|
PR PYLOROPLASTY
|
Professional
|
Both
|
$2,634.00
|
|
|
Service Code
|
HCPCS 43800
|
| Min. Negotiated Rate |
$555.50 |
| Max. Negotiated Rate |
$1,975.50 |
| Rate for Payer: Aetna Commercial |
$1,160.44
|
| Rate for Payer: Aetna Medicare |
$866.00
|
| Rate for Payer: BCBS Complete |
$583.27
|
| Rate for Payer: BCBS MAPPO |
$866.00
|
| Rate for Payer: BCN Commercial |
$1,398.83
|
| Rate for Payer: BCN Medicare Advantage |
$866.00
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cash Price |
$2,107.20
|
| Rate for Payer: Cofinity Commercial |
$1,247.04
|
| Rate for Payer: Cofinity Commercial |
$1,160.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.00
|
| Rate for Payer: Healthscope Commercial |
$1,039.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,039.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.30
|
| Rate for Payer: Meridian Medicaid |
$583.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$952.60
|
| Rate for Payer: Nomi Health Commercial |
$1,039.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,975.50
|
| Rate for Payer: PACE SWMI |
$866.00
|
| Rate for Payer: PHP Medicare Advantage |
$866.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,704.38
|
| Rate for Payer: Priority Health Medicare |
$866.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,704.38
|
| Rate for Payer: Railroad Medicare Medicare |
$866.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,664.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$866.00
|
| Rate for Payer: UHC Exchange |
$1,664.75
|
| Rate for Payer: UHC Medicaid |
$555.50
|
| Rate for Payer: UHCCP DNSP |
$866.00
|
| Rate for Payer: UHCCP Medicaid |
$555.50
|
|
|
PR QUADRICEPSPLASTY
|
Professional
|
Both
|
$2,110.00
|
|
|
Service Code
|
HCPCS 27430
|
| Min. Negotiated Rate |
$445.81 |
| Max. Negotiated Rate |
$1,582.50 |
| Rate for Payer: Aetna Commercial |
$914.16
|
| Rate for Payer: Aetna Medicare |
$682.21
|
| Rate for Payer: BCBS Complete |
$468.10
|
| Rate for Payer: BCBS MAPPO |
$682.21
|
| Rate for Payer: BCN Commercial |
$1,132.41
|
| Rate for Payer: BCN Medicare Advantage |
$682.21
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cash Price |
$1,688.00
|
| Rate for Payer: Cofinity Commercial |
$982.38
|
| Rate for Payer: Cofinity Commercial |
$914.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.21
|
| Rate for Payer: Healthscope Commercial |
$818.65
|
| Rate for Payer: Healthscope Whirlpool |
$818.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.32
|
| Rate for Payer: Meridian Medicaid |
$468.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$750.43
|
| Rate for Payer: Nomi Health Commercial |
$818.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,582.50
|
| Rate for Payer: PACE SWMI |
$682.21
|
| Rate for Payer: PHP Medicare Advantage |
$682.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,210.51
|
| Rate for Payer: Priority Health Medicare |
$682.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,210.51
|
| Rate for Payer: Railroad Medicare Medicare |
$682.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,294.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$682.21
|
| Rate for Payer: UHC Exchange |
$1,294.86
|
| Rate for Payer: UHC Medicaid |
$445.81
|
| Rate for Payer: UHCCP DNSP |
$682.21
|
| Rate for Payer: UHCCP Medicaid |
$445.81
|
|
|
PR QUAL NONMD EST PT 11-20M
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G2062
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
|
|
PR QUAL NONMD EST PT 21>MIN
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G2063
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
|
|
PR QUAL NONMD EST PT 5-10M
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G2061
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
|
|
PR RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 90375
|
| Min. Negotiated Rate |
$170.25 |
| Max. Negotiated Rate |
$396.26 |
| Rate for Payer: Aetna Commercial |
$368.74
|
| Rate for Payer: Aetna Medicare |
$275.18
|
| Rate for Payer: BCBS MAPPO |
$275.18
|
| Rate for Payer: BCBS Trust/PPO |
$347.06
|
| Rate for Payer: BCN Commercial |
$334.80
|
| Rate for Payer: BCN Medicare Advantage |
$275.18
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$396.26
|
| Rate for Payer: Cofinity Commercial |
$368.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.18
|
| Rate for Payer: Healthscope Commercial |
$330.22
|
| Rate for Payer: Healthscope Whirlpool |
$330.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$302.70
|
| Rate for Payer: Nomi Health Commercial |
$330.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.25
|
| Rate for Payer: PACE SWMI |
$275.18
|
| Rate for Payer: PHP Medicare Advantage |
$275.18
|
| Rate for Payer: Priority Health Medicare |
$275.18
|
| Rate for Payer: Railroad Medicare Medicare |
$275.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$279.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$275.18
|
| Rate for Payer: UHC Exchange |
$279.95
|
| Rate for Payer: UHCCP DNSP |
$275.18
|
|
|
PR RABIES VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 90675
|
| Min. Negotiated Rate |
$160.50 |
| Max. Negotiated Rate |
$453.92 |
| Rate for Payer: Aetna Commercial |
$422.39
|
| Rate for Payer: Aetna Medicare |
$315.22
|
| Rate for Payer: BCBS MAPPO |
$315.22
|
| Rate for Payer: BCBS Trust/PPO |
$434.61
|
| Rate for Payer: BCN Commercial |
$443.93
|
| Rate for Payer: BCN Medicare Advantage |
$315.22
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$422.39
|
| Rate for Payer: Cofinity Commercial |
$453.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.22
|
| Rate for Payer: Healthscope Commercial |
$378.26
|
| Rate for Payer: Healthscope Whirlpool |
$378.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$346.74
|
| Rate for Payer: Nomi Health Commercial |
$378.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.50
|
| Rate for Payer: PACE SWMI |
$315.22
|
| Rate for Payer: PHP Medicare Advantage |
$315.22
|
| Rate for Payer: Priority Health Medicare |
$315.22
|
| Rate for Payer: Railroad Medicare Medicare |
$315.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$315.22
|
| Rate for Payer: UHC Exchange |
$332.54
|
| Rate for Payer: UHCCP DNSP |
$315.22
|
|
|
PR RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY
|
Professional
|
Both
|
$6,209.00
|
|
|
Service Code
|
HCPCS 58210
|
| Min. Negotiated Rate |
$1,069.90 |
| Max. Negotiated Rate |
$4,656.75 |
| Rate for Payer: Aetna Commercial |
$2,233.06
|
| Rate for Payer: Aetna Medicare |
$1,666.46
|
| Rate for Payer: BCBS Complete |
$1,123.39
|
| Rate for Payer: BCBS MAPPO |
$1,666.46
|
| Rate for Payer: BCN Commercial |
$2,732.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,666.46
|
| Rate for Payer: Cash Price |
$4,967.20
|
| Rate for Payer: Cash Price |
$4,967.20
|
| Rate for Payer: Cofinity Commercial |
$2,399.70
|
| Rate for Payer: Cofinity Commercial |
$2,233.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,666.46
|
| Rate for Payer: Healthscope Commercial |
$1,999.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,999.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,749.78
|
| Rate for Payer: Meridian Medicaid |
$1,123.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,833.11
|
| Rate for Payer: Nomi Health Commercial |
$1,999.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,656.75
|
| Rate for Payer: PACE SWMI |
$1,666.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,666.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,069.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,767.86
|
| Rate for Payer: Priority Health Medicare |
$1,666.46
|
| Rate for Payer: Priority Health Narrow Network |
$2,767.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,666.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,200.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,666.46
|
| Rate for Payer: UHC Exchange |
$3,200.03
|
| Rate for Payer: UHC Medicaid |
$1,069.90
|
| Rate for Payer: UHCCP DNSP |
$1,666.46
|
| Rate for Payer: UHCCP Medicaid |
$1,069.90
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS
|
Professional
|
Both
|
$2,801.00
|
|
|
Service Code
|
HCPCS 25115
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$2,100.75 |
| Rate for Payer: Aetna Commercial |
$917.07
|
| Rate for Payer: Aetna Medicare |
$684.38
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS MAPPO |
$684.38
|
| Rate for Payer: BCN Commercial |
$1,162.29
|
| Rate for Payer: BCN Medicare Advantage |
$684.38
|
| Rate for Payer: Cash Price |
$2,240.80
|
| Rate for Payer: Cash Price |
$2,240.80
|
| Rate for Payer: Cofinity Commercial |
$985.51
|
| Rate for Payer: Cofinity Commercial |
$917.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.38
|
| Rate for Payer: Healthscope Commercial |
$821.26
|
| Rate for Payer: Healthscope Whirlpool |
$821.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.60
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.82
|
| Rate for Payer: Nomi Health Commercial |
$821.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,100.75
|
| Rate for Payer: PACE SWMI |
$684.38
|
| Rate for Payer: PHP Medicare Advantage |
$684.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,242.46
|
| Rate for Payer: Priority Health Medicare |
$684.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,242.46
|
| Rate for Payer: Railroad Medicare Medicare |
$684.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,316.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$684.38
|
| Rate for Payer: UHC Exchange |
$1,316.52
|
| Rate for Payer: UHC Medicaid |
$448.58
|
| Rate for Payer: UHCCP DNSP |
$684.38
|
| Rate for Payer: UHCCP Medicaid |
$448.58
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS
|
Professional
|
Both
|
$2,400.00
|
|
|
Service Code
|
HCPCS 25116
|
| Min. Negotiated Rate |
$364.23 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$741.09
|
| Rate for Payer: Aetna Medicare |
$553.05
|
| Rate for Payer: BCBS Complete |
$382.44
|
| Rate for Payer: BCBS MAPPO |
$553.05
|
| Rate for Payer: BCN Commercial |
$931.72
|
| Rate for Payer: BCN Medicare Advantage |
$553.05
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$796.39
|
| Rate for Payer: Cofinity Commercial |
$741.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$553.05
|
| Rate for Payer: Healthscope Commercial |
$663.66
|
| Rate for Payer: Healthscope Whirlpool |
$663.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.70
|
| Rate for Payer: Meridian Medicaid |
$382.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$608.36
|
| Rate for Payer: Nomi Health Commercial |
$663.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.00
|
| Rate for Payer: PACE SWMI |
$553.05
|
| Rate for Payer: PHP Medicare Advantage |
$553.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$995.98
|
| Rate for Payer: Priority Health Medicare |
$553.05
|
| Rate for Payer: Priority Health Narrow Network |
$995.98
|
| Rate for Payer: Railroad Medicare Medicare |
$553.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,041.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$553.05
|
| Rate for Payer: UHC Exchange |
$1,041.44
|
| Rate for Payer: UHC Medicaid |
$364.23
|
| Rate for Payer: UHCCP DNSP |
$553.05
|
| Rate for Payer: UHCCP Medicaid |
$364.23
|
|
|
PR RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ
|
Professional
|
Both
|
$1,959.00
|
|
|
Service Code
|
HCPCS 69150
|
| Min. Negotiated Rate |
$574.04 |
| Max. Negotiated Rate |
$1,763.80 |
| Rate for Payer: Aetna Commercial |
$1,172.85
|
| Rate for Payer: Aetna Medicare |
$875.26
|
| Rate for Payer: BCBS Complete |
$602.74
|
| Rate for Payer: BCBS MAPPO |
$875.26
|
| Rate for Payer: BCN Commercial |
$1,501.91
|
| Rate for Payer: BCN Medicare Advantage |
$875.26
|
| Rate for Payer: Cash Price |
$1,567.20
|
| Rate for Payer: Cash Price |
$1,567.20
|
| Rate for Payer: Cofinity Commercial |
$1,260.37
|
| Rate for Payer: Cofinity Commercial |
$1,172.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.26
|
| Rate for Payer: Healthscope Commercial |
$1,050.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,050.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$919.02
|
| Rate for Payer: Meridian Medicaid |
$602.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$962.79
|
| Rate for Payer: Nomi Health Commercial |
$1,050.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,469.25
|
| Rate for Payer: PACE SWMI |
$875.26
|
| Rate for Payer: PHP Medicare Advantage |
$875.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,484.04
|
| Rate for Payer: Priority Health Medicare |
$875.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,484.04
|
| Rate for Payer: Railroad Medicare Medicare |
$875.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,763.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$875.26
|
| Rate for Payer: UHC Exchange |
$1,763.80
|
| Rate for Payer: UHC Medicaid |
$574.04
|
| Rate for Payer: UHCCP DNSP |
$875.26
|
| Rate for Payer: UHCCP Medicaid |
$574.04
|
|
|
PR RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP
|
Professional
|
Both
|
$3,131.00
|
|
|
Service Code
|
HCPCS 42844
|
| Min. Negotiated Rate |
$783.41 |
| Max. Negotiated Rate |
$2,501.67 |
| Rate for Payer: Aetna Commercial |
$1,595.70
|
| Rate for Payer: Aetna Medicare |
$1,190.82
|
| Rate for Payer: BCBS Complete |
$822.58
|
| Rate for Payer: BCBS MAPPO |
$1,190.82
|
| Rate for Payer: BCN Commercial |
$2,053.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,190.82
|
| Rate for Payer: Cash Price |
$2,504.80
|
| Rate for Payer: Cash Price |
$2,504.80
|
| Rate for Payer: Cofinity Commercial |
$1,714.78
|
| Rate for Payer: Cofinity Commercial |
$1,595.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,190.82
|
| Rate for Payer: Healthscope Commercial |
$1,428.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,428.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,250.36
|
| Rate for Payer: Meridian Medicaid |
$822.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,309.90
|
| Rate for Payer: Nomi Health Commercial |
$1,428.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,348.25
|
| Rate for Payer: PACE SWMI |
$1,190.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,190.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$783.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,501.67
|
| Rate for Payer: Priority Health Medicare |
$1,190.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,501.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,190.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,387.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,190.82
|
| Rate for Payer: UHC Exchange |
$2,387.25
|
| Rate for Payer: UHC Medicaid |
$783.41
|
| Rate for Payer: UHCCP DNSP |
$1,190.82
|
| Rate for Payer: UHCCP Medicaid |
$783.41
|
|
|
PR RADICAL RESECTION STERNUM
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 21630
|
| Min. Negotiated Rate |
$746.57 |
| Max. Negotiated Rate |
$2,141.82 |
| Rate for Payer: Aetna Commercial |
$1,538.63
|
| Rate for Payer: Aetna Medicare |
$1,148.23
|
| Rate for Payer: BCBS Complete |
$783.90
|
| Rate for Payer: BCBS MAPPO |
$1,148.23
|
| Rate for Payer: BCN Commercial |
$1,980.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,148.23
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cofinity Commercial |
$1,653.45
|
| Rate for Payer: Cofinity Commercial |
$1,538.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,148.23
|
| Rate for Payer: Healthscope Commercial |
$1,377.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,377.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,205.64
|
| Rate for Payer: Meridian Medicaid |
$783.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,263.05
|
| Rate for Payer: Nomi Health Commercial |
$1,377.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,065.50
|
| Rate for Payer: PACE SWMI |
$1,148.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,148.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$746.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,117.59
|
| Rate for Payer: Priority Health Medicare |
$1,148.23
|
| Rate for Payer: Priority Health Narrow Network |
$2,117.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,148.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,141.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,148.23
|
| Rate for Payer: UHC Exchange |
$2,141.82
|
| Rate for Payer: UHC Medicaid |
$746.57
|
| Rate for Payer: UHCCP DNSP |
$1,148.23
|
| Rate for Payer: UHCCP Medicaid |
$746.57
|
|
|
PR RADICAL RESECTION TONSIL W/O CLOSURE
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 42842
|
| Min. Negotiated Rate |
$580.85 |
| Max. Negotiated Rate |
$1,838.48 |
| Rate for Payer: Aetna Commercial |
$1,177.87
|
| Rate for Payer: Aetna Medicare |
$879.01
|
| Rate for Payer: BCBS Complete |
$609.89
|
| Rate for Payer: BCBS MAPPO |
$879.01
|
| Rate for Payer: BCN Commercial |
$1,508.88
|
| Rate for Payer: BCN Medicare Advantage |
$879.01
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Cofinity Commercial |
$1,265.77
|
| Rate for Payer: Cofinity Commercial |
$1,177.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$879.01
|
| Rate for Payer: Healthscope Commercial |
$1,054.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,054.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.96
|
| Rate for Payer: Meridian Medicaid |
$609.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$966.91
|
| Rate for Payer: Nomi Health Commercial |
$1,054.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,392.00
|
| Rate for Payer: PACE SWMI |
$879.01
|
| Rate for Payer: PHP Medicare Advantage |
$879.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,838.48
|
| Rate for Payer: Priority Health Medicare |
$879.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,838.48
|
| Rate for Payer: Railroad Medicare Medicare |
$879.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,727.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$879.01
|
| Rate for Payer: UHC Exchange |
$1,727.84
|
| Rate for Payer: UHC Medicaid |
$580.85
|
| Rate for Payer: UHCCP DNSP |
$879.01
|
| Rate for Payer: UHCCP Medicaid |
$580.85
|
|
|
PR RADICAL RESECTION TUMOR CLAVICLE
|
Professional
|
Both
|
$2,709.00
|
|
|
Service Code
|
HCPCS 23200
|
| Min. Negotiated Rate |
$870.74 |
| Max. Negotiated Rate |
$2,653.01 |
| Rate for Payer: Aetna Commercial |
$1,802.43
|
| Rate for Payer: Aetna Medicare |
$1,345.10
|
| Rate for Payer: BCBS Complete |
$914.28
|
| Rate for Payer: BCBS MAPPO |
$1,345.10
|
| Rate for Payer: BCN Commercial |
$2,272.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,345.10
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cash Price |
$2,167.20
|
| Rate for Payer: Cofinity Commercial |
$1,936.94
|
| Rate for Payer: Cofinity Commercial |
$1,802.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,345.10
|
| Rate for Payer: Healthscope Commercial |
$1,614.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,614.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,412.36
|
| Rate for Payer: Meridian Medicaid |
$914.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,479.61
|
| Rate for Payer: Nomi Health Commercial |
$1,614.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,031.75
|
| Rate for Payer: PACE SWMI |
$1,345.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,345.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$870.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,429.01
|
| Rate for Payer: Priority Health Medicare |
$1,345.10
|
| Rate for Payer: Priority Health Narrow Network |
$2,429.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,345.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,653.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,345.10
|
| Rate for Payer: UHC Exchange |
$2,653.01
|
| Rate for Payer: UHC Medicaid |
$870.74
|
| Rate for Payer: UHCCP DNSP |
$1,345.10
|
| Rate for Payer: UHCCP Medicaid |
$870.74
|
|
|
PR RADICAL RESECTION TUMOR FEMOR OR KNEE
|
Professional
|
Both
|
$5,676.00
|
|
|
Service Code
|
HCPCS 27365
|
| Min. Negotiated Rate |
$1,171.50 |
| Max. Negotiated Rate |
$4,257.00 |
| Rate for Payer: Aetna Commercial |
$2,434.62
|
| Rate for Payer: Aetna Medicare |
$1,816.88
|
| Rate for Payer: BCBS Complete |
$1,230.08
|
| Rate for Payer: BCBS MAPPO |
$1,816.88
|
| Rate for Payer: BCN Commercial |
$3,088.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,816.88
|
| Rate for Payer: Cash Price |
$4,540.80
|
| Rate for Payer: Cash Price |
$4,540.80
|
| Rate for Payer: Cofinity Commercial |
$2,616.31
|
| Rate for Payer: Cofinity Commercial |
$2,434.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,816.88
|
| Rate for Payer: Healthscope Commercial |
$2,180.26
|
| Rate for Payer: Healthscope Whirlpool |
$2,180.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,907.72
|
| Rate for Payer: Meridian Medicaid |
$1,230.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,998.57
|
| Rate for Payer: Nomi Health Commercial |
$2,180.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,257.00
|
| Rate for Payer: PACE SWMI |
$1,816.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,816.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,301.50
|
| Rate for Payer: Priority Health Medicare |
$1,816.88
|
| Rate for Payer: Priority Health Narrow Network |
$3,301.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,816.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,633.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,816.88
|
| Rate for Payer: UHC Exchange |
$3,633.59
|
| Rate for Payer: UHC Medicaid |
$1,171.50
|
| Rate for Payer: UHCCP DNSP |
$1,816.88
|
| Rate for Payer: UHCCP Medicaid |
$1,171.50
|
|
|
PR RADICAL RESECTION TUMOR METACARPAL
|
Professional
|
Both
|
$3,120.00
|
|
|
Service Code
|
HCPCS 26250
|
| Min. Negotiated Rate |
$628.78 |
| Max. Negotiated Rate |
$2,340.00 |
| Rate for Payer: Aetna Commercial |
$1,294.59
|
| Rate for Payer: Aetna Medicare |
$966.11
|
| Rate for Payer: BCBS Complete |
$660.22
|
| Rate for Payer: BCBS MAPPO |
$966.11
|
| Rate for Payer: BCN Commercial |
$1,618.44
|
| Rate for Payer: BCN Medicare Advantage |
$966.11
|
| Rate for Payer: Cash Price |
$2,496.00
|
| Rate for Payer: Cash Price |
$2,496.00
|
| Rate for Payer: Cofinity Commercial |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$1,294.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$966.11
|
| Rate for Payer: Healthscope Commercial |
$1,159.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,159.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,014.42
|
| Rate for Payer: Meridian Medicaid |
$660.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,062.72
|
| Rate for Payer: Nomi Health Commercial |
$1,159.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,340.00
|
| Rate for Payer: PACE SWMI |
$966.11
|
| Rate for Payer: PHP Medicare Advantage |
$966.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,730.06
|
| Rate for Payer: Priority Health Medicare |
$966.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,730.06
|
| Rate for Payer: Railroad Medicare Medicare |
$966.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,866.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$966.11
|
| Rate for Payer: UHC Exchange |
$1,866.83
|
| Rate for Payer: UHC Medicaid |
$628.78
|
| Rate for Payer: UHCCP DNSP |
$966.11
|
| Rate for Payer: UHCCP Medicaid |
$628.78
|
|
|
PR RADICAL RESECTION TUMOR METATARSAL
|
Professional
|
Both
|
$1,420.00
|
|
|
Service Code
|
HCPCS 28173
|
| Min. Negotiated Rate |
$424.51 |
| Max. Negotiated Rate |
$1,302.27 |
| Rate for Payer: Aetna Commercial |
$879.68
|
| Rate for Payer: Aetna Medicare |
$656.48
|
| Rate for Payer: BCBS Complete |
$445.74
|
| Rate for Payer: BCBS MAPPO |
$656.48
|
| Rate for Payer: BCN Commercial |
$1,089.58
|
| Rate for Payer: BCN Medicare Advantage |
$656.48
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cofinity Commercial |
$945.33
|
| Rate for Payer: Cofinity Commercial |
$879.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$656.48
|
| Rate for Payer: Healthscope Commercial |
$787.78
|
| Rate for Payer: Healthscope Whirlpool |
$787.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$689.30
|
| Rate for Payer: Meridian Medicaid |
$445.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$722.13
|
| Rate for Payer: Nomi Health Commercial |
$787.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,065.00
|
| Rate for Payer: PACE SWMI |
$656.48
|
| Rate for Payer: PHP Medicare Advantage |
$656.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$424.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,164.73
|
| Rate for Payer: Priority Health Medicare |
$656.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,164.73
|
| Rate for Payer: Railroad Medicare Medicare |
$656.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,302.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$656.48
|
| Rate for Payer: UHC Exchange |
$1,302.27
|
| Rate for Payer: UHC Medicaid |
$424.51
|
| Rate for Payer: UHCCP DNSP |
$656.48
|
| Rate for Payer: UHCCP Medicaid |
$424.51
|
|
|
PR RADICAL RESECTION TUMOR RADIUS OR ULNA
|
Professional
|
Both
|
$2,673.00
|
|
|
Service Code
|
HCPCS 25170
|
| Min. Negotiated Rate |
$847.95 |
| Max. Negotiated Rate |
$2,588.91 |
| Rate for Payer: Aetna Commercial |
$1,755.64
|
| Rate for Payer: Aetna Medicare |
$1,310.18
|
| Rate for Payer: BCBS Complete |
$890.35
|
| Rate for Payer: BCBS MAPPO |
$1,310.18
|
| Rate for Payer: BCN Commercial |
$2,215.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,310.18
|
| Rate for Payer: Cash Price |
$2,138.40
|
| Rate for Payer: Cash Price |
$2,138.40
|
| Rate for Payer: Cofinity Commercial |
$1,886.66
|
| Rate for Payer: Cofinity Commercial |
$1,755.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,310.18
|
| Rate for Payer: Healthscope Commercial |
$1,572.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,572.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,375.69
|
| Rate for Payer: Meridian Medicaid |
$890.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,441.20
|
| Rate for Payer: Nomi Health Commercial |
$1,572.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,004.75
|
| Rate for Payer: PACE SWMI |
$1,310.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,310.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,368.33
|
| Rate for Payer: Priority Health Medicare |
$1,310.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,368.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,310.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,588.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,310.18
|
| Rate for Payer: UHC Exchange |
$2,588.91
|
| Rate for Payer: UHC Medicaid |
$847.95
|
| Rate for Payer: UHCCP DNSP |
$1,310.18
|
| Rate for Payer: UHCCP Medicaid |
$847.95
|
|
|
PR RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,383.00
|
|
|
Service Code
|
HCPCS 24150
|
| Min. Negotiated Rate |
$890.98 |
| Max. Negotiated Rate |
$2,724.41 |
| Rate for Payer: Aetna Commercial |
$1,845.45
|
| Rate for Payer: Aetna Medicare |
$1,377.20
|
| Rate for Payer: BCBS Complete |
$935.53
|
| Rate for Payer: BCBS MAPPO |
$1,377.20
|
| Rate for Payer: BCN Commercial |
$2,330.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,377.20
|
| Rate for Payer: Cash Price |
$1,906.40
|
| Rate for Payer: Cash Price |
$1,906.40
|
| Rate for Payer: Cofinity Commercial |
$1,983.17
|
| Rate for Payer: Cofinity Commercial |
$1,845.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,377.20
|
| Rate for Payer: Healthscope Commercial |
$1,652.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,652.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,446.06
|
| Rate for Payer: Meridian Medicaid |
$935.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,514.92
|
| Rate for Payer: Nomi Health Commercial |
$1,652.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,787.25
|
| Rate for Payer: PACE SWMI |
$1,377.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,377.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$890.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,490.76
|
| Rate for Payer: Priority Health Medicare |
$1,377.20
|
| Rate for Payer: Priority Health Narrow Network |
$2,490.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,377.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,724.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,377.20
|
| Rate for Payer: UHC Exchange |
$2,724.41
|
| Rate for Payer: UHC Medicaid |
$890.98
|
| Rate for Payer: UHCCP DNSP |
$1,377.20
|
| Rate for Payer: UHCCP Medicaid |
$890.98
|
|
|
PR RADICAL STYLOIDECTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,585.00
|
|
|
Service Code
|
HCPCS 25230
|
| Min. Negotiated Rate |
$263.69 |
| Max. Negotiated Rate |
$1,188.75 |
| Rate for Payer: Aetna Commercial |
$536.15
|
| Rate for Payer: Aetna Medicare |
$400.11
|
| Rate for Payer: BCBS Complete |
$276.87
|
| Rate for Payer: BCBS MAPPO |
$400.11
|
| Rate for Payer: BCN Commercial |
$670.78
|
| Rate for Payer: BCN Medicare Advantage |
$400.11
|
| Rate for Payer: Cash Price |
$1,268.00
|
| Rate for Payer: Cash Price |
$1,268.00
|
| Rate for Payer: Cofinity Commercial |
$576.16
|
| Rate for Payer: Cofinity Commercial |
$536.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.11
|
| Rate for Payer: Healthscope Commercial |
$480.13
|
| Rate for Payer: Healthscope Whirlpool |
$480.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.12
|
| Rate for Payer: Meridian Medicaid |
$276.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$440.12
|
| Rate for Payer: Nomi Health Commercial |
$480.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,188.75
|
| Rate for Payer: PACE SWMI |
$400.11
|
| Rate for Payer: PHP Medicare Advantage |
$400.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$717.05
|
| Rate for Payer: Priority Health Medicare |
$400.11
|
| Rate for Payer: Priority Health Narrow Network |
$717.05
|
| Rate for Payer: Railroad Medicare Medicare |
$400.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$748.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$400.11
|
| Rate for Payer: UHC Exchange |
$748.51
|
| Rate for Payer: UHC Medicaid |
$263.69
|
| Rate for Payer: UHCCP DNSP |
$400.11
|
| Rate for Payer: UHCCP Medicaid |
$263.69
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 64625
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$721.50 |
| Rate for Payer: Aetna Commercial |
$232.25
|
| Rate for Payer: Aetna Medicare |
$173.32
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$173.32
|
| Rate for Payer: BCN Commercial |
$293.81
|
| Rate for Payer: BCN Medicare Advantage |
$173.32
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$249.58
|
| Rate for Payer: Cofinity Commercial |
$232.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.32
|
| Rate for Payer: Healthscope Commercial |
$207.98
|
| Rate for Payer: Healthscope Whirlpool |
$207.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.99
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$190.65
|
| Rate for Payer: Nomi Health Commercial |
$207.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.50
|
| Rate for Payer: PACE SWMI |
$173.32
|
| Rate for Payer: PHP Medicare Advantage |
$173.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$341.25
|
| Rate for Payer: Priority Health Medicare |
$173.32
|
| Rate for Payer: Priority Health Narrow Network |
$341.25
|
| Rate for Payer: Railroad Medicare Medicare |
$173.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$173.32
|
| Rate for Payer: UHC Exchange |
$340.97
|
| Rate for Payer: UHC Medicaid |
$112.68
|
| Rate for Payer: UHCCP DNSP |
$173.32
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
|
|
PR RAD RESCJ CAPSL TISS&HTRTPC B1 ELBW CONTRCT RLS
|
Professional
|
Both
|
$2,748.00
|
|
|
Service Code
|
HCPCS 24149
|
| Min. Negotiated Rate |
$695.23 |
| Max. Negotiated Rate |
$2,061.00 |
| Rate for Payer: Aetna Commercial |
$1,426.08
|
| Rate for Payer: Aetna Medicare |
$1,064.24
|
| Rate for Payer: BCBS Complete |
$729.99
|
| Rate for Payer: BCBS MAPPO |
$1,064.24
|
| Rate for Payer: BCN Commercial |
$1,796.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,064.24
|
| Rate for Payer: Cash Price |
$2,198.40
|
| Rate for Payer: Cash Price |
$2,198.40
|
| Rate for Payer: Cofinity Commercial |
$1,532.51
|
| Rate for Payer: Cofinity Commercial |
$1,426.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,064.24
|
| Rate for Payer: Healthscope Commercial |
$1,277.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,277.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,117.45
|
| Rate for Payer: Meridian Medicaid |
$729.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,170.66
|
| Rate for Payer: Nomi Health Commercial |
$1,277.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,061.00
|
| Rate for Payer: PACE SWMI |
$1,064.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,064.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$695.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,920.11
|
| Rate for Payer: Priority Health Medicare |
$1,064.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,920.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,064.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,049.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,064.24
|
| Rate for Payer: UHC Exchange |
$2,049.09
|
| Rate for Payer: UHC Medicaid |
$695.23
|
| Rate for Payer: UHCCP DNSP |
$1,064.24
|
| Rate for Payer: UHCCP Medicaid |
$695.23
|
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW <5CM
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 24077
|
| Min. Negotiated Rate |
$610.88 |
| Max. Negotiated Rate |
$1,831.12 |
| Rate for Payer: Aetna Commercial |
$1,265.78
|
| Rate for Payer: Aetna Medicare |
$944.61
|
| Rate for Payer: BCBS Complete |
$641.42
|
| Rate for Payer: BCBS MAPPO |
$944.61
|
| Rate for Payer: BCN Commercial |
$1,549.72
|
| Rate for Payer: BCN Medicare Advantage |
$944.61
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,360.24
|
| Rate for Payer: Cofinity Commercial |
$1,265.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.61
|
| Rate for Payer: Healthscope Commercial |
$1,133.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,133.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$991.84
|
| Rate for Payer: Meridian Medicaid |
$641.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,039.07
|
| Rate for Payer: Nomi Health Commercial |
$1,133.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,426.50
|
| Rate for Payer: PACE SWMI |
$944.61
|
| Rate for Payer: PHP Medicare Advantage |
$944.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,656.60
|
| Rate for Payer: Priority Health Medicare |
$944.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,656.60
|
| Rate for Payer: Railroad Medicare Medicare |
$944.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,831.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$944.61
|
| Rate for Payer: UHC Exchange |
$1,831.12
|
| Rate for Payer: UHC Medicaid |
$610.88
|
| Rate for Payer: UHCCP DNSP |
$944.61
|
| Rate for Payer: UHCCP Medicaid |
$610.88
|
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW 5CM+
|
Professional
|
Both
|
$3,211.00
|
|
|
Service Code
|
HCPCS 24079
|
| Min. Negotiated Rate |
$781.92 |
| Max. Negotiated Rate |
$2,408.25 |
| Rate for Payer: Aetna Commercial |
$1,622.98
|
| Rate for Payer: Aetna Medicare |
$1,211.18
|
| Rate for Payer: BCBS Complete |
$821.02
|
| Rate for Payer: BCBS MAPPO |
$1,211.18
|
| Rate for Payer: BCN Commercial |
$2,002.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,211.18
|
| Rate for Payer: Cash Price |
$2,568.80
|
| Rate for Payer: Cash Price |
$2,568.80
|
| Rate for Payer: Cofinity Commercial |
$1,744.10
|
| Rate for Payer: Cofinity Commercial |
$1,622.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,211.18
|
| Rate for Payer: Healthscope Commercial |
$1,453.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,453.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,271.74
|
| Rate for Payer: Meridian Medicaid |
$821.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,332.30
|
| Rate for Payer: Nomi Health Commercial |
$1,453.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.25
|
| Rate for Payer: PACE SWMI |
$1,211.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,211.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,140.49
|
| Rate for Payer: Priority Health Medicare |
$1,211.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,140.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,211.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,337.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,211.18
|
| Rate for Payer: UHC Exchange |
$2,337.90
|
| Rate for Payer: UHC Medicaid |
$781.92
|
| Rate for Payer: UHCCP DNSP |
$1,211.18
|
| Rate for Payer: UHCCP Medicaid |
$781.92
|
|
