|
PR LIGATION MAJOR ARTERY CHEST
|
Professional
|
Both
|
$3,489.00
|
|
|
Service Code
|
HCPCS 37616
|
| Min. Negotiated Rate |
$682.88 |
| Max. Negotiated Rate |
$2,616.75 |
| Rate for Payer: Aetna Commercial |
$1,426.20
|
| Rate for Payer: Aetna Medicare |
$1,064.33
|
| Rate for Payer: BCBS Complete |
$717.02
|
| Rate for Payer: BCBS MAPPO |
$1,064.33
|
| Rate for Payer: BCN Commercial |
$1,700.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,064.33
|
| Rate for Payer: Cash Price |
$2,791.20
|
| Rate for Payer: Cash Price |
$2,791.20
|
| Rate for Payer: Cofinity Commercial |
$1,532.64
|
| Rate for Payer: Cofinity Commercial |
$1,426.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,064.33
|
| Rate for Payer: Healthscope Commercial |
$1,277.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,277.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,117.55
|
| Rate for Payer: Meridian Medicaid |
$717.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,170.76
|
| Rate for Payer: Nomi Health Commercial |
$1,277.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,616.75
|
| Rate for Payer: PACE SWMI |
$1,064.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,064.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,828.78
|
| Rate for Payer: Priority Health Medicare |
$1,064.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,828.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,064.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,963.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,064.33
|
| Rate for Payer: UHC Exchange |
$1,963.64
|
| Rate for Payer: UHC Medicaid |
$682.88
|
| Rate for Payer: UHCCP DNSP |
$1,064.33
|
| Rate for Payer: UHCCP Medicaid |
$682.88
|
|
|
PR LIGATION MAJOR ARTERY EXTREMITY
|
Professional
|
Both
|
$1,108.00
|
|
|
Service Code
|
HCPCS 37618
|
| Min. Negotiated Rate |
$235.58 |
| Max. Negotiated Rate |
$831.00 |
| Rate for Payer: Aetna Commercial |
$488.58
|
| Rate for Payer: Aetna Medicare |
$364.61
|
| Rate for Payer: BCBS Complete |
$247.36
|
| Rate for Payer: BCBS MAPPO |
$364.61
|
| Rate for Payer: BCN Commercial |
$583.64
|
| Rate for Payer: BCN Medicare Advantage |
$364.61
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cofinity Commercial |
$525.04
|
| Rate for Payer: Cofinity Commercial |
$488.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.61
|
| Rate for Payer: Healthscope Commercial |
$437.53
|
| Rate for Payer: Healthscope Whirlpool |
$437.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.84
|
| Rate for Payer: Meridian Medicaid |
$247.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$401.07
|
| Rate for Payer: Nomi Health Commercial |
$437.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$831.00
|
| Rate for Payer: PACE SWMI |
$364.61
|
| Rate for Payer: PHP Medicare Advantage |
$364.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$627.62
|
| Rate for Payer: Priority Health Medicare |
$364.61
|
| Rate for Payer: Priority Health Narrow Network |
$627.62
|
| Rate for Payer: Railroad Medicare Medicare |
$364.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$684.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$364.61
|
| Rate for Payer: UHC Exchange |
$684.62
|
| Rate for Payer: UHC Medicaid |
$235.58
|
| Rate for Payer: UHCCP DNSP |
$364.61
|
| Rate for Payer: UHCCP Medicaid |
$235.58
|
|
|
PR LIGATION MAJOR ARTERY NECK
|
Professional
|
Both
|
$1,249.00
|
|
|
Service Code
|
HCPCS 37615
|
| Min. Negotiated Rate |
$295.01 |
| Max. Negotiated Rate |
$936.75 |
| Rate for Payer: Aetna Commercial |
$609.42
|
| Rate for Payer: Aetna Medicare |
$454.79
|
| Rate for Payer: BCBS Complete |
$309.76
|
| Rate for Payer: BCBS MAPPO |
$454.79
|
| Rate for Payer: BCN Commercial |
$773.86
|
| Rate for Payer: BCN Medicare Advantage |
$454.79
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cash Price |
$999.20
|
| Rate for Payer: Cofinity Commercial |
$654.90
|
| Rate for Payer: Cofinity Commercial |
$609.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.79
|
| Rate for Payer: Healthscope Commercial |
$545.75
|
| Rate for Payer: Healthscope Whirlpool |
$545.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$477.53
|
| Rate for Payer: Meridian Medicaid |
$309.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$500.27
|
| Rate for Payer: Nomi Health Commercial |
$545.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$936.75
|
| Rate for Payer: PACE SWMI |
$454.79
|
| Rate for Payer: PHP Medicare Advantage |
$454.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$832.18
|
| Rate for Payer: Priority Health Medicare |
$454.79
|
| Rate for Payer: Priority Health Narrow Network |
$832.18
|
| Rate for Payer: Railroad Medicare Medicare |
$454.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$931.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$454.79
|
| Rate for Payer: UHC Exchange |
$931.86
|
| Rate for Payer: UHC Medicaid |
$295.01
|
| Rate for Payer: UHCCP DNSP |
$454.79
|
| Rate for Payer: UHCCP Medicaid |
$295.01
|
|
|
PR LIGATION OF FEMORAL VEIN
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 37650
|
| Min. Negotiated Rate |
$270.08 |
| Max. Negotiated Rate |
$1,296.75 |
| Rate for Payer: Aetna Commercial |
$570.79
|
| Rate for Payer: Aetna Medicare |
$425.96
|
| Rate for Payer: BCBS Complete |
$283.58
|
| Rate for Payer: BCBS MAPPO |
$425.96
|
| Rate for Payer: BCN Commercial |
$678.74
|
| Rate for Payer: BCN Medicare Advantage |
$425.96
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$613.38
|
| Rate for Payer: Cofinity Commercial |
$570.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.96
|
| Rate for Payer: Healthscope Commercial |
$511.15
|
| Rate for Payer: Healthscope Whirlpool |
$511.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.26
|
| Rate for Payer: Meridian Medicaid |
$283.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.56
|
| Rate for Payer: Nomi Health Commercial |
$511.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,296.75
|
| Rate for Payer: PACE SWMI |
$425.96
|
| Rate for Payer: PHP Medicare Advantage |
$425.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$729.90
|
| Rate for Payer: Priority Health Medicare |
$425.96
|
| Rate for Payer: Priority Health Narrow Network |
$729.90
|
| Rate for Payer: Railroad Medicare Medicare |
$425.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$819.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$425.96
|
| Rate for Payer: UHC Exchange |
$819.59
|
| Rate for Payer: UHC Medicaid |
$270.08
|
| Rate for Payer: UHCCP DNSP |
$425.96
|
| Rate for Payer: UHCCP Medicaid |
$270.08
|
|
|
PR LIGATION OF INFERIOR VENA CAVA
|
Professional
|
Both
|
$3,544.00
|
|
|
Service Code
|
HCPCS 37619
|
| Min. Negotiated Rate |
$1,009.41 |
| Max. Negotiated Rate |
$3,093.34 |
| Rate for Payer: Aetna Commercial |
$2,126.20
|
| Rate for Payer: Aetna Medicare |
$1,586.72
|
| Rate for Payer: BCBS Complete |
$1,059.88
|
| Rate for Payer: BCBS MAPPO |
$1,586.72
|
| Rate for Payer: BCN Commercial |
$2,577.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,586.72
|
| Rate for Payer: Cash Price |
$2,835.20
|
| Rate for Payer: Cash Price |
$2,835.20
|
| Rate for Payer: Cofinity Commercial |
$2,126.20
|
| Rate for Payer: Cofinity Commercial |
$2,284.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,586.72
|
| Rate for Payer: Healthscope Commercial |
$1,904.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,904.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.06
|
| Rate for Payer: Meridian Medicaid |
$1,059.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,745.39
|
| Rate for Payer: Nomi Health Commercial |
$1,904.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,658.00
|
| Rate for Payer: PACE SWMI |
$1,586.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,586.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,009.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,771.82
|
| Rate for Payer: Priority Health Medicare |
$1,586.72
|
| Rate for Payer: Priority Health Narrow Network |
$2,771.82
|
| Rate for Payer: Railroad Medicare Medicare |
$1,586.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,093.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,586.72
|
| Rate for Payer: UHC Exchange |
$3,093.34
|
| Rate for Payer: UHC Medicaid |
$1,009.41
|
| Rate for Payer: UHCCP DNSP |
$1,586.72
|
| Rate for Payer: UHCCP Medicaid |
$1,009.41
|
|
|
PR LIGATION OF SPERM DUCT
|
Professional
|
Both
|
$671.00
|
|
|
Service Code
|
HCPCS 55450
|
| Min. Negotiated Rate |
$268.40 |
| Max. Negotiated Rate |
$503.25 |
| Rate for Payer: BCBS Complete |
$268.40
|
| Rate for Payer: Cash Price |
$536.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.25
|
|
|
PR LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA
|
Professional
|
Both
|
$1,131.00
|
|
|
Service Code
|
HCPCS 37607
|
| Min. Negotiated Rate |
$220.67 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$461.36
|
| Rate for Payer: Aetna Medicare |
$344.30
|
| Rate for Payer: BCBS Complete |
$231.70
|
| Rate for Payer: BCBS MAPPO |
$344.30
|
| Rate for Payer: BCN Commercial |
$552.76
|
| Rate for Payer: BCN Medicare Advantage |
$344.30
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$495.79
|
| Rate for Payer: Cofinity Commercial |
$461.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.30
|
| Rate for Payer: Healthscope Commercial |
$413.16
|
| Rate for Payer: Healthscope Whirlpool |
$413.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.51
|
| Rate for Payer: Meridian Medicaid |
$231.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$378.73
|
| Rate for Payer: Nomi Health Commercial |
$413.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PACE SWMI |
$344.30
|
| Rate for Payer: PHP Medicare Advantage |
$344.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$594.43
|
| Rate for Payer: Priority Health Medicare |
$344.30
|
| Rate for Payer: Priority Health Narrow Network |
$594.43
|
| Rate for Payer: Railroad Medicare Medicare |
$344.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$665.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$344.30
|
| Rate for Payer: UHC Exchange |
$665.01
|
| Rate for Payer: UHC Medicaid |
$220.67
|
| Rate for Payer: UHCCP DNSP |
$344.30
|
| Rate for Payer: UHCCP Medicaid |
$220.67
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Professional
|
Both
|
$881.00
|
|
|
Service Code
|
HCPCS 37735
|
| Min. Negotiated Rate |
$341.01 |
| Max. Negotiated Rate |
$1,040.12 |
| Rate for Payer: Aetna Commercial |
$721.82
|
| Rate for Payer: Aetna Medicare |
$538.67
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS MAPPO |
$538.67
|
| Rate for Payer: BCN Commercial |
$857.02
|
| Rate for Payer: BCN Medicare Advantage |
$538.67
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cofinity Commercial |
$775.68
|
| Rate for Payer: Cofinity Commercial |
$721.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.67
|
| Rate for Payer: Healthscope Commercial |
$646.40
|
| Rate for Payer: Healthscope Whirlpool |
$646.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.60
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$592.54
|
| Rate for Payer: Nomi Health Commercial |
$646.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.75
|
| Rate for Payer: PACE SWMI |
$538.67
|
| Rate for Payer: PHP Medicare Advantage |
$538.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$921.62
|
| Rate for Payer: Priority Health Medicare |
$538.67
|
| Rate for Payer: Priority Health Narrow Network |
$921.62
|
| Rate for Payer: Railroad Medicare Medicare |
$538.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,040.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$538.67
|
| Rate for Payer: UHC Exchange |
$1,040.12
|
| Rate for Payer: UHC Medicaid |
$341.01
|
| Rate for Payer: UHCCP DNSP |
$538.67
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
|
|
PR LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ
|
Professional
|
Both
|
$488.00
|
|
|
Service Code
|
HCPCS 37700
|
| Min. Negotiated Rate |
$145.27 |
| Max. Negotiated Rate |
$431.94 |
| Rate for Payer: Aetna Commercial |
$302.36
|
| Rate for Payer: Aetna Medicare |
$225.64
|
| Rate for Payer: BCBS Complete |
$152.53
|
| Rate for Payer: BCBS MAPPO |
$225.64
|
| Rate for Payer: BCN Commercial |
$363.53
|
| Rate for Payer: BCN Medicare Advantage |
$225.64
|
| Rate for Payer: Cash Price |
$390.40
|
| Rate for Payer: Cash Price |
$390.40
|
| Rate for Payer: Cofinity Commercial |
$324.92
|
| Rate for Payer: Cofinity Commercial |
$302.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.64
|
| Rate for Payer: Healthscope Commercial |
$270.77
|
| Rate for Payer: Healthscope Whirlpool |
$270.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.92
|
| Rate for Payer: Meridian Medicaid |
$152.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.20
|
| Rate for Payer: Nomi Health Commercial |
$270.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$366.00
|
| Rate for Payer: PACE SWMI |
$225.64
|
| Rate for Payer: PHP Medicare Advantage |
$225.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$390.93
|
| Rate for Payer: Priority Health Medicare |
$225.64
|
| Rate for Payer: Priority Health Narrow Network |
$390.93
|
| Rate for Payer: Railroad Medicare Medicare |
$225.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$225.64
|
| Rate for Payer: UHC Exchange |
$431.94
|
| Rate for Payer: UHC Medicaid |
$145.27
|
| Rate for Payer: UHCCP DNSP |
$225.64
|
| Rate for Payer: UHCCP Medicaid |
$145.27
|
|
|
PR LIG DIV & STRIPPING SHORT SAPHENOUS VEIN
|
Professional
|
Both
|
$847.00
|
|
|
Service Code
|
HCPCS 37718
|
| Min. Negotiated Rate |
$231.32 |
| Max. Negotiated Rate |
$747.90 |
| Rate for Payer: Aetna Commercial |
$487.85
|
| Rate for Payer: Aetna Medicare |
$364.07
|
| Rate for Payer: BCBS Complete |
$242.89
|
| Rate for Payer: BCBS MAPPO |
$364.07
|
| Rate for Payer: BCN Commercial |
$581.64
|
| Rate for Payer: BCN Medicare Advantage |
$364.07
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cofinity Commercial |
$524.26
|
| Rate for Payer: Cofinity Commercial |
$487.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.07
|
| Rate for Payer: Healthscope Commercial |
$436.88
|
| Rate for Payer: Healthscope Whirlpool |
$436.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.27
|
| Rate for Payer: Meridian Medicaid |
$242.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$400.48
|
| Rate for Payer: Nomi Health Commercial |
$436.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$635.25
|
| Rate for Payer: PACE SWMI |
$364.07
|
| Rate for Payer: PHP Medicare Advantage |
$364.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$625.49
|
| Rate for Payer: Priority Health Medicare |
$364.07
|
| Rate for Payer: Priority Health Narrow Network |
$625.49
|
| Rate for Payer: Railroad Medicare Medicare |
$364.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$747.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$364.07
|
| Rate for Payer: UHC Exchange |
$747.90
|
| Rate for Payer: UHC Medicaid |
$231.32
|
| Rate for Payer: UHCCP DNSP |
$364.07
|
| Rate for Payer: UHCCP Medicaid |
$231.32
|
|
|
PR LIG DIV&STRPG LONG SAPH SAPHFEM JUNCT KNE/BELW
|
Professional
|
Both
|
$976.00
|
|
|
Service Code
|
HCPCS 37722
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$840.39 |
| Rate for Payer: Aetna Commercial |
$569.69
|
| Rate for Payer: Aetna Medicare |
$425.14
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$425.14
|
| Rate for Payer: BCN Commercial |
$676.26
|
| Rate for Payer: BCN Medicare Advantage |
$425.14
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cofinity Commercial |
$612.20
|
| Rate for Payer: Cofinity Commercial |
$569.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.14
|
| Rate for Payer: Healthscope Commercial |
$510.17
|
| Rate for Payer: Healthscope Whirlpool |
$510.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.40
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$467.65
|
| Rate for Payer: Nomi Health Commercial |
$510.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.00
|
| Rate for Payer: PACE SWMI |
$425.14
|
| Rate for Payer: PHP Medicare Advantage |
$425.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$727.24
|
| Rate for Payer: Priority Health Medicare |
$425.14
|
| Rate for Payer: Priority Health Narrow Network |
$727.24
|
| Rate for Payer: Railroad Medicare Medicare |
$425.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$840.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$425.14
|
| Rate for Payer: UHC Exchange |
$840.39
|
| Rate for Payer: UHC Medicaid |
$270.51
|
| Rate for Payer: UHCCP DNSP |
$425.14
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 37785
|
| Min. Negotiated Rate |
$149.31 |
| Max. Negotiated Rate |
$748.50 |
| Rate for Payer: Aetna Commercial |
$310.65
|
| Rate for Payer: Aetna Medicare |
$231.83
|
| Rate for Payer: BCBS Complete |
$156.78
|
| Rate for Payer: BCBS MAPPO |
$231.83
|
| Rate for Payer: BCN Commercial |
$373.49
|
| Rate for Payer: BCN Medicare Advantage |
$231.83
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$333.84
|
| Rate for Payer: Cofinity Commercial |
$310.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.83
|
| Rate for Payer: Healthscope Commercial |
$278.20
|
| Rate for Payer: Healthscope Whirlpool |
$278.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.42
|
| Rate for Payer: Meridian Medicaid |
$156.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$255.01
|
| Rate for Payer: Nomi Health Commercial |
$278.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$748.50
|
| Rate for Payer: PACE SWMI |
$231.83
|
| Rate for Payer: PHP Medicare Advantage |
$231.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$401.64
|
| Rate for Payer: Priority Health Medicare |
$231.83
|
| Rate for Payer: Priority Health Narrow Network |
$401.64
|
| Rate for Payer: Railroad Medicare Medicare |
$231.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$454.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$231.83
|
| Rate for Payer: UHC Exchange |
$454.31
|
| Rate for Payer: UHC Medicaid |
$149.31
|
| Rate for Payer: UHCCP DNSP |
$231.83
|
| Rate for Payer: UHCCP Medicaid |
$149.31
|
|
|
PR LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 37780
|
| Min. Negotiated Rate |
$140.79 |
| Max. Negotiated Rate |
$414.87 |
| Rate for Payer: Aetna Commercial |
$294.59
|
| Rate for Payer: Aetna Medicare |
$219.84
|
| Rate for Payer: BCBS Complete |
$147.83
|
| Rate for Payer: BCBS MAPPO |
$219.84
|
| Rate for Payer: BCN Commercial |
$350.58
|
| Rate for Payer: BCN Medicare Advantage |
$219.84
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$316.57
|
| Rate for Payer: Cofinity Commercial |
$294.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.84
|
| Rate for Payer: Healthscope Commercial |
$263.81
|
| Rate for Payer: Healthscope Whirlpool |
$263.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.83
|
| Rate for Payer: Meridian Medicaid |
$147.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$241.82
|
| Rate for Payer: Nomi Health Commercial |
$263.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.75
|
| Rate for Payer: PACE SWMI |
$219.84
|
| Rate for Payer: PHP Medicare Advantage |
$219.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$377.00
|
| Rate for Payer: Priority Health Medicare |
$219.84
|
| Rate for Payer: Priority Health Narrow Network |
$377.00
|
| Rate for Payer: Railroad Medicare Medicare |
$219.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$414.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$219.84
|
| Rate for Payer: UHC Exchange |
$414.87
|
| Rate for Payer: UHC Medicaid |
$140.79
|
| Rate for Payer: UHCCP DNSP |
$219.84
|
| Rate for Payer: UHCCP Medicaid |
$140.79
|
|
|
PR LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR
|
Professional
|
Both
|
$2,301.00
|
|
|
Service Code
|
HCPCS 27429
|
| Min. Negotiated Rate |
$747.42 |
| Max. Negotiated Rate |
$2,193.11 |
| Rate for Payer: Aetna Commercial |
$1,535.67
|
| Rate for Payer: Aetna Medicare |
$1,146.02
|
| Rate for Payer: BCBS Complete |
$784.79
|
| Rate for Payer: BCBS MAPPO |
$1,146.02
|
| Rate for Payer: BCN Commercial |
$1,916.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,146.02
|
| Rate for Payer: Cash Price |
$1,840.80
|
| Rate for Payer: Cash Price |
$1,840.80
|
| Rate for Payer: Cofinity Commercial |
$1,650.27
|
| Rate for Payer: Cofinity Commercial |
$1,535.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,146.02
|
| Rate for Payer: Healthscope Commercial |
$1,375.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,375.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,203.32
|
| Rate for Payer: Meridian Medicaid |
$784.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,260.62
|
| Rate for Payer: Nomi Health Commercial |
$1,375.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,725.75
|
| Rate for Payer: PACE SWMI |
$1,146.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,146.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$747.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,048.93
|
| Rate for Payer: Priority Health Medicare |
$1,146.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,048.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,146.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,193.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,146.02
|
| Rate for Payer: UHC Exchange |
$2,193.11
|
| Rate for Payer: UHC Medicaid |
$747.42
|
| Rate for Payer: UHCCP DNSP |
$1,146.02
|
| Rate for Payer: UHCCP Medicaid |
$747.42
|
|
|
PR LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG
|
Professional
|
Both
|
$1,160.00
|
|
|
Service Code
|
HCPCS 37761
|
| Min. Negotiated Rate |
$310.98 |
| Max. Negotiated Rate |
$962.59 |
| Rate for Payer: Aetna Commercial |
$652.73
|
| Rate for Payer: Aetna Medicare |
$487.11
|
| Rate for Payer: BCBS Complete |
$326.53
|
| Rate for Payer: BCBS MAPPO |
$487.11
|
| Rate for Payer: BCN Commercial |
$785.81
|
| Rate for Payer: BCN Medicare Advantage |
$487.11
|
| Rate for Payer: Cash Price |
$928.00
|
| Rate for Payer: Cash Price |
$928.00
|
| Rate for Payer: Cofinity Commercial |
$701.44
|
| Rate for Payer: Cofinity Commercial |
$652.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.11
|
| Rate for Payer: Healthscope Commercial |
$584.53
|
| Rate for Payer: Healthscope Whirlpool |
$584.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.47
|
| Rate for Payer: Meridian Medicaid |
$326.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$535.82
|
| Rate for Payer: Nomi Health Commercial |
$584.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.00
|
| Rate for Payer: PACE SWMI |
$487.11
|
| Rate for Payer: PHP Medicare Advantage |
$487.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$845.05
|
| Rate for Payer: Priority Health Medicare |
$487.11
|
| Rate for Payer: Priority Health Narrow Network |
$845.05
|
| Rate for Payer: Railroad Medicare Medicare |
$487.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$962.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$487.11
|
| Rate for Payer: UHC Exchange |
$962.59
|
| Rate for Payer: UHC Medicaid |
$310.98
|
| Rate for Payer: UHCCP DNSP |
$487.11
|
| Rate for Payer: UHCCP Medicaid |
$310.98
|
|
|
PR LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 58611
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$260.25 |
| Rate for Payer: Aetna Commercial |
$87.49
|
| Rate for Payer: Aetna Medicare |
$65.29
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$65.29
|
| Rate for Payer: BCN Commercial |
$112.05
|
| Rate for Payer: BCN Medicare Advantage |
$65.29
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cofinity Commercial |
$94.02
|
| Rate for Payer: Cofinity Commercial |
$87.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.29
|
| Rate for Payer: Healthscope Commercial |
$78.35
|
| Rate for Payer: Healthscope Whirlpool |
$78.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.55
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.82
|
| Rate for Payer: Nomi Health Commercial |
$78.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.25
|
| Rate for Payer: PACE SWMI |
$65.29
|
| Rate for Payer: PHP Medicare Advantage |
$65.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$113.48
|
| Rate for Payer: Priority Health Medicare |
$65.29
|
| Rate for Payer: Priority Health Narrow Network |
$113.48
|
| Rate for Payer: Railroad Medicare Medicare |
$65.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.29
|
| Rate for Payer: UHC Exchange |
$137.70
|
| Rate for Payer: UHC Medicaid |
$41.54
|
| Rate for Payer: UHCCP DNSP |
$65.29
|
| Rate for Payer: UHCCP Medicaid |
$41.54
|
|
|
PR LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI
|
Professional
|
Both
|
$1,324.00
|
|
|
Service Code
|
HCPCS 58600
|
| Min. Negotiated Rate |
$211.94 |
| Max. Negotiated Rate |
$993.00 |
| Rate for Payer: Aetna Commercial |
$438.88
|
| Rate for Payer: Aetna Medicare |
$327.52
|
| Rate for Payer: BCBS Complete |
$222.54
|
| Rate for Payer: BCBS MAPPO |
$327.52
|
| Rate for Payer: BCN Commercial |
$557.74
|
| Rate for Payer: BCN Medicare Advantage |
$327.52
|
| Rate for Payer: Cash Price |
$1,059.20
|
| Rate for Payer: Cash Price |
$1,059.20
|
| Rate for Payer: Cofinity Commercial |
$471.63
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.52
|
| Rate for Payer: Healthscope Commercial |
$393.02
|
| Rate for Payer: Healthscope Whirlpool |
$393.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.90
|
| Rate for Payer: Meridian Medicaid |
$222.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$360.27
|
| Rate for Payer: Nomi Health Commercial |
$393.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$993.00
|
| Rate for Payer: PACE SWMI |
$327.52
|
| Rate for Payer: PHP Medicare Advantage |
$327.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$564.87
|
| Rate for Payer: Priority Health Medicare |
$327.52
|
| Rate for Payer: Priority Health Narrow Network |
$564.87
|
| Rate for Payer: Railroad Medicare Medicare |
$327.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$648.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$327.52
|
| Rate for Payer: UHC Exchange |
$648.90
|
| Rate for Payer: UHC Medicaid |
$211.94
|
| Rate for Payer: UHCCP DNSP |
$327.52
|
| Rate for Payer: UHCCP Medicaid |
$211.94
|
|
|
PR LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 58605
|
| Min. Negotiated Rate |
$192.77 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Aetna Commercial |
$398.66
|
| Rate for Payer: Aetna Medicare |
$297.51
|
| Rate for Payer: BCBS Complete |
$202.41
|
| Rate for Payer: BCBS MAPPO |
$297.51
|
| Rate for Payer: BCN Commercial |
$506.44
|
| Rate for Payer: BCN Medicare Advantage |
$297.51
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$428.41
|
| Rate for Payer: Cofinity Commercial |
$398.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.51
|
| Rate for Payer: Healthscope Commercial |
$357.01
|
| Rate for Payer: Healthscope Whirlpool |
$357.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.39
|
| Rate for Payer: Meridian Medicaid |
$202.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$327.26
|
| Rate for Payer: Nomi Health Commercial |
$357.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE SWMI |
$297.51
|
| Rate for Payer: PHP Medicare Advantage |
$297.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$512.91
|
| Rate for Payer: Priority Health Medicare |
$297.51
|
| Rate for Payer: Priority Health Narrow Network |
$512.91
|
| Rate for Payer: Railroad Medicare Medicare |
$297.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.51
|
| Rate for Payer: UHC Exchange |
$586.99
|
| Rate for Payer: UHC Medicaid |
$192.77
|
| Rate for Payer: UHCCP DNSP |
$297.51
|
| Rate for Payer: UHCCP Medicaid |
$192.77
|
|
|
PR LILETTA, 52 MG
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS J7297
|
| Min. Negotiated Rate |
$679.50 |
| Max. Negotiated Rate |
$1,037.01 |
| Rate for Payer: Aetna Commercial |
$845.10
|
| Rate for Payer: BCBS Complete |
$1,037.01
|
| Rate for Payer: BCBS Trust/PPO |
$939.18
|
| Rate for Payer: BCN Commercial |
$941.98
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Meridian Medicaid |
$1,037.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$679.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$987.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$978.32
|
| Rate for Payer: UHC Exchange |
$978.32
|
| Rate for Payer: UHC Medicaid |
$987.63
|
| Rate for Payer: UHCCP Medicaid |
$987.63
|
|
|
PR LIMITED VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 92081
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$42.60
|
| Rate for Payer: Aetna Medicare |
$31.79
|
| Rate for Payer: BCBS MAPPO |
$31.79
|
| Rate for Payer: BCN Commercial |
$49.80
|
| Rate for Payer: BCN Medicare Advantage |
$31.79
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$42.60
|
| Rate for Payer: Cofinity Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.79
|
| Rate for Payer: Healthscope Commercial |
$38.15
|
| Rate for Payer: Healthscope Whirlpool |
$38.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.97
|
| Rate for Payer: Nomi Health Commercial |
$38.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: PACE SWMI |
$31.79
|
| Rate for Payer: PHP Medicare Advantage |
$31.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42.61
|
| Rate for Payer: Priority Health Medicare |
$31.79
|
| Rate for Payer: Priority Health Narrow Network |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$31.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.79
|
| Rate for Payer: UHC Exchange |
$40.94
|
| Rate for Payer: UHCCP DNSP |
$31.79
|
|
|
PR LINCOMYCIN INJECTION
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS J2010
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: Aetna Medicare |
$4.72
|
| Rate for Payer: BCBS MAPPO |
$4.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.95
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: BCN Medicare Advantage |
$4.72
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$6.32
|
| Rate for Payer: Cofinity Commercial |
$6.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.72
|
| Rate for Payer: Healthscope Commercial |
$5.66
|
| Rate for Payer: Healthscope Whirlpool |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.19
|
| Rate for Payer: Nomi Health Commercial |
$5.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$4.72
|
| Rate for Payer: PHP Medicare Advantage |
$4.72
|
| Rate for Payer: Priority Health Medicare |
$4.72
|
| Rate for Payer: Railroad Medicare Medicare |
$4.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.72
|
| Rate for Payer: UHC Exchange |
$5.40
|
| Rate for Payer: UHCCP DNSP |
$4.72
|
|
|
PR LITHOLAPAXY COMP/LG > 2.5 CM
|
Professional
|
Both
|
$964.00
|
|
|
Service Code
|
HCPCS 52318
|
| Min. Negotiated Rate |
$264.12 |
| Max. Negotiated Rate |
$839.41 |
| Rate for Payer: Aetna Commercial |
$552.76
|
| Rate for Payer: Aetna Medicare |
$412.51
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$412.51
|
| Rate for Payer: BCN Commercial |
$698.17
|
| Rate for Payer: BCN Medicare Advantage |
$412.51
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cofinity Commercial |
$594.01
|
| Rate for Payer: Cofinity Commercial |
$552.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.51
|
| Rate for Payer: Healthscope Commercial |
$495.01
|
| Rate for Payer: Healthscope Whirlpool |
$495.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.14
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$453.76
|
| Rate for Payer: Nomi Health Commercial |
$495.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.00
|
| Rate for Payer: PACE SWMI |
$412.51
|
| Rate for Payer: PHP Medicare Advantage |
$412.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$760.54
|
| Rate for Payer: Priority Health Medicare |
$412.51
|
| Rate for Payer: Priority Health Narrow Network |
$760.54
|
| Rate for Payer: Railroad Medicare Medicare |
$412.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$839.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.51
|
| Rate for Payer: UHC Exchange |
$839.41
|
| Rate for Payer: UHC Medicaid |
$264.12
|
| Rate for Payer: UHCCP DNSP |
$412.51
|
| Rate for Payer: UHCCP Medicaid |
$264.12
|
|
|
PR LITHOLAPAXY SMPL/SM <2.5 CM
|
Professional
|
Both
|
$1,708.00
|
|
|
Service Code
|
HCPCS 52317
|
| Min. Negotiated Rate |
$194.04 |
| Max. Negotiated Rate |
$1,281.00 |
| Rate for Payer: Aetna Commercial |
$405.95
|
| Rate for Payer: Aetna Medicare |
$302.95
|
| Rate for Payer: BCBS Complete |
$203.74
|
| Rate for Payer: BCBS MAPPO |
$302.95
|
| Rate for Payer: BCN Commercial |
$511.92
|
| Rate for Payer: BCN Medicare Advantage |
$302.95
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cofinity Commercial |
$436.25
|
| Rate for Payer: Cofinity Commercial |
$405.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.95
|
| Rate for Payer: Healthscope Commercial |
$363.54
|
| Rate for Payer: Healthscope Whirlpool |
$363.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.10
|
| Rate for Payer: Meridian Medicaid |
$203.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.25
|
| Rate for Payer: Nomi Health Commercial |
$363.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.00
|
| Rate for Payer: PACE SWMI |
$302.95
|
| Rate for Payer: PHP Medicare Advantage |
$302.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$557.65
|
| Rate for Payer: Priority Health Medicare |
$302.95
|
| Rate for Payer: Priority Health Narrow Network |
$557.65
|
| Rate for Payer: Railroad Medicare Medicare |
$302.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$616.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$302.95
|
| Rate for Payer: UHC Exchange |
$616.81
|
| Rate for Payer: UHC Medicaid |
$194.04
|
| Rate for Payer: UHCCP DNSP |
$302.95
|
| Rate for Payer: UHCCP Medicaid |
$194.04
|
|
|
PR LITHOTRIPSY XTRCORP SHOCK WAVE
|
Professional
|
Both
|
$1,593.00
|
|
|
Service Code
|
HCPCS 50590
|
| Min. Negotiated Rate |
$332.28 |
| Max. Negotiated Rate |
$1,194.75 |
| Rate for Payer: Aetna Commercial |
$686.47
|
| Rate for Payer: Aetna Medicare |
$512.29
|
| Rate for Payer: BCBS Complete |
$348.89
|
| Rate for Payer: BCBS MAPPO |
$512.29
|
| Rate for Payer: BCN Commercial |
$943.70
|
| Rate for Payer: BCN Medicare Advantage |
$512.29
|
| Rate for Payer: Cash Price |
$1,274.40
|
| Rate for Payer: Cash Price |
$1,274.40
|
| Rate for Payer: Cofinity Commercial |
$737.70
|
| Rate for Payer: Cofinity Commercial |
$686.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.29
|
| Rate for Payer: Healthscope Commercial |
$614.75
|
| Rate for Payer: Healthscope Whirlpool |
$614.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$537.90
|
| Rate for Payer: Meridian Medicaid |
$348.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$563.52
|
| Rate for Payer: Nomi Health Commercial |
$614.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,194.75
|
| Rate for Payer: PACE SWMI |
$512.29
|
| Rate for Payer: PHP Medicare Advantage |
$512.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$935.75
|
| Rate for Payer: Priority Health Medicare |
$512.29
|
| Rate for Payer: Priority Health Narrow Network |
$935.75
|
| Rate for Payer: Railroad Medicare Medicare |
$512.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,001.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$512.29
|
| Rate for Payer: UHC Exchange |
$1,001.58
|
| Rate for Payer: UHC Medicaid |
$332.28
|
| Rate for Payer: UHCCP DNSP |
$512.29
|
| Rate for Payer: UHCCP Medicaid |
$332.28
|
|
|
PR LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC
|
Professional
|
Both
|
$4,060.00
|
|
|
Service Code
|
HCPCS 38562
|
| Min. Negotiated Rate |
$427.07 |
| Max. Negotiated Rate |
$3,045.00 |
| Rate for Payer: Aetna Commercial |
$883.03
|
| Rate for Payer: Aetna Medicare |
$658.98
|
| Rate for Payer: BCBS Complete |
$448.42
|
| Rate for Payer: BCBS MAPPO |
$658.98
|
| Rate for Payer: BCN Commercial |
$1,068.17
|
| Rate for Payer: BCN Medicare Advantage |
$658.98
|
| Rate for Payer: Cash Price |
$3,248.00
|
| Rate for Payer: Cash Price |
$3,248.00
|
| Rate for Payer: Cofinity Commercial |
$948.93
|
| Rate for Payer: Cofinity Commercial |
$883.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.98
|
| Rate for Payer: Healthscope Commercial |
$790.78
|
| Rate for Payer: Healthscope Whirlpool |
$790.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.93
|
| Rate for Payer: Meridian Medicaid |
$448.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$724.88
|
| Rate for Payer: Nomi Health Commercial |
$790.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,045.00
|
| Rate for Payer: PACE SWMI |
$658.98
|
| Rate for Payer: PHP Medicare Advantage |
$658.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,421.28
|
| Rate for Payer: Priority Health Medicare |
$658.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,421.28
|
| Rate for Payer: Railroad Medicare Medicare |
$658.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,242.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$658.98
|
| Rate for Payer: UHC Exchange |
$1,242.10
|
| Rate for Payer: UHC Medicaid |
$427.07
|
| Rate for Payer: UHCCP DNSP |
$658.98
|
| Rate for Payer: UHCCP Medicaid |
$427.07
|
|
