|
PR OSTEOTOMY ULNA
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25360
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$871.38
|
| Rate for Payer: Aetna Medicare |
$1,114.00
|
| Rate for Payer: BCBS Complete |
$451.99
|
| Rate for Payer: BCBS Trust/PPO |
$677.28
|
| Rate for Payer: BCN Commercial |
$969.05
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Meridian Medicaid |
$451.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$795.02
|
| Rate for Payer: UHC Exchange |
$795.02
|
| Rate for Payer: UHCCP Medicaid |
$430.47
|
|
|
PR OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL
|
Professional
|
Both
|
$2,723.00
|
|
|
Service Code
|
HCPCS 27457
|
| Min. Negotiated Rate |
$619.83 |
| Max. Negotiated Rate |
$1,769.95 |
| Rate for Payer: Aetna Commercial |
$1,285.67
|
| Rate for Payer: Aetna Medicare |
$1,361.50
|
| Rate for Payer: BCBS Complete |
$650.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.50
|
| Rate for Payer: BCN Commercial |
$1,408.86
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Meridian Medicaid |
$650.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,769.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,451.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,451.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,114.79
|
| Rate for Payer: UHC Exchange |
$1,114.79
|
| Rate for Payer: UHCCP Medicaid |
$619.83
|
|
|
PR OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL
|
Professional
|
Both
|
$2,033.00
|
|
|
Service Code
|
HCPCS 27455
|
| Min. Negotiated Rate |
$623.66 |
| Max. Negotiated Rate |
$1,479.77 |
| Rate for Payer: Aetna Commercial |
$1,279.84
|
| Rate for Payer: Aetna Medicare |
$1,016.50
|
| Rate for Payer: BCBS Complete |
$654.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.98
|
| Rate for Payer: BCN Commercial |
$1,412.28
|
| Rate for Payer: Cash Price |
$1,626.40
|
| Rate for Payer: Cash Price |
$1,626.40
|
| Rate for Payer: Meridian Medicaid |
$654.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,321.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,479.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,479.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,082.47
|
| Rate for Payer: UHC Exchange |
$1,082.47
|
| Rate for Payer: UHCCP Medicaid |
$623.66
|
|
|
PR OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 28312
|
| Min. Negotiated Rate |
$231.74 |
| Max. Negotiated Rate |
$1,771.92 |
| Rate for Payer: Aetna Commercial |
$424.19
|
| Rate for Payer: Aetna Medicare |
$405.50
|
| Rate for Payer: BCBS Complete |
$243.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,771.92
|
| Rate for Payer: BCN Commercial |
$777.49
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Meridian Medicaid |
$243.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.28
|
| Rate for Payer: Priority Health Narrow Network |
$533.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$371.26
|
| Rate for Payer: UHC Exchange |
$371.26
|
| Rate for Payer: UHCCP Medicaid |
$231.74
|
|
|
PR OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 28310
|
| Min. Negotiated Rate |
$238.77 |
| Max. Negotiated Rate |
$1,691.62 |
| Rate for Payer: Aetna Commercial |
$478.50
|
| Rate for Payer: Aetna Medicare |
$478.00
|
| Rate for Payer: BCBS Complete |
$250.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.62
|
| Rate for Payer: BCN Commercial |
$790.19
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Meridian Medicaid |
$250.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.27
|
| Rate for Payer: Priority Health Narrow Network |
$561.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$415.88
|
| Rate for Payer: UHC Exchange |
$415.88
|
| Rate for Payer: UHCCP Medicaid |
$238.77
|
|
|
PR OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM
|
Professional
|
Both
|
$2,637.00
|
|
|
Service Code
|
HCPCS 22216
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$1,714.05 |
| Rate for Payer: Aetna Commercial |
$489.31
|
| Rate for Payer: Aetna Medicare |
$1,318.50
|
| Rate for Payer: BCBS Complete |
$243.78
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: BCN Commercial |
$580.04
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Meridian Medicaid |
$243.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,714.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.08
|
| Rate for Payer: Priority Health Narrow Network |
$550.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$437.92
|
| Rate for Payer: UHC Exchange |
$437.92
|
| Rate for Payer: UHCCP Medicaid |
$232.17
|
|
|
PR OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
HCPCS 28305
|
| Min. Negotiated Rate |
$436.22 |
| Max. Negotiated Rate |
$1,202.94 |
| Rate for Payer: Aetna Commercial |
$901.63
|
| Rate for Payer: Aetna Medicare |
$861.00
|
| Rate for Payer: BCBS Complete |
$458.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.94
|
| Rate for Payer: BCN Commercial |
$979.31
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Meridian Medicaid |
$458.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,038.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$781.98
|
| Rate for Payer: UHC Exchange |
$781.98
|
| Rate for Payer: UHCCP Medicaid |
$436.22
|
|
|
PR OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT
|
Professional
|
Both
|
$3,962.00
|
|
|
Service Code
|
HCPCS 28309
|
| Min. Negotiated Rate |
$586.60 |
| Max. Negotiated Rate |
$2,575.30 |
| Rate for Payer: Aetna Commercial |
$1,184.22
|
| Rate for Payer: Aetna Medicare |
$1,981.00
|
| Rate for Payer: BCBS Complete |
$615.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,728.07
|
| Rate for Payer: BCN Commercial |
$1,315.04
|
| Rate for Payer: Cash Price |
$3,169.60
|
| Rate for Payer: Cash Price |
$3,169.60
|
| Rate for Payer: Meridian Medicaid |
$615.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$586.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,575.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,391.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,391.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,043.00
|
| Rate for Payer: UHC Exchange |
$1,043.00
|
| Rate for Payer: UHCCP Medicaid |
$586.60
|
|
|
PR OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR
|
Professional
|
Both
|
$1,417.00
|
|
|
Service Code
|
HCPCS 28306
|
| Min. Negotiated Rate |
$264.76 |
| Max. Negotiated Rate |
$1,500.90 |
| Rate for Payer: Aetna Commercial |
$529.18
|
| Rate for Payer: Aetna Medicare |
$708.50
|
| Rate for Payer: BCBS Complete |
$278.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.90
|
| Rate for Payer: BCN Commercial |
$886.46
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Meridian Medicaid |
$278.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.95
|
| Rate for Payer: Priority Health Narrow Network |
$628.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$473.50
|
| Rate for Payer: UHC Exchange |
$473.50
|
| Rate for Payer: UHCCP Medicaid |
$264.76
|
|
|
PR OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA
|
Professional
|
Both
|
$1,087.00
|
|
|
Service Code
|
HCPCS 28308
|
| Min. Negotiated Rate |
$252.83 |
| Max. Negotiated Rate |
$1,566.94 |
| Rate for Payer: Aetna Commercial |
$506.51
|
| Rate for Payer: Aetna Medicare |
$543.50
|
| Rate for Payer: BCBS Complete |
$265.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.94
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Meridian Medicaid |
$265.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$706.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$599.44
|
| Rate for Payer: Priority Health Narrow Network |
$599.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$432.60
|
| Rate for Payer: UHC Exchange |
$432.60
|
| Rate for Payer: UHCCP Medicaid |
$252.83
|
|
|
PR OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX
|
Professional
|
Both
|
$1,270.00
|
|
|
Service Code
|
HCPCS 63295
|
| Min. Negotiated Rate |
$212.57 |
| Max. Negotiated Rate |
$825.50 |
| Rate for Payer: Aetna Commercial |
$425.26
|
| Rate for Payer: Aetna Medicare |
$635.00
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$483.30
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Meridian Medicaid |
$223.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$825.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.89
|
| Rate for Payer: Priority Health Narrow Network |
$561.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$391.64
|
| Rate for Payer: UHC Exchange |
$391.64
|
| Rate for Payer: UHCCP Medicaid |
$212.57
|
|
|
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$45.10
|
|
|
Service Code
|
HCPCS J2720
|
| Hospital Charge Code |
6677
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$45.10 |
| Rate for Payer: Aetna Commercial |
$40.59
|
| Rate for Payer: Aetna Commercial |
$121.95
|
| Rate for Payer: Aetna Medicare |
$67.75
|
| Rate for Payer: Aetna Medicare |
$22.55
|
| Rate for Payer: ASR ASR |
$43.75
|
| Rate for Payer: ASR ASR |
$131.44
|
| Rate for Payer: ASR Commercial |
$131.44
|
| Rate for Payer: ASR Commercial |
$43.75
|
| Rate for Payer: BCBS Complete |
$18.04
|
| Rate for Payer: BCBS Complete |
$54.20
|
| Rate for Payer: BCBS Trust/PPO |
$36.93
|
| Rate for Payer: BCBS Trust/PPO |
$110.96
|
| Rate for Payer: BCN Commercial |
$105.05
|
| Rate for Payer: BCN Commercial |
$34.97
|
| Rate for Payer: Cash Price |
$108.40
|
| Rate for Payer: Cash Price |
$108.40
|
| Rate for Payer: Cash Price |
$36.08
|
| Rate for Payer: Cash Price |
$36.08
|
| Rate for Payer: Cofinity Commercial |
$127.37
|
| Rate for Payer: Cofinity Commercial |
$42.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.40
|
| Rate for Payer: Healthscope Commercial |
$45.10
|
| Rate for Payer: Healthscope Commercial |
$135.50
|
| Rate for Payer: Healthscope Whirlpool |
$43.75
|
| Rate for Payer: Healthscope Whirlpool |
$131.44
|
| Rate for Payer: Mclaren Commercial |
$121.95
|
| Rate for Payer: Mclaren Commercial |
$40.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.18
|
| Rate for Payer: Nomi Health Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$111.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.45
|
| Rate for Payer: Priority Health Narrow Network |
$1.16
|
| Rate for Payer: Priority Health Narrow Network |
$1.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.69
|
|
|
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$45.10
|
|
|
Service Code
|
HCPCS J2720
|
| Hospital Charge Code |
6677
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.32 |
| Max. Negotiated Rate |
$45.10 |
| Rate for Payer: Aetna Commercial |
$40.59
|
| Rate for Payer: Aetna Commercial |
$121.95
|
| Rate for Payer: ASR ASR |
$43.75
|
| Rate for Payer: ASR ASR |
$131.44
|
| Rate for Payer: ASR Commercial |
$131.44
|
| Rate for Payer: ASR Commercial |
$43.75
|
| Rate for Payer: BCBS Trust/PPO |
$110.42
|
| Rate for Payer: BCBS Trust/PPO |
$36.75
|
| Rate for Payer: BCN Commercial |
$34.97
|
| Rate for Payer: BCN Commercial |
$105.05
|
| Rate for Payer: Cash Price |
$36.08
|
| Rate for Payer: Cash Price |
$108.40
|
| Rate for Payer: Cofinity Commercial |
$127.37
|
| Rate for Payer: Cofinity Commercial |
$42.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.08
|
| Rate for Payer: Healthscope Commercial |
$135.50
|
| Rate for Payer: Healthscope Commercial |
$45.10
|
| Rate for Payer: Healthscope Whirlpool |
$131.44
|
| Rate for Payer: Healthscope Whirlpool |
$43.75
|
| Rate for Payer: Mclaren Commercial |
$121.95
|
| Rate for Payer: Mclaren Commercial |
$40.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.34
|
| Rate for Payer: Nomi Health Commercial |
$111.11
|
| Rate for Payer: Nomi Health Commercial |
$36.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.69
|
|
|
PR OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA
|
Professional
|
Both
|
$4,482.00
|
|
|
Service Code
|
HCPCS 61345
|
| Min. Negotiated Rate |
$660.90 |
| Max. Negotiated Rate |
$4,181.49 |
| Rate for Payer: Aetna Commercial |
$2,639.58
|
| Rate for Payer: Aetna Medicare |
$2,241.00
|
| Rate for Payer: BCBS Complete |
$1,397.81
|
| Rate for Payer: BCBS Trust/PPO |
$660.90
|
| Rate for Payer: BCN Commercial |
$4,181.49
|
| Rate for Payer: Cash Price |
$3,585.60
|
| Rate for Payer: Cash Price |
$3,585.60
|
| Rate for Payer: Meridian Medicaid |
$1,397.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,331.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,538.55
|
| Rate for Payer: Priority Health Narrow Network |
$3,538.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,365.58
|
| Rate for Payer: UHC Exchange |
$2,365.58
|
| Rate for Payer: UHCCP Medicaid |
$1,331.25
|
|
|
PR OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 92502
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$1,298.03 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare |
$166.50
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,298.03
|
| Rate for Payer: BCN Commercial |
$137.32
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.91
|
| Rate for Payer: Priority Health Narrow Network |
$128.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.92
|
| Rate for Payer: UHC Exchange |
$98.92
|
| Rate for Payer: UHCCP Medicaid |
$60.92
|
|
|
PR OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ
|
Professional
|
Both
|
$1,581.00
|
|
|
Service Code
|
HCPCS 69300
|
| Min. Negotiated Rate |
$304.16 |
| Max. Negotiated Rate |
$1,934.63 |
| Rate for Payer: Aetna Commercial |
$518.23
|
| Rate for Payer: Aetna Medicare |
$790.50
|
| Rate for Payer: BCBS Complete |
$319.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.63
|
| Rate for Payer: BCN Commercial |
$958.30
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Meridian Medicaid |
$319.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.63
|
| Rate for Payer: Priority Health Narrow Network |
$691.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$527.59
|
| Rate for Payer: UHC Exchange |
$527.59
|
| Rate for Payer: UHCCP Medicaid |
$304.16
|
|
|
PR OVARIAN CYSTECTOMY UNI/BI
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 58925
|
| Min. Negotiated Rate |
$164.83 |
| Max. Negotiated Rate |
$1,550.25 |
| Rate for Payer: Aetna Commercial |
$912.21
|
| Rate for Payer: Aetna Medicare |
$1,192.50
|
| Rate for Payer: BCBS Complete |
$519.32
|
| Rate for Payer: BCBS Trust/PPO |
$164.83
|
| Rate for Payer: BCN Commercial |
$1,126.89
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Meridian Medicaid |
$519.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,550.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$841.03
|
| Rate for Payer: UHC Exchange |
$841.03
|
| Rate for Payer: UHCCP Medicaid |
$494.59
|
|
|
PR OVINE, UP TO 999 USP UNITS
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J3471
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Aetna Commercial |
$0.51
|
| Rate for Payer: Aetna Medicare |
$1.00
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS Trust/PPO |
$0.50
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.52
|
| Rate for Payer: UHC Exchange |
$0.52
|
|
|
PR PACKING STRIPS, NON-IMPREG
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS A6407
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna Commercial |
$1.74
|
| Rate for Payer: Aetna Medicare |
$3.00
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCN Commercial |
$2.06
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.18
|
| Rate for Payer: UHC Exchange |
$1.18
|
|
|
PR PALATOPHARYNGOPLASTY
|
Professional
|
Both
|
$2,472.00
|
|
|
Service Code
|
HCPCS 42145
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$1,606.80 |
| Rate for Payer: Aetna Commercial |
$914.29
|
| Rate for Payer: Aetna Medicare |
$1,236.00
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.94
|
| Rate for Payer: BCN Commercial |
$1,011.07
|
| Rate for Payer: Cash Price |
$1,977.60
|
| Rate for Payer: Cash Price |
$1,977.60
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,240.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,240.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$852.30
|
| Rate for Payer: UHC Exchange |
$852.30
|
| Rate for Payer: UHCCP Medicaid |
$442.83
|
|
|
PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS
|
Professional
|
Both
|
$7,598.00
|
|
|
Service Code
|
HCPCS 48160
|
| Min. Negotiated Rate |
$809.36 |
| Max. Negotiated Rate |
$5,573.98 |
| Rate for Payer: Aetna Commercial |
$4,176.69
|
| Rate for Payer: Aetna Medicare |
$3,799.00
|
| Rate for Payer: BCBS Complete |
$3,039.20
|
| Rate for Payer: BCBS Trust/PPO |
$809.36
|
| Rate for Payer: BCN Commercial |
$2,480.87
|
| Rate for Payer: Cash Price |
$6,078.40
|
| Rate for Payer: Cash Price |
$6,078.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,938.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,573.98
|
| Rate for Payer: Priority Health Narrow Network |
$5,573.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,762.60
|
| Rate for Payer: UHC Exchange |
$3,762.60
|
|
|
PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST
|
Professional
|
Both
|
$3,447.00
|
|
|
Service Code
|
HCPCS 48548
|
| Min. Negotiated Rate |
$484.98 |
| Max. Negotiated Rate |
$2,988.93 |
| Rate for Payer: Aetna Commercial |
$2,265.27
|
| Rate for Payer: Aetna Medicare |
$1,723.50
|
| Rate for Payer: BCBS Complete |
$1,125.41
|
| Rate for Payer: BCBS Trust/PPO |
$484.98
|
| Rate for Payer: BCN Commercial |
$2,437.52
|
| Rate for Payer: Cash Price |
$2,757.60
|
| Rate for Payer: Cash Price |
$2,757.60
|
| Rate for Payer: Meridian Medicaid |
$1,125.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,071.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,240.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,988.93
|
| Rate for Payer: Priority Health Narrow Network |
$2,988.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,011.76
|
| Rate for Payer: UHC Exchange |
$2,011.76
|
| Rate for Payer: UHCCP Medicaid |
$1,071.82
|
|
|
PR PANCREATORRHAPHY INJURY
|
Professional
|
Both
|
$3,272.00
|
|
|
Service Code
|
HCPCS 48545
|
| Min. Negotiated Rate |
$525.66 |
| Max. Negotiated Rate |
$2,412.02 |
| Rate for Payer: Aetna Commercial |
$1,824.64
|
| Rate for Payer: Aetna Medicare |
$1,636.00
|
| Rate for Payer: BCBS Complete |
$909.14
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$1,966.44
|
| Rate for Payer: Cash Price |
$2,617.60
|
| Rate for Payer: Cash Price |
$2,617.60
|
| Rate for Payer: Meridian Medicaid |
$909.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$865.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,412.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,412.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,607.19
|
| Rate for Payer: UHC Exchange |
$1,607.19
|
| Rate for Payer: UHCCP Medicaid |
$865.85
|
|
|
PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC
|
Professional
|
Both
|
$2,535.00
|
|
|
Service Code
|
HCPCS 60505
|
| Min. Negotiated Rate |
$576.38 |
| Max. Negotiated Rate |
$2,267.07 |
| Rate for Payer: Aetna Commercial |
$1,795.96
|
| Rate for Payer: Aetna Medicare |
$1,267.50
|
| Rate for Payer: BCBS Complete |
$940.00
|
| Rate for Payer: BCBS Trust/PPO |
$576.38
|
| Rate for Payer: BCN Commercial |
$2,042.19
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Meridian Medicaid |
$940.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$895.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,647.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,267.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,267.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,568.51
|
| Rate for Payer: UHC Exchange |
$1,568.51
|
| Rate for Payer: UHCCP Medicaid |
$895.24
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$153.15 |
| Max. Negotiated Rate |
$663.02 |
| Rate for Payer: Aetna Commercial |
$313.69
|
| Rate for Payer: Aetna Medicare |
$242.50
|
| Rate for Payer: BCBS Complete |
$160.81
|
| Rate for Payer: BCBS Trust/PPO |
$663.02
|
| Rate for Payer: BCN Commercial |
$350.87
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Meridian Medicaid |
$160.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.18
|
| Rate for Payer: Priority Health Narrow Network |
$387.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.47
|
| Rate for Payer: UHC Exchange |
$277.47
|
| Rate for Payer: UHCCP Medicaid |
$153.15
|
|
