|
PR LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR
|
Professional
|
Both
|
$3,247.00
|
|
|
Service Code
|
HCPCS 27428
|
| Min. Negotiated Rate |
$727.18 |
| Max. Negotiated Rate |
$2,110.55 |
| Rate for Payer: Aetna Commercial |
$1,488.41
|
| Rate for Payer: Aetna Medicare |
$1,623.50
|
| Rate for Payer: BCBS Complete |
$763.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,728.07
|
| Rate for Payer: BCN Commercial |
$1,639.03
|
| Rate for Payer: Cash Price |
$2,597.60
|
| Rate for Payer: Cash Price |
$2,597.60
|
| Rate for Payer: Meridian Medicaid |
$763.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$727.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,110.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,721.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,721.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,273.19
|
| Rate for Payer: UHC Exchange |
$1,273.19
|
| Rate for Payer: UHCCP Medicaid |
$727.18
|
|
|
PR LIGATION ARTERIES ETHMOIDAL
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 30915
|
| Min. Negotiated Rate |
$385.74 |
| Max. Negotiated Rate |
$935.09 |
| Rate for Payer: Aetna Commercial |
$764.23
|
| Rate for Payer: Aetna Medicare |
$519.00
|
| Rate for Payer: BCBS Complete |
$405.03
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$892.81
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Meridian Medicaid |
$405.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.29
|
| Rate for Payer: Priority Health Narrow Network |
$846.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$632.11
|
| Rate for Payer: UHC Exchange |
$632.11
|
| Rate for Payer: UHCCP Medicaid |
$385.74
|
|
|
PR LIGATION ARTERIES INT MAXILLARY TRANSANTRAL
|
Professional
|
Both
|
$1,501.00
|
|
|
Service Code
|
HCPCS 30920
|
| Min. Negotiated Rate |
$556.78 |
| Max. Negotiated Rate |
$2,317.12 |
| Rate for Payer: Aetna Commercial |
$1,110.06
|
| Rate for Payer: Aetna Medicare |
$750.50
|
| Rate for Payer: BCBS Complete |
$584.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,317.12
|
| Rate for Payer: BCN Commercial |
$1,291.09
|
| Rate for Payer: Cash Price |
$1,200.80
|
| Rate for Payer: Cash Price |
$1,200.80
|
| Rate for Payer: Meridian Medicaid |
$584.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$975.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,220.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,220.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$913.12
|
| Rate for Payer: UHC Exchange |
$913.12
|
| Rate for Payer: UHCCP Medicaid |
$556.78
|
|
|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
37609
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$585.00 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$810.00
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$873.00
|
| Rate for Payer: ASR Commercial |
$873.00
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$737.01
|
| Rate for Payer: BCN Commercial |
$697.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$846.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$900.00
|
| Rate for Payer: Healthscope Whirlpool |
$873.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$810.00
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.00
|
| Rate for Payer: Nomi Health Commercial |
$738.00
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.58
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$630.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 37609
|
| Hospital Charge Code |
37609
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$911.85 |
| Rate for Payer: Aetna Commercial |
$272.71
|
| Rate for Payer: Aetna Medicare |
$450.00
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS Trust/PPO |
$911.85
|
| Rate for Payer: BCN Commercial |
$458.86
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$324.95
|
| Rate for Payer: Priority Health Narrow Network |
$324.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.60
|
| Rate for Payer: UHC Exchange |
$253.60
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
|
|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 37609
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$911.85 |
| Rate for Payer: Aetna Commercial |
$272.71
|
| Rate for Payer: Aetna Medicare |
$450.00
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS Trust/PPO |
$911.85
|
| Rate for Payer: BCN Commercial |
$458.86
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$324.95
|
| Rate for Payer: Priority Health Narrow Network |
$324.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.60
|
| Rate for Payer: UHC Exchange |
$253.60
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
|
|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
37609
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$585.00 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna Commercial |
$810.00
|
| Rate for Payer: ASR ASR |
$873.00
|
| Rate for Payer: ASR Commercial |
$873.00
|
| Rate for Payer: BCBS Trust/PPO |
$733.41
|
| Rate for Payer: BCN Commercial |
$697.77
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$846.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Healthscope Commercial |
$900.00
|
| Rate for Payer: Healthscope Whirlpool |
$873.00
|
| Rate for Payer: Mclaren Commercial |
$810.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.00
|
| Rate for Payer: Nomi Health Commercial |
$738.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$792.00
|
|
|
PR LIGATION DIRECT ESOPHAGEAL VARICES
|
Professional
|
Both
|
$3,134.00
|
|
|
Service Code
|
HCPCS 43400
|
| Min. Negotiated Rate |
$977.46 |
| Max. Negotiated Rate |
$2,724.05 |
| Rate for Payer: Aetna Commercial |
$2,061.51
|
| Rate for Payer: Aetna Medicare |
$1,567.00
|
| Rate for Payer: BCBS Complete |
$1,026.33
|
| Rate for Payer: BCBS Trust/PPO |
$986.56
|
| Rate for Payer: BCN Commercial |
$2,221.53
|
| Rate for Payer: Cash Price |
$2,507.20
|
| Rate for Payer: Cash Price |
$2,507.20
|
| Rate for Payer: Meridian Medicaid |
$1,026.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$977.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,037.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,724.05
|
| Rate for Payer: Priority Health Narrow Network |
$2,724.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,939.40
|
| Rate for Payer: UHC Exchange |
$1,939.40
|
| Rate for Payer: UHCCP Medicaid |
$977.46
|
|
|
PR LIGATION HEMORRHOID BUNDLE W/US
|
Professional
|
Both
|
$2,091.00
|
|
|
Service Code
|
HCPCS 0249T
|
| Min. Negotiated Rate |
$836.40 |
| Max. Negotiated Rate |
$1,359.15 |
| Rate for Payer: Aetna Medicare |
$1,045.50
|
| Rate for Payer: BCBS Complete |
$836.40
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.15
|
|
|
PR LIGATION INTERNAL/COMMON CAROTID ARTERY
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 37605
|
| Min. Negotiated Rate |
$463.49 |
| Max. Negotiated Rate |
$1,342.94 |
| Rate for Payer: Aetna Commercial |
$991.38
|
| Rate for Payer: Aetna Medicare |
$998.00
|
| Rate for Payer: BCBS Complete |
$486.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.94
|
| Rate for Payer: BCN Commercial |
$1,055.06
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Meridian Medicaid |
$486.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.60
|
| Rate for Payer: UHC Exchange |
$1,055.60
|
| Rate for Payer: UHCCP Medicaid |
$463.49
|
|
|
PR LIGATION INTERNAL JUGULAR VEIN
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 37565
|
| Min. Negotiated Rate |
$463.28 |
| Max. Negotiated Rate |
$1,155.66 |
| Rate for Payer: Aetna Commercial |
$977.47
|
| Rate for Payer: Aetna Medicare |
$758.00
|
| Rate for Payer: BCBS Complete |
$486.44
|
| Rate for Payer: BCN Commercial |
$1,057.01
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Meridian Medicaid |
$486.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,155.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$907.80
|
| Rate for Payer: UHC Exchange |
$907.80
|
| Rate for Payer: UHCCP Medicaid |
$463.28
|
|
|
PR LIGATION MAJOR ARTERY ABDOMEN
|
Professional
|
Both
|
$3,271.00
|
|
|
Service Code
|
HCPCS 37617
|
| Min. Negotiated Rate |
$839.01 |
| Max. Negotiated Rate |
$2,126.15 |
| Rate for Payer: Aetna Commercial |
$1,785.58
|
| Rate for Payer: Aetna Medicare |
$1,635.50
|
| Rate for Payer: BCBS Complete |
$880.96
|
| Rate for Payer: BCBS Trust/PPO |
$999.54
|
| Rate for Payer: BCN Commercial |
$1,902.91
|
| Rate for Payer: Cash Price |
$2,616.80
|
| Rate for Payer: Cash Price |
$2,616.80
|
| Rate for Payer: Meridian Medicaid |
$880.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,090.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,090.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,681.53
|
| Rate for Payer: UHC Exchange |
$1,681.53
|
| Rate for Payer: UHCCP Medicaid |
$839.01
|
|
|
PR LIGATION MAJOR ARTERY CHEST
|
Professional
|
Both
|
$3,387.00
|
|
|
Service Code
|
HCPCS 37616
|
| Min. Negotiated Rate |
$727.40 |
| Max. Negotiated Rate |
$2,201.55 |
| Rate for Payer: Aetna Commercial |
$1,477.32
|
| Rate for Payer: Aetna Medicare |
$1,693.50
|
| Rate for Payer: BCBS Complete |
$763.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.22
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Meridian Medicaid |
$763.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$727.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,201.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,781.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,781.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,405.75
|
| Rate for Payer: UHC Exchange |
$1,405.75
|
| Rate for Payer: UHCCP Medicaid |
$727.40
|
|
|
PR LIGATION MAJOR ARTERY EXTREMITY
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 37618
|
| Min. Negotiated Rate |
$249.64 |
| Max. Negotiated Rate |
$848.45 |
| Rate for Payer: Aetna Commercial |
$521.95
|
| Rate for Payer: Aetna Medicare |
$538.00
|
| Rate for Payer: BCBS Complete |
$262.12
|
| Rate for Payer: BCBS Trust/PPO |
$848.45
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Meridian Medicaid |
$262.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$699.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$623.83
|
| Rate for Payer: Priority Health Narrow Network |
$623.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.75
|
| Rate for Payer: UHC Exchange |
$487.75
|
| Rate for Payer: UHCCP Medicaid |
$249.64
|
|
|
PR LIGATION MAJOR ARTERY NECK
|
Professional
|
Both
|
$1,213.00
|
|
|
Service Code
|
HCPCS 37615
|
| Min. Negotiated Rate |
$331.00 |
| Max. Negotiated Rate |
$1,021.20 |
| Rate for Payer: Aetna Commercial |
$713.42
|
| Rate for Payer: Aetna Medicare |
$606.50
|
| Rate for Payer: BCBS Complete |
$347.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.20
|
| Rate for Payer: BCN Commercial |
$750.61
|
| Rate for Payer: Cash Price |
$970.40
|
| Rate for Payer: Cash Price |
$970.40
|
| Rate for Payer: Meridian Medicaid |
$347.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.67
|
| Rate for Payer: Priority Health Narrow Network |
$821.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$619.44
|
| Rate for Payer: UHC Exchange |
$619.44
|
| Rate for Payer: UHCCP Medicaid |
$331.00
|
|
|
PR LIGATION OF FEMORAL VEIN
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 37650
|
| Min. Negotiated Rate |
$290.32 |
| Max. Negotiated Rate |
$1,285.88 |
| Rate for Payer: Aetna Commercial |
$615.48
|
| Rate for Payer: Aetna Medicare |
$839.50
|
| Rate for Payer: BCBS Complete |
$304.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.88
|
| Rate for Payer: BCN Commercial |
$658.74
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Meridian Medicaid |
$304.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,091.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.16
|
| Rate for Payer: Priority Health Narrow Network |
$721.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$657.95
|
| Rate for Payer: UHC Exchange |
$657.95
|
| Rate for Payer: UHCCP Medicaid |
$290.32
|
|
|
PR LIGATION OF INFERIOR VENA CAVA
|
Professional
|
Both
|
$3,441.00
|
|
|
Service Code
|
HCPCS 37619
|
| Min. Negotiated Rate |
$980.00 |
| Max. Negotiated Rate |
$2,739.43 |
| Rate for Payer: Aetna Commercial |
$2,337.83
|
| Rate for Payer: Aetna Medicare |
$1,720.50
|
| Rate for Payer: BCBS Complete |
$1,157.61
|
| Rate for Payer: BCBS Trust/PPO |
$980.00
|
| Rate for Payer: BCN Commercial |
$2,509.85
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Meridian Medicaid |
$1,157.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,102.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,739.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,739.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,254.30
|
| Rate for Payer: UHC Exchange |
$2,254.30
|
| Rate for Payer: UHCCP Medicaid |
$1,102.49
|
|
|
PR LIGATION OF SPERM DUCT
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 55450
|
| Min. Negotiated Rate |
$260.40 |
| Max. Negotiated Rate |
$423.15 |
| Rate for Payer: Aetna Medicare |
$325.50
|
| Rate for Payer: BCBS Complete |
$260.40
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.15
|
|
|
PR LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 37607
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$929.28 |
| Rate for Payer: Aetna Commercial |
$500.75
|
| Rate for Payer: Aetna Medicare |
$549.00
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS Trust/PPO |
$929.28
|
| Rate for Payer: BCN Commercial |
$538.04
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$588.73
|
| Rate for Payer: Priority Health Narrow Network |
$588.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.46
|
| Rate for Payer: UHC Exchange |
$487.46
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Facility
|
OP
|
$856.00
|
|
|
Service Code
|
CPT 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$556.40 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$770.40
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$830.32
|
| Rate for Payer: ASR Commercial |
$830.32
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$700.98
|
| Rate for Payer: BCN Commercial |
$663.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$804.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$856.00
|
| Rate for Payer: Healthscope Whirlpool |
$830.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$770.40
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.60
|
| Rate for Payer: Nomi Health Commercial |
$701.92
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$750.03
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$600.06
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$753.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Facility
|
IP
|
$856.00
|
|
|
Service Code
|
CPT 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$556.40 |
| Max. Negotiated Rate |
$856.00 |
| Rate for Payer: Aetna Commercial |
$770.40
|
| Rate for Payer: ASR ASR |
$830.32
|
| Rate for Payer: ASR Commercial |
$830.32
|
| Rate for Payer: BCBS Trust/PPO |
$697.55
|
| Rate for Payer: BCN Commercial |
$663.66
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$804.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.80
|
| Rate for Payer: Healthscope Commercial |
$856.00
|
| Rate for Payer: Healthscope Whirlpool |
$830.32
|
| Rate for Payer: Mclaren Commercial |
$770.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.60
|
| Rate for Payer: Nomi Health Commercial |
$701.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$753.28
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Professional
|
Both
|
$855.78
|
|
|
Service Code
|
HCPCS 37735
|
| Min. Negotiated Rate |
$366.57 |
| Max. Negotiated Rate |
$913.15 |
| Rate for Payer: Aetna Commercial |
$780.18
|
| Rate for Payer: Aetna Medicare |
$427.89
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCN Commercial |
$834.17
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.15
|
| Rate for Payer: Priority Health Narrow Network |
$913.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$817.71
|
| Rate for Payer: UHC Exchange |
$817.71
|
| Rate for Payer: UHCCP Medicaid |
$366.57
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Professional
|
Both
|
$855.78
|
|
|
Service Code
|
HCPCS 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$366.57 |
| Max. Negotiated Rate |
$913.15 |
| Rate for Payer: Aetna Commercial |
$780.18
|
| Rate for Payer: Aetna Medicare |
$427.89
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCN Commercial |
$834.17
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.15
|
| Rate for Payer: Priority Health Narrow Network |
$913.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$817.71
|
| Rate for Payer: UHC Exchange |
$817.71
|
| Rate for Payer: UHCCP Medicaid |
$366.57
|
|
|
PR LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 37700
|
| Min. Negotiated Rate |
$150.57 |
| Max. Negotiated Rate |
$386.11 |
| Rate for Payer: Aetna Commercial |
$327.02
|
| Rate for Payer: Aetna Medicare |
$237.00
|
| Rate for Payer: BCBS Complete |
$163.26
|
| Rate for Payer: BCBS Trust/PPO |
$150.57
|
| Rate for Payer: BCN Commercial |
$353.80
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Meridian Medicaid |
$163.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.11
|
| Rate for Payer: Priority Health Narrow Network |
$386.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.74
|
| Rate for Payer: UHC Exchange |
$322.74
|
| Rate for Payer: UHCCP Medicaid |
$155.49
|
|
|
PR LIG DIV & STRIPPING SHORT SAPHENOUS VEIN
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 37718
|
| Min. Negotiated Rate |
$219.24 |
| Max. Negotiated Rate |
$617.45 |
| Rate for Payer: Aetna Commercial |
$567.92
|
| Rate for Payer: Aetna Medicare |
$411.00
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS Trust/PPO |
$219.24
|
| Rate for Payer: BCN Commercial |
$564.43
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$534.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.45
|
| Rate for Payer: Priority Health Narrow Network |
$617.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$560.29
|
| Rate for Payer: UHC Exchange |
$560.29
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
|
