|
PR INSERTION PICC W/RS&I < 5 YR
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 36572
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$1,072.45 |
| Rate for Payer: Aetna Commercial |
$121.47
|
| Rate for Payer: Aetna Medicare |
$422.00
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.45
|
| Rate for Payer: BCN Commercial |
$552.21
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.57
|
| Rate for Payer: Priority Health Narrow Network |
$126.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$121.58
|
| Rate for Payer: UHC Exchange |
$121.58
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
|
|
PR INSERTION PICC W/RS&I 5 YR/>
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 36573
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$921.36 |
| Rate for Payer: Aetna Commercial |
$112.87
|
| Rate for Payer: Aetna Medicare |
$388.00
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS Trust/PPO |
$921.36
|
| Rate for Payer: BCN Commercial |
$565.89
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.76
|
| Rate for Payer: Priority Health Narrow Network |
$129.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.61
|
| Rate for Payer: UHC Exchange |
$112.61
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
|
|
PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 33285
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$6,374.79 |
| Rate for Payer: Aetna Commercial |
$118.22
|
| Rate for Payer: Aetna Medicare |
$134.00
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,495.09
|
| Rate for Payer: BCN Commercial |
$6,374.79
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.68
|
| Rate for Payer: Priority Health Narrow Network |
$136.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.53
|
| Rate for Payer: UHC Exchange |
$119.53
|
| Rate for Payer: UHCCP Medicaid |
$54.95
|
|
|
PR INSERTION TANDEM CUFF
|
Professional
|
Both
|
$1,517.00
|
|
|
Service Code
|
HCPCS 53444
|
| Min. Negotiated Rate |
$508.22 |
| Max. Negotiated Rate |
$2,999.16 |
| Rate for Payer: Aetna Commercial |
$1,018.14
|
| Rate for Payer: Aetna Medicare |
$758.50
|
| Rate for Payer: BCBS Complete |
$533.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,999.16
|
| Rate for Payer: BCN Commercial |
$1,143.01
|
| Rate for Payer: Cash Price |
$1,213.60
|
| Rate for Payer: Cash Price |
$1,213.60
|
| Rate for Payer: Meridian Medicaid |
$533.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,261.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,261.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$958.93
|
| Rate for Payer: UHC Exchange |
$958.93
|
| Rate for Payer: UHCCP Medicaid |
$508.22
|
|
|
PR INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN
|
Professional
|
Both
|
$1,308.00
|
|
|
Service Code
|
HCPCS 49421
|
| Min. Negotiated Rate |
$143.99 |
| Max. Negotiated Rate |
$2,980.67 |
| Rate for Payer: Aetna Commercial |
$308.24
|
| Rate for Payer: Aetna Medicare |
$654.00
|
| Rate for Payer: BCBS Complete |
$151.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,980.67
|
| Rate for Payer: BCN Commercial |
$327.41
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Meridian Medicaid |
$151.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$401.50
|
| Rate for Payer: Priority Health Narrow Network |
$401.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$464.29
|
| Rate for Payer: UHC Exchange |
$464.29
|
| Rate for Payer: UHCCP Medicaid |
$143.99
|
|
|
PR INSERTION VAGINAL RADIATION DEVICE
|
Professional
|
Both
|
$391.00
|
|
|
Service Code
|
HCPCS 57156
|
| Min. Negotiated Rate |
$97.77 |
| Max. Negotiated Rate |
$2,560.67 |
| Rate for Payer: Aetna Commercial |
$176.91
|
| Rate for Payer: Aetna Medicare |
$195.50
|
| Rate for Payer: BCBS Complete |
$102.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,560.67
|
| Rate for Payer: BCN Commercial |
$335.23
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Meridian Medicaid |
$102.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.21
|
| Rate for Payer: Priority Health Narrow Network |
$224.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.03
|
| Rate for Payer: UHC Exchange |
$127.03
|
| Rate for Payer: UHCCP Medicaid |
$97.77
|
|
|
PR INSERTION VASCULAR PEDICLE CARPAL BONE
|
Professional
|
Both
|
$1,235.00
|
|
|
Service Code
|
HCPCS 25430
|
| Min. Negotiated Rate |
$264.89 |
| Max. Negotiated Rate |
$1,135.78 |
| Rate for Payer: Aetna Commercial |
$974.68
|
| Rate for Payer: Aetna Medicare |
$617.50
|
| Rate for Payer: BCBS Complete |
$503.88
|
| Rate for Payer: BCBS Trust/PPO |
$264.89
|
| Rate for Payer: BCN Commercial |
$1,079.97
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Meridian Medicaid |
$503.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,135.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,135.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$802.61
|
| Rate for Payer: UHC Exchange |
$802.61
|
| Rate for Payer: UHCCP Medicaid |
$479.89
|
|
|
PR INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 20650
|
| Min. Negotiated Rate |
$63.44 |
| Max. Negotiated Rate |
$332.30 |
| Rate for Payer: Aetna Commercial |
$209.70
|
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$114.95
|
| Rate for Payer: BCBS Trust/PPO |
$63.44
|
| Rate for Payer: BCN Commercial |
$332.30
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Meridian Medicaid |
$114.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$257.48
|
| Rate for Payer: Priority Health Narrow Network |
$257.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.08
|
| Rate for Payer: UHC Exchange |
$176.08
|
| Rate for Payer: UHCCP Medicaid |
$109.48
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, EA ADD
|
Professional
|
Both
|
$529.00
|
|
|
Service Code
|
HCPCS 0172T
|
| Min. Negotiated Rate |
$211.60 |
| Max. Negotiated Rate |
$343.85 |
| Rate for Payer: Aetna Medicare |
$264.50
|
| Rate for Payer: BCBS Complete |
$211.60
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.85
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, SINGLE
|
Professional
|
Both
|
$2,734.00
|
|
|
Service Code
|
HCPCS 0171T
|
| Min. Negotiated Rate |
$1,093.60 |
| Max. Negotiated Rate |
$1,777.10 |
| Rate for Payer: Aetna Medicare |
$1,367.00
|
| Rate for Payer: BCBS Complete |
$1,093.60
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,777.10
|
|
|
PR INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT
|
Professional
|
Both
|
$1,168.00
|
|
|
Service Code
|
HCPCS 53855
|
| Min. Negotiated Rate |
$51.76 |
| Max. Negotiated Rate |
$2,298.11 |
| Rate for Payer: Aetna Commercial |
$105.97
|
| Rate for Payer: Aetna Medicare |
$584.00
|
| Rate for Payer: BCBS Complete |
$54.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,298.11
|
| Rate for Payer: BCN Commercial |
$963.67
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Meridian Medicaid |
$54.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.90
|
| Rate for Payer: Priority Health Narrow Network |
$128.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.08
|
| Rate for Payer: UHC Exchange |
$97.08
|
| Rate for Payer: UHCCP Medicaid |
$51.76
|
|
|
PR INSERT TRAY W/O BAG/CATH
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4310
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$8.51 |
| Rate for Payer: Aetna Commercial |
$7.19
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCN Commercial |
$8.51
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.87
|
| Rate for Payer: UHC Exchange |
$4.87
|
|
|
PR INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR
|
Professional
|
Both
|
$2,147.00
|
|
|
Service Code
|
HCPCS 36557
|
| Min. Negotiated Rate |
$206.18 |
| Max. Negotiated Rate |
$1,711.35 |
| Rate for Payer: Aetna Commercial |
$429.02
|
| Rate for Payer: Aetna Medicare |
$1,073.50
|
| Rate for Payer: BCBS Complete |
$216.49
|
| Rate for Payer: BCBS Trust/PPO |
$660.90
|
| Rate for Payer: BCN Commercial |
$1,711.35
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Meridian Medicaid |
$216.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.55
|
| Rate for Payer: Priority Health Narrow Network |
$510.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$397.89
|
| Rate for Payer: UHC Exchange |
$397.89
|
| Rate for Payer: UHCCP Medicaid |
$206.18
|
|
|
PR INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I
|
Professional
|
Both
|
$2,774.00
|
|
|
Service Code
|
HCPCS 37191
|
| Min. Negotiated Rate |
$137.60 |
| Max. Negotiated Rate |
$2,999.02 |
| Rate for Payer: Aetna Commercial |
$297.44
|
| Rate for Payer: Aetna Medicare |
$1,387.00
|
| Rate for Payer: BCBS Complete |
$144.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,200.83
|
| Rate for Payer: BCN Commercial |
$2,999.02
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Meridian Medicaid |
$144.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.44
|
| Rate for Payer: Priority Health Narrow Network |
$341.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.03
|
| Rate for Payer: UHC Exchange |
$326.03
|
| Rate for Payer: UHCCP Medicaid |
$137.60
|
|
|
PR IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART
|
Professional
|
Both
|
$3,309.00
|
|
|
Service Code
|
HCPCS 35585
|
| Min. Negotiated Rate |
$1,041.36 |
| Max. Negotiated Rate |
$2,597.43 |
| Rate for Payer: Aetna Commercial |
$2,251.28
|
| Rate for Payer: Aetna Medicare |
$1,654.50
|
| Rate for Payer: BCBS Complete |
$1,093.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.96
|
| Rate for Payer: BCN Commercial |
$2,378.40
|
| Rate for Payer: Cash Price |
$2,647.20
|
| Rate for Payer: Cash Price |
$2,647.20
|
| Rate for Payer: Meridian Medicaid |
$1,093.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,041.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,150.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,597.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,597.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,270.29
|
| Rate for Payer: UHC Exchange |
$2,270.29
|
| Rate for Payer: UHCCP Medicaid |
$1,041.36
|
|
|
PR IN-SITU VEIN BYPASS FEMORAL-POPLITEAL
|
Professional
|
Both
|
$4,664.00
|
|
|
Service Code
|
HCPCS 35583
|
| Min. Negotiated Rate |
$899.50 |
| Max. Negotiated Rate |
$3,031.60 |
| Rate for Payer: Aetna Commercial |
$1,939.24
|
| Rate for Payer: Aetna Medicare |
$2,332.00
|
| Rate for Payer: BCBS Complete |
$944.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.35
|
| Rate for Payer: BCN Commercial |
$2,057.33
|
| Rate for Payer: Cash Price |
$3,731.20
|
| Rate for Payer: Cash Price |
$3,731.20
|
| Rate for Payer: Meridian Medicaid |
$944.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$899.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,031.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,243.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,243.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,950.21
|
| Rate for Payer: UHC Exchange |
$1,950.21
|
| Rate for Payer: UHCCP Medicaid |
$899.50
|
|
|
PR IN-SITU VEIN BYP POP-TIBL PRONEAL
|
Professional
|
Both
|
$2,851.00
|
|
|
Service Code
|
HCPCS 35587
|
| Min. Negotiated Rate |
$833.68 |
| Max. Negotiated Rate |
$2,076.78 |
| Rate for Payer: Aetna Commercial |
$1,824.84
|
| Rate for Payer: Aetna Medicare |
$1,425.50
|
| Rate for Payer: BCBS Complete |
$875.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$1,945.42
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Meridian Medicaid |
$875.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$833.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,853.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,076.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,076.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,864.65
|
| Rate for Payer: UHC Exchange |
$1,864.65
|
| Rate for Payer: UHCCP Medicaid |
$833.68
|
|
|
PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 33216
|
| Min. Negotiated Rate |
$234.73 |
| Max. Negotiated Rate |
$1,885.50 |
| Rate for Payer: Aetna Commercial |
$497.89
|
| Rate for Payer: Aetna Medicare |
$620.50
|
| Rate for Payer: BCBS Complete |
$246.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,885.50
|
| Rate for Payer: BCN Commercial |
$539.01
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Meridian Medicaid |
$246.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$583.95
|
| Rate for Payer: Priority Health Narrow Network |
$583.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.15
|
| Rate for Payer: UHC Exchange |
$504.15
|
| Rate for Payer: UHCCP Medicaid |
$234.73
|
|
|
PR INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 33217
|
| Min. Negotiated Rate |
$233.45 |
| Max. Negotiated Rate |
$1,400.52 |
| Rate for Payer: Aetna Commercial |
$493.05
|
| Rate for Payer: Aetna Medicare |
$620.50
|
| Rate for Payer: BCBS Complete |
$245.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,400.52
|
| Rate for Payer: BCN Commercial |
$533.63
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Meridian Medicaid |
$245.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$579.68
|
| Rate for Payer: Priority Health Narrow Network |
$579.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$500.10
|
| Rate for Payer: UHC Exchange |
$500.10
|
| Rate for Payer: UHCCP Medicaid |
$233.45
|
|
|
PR INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 22853
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$391.82 |
| Rate for Payer: Aetna Commercial |
$347.96
|
| Rate for Payer: Aetna Medicare |
$273.00
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS Trust/PPO |
$89.99
|
| Rate for Payer: BCN Commercial |
$375.30
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.82
|
| Rate for Payer: Priority Health Narrow Network |
$391.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.64
|
| Rate for Payer: UHC Exchange |
$339.64
|
| Rate for Payer: UHCCP Medicaid |
$164.86
|
|
|
PR INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 22859
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$1,486.55 |
| Rate for Payer: Aetna Commercial |
$449.13
|
| Rate for Payer: Aetna Medicare |
$1,143.50
|
| Rate for Payer: BCBS Complete |
$225.21
|
| Rate for Payer: BCBS Trust/PPO |
$133.29
|
| Rate for Payer: BCN Commercial |
$484.28
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Meridian Medicaid |
$225.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$506.82
|
| Rate for Payer: Priority Health Narrow Network |
$506.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.64
|
| Rate for Payer: UHC Exchange |
$439.64
|
| Rate for Payer: UHCCP Medicaid |
$214.49
|
|
|
PR INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 22854
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$573.95 |
| Rate for Payer: Aetna Commercial |
$450.55
|
| Rate for Payer: Aetna Medicare |
$441.50
|
| Rate for Payer: BCBS Complete |
$225.44
|
| Rate for Payer: BCBS Trust/PPO |
$69.19
|
| Rate for Payer: BCN Commercial |
$488.19
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Meridian Medicaid |
$225.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.38
|
| Rate for Payer: Priority Health Narrow Network |
$510.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.64
|
| Rate for Payer: UHC Exchange |
$439.64
|
| Rate for Payer: UHCCP Medicaid |
$214.70
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 36810
|
| Min. Negotiated Rate |
$121.62 |
| Max. Negotiated Rate |
$1,011.69 |
| Rate for Payer: Aetna Commercial |
$285.92
|
| Rate for Payer: Aetna Medicare |
$741.50
|
| Rate for Payer: BCBS Complete |
$127.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,011.69
|
| Rate for Payer: BCN Commercial |
$301.51
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Meridian Medicaid |
$127.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.20
|
| Rate for Payer: Priority Health Narrow Network |
$329.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$273.76
|
| Rate for Payer: UHC Exchange |
$273.76
|
| Rate for Payer: UHCCP Medicaid |
$121.62
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 36800
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$720.07 |
| Rate for Payer: Aetna Commercial |
$164.38
|
| Rate for Payer: Aetna Medicare |
$332.50
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS Trust/PPO |
$720.07
|
| Rate for Payer: BCN Commercial |
$173.48
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.32
|
| Rate for Payer: Priority Health Narrow Network |
$189.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.53
|
| Rate for Payer: UHC Exchange |
$201.53
|
| Rate for Payer: UHCCP Medicaid |
$75.83
|
|
|
PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN
|
Professional
|
Both
|
$1,619.00
|
|
|
Service Code
|
HCPCS 33224
|
| Min. Negotiated Rate |
$320.35 |
| Max. Negotiated Rate |
$1,392.07 |
| Rate for Payer: Aetna Commercial |
$692.69
|
| Rate for Payer: Aetna Medicare |
$809.50
|
| Rate for Payer: BCBS Complete |
$336.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.07
|
| Rate for Payer: BCN Commercial |
$738.39
|
| Rate for Payer: Cash Price |
$1,295.20
|
| Rate for Payer: Cash Price |
$1,295.20
|
| Rate for Payer: Meridian Medicaid |
$336.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.21
|
| Rate for Payer: Priority Health Narrow Network |
$797.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$685.96
|
| Rate for Payer: UHC Exchange |
$685.96
|
| Rate for Payer: UHCCP Medicaid |
$320.35
|
|
