|
PR LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL
|
Professional
|
Both
|
$5,023.00
|
|
|
Service Code
|
HCPCS 63250
|
| Min. Negotiated Rate |
$1,807.52 |
| Max. Negotiated Rate |
$5,261.88 |
| Rate for Payer: Aetna Commercial |
$3,808.67
|
| Rate for Payer: Aetna Medicare |
$2,842.29
|
| Rate for Payer: BCBS Complete |
$1,897.90
|
| Rate for Payer: BCBS MAPPO |
$2,842.29
|
| Rate for Payer: BCN Commercial |
$4,498.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,842.29
|
| Rate for Payer: Cash Price |
$4,018.40
|
| Rate for Payer: Cash Price |
$4,018.40
|
| Rate for Payer: Cofinity Commercial |
$4,092.90
|
| Rate for Payer: Cofinity Commercial |
$3,808.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,842.29
|
| Rate for Payer: Healthscope Commercial |
$3,410.75
|
| Rate for Payer: Healthscope Whirlpool |
$3,410.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,984.40
|
| Rate for Payer: Meridian Medicaid |
$1,897.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,126.52
|
| Rate for Payer: Nomi Health Commercial |
$3,410.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,767.25
|
| Rate for Payer: PACE SWMI |
$2,842.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,842.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,807.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,224.65
|
| Rate for Payer: Priority Health Medicare |
$2,842.29
|
| Rate for Payer: Priority Health Narrow Network |
$5,224.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,842.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,261.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,842.29
|
| Rate for Payer: UHC Exchange |
$5,261.88
|
| Rate for Payer: UHC Medicaid |
$1,807.52
|
| Rate for Payer: UHCCP DNSP |
$2,842.29
|
| Rate for Payer: UHCCP Medicaid |
$1,807.52
|
|
|
PR LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC
|
Professional
|
Both
|
$6,033.00
|
|
|
Service Code
|
HCPCS 63251
|
| Min. Negotiated Rate |
$1,852.25 |
| Max. Negotiated Rate |
$5,376.79 |
| Rate for Payer: Aetna Commercial |
$3,900.53
|
| Rate for Payer: Aetna Medicare |
$2,910.84
|
| Rate for Payer: BCBS Complete |
$1,944.86
|
| Rate for Payer: BCBS MAPPO |
$2,910.84
|
| Rate for Payer: BCN Commercial |
$4,599.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,910.84
|
| Rate for Payer: Cash Price |
$4,826.40
|
| Rate for Payer: Cash Price |
$4,826.40
|
| Rate for Payer: Cofinity Commercial |
$4,191.61
|
| Rate for Payer: Cofinity Commercial |
$3,900.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,910.84
|
| Rate for Payer: Healthscope Commercial |
$3,493.01
|
| Rate for Payer: Healthscope Whirlpool |
$3,493.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,056.38
|
| Rate for Payer: Meridian Medicaid |
$1,944.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,201.92
|
| Rate for Payer: Nomi Health Commercial |
$3,493.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,524.75
|
| Rate for Payer: PACE SWMI |
$2,910.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,910.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,852.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,342.06
|
| Rate for Payer: Priority Health Medicare |
$2,910.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,342.06
|
| Rate for Payer: Railroad Medicare Medicare |
$2,910.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,376.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,910.84
|
| Rate for Payer: UHC Exchange |
$5,376.79
|
| Rate for Payer: UHC Medicaid |
$1,852.25
|
| Rate for Payer: UHCCP DNSP |
$2,910.84
|
| Rate for Payer: UHCCP Medicaid |
$1,852.25
|
|
|
PR LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 63053
|
| Min. Negotiated Rate |
$130.57 |
| Max. Negotiated Rate |
$397.93 |
| Rate for Payer: Aetna Commercial |
$276.56
|
| Rate for Payer: Aetna Medicare |
$206.39
|
| Rate for Payer: BCBS Complete |
$137.10
|
| Rate for Payer: BCBS MAPPO |
$206.39
|
| Rate for Payer: BCN Commercial |
$342.61
|
| Rate for Payer: BCN Medicare Advantage |
$206.39
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cofinity Commercial |
$297.20
|
| Rate for Payer: Cofinity Commercial |
$276.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.39
|
| Rate for Payer: Healthscope Commercial |
$247.67
|
| Rate for Payer: Healthscope Whirlpool |
$247.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.71
|
| Rate for Payer: Meridian Medicaid |
$137.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$227.03
|
| Rate for Payer: Nomi Health Commercial |
$247.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.75
|
| Rate for Payer: PACE SWMI |
$206.39
|
| Rate for Payer: PHP Medicare Advantage |
$206.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$397.93
|
| Rate for Payer: Priority Health Medicare |
$206.39
|
| Rate for Payer: Priority Health Narrow Network |
$397.93
|
| Rate for Payer: Railroad Medicare Medicare |
$206.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$349.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.39
|
| Rate for Payer: UHC Exchange |
$349.55
|
| Rate for Payer: UHC Medicaid |
$130.57
|
| Rate for Payer: UHCCP DNSP |
$206.39
|
| Rate for Payer: UHCCP Medicaid |
$130.57
|
|
|
PR LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 63052
|
| Min. Negotiated Rate |
$146.54 |
| Max. Negotiated Rate |
$504.75 |
| Rate for Payer: Aetna Commercial |
$310.32
|
| Rate for Payer: Aetna Medicare |
$231.58
|
| Rate for Payer: BCBS Complete |
$153.87
|
| Rate for Payer: BCBS MAPPO |
$231.58
|
| Rate for Payer: BCN Commercial |
$386.93
|
| Rate for Payer: BCN Medicare Advantage |
$231.58
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$333.48
|
| Rate for Payer: Cofinity Commercial |
$310.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.58
|
| Rate for Payer: Healthscope Commercial |
$277.90
|
| Rate for Payer: Healthscope Whirlpool |
$277.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.16
|
| Rate for Payer: Meridian Medicaid |
$153.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$254.74
|
| Rate for Payer: Nomi Health Commercial |
$277.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$504.75
|
| Rate for Payer: PACE SWMI |
$231.58
|
| Rate for Payer: PHP Medicare Advantage |
$231.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$449.41
|
| Rate for Payer: Priority Health Medicare |
$231.58
|
| Rate for Payer: Priority Health Narrow Network |
$449.41
|
| Rate for Payer: Railroad Medicare Medicare |
$231.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$467.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$231.58
|
| Rate for Payer: UHC Exchange |
$467.33
|
| Rate for Payer: UHC Medicaid |
$146.54
|
| Rate for Payer: UHCCP DNSP |
$231.58
|
| Rate for Payer: UHCCP Medicaid |
$146.54
|
|
|
PR LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM
|
Professional
|
Both
|
$2,377.00
|
|
|
Service Code
|
HCPCS 63048
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$1,782.75 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna Medicare |
$188.83
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$188.83
|
| Rate for Payer: BCN Commercial |
$346.30
|
| Rate for Payer: BCN Medicare Advantage |
$188.83
|
| Rate for Payer: Cash Price |
$1,901.60
|
| Rate for Payer: Cash Price |
$1,901.60
|
| Rate for Payer: Cofinity Commercial |
$271.92
|
| Rate for Payer: Cofinity Commercial |
$253.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.83
|
| Rate for Payer: Healthscope Commercial |
$226.60
|
| Rate for Payer: Healthscope Whirlpool |
$226.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.27
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.71
|
| Rate for Payer: Nomi Health Commercial |
$226.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,782.75
|
| Rate for Payer: PACE SWMI |
$188.83
|
| Rate for Payer: PHP Medicare Advantage |
$188.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$366.12
|
| Rate for Payer: Priority Health Medicare |
$188.83
|
| Rate for Payer: Priority Health Narrow Network |
$366.12
|
| Rate for Payer: Railroad Medicare Medicare |
$188.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$376.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.83
|
| Rate for Payer: UHC Exchange |
$376.01
|
| Rate for Payer: UHC Medicaid |
$119.49
|
| Rate for Payer: UHCCP DNSP |
$188.83
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL
|
Professional
|
Both
|
$2,758.00
|
|
|
Service Code
|
HCPCS 63045
|
| Min. Negotiated Rate |
$796.83 |
| Max. Negotiated Rate |
$2,278.87 |
| Rate for Payer: Aetna Commercial |
$1,658.04
|
| Rate for Payer: Aetna Medicare |
$1,237.34
|
| Rate for Payer: BCBS Complete |
$836.67
|
| Rate for Payer: BCBS MAPPO |
$1,237.34
|
| Rate for Payer: BCN Commercial |
$2,155.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.34
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cofinity Commercial |
$1,781.77
|
| Rate for Payer: Cofinity Commercial |
$1,658.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.34
|
| Rate for Payer: Healthscope Commercial |
$1,484.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.21
|
| Rate for Payer: Meridian Medicaid |
$836.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,361.07
|
| Rate for Payer: Nomi Health Commercial |
$1,484.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,068.50
|
| Rate for Payer: PACE SWMI |
$1,237.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$796.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,278.87
|
| Rate for Payer: Priority Health Medicare |
$1,237.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,278.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,237.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,263.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,237.34
|
| Rate for Payer: UHC Exchange |
$2,263.44
|
| Rate for Payer: UHC Medicaid |
$796.83
|
| Rate for Payer: UHCCP DNSP |
$1,237.34
|
| Rate for Payer: UHCCP Medicaid |
$796.83
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR
|
Professional
|
Both
|
$2,355.00
|
|
|
Service Code
|
HCPCS 63047
|
| Min. Negotiated Rate |
$679.47 |
| Max. Negotiated Rate |
$1,957.87 |
| Rate for Payer: Aetna Commercial |
$1,409.09
|
| Rate for Payer: Aetna Medicare |
$1,051.56
|
| Rate for Payer: BCBS Complete |
$713.44
|
| Rate for Payer: BCBS MAPPO |
$1,051.56
|
| Rate for Payer: BCN Commercial |
$1,851.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,051.56
|
| Rate for Payer: Cash Price |
$1,884.00
|
| Rate for Payer: Cash Price |
$1,884.00
|
| Rate for Payer: Cofinity Commercial |
$1,514.25
|
| Rate for Payer: Cofinity Commercial |
$1,409.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,051.56
|
| Rate for Payer: Healthscope Commercial |
$1,261.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,261.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,104.14
|
| Rate for Payer: Meridian Medicaid |
$713.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,156.72
|
| Rate for Payer: Nomi Health Commercial |
$1,261.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,766.25
|
| Rate for Payer: PACE SWMI |
$1,051.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,051.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$679.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,957.87
|
| Rate for Payer: Priority Health Medicare |
$1,051.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,957.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,051.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,938.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,051.56
|
| Rate for Payer: UHC Exchange |
$1,938.74
|
| Rate for Payer: UHC Medicaid |
$679.47
|
| Rate for Payer: UHCCP DNSP |
$1,051.56
|
| Rate for Payer: UHCCP Medicaid |
$679.47
|
|
|
PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC
|
Professional
|
Both
|
$2,628.00
|
|
|
Service Code
|
HCPCS 63046
|
| Min. Negotiated Rate |
$755.30 |
| Max. Negotiated Rate |
$2,176.50 |
| Rate for Payer: Aetna Commercial |
$1,570.00
|
| Rate for Payer: Aetna Medicare |
$1,171.64
|
| Rate for Payer: BCBS Complete |
$793.07
|
| Rate for Payer: BCBS MAPPO |
$1,171.64
|
| Rate for Payer: BCN Commercial |
$2,058.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.64
|
| Rate for Payer: Cash Price |
$2,102.40
|
| Rate for Payer: Cash Price |
$2,102.40
|
| Rate for Payer: Cofinity Commercial |
$1,687.16
|
| Rate for Payer: Cofinity Commercial |
$1,570.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.64
|
| Rate for Payer: Healthscope Commercial |
$1,405.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,230.22
|
| Rate for Payer: Meridian Medicaid |
$793.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,288.80
|
| Rate for Payer: Nomi Health Commercial |
$1,405.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,971.00
|
| Rate for Payer: PACE SWMI |
$1,171.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$755.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,176.50
|
| Rate for Payer: Priority Health Medicare |
$1,171.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,176.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,171.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,159.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,171.64
|
| Rate for Payer: UHC Exchange |
$2,159.01
|
| Rate for Payer: UHC Medicaid |
$755.30
|
| Rate for Payer: UHCCP DNSP |
$1,171.64
|
| Rate for Payer: UHCCP Medicaid |
$755.30
|
|
|
PR LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL
|
Professional
|
Both
|
$1,772.00
|
|
|
Service Code
|
HCPCS 63655
|
| Min. Negotiated Rate |
$534.84 |
| Max. Negotiated Rate |
$1,492.83 |
| Rate for Payer: Aetna Commercial |
$1,104.58
|
| Rate for Payer: Aetna Medicare |
$824.31
|
| Rate for Payer: BCBS Complete |
$561.58
|
| Rate for Payer: BCBS MAPPO |
$824.31
|
| Rate for Payer: BCN Commercial |
$1,411.98
|
| Rate for Payer: BCN Medicare Advantage |
$824.31
|
| Rate for Payer: Cash Price |
$1,417.60
|
| Rate for Payer: Cash Price |
$1,417.60
|
| Rate for Payer: Cofinity Commercial |
$1,187.01
|
| Rate for Payer: Cofinity Commercial |
$1,104.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$824.31
|
| Rate for Payer: Healthscope Commercial |
$989.17
|
| Rate for Payer: Healthscope Whirlpool |
$989.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$865.53
|
| Rate for Payer: Meridian Medicaid |
$561.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$906.74
|
| Rate for Payer: Nomi Health Commercial |
$989.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,329.00
|
| Rate for Payer: PACE SWMI |
$824.31
|
| Rate for Payer: PHP Medicare Advantage |
$824.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,492.83
|
| Rate for Payer: Priority Health Medicare |
$824.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,492.83
|
| Rate for Payer: Railroad Medicare Medicare |
$824.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,456.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$824.31
|
| Rate for Payer: UHC Exchange |
$1,456.05
|
| Rate for Payer: UHC Medicaid |
$534.84
|
| Rate for Payer: UHCCP DNSP |
$824.31
|
| Rate for Payer: UHCCP Medicaid |
$534.84
|
|
|
PR LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL
|
Professional
|
Both
|
$7,006.00
|
|
|
Service Code
|
HCPCS 63275
|
| Min. Negotiated Rate |
$1,104.41 |
| Max. Negotiated Rate |
$5,254.50 |
| Rate for Payer: Aetna Commercial |
$2,311.47
|
| Rate for Payer: Aetna Medicare |
$1,724.98
|
| Rate for Payer: BCBS Complete |
$1,159.63
|
| Rate for Payer: BCBS MAPPO |
$1,724.98
|
| Rate for Payer: BCN Commercial |
$3,009.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,724.98
|
| Rate for Payer: Cash Price |
$5,604.80
|
| Rate for Payer: Cash Price |
$5,604.80
|
| Rate for Payer: Cofinity Commercial |
$2,483.97
|
| Rate for Payer: Cofinity Commercial |
$2,311.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,724.98
|
| Rate for Payer: Healthscope Commercial |
$2,069.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,069.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,811.23
|
| Rate for Payer: Meridian Medicaid |
$1,159.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,897.48
|
| Rate for Payer: Nomi Health Commercial |
$2,069.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,254.50
|
| Rate for Payer: PACE SWMI |
$1,724.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,724.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,104.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,181.75
|
| Rate for Payer: Priority Health Medicare |
$1,724.98
|
| Rate for Payer: Priority Health Narrow Network |
$3,181.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,724.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,181.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,724.98
|
| Rate for Payer: UHC Exchange |
$3,181.54
|
| Rate for Payer: UHC Medicaid |
$1,104.41
|
| Rate for Payer: UHCCP DNSP |
$1,724.98
|
| Rate for Payer: UHCCP Medicaid |
$1,104.41
|
|
|
PR LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR
|
Professional
|
Both
|
$6,398.00
|
|
|
Service Code
|
HCPCS 63277
|
| Min. Negotiated Rate |
$958.07 |
| Max. Negotiated Rate |
$4,798.50 |
| Rate for Payer: Aetna Commercial |
$2,001.25
|
| Rate for Payer: Aetna Medicare |
$1,493.47
|
| Rate for Payer: BCBS Complete |
$1,005.97
|
| Rate for Payer: BCBS MAPPO |
$1,493.47
|
| Rate for Payer: BCN Commercial |
$2,615.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,493.47
|
| Rate for Payer: Cash Price |
$5,118.40
|
| Rate for Payer: Cash Price |
$5,118.40
|
| Rate for Payer: Cofinity Commercial |
$2,150.60
|
| Rate for Payer: Cofinity Commercial |
$2,001.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,493.47
|
| Rate for Payer: Healthscope Commercial |
$1,792.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,792.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,568.14
|
| Rate for Payer: Meridian Medicaid |
$1,005.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,642.82
|
| Rate for Payer: Nomi Health Commercial |
$1,792.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,798.50
|
| Rate for Payer: PACE SWMI |
$1,493.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,493.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$958.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,765.32
|
| Rate for Payer: Priority Health Medicare |
$1,493.47
|
| Rate for Payer: Priority Health Narrow Network |
$2,765.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,493.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,748.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,493.47
|
| Rate for Payer: UHC Exchange |
$2,748.33
|
| Rate for Payer: UHC Medicaid |
$958.07
|
| Rate for Payer: UHCCP DNSP |
$1,493.47
|
| Rate for Payer: UHCCP Medicaid |
$958.07
|
|
|
PR LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL
|
Professional
|
Both
|
$5,566.00
|
|
|
Service Code
|
HCPCS 63278
|
| Min. Negotiated Rate |
$1,007.28 |
| Max. Negotiated Rate |
$4,174.50 |
| Rate for Payer: Aetna Commercial |
$2,104.59
|
| Rate for Payer: Aetna Medicare |
$1,570.59
|
| Rate for Payer: BCBS Complete |
$1,057.64
|
| Rate for Payer: BCBS MAPPO |
$1,570.59
|
| Rate for Payer: BCN Commercial |
$2,679.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,570.59
|
| Rate for Payer: Cash Price |
$4,452.80
|
| Rate for Payer: Cash Price |
$4,452.80
|
| Rate for Payer: Cofinity Commercial |
$2,261.65
|
| Rate for Payer: Cofinity Commercial |
$2,104.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,570.59
|
| Rate for Payer: Healthscope Commercial |
$1,884.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,884.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,649.12
|
| Rate for Payer: Meridian Medicaid |
$1,057.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,727.65
|
| Rate for Payer: Nomi Health Commercial |
$1,884.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,174.50
|
| Rate for Payer: PACE SWMI |
$1,570.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,570.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,007.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,832.98
|
| Rate for Payer: Priority Health Medicare |
$1,570.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,832.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,570.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,798.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,570.59
|
| Rate for Payer: UHC Exchange |
$2,798.96
|
| Rate for Payer: UHC Medicaid |
$1,007.28
|
| Rate for Payer: UHCCP DNSP |
$1,570.59
|
| Rate for Payer: UHCCP Medicaid |
$1,007.28
|
|
|
PR LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC
|
Professional
|
Both
|
$7,132.00
|
|
|
Service Code
|
HCPCS 63276
|
| Min. Negotiated Rate |
$1,101.42 |
| Max. Negotiated Rate |
$5,349.00 |
| Rate for Payer: Aetna Commercial |
$2,305.52
|
| Rate for Payer: Aetna Medicare |
$1,720.54
|
| Rate for Payer: BCBS Complete |
$1,156.49
|
| Rate for Payer: BCBS MAPPO |
$1,720.54
|
| Rate for Payer: BCN Commercial |
$2,990.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,720.54
|
| Rate for Payer: Cash Price |
$5,705.60
|
| Rate for Payer: Cash Price |
$5,705.60
|
| Rate for Payer: Cofinity Commercial |
$2,477.58
|
| Rate for Payer: Cofinity Commercial |
$2,305.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,720.54
|
| Rate for Payer: Healthscope Commercial |
$2,064.65
|
| Rate for Payer: Healthscope Whirlpool |
$2,064.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,806.57
|
| Rate for Payer: Meridian Medicaid |
$1,156.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,892.59
|
| Rate for Payer: Nomi Health Commercial |
$2,064.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,349.00
|
| Rate for Payer: PACE SWMI |
$1,720.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,720.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,101.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,161.51
|
| Rate for Payer: Priority Health Medicare |
$1,720.54
|
| Rate for Payer: Priority Health Narrow Network |
$3,161.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,720.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,156.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,720.54
|
| Rate for Payer: UHC Exchange |
$3,156.45
|
| Rate for Payer: UHC Medicaid |
$1,101.42
|
| Rate for Payer: UHCCP DNSP |
$1,720.54
|
| Rate for Payer: UHCCP Medicaid |
$1,101.42
|
|
|
PR LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR
|
Professional
|
Both
|
$6,093.00
|
|
|
Service Code
|
HCPCS 63200
|
| Min. Negotiated Rate |
$978.95 |
| Max. Negotiated Rate |
$4,569.75 |
| Rate for Payer: Aetna Commercial |
$2,043.86
|
| Rate for Payer: Aetna Medicare |
$1,525.27
|
| Rate for Payer: BCBS Complete |
$1,027.90
|
| Rate for Payer: BCBS MAPPO |
$1,525.27
|
| Rate for Payer: BCN Commercial |
$2,598.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,525.27
|
| Rate for Payer: Cash Price |
$4,874.40
|
| Rate for Payer: Cash Price |
$4,874.40
|
| Rate for Payer: Cofinity Commercial |
$2,196.39
|
| Rate for Payer: Cofinity Commercial |
$2,043.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,525.27
|
| Rate for Payer: Healthscope Commercial |
$1,830.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,830.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,601.53
|
| Rate for Payer: Meridian Medicaid |
$1,027.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,677.80
|
| Rate for Payer: Nomi Health Commercial |
$1,830.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,569.75
|
| Rate for Payer: PACE SWMI |
$1,525.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,525.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$978.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,746.81
|
| Rate for Payer: Priority Health Medicare |
$1,525.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,746.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,525.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,693.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,525.27
|
| Rate for Payer: UHC Exchange |
$2,693.61
|
| Rate for Payer: UHC Medicaid |
$978.95
|
| Rate for Payer: UHCCP DNSP |
$1,525.27
|
| Rate for Payer: UHCCP Medicaid |
$978.95
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR
|
Professional
|
Both
|
$5,184.00
|
|
|
Service Code
|
HCPCS 63005
|
| Min. Negotiated Rate |
$760.41 |
| Max. Negotiated Rate |
$3,888.00 |
| Rate for Payer: Aetna Commercial |
$1,580.37
|
| Rate for Payer: Aetna Medicare |
$1,179.38
|
| Rate for Payer: BCBS Complete |
$798.43
|
| Rate for Payer: BCBS MAPPO |
$1,179.38
|
| Rate for Payer: BCN Commercial |
$2,021.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,179.38
|
| Rate for Payer: Cash Price |
$4,147.20
|
| Rate for Payer: Cash Price |
$4,147.20
|
| Rate for Payer: Cofinity Commercial |
$1,698.31
|
| Rate for Payer: Cofinity Commercial |
$1,580.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,179.38
|
| Rate for Payer: Healthscope Commercial |
$1,415.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,415.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,238.35
|
| Rate for Payer: Meridian Medicaid |
$798.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,297.32
|
| Rate for Payer: Nomi Health Commercial |
$1,415.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,888.00
|
| Rate for Payer: PACE SWMI |
$1,179.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,179.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$760.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,137.76
|
| Rate for Payer: Priority Health Medicare |
$1,179.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,137.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,179.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,094.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,179.38
|
| Rate for Payer: UHC Exchange |
$2,094.58
|
| Rate for Payer: UHC Medicaid |
$760.41
|
| Rate for Payer: UHCCP DNSP |
$1,179.38
|
| Rate for Payer: UHCCP Medicaid |
$760.41
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL
|
Professional
|
Both
|
$2,308.00
|
|
|
Service Code
|
HCPCS 63011
|
| Min. Negotiated Rate |
$644.54 |
| Max. Negotiated Rate |
$1,919.69 |
| Rate for Payer: Aetna Commercial |
$1,335.87
|
| Rate for Payer: Aetna Medicare |
$996.92
|
| Rate for Payer: BCBS Complete |
$676.77
|
| Rate for Payer: BCBS MAPPO |
$996.92
|
| Rate for Payer: BCN Commercial |
$1,652.80
|
| Rate for Payer: BCN Medicare Advantage |
$996.92
|
| Rate for Payer: Cash Price |
$1,846.40
|
| Rate for Payer: Cash Price |
$1,846.40
|
| Rate for Payer: Cofinity Commercial |
$1,435.56
|
| Rate for Payer: Cofinity Commercial |
$1,335.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.92
|
| Rate for Payer: Healthscope Commercial |
$1,196.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,196.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.77
|
| Rate for Payer: Meridian Medicaid |
$676.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,096.61
|
| Rate for Payer: Nomi Health Commercial |
$1,196.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,731.00
|
| Rate for Payer: PACE SWMI |
$996.92
|
| Rate for Payer: PHP Medicare Advantage |
$996.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,919.69
|
| Rate for Payer: Priority Health Medicare |
$996.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,919.69
|
| Rate for Payer: Railroad Medicare Medicare |
$996.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,910.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$996.92
|
| Rate for Payer: UHC Exchange |
$1,910.94
|
| Rate for Payer: UHC Medicaid |
$644.54
|
| Rate for Payer: UHCCP DNSP |
$996.92
|
| Rate for Payer: UHCCP Medicaid |
$644.54
|
|
|
PR LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC
|
Professional
|
Both
|
$6,368.00
|
|
|
Service Code
|
HCPCS 63003
|
| Min. Negotiated Rate |
$764.03 |
| Max. Negotiated Rate |
$4,776.00 |
| Rate for Payer: Aetna Commercial |
$1,595.58
|
| Rate for Payer: Aetna Medicare |
$1,190.73
|
| Rate for Payer: BCBS Complete |
$802.23
|
| Rate for Payer: BCBS MAPPO |
$1,190.73
|
| Rate for Payer: BCN Commercial |
$2,074.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,190.73
|
| Rate for Payer: Cash Price |
$5,094.40
|
| Rate for Payer: Cash Price |
$5,094.40
|
| Rate for Payer: Cofinity Commercial |
$1,714.65
|
| Rate for Payer: Cofinity Commercial |
$1,595.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,190.73
|
| Rate for Payer: Healthscope Commercial |
$1,428.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,428.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,250.27
|
| Rate for Payer: Meridian Medicaid |
$802.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,309.80
|
| Rate for Payer: Nomi Health Commercial |
$1,428.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,776.00
|
| Rate for Payer: PACE SWMI |
$1,190.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,190.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$764.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,193.28
|
| Rate for Payer: Priority Health Medicare |
$1,190.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,193.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,190.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,178.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,190.73
|
| Rate for Payer: UHC Exchange |
$2,178.90
|
| Rate for Payer: UHC Medicaid |
$764.03
|
| Rate for Payer: UHCCP DNSP |
$1,190.73
|
| Rate for Payer: UHCCP Medicaid |
$764.03
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL
|
Professional
|
Both
|
$6,444.00
|
|
|
Service Code
|
HCPCS 63015
|
| Min. Negotiated Rate |
$921.23 |
| Max. Negotiated Rate |
$4,833.00 |
| Rate for Payer: Aetna Commercial |
$1,922.30
|
| Rate for Payer: Aetna Medicare |
$1,434.55
|
| Rate for Payer: BCBS Complete |
$967.29
|
| Rate for Payer: BCBS MAPPO |
$1,434.55
|
| Rate for Payer: BCN Commercial |
$2,486.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,434.55
|
| Rate for Payer: Cash Price |
$5,155.20
|
| Rate for Payer: Cash Price |
$5,155.20
|
| Rate for Payer: Cofinity Commercial |
$2,065.75
|
| Rate for Payer: Cofinity Commercial |
$1,922.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,434.55
|
| Rate for Payer: Healthscope Commercial |
$1,721.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,721.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,506.28
|
| Rate for Payer: Meridian Medicaid |
$967.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,578.01
|
| Rate for Payer: Nomi Health Commercial |
$1,721.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,833.00
|
| Rate for Payer: PACE SWMI |
$1,434.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,434.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,628.81
|
| Rate for Payer: Priority Health Medicare |
$1,434.55
|
| Rate for Payer: Priority Health Narrow Network |
$2,628.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,434.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,605.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,434.55
|
| Rate for Payer: UHC Exchange |
$2,605.96
|
| Rate for Payer: UHC Medicaid |
$921.23
|
| Rate for Payer: UHCCP DNSP |
$1,434.55
|
| Rate for Payer: UHCCP Medicaid |
$921.23
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR
|
Professional
|
Both
|
$6,446.00
|
|
|
Service Code
|
HCPCS 63017
|
| Min. Negotiated Rate |
$794.06 |
| Max. Negotiated Rate |
$4,834.50 |
| Rate for Payer: Aetna Commercial |
$1,651.94
|
| Rate for Payer: Aetna Medicare |
$1,232.79
|
| Rate for Payer: BCBS Complete |
$833.76
|
| Rate for Payer: BCBS MAPPO |
$1,232.79
|
| Rate for Payer: BCN Commercial |
$2,126.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,232.79
|
| Rate for Payer: Cash Price |
$5,156.80
|
| Rate for Payer: Cash Price |
$5,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,775.22
|
| Rate for Payer: Cofinity Commercial |
$1,651.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,232.79
|
| Rate for Payer: Healthscope Commercial |
$1,479.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,479.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,294.43
|
| Rate for Payer: Meridian Medicaid |
$833.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,356.07
|
| Rate for Payer: Nomi Health Commercial |
$1,479.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,834.50
|
| Rate for Payer: PACE SWMI |
$1,232.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,232.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$794.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,248.23
|
| Rate for Payer: Priority Health Medicare |
$1,232.79
|
| Rate for Payer: Priority Health Narrow Network |
$2,248.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,232.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,214.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,232.79
|
| Rate for Payer: UHC Exchange |
$2,214.22
|
| Rate for Payer: UHC Medicaid |
$794.06
|
| Rate for Payer: UHCCP DNSP |
$1,232.79
|
| Rate for Payer: UHCCP Medicaid |
$794.06
|
|
|
PR LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC
|
Professional
|
Both
|
$6,976.00
|
|
|
Service Code
|
HCPCS 63016
|
| Min. Negotiated Rate |
$933.15 |
| Max. Negotiated Rate |
$5,232.00 |
| Rate for Payer: Aetna Commercial |
$1,950.62
|
| Rate for Payer: Aetna Medicare |
$1,455.69
|
| Rate for Payer: BCBS Complete |
$979.81
|
| Rate for Payer: BCBS MAPPO |
$1,455.69
|
| Rate for Payer: BCN Commercial |
$2,550.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,455.69
|
| Rate for Payer: Cash Price |
$5,580.80
|
| Rate for Payer: Cash Price |
$5,580.80
|
| Rate for Payer: Cofinity Commercial |
$2,096.19
|
| Rate for Payer: Cofinity Commercial |
$1,950.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,455.69
|
| Rate for Payer: Healthscope Commercial |
$1,746.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,746.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,528.47
|
| Rate for Payer: Meridian Medicaid |
$979.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,601.26
|
| Rate for Payer: Nomi Health Commercial |
$1,746.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,232.00
|
| Rate for Payer: PACE SWMI |
$1,455.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,455.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$933.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,696.47
|
| Rate for Payer: Priority Health Medicare |
$1,455.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,696.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,455.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,683.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,455.69
|
| Rate for Payer: UHC Exchange |
$2,683.88
|
| Rate for Payer: UHC Medicaid |
$933.15
|
| Rate for Payer: UHCCP DNSP |
$1,455.69
|
| Rate for Payer: UHCCP Medicaid |
$933.15
|
|
|
PR LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS
|
Professional
|
Both
|
$5,958.00
|
|
|
Service Code
|
HCPCS 63185
|
| Min. Negotiated Rate |
$788.53 |
| Max. Negotiated Rate |
$4,468.50 |
| Rate for Payer: Aetna Commercial |
$1,640.83
|
| Rate for Payer: Aetna Medicare |
$1,224.50
|
| Rate for Payer: BCBS Complete |
$827.96
|
| Rate for Payer: BCBS MAPPO |
$1,224.50
|
| Rate for Payer: BCN Commercial |
$1,886.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,224.50
|
| Rate for Payer: Cash Price |
$4,766.40
|
| Rate for Payer: Cash Price |
$4,766.40
|
| Rate for Payer: Cofinity Commercial |
$1,763.28
|
| Rate for Payer: Cofinity Commercial |
$1,640.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,224.50
|
| Rate for Payer: Healthscope Commercial |
$1,469.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,469.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,285.72
|
| Rate for Payer: Meridian Medicaid |
$827.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,346.95
|
| Rate for Payer: Nomi Health Commercial |
$1,469.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,468.50
|
| Rate for Payer: PACE SWMI |
$1,224.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,224.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,190.97
|
| Rate for Payer: Priority Health Medicare |
$1,224.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,190.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,224.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,016.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,224.50
|
| Rate for Payer: UHC Exchange |
$2,016.38
|
| Rate for Payer: UHC Medicaid |
$788.53
|
| Rate for Payer: UHCCP DNSP |
$1,224.50
|
| Rate for Payer: UHCCP Medicaid |
$788.53
|
|
|
PR LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR
|
Professional
|
Both
|
$6,340.00
|
|
|
Service Code
|
HCPCS 63012
|
| Min. Negotiated Rate |
$733.15 |
| Max. Negotiated Rate |
$4,755.00 |
| Rate for Payer: Aetna Commercial |
$1,524.83
|
| Rate for Payer: Aetna Medicare |
$1,137.93
|
| Rate for Payer: BCBS Complete |
$769.81
|
| Rate for Payer: BCBS MAPPO |
$1,137.93
|
| Rate for Payer: BCN Commercial |
$1,997.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,137.93
|
| Rate for Payer: Cash Price |
$5,072.00
|
| Rate for Payer: Cash Price |
$5,072.00
|
| Rate for Payer: Cofinity Commercial |
$1,638.62
|
| Rate for Payer: Cofinity Commercial |
$1,524.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,137.93
|
| Rate for Payer: Healthscope Commercial |
$1,365.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,365.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,194.83
|
| Rate for Payer: Meridian Medicaid |
$769.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,251.72
|
| Rate for Payer: Nomi Health Commercial |
$1,365.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,755.00
|
| Rate for Payer: PACE SWMI |
$1,137.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,137.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,111.72
|
| Rate for Payer: Priority Health Medicare |
$1,137.93
|
| Rate for Payer: Priority Health Narrow Network |
$2,111.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,137.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,102.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,137.93
|
| Rate for Payer: UHC Exchange |
$2,102.29
|
| Rate for Payer: UHC Medicaid |
$733.15
|
| Rate for Payer: UHCCP DNSP |
$1,137.93
|
| Rate for Payer: UHCCP Medicaid |
$733.15
|
|
|
PR LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 63191
|
| Min. Negotiated Rate |
$877.99 |
| Max. Negotiated Rate |
$2,458.76 |
| Rate for Payer: Aetna Commercial |
$1,831.35
|
| Rate for Payer: Aetna Medicare |
$1,366.68
|
| Rate for Payer: BCBS Complete |
$921.89
|
| Rate for Payer: BCBS MAPPO |
$1,366.68
|
| Rate for Payer: BCN Commercial |
$2,116.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,366.68
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Cofinity Commercial |
$1,968.02
|
| Rate for Payer: Cofinity Commercial |
$1,831.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,366.68
|
| Rate for Payer: Healthscope Commercial |
$1,640.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,640.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,435.01
|
| Rate for Payer: Meridian Medicaid |
$921.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,503.35
|
| Rate for Payer: Nomi Health Commercial |
$1,640.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.25
|
| Rate for Payer: PACE SWMI |
$1,366.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,366.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$877.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,458.76
|
| Rate for Payer: Priority Health Medicare |
$1,366.68
|
| Rate for Payer: Priority Health Narrow Network |
$2,458.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,366.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,422.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,366.68
|
| Rate for Payer: UHC Exchange |
$2,422.86
|
| Rate for Payer: UHC Medicaid |
$877.99
|
| Rate for Payer: UHCCP DNSP |
$1,366.68
|
| Rate for Payer: UHCCP Medicaid |
$877.99
|
|
|
PR LAMINOTOMY DCMPRN NRV ROOT 1 NTRSPC CERVICAL
|
Professional
|
Both
|
$5,918.00
|
|
|
Service Code
|
HCPCS 63020
|
| Min. Negotiated Rate |
$678.62 |
| Max. Negotiated Rate |
$4,438.50 |
| Rate for Payer: Aetna Commercial |
$1,404.53
|
| Rate for Payer: Aetna Medicare |
$1,048.16
|
| Rate for Payer: BCBS Complete |
$712.55
|
| Rate for Payer: BCBS MAPPO |
$1,048.16
|
| Rate for Payer: BCN Commercial |
$1,845.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.16
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cofinity Commercial |
$1,509.35
|
| Rate for Payer: Cofinity Commercial |
$1,404.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.16
|
| Rate for Payer: Healthscope Commercial |
$1,257.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,257.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.57
|
| Rate for Payer: Meridian Medicaid |
$712.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,152.98
|
| Rate for Payer: Nomi Health Commercial |
$1,257.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,438.50
|
| Rate for Payer: PACE SWMI |
$1,048.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,951.50
|
| Rate for Payer: Priority Health Medicare |
$1,048.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,951.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,035.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,048.16
|
| Rate for Payer: UHC Exchange |
$2,035.85
|
| Rate for Payer: UHC Medicaid |
$678.62
|
| Rate for Payer: UHCCP DNSP |
$1,048.16
|
| Rate for Payer: UHCCP Medicaid |
$678.62
|
|
|
PR LAMINOTOMY DCMPRN NRV ROOT 1 NTRSPC LUMBAR
|
Professional
|
Both
|
$5,731.00
|
|
|
Service Code
|
HCPCS 63030
|
| Min. Negotiated Rate |
$572.76 |
| Max. Negotiated Rate |
$4,298.25 |
| Rate for Payer: Aetna Commercial |
$1,181.49
|
| Rate for Payer: Aetna Medicare |
$881.71
|
| Rate for Payer: BCBS Complete |
$601.40
|
| Rate for Payer: BCBS MAPPO |
$881.71
|
| Rate for Payer: BCN Commercial |
$1,146.75
|
| Rate for Payer: BCN Medicare Advantage |
$881.71
|
| Rate for Payer: Cash Price |
$4,584.80
|
| Rate for Payer: Cash Price |
$4,584.80
|
| Rate for Payer: Cofinity Commercial |
$1,269.66
|
| Rate for Payer: Cofinity Commercial |
$1,181.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.71
|
| Rate for Payer: Healthscope Commercial |
$1,058.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,058.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.80
|
| Rate for Payer: Meridian Medicaid |
$601.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.88
|
| Rate for Payer: Nomi Health Commercial |
$1,058.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,298.25
|
| Rate for Payer: PACE SWMI |
$881.71
|
| Rate for Payer: PHP Medicare Advantage |
$881.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,622.97
|
| Rate for Payer: Priority Health Medicare |
$881.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,622.97
|
| Rate for Payer: Railroad Medicare Medicare |
$881.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,706.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.71
|
| Rate for Payer: UHC Exchange |
$1,706.17
|
| Rate for Payer: UHC Medicaid |
$572.76
|
| Rate for Payer: UHCCP DNSP |
$881.71
|
| Rate for Payer: UHCCP Medicaid |
$572.76
|
|
