|
PR VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG
|
Professional
|
Both
|
$7,131.00
|
|
|
Service Code
|
HCPCS 63090
|
| Min. Negotiated Rate |
$1,249.46 |
| Max. Negotiated Rate |
$4,991.70 |
| Rate for Payer: Aetna Commercial |
$2,595.57
|
| Rate for Payer: Aetna Medicare |
$1,936.99
|
| Rate for Payer: BCBS Complete |
$1,311.93
|
| Rate for Payer: BCBS MAPPO |
$1,936.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,683.69
|
| Rate for Payer: BCN Commercial |
$3,133.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,936.99
|
| Rate for Payer: Cash Price |
$5,704.80
|
| Rate for Payer: Cash Price |
$5,704.80
|
| Rate for Payer: Cofinity Commercial |
$2,595.57
|
| Rate for Payer: Cofinity Commercial |
$2,789.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,936.99
|
| Rate for Payer: Healthscope Commercial |
$2,324.39
|
| Rate for Payer: Healthscope Whirlpool |
$2,324.39
|
| Rate for Payer: Meridian Medicaid |
$1,311.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,033.84
|
| Rate for Payer: PACE SWMI |
$1,936.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,936.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,249.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,991.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,297.12
|
| Rate for Payer: Priority Health Medicare |
$1,936.99
|
| Rate for Payer: Priority Health Narrow Network |
$3,297.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,995.10
|
|
|
PR VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG
|
Professional
|
Both
|
$2,429.00
|
|
|
Service Code
|
HCPCS 63091
|
| Min. Negotiated Rate |
$111.40 |
| Max. Negotiated Rate |
$2,079.39 |
| Rate for Payer: Aetna Commercial |
$234.59
|
| Rate for Payer: Aetna Medicare |
$175.07
|
| Rate for Payer: BCBS Complete |
$116.97
|
| Rate for Payer: BCBS MAPPO |
$175.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,079.39
|
| Rate for Payer: BCN Commercial |
$281.41
|
| Rate for Payer: BCN Medicare Advantage |
$175.07
|
| Rate for Payer: Cash Price |
$1,943.20
|
| Rate for Payer: Cash Price |
$1,943.20
|
| Rate for Payer: Cofinity Commercial |
$234.59
|
| Rate for Payer: Cofinity Commercial |
$252.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.07
|
| Rate for Payer: Healthscope Commercial |
$210.08
|
| Rate for Payer: Healthscope Whirlpool |
$210.08
|
| Rate for Payer: Meridian Medicaid |
$116.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$183.82
|
| Rate for Payer: PACE SWMI |
$175.07
|
| Rate for Payer: PHP Medicare Advantage |
$175.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,700.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$296.13
|
| Rate for Payer: Priority Health Medicare |
$175.07
|
| Rate for Payer: Priority Health Narrow Network |
$296.13
|
| Rate for Payer: UHC Medicare Advantage |
$180.32
|
|
|
PR VEIN SCREEN
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 00515
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
|
|
PR VEN CATHJ SLCTV ORGAN BLD SAMPLING
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 36500
|
| Min. Negotiated Rate |
$113.53 |
| Max. Negotiated Rate |
$428.45 |
| Rate for Payer: Aetna Commercial |
$238.72
|
| Rate for Payer: Aetna Medicare |
$178.15
|
| Rate for Payer: BCBS Complete |
$119.21
|
| Rate for Payer: BCBS MAPPO |
$178.15
|
| Rate for Payer: BCBS Trust/PPO |
$428.45
|
| Rate for Payer: BCN Commercial |
$259.49
|
| Rate for Payer: BCN Medicare Advantage |
$178.15
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$238.72
|
| Rate for Payer: Cofinity Commercial |
$256.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.15
|
| Rate for Payer: Healthscope Commercial |
$213.78
|
| Rate for Payer: Healthscope Whirlpool |
$213.78
|
| Rate for Payer: Meridian Medicaid |
$119.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$187.06
|
| Rate for Payer: PACE SWMI |
$178.15
|
| Rate for Payer: PHP Medicare Advantage |
$178.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.47
|
| Rate for Payer: Priority Health Medicare |
$178.15
|
| Rate for Payer: Priority Health Narrow Network |
$282.47
|
| Rate for Payer: UHC Medicare Advantage |
$183.49
|
|
|
PR VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL
|
Professional
|
Both
|
$4,281.00
|
|
|
Service Code
|
HCPCS 37180
|
| Min. Negotiated Rate |
$1,352.34 |
| Max. Negotiated Rate |
$3,361.97 |
| Rate for Payer: Aetna Commercial |
$2,830.50
|
| Rate for Payer: Aetna Medicare |
$2,112.31
|
| Rate for Payer: BCBS Complete |
$1,419.96
|
| Rate for Payer: BCBS MAPPO |
$2,112.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.77
|
| Rate for Payer: BCN Commercial |
$3,088.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,112.31
|
| Rate for Payer: Cash Price |
$3,424.80
|
| Rate for Payer: Cash Price |
$3,424.80
|
| Rate for Payer: Cofinity Commercial |
$3,041.73
|
| Rate for Payer: Cofinity Commercial |
$2,830.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,112.31
|
| Rate for Payer: Healthscope Commercial |
$2,534.77
|
| Rate for Payer: Healthscope Whirlpool |
$2,534.77
|
| Rate for Payer: Meridian Medicaid |
$1,419.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,217.93
|
| Rate for Payer: PACE SWMI |
$2,112.31
|
| Rate for Payer: PHP Medicare Advantage |
$2,112.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,352.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,996.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,361.97
|
| Rate for Payer: Priority Health Medicare |
$2,112.31
|
| Rate for Payer: Priority Health Narrow Network |
$3,361.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,175.68
|
|
|
PR VENTILATING TUBE RMVL REQUIRING GENERAL ANES
|
Professional
|
Both
|
$601.00
|
|
|
Service Code
|
HCPCS 69424
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$2,176.60 |
| Rate for Payer: Aetna Commercial |
$78.64
|
| Rate for Payer: Aetna Medicare |
$58.69
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCBS MAPPO |
$58.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,176.60
|
| Rate for Payer: BCN Commercial |
$188.63
|
| Rate for Payer: BCN Medicare Advantage |
$58.69
|
| Rate for Payer: Cash Price |
$480.80
|
| Rate for Payer: Cash Price |
$480.80
|
| Rate for Payer: Cofinity Commercial |
$84.51
|
| Rate for Payer: Cofinity Commercial |
$78.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.69
|
| Rate for Payer: Healthscope Commercial |
$70.43
|
| Rate for Payer: Healthscope Whirlpool |
$70.43
|
| Rate for Payer: Meridian Medicaid |
$40.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.62
|
| Rate for Payer: PACE SWMI |
$58.69
|
| Rate for Payer: PHP Medicare Advantage |
$58.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.87
|
| Rate for Payer: Priority Health Medicare |
$58.69
|
| Rate for Payer: Priority Health Narrow Network |
$84.87
|
| Rate for Payer: UHC Medicare Advantage |
$60.45
|
|
|
PR VENTILATION ASSIST & MGMT INPATIENT 1ST DAY
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 94002
|
| Min. Negotiated Rate |
$57.51 |
| Max. Negotiated Rate |
$1,687.92 |
| Rate for Payer: Aetna Commercial |
$121.00
|
| Rate for Payer: Aetna Medicare |
$90.30
|
| Rate for Payer: BCBS Complete |
$60.39
|
| Rate for Payer: BCBS MAPPO |
$90.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,687.92
|
| Rate for Payer: BCN Commercial |
$131.94
|
| Rate for Payer: BCN Medicare Advantage |
$90.30
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$121.00
|
| Rate for Payer: Cofinity Commercial |
$130.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.30
|
| Rate for Payer: Healthscope Commercial |
$108.36
|
| Rate for Payer: Healthscope Whirlpool |
$108.36
|
| Rate for Payer: Meridian Medicaid |
$60.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.82
|
| Rate for Payer: PACE SWMI |
$90.30
|
| Rate for Payer: PHP Medicare Advantage |
$90.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.27
|
| Rate for Payer: Priority Health Medicare |
$90.30
|
| Rate for Payer: Priority Health Narrow Network |
$121.27
|
| Rate for Payer: UHC Medicare Advantage |
$93.01
|
|
|
PR VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 94003
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$1,092.52 |
| Rate for Payer: Aetna Commercial |
$84.54
|
| Rate for Payer: Aetna Medicare |
$63.09
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$63.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,092.52
|
| Rate for Payer: BCN Commercial |
$92.36
|
| Rate for Payer: BCN Medicare Advantage |
$63.09
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$90.85
|
| Rate for Payer: Cofinity Commercial |
$84.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.09
|
| Rate for Payer: Healthscope Commercial |
$75.71
|
| Rate for Payer: Healthscope Whirlpool |
$75.71
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.24
|
| Rate for Payer: PACE SWMI |
$63.09
|
| Rate for Payer: PHP Medicare Advantage |
$63.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.89
|
| Rate for Payer: Priority Health Medicare |
$63.09
|
| Rate for Payer: Priority Health Narrow Network |
$84.89
|
| Rate for Payer: UHC Medicare Advantage |
$64.98
|
|
|
PR VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ
|
Professional
|
Both
|
$552.00
|
|
|
Service Code
|
HCPCS 61026
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$593.81 |
| Rate for Payer: Aetna Commercial |
$141.79
|
| Rate for Payer: Aetna Medicare |
$105.81
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS MAPPO |
$105.81
|
| Rate for Payer: BCBS Trust/PPO |
$593.81
|
| Rate for Payer: BCN Commercial |
$155.89
|
| Rate for Payer: BCN Medicare Advantage |
$105.81
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Commercial |
$152.37
|
| Rate for Payer: Cofinity Commercial |
$141.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.81
|
| Rate for Payer: Healthscope Commercial |
$126.97
|
| Rate for Payer: Healthscope Whirlpool |
$126.97
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.10
|
| Rate for Payer: PACE SWMI |
$105.81
|
| Rate for Payer: PHP Medicare Advantage |
$105.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.63
|
| Rate for Payer: Priority Health Medicare |
$105.81
|
| Rate for Payer: Priority Health Narrow Network |
$180.63
|
| Rate for Payer: UHC Medicare Advantage |
$108.98
|
|
|
PR VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 61020
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$330.19 |
| Rate for Payer: Aetna Commercial |
$141.77
|
| Rate for Payer: Aetna Medicare |
$105.80
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$105.80
|
| Rate for Payer: BCBS Trust/PPO |
$330.19
|
| Rate for Payer: BCN Commercial |
$155.40
|
| Rate for Payer: BCN Medicare Advantage |
$105.80
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$141.77
|
| Rate for Payer: Cofinity Commercial |
$152.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.80
|
| Rate for Payer: Healthscope Commercial |
$126.96
|
| Rate for Payer: Healthscope Whirlpool |
$126.96
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.09
|
| Rate for Payer: PACE SWMI |
$105.80
|
| Rate for Payer: PHP Medicare Advantage |
$105.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$314.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.06
|
| Rate for Payer: Priority Health Medicare |
$105.80
|
| Rate for Payer: Priority Health Narrow Network |
$180.06
|
| Rate for Payer: UHC Medicare Advantage |
$108.97
|
|
|
PR VENTRICULOCISTERNOSTOMY
|
Professional
|
Both
|
$4,660.00
|
|
|
Service Code
|
HCPCS 62180
|
| Min. Negotiated Rate |
$1,040.08 |
| Max. Negotiated Rate |
$3,278.48 |
| Rate for Payer: Aetna Commercial |
$2,160.27
|
| Rate for Payer: Aetna Medicare |
$1,612.14
|
| Rate for Payer: BCBS Complete |
$1,092.08
|
| Rate for Payer: BCBS MAPPO |
$1,612.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,771.92
|
| Rate for Payer: BCN Commercial |
$3,278.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,612.14
|
| Rate for Payer: Cash Price |
$3,728.00
|
| Rate for Payer: Cash Price |
$3,728.00
|
| Rate for Payer: Cofinity Commercial |
$2,160.27
|
| Rate for Payer: Cofinity Commercial |
$2,321.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,612.14
|
| Rate for Payer: Healthscope Commercial |
$1,934.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,934.57
|
| Rate for Payer: Meridian Medicaid |
$1,092.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,692.75
|
| Rate for Payer: PACE SWMI |
$1,612.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,612.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,040.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,262.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,738.25
|
| Rate for Payer: Priority Health Medicare |
$1,612.14
|
| Rate for Payer: Priority Health Narrow Network |
$2,738.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,660.50
|
|
|
PR VENTRICULOCISTERNOSTOMY 3RD VENTRICLE
|
Professional
|
Both
|
$6,420.00
|
|
|
Service Code
|
HCPCS 62200
|
| Min. Negotiated Rate |
$895.67 |
| Max. Negotiated Rate |
$4,494.00 |
| Rate for Payer: Aetna Commercial |
$1,859.84
|
| Rate for Payer: Aetna Medicare |
$1,387.94
|
| Rate for Payer: BCBS Complete |
$940.45
|
| Rate for Payer: BCBS MAPPO |
$1,387.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.01
|
| Rate for Payer: BCN Commercial |
$2,824.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,387.94
|
| Rate for Payer: Cash Price |
$5,136.00
|
| Rate for Payer: Cash Price |
$5,136.00
|
| Rate for Payer: Cofinity Commercial |
$1,998.63
|
| Rate for Payer: Cofinity Commercial |
$1,859.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,387.94
|
| Rate for Payer: Healthscope Commercial |
$1,665.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,665.53
|
| Rate for Payer: Meridian Medicaid |
$940.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,457.34
|
| Rate for Payer: PACE SWMI |
$1,387.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,387.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$895.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,494.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,358.89
|
| Rate for Payer: Priority Health Medicare |
$1,387.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,358.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,429.58
|
|
|
PR VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC
|
Professional
|
Both
|
$5,833.00
|
|
|
Service Code
|
HCPCS 62201
|
| Min. Negotiated Rate |
$792.36 |
| Max. Negotiated Rate |
$9,012.27 |
| Rate for Payer: Aetna Commercial |
$1,639.49
|
| Rate for Payer: Aetna Medicare |
$1,223.50
|
| Rate for Payer: BCBS Complete |
$831.98
|
| Rate for Payer: BCBS MAPPO |
$1,223.50
|
| Rate for Payer: BCBS Trust/PPO |
$9,012.27
|
| Rate for Payer: BCN Commercial |
$2,500.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,223.50
|
| Rate for Payer: Cash Price |
$4,666.40
|
| Rate for Payer: Cash Price |
$4,666.40
|
| Rate for Payer: Cofinity Commercial |
$1,761.84
|
| Rate for Payer: Cofinity Commercial |
$1,639.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,223.50
|
| Rate for Payer: Healthscope Commercial |
$1,468.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,468.20
|
| Rate for Payer: Meridian Medicaid |
$831.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,284.68
|
| Rate for Payer: PACE SWMI |
$1,223.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,223.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$792.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,083.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,088.80
|
| Rate for Payer: Priority Health Medicare |
$1,223.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,088.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,260.20
|
|
|
PR VENTRICULOMYOTOMY-MYECTOMY
|
Professional
|
Both
|
$8,920.00
|
|
|
Service Code
|
HCPCS 33416
|
| Min. Negotiated Rate |
$718.49 |
| Max. Negotiated Rate |
$6,244.00 |
| Rate for Payer: Aetna Commercial |
$2,666.41
|
| Rate for Payer: Aetna Medicare |
$1,989.86
|
| Rate for Payer: BCBS Complete |
$1,331.84
|
| Rate for Payer: BCBS MAPPO |
$1,989.86
|
| Rate for Payer: BCBS Trust/PPO |
$718.49
|
| Rate for Payer: BCN Commercial |
$2,899.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,989.86
|
| Rate for Payer: Cash Price |
$7,136.00
|
| Rate for Payer: Cash Price |
$7,136.00
|
| Rate for Payer: Cofinity Commercial |
$2,666.41
|
| Rate for Payer: Cofinity Commercial |
$2,865.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,989.86
|
| Rate for Payer: Healthscope Commercial |
$2,387.83
|
| Rate for Payer: Healthscope Whirlpool |
$2,387.83
|
| Rate for Payer: Meridian Medicaid |
$1,331.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,089.35
|
| Rate for Payer: PACE SWMI |
$1,989.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,989.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,268.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,244.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,156.64
|
| Rate for Payer: Priority Health Medicare |
$1,989.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,156.64
|
| Rate for Payer: UHC Medicare Advantage |
$2,049.56
|
|
|
PR VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT
|
Professional
|
Both
|
$734.00
|
|
|
Service Code
|
HCPCS 40500
|
| Min. Negotiated Rate |
$239.20 |
| Max. Negotiated Rate |
$776.51 |
| Rate for Payer: Aetna Commercial |
$481.60
|
| Rate for Payer: Aetna Medicare |
$359.40
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$359.40
|
| Rate for Payer: BCBS Trust/PPO |
$449.06
|
| Rate for Payer: BCN Commercial |
$776.51
|
| Rate for Payer: BCN Medicare Advantage |
$359.40
|
| Rate for Payer: Cash Price |
$587.20
|
| Rate for Payer: Cash Price |
$587.20
|
| Rate for Payer: Cofinity Commercial |
$517.54
|
| Rate for Payer: Cofinity Commercial |
$481.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.40
|
| Rate for Payer: Healthscope Commercial |
$431.28
|
| Rate for Payer: Healthscope Whirlpool |
$431.28
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$377.37
|
| Rate for Payer: PACE SWMI |
$359.40
|
| Rate for Payer: PHP Medicare Advantage |
$359.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.65
|
| Rate for Payer: Priority Health Medicare |
$359.40
|
| Rate for Payer: Priority Health Narrow Network |
$652.65
|
| Rate for Payer: UHC Medicare Advantage |
$370.18
|
|
|
PR VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG
|
Professional
|
Both
|
$8,406.00
|
|
|
Service Code
|
HCPCS 63102
|
| Min. Negotiated Rate |
$1,473.32 |
| Max. Negotiated Rate |
$5,884.20 |
| Rate for Payer: Aetna Commercial |
$3,063.37
|
| Rate for Payer: Aetna Medicare |
$2,286.10
|
| Rate for Payer: BCBS Complete |
$1,546.99
|
| Rate for Payer: BCBS MAPPO |
$2,286.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,448.21
|
| Rate for Payer: BCN Commercial |
$3,359.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,286.10
|
| Rate for Payer: Cash Price |
$6,724.80
|
| Rate for Payer: Cash Price |
$6,724.80
|
| Rate for Payer: Cofinity Commercial |
$3,291.98
|
| Rate for Payer: Cofinity Commercial |
$3,063.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,286.10
|
| Rate for Payer: Healthscope Commercial |
$2,743.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,743.32
|
| Rate for Payer: Meridian Medicaid |
$1,546.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,400.40
|
| Rate for Payer: PACE SWMI |
$2,286.10
|
| Rate for Payer: PHP Medicare Advantage |
$2,286.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,473.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,884.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,892.23
|
| Rate for Payer: Priority Health Medicare |
$2,286.10
|
| Rate for Payer: Priority Health Narrow Network |
$3,892.23
|
| Rate for Payer: UHC Medicare Advantage |
$2,354.68
|
|
|
PR VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG
|
Professional
|
Both
|
$4,775.10
|
|
|
Service Code
|
HCPCS 63101
|
| Min. Negotiated Rate |
$1,501.86 |
| Max. Negotiated Rate |
$3,960.17 |
| Rate for Payer: Aetna Commercial |
$3,120.59
|
| Rate for Payer: Aetna Medicare |
$2,328.80
|
| Rate for Payer: BCBS Complete |
$1,576.95
|
| Rate for Payer: BCBS MAPPO |
$2,328.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,418.10
|
| Rate for Payer: BCN Commercial |
$3,417.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,328.80
|
| Rate for Payer: Cash Price |
$3,820.08
|
| Rate for Payer: Cash Price |
$3,820.08
|
| Rate for Payer: Cofinity Commercial |
$3,353.47
|
| Rate for Payer: Cofinity Commercial |
$3,120.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,328.80
|
| Rate for Payer: Healthscope Commercial |
$2,794.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,794.56
|
| Rate for Payer: Meridian Medicaid |
$1,576.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,445.24
|
| Rate for Payer: PACE SWMI |
$2,328.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,328.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,501.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,342.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,960.17
|
| Rate for Payer: Priority Health Medicare |
$2,328.80
|
| Rate for Payer: Priority Health Narrow Network |
$3,960.17
|
| Rate for Payer: UHC Medicare Advantage |
$2,398.66
|
|
|
PR VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG
|
Professional
|
Both
|
$6,311.00
|
|
|
Service Code
|
HCPCS 63081
|
| Min. Negotiated Rate |
$206.57 |
| Max. Negotiated Rate |
$4,417.70 |
| Rate for Payer: Aetna Commercial |
$2,354.39
|
| Rate for Payer: Aetna Medicare |
$1,757.01
|
| Rate for Payer: BCBS Complete |
$1,194.51
|
| Rate for Payer: BCBS MAPPO |
$1,757.01
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: BCN Commercial |
$2,843.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,757.01
|
| Rate for Payer: Cash Price |
$5,048.80
|
| Rate for Payer: Cash Price |
$5,048.80
|
| Rate for Payer: Cofinity Commercial |
$2,530.09
|
| Rate for Payer: Cofinity Commercial |
$2,354.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,757.01
|
| Rate for Payer: Healthscope Commercial |
$2,108.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,108.41
|
| Rate for Payer: Meridian Medicaid |
$1,194.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,844.86
|
| Rate for Payer: PACE SWMI |
$1,757.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,757.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,137.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,417.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,992.49
|
| Rate for Payer: Priority Health Medicare |
$1,757.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,992.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,809.72
|
|
|
PR VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG
|
Professional
|
Both
|
$2,104.00
|
|
|
Service Code
|
HCPCS 63082
|
| Min. Negotiated Rate |
$169.55 |
| Max. Negotiated Rate |
$1,472.80 |
| Rate for Payer: Aetna Commercial |
$354.20
|
| Rate for Payer: Aetna Medicare |
$264.33
|
| Rate for Payer: BCBS Complete |
$178.03
|
| Rate for Payer: BCBS MAPPO |
$264.33
|
| Rate for Payer: BCBS Trust/PPO |
$385.66
|
| Rate for Payer: BCN Commercial |
$424.54
|
| Rate for Payer: BCN Medicare Advantage |
$264.33
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cofinity Commercial |
$354.20
|
| Rate for Payer: Cofinity Commercial |
$380.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.33
|
| Rate for Payer: Healthscope Commercial |
$317.20
|
| Rate for Payer: Healthscope Whirlpool |
$317.20
|
| Rate for Payer: Meridian Medicaid |
$178.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$277.55
|
| Rate for Payer: PACE SWMI |
$264.33
|
| Rate for Payer: PHP Medicare Advantage |
$264.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.75
|
| Rate for Payer: Priority Health Medicare |
$264.33
|
| Rate for Payer: Priority Health Narrow Network |
$446.75
|
| Rate for Payer: UHC Medicare Advantage |
$272.26
|
|
|
PR VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG
|
Professional
|
Both
|
$6,953.00
|
|
|
Service Code
|
HCPCS 63085
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$4,867.10 |
| Rate for Payer: Aetna Commercial |
$2,579.93
|
| Rate for Payer: Aetna Medicare |
$1,925.32
|
| Rate for Payer: BCBS Complete |
$1,315.06
|
| Rate for Payer: BCBS MAPPO |
$1,925.32
|
| Rate for Payer: BCBS Trust/PPO |
$420.00
|
| Rate for Payer: BCN Commercial |
$3,110.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,925.32
|
| Rate for Payer: Cash Price |
$5,562.40
|
| Rate for Payer: Cash Price |
$5,562.40
|
| Rate for Payer: Cofinity Commercial |
$2,772.46
|
| Rate for Payer: Cofinity Commercial |
$2,579.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,925.32
|
| Rate for Payer: Healthscope Commercial |
$2,310.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,310.38
|
| Rate for Payer: Meridian Medicaid |
$1,315.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,021.59
|
| Rate for Payer: PACE SWMI |
$1,925.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,925.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,252.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,867.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,273.34
|
| Rate for Payer: Priority Health Medicare |
$1,925.32
|
| Rate for Payer: Priority Health Narrow Network |
$3,273.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,983.08
|
|
|
PR VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG
|
Professional
|
Both
|
$2,318.00
|
|
|
Service Code
|
HCPCS 63086
|
| Min. Negotiated Rate |
$122.05 |
| Max. Negotiated Rate |
$1,622.60 |
| Rate for Payer: Aetna Commercial |
$252.68
|
| Rate for Payer: Aetna Medicare |
$188.57
|
| Rate for Payer: BCBS Complete |
$128.15
|
| Rate for Payer: BCBS MAPPO |
$188.57
|
| Rate for Payer: BCBS Trust/PPO |
$985.81
|
| Rate for Payer: BCN Commercial |
$302.94
|
| Rate for Payer: BCN Medicare Advantage |
$188.57
|
| Rate for Payer: Cash Price |
$1,854.40
|
| Rate for Payer: Cash Price |
$1,854.40
|
| Rate for Payer: Cofinity Commercial |
$252.68
|
| Rate for Payer: Cofinity Commercial |
$271.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.57
|
| Rate for Payer: Healthscope Commercial |
$226.28
|
| Rate for Payer: Healthscope Whirlpool |
$226.28
|
| Rate for Payer: Meridian Medicaid |
$128.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.00
|
| Rate for Payer: PACE SWMI |
$188.57
|
| Rate for Payer: PHP Medicare Advantage |
$188.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,622.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.78
|
| Rate for Payer: Priority Health Medicare |
$188.57
|
| Rate for Payer: Priority Health Narrow Network |
$318.78
|
| Rate for Payer: UHC Medicare Advantage |
$194.23
|
|
|
PR VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG
|
Professional
|
Both
|
$1,533.00
|
|
|
Service Code
|
HCPCS 63308
|
| Min. Negotiated Rate |
$204.69 |
| Max. Negotiated Rate |
$1,073.10 |
| Rate for Payer: Aetna Commercial |
$428.67
|
| Rate for Payer: Aetna Medicare |
$319.90
|
| Rate for Payer: BCBS Complete |
$214.92
|
| Rate for Payer: BCBS MAPPO |
$319.90
|
| Rate for Payer: BCBS Trust/PPO |
$257.81
|
| Rate for Payer: BCN Commercial |
$512.78
|
| Rate for Payer: BCN Medicare Advantage |
$319.90
|
| Rate for Payer: Cash Price |
$1,226.40
|
| Rate for Payer: Cash Price |
$1,226.40
|
| Rate for Payer: Cofinity Commercial |
$428.67
|
| Rate for Payer: Cofinity Commercial |
$460.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.90
|
| Rate for Payer: Healthscope Commercial |
$383.88
|
| Rate for Payer: Healthscope Whirlpool |
$383.88
|
| Rate for Payer: Meridian Medicaid |
$214.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.90
|
| Rate for Payer: PACE SWMI |
$319.90
|
| Rate for Payer: PHP Medicare Advantage |
$319.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.62
|
| Rate for Payer: Priority Health Medicare |
$319.90
|
| Rate for Payer: Priority Health Narrow Network |
$539.62
|
| Rate for Payer: UHC Medicare Advantage |
$329.50
|
|
|
PR VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL
|
Professional
|
Both
|
$1,723.00
|
|
|
Service Code
|
HCPCS 22512
|
| Min. Negotiated Rate |
$130.57 |
| Max. Negotiated Rate |
$1,206.10 |
| Rate for Payer: Aetna Commercial |
$273.94
|
| Rate for Payer: Aetna Medicare |
$204.43
|
| Rate for Payer: BCBS Complete |
$137.10
|
| Rate for Payer: BCBS MAPPO |
$204.43
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: BCN Commercial |
$1,078.02
|
| Rate for Payer: BCN Medicare Advantage |
$204.43
|
| Rate for Payer: Cash Price |
$1,378.40
|
| Rate for Payer: Cash Price |
$1,378.40
|
| Rate for Payer: Cofinity Commercial |
$294.38
|
| Rate for Payer: Cofinity Commercial |
$273.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.43
|
| Rate for Payer: Healthscope Commercial |
$245.32
|
| Rate for Payer: Healthscope Whirlpool |
$245.32
|
| Rate for Payer: Meridian Medicaid |
$137.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$214.65
|
| Rate for Payer: PACE SWMI |
$204.43
|
| Rate for Payer: PHP Medicare Advantage |
$204.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.01
|
| Rate for Payer: Priority Health Medicare |
$204.43
|
| Rate for Payer: Priority Health Narrow Network |
$312.01
|
| Rate for Payer: UHC Medicare Advantage |
$210.56
|
|
|
PR VESICULOTOMY COMPLICATED
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 55605
|
| Min. Negotiated Rate |
$335.69 |
| Max. Negotiated Rate |
$2,259.54 |
| Rate for Payer: Aetna Commercial |
$685.79
|
| Rate for Payer: Aetna Medicare |
$511.78
|
| Rate for Payer: BCBS Complete |
$352.47
|
| Rate for Payer: BCBS MAPPO |
$511.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,259.54
|
| Rate for Payer: BCN Commercial |
$758.92
|
| Rate for Payer: BCN Medicare Advantage |
$511.78
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$685.79
|
| Rate for Payer: Cofinity Commercial |
$736.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.78
|
| Rate for Payer: Healthscope Commercial |
$614.14
|
| Rate for Payer: Healthscope Whirlpool |
$614.14
|
| Rate for Payer: Meridian Medicaid |
$352.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$537.37
|
| Rate for Payer: PACE SWMI |
$511.78
|
| Rate for Payer: PHP Medicare Advantage |
$511.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$569.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.18
|
| Rate for Payer: Priority Health Medicare |
$511.78
|
| Rate for Payer: Priority Health Narrow Network |
$839.18
|
| Rate for Payer: UHC Medicare Advantage |
$527.13
|
|
|
PR VESSEL MAPPING HEMO ACCESS
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS G0365
|
| Min. Negotiated Rate |
$143.60 |
| Max. Negotiated Rate |
$251.30 |
| Rate for Payer: BCBS Complete |
$143.60
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.30
|
|
