|
PR NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 31231
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$698.94 |
| Rate for Payer: Aetna Commercial |
$81.77
|
| Rate for Payer: Aetna Medicare |
$157.00
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS Trust/PPO |
$698.94
|
| Rate for Payer: BCN Commercial |
$223.82
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.12
|
| Rate for Payer: Priority Health Narrow Network |
$86.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.46
|
| Rate for Payer: UHC Exchange |
$85.46
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 31233
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$844.75 |
| Rate for Payer: Aetna Commercial |
$170.89
|
| Rate for Payer: Aetna Medicare |
$258.50
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS Trust/PPO |
$844.75
|
| Rate for Payer: BCN Commercial |
$404.62
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.17
|
| Rate for Payer: Priority Health Narrow Network |
$188.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.53
|
| Rate for Payer: UHC Exchange |
$155.53
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
|
PR NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY
|
Professional
|
Both
|
$507.00
|
|
|
Service Code
|
HCPCS 31235
|
| Min. Negotiated Rate |
$102.88 |
| Max. Negotiated Rate |
$1,103.09 |
| Rate for Payer: Aetna Commercial |
$199.96
|
| Rate for Payer: Aetna Medicare |
$253.50
|
| Rate for Payer: BCBS Complete |
$108.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,103.09
|
| Rate for Payer: BCN Commercial |
$457.89
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Meridian Medicaid |
$108.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.53
|
| Rate for Payer: Priority Health Narrow Network |
$221.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.56
|
| Rate for Payer: UHC Exchange |
$184.56
|
| Rate for Payer: UHCCP Medicaid |
$102.88
|
|
|
PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY
|
Professional
|
Both
|
$541.00
|
|
|
Service Code
|
HCPCS 31256
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$1,413.73 |
| Rate for Payer: Aetna Commercial |
$229.59
|
| Rate for Payer: Aetna Medicare |
$270.50
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,413.73
|
| Rate for Payer: BCN Commercial |
$261.93
|
| Rate for Payer: Cash Price |
$432.80
|
| Rate for Payer: Cash Price |
$432.80
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$351.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.88
|
| Rate for Payer: Priority Health Narrow Network |
$248.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$226.71
|
| Rate for Payer: UHC Exchange |
$226.71
|
| Rate for Payer: UHCCP Medicaid |
$115.66
|
|
|
PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
HCPCS 31287
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$1,608.67 |
| Rate for Payer: Aetna Commercial |
$256.12
|
| Rate for Payer: Aetna Medicare |
$444.50
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,608.67
|
| Rate for Payer: BCN Commercial |
$293.21
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.09
|
| Rate for Payer: Priority Health Narrow Network |
$278.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$267.23
|
| Rate for Payer: UHC Exchange |
$267.23
|
| Rate for Payer: UHCCP Medicaid |
$128.44
|
|
|
PR NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV
|
Professional
|
Both
|
$4,457.00
|
|
|
Service Code
|
HCPCS 31243
|
| Min. Negotiated Rate |
$100.75 |
| Max. Negotiated Rate |
$2,897.05 |
| Rate for Payer: Aetna Commercial |
$197.73
|
| Rate for Payer: Aetna Medicare |
$2,228.50
|
| Rate for Payer: BCBS Complete |
$105.79
|
| Rate for Payer: Cash Price |
$3,565.60
|
| Rate for Payer: Cash Price |
$3,565.60
|
| Rate for Payer: Meridian Medicaid |
$105.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,897.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.76
|
| Rate for Payer: Priority Health Narrow Network |
$218.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.94
|
| Rate for Payer: UHC Exchange |
$198.94
|
| Rate for Payer: UHCCP Medicaid |
$100.75
|
|
|
PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID
|
Professional
|
Both
|
$2,110.00
|
|
|
Service Code
|
HCPCS 31290
|
| Min. Negotiated Rate |
$733.79 |
| Max. Negotiated Rate |
$1,674.21 |
| Rate for Payer: Aetna Commercial |
$1,463.14
|
| Rate for Payer: Aetna Medicare |
$1,055.00
|
| Rate for Payer: BCBS Complete |
$770.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.13
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Meridian Medicaid |
$770.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,586.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,586.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,316.34
|
| Rate for Payer: UHC Exchange |
$1,316.34
|
| Rate for Payer: UHCCP Medicaid |
$733.79
|
|
|
PR NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID
|
Professional
|
Both
|
$2,318.00
|
|
|
Service Code
|
HCPCS 31291
|
| Min. Negotiated Rate |
$785.54 |
| Max. Negotiated Rate |
$1,781.23 |
| Rate for Payer: Aetna Commercial |
$1,549.71
|
| Rate for Payer: Aetna Medicare |
$1,159.00
|
| Rate for Payer: BCBS Complete |
$824.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,581.20
|
| Rate for Payer: BCN Commercial |
$1,781.23
|
| Rate for Payer: Cash Price |
$1,854.40
|
| Rate for Payer: Cash Price |
$1,854.40
|
| Rate for Payer: Meridian Medicaid |
$824.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$785.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,506.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,702.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,702.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,392.37
|
| Rate for Payer: UHC Exchange |
$1,392.37
|
| Rate for Payer: UHCCP Medicaid |
$785.54
|
|
|
PR NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 31292
|
| Min. Negotiated Rate |
$633.25 |
| Max. Negotiated Rate |
$1,608.67 |
| Rate for Payer: Aetna Commercial |
$1,268.54
|
| Rate for Payer: Aetna Medicare |
$1,027.50
|
| Rate for Payer: BCBS Complete |
$664.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,608.67
|
| Rate for Payer: BCN Commercial |
$1,455.28
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Meridian Medicaid |
$664.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,335.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,375.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,375.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,131.85
|
| Rate for Payer: UHC Exchange |
$1,131.85
|
| Rate for Payer: UHCCP Medicaid |
$633.25
|
|
|
PR NASAL/SINUS NDSC SURG W/BX POLYPC/DBRDMT SPX
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 31237
|
| Min. Negotiated Rate |
$102.88 |
| Max. Negotiated Rate |
$1,028.07 |
| Rate for Payer: Aetna Commercial |
$202.11
|
| Rate for Payer: Aetna Medicare |
$295.50
|
| Rate for Payer: BCBS Complete |
$108.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.07
|
| Rate for Payer: BCN Commercial |
$303.13
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Meridian Medicaid |
$108.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.00
|
| Rate for Payer: Priority Health Narrow Network |
$222.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.94
|
| Rate for Payer: UHC Exchange |
$206.94
|
| Rate for Payer: UHCCP Medicaid |
$102.88
|
|
|
PR NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 31240
|
| Min. Negotiated Rate |
$102.03 |
| Max. Negotiated Rate |
$1,226.18 |
| Rate for Payer: Aetna Commercial |
$201.32
|
| Rate for Payer: Aetna Medicare |
$258.50
|
| Rate for Payer: BCBS Complete |
$107.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,226.18
|
| Rate for Payer: BCN Commercial |
$231.15
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Meridian Medicaid |
$107.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.61
|
| Rate for Payer: Priority Health Narrow Network |
$220.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.75
|
| Rate for Payer: UHC Exchange |
$183.75
|
| Rate for Payer: UHCCP Medicaid |
$102.03
|
|
|
PR NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMORRHAGE
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS 31238
|
| Min. Negotiated Rate |
$107.14 |
| Max. Negotiated Rate |
$993.73 |
| Rate for Payer: Aetna Commercial |
$211.83
|
| Rate for Payer: Aetna Medicare |
$324.00
|
| Rate for Payer: BCBS Complete |
$112.50
|
| Rate for Payer: BCBS Trust/PPO |
$993.73
|
| Rate for Payer: BCN Commercial |
$367.97
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Meridian Medicaid |
$112.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.20
|
| Rate for Payer: Priority Health Narrow Network |
$232.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$225.03
|
| Rate for Payer: UHC Exchange |
$225.03
|
| Rate for Payer: UHCCP Medicaid |
$107.14
|
|
|
PR NASAL/SINUS NDSC SURG W/DACRYOCYSTORHINOSTOMY
|
Professional
|
Both
|
$1,332.00
|
|
|
Service Code
|
HCPCS 31239
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$1,144.83 |
| Rate for Payer: Aetna Commercial |
$773.69
|
| Rate for Payer: Aetna Medicare |
$666.00
|
| Rate for Payer: BCBS Complete |
$408.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,144.83
|
| Rate for Payer: BCN Commercial |
$883.53
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Meridian Medicaid |
$408.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$842.59
|
| Rate for Payer: Priority Health Narrow Network |
$842.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$742.54
|
| Rate for Payer: UHC Exchange |
$742.54
|
| Rate for Payer: UHCCP Medicaid |
$389.36
|
|
|
PR NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS
|
Professional
|
Both
|
$571.00
|
|
|
Service Code
|
HCPCS 31296
|
| Min. Negotiated Rate |
$115.23 |
| Max. Negotiated Rate |
$2,519.62 |
| Rate for Payer: Aetna Commercial |
$228.73
|
| Rate for Payer: Aetna Medicare |
$285.50
|
| Rate for Payer: BCBS Complete |
$120.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.37
|
| Rate for Payer: BCN Commercial |
$2,519.62
|
| Rate for Payer: Cash Price |
$456.80
|
| Rate for Payer: Cash Price |
$456.80
|
| Rate for Payer: Meridian Medicaid |
$120.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.96
|
| Rate for Payer: Priority Health Narrow Network |
$247.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.74
|
| Rate for Payer: UHC Exchange |
$258.74
|
| Rate for Payer: UHCCP Medicaid |
$115.23
|
|
|
PR NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS
|
Professional
|
Both
|
$3,993.00
|
|
|
Service Code
|
HCPCS 31295
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$2,595.45 |
| Rate for Payer: Aetna Commercial |
$200.89
|
| Rate for Payer: Aetna Medicare |
$1,996.50
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,788.82
|
| Rate for Payer: BCN Commercial |
$2,482.00
|
| Rate for Payer: Cash Price |
$3,194.40
|
| Rate for Payer: Cash Price |
$3,194.40
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,595.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.29
|
| Rate for Payer: Priority Health Narrow Network |
$218.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.64
|
| Rate for Payer: UHC Exchange |
$216.64
|
| Rate for Payer: UHCCP Medicaid |
$100.96
|
|
|
PR NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS
|
Professional
|
Both
|
$3,272.00
|
|
|
Service Code
|
HCPCS 31297
|
| Min. Negotiated Rate |
$92.02 |
| Max. Negotiated Rate |
$2,461.47 |
| Rate for Payer: Aetna Commercial |
$182.81
|
| Rate for Payer: Aetna Medicare |
$1,636.00
|
| Rate for Payer: BCBS Complete |
$96.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,278.49
|
| Rate for Payer: BCN Commercial |
$2,461.47
|
| Rate for Payer: Cash Price |
$2,617.60
|
| Rate for Payer: Cash Price |
$2,617.60
|
| Rate for Payer: Meridian Medicaid |
$96.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.30
|
| Rate for Payer: Priority Health Narrow Network |
$199.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$212.00
|
| Rate for Payer: UHC Exchange |
$212.00
|
| Rate for Payer: UHCCP Medicaid |
$92.02
|
|
|
PR NASAL/SINUS NDSC SURG W/LIG SPHENOPALATINE ART
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 31241
|
| Min. Negotiated Rate |
$282.44 |
| Max. Negotiated Rate |
$1,456.52 |
| Rate for Payer: Aetna Commercial |
$567.94
|
| Rate for Payer: Aetna Medicare |
$462.00
|
| Rate for Payer: BCBS Complete |
$296.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCN Commercial |
$645.54
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Meridian Medicaid |
$296.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.03
|
| Rate for Payer: Priority Health Narrow Network |
$615.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$542.51
|
| Rate for Payer: UHC Exchange |
$542.51
|
| Rate for Payer: UHCCP Medicaid |
$282.44
|
|
|
PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN
|
Professional
|
Both
|
$2,591.00
|
|
|
Service Code
|
HCPCS 31294
|
| Min. Negotiated Rate |
$783.20 |
| Max. Negotiated Rate |
$1,797.36 |
| Rate for Payer: Aetna Commercial |
$1,571.24
|
| Rate for Payer: Aetna Medicare |
$1,295.50
|
| Rate for Payer: BCBS Complete |
$822.36
|
| Rate for Payer: BCN Commercial |
$1,797.36
|
| Rate for Payer: Cash Price |
$2,072.80
|
| Rate for Payer: Cash Price |
$2,072.80
|
| Rate for Payer: Meridian Medicaid |
$822.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$783.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,684.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,704.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,704.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,416.06
|
| Rate for Payer: UHC Exchange |
$1,416.06
|
| Rate for Payer: UHCCP Medicaid |
$783.20
|
|
|
PR NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 31257
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$1,077.73 |
| Rate for Payer: Aetna Commercial |
$570.01
|
| Rate for Payer: Aetna Medicare |
$460.00
|
| Rate for Payer: BCBS Complete |
$297.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.73
|
| Rate for Payer: BCN Commercial |
$647.50
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Meridian Medicaid |
$297.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.49
|
| Rate for Payer: Priority Health Narrow Network |
$615.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$540.88
|
| Rate for Payer: UHC Exchange |
$540.88
|
| Rate for Payer: UHCCP Medicaid |
$283.50
|
|
|
PR NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL
|
Professional
|
Both
|
$1,019.00
|
|
|
Service Code
|
HCPCS 31253
|
| Min. Negotiated Rate |
$317.80 |
| Max. Negotiated Rate |
$1,572.75 |
| Rate for Payer: Aetna Commercial |
$639.80
|
| Rate for Payer: Aetna Medicare |
$509.50
|
| Rate for Payer: BCBS Complete |
$333.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,572.75
|
| Rate for Payer: BCN Commercial |
$726.66
|
| Rate for Payer: Cash Price |
$815.20
|
| Rate for Payer: Cash Price |
$815.20
|
| Rate for Payer: Meridian Medicaid |
$333.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$662.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.64
|
| Rate for Payer: Priority Health Narrow Network |
$689.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.76
|
| Rate for Payer: UHC Exchange |
$607.76
|
| Rate for Payer: UHCCP Medicaid |
$317.80
|
|
|
PR NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL
|
Professional
|
Both
|
$975.00
|
|
|
Service Code
|
HCPCS 31259
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,218.26 |
| Rate for Payer: Aetna Commercial |
$603.57
|
| Rate for Payer: Aetna Medicare |
$487.50
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.26
|
| Rate for Payer: BCN Commercial |
$685.13
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.24
|
| Rate for Payer: Priority Health Narrow Network |
$650.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$573.48
|
| Rate for Payer: UHC Exchange |
$573.48
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
|
|
PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
HCPCS 31254
|
| Min. Negotiated Rate |
$155.06 |
| Max. Negotiated Rate |
$1,345.05 |
| Rate for Payer: Aetna Commercial |
$310.39
|
| Rate for Payer: Aetna Medicare |
$371.50
|
| Rate for Payer: BCBS Complete |
$162.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,345.05
|
| Rate for Payer: BCN Commercial |
$646.03
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Meridian Medicaid |
$162.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$336.01
|
| Rate for Payer: Priority Health Narrow Network |
$336.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.46
|
| Rate for Payer: UHC Exchange |
$314.46
|
| Rate for Payer: UHCCP Medicaid |
$155.06
|
|
|
PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
Professional
|
Both
|
$1,360.00
|
|
|
Service Code
|
HCPCS 31276
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$1,458.11 |
| Rate for Payer: Aetna Commercial |
$482.62
|
| Rate for Payer: Aetna Medicare |
$680.00
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.11
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.33
|
| Rate for Payer: Priority Health Narrow Network |
$522.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.94
|
| Rate for Payer: UHC Exchange |
$583.94
|
| Rate for Payer: UHCCP Medicaid |
$240.69
|
|
|
PR NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY
|
Professional
|
Both
|
$945.00
|
|
|
Service Code
|
HCPCS 31255
|
| Min. Negotiated Rate |
$205.76 |
| Max. Negotiated Rate |
$1,500.90 |
| Rate for Payer: Aetna Commercial |
$412.82
|
| Rate for Payer: Aetna Medicare |
$472.50
|
| Rate for Payer: BCBS Complete |
$216.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.90
|
| Rate for Payer: BCN Commercial |
$470.10
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Meridian Medicaid |
$216.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$614.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.32
|
| Rate for Payer: Priority Health Narrow Network |
$446.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$462.02
|
| Rate for Payer: UHC Exchange |
$462.02
|
| Rate for Payer: UHCCP Medicaid |
$205.76
|
|
|
PR NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 43752
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$1,612.37 |
| Rate for Payer: Aetna Commercial |
$54.32
|
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: BCBS Complete |
$26.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.37
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Meridian Medicaid |
$26.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.40
|
| Rate for Payer: Priority Health Narrow Network |
$70.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.75
|
| Rate for Payer: UHC Exchange |
$52.75
|
| Rate for Payer: UHCCP Medicaid |
$25.35
|
|
