|
PR PERQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION
|
Professional
|
Both
|
$1,471.00
|
|
|
Service Code
|
HCPCS 25671
|
| Min. Negotiated Rate |
$333.35 |
| Max. Negotiated Rate |
$1,103.25 |
| Rate for Payer: Aetna Commercial |
$676.90
|
| Rate for Payer: Aetna Medicare |
$505.15
|
| Rate for Payer: BCBS Complete |
$350.02
|
| Rate for Payer: BCBS MAPPO |
$505.15
|
| Rate for Payer: BCN Commercial |
$827.64
|
| Rate for Payer: BCN Medicare Advantage |
$505.15
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cash Price |
$1,176.80
|
| Rate for Payer: Cofinity Commercial |
$727.42
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.15
|
| Rate for Payer: Healthscope Commercial |
$606.18
|
| Rate for Payer: Healthscope Whirlpool |
$606.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.41
|
| Rate for Payer: Meridian Medicaid |
$350.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$555.66
|
| Rate for Payer: Nomi Health Commercial |
$606.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,103.25
|
| Rate for Payer: PACE SWMI |
$505.15
|
| Rate for Payer: PHP Medicare Advantage |
$505.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$884.73
|
| Rate for Payer: Priority Health Medicare |
$505.15
|
| Rate for Payer: Priority Health Narrow Network |
$884.73
|
| Rate for Payer: Railroad Medicare Medicare |
$505.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$920.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$505.15
|
| Rate for Payer: UHC Exchange |
$920.13
|
| Rate for Payer: UHC Medicaid |
$333.35
|
| Rate for Payer: UHCCP DNSP |
$505.15
|
| Rate for Payer: UHCCP Medicaid |
$333.35
|
|
|
PR PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP
|
Professional
|
Both
|
$2,002.00
|
|
|
Service Code
|
HCPCS 25606
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$832.86
|
| Rate for Payer: Aetna Medicare |
$621.54
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCBS MAPPO |
$621.54
|
| Rate for Payer: BCN Commercial |
$1,030.32
|
| Rate for Payer: BCN Medicare Advantage |
$621.54
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cash Price |
$1,601.60
|
| Rate for Payer: Cofinity Commercial |
$895.02
|
| Rate for Payer: Cofinity Commercial |
$832.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.54
|
| Rate for Payer: Healthscope Commercial |
$745.85
|
| Rate for Payer: Healthscope Whirlpool |
$745.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.62
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$683.69
|
| Rate for Payer: Nomi Health Commercial |
$745.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.50
|
| Rate for Payer: PACE SWMI |
$621.54
|
| Rate for Payer: PHP Medicare Advantage |
$621.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,101.39
|
| Rate for Payer: Priority Health Medicare |
$621.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,101.39
|
| Rate for Payer: Railroad Medicare Medicare |
$621.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,150.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$621.54
|
| Rate for Payer: UHC Exchange |
$1,150.87
|
| Rate for Payer: UHC Medicaid |
$409.17
|
| Rate for Payer: UHCCP DNSP |
$621.54
|
| Rate for Payer: UHCCP Medicaid |
$409.17
|
|
|
PR PERQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MNPJ
|
Professional
|
Both
|
$2,446.00
|
|
|
Service Code
|
HCPCS 24582
|
| Min. Negotiated Rate |
$499.27 |
| Max. Negotiated Rate |
$1,834.50 |
| Rate for Payer: Aetna Commercial |
$1,016.64
|
| Rate for Payer: Aetna Medicare |
$758.69
|
| Rate for Payer: BCBS Complete |
$524.23
|
| Rate for Payer: BCBS MAPPO |
$758.69
|
| Rate for Payer: BCN Commercial |
$1,253.41
|
| Rate for Payer: BCN Medicare Advantage |
$758.69
|
| Rate for Payer: Cash Price |
$1,956.80
|
| Rate for Payer: Cash Price |
$1,956.80
|
| Rate for Payer: Cofinity Commercial |
$1,092.51
|
| Rate for Payer: Cofinity Commercial |
$1,016.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.69
|
| Rate for Payer: Healthscope Commercial |
$910.43
|
| Rate for Payer: Healthscope Whirlpool |
$910.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$796.62
|
| Rate for Payer: Meridian Medicaid |
$524.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$834.56
|
| Rate for Payer: Nomi Health Commercial |
$910.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,834.50
|
| Rate for Payer: PACE SWMI |
$758.69
|
| Rate for Payer: PHP Medicare Advantage |
$758.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,339.87
|
| Rate for Payer: Priority Health Medicare |
$758.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,339.87
|
| Rate for Payer: Railroad Medicare Medicare |
$758.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,406.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$758.69
|
| Rate for Payer: UHC Exchange |
$1,406.84
|
| Rate for Payer: UHC Medicaid |
$499.27
|
| Rate for Payer: UHCCP DNSP |
$758.69
|
| Rate for Payer: UHCCP Medicaid |
$499.27
|
|
|
PR PERQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MNPJ
|
Professional
|
Both
|
$1,943.00
|
|
|
Service Code
|
HCPCS 24566
|
| Min. Negotiated Rate |
$440.48 |
| Max. Negotiated Rate |
$1,457.25 |
| Rate for Payer: Aetna Commercial |
$897.61
|
| Rate for Payer: Aetna Medicare |
$669.86
|
| Rate for Payer: BCBS Complete |
$462.50
|
| Rate for Payer: BCBS MAPPO |
$669.86
|
| Rate for Payer: BCN Commercial |
$1,108.01
|
| Rate for Payer: BCN Medicare Advantage |
$669.86
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cofinity Commercial |
$964.60
|
| Rate for Payer: Cofinity Commercial |
$897.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$669.86
|
| Rate for Payer: Healthscope Commercial |
$803.83
|
| Rate for Payer: Healthscope Whirlpool |
$803.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.35
|
| Rate for Payer: Meridian Medicaid |
$462.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$736.85
|
| Rate for Payer: Nomi Health Commercial |
$803.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,457.25
|
| Rate for Payer: PACE SWMI |
$669.86
|
| Rate for Payer: PHP Medicare Advantage |
$669.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,184.43
|
| Rate for Payer: Priority Health Medicare |
$669.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,184.43
|
| Rate for Payer: Railroad Medicare Medicare |
$669.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,247.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$669.86
|
| Rate for Payer: UHC Exchange |
$1,247.81
|
| Rate for Payer: UHC Medicaid |
$440.48
|
| Rate for Payer: UHCCP DNSP |
$669.86
|
| Rate for Payer: UHCCP Medicaid |
$440.48
|
|
|
PR PERQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX
|
Professional
|
Both
|
$2,654.00
|
|
|
Service Code
|
HCPCS 24538
|
| Min. Negotiated Rate |
$479.46 |
| Max. Negotiated Rate |
$1,990.50 |
| Rate for Payer: Aetna Commercial |
$976.66
|
| Rate for Payer: Aetna Medicare |
$728.85
|
| Rate for Payer: BCBS Complete |
$503.43
|
| Rate for Payer: BCBS MAPPO |
$728.85
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$728.85
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cash Price |
$2,123.20
|
| Rate for Payer: Cofinity Commercial |
$976.66
|
| Rate for Payer: Cofinity Commercial |
$1,049.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.85
|
| Rate for Payer: Healthscope Commercial |
$874.62
|
| Rate for Payer: Healthscope Whirlpool |
$874.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$765.29
|
| Rate for Payer: Meridian Medicaid |
$503.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$801.74
|
| Rate for Payer: Nomi Health Commercial |
$874.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,990.50
|
| Rate for Payer: PACE SWMI |
$728.85
|
| Rate for Payer: PHP Medicare Advantage |
$728.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,286.10
|
| Rate for Payer: Priority Health Medicare |
$728.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,286.10
|
| Rate for Payer: Railroad Medicare Medicare |
$728.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,327.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$728.85
|
| Rate for Payer: UHC Exchange |
$1,327.05
|
| Rate for Payer: UHC Medicaid |
$479.46
|
| Rate for Payer: UHCCP DNSP |
$728.85
|
| Rate for Payer: UHCCP Medicaid |
$479.46
|
|
|
PR PERQ TCAT PLMT NTRAC ST 1 LES 1+C SEGMENTS
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 92928
|
| Min. Negotiated Rate |
$295.86 |
| Max. Negotiated Rate |
$977.14 |
| Rate for Payer: Aetna Commercial |
$627.79
|
| Rate for Payer: Aetna Medicare |
$468.50
|
| Rate for Payer: BCBS Complete |
$310.65
|
| Rate for Payer: BCBS MAPPO |
$468.50
|
| Rate for Payer: BCN Commercial |
$857.02
|
| Rate for Payer: BCN Medicare Advantage |
$468.50
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cofinity Commercial |
$674.64
|
| Rate for Payer: Cofinity Commercial |
$627.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.50
|
| Rate for Payer: Healthscope Commercial |
$562.20
|
| Rate for Payer: Healthscope Whirlpool |
$562.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.93
|
| Rate for Payer: Meridian Medicaid |
$310.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$515.35
|
| Rate for Payer: Nomi Health Commercial |
$562.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: PACE SWMI |
$468.50
|
| Rate for Payer: PHP Medicare Advantage |
$468.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$814.55
|
| Rate for Payer: Priority Health Medicare |
$468.50
|
| Rate for Payer: Priority Health Narrow Network |
$814.55
|
| Rate for Payer: Railroad Medicare Medicare |
$468.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$977.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$468.50
|
| Rate for Payer: UHC Exchange |
$977.14
|
| Rate for Payer: UHC Medicaid |
$295.86
|
| Rate for Payer: UHCCP DNSP |
$468.50
|
| Rate for Payer: UHCCP Medicaid |
$295.86
|
|
|
PR PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS
|
Professional
|
Both
|
$1,130.00
|
|
|
Service Code
|
HCPCS 92930
|
| Min. Negotiated Rate |
$322.27 |
| Max. Negotiated Rate |
$867.85 |
| Rate for Payer: Aetna Commercial |
$673.30
|
| Rate for Payer: Aetna Medicare |
$502.46
|
| Rate for Payer: BCBS Complete |
$338.38
|
| Rate for Payer: BCBS MAPPO |
$502.46
|
| Rate for Payer: BCN Medicare Advantage |
$502.46
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cofinity Commercial |
$723.54
|
| Rate for Payer: Cofinity Commercial |
$673.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.46
|
| Rate for Payer: Healthscope Commercial |
$602.95
|
| Rate for Payer: Healthscope Whirlpool |
$602.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.58
|
| Rate for Payer: Meridian Medicaid |
$338.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$552.71
|
| Rate for Payer: Nomi Health Commercial |
$602.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$847.50
|
| Rate for Payer: PACE SWMI |
$502.46
|
| Rate for Payer: PHP Medicare Advantage |
$502.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$745.13
|
| Rate for Payer: Priority Health Medicare |
$502.46
|
| Rate for Payer: Priority Health Narrow Network |
$745.13
|
| Rate for Payer: Railroad Medicare Medicare |
$502.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$867.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$502.46
|
| Rate for Payer: UHC Exchange |
$867.85
|
| Rate for Payer: UHC Medicaid |
$322.27
|
| Rate for Payer: UHCCP DNSP |
$502.46
|
| Rate for Payer: UHCCP Medicaid |
$322.27
|
|
|
PR PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART
|
Professional
|
Both
|
$1,179.00
|
|
|
Service Code
|
HCPCS 0913T
|
| Min. Negotiated Rate |
$471.60 |
| Max. Negotiated Rate |
$5,330.92 |
| Rate for Payer: BCBS Complete |
$471.60
|
| Rate for Payer: BCN Commercial |
$5,330.92
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$884.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$877.22
|
| Rate for Payer: UHC Exchange |
$877.22
|
|
|
PR PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 0914T
|
| Min. Negotiated Rate |
$236.00 |
| Max. Negotiated Rate |
$442.50 |
| Rate for Payer: BCBS Complete |
$236.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
HCPCS 36906
|
| Min. Negotiated Rate |
$283.93 |
| Max. Negotiated Rate |
$1,191.00 |
| Rate for Payer: Aetna Commercial |
$598.77
|
| Rate for Payer: Aetna Medicare |
$446.84
|
| Rate for Payer: BCBS Complete |
$298.13
|
| Rate for Payer: BCBS MAPPO |
$446.84
|
| Rate for Payer: BCN Commercial |
$742.49
|
| Rate for Payer: BCN Medicare Advantage |
$446.84
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cofinity Commercial |
$598.77
|
| Rate for Payer: Cofinity Commercial |
$643.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.84
|
| Rate for Payer: Healthscope Commercial |
$536.21
|
| Rate for Payer: Healthscope Whirlpool |
$536.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.18
|
| Rate for Payer: Meridian Medicaid |
$298.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.52
|
| Rate for Payer: Nomi Health Commercial |
$536.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.00
|
| Rate for Payer: PACE SWMI |
$446.84
|
| Rate for Payer: PHP Medicare Advantage |
$446.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$798.46
|
| Rate for Payer: Priority Health Medicare |
$446.84
|
| Rate for Payer: Priority Health Narrow Network |
$798.46
|
| Rate for Payer: Railroad Medicare Medicare |
$446.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$917.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$446.84
|
| Rate for Payer: UHC Exchange |
$917.29
|
| Rate for Payer: UHC Medicaid |
$283.93
|
| Rate for Payer: UHCCP DNSP |
$446.84
|
| Rate for Payer: UHCCP Medicaid |
$283.93
|
|
|
PR PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP
|
Professional
|
Both
|
$1,362.00
|
|
|
Service Code
|
HCPCS 36905
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$1,021.50 |
| Rate for Payer: Aetna Commercial |
$518.63
|
| Rate for Payer: Aetna Medicare |
$387.04
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCBS MAPPO |
$387.04
|
| Rate for Payer: BCN Commercial |
$644.89
|
| Rate for Payer: BCN Medicare Advantage |
$387.04
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cofinity Commercial |
$557.34
|
| Rate for Payer: Cofinity Commercial |
$518.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.04
|
| Rate for Payer: Healthscope Commercial |
$464.45
|
| Rate for Payer: Healthscope Whirlpool |
$464.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.39
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$425.74
|
| Rate for Payer: Nomi Health Commercial |
$464.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,021.50
|
| Rate for Payer: PACE SWMI |
$387.04
|
| Rate for Payer: PHP Medicare Advantage |
$387.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$693.50
|
| Rate for Payer: Priority Health Medicare |
$387.04
|
| Rate for Payer: Priority Health Narrow Network |
$693.50
|
| Rate for Payer: Railroad Medicare Medicare |
$387.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$794.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.04
|
| Rate for Payer: UHC Exchange |
$794.17
|
| Rate for Payer: UHC Medicaid |
$246.02
|
| Rate for Payer: UHCCP DNSP |
$387.04
|
| Rate for Payer: UHCCP Medicaid |
$246.02
|
|
|
PR PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 36904
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$685.50 |
| Rate for Payer: Aetna Commercial |
$431.68
|
| Rate for Payer: Aetna Medicare |
$322.15
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$322.15
|
| Rate for Payer: BCN Commercial |
$535.83
|
| Rate for Payer: BCN Medicare Advantage |
$322.15
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cofinity Commercial |
$463.90
|
| Rate for Payer: Cofinity Commercial |
$431.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.15
|
| Rate for Payer: Healthscope Commercial |
$386.58
|
| Rate for Payer: Healthscope Whirlpool |
$386.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.26
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$354.37
|
| Rate for Payer: Nomi Health Commercial |
$386.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$685.50
|
| Rate for Payer: PACE SWMI |
$322.15
|
| Rate for Payer: PHP Medicare Advantage |
$322.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$576.22
|
| Rate for Payer: Priority Health Medicare |
$322.15
|
| Rate for Payer: Priority Health Narrow Network |
$576.22
|
| Rate for Payer: Railroad Medicare Medicare |
$322.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$662.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$322.15
|
| Rate for Payer: UHC Exchange |
$662.47
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP DNSP |
$322.15
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA
|
Professional
|
Both
|
$1,281.00
|
|
|
Service Code
|
HCPCS 33897
|
| Min. Negotiated Rate |
$319.93 |
| Max. Negotiated Rate |
$1,038.47 |
| Rate for Payer: Aetna Commercial |
$679.17
|
| Rate for Payer: Aetna Medicare |
$506.84
|
| Rate for Payer: BCBS Complete |
$335.93
|
| Rate for Payer: BCBS MAPPO |
$506.84
|
| Rate for Payer: BCN Commercial |
$846.57
|
| Rate for Payer: BCN Medicare Advantage |
$506.84
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cash Price |
$1,024.80
|
| Rate for Payer: Cofinity Commercial |
$729.85
|
| Rate for Payer: Cofinity Commercial |
$679.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.84
|
| Rate for Payer: Healthscope Commercial |
$608.21
|
| Rate for Payer: Healthscope Whirlpool |
$608.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$532.18
|
| Rate for Payer: Meridian Medicaid |
$335.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$557.52
|
| Rate for Payer: Nomi Health Commercial |
$608.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.75
|
| Rate for Payer: PACE SWMI |
$506.84
|
| Rate for Payer: PHP Medicare Advantage |
$506.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$910.38
|
| Rate for Payer: Priority Health Medicare |
$506.84
|
| Rate for Payer: Priority Health Narrow Network |
$910.38
|
| Rate for Payer: Railroad Medicare Medicare |
$506.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,038.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$506.84
|
| Rate for Payer: UHC Exchange |
$1,038.47
|
| Rate for Payer: UHC Medicaid |
$319.93
|
| Rate for Payer: UHCCP DNSP |
$506.84
|
| Rate for Payer: UHCCP Medicaid |
$319.93
|
|
|
PR PERQ TRLUML C ANGIOPLASTY 1 MAJ C ART&/BRANCHES
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 92920
|
| Min. Negotiated Rate |
$246.87 |
| Max. Negotiated Rate |
$878.46 |
| Rate for Payer: Aetna Commercial |
$523.77
|
| Rate for Payer: Aetna Medicare |
$390.87
|
| Rate for Payer: BCBS Complete |
$259.21
|
| Rate for Payer: BCBS MAPPO |
$390.87
|
| Rate for Payer: BCN Commercial |
$771.38
|
| Rate for Payer: BCN Medicare Advantage |
$390.87
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$562.85
|
| Rate for Payer: Cofinity Commercial |
$523.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.87
|
| Rate for Payer: Healthscope Commercial |
$469.04
|
| Rate for Payer: Healthscope Whirlpool |
$469.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.41
|
| Rate for Payer: Meridian Medicaid |
$259.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$429.96
|
| Rate for Payer: Nomi Health Commercial |
$469.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$864.75
|
| Rate for Payer: PACE SWMI |
$390.87
|
| Rate for Payer: PHP Medicare Advantage |
$390.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$733.15
|
| Rate for Payer: Priority Health Medicare |
$390.87
|
| Rate for Payer: Priority Health Narrow Network |
$733.15
|
| Rate for Payer: Railroad Medicare Medicare |
$390.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$878.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$390.87
|
| Rate for Payer: UHC Exchange |
$878.46
|
| Rate for Payer: UHC Medicaid |
$246.87
|
| Rate for Payer: UHCCP DNSP |
$390.87
|
| Rate for Payer: UHCCP Medicaid |
$246.87
|
|
|
PR PERQ TRLUML C ATHRC ANGIOP 1 MAJ C ART&/BRANCHES
|
Professional
|
Both
|
$2,627.00
|
|
|
Service Code
|
HCPCS 92924
|
| Min. Negotiated Rate |
$299.27 |
| Max. Negotiated Rate |
$1,970.25 |
| Rate for Payer: Aetna Commercial |
$634.93
|
| Rate for Payer: Aetna Medicare |
$473.83
|
| Rate for Payer: BCBS Complete |
$314.23
|
| Rate for Payer: BCBS MAPPO |
$473.83
|
| Rate for Payer: BCN Commercial |
$918.78
|
| Rate for Payer: BCN Medicare Advantage |
$473.83
|
| Rate for Payer: Cash Price |
$2,101.60
|
| Rate for Payer: Cash Price |
$2,101.60
|
| Rate for Payer: Cofinity Commercial |
$682.32
|
| Rate for Payer: Cofinity Commercial |
$634.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.83
|
| Rate for Payer: Healthscope Commercial |
$568.60
|
| Rate for Payer: Healthscope Whirlpool |
$568.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.52
|
| Rate for Payer: Meridian Medicaid |
$314.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$521.21
|
| Rate for Payer: Nomi Health Commercial |
$568.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,970.25
|
| Rate for Payer: PACE SWMI |
$473.83
|
| Rate for Payer: PHP Medicare Advantage |
$473.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$873.25
|
| Rate for Payer: Priority Health Medicare |
$473.83
|
| Rate for Payer: Priority Health Narrow Network |
$873.25
|
| Rate for Payer: Railroad Medicare Medicare |
$473.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,047.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$473.83
|
| Rate for Payer: UHC Exchange |
$1,047.27
|
| Rate for Payer: UHC Medicaid |
$299.27
|
| Rate for Payer: UHCCP DNSP |
$473.83
|
| Rate for Payer: UHCCP Medicaid |
$299.27
|
|
|
PR PERQ TRLUML C ATHRC ST ANGIOP 1 MAJ C ART&/BRNCH
|
Professional
|
Both
|
$1,480.00
|
|
|
Service Code
|
HCPCS 92933
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$1,110.00 |
| Rate for Payer: Aetna Commercial |
$748.82
|
| Rate for Payer: Aetna Medicare |
$558.82
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$558.82
|
| Rate for Payer: BCN Commercial |
$962.10
|
| Rate for Payer: BCN Medicare Advantage |
$558.82
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cofinity Commercial |
$804.70
|
| Rate for Payer: Cofinity Commercial |
$748.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.82
|
| Rate for Payer: Healthscope Commercial |
$670.58
|
| Rate for Payer: Healthscope Whirlpool |
$670.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$586.76
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$614.70
|
| Rate for Payer: Nomi Health Commercial |
$670.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,110.00
|
| Rate for Payer: PACE SWMI |
$558.82
|
| Rate for Payer: PHP Medicare Advantage |
$558.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$914.42
|
| Rate for Payer: Priority Health Medicare |
$558.82
|
| Rate for Payer: Priority Health Narrow Network |
$914.42
|
| Rate for Payer: Railroad Medicare Medicare |
$558.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,096.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$558.82
|
| Rate for Payer: UHC Exchange |
$1,096.93
|
| Rate for Payer: UHC Medicaid |
$352.94
|
| Rate for Payer: UHCCP DNSP |
$558.82
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
|
|
PR PERQ TRLUML CORONARY MCHNL ASPIR THROMBECTOMY
|
Professional
|
Both
|
$1,077.00
|
|
|
Service Code
|
HCPCS 92973
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$807.75 |
| Rate for Payer: Aetna Commercial |
$110.23
|
| Rate for Payer: Aetna Medicare |
$82.26
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$82.26
|
| Rate for Payer: BCN Commercial |
$256.46
|
| Rate for Payer: BCN Medicare Advantage |
$82.26
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cofinity Commercial |
$118.45
|
| Rate for Payer: Cofinity Commercial |
$110.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.26
|
| Rate for Payer: Healthscope Commercial |
$98.71
|
| Rate for Payer: Healthscope Whirlpool |
$98.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.37
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.49
|
| Rate for Payer: Nomi Health Commercial |
$98.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$807.75
|
| Rate for Payer: PACE SWMI |
$82.26
|
| Rate for Payer: PHP Medicare Advantage |
$82.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$243.75
|
| Rate for Payer: Priority Health Medicare |
$82.26
|
| Rate for Payer: Priority Health Narrow Network |
$243.75
|
| Rate for Payer: Railroad Medicare Medicare |
$82.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.26
|
| Rate for Payer: UHC Exchange |
$291.93
|
| Rate for Payer: UHC Medicaid |
$51.97
|
| Rate for Payer: UHCCP DNSP |
$82.26
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR PERQ TRLUML REVSC CHRNC TOT OCCLS 1 C ART ANTGRD
|
Professional
|
Both
|
$1,434.00
|
|
|
Service Code
|
HCPCS 92943
|
| Min. Negotiated Rate |
$404.27 |
| Max. Negotiated Rate |
$1,098.57 |
| Rate for Payer: Aetna Commercial |
$857.73
|
| Rate for Payer: Aetna Medicare |
$640.10
|
| Rate for Payer: BCBS Complete |
$424.48
|
| Rate for Payer: BCBS MAPPO |
$640.10
|
| Rate for Payer: BCN Commercial |
$963.10
|
| Rate for Payer: BCN Medicare Advantage |
$640.10
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cofinity Commercial |
$921.74
|
| Rate for Payer: Cofinity Commercial |
$857.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.10
|
| Rate for Payer: Healthscope Commercial |
$768.12
|
| Rate for Payer: Healthscope Whirlpool |
$768.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.11
|
| Rate for Payer: Meridian Medicaid |
$424.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$704.11
|
| Rate for Payer: Nomi Health Commercial |
$768.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,075.50
|
| Rate for Payer: PACE SWMI |
$640.10
|
| Rate for Payer: PHP Medicare Advantage |
$640.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$915.37
|
| Rate for Payer: Priority Health Medicare |
$640.10
|
| Rate for Payer: Priority Health Narrow Network |
$915.37
|
| Rate for Payer: Railroad Medicare Medicare |
$640.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,098.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$640.10
|
| Rate for Payer: UHC Exchange |
$1,098.57
|
| Rate for Payer: UHC Medicaid |
$404.27
|
| Rate for Payer: UHCCP DNSP |
$640.10
|
| Rate for Payer: UHCCP Medicaid |
$404.27
|
|
|
PR PERQ TRLUML REVSC OF/-CAB GRF 1 MAJ C ART&/BRNCH
|
Professional
|
Both
|
$1,280.00
|
|
|
Service Code
|
HCPCS 92937
|
| Min. Negotiated Rate |
$333.98 |
| Max. Negotiated Rate |
$976.03 |
| Rate for Payer: Aetna Commercial |
$708.69
|
| Rate for Payer: Aetna Medicare |
$528.87
|
| Rate for Payer: BCBS Complete |
$350.68
|
| Rate for Payer: BCBS MAPPO |
$528.87
|
| Rate for Payer: BCN Commercial |
$856.53
|
| Rate for Payer: BCN Medicare Advantage |
$528.87
|
| Rate for Payer: Cash Price |
$1,024.00
|
| Rate for Payer: Cash Price |
$1,024.00
|
| Rate for Payer: Cofinity Commercial |
$761.57
|
| Rate for Payer: Cofinity Commercial |
$708.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.87
|
| Rate for Payer: Healthscope Commercial |
$634.64
|
| Rate for Payer: Healthscope Whirlpool |
$634.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.31
|
| Rate for Payer: Meridian Medicaid |
$350.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$581.76
|
| Rate for Payer: Nomi Health Commercial |
$634.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$960.00
|
| Rate for Payer: PACE SWMI |
$528.87
|
| Rate for Payer: PHP Medicare Advantage |
$528.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$814.09
|
| Rate for Payer: Priority Health Medicare |
$528.87
|
| Rate for Payer: Priority Health Narrow Network |
$814.09
|
| Rate for Payer: Railroad Medicare Medicare |
$528.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$976.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$528.87
|
| Rate for Payer: UHC Exchange |
$976.03
|
| Rate for Payer: UHC Medicaid |
$333.98
|
| Rate for Payer: UHCCP DNSP |
$528.87
|
| Rate for Payer: UHCCP Medicaid |
$333.98
|
|
|
PR PERQ TRLUML REVSC TOT/STOT OCCLS AMI 1MAJ C ART
|
Professional
|
Both
|
$1,440.00
|
|
|
Service Code
|
HCPCS 92941
|
| Min. Negotiated Rate |
$375.95 |
| Max. Negotiated Rate |
$1,098.57 |
| Rate for Payer: Aetna Commercial |
$797.55
|
| Rate for Payer: Aetna Medicare |
$595.19
|
| Rate for Payer: BCBS Complete |
$394.75
|
| Rate for Payer: BCBS MAPPO |
$595.19
|
| Rate for Payer: BCN Commercial |
$963.10
|
| Rate for Payer: BCN Medicare Advantage |
$595.19
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Cofinity Commercial |
$857.07
|
| Rate for Payer: Cofinity Commercial |
$797.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.19
|
| Rate for Payer: Healthscope Commercial |
$714.23
|
| Rate for Payer: Healthscope Whirlpool |
$714.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.95
|
| Rate for Payer: Meridian Medicaid |
$394.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$654.71
|
| Rate for Payer: Nomi Health Commercial |
$714.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.00
|
| Rate for Payer: PACE SWMI |
$595.19
|
| Rate for Payer: PHP Medicare Advantage |
$595.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$915.37
|
| Rate for Payer: Priority Health Medicare |
$595.19
|
| Rate for Payer: Priority Health Narrow Network |
$915.37
|
| Rate for Payer: Railroad Medicare Medicare |
$595.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,098.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$595.19
|
| Rate for Payer: UHC Exchange |
$1,098.57
|
| Rate for Payer: UHC Medicaid |
$375.95
|
| Rate for Payer: UHCCP DNSP |
$595.19
|
| Rate for Payer: UHCCP Medicaid |
$375.95
|
|
|
PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION
|
Professional
|
Both
|
$1,592.00
|
|
|
Service Code
|
HCPCS 22513
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$1,194.00 |
| Rate for Payer: Aetna Commercial |
$602.93
|
| Rate for Payer: Aetna Medicare |
$449.95
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$449.95
|
| Rate for Payer: BCN Commercial |
$759.43
|
| Rate for Payer: BCN Medicare Advantage |
$449.95
|
| Rate for Payer: Cash Price |
$1,273.60
|
| Rate for Payer: Cash Price |
$1,273.60
|
| Rate for Payer: Cofinity Commercial |
$647.93
|
| Rate for Payer: Cofinity Commercial |
$602.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.95
|
| Rate for Payer: Healthscope Commercial |
$539.94
|
| Rate for Payer: Healthscope Whirlpool |
$539.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.45
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$494.94
|
| Rate for Payer: Nomi Health Commercial |
$539.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,194.00
|
| Rate for Payer: PACE SWMI |
$449.95
|
| Rate for Payer: PHP Medicare Advantage |
$449.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$811.79
|
| Rate for Payer: Priority Health Medicare |
$449.95
|
| Rate for Payer: Priority Health Narrow Network |
$811.79
|
| Rate for Payer: Railroad Medicare Medicare |
$449.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$906.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$449.95
|
| Rate for Payer: UHC Exchange |
$906.09
|
| Rate for Payer: UHC Medicaid |
$289.25
|
| Rate for Payer: UHCCP DNSP |
$449.95
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 22515
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$622.50 |
| Rate for Payer: Aetna Commercial |
$254.10
|
| Rate for Payer: Aetna Medicare |
$189.63
|
| Rate for Payer: BCBS Complete |
$126.59
|
| Rate for Payer: BCBS MAPPO |
$189.63
|
| Rate for Payer: BCN Commercial |
$322.69
|
| Rate for Payer: BCN Medicare Advantage |
$189.63
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$273.07
|
| Rate for Payer: Cofinity Commercial |
$254.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.63
|
| Rate for Payer: Healthscope Commercial |
$227.56
|
| Rate for Payer: Healthscope Whirlpool |
$227.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.11
|
| Rate for Payer: Meridian Medicaid |
$126.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$208.59
|
| Rate for Payer: Nomi Health Commercial |
$227.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PACE SWMI |
$189.63
|
| Rate for Payer: PHP Medicare Advantage |
$189.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$344.96
|
| Rate for Payer: Priority Health Medicare |
$189.63
|
| Rate for Payer: Priority Health Narrow Network |
$344.96
|
| Rate for Payer: Railroad Medicare Medicare |
$189.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$189.63
|
| Rate for Payer: UHC Exchange |
$392.35
|
| Rate for Payer: UHC Medicaid |
$120.56
|
| Rate for Payer: UHCCP DNSP |
$189.63
|
| Rate for Payer: UHCCP Medicaid |
$120.56
|
|
|
PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR
|
Professional
|
Both
|
$1,487.00
|
|
|
Service Code
|
HCPCS 22514
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$1,115.25 |
| Rate for Payer: Aetna Commercial |
$563.22
|
| Rate for Payer: Aetna Medicare |
$420.31
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$420.31
|
| Rate for Payer: BCN Commercial |
$709.63
|
| Rate for Payer: BCN Medicare Advantage |
$420.31
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cash Price |
$1,189.60
|
| Rate for Payer: Cofinity Commercial |
$605.25
|
| Rate for Payer: Cofinity Commercial |
$563.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.31
|
| Rate for Payer: Healthscope Commercial |
$504.37
|
| Rate for Payer: Healthscope Whirlpool |
$504.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.33
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$462.34
|
| Rate for Payer: Nomi Health Commercial |
$504.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,115.25
|
| Rate for Payer: PACE SWMI |
$420.31
|
| Rate for Payer: PHP Medicare Advantage |
$420.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$758.57
|
| Rate for Payer: Priority Health Medicare |
$420.31
|
| Rate for Payer: Priority Health Narrow Network |
$758.57
|
| Rate for Payer: Railroad Medicare Medicare |
$420.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$844.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.31
|
| Rate for Payer: UHC Exchange |
$844.58
|
| Rate for Payer: UHC Medicaid |
$270.51
|
| Rate for Payer: UHCCP DNSP |
$420.31
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL
|
Professional
|
Both
|
$1,089.00
|
|
|
Service Code
|
HCPCS 22511
|
| Min. Negotiated Rate |
$230.47 |
| Max. Negotiated Rate |
$816.75 |
| Rate for Payer: Aetna Commercial |
$480.32
|
| Rate for Payer: Aetna Medicare |
$358.45
|
| Rate for Payer: BCBS Complete |
$241.99
|
| Rate for Payer: BCBS MAPPO |
$358.45
|
| Rate for Payer: BCN Commercial |
$606.04
|
| Rate for Payer: BCN Medicare Advantage |
$358.45
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$516.17
|
| Rate for Payer: Cofinity Commercial |
$480.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.45
|
| Rate for Payer: Healthscope Commercial |
$430.14
|
| Rate for Payer: Healthscope Whirlpool |
$430.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.37
|
| Rate for Payer: Meridian Medicaid |
$241.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$394.30
|
| Rate for Payer: Nomi Health Commercial |
$430.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$816.75
|
| Rate for Payer: PACE SWMI |
$358.45
|
| Rate for Payer: PHP Medicare Advantage |
$358.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$647.85
|
| Rate for Payer: Priority Health Medicare |
$358.45
|
| Rate for Payer: Priority Health Narrow Network |
$647.85
|
| Rate for Payer: Railroad Medicare Medicare |
$358.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$717.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$358.45
|
| Rate for Payer: UHC Exchange |
$717.02
|
| Rate for Payer: UHC Medicaid |
$230.47
|
| Rate for Payer: UHCCP DNSP |
$358.45
|
| Rate for Payer: UHCCP Medicaid |
$230.47
|
|
|
PR PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC
|
Professional
|
Both
|
$3,524.00
|
|
|
Service Code
|
HCPCS 22510
|
| Min. Negotiated Rate |
$244.31 |
| Max. Negotiated Rate |
$2,643.00 |
| Rate for Payer: Aetna Commercial |
$509.90
|
| Rate for Payer: Aetna Medicare |
$380.52
|
| Rate for Payer: BCBS Complete |
$256.53
|
| Rate for Payer: BCBS MAPPO |
$380.52
|
| Rate for Payer: BCN Commercial |
$643.39
|
| Rate for Payer: BCN Medicare Advantage |
$380.52
|
| Rate for Payer: Cash Price |
$2,819.20
|
| Rate for Payer: Cash Price |
$2,819.20
|
| Rate for Payer: Cofinity Commercial |
$509.90
|
| Rate for Payer: Cofinity Commercial |
$547.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.52
|
| Rate for Payer: Healthscope Commercial |
$456.62
|
| Rate for Payer: Healthscope Whirlpool |
$456.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.55
|
| Rate for Payer: Meridian Medicaid |
$256.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.57
|
| Rate for Payer: Nomi Health Commercial |
$456.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,643.00
|
| Rate for Payer: PACE SWMI |
$380.52
|
| Rate for Payer: PHP Medicare Advantage |
$380.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$687.77
|
| Rate for Payer: Priority Health Medicare |
$380.52
|
| Rate for Payer: Priority Health Narrow Network |
$687.77
|
| Rate for Payer: Railroad Medicare Medicare |
$380.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.52
|
| Rate for Payer: UHC Exchange |
$765.15
|
| Rate for Payer: UHC Medicaid |
$244.31
|
| Rate for Payer: UHCCP DNSP |
$380.52
|
| Rate for Payer: UHCCP Medicaid |
$244.31
|
|
