|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS
|
Professional
|
Both
|
$749.00
|
|
|
Service Code
|
HCPCS 33228
|
| Min. Negotiated Rate |
$201.07 |
| Max. Negotiated Rate |
$626.68 |
| Rate for Payer: Aetna Commercial |
$419.07
|
| Rate for Payer: Aetna Medicare |
$312.74
|
| Rate for Payer: BCBS Complete |
$211.12
|
| Rate for Payer: BCBS MAPPO |
$312.74
|
| Rate for Payer: BCN Commercial |
$523.88
|
| Rate for Payer: BCN Medicare Advantage |
$312.74
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$450.35
|
| Rate for Payer: Cofinity Commercial |
$419.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.74
|
| Rate for Payer: Healthscope Commercial |
$375.29
|
| Rate for Payer: Healthscope Whirlpool |
$375.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.38
|
| Rate for Payer: Meridian Medicaid |
$211.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.01
|
| Rate for Payer: Nomi Health Commercial |
$375.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$561.75
|
| Rate for Payer: PACE SWMI |
$312.74
|
| Rate for Payer: PHP Medicare Advantage |
$312.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$563.37
|
| Rate for Payer: Priority Health Medicare |
$312.74
|
| Rate for Payer: Priority Health Narrow Network |
$563.37
|
| Rate for Payer: Railroad Medicare Medicare |
$312.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$626.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.74
|
| Rate for Payer: UHC Exchange |
$626.68
|
| Rate for Payer: UHC Medicaid |
$201.07
|
| Rate for Payer: UHCCP DNSP |
$312.74
|
| Rate for Payer: UHCCP Medicaid |
$201.07
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 33229
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$662.23 |
| Rate for Payer: Aetna Commercial |
$438.18
|
| Rate for Payer: Aetna Medicare |
$327.00
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$327.00
|
| Rate for Payer: BCN Commercial |
$549.28
|
| Rate for Payer: BCN Medicare Advantage |
$327.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$470.88
|
| Rate for Payer: Cofinity Commercial |
$438.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.00
|
| Rate for Payer: Healthscope Commercial |
$392.40
|
| Rate for Payer: Healthscope Whirlpool |
$392.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.35
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.70
|
| Rate for Payer: Nomi Health Commercial |
$392.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.25
|
| Rate for Payer: PACE SWMI |
$327.00
|
| Rate for Payer: PHP Medicare Advantage |
$327.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$590.67
|
| Rate for Payer: Priority Health Medicare |
$327.00
|
| Rate for Payer: Priority Health Narrow Network |
$590.67
|
| Rate for Payer: Railroad Medicare Medicare |
$327.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$662.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$327.00
|
| Rate for Payer: UHC Exchange |
$662.23
|
| Rate for Payer: UHC Medicaid |
$210.23
|
| Rate for Payer: UHCCP DNSP |
$327.00
|
| Rate for Payer: UHCCP Medicaid |
$210.23
|
|
|
PR REMV TISSUE FOR GRAFT OTHR
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 20926
|
| Min. Negotiated Rate |
$337.60 |
| Max. Negotiated Rate |
$633.00 |
| Rate for Payer: BCBS Complete |
$337.60
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$633.00
|
|
|
PR RENAL ANGIO, CARDIAC CATH
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0275
|
| 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 RENAL BIOPSY PRQ TROCAR/NEEDLE
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
HCPCS 50200
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$813.75 |
| Rate for Payer: Aetna Commercial |
$146.21
|
| Rate for Payer: Aetna Medicare |
$109.11
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCBS MAPPO |
$109.11
|
| Rate for Payer: BCN Commercial |
$186.24
|
| Rate for Payer: BCN Medicare Advantage |
$109.11
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$157.12
|
| Rate for Payer: Cofinity Commercial |
$146.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.11
|
| Rate for Payer: Healthscope Commercial |
$130.93
|
| Rate for Payer: Healthscope Whirlpool |
$130.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.57
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.02
|
| Rate for Payer: Nomi Health Commercial |
$130.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.75
|
| Rate for Payer: PACE SWMI |
$109.11
|
| Rate for Payer: PHP Medicare Advantage |
$109.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$202.89
|
| Rate for Payer: Priority Health Medicare |
$109.11
|
| Rate for Payer: Priority Health Narrow Network |
$202.89
|
| Rate for Payer: Railroad Medicare Medicare |
$109.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$226.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.11
|
| Rate for Payer: UHC Exchange |
$226.46
|
| Rate for Payer: UHC Medicaid |
$70.29
|
| Rate for Payer: UHCCP DNSP |
$109.11
|
| Rate for Payer: UHCCP Medicaid |
$70.29
|
|
|
PR RENAL BIOPSY SURG EXPOSURE KIDNEY
|
Professional
|
Both
|
$1,750.00
|
|
|
Service Code
|
HCPCS 50205
|
| Min. Negotiated Rate |
$454.76 |
| Max. Negotiated Rate |
$1,340.74 |
| Rate for Payer: Aetna Commercial |
$947.89
|
| Rate for Payer: Aetna Medicare |
$707.38
|
| Rate for Payer: BCBS Complete |
$477.50
|
| Rate for Payer: BCBS MAPPO |
$707.38
|
| Rate for Payer: BCN Commercial |
$1,137.89
|
| Rate for Payer: BCN Medicare Advantage |
$707.38
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cash Price |
$1,400.00
|
| Rate for Payer: Cofinity Commercial |
$947.89
|
| Rate for Payer: Cofinity Commercial |
$1,018.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.38
|
| Rate for Payer: Healthscope Commercial |
$848.86
|
| Rate for Payer: Healthscope Whirlpool |
$848.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.75
|
| Rate for Payer: Meridian Medicaid |
$477.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$778.12
|
| Rate for Payer: Nomi Health Commercial |
$848.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,312.50
|
| Rate for Payer: PACE SWMI |
$707.38
|
| Rate for Payer: PHP Medicare Advantage |
$707.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,239.53
|
| Rate for Payer: Priority Health Medicare |
$707.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.53
|
| Rate for Payer: Railroad Medicare Medicare |
$707.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,340.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$707.38
|
| Rate for Payer: UHC Exchange |
$1,340.74
|
| Rate for Payer: UHC Medicaid |
$454.76
|
| Rate for Payer: UHCCP DNSP |
$707.38
|
| Rate for Payer: UHCCP Medicaid |
$454.76
|
|
|
PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$748.00
|
|
|
Service Code
|
HCPCS 50551
|
| Min. Negotiated Rate |
$165.50 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Aetna Commercial |
$345.49
|
| Rate for Payer: Aetna Medicare |
$257.83
|
| Rate for Payer: BCBS Complete |
$173.78
|
| Rate for Payer: BCBS MAPPO |
$257.83
|
| Rate for Payer: BCN Commercial |
$434.24
|
| Rate for Payer: BCN Medicare Advantage |
$257.83
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cofinity Commercial |
$371.28
|
| Rate for Payer: Cofinity Commercial |
$345.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.83
|
| Rate for Payer: Healthscope Commercial |
$309.40
|
| Rate for Payer: Healthscope Whirlpool |
$309.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.72
|
| Rate for Payer: Meridian Medicaid |
$173.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.61
|
| Rate for Payer: Nomi Health Commercial |
$309.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$561.00
|
| Rate for Payer: PACE SWMI |
$257.83
|
| Rate for Payer: PHP Medicare Advantage |
$257.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$473.03
|
| Rate for Payer: Priority Health Medicare |
$257.83
|
| Rate for Payer: Priority Health Narrow Network |
$473.03
|
| Rate for Payer: Railroad Medicare Medicare |
$257.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$520.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$257.83
|
| Rate for Payer: UHC Exchange |
$520.40
|
| Rate for Payer: UHC Medicaid |
$165.50
|
| Rate for Payer: UHCCP DNSP |
$257.83
|
| Rate for Payer: UHCCP Medicaid |
$165.50
|
|
|
PR RENAL EXPLORATION NOT NECESSITATING OTH SPEC PX
|
Professional
|
Both
|
$2,589.00
|
|
|
Service Code
|
HCPCS 50010
|
| Min. Negotiated Rate |
$408.96 |
| Max. Negotiated Rate |
$1,941.75 |
| Rate for Payer: Aetna Commercial |
$845.98
|
| Rate for Payer: Aetna Medicare |
$631.33
|
| Rate for Payer: BCBS Complete |
$429.41
|
| Rate for Payer: BCBS MAPPO |
$631.33
|
| Rate for Payer: BCN Commercial |
$1,057.21
|
| Rate for Payer: BCN Medicare Advantage |
$631.33
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cash Price |
$2,071.20
|
| Rate for Payer: Cofinity Commercial |
$909.12
|
| Rate for Payer: Cofinity Commercial |
$845.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.33
|
| Rate for Payer: Healthscope Commercial |
$757.60
|
| Rate for Payer: Healthscope Whirlpool |
$757.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.90
|
| Rate for Payer: Meridian Medicaid |
$429.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.46
|
| Rate for Payer: Nomi Health Commercial |
$757.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,941.75
|
| Rate for Payer: PACE SWMI |
$631.33
|
| Rate for Payer: PHP Medicare Advantage |
$631.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,151.66
|
| Rate for Payer: Priority Health Medicare |
$631.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,151.66
|
| Rate for Payer: Railroad Medicare Medicare |
$631.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,296.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.33
|
| Rate for Payer: UHC Exchange |
$1,296.40
|
| Rate for Payer: UHC Medicaid |
$408.96
|
| Rate for Payer: UHCCP DNSP |
$631.33
|
| Rate for Payer: UHCCP Medicaid |
$408.96
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 50555
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$606.00 |
| Rate for Payer: Aetna Commercial |
$399.64
|
| Rate for Payer: Aetna Medicare |
$298.24
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS MAPPO |
$298.24
|
| Rate for Payer: BCN Commercial |
$504.45
|
| Rate for Payer: BCN Medicare Advantage |
$298.24
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$429.47
|
| Rate for Payer: Cofinity Commercial |
$399.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.24
|
| Rate for Payer: Healthscope Commercial |
$357.89
|
| Rate for Payer: Healthscope Whirlpool |
$357.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.15
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$328.06
|
| Rate for Payer: Nomi Health Commercial |
$357.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.00
|
| Rate for Payer: PACE SWMI |
$298.24
|
| Rate for Payer: PHP Medicare Advantage |
$298.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$549.52
|
| Rate for Payer: Priority Health Medicare |
$298.24
|
| Rate for Payer: Priority Health Narrow Network |
$549.52
|
| Rate for Payer: Railroad Medicare Medicare |
$298.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$298.24
|
| Rate for Payer: UHC Exchange |
$605.35
|
| Rate for Payer: UHC Medicaid |
$191.27
|
| Rate for Payer: UHCCP DNSP |
$298.24
|
| Rate for Payer: UHCCP Medicaid |
$191.27
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI
|
Professional
|
Both
|
$856.00
|
|
|
Service Code
|
HCPCS 50557
|
| Min. Negotiated Rate |
$193.62 |
| Max. Negotiated Rate |
$642.00 |
| Rate for Payer: Aetna Commercial |
$404.55
|
| Rate for Payer: Aetna Medicare |
$301.90
|
| Rate for Payer: BCBS Complete |
$203.30
|
| Rate for Payer: BCBS MAPPO |
$301.90
|
| Rate for Payer: BCN Commercial |
$510.44
|
| Rate for Payer: BCN Medicare Advantage |
$301.90
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$434.74
|
| Rate for Payer: Cofinity Commercial |
$404.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.90
|
| Rate for Payer: Healthscope Commercial |
$362.28
|
| Rate for Payer: Healthscope Whirlpool |
$362.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.00
|
| Rate for Payer: Meridian Medicaid |
$203.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.09
|
| Rate for Payer: Nomi Health Commercial |
$362.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$642.00
|
| Rate for Payer: PACE SWMI |
$301.90
|
| Rate for Payer: PHP Medicare Advantage |
$301.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$556.02
|
| Rate for Payer: Priority Health Medicare |
$301.90
|
| Rate for Payer: Priority Health Narrow Network |
$556.02
|
| Rate for Payer: Railroad Medicare Medicare |
$301.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$613.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$301.90
|
| Rate for Payer: UHC Exchange |
$613.35
|
| Rate for Payer: UHC Medicaid |
$193.62
|
| Rate for Payer: UHCCP DNSP |
$301.90
|
| Rate for Payer: UHCCP Medicaid |
$193.62
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 50561
|
| Min. Negotiated Rate |
$220.88 |
| Max. Negotiated Rate |
$701.25 |
| Rate for Payer: Aetna Commercial |
$461.80
|
| Rate for Payer: Aetna Medicare |
$344.63
|
| Rate for Payer: BCBS Complete |
$231.92
|
| Rate for Payer: BCBS MAPPO |
$344.63
|
| Rate for Payer: BCN Commercial |
$581.64
|
| Rate for Payer: BCN Medicare Advantage |
$344.63
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cofinity Commercial |
$496.27
|
| Rate for Payer: Cofinity Commercial |
$461.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.63
|
| Rate for Payer: Healthscope Commercial |
$413.56
|
| Rate for Payer: Healthscope Whirlpool |
$413.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.86
|
| Rate for Payer: Meridian Medicaid |
$231.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$379.09
|
| Rate for Payer: Nomi Health Commercial |
$413.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$701.25
|
| Rate for Payer: PACE SWMI |
$344.63
|
| Rate for Payer: PHP Medicare Advantage |
$344.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$633.60
|
| Rate for Payer: Priority Health Medicare |
$344.63
|
| Rate for Payer: Priority Health Narrow Network |
$633.60
|
| Rate for Payer: Railroad Medicare Medicare |
$344.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$697.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$344.63
|
| Rate for Payer: UHC Exchange |
$697.72
|
| Rate for Payer: UHC Medicaid |
$220.88
|
| Rate for Payer: UHCCP DNSP |
$344.63
|
| Rate for Payer: UHCCP Medicaid |
$220.88
|
|
|
PR RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA
|
Professional
|
Both
|
$748.00
|
|
|
Service Code
|
HCPCS 50553
|
| Min. Negotiated Rate |
$176.36 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Aetna Commercial |
$368.30
|
| Rate for Payer: Aetna Medicare |
$274.85
|
| Rate for Payer: BCBS Complete |
$185.18
|
| Rate for Payer: BCBS MAPPO |
$274.85
|
| Rate for Payer: BCN Commercial |
$463.62
|
| Rate for Payer: BCN Medicare Advantage |
$274.85
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cash Price |
$598.40
|
| Rate for Payer: Cofinity Commercial |
$395.78
|
| Rate for Payer: Cofinity Commercial |
$368.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.85
|
| Rate for Payer: Healthscope Commercial |
$329.82
|
| Rate for Payer: Healthscope Whirlpool |
$329.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.59
|
| Rate for Payer: Meridian Medicaid |
$185.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$302.33
|
| Rate for Payer: Nomi Health Commercial |
$329.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$561.00
|
| Rate for Payer: PACE SWMI |
$274.85
|
| Rate for Payer: PHP Medicare Advantage |
$274.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$505.04
|
| Rate for Payer: Priority Health Medicare |
$274.85
|
| Rate for Payer: Priority Health Narrow Network |
$505.04
|
| Rate for Payer: Railroad Medicare Medicare |
$274.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$554.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$274.85
|
| Rate for Payer: UHC Exchange |
$554.82
|
| Rate for Payer: UHC Medicaid |
$176.36
|
| Rate for Payer: UHCCP DNSP |
$274.85
|
| Rate for Payer: UHCCP Medicaid |
$176.36
|
|
|
PR RENAL NDSC NEPHROTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$983.00
|
|
|
Service Code
|
HCPCS 50570
|
| Min. Negotiated Rate |
$274.34 |
| Max. Negotiated Rate |
$871.37 |
| Rate for Payer: Aetna Commercial |
$574.19
|
| Rate for Payer: Aetna Medicare |
$428.50
|
| Rate for Payer: BCBS Complete |
$288.06
|
| Rate for Payer: BCBS MAPPO |
$428.50
|
| Rate for Payer: BCN Commercial |
$724.06
|
| Rate for Payer: BCN Medicare Advantage |
$428.50
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cofinity Commercial |
$617.04
|
| Rate for Payer: Cofinity Commercial |
$574.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.50
|
| Rate for Payer: Healthscope Commercial |
$514.20
|
| Rate for Payer: Healthscope Whirlpool |
$514.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.93
|
| Rate for Payer: Meridian Medicaid |
$288.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$471.35
|
| Rate for Payer: Nomi Health Commercial |
$514.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$737.25
|
| Rate for Payer: PACE SWMI |
$428.50
|
| Rate for Payer: PHP Medicare Advantage |
$428.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$788.74
|
| Rate for Payer: Priority Health Medicare |
$428.50
|
| Rate for Payer: Priority Health Narrow Network |
$788.74
|
| Rate for Payer: Railroad Medicare Medicare |
$428.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$871.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$428.50
|
| Rate for Payer: UHC Exchange |
$871.37
|
| Rate for Payer: UHC Medicaid |
$274.34
|
| Rate for Payer: UHCCP DNSP |
$428.50
|
| Rate for Payer: UHCCP Medicaid |
$274.34
|
|
|
PR REOPENING RECENT LAPAROTOMY
|
Professional
|
Both
|
$2,191.00
|
|
|
Service Code
|
HCPCS 49002
|
| Min. Negotiated Rate |
$621.32 |
| Max. Negotiated Rate |
$1,906.44 |
| Rate for Payer: Aetna Commercial |
$1,300.20
|
| Rate for Payer: Aetna Medicare |
$970.30
|
| Rate for Payer: BCBS Complete |
$652.39
|
| Rate for Payer: BCBS MAPPO |
$970.30
|
| Rate for Payer: BCN Commercial |
$1,564.66
|
| Rate for Payer: BCN Medicare Advantage |
$970.30
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cofinity Commercial |
$1,397.23
|
| Rate for Payer: Cofinity Commercial |
$1,300.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$970.30
|
| Rate for Payer: Healthscope Commercial |
$1,164.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,164.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,018.82
|
| Rate for Payer: Meridian Medicaid |
$652.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,067.33
|
| Rate for Payer: Nomi Health Commercial |
$1,164.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,643.25
|
| Rate for Payer: PACE SWMI |
$970.30
|
| Rate for Payer: PHP Medicare Advantage |
$970.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,906.44
|
| Rate for Payer: Priority Health Medicare |
$970.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,906.44
|
| Rate for Payer: Railroad Medicare Medicare |
$970.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,864.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$970.30
|
| Rate for Payer: UHC Exchange |
$1,864.24
|
| Rate for Payer: UHC Medicaid |
$621.32
|
| Rate for Payer: UHCCP DNSP |
$970.30
|
| Rate for Payer: UHCCP Medicaid |
$621.32
|
|
|
PR REPAIR ANAL FISTULA W/FIBRIN GLUE
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 46706
|
| Min. Negotiated Rate |
$113.53 |
| Max. Negotiated Rate |
$334.93 |
| Rate for Payer: Aetna Commercial |
$233.07
|
| Rate for Payer: Aetna Medicare |
$173.93
|
| Rate for Payer: BCBS Complete |
$119.21
|
| Rate for Payer: BCBS MAPPO |
$173.93
|
| Rate for Payer: BCN Commercial |
$274.89
|
| Rate for Payer: BCN Medicare Advantage |
$173.93
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$250.46
|
| Rate for Payer: Cofinity Commercial |
$233.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.93
|
| Rate for Payer: Healthscope Commercial |
$208.72
|
| Rate for Payer: Healthscope Whirlpool |
$208.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.63
|
| Rate for Payer: Meridian Medicaid |
$119.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$191.32
|
| Rate for Payer: Nomi Health Commercial |
$208.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$263.25
|
| Rate for Payer: PACE SWMI |
$173.93
|
| Rate for Payer: PHP Medicare Advantage |
$173.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$334.93
|
| Rate for Payer: Priority Health Medicare |
$173.93
|
| Rate for Payer: Priority Health Narrow Network |
$334.93
|
| Rate for Payer: Railroad Medicare Medicare |
$173.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$311.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$173.93
|
| Rate for Payer: UHC Exchange |
$311.53
|
| Rate for Payer: UHC Medicaid |
$113.53
|
| Rate for Payer: UHCCP DNSP |
$173.93
|
| Rate for Payer: UHCCP Medicaid |
$113.53
|
|
|
PR REPAIR ANORECTAL FISTULA PLUG
|
Professional
|
Both
|
$1,068.00
|
|
|
Service Code
|
HCPCS 46707
|
| Min. Negotiated Rate |
$327.38 |
| Max. Negotiated Rate |
$936.83 |
| Rate for Payer: Aetna Commercial |
$668.38
|
| Rate for Payer: Aetna Medicare |
$498.79
|
| Rate for Payer: BCBS Complete |
$343.75
|
| Rate for Payer: BCBS MAPPO |
$498.79
|
| Rate for Payer: BCN Commercial |
$768.88
|
| Rate for Payer: BCN Medicare Advantage |
$498.79
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$668.38
|
| Rate for Payer: Cofinity Commercial |
$718.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.79
|
| Rate for Payer: Healthscope Commercial |
$598.55
|
| Rate for Payer: Healthscope Whirlpool |
$598.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.73
|
| Rate for Payer: Meridian Medicaid |
$343.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$548.67
|
| Rate for Payer: Nomi Health Commercial |
$598.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.00
|
| Rate for Payer: PACE SWMI |
$498.79
|
| Rate for Payer: PHP Medicare Advantage |
$498.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$936.83
|
| Rate for Payer: Priority Health Medicare |
$498.79
|
| Rate for Payer: Priority Health Narrow Network |
$936.83
|
| Rate for Payer: Railroad Medicare Medicare |
$498.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$870.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$498.79
|
| Rate for Payer: UHC Exchange |
$870.31
|
| Rate for Payer: UHC Medicaid |
$327.38
|
| Rate for Payer: UHCCP DNSP |
$498.79
|
| Rate for Payer: UHCCP Medicaid |
$327.38
|
|
|
PR REPAIR BIFID EARLOBES - BILATERAL
|
Professional
|
Both
|
$1,391.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$556.40 |
| Max. Negotiated Rate |
$1,043.25 |
| Rate for Payer: BCBS Complete |
$556.40
|
| Rate for Payer: Cash Price |
$1,112.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,043.25
|
|
|
PR REPAIR BIFID EARLOBES - UNILATERAL
|
Professional
|
Both
|
$901.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$360.40 |
| Max. Negotiated Rate |
$675.75 |
| Rate for Payer: BCBS Complete |
$360.40
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$675.75
|
|
|
PR REPAIR BLOOD VESSEL DIRECT HAND FINGER
|
Professional
|
Both
|
$1,394.00
|
|
|
Service Code
|
HCPCS 35207
|
| Min. Negotiated Rate |
$435.80 |
| Max. Negotiated Rate |
$1,319.02 |
| Rate for Payer: Aetna Commercial |
$897.53
|
| Rate for Payer: Aetna Medicare |
$669.80
|
| Rate for Payer: BCBS Complete |
$457.59
|
| Rate for Payer: BCBS MAPPO |
$669.80
|
| Rate for Payer: BCN Commercial |
$1,144.86
|
| Rate for Payer: BCN Medicare Advantage |
$669.80
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Cofinity Commercial |
$897.53
|
| Rate for Payer: Cofinity Commercial |
$964.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$669.80
|
| Rate for Payer: Healthscope Commercial |
$803.76
|
| Rate for Payer: Healthscope Whirlpool |
$803.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.29
|
| Rate for Payer: Meridian Medicaid |
$457.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$736.78
|
| Rate for Payer: Nomi Health Commercial |
$803.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,045.50
|
| Rate for Payer: PACE SWMI |
$669.80
|
| Rate for Payer: PHP Medicare Advantage |
$669.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,231.16
|
| Rate for Payer: Priority Health Medicare |
$669.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.16
|
| Rate for Payer: Railroad Medicare Medicare |
$669.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,319.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$669.80
|
| Rate for Payer: UHC Exchange |
$1,319.02
|
| Rate for Payer: UHC Medicaid |
$435.80
|
| Rate for Payer: UHCCP DNSP |
$669.80
|
| Rate for Payer: UHCCP Medicaid |
$435.80
|
|
|
PR REPAIR BLOOD VESSEL DIRECT INTRA-ABDOMINAL
|
Professional
|
Both
|
$5,204.00
|
|
|
Service Code
|
HCPCS 35221
|
| Min. Negotiated Rate |
$853.49 |
| Max. Negotiated Rate |
$3,903.00 |
| Rate for Payer: Aetna Commercial |
$1,801.67
|
| Rate for Payer: Aetna Medicare |
$1,344.53
|
| Rate for Payer: BCBS Complete |
$896.16
|
| Rate for Payer: BCBS MAPPO |
$1,344.53
|
| Rate for Payer: BCN Commercial |
$2,165.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,344.53
|
| Rate for Payer: Cash Price |
$4,163.20
|
| Rate for Payer: Cash Price |
$4,163.20
|
| Rate for Payer: Cofinity Commercial |
$1,936.12
|
| Rate for Payer: Cofinity Commercial |
$1,801.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,344.53
|
| Rate for Payer: Healthscope Commercial |
$1,613.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,613.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,411.76
|
| Rate for Payer: Meridian Medicaid |
$896.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,478.98
|
| Rate for Payer: Nomi Health Commercial |
$1,613.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,903.00
|
| Rate for Payer: PACE SWMI |
$1,344.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,344.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$853.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,328.96
|
| Rate for Payer: Priority Health Medicare |
$1,344.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,328.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,344.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,624.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,344.53
|
| Rate for Payer: UHC Exchange |
$2,624.91
|
| Rate for Payer: UHC Medicaid |
$853.49
|
| Rate for Payer: UHCCP DNSP |
$1,344.53
|
| Rate for Payer: UHCCP Medicaid |
$853.49
|
|
|
PR REPAIR BLOOD VESSEL DIRECT LOWER EXTREMITY
|
Professional
|
Both
|
$2,740.00
|
|
|
Service Code
|
HCPCS 35226
|
| Min. Negotiated Rate |
$482.45 |
| Max. Negotiated Rate |
$2,055.00 |
| Rate for Payer: Aetna Commercial |
$1,019.90
|
| Rate for Payer: Aetna Medicare |
$761.12
|
| Rate for Payer: BCBS Complete |
$506.57
|
| Rate for Payer: BCBS MAPPO |
$761.12
|
| Rate for Payer: BCN Commercial |
$1,214.57
|
| Rate for Payer: BCN Medicare Advantage |
$761.12
|
| Rate for Payer: Cash Price |
$2,192.00
|
| Rate for Payer: Cash Price |
$2,192.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.01
|
| Rate for Payer: Cofinity Commercial |
$1,019.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.12
|
| Rate for Payer: Healthscope Commercial |
$913.34
|
| Rate for Payer: Healthscope Whirlpool |
$913.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.18
|
| Rate for Payer: Meridian Medicaid |
$506.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$837.23
|
| Rate for Payer: Nomi Health Commercial |
$913.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,055.00
|
| Rate for Payer: PACE SWMI |
$761.12
|
| Rate for Payer: PHP Medicare Advantage |
$761.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,306.12
|
| Rate for Payer: Priority Health Medicare |
$761.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,306.12
|
| Rate for Payer: Railroad Medicare Medicare |
$761.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,489.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$761.12
|
| Rate for Payer: UHC Exchange |
$1,489.21
|
| Rate for Payer: UHC Medicaid |
$482.45
|
| Rate for Payer: UHCCP DNSP |
$761.12
|
| Rate for Payer: UHCCP Medicaid |
$482.45
|
|
|
PR REPAIR BLOOD VESSEL DIRECT NECK
|
Professional
|
Both
|
$4,367.00
|
|
|
Service Code
|
HCPCS 35201
|
| Min. Negotiated Rate |
$539.32 |
| Max. Negotiated Rate |
$3,275.25 |
| Rate for Payer: Aetna Commercial |
$1,137.81
|
| Rate for Payer: Aetna Medicare |
$849.11
|
| Rate for Payer: BCBS Complete |
$566.29
|
| Rate for Payer: BCBS MAPPO |
$849.11
|
| Rate for Payer: BCN Commercial |
$1,365.46
|
| Rate for Payer: BCN Medicare Advantage |
$849.11
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,222.72
|
| Rate for Payer: Cofinity Commercial |
$1,137.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.11
|
| Rate for Payer: Healthscope Commercial |
$1,018.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.57
|
| Rate for Payer: Meridian Medicaid |
$566.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$934.02
|
| Rate for Payer: Nomi Health Commercial |
$1,018.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,275.25
|
| Rate for Payer: PACE SWMI |
$849.11
|
| Rate for Payer: PHP Medicare Advantage |
$849.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,468.38
|
| Rate for Payer: Priority Health Medicare |
$849.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,468.38
|
| Rate for Payer: Railroad Medicare Medicare |
$849.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,681.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$849.11
|
| Rate for Payer: UHC Exchange |
$1,681.59
|
| Rate for Payer: UHC Medicaid |
$539.32
|
| Rate for Payer: UHCCP DNSP |
$849.11
|
| Rate for Payer: UHCCP Medicaid |
$539.32
|
|
|
PR REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY
|
Professional
|
Both
|
$2,874.00
|
|
|
Service Code
|
HCPCS 35206
|
| Min. Negotiated Rate |
$461.78 |
| Max. Negotiated Rate |
$2,155.50 |
| Rate for Payer: Aetna Commercial |
$968.70
|
| Rate for Payer: Aetna Medicare |
$722.91
|
| Rate for Payer: BCBS Complete |
$484.87
|
| Rate for Payer: BCBS MAPPO |
$722.91
|
| Rate for Payer: BCN Commercial |
$1,177.23
|
| Rate for Payer: BCN Medicare Advantage |
$722.91
|
| Rate for Payer: Cash Price |
$2,299.20
|
| Rate for Payer: Cash Price |
$2,299.20
|
| Rate for Payer: Cofinity Commercial |
$968.70
|
| Rate for Payer: Cofinity Commercial |
$1,040.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.91
|
| Rate for Payer: Healthscope Commercial |
$867.49
|
| Rate for Payer: Healthscope Whirlpool |
$867.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$759.06
|
| Rate for Payer: Meridian Medicaid |
$484.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$795.20
|
| Rate for Payer: Nomi Health Commercial |
$867.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,155.50
|
| Rate for Payer: PACE SWMI |
$722.91
|
| Rate for Payer: PHP Medicare Advantage |
$722.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,265.96
|
| Rate for Payer: Priority Health Medicare |
$722.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,265.96
|
| Rate for Payer: Railroad Medicare Medicare |
$722.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,393.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$722.91
|
| Rate for Payer: UHC Exchange |
$1,393.48
|
| Rate for Payer: UHC Medicaid |
$461.78
|
| Rate for Payer: UHCCP DNSP |
$722.91
|
| Rate for Payer: UHCCP Medicaid |
$461.78
|
|
|
PR REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL
|
Professional
|
Both
|
$3,954.00
|
|
|
Service Code
|
HCPCS 35251
|
| Min. Negotiated Rate |
$998.33 |
| Max. Negotiated Rate |
$3,123.02 |
| Rate for Payer: Aetna Commercial |
$2,112.30
|
| Rate for Payer: Aetna Medicare |
$1,576.34
|
| Rate for Payer: BCBS Complete |
$1,048.25
|
| Rate for Payer: BCBS MAPPO |
$1,576.34
|
| Rate for Payer: BCN Commercial |
$2,542.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,576.34
|
| Rate for Payer: Cash Price |
$3,163.20
|
| Rate for Payer: Cash Price |
$3,163.20
|
| Rate for Payer: Cofinity Commercial |
$2,269.93
|
| Rate for Payer: Cofinity Commercial |
$2,112.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,576.34
|
| Rate for Payer: Healthscope Commercial |
$1,891.61
|
| Rate for Payer: Healthscope Whirlpool |
$1,891.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,655.16
|
| Rate for Payer: Meridian Medicaid |
$1,048.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,733.97
|
| Rate for Payer: Nomi Health Commercial |
$1,891.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,965.50
|
| Rate for Payer: PACE SWMI |
$1,576.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,576.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$998.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,733.81
|
| Rate for Payer: Priority Health Medicare |
$1,576.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,733.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,576.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,123.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,576.34
|
| Rate for Payer: UHC Exchange |
$3,123.02
|
| Rate for Payer: UHC Medicaid |
$998.33
|
| Rate for Payer: UHCCP DNSP |
$1,576.34
|
| Rate for Payer: UHCCP Medicaid |
$998.33
|
|
|
PR REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY
|
Professional
|
Both
|
$4,712.00
|
|
|
Service Code
|
HCPCS 35256
|
| Min. Negotiated Rate |
$591.50 |
| Max. Negotiated Rate |
$3,534.00 |
| Rate for Payer: Aetna Commercial |
$1,250.82
|
| Rate for Payer: Aetna Medicare |
$933.45
|
| Rate for Payer: BCBS Complete |
$621.08
|
| Rate for Payer: BCBS MAPPO |
$933.45
|
| Rate for Payer: BCN Commercial |
$1,494.94
|
| Rate for Payer: BCN Medicare Advantage |
$933.45
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cash Price |
$3,769.60
|
| Rate for Payer: Cofinity Commercial |
$1,344.17
|
| Rate for Payer: Cofinity Commercial |
$1,250.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.45
|
| Rate for Payer: Healthscope Commercial |
$1,120.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,120.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.12
|
| Rate for Payer: Meridian Medicaid |
$621.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,026.80
|
| Rate for Payer: Nomi Health Commercial |
$1,120.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,534.00
|
| Rate for Payer: PACE SWMI |
$933.45
|
| Rate for Payer: PHP Medicare Advantage |
$933.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,607.61
|
| Rate for Payer: Priority Health Medicare |
$933.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,607.61
|
| Rate for Payer: Railroad Medicare Medicare |
$933.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,836.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$933.45
|
| Rate for Payer: UHC Exchange |
$1,836.36
|
| Rate for Payer: UHC Medicaid |
$591.50
|
| Rate for Payer: UHCCP DNSP |
$933.45
|
| Rate for Payer: UHCCP Medicaid |
$591.50
|
|
