |
$3,165.67
|
| Rate for Payer: BCN Medicare Advantage |
$2,020.12
|
| Rate for Payer: Cash Price |
$5,117.60
|
| Rate for Payer: Cash Price |
$5,117.60
|
| Rate for Payer: Cofinity Commercial |
$2,908.97
|
| Rate for Payer: Cofinity Commercial |
$2,706.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,020.12
|
| Rate for Payer: Healthscope Commercial |
$2,424.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,424.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,121.13
|
| Rate for Payer: Meridian Medicaid |
$1,354.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,222.13
|
| Rate for Payer: Nomi Health Commercial |
$2,424.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,797.75
|
| Rate for Payer: PACE SWMI |
$2,020.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,020.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,290.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,676.87
|
| Rate for Payer: Priority Health Medicare |
$2,020.12
|
| Rate for Payer: Priority Health Narrow Network |
$3,676.87
|
| Rate for Payer: Railroad Medicare Medicare |
$2,020.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,665.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,020.12
|
| Rate for Payer: UHC Exchange |
$3,665.36
|
| Rate for Payer: UHC Medicaid |
$1,290.14
|
| Rate for Payer: UHCCP DNSP |
$2,020.12
|
| Rate for Payer: UHCCP Medicaid |
$1,290.14
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR
|
Professional
|
Both
|
$6,742.00
|
|
|
Service Code
|
HCPCS 63272
|
| Min. Negotiated Rate |
$1,166.60 |
| Max. Negotiated Rate |
$5,056.50 |
| Rate for Payer: Aetna Commercial |
$2,444.37
|
| Rate for Payer: Aetna Medicare |
$1,824.16
|
| Rate for Payer: BCBS Complete |
$1,224.93
|
| Rate for Payer: BCBS MAPPO |
$1,824.16
|
| Rate for Payer: BCN Commercial |
$3,152.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,824.16
|
| Rate for Payer: Cash Price |
$5,393.60
|
| Rate for Payer: Cash Price |
$5,393.60
|
| Rate for Payer: Cofinity Commercial |
$2,626.79
|
| Rate for Payer: Cofinity Commercial |
$2,444.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,824.16
|
| Rate for Payer: Healthscope Commercial |
$2,188.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,188.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,915.37
|
| Rate for Payer: Meridian Medicaid |
$1,224.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,006.58
|
| Rate for Payer: Nomi Health Commercial |
$2,188.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,056.50
|
| Rate for Payer: PACE SWMI |
$1,824.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,824.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,166.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,333.30
|
| Rate for Payer: Priority Health Medicare |
$1,824.16
|
| Rate for Payer: Priority Health Narrow Network |
$3,333.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,824.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,331.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,824.16
|
| Rate for Payer: UHC Exchange |
$3,331.65
|
| Rate for Payer: UHC Medicaid |
$1,166.60
|
| Rate for Payer: UHCCP DNSP |
$1,824.16
|
| Rate for Payer: UHCCP Medicaid |
$1,166.60
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL
|
Professional
|
Both
|
$5,916.00
|
|
|
Service Code
|
HCPCS 63273
|
| Min. Negotiated Rate |
$1,167.24 |
| Max. Negotiated Rate |
$4,437.00 |
| Rate for Payer: Aetna Commercial |
$2,445.19
|
| Rate for Payer: Aetna Medicare |
$1,824.77
|
| Rate for Payer: BCBS Complete |
$1,225.60
|
| Rate for Payer: BCBS MAPPO |
$1,824.77
|
| Rate for Payer: BCN Commercial |
$3,131.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,824.77
|
| Rate for Payer: Cash Price |
$4,732.80
|
| Rate for Payer: Cash Price |
$4,732.80
|
| Rate for Payer: Cofinity Commercial |
$2,627.67
|
| Rate for Payer: Cofinity Commercial |
$2,445.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,824.77
|
| Rate for Payer: Healthscope Commercial |
$2,189.72
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,916.01
|
| Rate for Payer: Meridian Medicaid |
$1,225.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,007.25
|
| Rate for Payer: Nomi Health Commercial |
$2,189.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,437.00
|
| Rate for Payer: PACE SWMI |
$1,824.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,824.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,167.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,310.73
|
| Rate for Payer: Priority Health Medicare |
$1,824.77
|
| Rate for Payer: Priority Health Narrow Network |
$3,310.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,824.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,288.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,824.77
|
| Rate for Payer: UHC Exchange |
$3,288.67
|
| Rate for Payer: UHC Medicaid |
$1,167.24
|
| Rate for Payer: UHCCP DNSP |
$1,824.77
|
| Rate for Payer: UHCCP Medicaid |
$1,167.24
|
|
|
PR LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC
|
Professional
|
Both
|
$6,293.00
|
|
|
Service Code
|
HCPCS 63271
|
| Min. Negotiated Rate |
$1,283.33 |
| Max. Negotiated Rate |
$4,719.75 |
| Rate for Payer: Aetna Commercial |
$2,692.10
|
| Rate for Payer: Aetna Medicare |
$2,009.03
|
| Rate for Payer: BCBS Complete |
$1,347.50
|
| Rate for Payer: BCBS MAPPO |
$2,009.03
|
| Rate for Payer: BCN Commercial |
$3,473.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,009.03
|
| Rate for Payer: Cash Price |
$5,034.40
|
| Rate for Payer: Cash Price |
$5,034.40
|
| Rate for Payer: Cofinity Commercial |
$2,893.00
|
| Rate for Payer: Cofinity Commercial |
$2,692.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,009.03
|
| Rate for Payer: Healthscope Commercial |
$2,410.84
|
| Rate for Payer: Healthscope Whirlpool |
$2,410.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,109.48
|
| Rate for Payer: Meridian Medicaid |
$1,347.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,209.93
|
| Rate for Payer: Nomi Health Commercial |
$2,410.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,719.75
|
| Rate for Payer: PACE SWMI |
$2,009.03
|
| Rate for Payer: PHP Medicare Advantage |
$2,009.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,283.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,672.23
|
| Rate for Payer: Priority Health Medicare |
$2,009.03
|
| Rate for Payer: Priority Health Narrow Network |
$3,672.23
|
| Rate for Payer: Railroad Medicare Medicare |
$2,009.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,654.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,009.03
|
| Rate for Payer: UHC Exchange |
$3,654.77
|
| Rate for Payer: UHC Medicaid |
$1,283.33
|
| Rate for Payer: UHCCP DNSP |
$2,009.03
|
| Rate for Payer: UHCCP Medicaid |
$1,283.33
|
|
|
PR LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR
|
Professional
|
Both
|
$6,662.00
|
|
|
Service Code
|
HCPCS 63252
|
| Min. Negotiated Rate |
$1,851.82 |
| Max. Negotiated Rate |
$5,375.59 |
| Rate for Payer: Aetna Commercial |
$3,899.67
|
| Rate for Payer: Aetna Medicare |
$2,910.20
|
| Rate for Payer: BCBS Complete |
$1,944.41
|
| Rate for Payer: BCBS MAPPO |
$2,910.20
|
| Rate for Payer: BCN Commercial |
$4,598.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,910.20
|
| Rate for Payer: Cash Price |
$5,329.60
|
| Rate for Payer: Cash Price |
$5,329.60
|
| Rate for Payer: Cofinity Commercial |
$4,190.69
|
| Rate for Payer: Cofinity Commercial |
$3,899.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,910.20
|
| Rate for Payer: Healthscope Commercial |
$3,492.24
|
| Rate for Payer: Healthscope Whirlpool |
$3,492.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,055.71
|
| Rate for Payer: Meridian Medicaid |
$1,944.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,201.22
|
| Rate for Payer: Nomi Health Commercial |
$3,492.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,996.50
|
| Rate for Payer: PACE SWMI |
$2,910.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,910.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,851.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,341.48
|
| Rate for Payer: Priority Health Medicare |
$2,910.20
|
| Rate for Payer: Priority Health Narrow Network |
$5,341.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,910.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,375.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,910.20
|
| Rate for Payer: UHC Exchange |
$5,375.59
|
| Rate for Payer: UHC Medicaid |
$1,851.82
|
| Rate for Payer: UHCCP DNSP |
$2,910.20
|
| Rate for Payer: UHCCP Medicaid |
$1,851.82
|
|
