|
PR PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT
|
Professional
|
Both
|
$1,650.00
|
|
|
Service Code
|
HCPCS 26676
|
| Min. Negotiated Rate |
$65.37 |
| Max. Negotiated Rate |
$1,072.50 |
| Rate for Payer: Aetna Commercial |
$675.35
|
| Rate for Payer: Aetna Medicare |
$825.00
|
| Rate for Payer: BCBS Complete |
$354.71
|
| Rate for Payer: BCBS Trust/PPO |
$65.37
|
| Rate for Payer: BCN Commercial |
$758.92
|
| Rate for Payer: Cash Price |
$1,320.00
|
| Rate for Payer: Cash Price |
$1,320.00
|
| Rate for Payer: Meridian Medicaid |
$354.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,072.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$799.43
|
| Rate for Payer: Priority Health Narrow Network |
$799.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$554.41
|
| Rate for Payer: UHC Exchange |
$554.41
|
| Rate for Payer: UHCCP Medicaid |
$337.82
|
|
|
PR PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA
|
Professional
|
Both
|
$1,100.00
|
|
|
Service Code
|
HCPCS 26756
|
| Min. Negotiated Rate |
$280.95 |
| Max. Negotiated Rate |
$715.00 |
| Rate for Payer: Aetna Commercial |
$560.82
|
| Rate for Payer: Aetna Medicare |
$550.00
|
| Rate for Payer: BCBS Complete |
$295.00
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$633.33
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Meridian Medicaid |
$295.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$280.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$715.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$666.61
|
| Rate for Payer: Priority Health Narrow Network |
$666.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.76
|
| Rate for Payer: UHC Exchange |
$458.76
|
| Rate for Payer: UHCCP Medicaid |
$280.95
|
|
|
PR PRQ SKEL FIXJ FEMORAL FX PROX END NECK
|
Professional
|
Both
|
$3,359.00
|
|
|
Service Code
|
HCPCS 27235
|
| Min. Negotiated Rate |
$588.95 |
| Max. Negotiated Rate |
$2,183.35 |
| Rate for Payer: Aetna Commercial |
$1,211.46
|
| Rate for Payer: Aetna Medicare |
$1,679.50
|
| Rate for Payer: BCBS Complete |
$618.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.62
|
| Rate for Payer: BCN Commercial |
$1,463.55
|
| Rate for Payer: Cash Price |
$2,687.20
|
| Rate for Payer: Cash Price |
$2,687.20
|
| Rate for Payer: Meridian Medicaid |
$618.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$588.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,395.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,395.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,047.97
|
| Rate for Payer: UHC Exchange |
$1,047.97
|
| Rate for Payer: UHCCP Medicaid |
$588.95
|
|
|
PR PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 28496
|
| Min. Negotiated Rate |
$181.90 |
| Max. Negotiated Rate |
$729.30 |
| Rate for Payer: Aetna Commercial |
$319.73
|
| Rate for Payer: Aetna Medicare |
$561.00
|
| Rate for Payer: BCBS Complete |
$191.00
|
| Rate for Payer: BCBS Trust/PPO |
$690.49
|
| Rate for Payer: BCN Commercial |
$667.05
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Meridian Medicaid |
$191.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.96
|
| Rate for Payer: Priority Health Narrow Network |
$428.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.15
|
| Rate for Payer: UHC Exchange |
$254.15
|
| Rate for Payer: UHCCP Medicaid |
$181.90
|
|
|
PR PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ
|
Professional
|
Both
|
$2,375.00
|
|
|
Service Code
|
HCPCS 24582
|
| Min. Negotiated Rate |
$473.89 |
| Max. Negotiated Rate |
$1,543.75 |
| Rate for Payer: Aetna Commercial |
$1,082.70
|
| Rate for Payer: Aetna Medicare |
$1,187.50
|
| Rate for Payer: BCBS Complete |
$562.93
|
| Rate for Payer: BCBS Trust/PPO |
$473.89
|
| Rate for Payer: BCN Commercial |
$1,205.57
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Meridian Medicaid |
$562.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,543.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,268.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,268.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$897.05
|
| Rate for Payer: UHC Exchange |
$897.05
|
| Rate for Payer: UHCCP Medicaid |
$536.12
|
|
|
PR PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ
|
Professional
|
Both
|
$1,886.00
|
|
|
Service Code
|
HCPCS 24566
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$1,225.90 |
| Rate for Payer: Aetna Commercial |
$959.55
|
| Rate for Payer: Aetna Medicare |
$943.00
|
| Rate for Payer: BCBS Complete |
$497.63
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$1,064.83
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Meridian Medicaid |
$497.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,225.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,120.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,120.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$802.12
|
| Rate for Payer: UHC Exchange |
$802.12
|
| Rate for Payer: UHCCP Medicaid |
$473.93
|
|
|
PR PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 28666
|
| Min. Negotiated Rate |
$112.46 |
| Max. Negotiated Rate |
$384.15 |
| Rate for Payer: Aetna Commercial |
$229.82
|
| Rate for Payer: Aetna Medicare |
$295.50
|
| Rate for Payer: BCBS Complete |
$118.08
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$257.53
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Meridian Medicaid |
$118.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.69
|
| Rate for Payer: Priority Health Narrow Network |
$269.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.70
|
| Rate for Payer: UHC Exchange |
$228.70
|
| Rate for Payer: UHCCP Medicaid |
$112.46
|
|
|
PR PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ
|
Professional
|
Both
|
$1,389.00
|
|
|
Service Code
|
HCPCS 26776
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$902.85 |
| Rate for Payer: Aetna Commercial |
$596.33
|
| Rate for Payer: Aetna Medicare |
$694.50
|
| Rate for Payer: BCBS Complete |
$313.11
|
| Rate for Payer: BCBS Trust/PPO |
$132.60
|
| Rate for Payer: BCN Commercial |
$669.98
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Meridian Medicaid |
$313.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$705.79
|
| Rate for Payer: Priority Health Narrow Network |
$705.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.44
|
| Rate for Payer: UHC Exchange |
$487.44
|
| Rate for Payer: UHCCP Medicaid |
$298.20
|
|
|
PR PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ
|
Professional
|
Both
|
$1,375.00
|
|
|
Service Code
|
HCPCS 26706
|
| Min. Negotiated Rate |
$258.87 |
| Max. Negotiated Rate |
$893.75 |
| Rate for Payer: Aetna Commercial |
$592.71
|
| Rate for Payer: Aetna Medicare |
$687.50
|
| Rate for Payer: BCBS Complete |
$311.77
|
| Rate for Payer: BCBS Trust/PPO |
$258.87
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: Cash Price |
$1,100.00
|
| Rate for Payer: Cash Price |
$1,100.00
|
| Rate for Payer: Meridian Medicaid |
$311.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$893.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$701.21
|
| Rate for Payer: Priority Health Narrow Network |
$701.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$483.89
|
| Rate for Payer: UHC Exchange |
$483.89
|
| Rate for Payer: UHCCP Medicaid |
$296.92
|
|
|
PR PRQ SKEL FIXJ METAR FX W/MANJ
|
Professional
|
Both
|
$1,077.00
|
|
|
Service Code
|
HCPCS 28476
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$700.05 |
| Rate for Payer: Aetna Commercial |
$503.59
|
| Rate for Payer: Aetna Medicare |
$538.50
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS Trust/PPO |
$394.11
|
| Rate for Payer: BCN Commercial |
$575.66
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Cash Price |
$861.60
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.00
|
| Rate for Payer: Priority Health Narrow Network |
$603.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.62
|
| Rate for Payer: UHC Exchange |
$377.62
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
|
|
PR PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 28636
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$456.42 |
| Rate for Payer: Aetna Commercial |
$263.14
|
| Rate for Payer: Aetna Medicare |
$328.50
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$456.42
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.03
|
| Rate for Payer: Priority Health Narrow Network |
$346.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.26
|
| Rate for Payer: UHC Exchange |
$229.26
|
| Rate for Payer: UHCCP Medicaid |
$146.76
|
|
|
PR PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 26727
|
| Min. Negotiated Rate |
$314.18 |
| Max. Negotiated Rate |
$1,001.00 |
| Rate for Payer: Aetna Commercial |
$629.68
|
| Rate for Payer: Aetna Medicare |
$770.00
|
| Rate for Payer: BCBS Complete |
$329.89
|
| Rate for Payer: BCBS Trust/PPO |
$765.51
|
| Rate for Payer: BCN Commercial |
$706.14
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Meridian Medicaid |
$329.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.47
|
| Rate for Payer: Priority Health Narrow Network |
$744.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$519.98
|
| Rate for Payer: UHC Exchange |
$519.98
|
| Rate for Payer: UHCCP Medicaid |
$314.18
|
|
|
PR PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX
|
Professional
|
Both
|
$2,577.00
|
|
|
Service Code
|
HCPCS 24538
|
| Min. Negotiated Rate |
$514.61 |
| Max. Negotiated Rate |
$1,675.05 |
| Rate for Payer: Aetna Commercial |
$1,038.87
|
| Rate for Payer: Aetna Medicare |
$1,288.50
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCBS Trust/PPO |
$660.38
|
| Rate for Payer: BCN Commercial |
$1,167.45
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Meridian Medicaid |
$540.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,675.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,223.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$843.37
|
| Rate for Payer: UHC Exchange |
$843.37
|
| Rate for Payer: UHCCP Medicaid |
$514.61
|
|
|
PR PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ
|
Professional
|
Both
|
$978.00
|
|
|
Service Code
|
HCPCS 28576
|
| Min. Negotiated Rate |
$258.80 |
| Max. Negotiated Rate |
$1,476.60 |
| Rate for Payer: Aetna Commercial |
$511.48
|
| Rate for Payer: Aetna Medicare |
$489.00
|
| Rate for Payer: BCBS Complete |
$271.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.60
|
| Rate for Payer: BCN Commercial |
$572.73
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Meridian Medicaid |
$271.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$635.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$608.60
|
| Rate for Payer: Priority Health Narrow Network |
$608.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$415.22
|
| Rate for Payer: UHC Exchange |
$415.22
|
| Rate for Payer: UHCCP Medicaid |
$258.80
|
|
|
PR PRQ SKEL FIXJ TARS JT DISLC W/MANJ
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 28606
|
| Min. Negotiated Rate |
$261.99 |
| Max. Negotiated Rate |
$2,188.75 |
| Rate for Payer: Aetna Commercial |
$504.07
|
| Rate for Payer: Aetna Medicare |
$673.00
|
| Rate for Payer: BCBS Complete |
$275.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,188.75
|
| Rate for Payer: BCN Commercial |
$567.84
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Meridian Medicaid |
$275.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.63
|
| Rate for Payer: Priority Health Narrow Network |
$610.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$442.64
|
| Rate for Payer: UHC Exchange |
$442.64
|
| Rate for Payer: UHCCP Medicaid |
$261.99
|
|
|
PR PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ
|
Professional
|
Both
|
$798.00
|
|
|
Service Code
|
HCPCS 28546
|
| Min. Negotiated Rate |
$234.30 |
| Max. Negotiated Rate |
$938.26 |
| Rate for Payer: Aetna Commercial |
$459.30
|
| Rate for Payer: Aetna Medicare |
$399.00
|
| Rate for Payer: BCBS Complete |
$246.02
|
| Rate for Payer: BCBS Trust/PPO |
$938.26
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Meridian Medicaid |
$246.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.64
|
| Rate for Payer: Priority Health Narrow Network |
$553.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$349.30
|
| Rate for Payer: UHC Exchange |
$349.30
|
| Rate for Payer: UHCCP Medicaid |
$234.30
|
|
|
PR PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 28456
|
| Min. Negotiated Rate |
$232.00 |
| Max. Negotiated Rate |
$580.11 |
| Rate for Payer: Aetna Commercial |
$473.02
|
| Rate for Payer: Aetna Medicare |
$232.00
|
| Rate for Payer: BCBS Complete |
$256.08
|
| Rate for Payer: BCBS Trust/PPO |
$385.66
|
| Rate for Payer: BCN Commercial |
$552.21
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Meridian Medicaid |
$256.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$243.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.11
|
| Rate for Payer: Priority Health Narrow Network |
$580.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.14
|
| Rate for Payer: UHC Exchange |
$321.14
|
| Rate for Payer: UHCCP Medicaid |
$243.89
|
|
|
PR PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT
|
Professional
|
Both
|
$2,053.00
|
|
|
Service Code
|
HCPCS 93580
|
| Min. Negotiated Rate |
$222.94 |
| Max. Negotiated Rate |
$1,387.84 |
| Rate for Payer: Aetna Commercial |
$1,305.02
|
| Rate for Payer: Aetna Medicare |
$1,026.50
|
| Rate for Payer: BCBS Complete |
$638.53
|
| Rate for Payer: BCBS Trust/PPO |
$222.94
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Meridian Medicaid |
$638.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$608.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,342.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,342.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,346.69
|
| Rate for Payer: UHC Exchange |
$1,346.69
|
| Rate for Payer: UHCCP Medicaid |
$608.12
|
|
|
PR PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 37197
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$2,291.90 |
| Rate for Payer: Aetna Commercial |
$402.50
|
| Rate for Payer: Aetna Medicare |
$256.50
|
| Rate for Payer: BCBS Complete |
$196.81
|
| Rate for Payer: BCBS Trust/PPO |
$922.41
|
| Rate for Payer: BCN Commercial |
$2,291.90
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Meridian Medicaid |
$196.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.88
|
| Rate for Payer: Priority Health Narrow Network |
$465.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$414.14
|
| Rate for Payer: UHC Exchange |
$414.14
|
| Rate for Payer: UHCCP Medicaid |
$187.44
|
|
|
PR PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 92973
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$679.90 |
| Rate for Payer: Aetna Commercial |
$237.55
|
| Rate for Payer: Aetna Medicare |
$523.00
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$250.20
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$679.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.48
|
| Rate for Payer: Priority Health Narrow Network |
$242.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.98
|
| Rate for Payer: UHC Exchange |
$244.98
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
|
|
PR PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN
|
Professional
|
Both
|
$1,841.00
|
|
|
Service Code
|
HCPCS 37187
|
| Min. Negotiated Rate |
$245.59 |
| Max. Negotiated Rate |
$2,507.41 |
| Rate for Payer: Aetna Commercial |
$525.11
|
| Rate for Payer: Aetna Medicare |
$920.50
|
| Rate for Payer: BCBS Complete |
$257.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.98
|
| Rate for Payer: BCN Commercial |
$2,507.41
|
| Rate for Payer: Cash Price |
$1,472.80
|
| Rate for Payer: Cash Price |
$1,472.80
|
| Rate for Payer: Meridian Medicaid |
$257.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,196.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$608.94
|
| Rate for Payer: Priority Health Narrow Network |
$608.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$551.65
|
| Rate for Payer: UHC Exchange |
$551.65
|
| Rate for Payer: UHCCP Medicaid |
$245.59
|
|
|
PR PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH
|
Professional
|
Both
|
$2,550.00
|
|
|
Service Code
|
HCPCS 92924
|
| Min. Negotiated Rate |
$350.79 |
| Max. Negotiated Rate |
$1,657.50 |
| Rate for Payer: Aetna Commercial |
$703.51
|
| Rate for Payer: Aetna Medicare |
$1,275.00
|
| Rate for Payer: BCBS Complete |
$412.64
|
| Rate for Payer: BCBS Trust/PPO |
$350.79
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Meridian Medicaid |
$412.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.75
|
| Rate for Payer: Priority Health Narrow Network |
$867.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$878.45
|
| Rate for Payer: UHC Exchange |
$878.45
|
| Rate for Payer: UHCCP Medicaid |
$392.99
|
|
|
PR PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH
|
Professional
|
Both
|
$1,078.00
|
|
|
Service Code
|
HCPCS 92921
|
| Min. Negotiated Rate |
$203.06 |
| Max. Negotiated Rate |
$700.70 |
| Rate for Payer: Aetna Commercial |
$300.69
|
| Rate for Payer: Aetna Medicare |
$539.00
|
| Rate for Payer: BCBS Complete |
$431.20
|
| Rate for Payer: BCBS Trust/PPO |
$388.83
|
| Rate for Payer: BCN Commercial |
$203.06
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Cash Price |
$862.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.00
|
| Rate for Payer: Priority Health Narrow Network |
$249.00
|
|
|
PR PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH
|
Professional
|
Both
|
$1,119.00
|
|
|
Service Code
|
HCPCS 92920
|
| Min. Negotiated Rate |
$329.94 |
| Max. Negotiated Rate |
$3,219.99 |
| Rate for Payer: Aetna Commercial |
$590.08
|
| Rate for Payer: Aetna Medicare |
$559.50
|
| Rate for Payer: BCBS Complete |
$346.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,219.99
|
| Rate for Payer: BCN Commercial |
$752.07
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Meridian Medicaid |
$346.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.44
|
| Rate for Payer: Priority Health Narrow Network |
$727.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$738.90
|
| Rate for Payer: UHC Exchange |
$738.90
|
| Rate for Payer: UHCCP Medicaid |
$329.94
|
|
|
PR PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 92938
|
| Min. Negotiated Rate |
$112.40 |
| Max. Negotiated Rate |
$316.80 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: Aetna Medicare |
$140.50
|
| Rate for Payer: BCBS Complete |
$112.40
|
| Rate for Payer: BCBS Trust/PPO |
$151.09
|
| Rate for Payer: BCN Commercial |
$226.15
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.00
|
| Rate for Payer: Priority Health Narrow Network |
$249.00
|
|
