|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,809.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$79.81 |
| Max. Negotiated Rate |
$6,577.06 |
| Rate for Payer: Aetna Commercial |
$5,031.18
|
| Rate for Payer: Aetna Medicare |
$3,754.61
|
| Rate for Payer: BCBS Complete |
$2,511.37
|
| Rate for Payer: BCBS MAPPO |
$3,754.61
|
| Rate for Payer: BCBS Trust/PPO |
$79.81
|
| Rate for Payer: BCN Commercial |
$5,466.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,754.61
|
| Rate for Payer: Cash Price |
$6,247.20
|
| Rate for Payer: Cash Price |
$6,247.20
|
| Rate for Payer: Cofinity Commercial |
$5,031.18
|
| Rate for Payer: Cofinity Commercial |
$5,406.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,754.61
|
| Rate for Payer: Healthscope Commercial |
$4,505.53
|
| Rate for Payer: Healthscope Whirlpool |
$4,505.53
|
| Rate for Payer: Meridian Medicaid |
$2,511.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,942.34
|
| Rate for Payer: PACE SWMI |
$3,754.61
|
| Rate for Payer: PHP Medicare Advantage |
$3,754.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,391.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,466.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,577.06
|
| Rate for Payer: Priority Health Medicare |
$3,754.61
|
| Rate for Payer: Priority Health Narrow Network |
$6,577.06
|
| Rate for Payer: UHC Medicare Advantage |
$3,867.25
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,208.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$845.60 |
| Rate for Payer: Aetna Commercial |
$263.71
|
| Rate for Payer: Aetna Medicare |
$196.80
|
| Rate for Payer: BCBS Complete |
$136.21
|
| Rate for Payer: BCBS MAPPO |
$196.80
|
| Rate for Payer: BCBS Trust/PPO |
$406.79
|
| Rate for Payer: BCN Commercial |
$285.08
|
| Rate for Payer: BCN Medicare Advantage |
$196.80
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cofinity Commercial |
$283.39
|
| Rate for Payer: Cofinity Commercial |
$263.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.80
|
| Rate for Payer: Healthscope Commercial |
$236.16
|
| Rate for Payer: Healthscope Whirlpool |
$236.16
|
| Rate for Payer: Meridian Medicaid |
$136.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.64
|
| Rate for Payer: PACE SWMI |
$196.80
|
| Rate for Payer: PHP Medicare Advantage |
$196.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.60
|
| Rate for Payer: Priority Health Medicare |
$196.80
|
| Rate for Payer: Priority Health Narrow Network |
$353.60
|
| Rate for Payer: UHC Medicare Advantage |
$202.70
|
|
|
PR TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$1,068.75 |
| Rate for Payer: Aetna Commercial |
$64.94
|
| Rate for Payer: Aetna Medicare |
$48.46
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS MAPPO |
$48.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.75
|
| Rate for Payer: BCN Commercial |
$137.81
|
| Rate for Payer: BCN Medicare Advantage |
$48.46
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$69.78
|
| Rate for Payer: Cofinity Commercial |
$64.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.46
|
| Rate for Payer: Healthscope Commercial |
$58.15
|
| Rate for Payer: Healthscope Whirlpool |
$58.15
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.88
|
| Rate for Payer: PACE SWMI |
$48.46
|
| Rate for Payer: PHP Medicare Advantage |
$48.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.15
|
| Rate for Payer: Priority Health Medicare |
$48.46
|
| Rate for Payer: Priority Health Narrow Network |
$67.15
|
| Rate for Payer: UHC Medicare Advantage |
$49.91
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$241.97 |
| Max. Negotiated Rate |
$1,900.30 |
| Rate for Payer: Aetna Commercial |
$493.47
|
| Rate for Payer: Aetna Medicare |
$368.26
|
| Rate for Payer: BCBS Complete |
$254.07
|
| Rate for Payer: BCBS MAPPO |
$368.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,900.30
|
| Rate for Payer: BCN Commercial |
$550.25
|
| Rate for Payer: BCN Medicare Advantage |
$368.26
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$530.29
|
| Rate for Payer: Cofinity Commercial |
$493.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.26
|
| Rate for Payer: Healthscope Commercial |
$441.91
|
| Rate for Payer: Healthscope Whirlpool |
$441.91
|
| Rate for Payer: Meridian Medicaid |
$254.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$386.67
|
| Rate for Payer: PACE SWMI |
$368.26
|
| Rate for Payer: PHP Medicare Advantage |
$368.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.08
|
| Rate for Payer: Priority Health Medicare |
$368.26
|
| Rate for Payer: Priority Health Narrow Network |
$533.08
|
| Rate for Payer: UHC Medicare Advantage |
$379.31
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$933.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$215.98 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$441.65
|
| Rate for Payer: Aetna Medicare |
$329.59
|
| Rate for Payer: BCBS Complete |
$226.78
|
| Rate for Payer: BCBS MAPPO |
$329.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$493.07
|
| Rate for Payer: BCN Medicare Advantage |
$329.59
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cofinity Commercial |
$474.61
|
| Rate for Payer: Cofinity Commercial |
$441.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.59
|
| Rate for Payer: Healthscope Commercial |
$395.51
|
| Rate for Payer: Healthscope Whirlpool |
$395.51
|
| Rate for Payer: Meridian Medicaid |
$226.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$346.07
|
| Rate for Payer: PACE SWMI |
$329.59
|
| Rate for Payer: PHP Medicare Advantage |
$329.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.68
|
| Rate for Payer: Priority Health Medicare |
$329.59
|
| Rate for Payer: Priority Health Narrow Network |
$477.68
|
| Rate for Payer: UHC Medicare Advantage |
$339.48
|
|
|
PR TRACHEOBRNCHSC THRU EST TRACHS INC
|
Professional
|
Both
|
$453.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$73.70 |
| Max. Negotiated Rate |
$1,672.60 |
| Rate for Payer: Aetna Commercial |
$150.79
|
| Rate for Payer: Aetna Medicare |
$112.53
|
| Rate for Payer: BCBS Complete |
$77.38
|
| Rate for Payer: BCBS MAPPO |
$112.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,672.60
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: BCN Medicare Advantage |
$112.53
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cofinity Commercial |
$162.04
|
| Rate for Payer: Cofinity Commercial |
$150.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.53
|
| Rate for Payer: Healthscope Commercial |
$135.04
|
| Rate for Payer: Healthscope Whirlpool |
$135.04
|
| Rate for Payer: Meridian Medicaid |
$77.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.16
|
| Rate for Payer: PACE SWMI |
$112.53
|
| Rate for Payer: PHP Medicare Advantage |
$112.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$317.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.36
|
| Rate for Payer: Priority Health Medicare |
$112.53
|
| Rate for Payer: Priority Health Narrow Network |
$158.36
|
| Rate for Payer: UHC Medicare Advantage |
$115.91
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,319.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$864.35 |
| Max. Negotiated Rate |
$3,023.30 |
| Rate for Payer: Aetna Commercial |
$1,769.32
|
| Rate for Payer: Aetna Medicare |
$1,320.39
|
| Rate for Payer: BCBS Complete |
$907.57
|
| Rate for Payer: BCBS MAPPO |
$1,320.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,349.28
|
| Rate for Payer: BCN Commercial |
$1,995.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,320.39
|
| Rate for Payer: Cash Price |
$3,455.20
|
| Rate for Payer: Cash Price |
$3,455.20
|
| Rate for Payer: Cofinity Commercial |
$1,901.36
|
| Rate for Payer: Cofinity Commercial |
$1,769.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,320.39
|
| Rate for Payer: Healthscope Commercial |
$1,584.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,584.47
|
| Rate for Payer: Meridian Medicaid |
$907.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,386.41
|
| Rate for Payer: PACE SWMI |
$1,320.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,320.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$864.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,891.07
|
| Rate for Payer: Priority Health Medicare |
$1,320.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,891.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,360.00
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,328.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$457.52 |
| Max. Negotiated Rate |
$1,319.17 |
| Rate for Payer: Aetna Commercial |
$935.19
|
| Rate for Payer: Aetna Medicare |
$697.90
|
| Rate for Payer: BCBS Complete |
$480.40
|
| Rate for Payer: BCBS MAPPO |
$697.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.17
|
| Rate for Payer: BCN Commercial |
$1,052.12
|
| Rate for Payer: BCN Medicare Advantage |
$697.90
|
| Rate for Payer: Cash Price |
$1,062.40
|
| Rate for Payer: Cash Price |
$1,062.40
|
| Rate for Payer: Cofinity Commercial |
$1,004.98
|
| Rate for Payer: Cofinity Commercial |
$935.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$697.90
|
| Rate for Payer: Healthscope Commercial |
$837.48
|
| Rate for Payer: Healthscope Whirlpool |
$837.48
|
| Rate for Payer: Meridian Medicaid |
$480.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$732.80
|
| Rate for Payer: PACE SWMI |
$697.90
|
| Rate for Payer: PHP Medicare Advantage |
$697.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$929.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$996.93
|
| Rate for Payer: Priority Health Medicare |
$697.90
|
| Rate for Payer: Priority Health Narrow Network |
$996.93
|
| Rate for Payer: UHC Medicare Advantage |
$718.84
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$894.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$272.64 |
| Max. Negotiated Rate |
$1,181.81 |
| Rate for Payer: Aetna Commercial |
$554.72
|
| Rate for Payer: Aetna Medicare |
$413.97
|
| Rate for Payer: BCBS Complete |
$286.27
|
| Rate for Payer: BCBS MAPPO |
$413.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.81
|
| Rate for Payer: BCN Commercial |
$625.99
|
| Rate for Payer: BCN Medicare Advantage |
$413.97
|
| Rate for Payer: Cash Price |
$715.20
|
| Rate for Payer: Cash Price |
$715.20
|
| Rate for Payer: Cofinity Commercial |
$596.12
|
| Rate for Payer: Cofinity Commercial |
$554.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.97
|
| Rate for Payer: Healthscope Commercial |
$496.76
|
| Rate for Payer: Healthscope Whirlpool |
$496.76
|
| Rate for Payer: Meridian Medicaid |
$286.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$434.67
|
| Rate for Payer: PACE SWMI |
$413.97
|
| Rate for Payer: PHP Medicare Advantage |
$413.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$593.17
|
| Rate for Payer: Priority Health Medicare |
$413.97
|
| Rate for Payer: Priority Health Narrow Network |
$593.17
|
| Rate for Payer: UHC Medicare Advantage |
$426.39
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$208.53 |
| Max. Negotiated Rate |
$555.10 |
| Rate for Payer: Aetna Commercial |
$443.12
|
| Rate for Payer: Aetna Medicare |
$330.69
|
| Rate for Payer: BCBS Complete |
$218.96
|
| Rate for Payer: BCBS MAPPO |
$330.69
|
| Rate for Payer: BCBS Trust/PPO |
$424.08
|
| Rate for Payer: BCN Commercial |
$481.35
|
| Rate for Payer: BCN Medicare Advantage |
$330.69
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$476.19
|
| Rate for Payer: Cofinity Commercial |
$443.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.69
|
| Rate for Payer: Healthscope Commercial |
$396.83
|
| Rate for Payer: Healthscope Whirlpool |
$396.83
|
| Rate for Payer: Meridian Medicaid |
$218.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$347.22
|
| Rate for Payer: PACE SWMI |
$330.69
|
| Rate for Payer: PHP Medicare Advantage |
$330.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.10
|
| Rate for Payer: Priority Health Medicare |
$330.69
|
| Rate for Payer: Priority Health Narrow Network |
$456.10
|
| Rate for Payer: UHC Medicare Advantage |
$340.61
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,166.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$1,439.09 |
| Rate for Payer: Aetna Commercial |
$425.89
|
| Rate for Payer: Aetna Medicare |
$317.83
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$317.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.09
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: BCN Medicare Advantage |
$317.83
|
| Rate for Payer: Cash Price |
$932.80
|
| Rate for Payer: Cash Price |
$932.80
|
| Rate for Payer: Cofinity Commercial |
$425.89
|
| Rate for Payer: Cofinity Commercial |
$457.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.83
|
| Rate for Payer: Healthscope Commercial |
$381.40
|
| Rate for Payer: Healthscope Whirlpool |
$381.40
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$333.72
|
| Rate for Payer: PACE SWMI |
$317.83
|
| Rate for Payer: PHP Medicare Advantage |
$317.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.36
|
| Rate for Payer: Priority Health Medicare |
$317.83
|
| Rate for Payer: Priority Health Narrow Network |
$440.36
|
| Rate for Payer: UHC Medicare Advantage |
$327.36
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$613.65 |
| Max. Negotiated Rate |
$1,410.81 |
| Rate for Payer: Aetna Commercial |
$1,256.33
|
| Rate for Payer: Aetna Medicare |
$937.56
|
| Rate for Payer: BCBS Complete |
$644.33
|
| Rate for Payer: BCBS MAPPO |
$937.56
|
| Rate for Payer: BCBS Trust/PPO |
$825.73
|
| Rate for Payer: BCN Commercial |
$1,410.81
|
| Rate for Payer: BCN Medicare Advantage |
$937.56
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cofinity Commercial |
$1,350.09
|
| Rate for Payer: Cofinity Commercial |
$1,256.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$937.56
|
| Rate for Payer: Healthscope Commercial |
$1,125.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,125.07
|
| Rate for Payer: Meridian Medicaid |
$644.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$984.44
|
| Rate for Payer: PACE SWMI |
$937.56
|
| Rate for Payer: PHP Medicare Advantage |
$937.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$613.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.81
|
| Rate for Payer: Priority Health Medicare |
$937.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,336.81
|
| Rate for Payer: UHC Medicare Advantage |
$965.69
|
|
|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$193.19 |
| Max. Negotiated Rate |
$753.88 |
| Rate for Payer: Aetna Commercial |
$405.20
|
| Rate for Payer: Aetna Medicare |
$302.39
|
| Rate for Payer: BCBS Complete |
$202.85
|
| Rate for Payer: BCBS MAPPO |
$302.39
|
| Rate for Payer: BCBS Trust/PPO |
$753.88
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$302.39
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$405.20
|
| Rate for Payer: Cofinity Commercial |
$435.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.39
|
| Rate for Payer: Healthscope Commercial |
$362.87
|
| Rate for Payer: Healthscope Whirlpool |
$362.87
|
| Rate for Payer: Meridian Medicaid |
$202.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$317.51
|
| Rate for Payer: PACE SWMI |
$302.39
|
| Rate for Payer: PHP Medicare Advantage |
$302.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$720.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.52
|
| Rate for Payer: Priority Health Medicare |
$302.39
|
| Rate for Payer: Priority Health Narrow Network |
$419.52
|
| Rate for Payer: UHC Medicare Advantage |
$311.46
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$1,079.85 |
| Rate for Payer: Aetna Commercial |
$593.87
|
| Rate for Payer: Aetna Medicare |
$443.19
|
| Rate for Payer: BCBS Complete |
$299.91
|
| Rate for Payer: BCBS MAPPO |
$443.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.85
|
| Rate for Payer: BCN Commercial |
$653.36
|
| Rate for Payer: BCN Medicare Advantage |
$443.19
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cofinity Commercial |
$638.19
|
| Rate for Payer: Cofinity Commercial |
$593.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.19
|
| Rate for Payer: Healthscope Commercial |
$531.83
|
| Rate for Payer: Healthscope Whirlpool |
$531.83
|
| Rate for Payer: Meridian Medicaid |
$299.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$465.35
|
| Rate for Payer: PACE SWMI |
$443.19
|
| Rate for Payer: PHP Medicare Advantage |
$443.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.09
|
| Rate for Payer: Priority Health Medicare |
$443.19
|
| Rate for Payer: Priority Health Narrow Network |
$619.09
|
| Rate for Payer: UHC Medicare Advantage |
$456.49
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$1,778.79 |
| Rate for Payer: Aetna Commercial |
$46.40
|
| Rate for Payer: Aetna Medicare |
$34.63
|
| Rate for Payer: BCBS Complete |
$23.26
|
| Rate for Payer: BCBS MAPPO |
$34.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.79
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: BCN Medicare Advantage |
$34.63
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$49.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.63
|
| Rate for Payer: Healthscope Commercial |
$41.56
|
| Rate for Payer: Healthscope Whirlpool |
$41.56
|
| Rate for Payer: Meridian Medicaid |
$23.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.36
|
| Rate for Payer: PACE SWMI |
$34.63
|
| Rate for Payer: PHP Medicare Advantage |
$34.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.15
|
| Rate for Payer: Priority Health Medicare |
$34.63
|
| Rate for Payer: Priority Health Narrow Network |
$48.15
|
| Rate for Payer: UHC Medicare Advantage |
$35.67
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,358.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$408.96 |
| Max. Negotiated Rate |
$1,464.98 |
| Rate for Payer: Aetna Commercial |
$862.49
|
| Rate for Payer: Aetna Medicare |
$643.65
|
| Rate for Payer: BCBS Complete |
$429.41
|
| Rate for Payer: BCBS MAPPO |
$643.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,464.98
|
| Rate for Payer: BCN Commercial |
$936.79
|
| Rate for Payer: BCN Medicare Advantage |
$643.65
|
| Rate for Payer: Cash Price |
$1,086.40
|
| Rate for Payer: Cash Price |
$1,086.40
|
| Rate for Payer: Cofinity Commercial |
$926.86
|
| Rate for Payer: Cofinity Commercial |
$862.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$643.65
|
| Rate for Payer: Healthscope Commercial |
$772.38
|
| Rate for Payer: Healthscope Whirlpool |
$772.38
|
| Rate for Payer: Meridian Medicaid |
$429.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$675.83
|
| Rate for Payer: PACE SWMI |
$643.65
|
| Rate for Payer: PHP Medicare Advantage |
$643.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$950.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.77
|
| Rate for Payer: Priority Health Medicare |
$643.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.77
|
| Rate for Payer: UHC Medicare Advantage |
$662.96
|
|
|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,554.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$978.10 |
| Max. Negotiated Rate |
$3,887.80 |
| Rate for Payer: Aetna Commercial |
$2,068.41
|
| Rate for Payer: Aetna Medicare |
$1,543.59
|
| Rate for Payer: BCBS Complete |
$1,027.00
|
| Rate for Payer: BCBS MAPPO |
$1,543.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.66
|
| Rate for Payer: BCN Commercial |
$2,244.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,543.59
|
| Rate for Payer: Cash Price |
$4,443.20
|
| Rate for Payer: Cash Price |
$4,443.20
|
| Rate for Payer: Cofinity Commercial |
$2,222.77
|
| Rate for Payer: Cofinity Commercial |
$2,068.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,543.59
|
| Rate for Payer: Healthscope Commercial |
$1,852.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,852.31
|
| Rate for Payer: Meridian Medicaid |
$1,027.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,620.77
|
| Rate for Payer: PACE SWMI |
$1,543.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,543.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$978.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,887.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,442.75
|
| Rate for Payer: Priority Health Medicare |
$1,543.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,442.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,589.90
|
|
|
PR TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR
|
Professional
|
Both
|
$1,598.00
|
|
|
Service Code
|
HCPCS 0387T
|
| Min. Negotiated Rate |
$639.20 |
| Max. Negotiated Rate |
$1,118.60 |
| Rate for Payer: BCBS Complete |
$639.20
|
| Rate for Payer: Cash Price |
$1,278.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.60
|
|
|
PR TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 75960
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
|
|
PR TRANSCATH OCCLUSION,PERCUT
|
Professional
|
Both
|
$1,820.00
|
|
|
Service Code
|
HCPCS 37204
|
| Min. Negotiated Rate |
$728.00 |
| Max. Negotiated Rate |
$1,274.00 |
| Rate for Payer: BCBS Complete |
$728.00
|
| Rate for Payer: Cash Price |
$1,456.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,274.00
|
|
|
PR TRANSCATH RX INFUSE OTHER
|
Professional
|
Both
|
$1,607.00
|
|
|
Service Code
|
HCPCS 37202
|
| Min. Negotiated Rate |
$642.80 |
| Max. Negotiated Rate |
$1,124.90 |
| Rate for Payer: BCBS Complete |
$642.80
|
| Rate for Payer: Cash Price |
$1,285.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,124.90
|
|
|
PR TRANSCATH STENT EACH ADDN VESSL,PERC
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 37206
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$637.00 |
| Rate for Payer: BCBS Complete |
$364.00
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.00
|
|
|
PR TRANSCATH STENT INIT VESSEL,PERCUT
|
Professional
|
Both
|
$1,685.00
|
|
|
Service Code
|
HCPCS 37205
|
| Min. Negotiated Rate |
$674.00 |
| Max. Negotiated Rate |
$1,179.50 |
| Rate for Payer: BCBS Complete |
$674.00
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,179.50
|
|
|
PR TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART
|
Professional
|
Both
|
$4,430.00
|
|
|
Service Code
|
HCPCS 61596
|
| Min. Negotiated Rate |
$757.05 |
| Max. Negotiated Rate |
$4,141.36 |
| Rate for Payer: Aetna Commercial |
$3,226.92
|
| Rate for Payer: Aetna Medicare |
$2,408.15
|
| Rate for Payer: BCBS Complete |
$1,634.88
|
| Rate for Payer: BCBS MAPPO |
$2,408.15
|
| Rate for Payer: BCBS Trust/PPO |
$757.05
|
| Rate for Payer: BCN Commercial |
$3,574.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,408.15
|
| Rate for Payer: Cash Price |
$3,544.00
|
| Rate for Payer: Cash Price |
$3,544.00
|
| Rate for Payer: Cofinity Commercial |
$3,467.74
|
| Rate for Payer: Cofinity Commercial |
$3,226.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,408.15
|
| Rate for Payer: Healthscope Commercial |
$2,889.78
|
| Rate for Payer: Healthscope Whirlpool |
$2,889.78
|
| Rate for Payer: Meridian Medicaid |
$1,634.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,528.56
|
| Rate for Payer: PACE SWMI |
$2,408.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,408.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,557.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,101.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,141.36
|
| Rate for Payer: Priority Health Medicare |
$2,408.15
|
| Rate for Payer: Priority Health Narrow Network |
$4,141.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,480.39
|
|
|
PR TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ
|
Professional
|
Both
|
$662.00
|
|
|
Service Code
|
HCPCS 93893
|
| Min. Negotiated Rate |
$264.80 |
| Max. Negotiated Rate |
$578.11 |
| Rate for Payer: Aetna Commercial |
$494.93
|
| Rate for Payer: Aetna Medicare |
$369.35
|
| Rate for Payer: BCBS Complete |
$264.80
|
| Rate for Payer: BCBS MAPPO |
$369.35
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$369.35
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cofinity Commercial |
$531.86
|
| Rate for Payer: Cofinity Commercial |
$494.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.35
|
| Rate for Payer: Healthscope Commercial |
$443.22
|
| Rate for Payer: Healthscope Whirlpool |
$443.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$387.82
|
| Rate for Payer: PACE SWMI |
$369.35
|
| Rate for Payer: PHP Medicare Advantage |
$369.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$463.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.34
|
| Rate for Payer: Priority Health Medicare |
$369.35
|
| Rate for Payer: Priority Health Narrow Network |
$531.34
|
| Rate for Payer: UHC Medicare Advantage |
$380.43
|
|
