|
PR TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 38207
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$1,622.41 |
| Rate for Payer: Aetna Commercial |
$54.89
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,622.41
|
| Rate for Payer: BCN Commercial |
$64.99
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.34
|
| Rate for Payer: Priority Health Narrow Network |
$96.34
|
|
|
PR TR PARASPI MUSC HIP FASC/TDN XTN GRF
|
Professional
|
Both
|
$6,193.00
|
|
|
Service Code
|
HCPCS 27105
|
| Min. Negotiated Rate |
$562.75 |
| Max. Negotiated Rate |
$4,335.10 |
| Rate for Payer: Aetna Commercial |
$1,150.62
|
| Rate for Payer: Aetna Medicare |
$858.67
|
| Rate for Payer: BCBS Complete |
$590.89
|
| Rate for Payer: BCBS MAPPO |
$858.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.41
|
| Rate for Payer: BCN Commercial |
$1,280.34
|
| Rate for Payer: BCN Medicare Advantage |
$858.67
|
| Rate for Payer: Cash Price |
$4,954.40
|
| Rate for Payer: Cash Price |
$4,954.40
|
| Rate for Payer: Cofinity Commercial |
$1,150.62
|
| Rate for Payer: Cofinity Commercial |
$1,236.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.67
|
| Rate for Payer: Healthscope Commercial |
$1,030.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,030.40
|
| Rate for Payer: Meridian Medicaid |
$590.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$901.60
|
| Rate for Payer: PACE SWMI |
$858.67
|
| Rate for Payer: PHP Medicare Advantage |
$858.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$562.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,335.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,337.90
|
| Rate for Payer: Priority Health Medicare |
$858.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,337.90
|
| Rate for Payer: UHC Medicare Advantage |
$884.43
|
|
|
PR TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART
|
Professional
|
Both
|
$2,035.00
|
|
|
Service Code
|
HCPCS 35695
|
| Min. Negotiated Rate |
$640.70 |
| Max. Negotiated Rate |
$1,593.21 |
| Rate for Payer: Aetna Commercial |
$1,356.51
|
| Rate for Payer: Aetna Medicare |
$1,012.32
|
| Rate for Payer: BCBS Complete |
$672.74
|
| Rate for Payer: BCBS MAPPO |
$1,012.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.09
|
| Rate for Payer: BCN Commercial |
$1,463.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.32
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cofinity Commercial |
$1,356.51
|
| Rate for Payer: Cofinity Commercial |
$1,457.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.32
|
| Rate for Payer: Healthscope Commercial |
$1,214.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,214.78
|
| Rate for Payer: Meridian Medicaid |
$672.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,062.94
|
| Rate for Payer: PACE SWMI |
$1,012.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$640.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,424.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,593.21
|
| Rate for Payer: Priority Health Medicare |
$1,012.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,593.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,042.69
|
|
|
PR TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART
|
Professional
|
Both
|
$2,100.00
|
|
|
Service Code
|
HCPCS 35694
|
| Min. Negotiated Rate |
$617.49 |
| Max. Negotiated Rate |
$1,534.70 |
| Rate for Payer: Aetna Commercial |
$1,306.35
|
| Rate for Payer: Aetna Medicare |
$974.89
|
| Rate for Payer: BCBS Complete |
$648.36
|
| Rate for Payer: BCBS MAPPO |
$974.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
| Rate for Payer: BCN Commercial |
$1,409.84
|
| Rate for Payer: BCN Medicare Advantage |
$974.89
|
| Rate for Payer: Cash Price |
$1,680.00
|
| Rate for Payer: Cash Price |
$1,680.00
|
| Rate for Payer: Cofinity Commercial |
$1,403.84
|
| Rate for Payer: Cofinity Commercial |
$1,306.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.89
|
| Rate for Payer: Healthscope Commercial |
$1,169.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,169.87
|
| Rate for Payer: Meridian Medicaid |
$648.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,023.63
|
| Rate for Payer: PACE SWMI |
$974.89
|
| Rate for Payer: PHP Medicare Advantage |
$974.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$617.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,534.70
|
| Rate for Payer: Priority Health Medicare |
$974.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,004.14
|
|
|
PR TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART
|
Professional
|
Both
|
$4,476.00
|
|
|
Service Code
|
HCPCS 35691
|
| Min. Negotiated Rate |
$591.29 |
| Max. Negotiated Rate |
$3,133.20 |
| Rate for Payer: Aetna Commercial |
$1,251.29
|
| Rate for Payer: Aetna Medicare |
$933.80
|
| Rate for Payer: BCBS Complete |
$620.85
|
| Rate for Payer: BCBS MAPPO |
$933.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.26
|
| Rate for Payer: BCN Commercial |
$1,350.70
|
| Rate for Payer: BCN Medicare Advantage |
$933.80
|
| Rate for Payer: Cash Price |
$3,580.80
|
| Rate for Payer: Cash Price |
$3,580.80
|
| Rate for Payer: Cofinity Commercial |
$1,251.29
|
| Rate for Payer: Cofinity Commercial |
$1,344.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.80
|
| Rate for Payer: Healthscope Commercial |
$1,120.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,120.56
|
| Rate for Payer: Meridian Medicaid |
$620.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$980.49
|
| Rate for Payer: PACE SWMI |
$933.80
|
| Rate for Payer: PHP Medicare Advantage |
$933.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,133.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,470.33
|
| Rate for Payer: Priority Health Medicare |
$933.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,470.33
|
| Rate for Payer: UHC Medicare Advantage |
$961.81
|
|
|
PR TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
HCPCS 35693
|
| Min. Negotiated Rate |
$524.41 |
| Max. Negotiated Rate |
$2,046.11 |
| Rate for Payer: Aetna Commercial |
$1,102.58
|
| Rate for Payer: Aetna Medicare |
$822.82
|
| Rate for Payer: BCBS Complete |
$550.63
|
| Rate for Payer: BCBS MAPPO |
$822.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,046.11
|
| Rate for Payer: BCN Commercial |
$1,193.84
|
| Rate for Payer: BCN Medicare Advantage |
$822.82
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cofinity Commercial |
$1,102.58
|
| Rate for Payer: Cofinity Commercial |
$1,184.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.82
|
| Rate for Payer: Healthscope Commercial |
$987.38
|
| Rate for Payer: Healthscope Whirlpool |
$987.38
|
| Rate for Payer: Meridian Medicaid |
$550.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$863.96
|
| Rate for Payer: PACE SWMI |
$822.82
|
| Rate for Payer: PHP Medicare Advantage |
$822.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$524.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,299.57
|
| Rate for Payer: Priority Health Medicare |
$822.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,299.57
|
| Rate for Payer: UHC Medicare Advantage |
$847.50
|
|
|
PR TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR
|
Professional
|
Both
|
$2,721.00
|
|
|
Service Code
|
HCPCS 26497
|
| Min. Negotiated Rate |
$585.75 |
| Max. Negotiated Rate |
$2,458.71 |
| Rate for Payer: Aetna Commercial |
$1,192.64
|
| Rate for Payer: Aetna Medicare |
$890.03
|
| Rate for Payer: BCBS Complete |
$615.04
|
| Rate for Payer: BCBS MAPPO |
$890.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.71
|
| Rate for Payer: BCN Commercial |
$1,344.84
|
| Rate for Payer: BCN Medicare Advantage |
$890.03
|
| Rate for Payer: Cash Price |
$2,176.80
|
| Rate for Payer: Cash Price |
$2,176.80
|
| Rate for Payer: Cofinity Commercial |
$1,192.64
|
| Rate for Payer: Cofinity Commercial |
$1,281.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.03
|
| Rate for Payer: Healthscope Commercial |
$1,068.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,068.04
|
| Rate for Payer: Meridian Medicaid |
$615.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$934.53
|
| Rate for Payer: PACE SWMI |
$890.03
|
| Rate for Payer: PHP Medicare Advantage |
$890.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$585.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,904.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,405.32
|
| Rate for Payer: Priority Health Medicare |
$890.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,405.32
|
| Rate for Payer: UHC Medicare Advantage |
$916.73
|
|
|
PR TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND
|
Professional
|
Both
|
$5,505.00
|
|
|
Service Code
|
HCPCS 26551
|
| Min. Negotiated Rate |
$201.28 |
| Max. Negotiated Rate |
$5,035.52 |
| Rate for Payer: Aetna Commercial |
$4,348.22
|
| Rate for Payer: Aetna Medicare |
$3,244.94
|
| Rate for Payer: BCBS Complete |
$2,210.33
|
| Rate for Payer: BCBS MAPPO |
$3,244.94
|
| Rate for Payer: BCBS Trust/PPO |
$201.28
|
| Rate for Payer: BCN Commercial |
$4,818.85
|
| Rate for Payer: BCN Medicare Advantage |
$3,244.94
|
| Rate for Payer: Cash Price |
$4,404.00
|
| Rate for Payer: Cash Price |
$4,404.00
|
| Rate for Payer: Cofinity Commercial |
$4,672.71
|
| Rate for Payer: Cofinity Commercial |
$4,348.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,244.94
|
| Rate for Payer: Healthscope Commercial |
$3,893.93
|
| Rate for Payer: Healthscope Whirlpool |
$3,893.93
|
| Rate for Payer: Meridian Medicaid |
$2,210.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,407.19
|
| Rate for Payer: PACE SWMI |
$3,244.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,244.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,105.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,853.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,035.52
|
| Rate for Payer: Priority Health Medicare |
$3,244.94
|
| Rate for Payer: Priority Health Narrow Network |
$5,035.52
|
| Rate for Payer: UHC Medicare Advantage |
$3,342.29
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP
|
Professional
|
Both
|
$2,764.00
|
|
|
Service Code
|
HCPCS 27691
|
| Min. Negotiated Rate |
$479.68 |
| Max. Negotiated Rate |
$2,829.97 |
| Rate for Payer: Aetna Commercial |
$978.60
|
| Rate for Payer: Aetna Medicare |
$730.30
|
| Rate for Payer: BCBS Complete |
$503.66
|
| Rate for Payer: BCBS MAPPO |
$730.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,829.97
|
| Rate for Payer: BCN Commercial |
$1,090.73
|
| Rate for Payer: BCN Medicare Advantage |
$730.30
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cofinity Commercial |
$978.60
|
| Rate for Payer: Cofinity Commercial |
$1,051.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$730.30
|
| Rate for Payer: Healthscope Commercial |
$876.36
|
| Rate for Payer: Healthscope Whirlpool |
$876.36
|
| Rate for Payer: Meridian Medicaid |
$503.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$766.82
|
| Rate for Payer: PACE SWMI |
$730.30
|
| Rate for Payer: PHP Medicare Advantage |
$730.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,934.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,139.77
|
| Rate for Payer: Priority Health Medicare |
$730.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,139.77
|
| Rate for Payer: UHC Medicare Advantage |
$752.21
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 27692
|
| Min. Negotiated Rate |
$64.54 |
| Max. Negotiated Rate |
$3,094.06 |
| Rate for Payer: Aetna Commercial |
$132.66
|
| Rate for Payer: Aetna Medicare |
$99.00
|
| Rate for Payer: BCBS Complete |
$67.77
|
| Rate for Payer: BCBS MAPPO |
$99.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,094.06
|
| Rate for Payer: BCN Commercial |
$145.14
|
| Rate for Payer: BCN Medicare Advantage |
$99.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$142.56
|
| Rate for Payer: Cofinity Commercial |
$132.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.00
|
| Rate for Payer: Healthscope Commercial |
$118.80
|
| Rate for Payer: Healthscope Whirlpool |
$118.80
|
| Rate for Payer: Meridian Medicaid |
$67.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.95
|
| Rate for Payer: PACE SWMI |
$99.00
|
| Rate for Payer: PHP Medicare Advantage |
$99.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.66
|
| Rate for Payer: Priority Health Medicare |
$99.00
|
| Rate for Payer: Priority Health Narrow Network |
$151.66
|
| Rate for Payer: UHC Medicare Advantage |
$101.97
|
|
|
PR TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC
|
Professional
|
Both
|
$1,956.00
|
|
|
Service Code
|
HCPCS 27690
|
| Min. Negotiated Rate |
$411.94 |
| Max. Negotiated Rate |
$1,369.20 |
| Rate for Payer: Aetna Commercial |
$839.13
|
| Rate for Payer: Aetna Medicare |
$626.22
|
| Rate for Payer: BCBS Complete |
$432.54
|
| Rate for Payer: BCBS MAPPO |
$626.22
|
| Rate for Payer: BCBS Trust/PPO |
$627.07
|
| Rate for Payer: BCN Commercial |
$935.81
|
| Rate for Payer: BCN Medicare Advantage |
$626.22
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cofinity Commercial |
$901.76
|
| Rate for Payer: Cofinity Commercial |
$839.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.22
|
| Rate for Payer: Healthscope Commercial |
$751.46
|
| Rate for Payer: Healthscope Whirlpool |
$751.46
|
| Rate for Payer: Meridian Medicaid |
$432.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.53
|
| Rate for Payer: PACE SWMI |
$626.22
|
| Rate for Payer: PHP Medicare Advantage |
$626.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$977.89
|
| Rate for Payer: Priority Health Medicare |
$626.22
|
| Rate for Payer: Priority Health Narrow Network |
$977.89
|
| Rate for Payer: UHC Medicare Advantage |
$645.01
|
|
|
PR TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN
|
Professional
|
Both
|
$2,022.00
|
|
|
Service Code
|
HCPCS 26480
|
| Min. Negotiated Rate |
$508.43 |
| Max. Negotiated Rate |
$1,415.40 |
| Rate for Payer: Aetna Commercial |
$1,026.84
|
| Rate for Payer: Aetna Medicare |
$766.30
|
| Rate for Payer: BCBS Complete |
$533.85
|
| Rate for Payer: BCBS MAPPO |
$766.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.37
|
| Rate for Payer: BCN Commercial |
$1,168.91
|
| Rate for Payer: BCN Medicare Advantage |
$766.30
|
| Rate for Payer: Cash Price |
$1,617.60
|
| Rate for Payer: Cash Price |
$1,617.60
|
| Rate for Payer: Cofinity Commercial |
$1,026.84
|
| Rate for Payer: Cofinity Commercial |
$1,103.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.30
|
| Rate for Payer: Healthscope Commercial |
$919.56
|
| Rate for Payer: Healthscope Whirlpool |
$919.56
|
| Rate for Payer: Meridian Medicaid |
$533.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$804.62
|
| Rate for Payer: PACE SWMI |
$766.30
|
| Rate for Payer: PHP Medicare Advantage |
$766.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,415.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,221.47
|
| Rate for Payer: Priority Health Medicare |
$766.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,221.47
|
| Rate for Payer: UHC Medicare Advantage |
$789.29
|
|
|
PR TRURL DRAINAGE PROSTATIC ABSCESS
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 52700
|
| Min. Negotiated Rate |
$283.08 |
| Max. Negotiated Rate |
$707.87 |
| Rate for Payer: Aetna Commercial |
$578.93
|
| Rate for Payer: Aetna Medicare |
$432.04
|
| Rate for Payer: BCBS Complete |
$297.23
|
| Rate for Payer: BCBS MAPPO |
$432.04
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: BCN Medicare Advantage |
$432.04
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cofinity Commercial |
$622.14
|
| Rate for Payer: Cofinity Commercial |
$578.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.04
|
| Rate for Payer: Healthscope Commercial |
$518.45
|
| Rate for Payer: Healthscope Whirlpool |
$518.45
|
| Rate for Payer: Meridian Medicaid |
$297.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$453.64
|
| Rate for Payer: PACE SWMI |
$432.04
|
| Rate for Payer: PHP Medicare Advantage |
$432.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$707.87
|
| Rate for Payer: Priority Health Medicare |
$432.04
|
| Rate for Payer: Priority Health Narrow Network |
$707.87
|
| Rate for Payer: UHC Medicare Advantage |
$445.00
|
|
|
PR TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY
|
Professional
|
Both
|
$3,480.00
|
|
|
Service Code
|
HCPCS 53854
|
| Min. Negotiated Rate |
$244.52 |
| Max. Negotiated Rate |
$2,456.58 |
| Rate for Payer: Aetna Commercial |
$495.91
|
| Rate for Payer: Aetna Medicare |
$370.08
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$370.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,462.86
|
| Rate for Payer: BCN Commercial |
$2,456.58
|
| Rate for Payer: BCN Medicare Advantage |
$370.08
|
| Rate for Payer: Cash Price |
$2,784.00
|
| Rate for Payer: Cash Price |
$2,784.00
|
| Rate for Payer: Cofinity Commercial |
$495.91
|
| Rate for Payer: Cofinity Commercial |
$532.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.08
|
| Rate for Payer: Healthscope Commercial |
$444.10
|
| Rate for Payer: Healthscope Whirlpool |
$444.10
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$388.58
|
| Rate for Payer: PACE SWMI |
$370.08
|
| Rate for Payer: PHP Medicare Advantage |
$370.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,436.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.53
|
| Rate for Payer: Priority Health Medicare |
$370.08
|
| Rate for Payer: Priority Health Narrow Network |
$609.53
|
| Rate for Payer: UHC Medicare Advantage |
$381.18
|
|
|
PR TRURL DSTRJ PRSTATE TISS RF THERMOTH
|
Professional
|
Both
|
$2,877.00
|
|
|
Service Code
|
HCPCS 53852
|
| Min. Negotiated Rate |
$244.52 |
| Max. Negotiated Rate |
$2,032.41 |
| Rate for Payer: Aetna Commercial |
$496.40
|
| Rate for Payer: Aetna Medicare |
$370.45
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$370.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.92
|
| Rate for Payer: BCN Commercial |
$2,032.41
|
| Rate for Payer: BCN Medicare Advantage |
$370.45
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cofinity Commercial |
$496.40
|
| Rate for Payer: Cofinity Commercial |
$533.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.45
|
| Rate for Payer: Healthscope Commercial |
$444.54
|
| Rate for Payer: Healthscope Whirlpool |
$444.54
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$388.97
|
| Rate for Payer: PACE SWMI |
$370.45
|
| Rate for Payer: PHP Medicare Advantage |
$370.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.07
|
| Rate for Payer: Priority Health Medicare |
$370.45
|
| Rate for Payer: Priority Health Narrow Network |
$610.07
|
| Rate for Payer: UHC Medicare Advantage |
$381.56
|
|
|
PR TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE
|
Professional
|
Both
|
$1,559.00
|
|
|
Service Code
|
HCPCS 52601
|
| Min. Negotiated Rate |
$462.85 |
| Max. Negotiated Rate |
$1,159.61 |
| Rate for Payer: Aetna Commercial |
$952.62
|
| Rate for Payer: Aetna Medicare |
$710.91
|
| Rate for Payer: BCBS Complete |
$485.99
|
| Rate for Payer: BCBS MAPPO |
$710.91
|
| Rate for Payer: BCBS Trust/PPO |
$659.32
|
| Rate for Payer: BCN Commercial |
$1,048.70
|
| Rate for Payer: BCN Medicare Advantage |
$710.91
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cash Price |
$1,247.20
|
| Rate for Payer: Cofinity Commercial |
$1,023.71
|
| Rate for Payer: Cofinity Commercial |
$952.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.91
|
| Rate for Payer: Healthscope Commercial |
$853.09
|
| Rate for Payer: Healthscope Whirlpool |
$853.09
|
| Rate for Payer: Meridian Medicaid |
$485.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$746.46
|
| Rate for Payer: PACE SWMI |
$710.91
|
| Rate for Payer: PHP Medicare Advantage |
$710.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$462.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,091.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,159.61
|
| Rate for Payer: Priority Health Medicare |
$710.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,159.61
|
| Rate for Payer: UHC Medicare Advantage |
$732.24
|
|
|
PR TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 52640
|
| Min. Negotiated Rate |
$207.46 |
| Max. Negotiated Rate |
$733.28 |
| Rate for Payer: Aetna Commercial |
$419.18
|
| Rate for Payer: Aetna Medicare |
$312.82
|
| Rate for Payer: BCBS Complete |
$217.83
|
| Rate for Payer: BCBS MAPPO |
$312.82
|
| Rate for Payer: BCBS Trust/PPO |
$733.28
|
| Rate for Payer: BCN Commercial |
$467.17
|
| Rate for Payer: BCN Medicare Advantage |
$312.82
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cofinity Commercial |
$450.46
|
| Rate for Payer: Cofinity Commercial |
$419.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.82
|
| Rate for Payer: Healthscope Commercial |
$375.38
|
| Rate for Payer: Healthscope Whirlpool |
$375.38
|
| Rate for Payer: Meridian Medicaid |
$217.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$328.46
|
| Rate for Payer: PACE SWMI |
$312.82
|
| Rate for Payer: PHP Medicare Advantage |
$312.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$516.58
|
| Rate for Payer: Priority Health Medicare |
$312.82
|
| Rate for Payer: Priority Health Narrow Network |
$516.58
|
| Rate for Payer: UHC Medicare Advantage |
$322.20
|
|
|
PR TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 52630
|
| Min. Negotiated Rate |
$259.86 |
| Max. Negotiated Rate |
$727.47 |
| Rate for Payer: Aetna Commercial |
$529.14
|
| Rate for Payer: Aetna Medicare |
$394.88
|
| Rate for Payer: BCBS Complete |
$272.85
|
| Rate for Payer: BCBS MAPPO |
$394.88
|
| Rate for Payer: BCBS Trust/PPO |
$727.47
|
| Rate for Payer: BCN Commercial |
$586.90
|
| Rate for Payer: BCN Medicare Advantage |
$394.88
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$568.63
|
| Rate for Payer: Cofinity Commercial |
$529.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.88
|
| Rate for Payer: Healthscope Commercial |
$473.86
|
| Rate for Payer: Healthscope Whirlpool |
$473.86
|
| Rate for Payer: Meridian Medicaid |
$272.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$414.62
|
| Rate for Payer: PACE SWMI |
$394.88
|
| Rate for Payer: PHP Medicare Advantage |
$394.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$648.98
|
| Rate for Payer: Priority Health Medicare |
$394.88
|
| Rate for Payer: Priority Health Narrow Network |
$648.98
|
| Rate for Payer: UHC Medicare Advantage |
$406.73
|
|
|
PR TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 95921
|
| Min. Negotiated Rate |
$60.40 |
| Max. Negotiated Rate |
$1,174.41 |
| Rate for Payer: Aetna Commercial |
$111.98
|
| Rate for Payer: Aetna Medicare |
$83.57
|
| Rate for Payer: BCBS Complete |
$60.40
|
| Rate for Payer: BCBS MAPPO |
$83.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,174.41
|
| Rate for Payer: BCN Commercial |
$127.55
|
| Rate for Payer: BCN Medicare Advantage |
$83.57
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$120.34
|
| Rate for Payer: Cofinity Commercial |
$111.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.57
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Healthscope Whirlpool |
$100.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.75
|
| Rate for Payer: PACE SWMI |
$83.57
|
| Rate for Payer: PHP Medicare Advantage |
$83.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.23
|
| Rate for Payer: Priority Health Medicare |
$83.57
|
| Rate for Payer: Priority Health Narrow Network |
$117.23
|
| Rate for Payer: UHC Medicare Advantage |
$86.08
|
|
|
PR TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 95924
|
| Min. Negotiated Rate |
$70.80 |
| Max. Negotiated Rate |
$987.92 |
| Rate for Payer: Aetna Commercial |
$195.29
|
| Rate for Payer: Aetna Medicare |
$145.74
|
| Rate for Payer: BCBS Complete |
$70.80
|
| Rate for Payer: BCBS MAPPO |
$145.74
|
| Rate for Payer: BCBS Trust/PPO |
$987.92
|
| Rate for Payer: BCN Commercial |
$221.37
|
| Rate for Payer: BCN Medicare Advantage |
$145.74
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$195.29
|
| Rate for Payer: Cofinity Commercial |
$209.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.74
|
| Rate for Payer: Healthscope Commercial |
$174.89
|
| Rate for Payer: Healthscope Whirlpool |
$174.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.03
|
| Rate for Payer: PACE SWMI |
$145.74
|
| Rate for Payer: PHP Medicare Advantage |
$145.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.46
|
| Rate for Payer: Priority Health Medicare |
$145.74
|
| Rate for Payer: Priority Health Narrow Network |
$203.46
|
| Rate for Payer: UHC Medicare Advantage |
$150.11
|
|
|
PR TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 95922
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$759.70 |
| Rate for Payer: Aetna Commercial |
$123.88
|
| Rate for Payer: Aetna Medicare |
$92.45
|
| Rate for Payer: BCBS Complete |
$72.40
|
| Rate for Payer: BCBS MAPPO |
$92.45
|
| Rate for Payer: BCBS Trust/PPO |
$759.70
|
| Rate for Payer: BCN Commercial |
$141.23
|
| Rate for Payer: BCN Medicare Advantage |
$92.45
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$133.13
|
| Rate for Payer: Cofinity Commercial |
$123.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.45
|
| Rate for Payer: Healthscope Commercial |
$110.94
|
| Rate for Payer: Healthscope Whirlpool |
$110.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.07
|
| Rate for Payer: PACE SWMI |
$92.45
|
| Rate for Payer: PHP Medicare Advantage |
$92.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.80
|
| Rate for Payer: Priority Health Medicare |
$92.45
|
| Rate for Payer: Priority Health Narrow Network |
$129.80
|
| Rate for Payer: UHC Medicare Advantage |
$95.22
|
|
|
PR TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 31730
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$1,574.52 |
| Rate for Payer: Aetna Commercial |
$197.96
|
| Rate for Payer: Aetna Medicare |
$147.73
|
| Rate for Payer: BCBS Complete |
$119.60
|
| Rate for Payer: BCBS MAPPO |
$147.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.54
|
| Rate for Payer: BCN Commercial |
$1,574.52
|
| Rate for Payer: BCN Medicare Advantage |
$147.73
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$197.96
|
| Rate for Payer: Cofinity Commercial |
$212.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.73
|
| Rate for Payer: Healthscope Commercial |
$177.28
|
| Rate for Payer: Healthscope Whirlpool |
$177.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$155.12
|
| Rate for Payer: PACE SWMI |
$147.73
|
| Rate for Payer: PHP Medicare Advantage |
$147.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.73
|
| Rate for Payer: Priority Health Medicare |
$147.73
|
| Rate for Payer: Priority Health Narrow Network |
$203.73
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
|
|
PR TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD
|
Professional
|
Both
|
$1,219.00
|
|
|
Service Code
|
HCPCS 44015
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$2,262.71 |
| Rate for Payer: Aetna Commercial |
$189.61
|
| Rate for Payer: Aetna Medicare |
$141.50
|
| Rate for Payer: BCBS Complete |
$93.71
|
| Rate for Payer: BCBS MAPPO |
$141.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,262.71
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: BCN Medicare Advantage |
$141.50
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cofinity Commercial |
$203.76
|
| Rate for Payer: Cofinity Commercial |
$189.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.50
|
| Rate for Payer: Healthscope Commercial |
$169.80
|
| Rate for Payer: Healthscope Whirlpool |
$169.80
|
| Rate for Payer: Meridian Medicaid |
$93.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.58
|
| Rate for Payer: PACE SWMI |
$141.50
|
| Rate for Payer: PHP Medicare Advantage |
$141.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.55
|
| Rate for Payer: Priority Health Medicare |
$141.50
|
| Rate for Payer: Priority Health Narrow Network |
$247.55
|
| Rate for Payer: UHC Medicare Advantage |
$145.74
|
|
|
PR TUBE THORACOSTOMY INCLUDES WATER SEAL
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 32551
|
| Min. Negotiated Rate |
$97.77 |
| Max. Negotiated Rate |
$753.36 |
| Rate for Payer: Aetna Commercial |
$205.72
|
| Rate for Payer: Aetna Medicare |
$153.52
|
| Rate for Payer: BCBS Complete |
$102.66
|
| Rate for Payer: BCBS MAPPO |
$153.52
|
| Rate for Payer: BCBS Trust/PPO |
$753.36
|
| Rate for Payer: BCN Commercial |
$223.81
|
| Rate for Payer: BCN Medicare Advantage |
$153.52
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cofinity Commercial |
$221.07
|
| Rate for Payer: Cofinity Commercial |
$205.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.52
|
| Rate for Payer: Healthscope Commercial |
$184.22
|
| Rate for Payer: Healthscope Whirlpool |
$184.22
|
| Rate for Payer: Meridian Medicaid |
$102.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.20
|
| Rate for Payer: PACE SWMI |
$153.52
|
| Rate for Payer: PHP Medicare Advantage |
$153.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.07
|
| Rate for Payer: Priority Health Medicare |
$153.52
|
| Rate for Payer: Priority Health Narrow Network |
$212.07
|
| Rate for Payer: UHC Medicare Advantage |
$158.13
|
|
|
PR TUBOTUBAL ANASTATOMOSIS
|
Professional
|
Both
|
$1,621.00
|
|
|
Service Code
|
HCPCS 58750
|
| Min. Negotiated Rate |
$428.98 |
| Max. Negotiated Rate |
$1,334.09 |
| Rate for Payer: Aetna Commercial |
$1,211.72
|
| Rate for Payer: Aetna Medicare |
$904.27
|
| Rate for Payer: BCBS Complete |
$648.40
|
| Rate for Payer: BCBS MAPPO |
$904.27
|
| Rate for Payer: BCBS Trust/PPO |
$428.98
|
| Rate for Payer: BCN Commercial |
$1,334.09
|
| Rate for Payer: BCN Medicare Advantage |
$904.27
|
| Rate for Payer: Cash Price |
$1,296.80
|
| Rate for Payer: Cash Price |
$1,296.80
|
| Rate for Payer: Cofinity Commercial |
$1,302.15
|
| Rate for Payer: Cofinity Commercial |
$1,211.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.27
|
| Rate for Payer: Healthscope Commercial |
$1,085.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,085.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$949.48
|
| Rate for Payer: PACE SWMI |
$904.27
|
| Rate for Payer: PHP Medicare Advantage |
$904.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,292.45
|
| Rate for Payer: Priority Health Medicare |
$904.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,292.45
|
| Rate for Payer: UHC Medicare Advantage |
$931.40
|
|
