|
PR THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 60522
|
| Min. Negotiated Rate |
$603.85 |
| Max. Negotiated Rate |
$1,968.88 |
| Rate for Payer: Aetna Commercial |
$1,803.32
|
| Rate for Payer: Aetna Medicare |
$1,345.76
|
| Rate for Payer: BCBS Complete |
$904.89
|
| Rate for Payer: BCBS MAPPO |
$1,345.76
|
| Rate for Payer: BCBS Trust/PPO |
$603.85
|
| Rate for Payer: BCN Commercial |
$1,968.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,345.76
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$1,937.89
|
| Rate for Payer: Cofinity Commercial |
$1,803.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,345.76
|
| Rate for Payer: Healthscope Commercial |
$1,614.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,614.91
|
| Rate for Payer: Meridian Medicaid |
$904.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,413.05
|
| Rate for Payer: PACE SWMI |
$1,345.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,345.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$861.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,756.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,906.30
|
| Rate for Payer: Priority Health Medicare |
$1,345.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,906.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,386.13
|
|
|
PR THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX
|
Professional
|
Both
|
$3,462.00
|
|
|
Service Code
|
HCPCS 60520
|
| Min. Negotiated Rate |
$250.94 |
| Max. Negotiated Rate |
$2,423.40 |
| Rate for Payer: Aetna Commercial |
$1,395.70
|
| Rate for Payer: Aetna Medicare |
$1,041.57
|
| Rate for Payer: BCBS Complete |
$704.95
|
| Rate for Payer: BCBS MAPPO |
$1,041.57
|
| Rate for Payer: BCBS Trust/PPO |
$250.94
|
| Rate for Payer: BCN Commercial |
$1,531.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.57
|
| Rate for Payer: Cash Price |
$2,769.60
|
| Rate for Payer: Cash Price |
$2,769.60
|
| Rate for Payer: Cofinity Commercial |
$1,499.86
|
| Rate for Payer: Cofinity Commercial |
$1,395.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.57
|
| Rate for Payer: Healthscope Commercial |
$1,249.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,249.88
|
| Rate for Payer: Meridian Medicaid |
$704.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,093.65
|
| Rate for Payer: PACE SWMI |
$1,041.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$671.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,423.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,482.82
|
| Rate for Payer: Priority Health Medicare |
$1,041.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,482.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.82
|
|
|
PR THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$3,870.00
|
|
|
Service Code
|
HCPCS 60521
|
| Min. Negotiated Rate |
$373.51 |
| Max. Negotiated Rate |
$2,709.00 |
| Rate for Payer: Aetna Commercial |
$1,487.41
|
| Rate for Payer: Aetna Medicare |
$1,110.01
|
| Rate for Payer: BCBS Complete |
$747.66
|
| Rate for Payer: BCBS MAPPO |
$1,110.01
|
| Rate for Payer: BCBS Trust/PPO |
$373.51
|
| Rate for Payer: BCN Commercial |
$1,625.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,110.01
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Cofinity Commercial |
$1,598.41
|
| Rate for Payer: Cofinity Commercial |
$1,487.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,110.01
|
| Rate for Payer: Healthscope Commercial |
$1,332.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,332.01
|
| Rate for Payer: Meridian Medicaid |
$747.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,165.51
|
| Rate for Payer: PACE SWMI |
$1,110.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,110.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$712.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,573.67
|
| Rate for Payer: Priority Health Medicare |
$1,110.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,573.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,143.31
|
|
|
PR THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL
|
Professional
|
Both
|
$3,128.00
|
|
|
Service Code
|
HCPCS 60260
|
| Min. Negotiated Rate |
$317.51 |
| Max. Negotiated Rate |
$2,189.60 |
| Rate for Payer: Aetna Commercial |
$1,446.20
|
| Rate for Payer: Aetna Medicare |
$1,079.25
|
| Rate for Payer: BCBS Complete |
$731.12
|
| Rate for Payer: BCBS MAPPO |
$1,079.25
|
| Rate for Payer: BCBS Trust/PPO |
$317.51
|
| Rate for Payer: BCN Commercial |
$1,591.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,079.25
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cofinity Commercial |
$1,554.12
|
| Rate for Payer: Cofinity Commercial |
$1,446.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,079.25
|
| Rate for Payer: Healthscope Commercial |
$1,295.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,295.10
|
| Rate for Payer: Meridian Medicaid |
$731.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,133.21
|
| Rate for Payer: PACE SWMI |
$1,079.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,079.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,540.56
|
| Rate for Payer: Priority Health Medicare |
$1,079.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,540.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,111.63
|
|
|
PR THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH
|
Professional
|
Both
|
$2,143.36
|
|
|
Service Code
|
HCPCS 60271
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$3,645.80 |
| Rate for Payer: Aetna Commercial |
$1,402.02
|
| Rate for Payer: Aetna Medicare |
$1,046.28
|
| Rate for Payer: BCBS Complete |
$708.75
|
| Rate for Payer: BCBS MAPPO |
$1,046.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,645.80
|
| Rate for Payer: BCN Commercial |
$1,542.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,046.28
|
| Rate for Payer: Cash Price |
$1,714.69
|
| Rate for Payer: Cash Price |
$1,714.69
|
| Rate for Payer: Cofinity Commercial |
$1,506.64
|
| Rate for Payer: Cofinity Commercial |
$1,402.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,046.28
|
| Rate for Payer: Healthscope Commercial |
$1,255.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,255.54
|
| Rate for Payer: Meridian Medicaid |
$708.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,098.59
|
| Rate for Payer: PACE SWMI |
$1,046.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,046.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,500.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,493.24
|
| Rate for Payer: Priority Health Medicare |
$1,046.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,493.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.67
|
|
|
PR THYROIDECTOMY TOTAL/COMPLETE
|
Professional
|
Both
|
$3,049.00
|
|
|
Service Code
|
HCPCS 60240
|
| Min. Negotiated Rate |
$587.67 |
| Max. Negotiated Rate |
$2,134.30 |
| Rate for Payer: Aetna Commercial |
$1,219.06
|
| Rate for Payer: Aetna Medicare |
$909.75
|
| Rate for Payer: BCBS Complete |
$617.05
|
| Rate for Payer: BCBS MAPPO |
$909.75
|
| Rate for Payer: BCBS Trust/PPO |
$681.51
|
| Rate for Payer: BCN Commercial |
$1,341.91
|
| Rate for Payer: BCN Medicare Advantage |
$909.75
|
| Rate for Payer: Cash Price |
$2,439.20
|
| Rate for Payer: Cash Price |
$2,439.20
|
| Rate for Payer: Cofinity Commercial |
$1,219.06
|
| Rate for Payer: Cofinity Commercial |
$1,310.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$909.75
|
| Rate for Payer: Healthscope Commercial |
$1,091.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,091.70
|
| Rate for Payer: Meridian Medicaid |
$617.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$955.24
|
| Rate for Payer: PACE SWMI |
$909.75
|
| Rate for Payer: PHP Medicare Advantage |
$909.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$587.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,134.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,299.25
|
| Rate for Payer: Priority Health Medicare |
$909.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,299.25
|
| Rate for Payer: UHC Medicare Advantage |
$937.04
|
|
|
PR THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT
|
Professional
|
Both
|
$2,350.00
|
|
|
Service Code
|
HCPCS 60252
|
| Min. Negotiated Rate |
$785.58 |
| Max. Negotiated Rate |
$1,930.76 |
| Rate for Payer: Aetna Commercial |
$1,755.60
|
| Rate for Payer: Aetna Medicare |
$1,310.15
|
| Rate for Payer: BCBS Complete |
$886.55
|
| Rate for Payer: BCBS MAPPO |
$1,310.15
|
| Rate for Payer: BCBS Trust/PPO |
$785.58
|
| Rate for Payer: BCN Commercial |
$1,930.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,310.15
|
| Rate for Payer: Cash Price |
$1,880.00
|
| Rate for Payer: Cash Price |
$1,880.00
|
| Rate for Payer: Cofinity Commercial |
$1,886.62
|
| Rate for Payer: Cofinity Commercial |
$1,755.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,310.15
|
| Rate for Payer: Healthscope Commercial |
$1,572.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,572.18
|
| Rate for Payer: Meridian Medicaid |
$886.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,375.66
|
| Rate for Payer: PACE SWMI |
$1,310.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,310.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$844.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,645.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,869.38
|
| Rate for Payer: Priority Health Medicare |
$1,310.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,869.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,349.45
|
|
|
PR THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT
|
Professional
|
Both
|
$3,099.00
|
|
|
Service Code
|
HCPCS 60254
|
| Min. Negotiated Rate |
$225.06 |
| Max. Negotiated Rate |
$2,438.50 |
| Rate for Payer: Aetna Commercial |
$2,218.21
|
| Rate for Payer: Aetna Medicare |
$1,655.38
|
| Rate for Payer: BCBS Complete |
$1,118.47
|
| Rate for Payer: BCBS MAPPO |
$1,655.38
|
| Rate for Payer: BCBS Trust/PPO |
$225.06
|
| Rate for Payer: BCN Commercial |
$2,438.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,655.38
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cofinity Commercial |
$2,218.21
|
| Rate for Payer: Cofinity Commercial |
$2,383.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,655.38
|
| Rate for Payer: Healthscope Commercial |
$1,986.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,986.46
|
| Rate for Payer: Meridian Medicaid |
$1,118.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,738.15
|
| Rate for Payer: PACE SWMI |
$1,655.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,655.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,065.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,169.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,360.98
|
| Rate for Payer: Priority Health Medicare |
$1,655.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,360.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,705.04
|
|
|
PR THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC
|
Professional
|
Both
|
$5,346.00
|
|
|
Service Code
|
HCPCS 60270
|
| Min. Negotiated Rate |
$309.58 |
| Max. Negotiated Rate |
$3,742.20 |
| Rate for Payer: Aetna Commercial |
$1,814.92
|
| Rate for Payer: Aetna Medicare |
$1,354.42
|
| Rate for Payer: BCBS Complete |
$914.28
|
| Rate for Payer: BCBS MAPPO |
$1,354.42
|
| Rate for Payer: BCBS Trust/PPO |
$309.58
|
| Rate for Payer: BCN Commercial |
$1,991.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,354.42
|
| Rate for Payer: Cash Price |
$4,276.80
|
| Rate for Payer: Cash Price |
$4,276.80
|
| Rate for Payer: Cofinity Commercial |
$1,950.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,354.42
|
| Rate for Payer: Healthscope Commercial |
$1,625.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,625.30
|
| Rate for Payer: Meridian Medicaid |
$914.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,422.14
|
| Rate for Payer: PACE SWMI |
$1,354.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,354.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$870.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,742.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,928.05
|
| Rate for Payer: Priority Health Medicare |
$1,354.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,928.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,395.05
|
|
|
PR TISSUE EXPANDER PLACEMENT BREAST RECONSTRUCTION
|
Professional
|
Both
|
$2,400.00
|
|
|
Service Code
|
HCPCS 19357
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$1,696.69 |
| Rate for Payer: Aetna Commercial |
$1,516.93
|
| Rate for Payer: Aetna Medicare |
$1,132.04
|
| Rate for Payer: BCBS Complete |
$780.76
|
| Rate for Payer: BCBS MAPPO |
$1,132.04
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$1,696.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,132.04
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$1,630.14
|
| Rate for Payer: Cofinity Commercial |
$1,516.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,132.04
|
| Rate for Payer: Healthscope Commercial |
$1,358.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,358.45
|
| Rate for Payer: Meridian Medicaid |
$780.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,188.64
|
| Rate for Payer: PACE SWMI |
$1,132.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,132.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$743.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,680.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,427.12
|
| Rate for Payer: Priority Health Medicare |
$1,132.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,427.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,166.00
|
|
|
PR TIXAGEV AND CILGAV INJ - ADMIN
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS M0220
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$2,507.84 |
| Rate for Payer: Aetna Commercial |
$150.50
|
| Rate for Payer: BCBS Complete |
$80.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.84
|
| Rate for Payer: BCN Commercial |
$99.03
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.93
|
| Rate for Payer: Priority Health Narrow Network |
$144.93
|
|
|
PR TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP
|
Professional
|
Both
|
$3,534.00
|
|
|
Service Code
|
HCPCS 69637
|
| Min. Negotiated Rate |
$899.07 |
| Max. Negotiated Rate |
$2,473.80 |
| Rate for Payer: Aetna Commercial |
$1,832.91
|
| Rate for Payer: Aetna Medicare |
$1,367.84
|
| Rate for Payer: BCBS Complete |
$944.02
|
| Rate for Payer: BCBS MAPPO |
$1,367.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,372.93
|
| Rate for Payer: BCN Commercial |
$2,072.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,367.84
|
| Rate for Payer: Cash Price |
$2,827.20
|
| Rate for Payer: Cash Price |
$2,827.20
|
| Rate for Payer: Cofinity Commercial |
$1,832.91
|
| Rate for Payer: Cofinity Commercial |
$1,969.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,367.84
|
| Rate for Payer: Healthscope Commercial |
$1,641.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,641.41
|
| Rate for Payer: Meridian Medicaid |
$944.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,436.23
|
| Rate for Payer: PACE SWMI |
$1,367.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,367.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$899.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,473.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,999.94
|
| Rate for Payer: Priority Health Medicare |
$1,367.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,999.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,408.88
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR
|
Professional
|
Both
|
$4,225.00
|
|
|
Service Code
|
HCPCS 69644
|
| Min. Negotiated Rate |
$964.89 |
| Max. Negotiated Rate |
$2,957.50 |
| Rate for Payer: Aetna Commercial |
$1,972.92
|
| Rate for Payer: Aetna Medicare |
$1,472.33
|
| Rate for Payer: BCBS Complete |
$1,013.13
|
| Rate for Payer: BCBS MAPPO |
$1,472.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,406.93
|
| Rate for Payer: BCN Commercial |
$2,226.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,472.33
|
| Rate for Payer: Cash Price |
$3,380.00
|
| Rate for Payer: Cash Price |
$3,380.00
|
| Rate for Payer: Cofinity Commercial |
$1,972.92
|
| Rate for Payer: Cofinity Commercial |
$2,120.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,472.33
|
| Rate for Payer: Healthscope Commercial |
$1,766.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,766.80
|
| Rate for Payer: Meridian Medicaid |
$1,013.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,545.95
|
| Rate for Payer: PACE SWMI |
$1,472.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,472.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$964.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,957.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,147.97
|
| Rate for Payer: Priority Health Medicare |
$1,472.33
|
| Rate for Payer: Priority Health Narrow Network |
$2,147.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,516.50
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR
|
Professional
|
Both
|
$3,996.00
|
|
|
Service Code
|
HCPCS 69643
|
| Min. Negotiated Rate |
$785.12 |
| Max. Negotiated Rate |
$2,797.20 |
| Rate for Payer: Aetna Commercial |
$1,610.87
|
| Rate for Payer: Aetna Medicare |
$1,202.14
|
| Rate for Payer: BCBS Complete |
$824.38
|
| Rate for Payer: BCBS MAPPO |
$1,202.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,123.77
|
| Rate for Payer: BCN Commercial |
$1,808.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,202.14
|
| Rate for Payer: Cash Price |
$3,196.80
|
| Rate for Payer: Cash Price |
$3,196.80
|
| Rate for Payer: Cofinity Commercial |
$1,731.08
|
| Rate for Payer: Cofinity Commercial |
$1,610.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,202.14
|
| Rate for Payer: Healthscope Commercial |
$1,442.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,442.57
|
| Rate for Payer: Meridian Medicaid |
$824.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,262.25
|
| Rate for Payer: PACE SWMI |
$1,202.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,202.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$785.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,744.88
|
| Rate for Payer: Priority Health Medicare |
$1,202.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,744.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,238.20
|
|
|
PR TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$3,854.00
|
|
|
Service Code
|
HCPCS 69641
|
| Min. Negotiated Rate |
$669.46 |
| Max. Negotiated Rate |
$2,697.80 |
| Rate for Payer: Aetna Commercial |
$1,370.69
|
| Rate for Payer: Aetna Medicare |
$1,022.90
|
| Rate for Payer: BCBS Complete |
$702.93
|
| Rate for Payer: BCBS MAPPO |
$1,022.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,242.56
|
| Rate for Payer: BCN Commercial |
$1,541.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,022.90
|
| Rate for Payer: Cash Price |
$3,083.20
|
| Rate for Payer: Cash Price |
$3,083.20
|
| Rate for Payer: Cofinity Commercial |
$1,370.69
|
| Rate for Payer: Cofinity Commercial |
$1,472.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,022.90
|
| Rate for Payer: Healthscope Commercial |
$1,227.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,227.48
|
| Rate for Payer: Meridian Medicaid |
$702.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,074.04
|
| Rate for Payer: PACE SWMI |
$1,022.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,022.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$669.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,697.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,486.98
|
| Rate for Payer: Priority Health Medicare |
$1,022.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,486.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,053.59
|
|
|
PR TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$2,631.00
|
|
|
Service Code
|
HCPCS 69642
|
| Min. Negotiated Rate |
$859.24 |
| Max. Negotiated Rate |
$1,975.73 |
| Rate for Payer: Aetna Commercial |
$1,759.57
|
| Rate for Payer: Aetna Medicare |
$1,313.11
|
| Rate for Payer: BCBS Complete |
$902.20
|
| Rate for Payer: BCBS MAPPO |
$1,313.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,237.81
|
| Rate for Payer: BCN Commercial |
$1,975.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,313.11
|
| Rate for Payer: Cash Price |
$2,104.80
|
| Rate for Payer: Cash Price |
$2,104.80
|
| Rate for Payer: Cofinity Commercial |
$1,759.57
|
| Rate for Payer: Cofinity Commercial |
$1,890.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,313.11
|
| Rate for Payer: Healthscope Commercial |
$1,575.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,575.73
|
| Rate for Payer: Meridian Medicaid |
$902.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,378.77
|
| Rate for Payer: PACE SWMI |
$1,313.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,313.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$859.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,906.11
|
| Rate for Payer: Priority Health Medicare |
$1,313.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,906.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,352.50
|
|
|
PR TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH
|
Professional
|
Both
|
$3,685.00
|
|
|
Service Code
|
HCPCS 0483T
|
| Min. Negotiated Rate |
$131.11 |
| Max. Negotiated Rate |
$2,579.50 |
| Rate for Payer: Aetna Commercial |
$1,415.73
|
| Rate for Payer: BCBS Complete |
$1,474.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.11
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,579.50
|
|
|
PR TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 27681
|
| Min. Negotiated Rate |
$328.87 |
| Max. Negotiated Rate |
$1,190.70 |
| Rate for Payer: Aetna Commercial |
$665.18
|
| Rate for Payer: Aetna Medicare |
$496.40
|
| Rate for Payer: BCBS Complete |
$345.31
|
| Rate for Payer: BCBS MAPPO |
$496.40
|
| Rate for Payer: BCBS Trust/PPO |
$924.00
|
| Rate for Payer: BCN Commercial |
$742.30
|
| Rate for Payer: BCN Medicare Advantage |
$496.40
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$665.18
|
| Rate for Payer: Cofinity Commercial |
$714.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.40
|
| Rate for Payer: Healthscope Commercial |
$595.68
|
| Rate for Payer: Healthscope Whirlpool |
$595.68
|
| Rate for Payer: Meridian Medicaid |
$345.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$521.22
|
| Rate for Payer: PACE SWMI |
$496.40
|
| Rate for Payer: PHP Medicare Advantage |
$496.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$775.68
|
| Rate for Payer: Priority Health Medicare |
$496.40
|
| Rate for Payer: Priority Health Narrow Network |
$775.68
|
| Rate for Payer: UHC Medicare Advantage |
$511.29
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Facility
|
IP
|
$1,445.00
|
|
|
Service Code
|
CPT 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$1,011.50 |
| Max. Negotiated Rate |
$1,445.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: ASR ASR |
$1,401.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.31
|
| Rate for Payer: BCN Commercial |
$1,120.31
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cofinity Commercial |
$1,358.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.00
|
| Rate for Payer: Healthscope Commercial |
$1,445.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,401.65
|
| Rate for Payer: Mclaren Commercial |
$1,300.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,228.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,271.60
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,445.00
|
|
|
Service Code
|
HCPCS 25295
|
| Min. Negotiated Rate |
$343.78 |
| Max. Negotiated Rate |
$1,011.50 |
| Rate for Payer: Aetna Commercial |
$697.99
|
| Rate for Payer: Aetna Medicare |
$520.89
|
| Rate for Payer: BCBS Complete |
$360.97
|
| Rate for Payer: BCBS MAPPO |
$520.89
|
| Rate for Payer: BCBS Trust/PPO |
$803.02
|
| Rate for Payer: BCN Commercial |
$781.39
|
| Rate for Payer: BCN Medicare Advantage |
$520.89
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cofinity Commercial |
$750.08
|
| Rate for Payer: Cofinity Commercial |
$697.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.89
|
| Rate for Payer: Healthscope Commercial |
$625.07
|
| Rate for Payer: Healthscope Whirlpool |
$625.07
|
| Rate for Payer: Meridian Medicaid |
$360.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$546.93
|
| Rate for Payer: PACE SWMI |
$520.89
|
| Rate for Payer: PHP Medicare Advantage |
$520.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.53
|
| Rate for Payer: Priority Health Medicare |
$520.89
|
| Rate for Payer: Priority Health Narrow Network |
$816.53
|
| Rate for Payer: UHC Medicare Advantage |
$536.52
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,445.00
|
|
|
Service Code
|
HCPCS 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$343.78 |
| Max. Negotiated Rate |
$1,011.50 |
| Rate for Payer: Aetna Commercial |
$697.99
|
| Rate for Payer: Aetna Medicare |
$520.89
|
| Rate for Payer: BCBS Complete |
$360.97
|
| Rate for Payer: BCBS MAPPO |
$520.89
|
| Rate for Payer: BCBS Trust/PPO |
$803.02
|
| Rate for Payer: BCN Commercial |
$781.39
|
| Rate for Payer: BCN Medicare Advantage |
$520.89
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cofinity Commercial |
$750.08
|
| Rate for Payer: Cofinity Commercial |
$697.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.89
|
| Rate for Payer: Healthscope Commercial |
$625.07
|
| Rate for Payer: Healthscope Whirlpool |
$625.07
|
| Rate for Payer: Meridian Medicaid |
$360.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$546.93
|
| Rate for Payer: PACE SWMI |
$520.89
|
| Rate for Payer: PHP Medicare Advantage |
$520.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.53
|
| Rate for Payer: Priority Health Medicare |
$520.89
|
| Rate for Payer: Priority Health Narrow Network |
$816.53
|
| Rate for Payer: UHC Medicare Advantage |
$536.52
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Facility
|
OP
|
$1,445.00
|
|
|
Service Code
|
CPT 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$1,011.50 |
| Max. Negotiated Rate |
$3,596.44 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$1,401.65
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.31
|
| Rate for Payer: BCN Commercial |
$1,120.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cash Price |
$1,156.00
|
| Rate for Payer: Cofinity Commercial |
$1,358.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,445.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,401.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$1,300.50
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,228.25
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,314.95
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,271.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 24358
|
| Min. Negotiated Rate |
$222.41 |
| Max. Negotiated Rate |
$1,068.20 |
| Rate for Payer: Aetna Commercial |
$699.48
|
| Rate for Payer: Aetna Medicare |
$522.00
|
| Rate for Payer: BCBS Complete |
$362.98
|
| Rate for Payer: BCBS MAPPO |
$522.00
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCN Commercial |
$783.35
|
| Rate for Payer: BCN Medicare Advantage |
$522.00
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$751.68
|
| Rate for Payer: Cofinity Commercial |
$699.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.00
|
| Rate for Payer: Healthscope Commercial |
$626.40
|
| Rate for Payer: Healthscope Whirlpool |
$626.40
|
| Rate for Payer: Meridian Medicaid |
$362.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$548.10
|
| Rate for Payer: PACE SWMI |
$522.00
|
| Rate for Payer: PHP Medicare Advantage |
$522.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,068.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$818.57
|
| Rate for Payer: Priority Health Medicare |
$522.00
|
| Rate for Payer: Priority Health Narrow Network |
$818.57
|
| Rate for Payer: UHC Medicare Advantage |
$537.66
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Facility
|
IP
|
$1,817.00
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
24359
|
| Min. Negotiated Rate |
$1,271.90 |
| Max. Negotiated Rate |
$1,817.00 |
| Rate for Payer: Aetna Commercial |
$1,635.30
|
| Rate for Payer: ASR ASR |
$1,762.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,408.72
|
| Rate for Payer: BCN Commercial |
$1,408.72
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cofinity Commercial |
$1,707.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,453.60
|
| Rate for Payer: Healthscope Commercial |
$1,817.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,762.49
|
| Rate for Payer: Mclaren Commercial |
$1,635.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,544.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,271.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,598.96
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$1,817.00
|
|
|
Service Code
|
HCPCS 24359
|
| Hospital Charge Code |
24359
|
| Min. Negotiated Rate |
$191.45 |
| Max. Negotiated Rate |
$1,271.90 |
| Rate for Payer: Aetna Commercial |
$877.70
|
| Rate for Payer: Aetna Medicare |
$655.00
|
| Rate for Payer: BCBS Complete |
$452.67
|
| Rate for Payer: BCBS MAPPO |
$655.00
|
| Rate for Payer: BCBS Trust/PPO |
$191.45
|
| Rate for Payer: BCN Commercial |
$978.82
|
| Rate for Payer: BCN Medicare Advantage |
$655.00
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cofinity Commercial |
$877.70
|
| Rate for Payer: Cofinity Commercial |
$943.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.00
|
| Rate for Payer: Healthscope Commercial |
$786.00
|
| Rate for Payer: Healthscope Whirlpool |
$786.00
|
| Rate for Payer: Meridian Medicaid |
$452.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$687.75
|
| Rate for Payer: PACE SWMI |
$655.00
|
| Rate for Payer: PHP Medicare Advantage |
$655.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,271.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,022.83
|
| Rate for Payer: Priority Health Medicare |
$655.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,022.83
|
| Rate for Payer: UHC Medicare Advantage |
$674.65
|
|
