|
PR INSULIN INJECTION
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS J1815
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$0.30
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.22
|
| Rate for Payer: UHC Exchange |
$0.22
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT DIRECT
|
Professional
|
Both
|
$1,966.00
|
|
|
Service Code
|
HCPCS 48520
|
| Min. Negotiated Rate |
$260.45 |
| Max. Negotiated Rate |
$1,970.56 |
| Rate for Payer: Aetna Commercial |
$1,491.40
|
| Rate for Payer: Aetna Medicare |
$983.00
|
| Rate for Payer: BCBS Complete |
$742.30
|
| Rate for Payer: BCBS Trust/PPO |
$260.45
|
| Rate for Payer: BCN Commercial |
$1,608.24
|
| Rate for Payer: Cash Price |
$1,572.80
|
| Rate for Payer: Cash Price |
$1,572.80
|
| Rate for Payer: Meridian Medicaid |
$742.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,277.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,970.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,970.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,317.40
|
| Rate for Payer: UHC Exchange |
$1,317.40
|
| Rate for Payer: UHCCP Medicaid |
$706.95
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y
|
Professional
|
Both
|
$2,887.00
|
|
|
Service Code
|
HCPCS 48540
|
| Min. Negotiated Rate |
$502.41 |
| Max. Negotiated Rate |
$2,338.65 |
| Rate for Payer: Aetna Commercial |
$1,774.25
|
| Rate for Payer: Aetna Medicare |
$1,443.50
|
| Rate for Payer: BCBS Complete |
$881.40
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: BCN Commercial |
$1,908.28
|
| Rate for Payer: Cash Price |
$2,309.60
|
| Rate for Payer: Cash Price |
$2,309.60
|
| Rate for Payer: Meridian Medicaid |
$881.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,876.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,338.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,338.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,574.41
|
| Rate for Payer: UHC Exchange |
$1,574.41
|
| Rate for Payer: UHCCP Medicaid |
$839.43
|
|
|
PR INTENSIVE OUTPATIENT PSYCHIA
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS S9480
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$820.98 |
| Rate for Payer: Aetna Commercial |
$63.28
|
| Rate for Payer: Aetna Medicare |
$65.00
|
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: BCBS Trust/PPO |
$820.98
|
| Rate for Payer: BCN Commercial |
$256.38
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.50
|
|
|
PR INTER DEVC REMOTE 30D
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS G2066
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$1,033.35 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.35
|
| Rate for Payer: BCN Commercial |
$32.38
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
|
|
PR INTERMITTENT URINARY CATH
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS A4353
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.71 |
| Rate for Payer: Aetna Commercial |
$6.52
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCN Commercial |
$7.71
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.41
|
| Rate for Payer: UHC Exchange |
$4.41
|
|
|
PR INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 64727
|
| Min. Negotiated Rate |
$113.53 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$232.94
|
| Rate for Payer: Aetna Medicare |
$375.00
|
| Rate for Payer: BCBS Complete |
$119.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: BCN Commercial |
$259.98
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Meridian Medicaid |
$119.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$302.56
|
| Rate for Payer: Priority Health Narrow Network |
$302.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.27
|
| Rate for Payer: UHC Exchange |
$218.27
|
| Rate for Payer: UHCCP Medicaid |
$113.53
|
|
|
PR INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 22841
|
| Min. Negotiated Rate |
$123.16 |
| Max. Negotiated Rate |
$791.70 |
| Rate for Payer: Aetna Commercial |
$519.10
|
| Rate for Payer: Aetna Medicare |
$609.00
|
| Rate for Payer: BCBS Complete |
$487.20
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$123.16
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$597.41
|
| Rate for Payer: Priority Health Narrow Network |
$597.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$432.94
|
| Rate for Payer: UHC Exchange |
$432.94
|
|
|
PR INTERPELVIABDOMINAL AMPUTATION
|
Professional
|
Both
|
$5,330.00
|
|
|
Service Code
|
HCPCS 27290
|
| Min. Negotiated Rate |
$1,047.75 |
| Max. Negotiated Rate |
$3,464.50 |
| Rate for Payer: Aetna Commercial |
$2,173.74
|
| Rate for Payer: Aetna Medicare |
$2,665.00
|
| Rate for Payer: BCBS Complete |
$1,100.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,174.41
|
| Rate for Payer: BCN Commercial |
$2,371.55
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Meridian Medicaid |
$1,100.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,047.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,464.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,484.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,484.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,850.24
|
| Rate for Payer: UHC Exchange |
$1,850.24
|
| Rate for Payer: UHCCP Medicaid |
$1,047.75
|
|
|
PR INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 90887
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$99.35 |
| Rate for Payer: Aetna Commercial |
$83.11
|
| Rate for Payer: Aetna Medicare |
$76.00
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$60.75
|
| Rate for Payer: BCN Commercial |
$99.35
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.40
|
| Rate for Payer: Priority Health Narrow Network |
$98.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.98
|
| Rate for Payer: UHC Exchange |
$79.98
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 93261
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Aetna Commercial |
$89.88
|
| Rate for Payer: Aetna Medicare |
$68.00
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS Trust/PPO |
$756.00
|
| Rate for Payer: BCN Commercial |
$102.62
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.97
|
| Rate for Payer: Priority Health Narrow Network |
$48.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.23
|
| Rate for Payer: UHC Exchange |
$78.23
|
| Rate for Payer: UHCCP Medicaid |
$22.37
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 93292
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$410.49 |
| Rate for Payer: Aetna Commercial |
$63.69
|
| Rate for Payer: Aetna Medicare |
$32.00
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$74.77
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.73
|
| Rate for Payer: Priority Health Narrow Network |
$28.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.86
|
| Rate for Payer: UHC Exchange |
$36.86
|
| Rate for Payer: UHCCP Medicaid |
$12.99
|
|
|
PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 93295
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$274.19 |
| Rate for Payer: Aetna Commercial |
$50.04
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS Trust/PPO |
$274.19
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.85
|
| Rate for Payer: Priority Health Narrow Network |
$50.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.43
|
| Rate for Payer: UHC Exchange |
$74.43
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 93290
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$108.83 |
| Rate for Payer: Aetna Commercial |
$67.56
|
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS Trust/PPO |
$108.83
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.73
|
| Rate for Payer: Priority Health Narrow Network |
$28.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.76
|
| Rate for Payer: UHC Exchange |
$32.76
|
| Rate for Payer: UHCCP Medicaid |
$12.99
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 93288
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$111.15 |
| Rate for Payer: Aetna Commercial |
$70.53
|
| Rate for Payer: Aetna Commercial |
$70.53
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: Aetna Medicare |
$85.50
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$79.25
|
| Rate for Payer: BCBS Trust/PPO |
$79.25
|
| Rate for Payer: BCN Commercial |
$82.58
|
| Rate for Payer: BCN Commercial |
$82.58
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Meridian Medicaid |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.25
|
| Rate for Payer: Priority Health Narrow Network |
$28.25
|
| Rate for Payer: Priority Health Narrow Network |
$28.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.44
|
| Rate for Payer: UHC Exchange |
$42.44
|
| Rate for Payer: UHC Exchange |
$42.44
|
| Rate for Payer: UHCCP Medicaid |
$12.78
|
| Rate for Payer: UHCCP Medicaid |
$12.78
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 93291
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$313.28 |
| Rate for Payer: Aetna Commercial |
$62.12
|
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$72.82
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.48
|
| Rate for Payer: Priority Health Narrow Network |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.95
|
| Rate for Payer: UHC Exchange |
$40.95
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
|
|
PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 93289
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$133.90 |
| Rate for Payer: Aetna Commercial |
$92.99
|
| Rate for Payer: Aetna Medicare |
$103.00
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS Trust/PPO |
$120.45
|
| Rate for Payer: BCN Commercial |
$106.53
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.90
|
| Rate for Payer: Priority Health Narrow Network |
$49.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.26
|
| Rate for Payer: UHC Exchange |
$72.26
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
|
|
PR INTERTHORACOSCAPULAR AMPUTATION
|
Professional
|
Both
|
$5,989.00
|
|
|
Service Code
|
HCPCS 23900
|
| Min. Negotiated Rate |
$354.88 |
| Max. Negotiated Rate |
$3,892.85 |
| Rate for Payer: Aetna Commercial |
$1,852.71
|
| Rate for Payer: Aetna Medicare |
$2,994.50
|
| Rate for Payer: BCBS Complete |
$939.78
|
| Rate for Payer: BCBS Trust/PPO |
$354.88
|
| Rate for Payer: BCN Commercial |
$2,024.59
|
| Rate for Payer: Cash Price |
$4,791.20
|
| Rate for Payer: Cash Price |
$4,791.20
|
| Rate for Payer: Meridian Medicaid |
$939.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$895.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,892.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,121.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,121.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,556.94
|
| Rate for Payer: UHC Exchange |
$1,556.94
|
| Rate for Payer: UHCCP Medicaid |
$895.03
|
|
|
PR INTESTINAL PLICATION SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,967.00
|
|
|
Service Code
|
HCPCS 44680
|
| Min. Negotiated Rate |
$305.89 |
| Max. Negotiated Rate |
$1,928.55 |
| Rate for Payer: Aetna Commercial |
$1,457.86
|
| Rate for Payer: Aetna Medicare |
$1,483.50
|
| Rate for Payer: BCBS Complete |
$727.08
|
| Rate for Payer: BCBS Trust/PPO |
$305.89
|
| Rate for Payer: BCN Commercial |
$1,572.56
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Meridian Medicaid |
$727.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,927.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,927.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,295.35
|
| Rate for Payer: UHC Exchange |
$1,295.35
|
| Rate for Payer: UHCCP Medicaid |
$692.46
|
|
|
PR INT HRHC BY LIGATION 2+ HROID W/O IMG GDN
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 46946
|
| Min. Negotiated Rate |
$245.00 |
| Max. Negotiated Rate |
$1,392.60 |
| Rate for Payer: Aetna Commercial |
$507.35
|
| Rate for Payer: Aetna Medicare |
$245.00
|
| Rate for Payer: BCBS Complete |
$258.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.60
|
| Rate for Payer: BCN Commercial |
$558.56
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Meridian Medicaid |
$258.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.89
|
| Rate for Payer: Priority Health Narrow Network |
$684.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.91
|
| Rate for Payer: UHC Exchange |
$256.91
|
| Rate for Payer: UHCCP Medicaid |
$246.44
|
|
|
PR INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN
|
Professional
|
Both
|
$461.00
|
|
|
Service Code
|
HCPCS 46945
|
| Min. Negotiated Rate |
$221.52 |
| Max. Negotiated Rate |
$1,245.20 |
| Rate for Payer: Aetna Commercial |
$449.56
|
| Rate for Payer: Aetna Medicare |
$230.50
|
| Rate for Payer: BCBS Complete |
$232.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,245.20
|
| Rate for Payer: BCN Commercial |
$497.96
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Meridian Medicaid |
$232.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.31
|
| Rate for Payer: Priority Health Narrow Network |
$613.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.41
|
| Rate for Payer: UHC Exchange |
$248.41
|
| Rate for Payer: UHCCP Medicaid |
$221.52
|
|
|
PR INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 93662
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$211.11 |
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Medicare |
$146.50
|
| Rate for Payer: Aetna Medicare |
$279.50
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS Trust/PPO |
$68.15
|
| Rate for Payer: BCBS Trust/PPO |
$68.15
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.52
|
| Rate for Payer: Priority Health Narrow Network |
$96.52
|
| Rate for Payer: Priority Health Narrow Network |
$96.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.31
|
| Rate for Payer: UHC Exchange |
$193.31
|
| Rate for Payer: UHC Exchange |
$193.31
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
|
|
PR INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING
|
Professional
|
Both
|
$1,201.00
|
|
|
Service Code
|
HCPCS 93613
|
| Min. Negotiated Rate |
$181.26 |
| Max. Negotiated Rate |
$1,339.77 |
| Rate for Payer: Aetna Commercial |
$397.73
|
| Rate for Payer: Aetna Medicare |
$600.50
|
| Rate for Payer: BCBS Complete |
$190.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$420.26
|
| Rate for Payer: Cash Price |
$960.80
|
| Rate for Payer: Cash Price |
$960.80
|
| Rate for Payer: Meridian Medicaid |
$190.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$780.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.62
|
| Rate for Payer: Priority Health Narrow Network |
$288.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$521.30
|
| Rate for Payer: UHC Exchange |
$521.30
|
| Rate for Payer: UHCCP Medicaid |
$181.26
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ DURAL CMPL
|
Professional
|
Both
|
$9,212.00
|
|
|
Service Code
|
HCPCS 61692
|
| Min. Negotiated Rate |
$784.00 |
| Max. Negotiated Rate |
$6,284.31 |
| Rate for Payer: Aetna Commercial |
$4,717.73
|
| Rate for Payer: Aetna Medicare |
$4,606.00
|
| Rate for Payer: BCBS Complete |
$2,480.95
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$5,360.79
|
| Rate for Payer: Cash Price |
$7,369.60
|
| Rate for Payer: Cash Price |
$7,369.60
|
| Rate for Payer: Meridian Medicaid |
$2,480.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,362.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,987.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,284.31
|
| Rate for Payer: Priority Health Narrow Network |
$6,284.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,278.64
|
| Rate for Payer: UHC Exchange |
$4,278.64
|
| Rate for Payer: UHCCP Medicaid |
$2,362.81
|
|
|
PR INTRACRANIAL ARVEN MALFRMJ DURAL SMPL
|
Professional
|
Both
|
$7,820.00
|
|
|
Service Code
|
HCPCS 61690
|
| Min. Negotiated Rate |
$331.77 |
| Max. Negotiated Rate |
$5,083.00 |
| Rate for Payer: Aetna Commercial |
$2,817.87
|
| Rate for Payer: Aetna Medicare |
$3,910.00
|
| Rate for Payer: BCBS Complete |
$1,492.64
|
| Rate for Payer: BCBS Trust/PPO |
$331.77
|
| Rate for Payer: BCN Commercial |
$3,215.01
|
| Rate for Payer: Cash Price |
$6,256.00
|
| Rate for Payer: Cash Price |
$6,256.00
|
| Rate for Payer: Meridian Medicaid |
$1,492.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,421.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,083.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,777.98
|
| Rate for Payer: Priority Health Narrow Network |
$3,777.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,530.04
|
| Rate for Payer: UHC Exchange |
$2,530.04
|
| Rate for Payer: UHCCP Medicaid |
$1,421.56
|
|
