|
PR REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC
|
Professional
|
Both
|
$4,265.00
|
|
|
Service Code
|
HCPCS 21743
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$3,198.75 |
| Rate for Payer: Aetna Commercial |
$2,118.84
|
| Rate for Payer: BCBS Complete |
$442.38
|
| Rate for Payer: BCN Commercial |
$3,033.71
|
| Rate for Payer: Cash Price |
$3,412.00
|
| Rate for Payer: Cash Price |
$3,412.00
|
| Rate for Payer: Meridian Medicaid |
$442.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,198.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,544.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,544.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,771.23
|
| Rate for Payer: UHC Exchange |
$2,771.23
|
| Rate for Payer: UHC Medicaid |
$421.31
|
| Rate for Payer: UHCCP Medicaid |
$421.31
|
|
|
PR REPAIR PECTUS EXCAVATUM/CARINATUM OPEN
|
Professional
|
Both
|
$4,265.00
|
|
|
Service Code
|
HCPCS 21740
|
| Min. Negotiated Rate |
$631.12 |
| Max. Negotiated Rate |
$3,198.75 |
| Rate for Payer: Aetna Commercial |
$1,319.15
|
| Rate for Payer: Aetna Medicare |
$984.44
|
| Rate for Payer: BCBS Complete |
$662.68
|
| Rate for Payer: BCBS MAPPO |
$984.44
|
| Rate for Payer: BCN Commercial |
$1,530.30
|
| Rate for Payer: BCN Medicare Advantage |
$984.44
|
| Rate for Payer: Cash Price |
$3,412.00
|
| Rate for Payer: Cash Price |
$3,412.00
|
| Rate for Payer: Cofinity Commercial |
$1,417.59
|
| Rate for Payer: Cofinity Commercial |
$1,319.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$984.44
|
| Rate for Payer: Healthscope Commercial |
$1,181.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,181.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,033.66
|
| Rate for Payer: Meridian Medicaid |
$662.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,082.88
|
| Rate for Payer: Nomi Health Commercial |
$1,181.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,198.75
|
| Rate for Payer: PACE SWMI |
$984.44
|
| Rate for Payer: PHP Medicare Advantage |
$984.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$631.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,635.85
|
| Rate for Payer: Priority Health Medicare |
$984.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,635.85
|
| Rate for Payer: Railroad Medicare Medicare |
$984.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,825.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$984.44
|
| Rate for Payer: UHC Exchange |
$1,825.42
|
| Rate for Payer: UHC Medicaid |
$631.12
|
| Rate for Payer: UHCCP DNSP |
$984.44
|
| Rate for Payer: UHCCP Medicaid |
$631.12
|
|
|
PR REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON
|
Professional
|
Both
|
$2,680.00
|
|
|
Service Code
|
HCPCS 27650
|
| Min. Negotiated Rate |
$398.10 |
| Max. Negotiated Rate |
$2,010.00 |
| Rate for Payer: Aetna Commercial |
$812.72
|
| Rate for Payer: Aetna Medicare |
$606.51
|
| Rate for Payer: BCBS Complete |
$418.00
|
| Rate for Payer: BCBS MAPPO |
$606.51
|
| Rate for Payer: BCN Commercial |
$1,102.89
|
| Rate for Payer: BCN Medicare Advantage |
$606.51
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cash Price |
$2,144.00
|
| Rate for Payer: Cofinity Commercial |
$873.37
|
| Rate for Payer: Cofinity Commercial |
$812.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.51
|
| Rate for Payer: Healthscope Commercial |
$727.81
|
| Rate for Payer: Healthscope Whirlpool |
$727.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.84
|
| Rate for Payer: Meridian Medicaid |
$418.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$667.16
|
| Rate for Payer: Nomi Health Commercial |
$727.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,010.00
|
| Rate for Payer: PACE SWMI |
$606.51
|
| Rate for Payer: PHP Medicare Advantage |
$606.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,073.18
|
| Rate for Payer: Priority Health Medicare |
$606.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,073.18
|
| Rate for Payer: Railroad Medicare Medicare |
$606.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,145.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$606.51
|
| Rate for Payer: UHC Exchange |
$1,145.42
|
| Rate for Payer: UHC Medicaid |
$398.10
|
| Rate for Payer: UHCCP DNSP |
$606.51
|
| Rate for Payer: UHCCP Medicaid |
$398.10
|
|
|
PR REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT
|
Professional
|
Both
|
$1,868.00
|
|
|
Service Code
|
HCPCS 27407
|
| Min. Negotiated Rate |
$477.12 |
| Max. Negotiated Rate |
$1,401.00 |
| Rate for Payer: Aetna Commercial |
$978.29
|
| Rate for Payer: Aetna Medicare |
$730.07
|
| Rate for Payer: BCBS Complete |
$500.98
|
| Rate for Payer: BCBS MAPPO |
$730.07
|
| Rate for Payer: BCN Commercial |
$1,218.06
|
| Rate for Payer: BCN Medicare Advantage |
$730.07
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cash Price |
$1,494.40
|
| Rate for Payer: Cofinity Commercial |
$978.29
|
| Rate for Payer: Cofinity Commercial |
$1,051.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$730.07
|
| Rate for Payer: Healthscope Commercial |
$876.08
|
| Rate for Payer: Healthscope Whirlpool |
$876.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$766.57
|
| Rate for Payer: Meridian Medicaid |
$500.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$803.08
|
| Rate for Payer: Nomi Health Commercial |
$876.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,401.00
|
| Rate for Payer: PACE SWMI |
$730.07
|
| Rate for Payer: PHP Medicare Advantage |
$730.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,302.08
|
| Rate for Payer: Priority Health Medicare |
$730.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,302.08
|
| Rate for Payer: Railroad Medicare Medicare |
$730.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,387.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$730.07
|
| Rate for Payer: UHC Exchange |
$1,387.98
|
| Rate for Payer: UHC Medicaid |
$477.12
|
| Rate for Payer: UHCCP DNSP |
$730.07
|
| Rate for Payer: UHCCP Medicaid |
$477.12
|
|
|
PR REPAIR RECTOCELE SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 45560
|
| Min. Negotiated Rate |
$404.06 |
| Max. Negotiated Rate |
$1,265.08 |
| Rate for Payer: Aetna Commercial |
$837.39
|
| Rate for Payer: Aetna Medicare |
$624.92
|
| Rate for Payer: BCBS Complete |
$424.26
|
| Rate for Payer: BCBS MAPPO |
$624.92
|
| Rate for Payer: BCN Commercial |
$1,038.29
|
| Rate for Payer: BCN Medicare Advantage |
$624.92
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$899.88
|
| Rate for Payer: Cofinity Commercial |
$837.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.92
|
| Rate for Payer: Healthscope Commercial |
$749.90
|
| Rate for Payer: Healthscope Whirlpool |
$749.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.17
|
| Rate for Payer: Meridian Medicaid |
$424.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.41
|
| Rate for Payer: Nomi Health Commercial |
$749.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$995.25
|
| Rate for Payer: PACE SWMI |
$624.92
|
| Rate for Payer: PHP Medicare Advantage |
$624.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,265.08
|
| Rate for Payer: Priority Health Medicare |
$624.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,265.08
|
| Rate for Payer: Railroad Medicare Medicare |
$624.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,220.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$624.92
|
| Rate for Payer: UHC Exchange |
$1,220.66
|
| Rate for Payer: UHC Medicaid |
$404.06
|
| Rate for Payer: UHCCP DNSP |
$624.92
|
| Rate for Payer: UHCCP Medicaid |
$404.06
|
|
|
PR REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT
|
Professional
|
Both
|
$2,858.00
|
|
|
Service Code
|
HCPCS 27654
|
| Min. Negotiated Rate |
$431.11 |
| Max. Negotiated Rate |
$2,143.50 |
| Rate for Payer: Aetna Commercial |
$882.73
|
| Rate for Payer: Aetna Medicare |
$658.75
|
| Rate for Payer: BCBS Complete |
$452.67
|
| Rate for Payer: BCBS MAPPO |
$658.75
|
| Rate for Payer: BCN Commercial |
$1,092.07
|
| Rate for Payer: BCN Medicare Advantage |
$658.75
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cofinity Commercial |
$948.60
|
| Rate for Payer: Cofinity Commercial |
$882.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.75
|
| Rate for Payer: Healthscope Commercial |
$790.50
|
| Rate for Payer: Healthscope Whirlpool |
$790.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.69
|
| Rate for Payer: Meridian Medicaid |
$452.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$724.62
|
| Rate for Payer: Nomi Health Commercial |
$790.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,143.50
|
| Rate for Payer: PACE SWMI |
$658.75
|
| Rate for Payer: PHP Medicare Advantage |
$658.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,167.40
|
| Rate for Payer: Priority Health Medicare |
$658.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,167.40
|
| Rate for Payer: Railroad Medicare Medicare |
$658.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,244.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$658.75
|
| Rate for Payer: UHC Exchange |
$1,244.31
|
| Rate for Payer: UHC Medicaid |
$431.11
|
| Rate for Payer: UHCCP DNSP |
$658.75
|
| Rate for Payer: UHCCP Medicaid |
$431.11
|
|
|
PR REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL
|
Professional
|
Both
|
$3,083.00
|
|
|
Service Code
|
HCPCS 27698
|
| Min. Negotiated Rate |
$380.63 |
| Max. Negotiated Rate |
$2,312.25 |
| Rate for Payer: Aetna Commercial |
$781.22
|
| Rate for Payer: Aetna Medicare |
$583.00
|
| Rate for Payer: BCBS Complete |
$399.66
|
| Rate for Payer: BCBS MAPPO |
$583.00
|
| Rate for Payer: BCN Commercial |
$970.06
|
| Rate for Payer: BCN Medicare Advantage |
$583.00
|
| Rate for Payer: Cash Price |
$2,466.40
|
| Rate for Payer: Cash Price |
$2,466.40
|
| Rate for Payer: Cofinity Commercial |
$839.52
|
| Rate for Payer: Cofinity Commercial |
$781.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.00
|
| Rate for Payer: Healthscope Commercial |
$699.60
|
| Rate for Payer: Healthscope Whirlpool |
$699.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.15
|
| Rate for Payer: Meridian Medicaid |
$399.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$641.30
|
| Rate for Payer: Nomi Health Commercial |
$699.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,312.25
|
| Rate for Payer: PACE SWMI |
$583.00
|
| Rate for Payer: PHP Medicare Advantage |
$583.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,036.97
|
| Rate for Payer: Priority Health Medicare |
$583.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,036.97
|
| Rate for Payer: Railroad Medicare Medicare |
$583.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,115.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$583.00
|
| Rate for Payer: UHC Exchange |
$1,115.44
|
| Rate for Payer: UHC Medicaid |
$380.63
|
| Rate for Payer: UHCCP DNSP |
$583.00
|
| Rate for Payer: UHCCP Medicaid |
$380.63
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE COMPLEX
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 26562
|
| Min. Negotiated Rate |
$835.17 |
| Max. Negotiated Rate |
$2,339.80 |
| Rate for Payer: Aetna Commercial |
$1,699.01
|
| Rate for Payer: Aetna Medicare |
$1,267.92
|
| Rate for Payer: BCBS Complete |
$876.93
|
| Rate for Payer: BCBS MAPPO |
$1,267.92
|
| Rate for Payer: BCN Commercial |
$2,079.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,267.92
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cofinity Commercial |
$1,825.80
|
| Rate for Payer: Cofinity Commercial |
$1,699.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,267.92
|
| Rate for Payer: Healthscope Commercial |
$1,521.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,521.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,331.32
|
| Rate for Payer: Meridian Medicaid |
$876.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,394.71
|
| Rate for Payer: Nomi Health Commercial |
$1,521.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,746.75
|
| Rate for Payer: PACE SWMI |
$1,267.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,267.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,223.00
|
| Rate for Payer: Priority Health Medicare |
$1,267.92
|
| Rate for Payer: Priority Health Narrow Network |
$2,223.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,267.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,339.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,267.92
|
| Rate for Payer: UHC Exchange |
$2,339.80
|
| Rate for Payer: UHC Medicaid |
$835.17
|
| Rate for Payer: UHCCP DNSP |
$1,267.92
|
| Rate for Payer: UHCCP Medicaid |
$835.17
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 26560
|
| Min. Negotiated Rate |
$406.83 |
| Max. Negotiated Rate |
$1,531.50 |
| Rate for Payer: Aetna Commercial |
$812.56
|
| Rate for Payer: Aetna Medicare |
$606.39
|
| Rate for Payer: BCBS Complete |
$427.17
|
| Rate for Payer: BCBS MAPPO |
$606.39
|
| Rate for Payer: BCN Commercial |
$959.61
|
| Rate for Payer: BCN Medicare Advantage |
$606.39
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cofinity Commercial |
$873.20
|
| Rate for Payer: Cofinity Commercial |
$812.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.39
|
| Rate for Payer: Healthscope Commercial |
$727.67
|
| Rate for Payer: Healthscope Whirlpool |
$727.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.71
|
| Rate for Payer: Meridian Medicaid |
$427.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$667.03
|
| Rate for Payer: Nomi Health Commercial |
$727.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: PACE SWMI |
$606.39
|
| Rate for Payer: PHP Medicare Advantage |
$606.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,025.80
|
| Rate for Payer: Priority Health Medicare |
$606.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.80
|
| Rate for Payer: Railroad Medicare Medicare |
$606.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,035.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$606.39
|
| Rate for Payer: UHC Exchange |
$1,035.56
|
| Rate for Payer: UHC Medicaid |
$406.83
|
| Rate for Payer: UHCCP DNSP |
$606.39
|
| Rate for Payer: UHCCP Medicaid |
$406.83
|
|
|
PR REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT
|
Professional
|
Both
|
$2,476.00
|
|
|
Service Code
|
HCPCS 26561
|
| Min. Negotiated Rate |
$603.43 |
| Max. Negotiated Rate |
$1,857.00 |
| Rate for Payer: Aetna Commercial |
$1,222.12
|
| Rate for Payer: Aetna Medicare |
$912.03
|
| Rate for Payer: BCBS Complete |
$633.60
|
| Rate for Payer: BCBS MAPPO |
$912.03
|
| Rate for Payer: BCN Commercial |
$1,481.99
|
| Rate for Payer: BCN Medicare Advantage |
$912.03
|
| Rate for Payer: Cash Price |
$1,980.80
|
| Rate for Payer: Cash Price |
$1,980.80
|
| Rate for Payer: Cofinity Commercial |
$1,313.32
|
| Rate for Payer: Cofinity Commercial |
$1,222.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$912.03
|
| Rate for Payer: Healthscope Commercial |
$1,094.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,094.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$957.63
|
| Rate for Payer: Meridian Medicaid |
$633.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,003.23
|
| Rate for Payer: Nomi Health Commercial |
$1,094.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,857.00
|
| Rate for Payer: PACE SWMI |
$912.03
|
| Rate for Payer: PHP Medicare Advantage |
$912.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$603.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,584.20
|
| Rate for Payer: Priority Health Medicare |
$912.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,584.20
|
| Rate for Payer: Railroad Medicare Medicare |
$912.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,653.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$912.03
|
| Rate for Payer: UHC Exchange |
$1,653.84
|
| Rate for Payer: UHC Medicaid |
$603.43
|
| Rate for Payer: UHCCP DNSP |
$912.03
|
| Rate for Payer: UHCCP Medicaid |
$603.43
|
|
|
PR REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON
|
Professional
|
Both
|
$784.00
|
|
|
Service Code
|
HCPCS 28208
|
| Min. Negotiated Rate |
$197.45 |
| Max. Negotiated Rate |
$588.00 |
| Rate for Payer: Aetna Commercial |
$401.34
|
| Rate for Payer: Aetna Medicare |
$299.51
|
| Rate for Payer: BCBS Complete |
$207.32
|
| Rate for Payer: BCBS MAPPO |
$299.51
|
| Rate for Payer: BCN Commercial |
$488.02
|
| Rate for Payer: BCN Medicare Advantage |
$299.51
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cofinity Commercial |
$431.29
|
| Rate for Payer: Cofinity Commercial |
$401.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.51
|
| Rate for Payer: Healthscope Commercial |
$359.41
|
| Rate for Payer: Healthscope Whirlpool |
$359.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.49
|
| Rate for Payer: Meridian Medicaid |
$207.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.46
|
| Rate for Payer: Nomi Health Commercial |
$359.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$588.00
|
| Rate for Payer: PACE SWMI |
$299.51
|
| Rate for Payer: PHP Medicare Advantage |
$299.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$521.69
|
| Rate for Payer: Priority Health Medicare |
$299.51
|
| Rate for Payer: Priority Health Narrow Network |
$521.69
|
| Rate for Payer: Railroad Medicare Medicare |
$299.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$550.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$299.51
|
| Rate for Payer: UHC Exchange |
$550.26
|
| Rate for Payer: UHC Medicaid |
$197.45
|
| Rate for Payer: UHCCP DNSP |
$299.51
|
| Rate for Payer: UHCCP Medicaid |
$197.45
|
|
|
PR REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA TDN/MUSC
|
Professional
|
Both
|
$2,405.00
|
|
|
Service Code
|
HCPCS 24341
|
| Min. Negotiated Rate |
$451.56 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$920.02
|
| Rate for Payer: Aetna Medicare |
$686.58
|
| Rate for Payer: BCBS Complete |
$474.14
|
| Rate for Payer: BCBS MAPPO |
$686.58
|
| Rate for Payer: BCN Commercial |
$1,148.35
|
| Rate for Payer: BCN Medicare Advantage |
$686.58
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cofinity Commercial |
$988.68
|
| Rate for Payer: Cofinity Commercial |
$920.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.58
|
| Rate for Payer: Healthscope Commercial |
$823.90
|
| Rate for Payer: Healthscope Whirlpool |
$823.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.91
|
| Rate for Payer: Meridian Medicaid |
$474.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$755.24
|
| Rate for Payer: Nomi Health Commercial |
$823.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,803.75
|
| Rate for Payer: PACE SWMI |
$686.58
|
| Rate for Payer: PHP Medicare Advantage |
$686.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,227.55
|
| Rate for Payer: Priority Health Medicare |
$686.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,227.55
|
| Rate for Payer: Railroad Medicare Medicare |
$686.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,293.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$686.58
|
| Rate for Payer: UHC Exchange |
$1,293.78
|
| Rate for Payer: UHC Medicaid |
$451.56
|
| Rate for Payer: UHCCP DNSP |
$686.58
|
| Rate for Payer: UHCCP Medicaid |
$451.56
|
|
|
PR REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH
|
Professional
|
Both
|
$2,651.00
|
|
|
Service Code
|
HCPCS 33363
|
| Min. Negotiated Rate |
$778.73 |
| Max. Negotiated Rate |
$2,448.27 |
| Rate for Payer: Aetna Commercial |
$1,648.84
|
| Rate for Payer: Aetna Medicare |
$1,230.48
|
| Rate for Payer: BCBS Complete |
$817.67
|
| Rate for Payer: BCBS MAPPO |
$1,230.48
|
| Rate for Payer: BCN Commercial |
$1,998.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,230.48
|
| Rate for Payer: Cash Price |
$2,120.80
|
| Rate for Payer: Cash Price |
$2,120.80
|
| Rate for Payer: Cofinity Commercial |
$1,771.89
|
| Rate for Payer: Cofinity Commercial |
$1,648.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,230.48
|
| Rate for Payer: Healthscope Commercial |
$1,476.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,476.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,292.00
|
| Rate for Payer: Meridian Medicaid |
$817.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,353.53
|
| Rate for Payer: Nomi Health Commercial |
$1,476.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,988.25
|
| Rate for Payer: PACE SWMI |
$1,230.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,230.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,149.03
|
| Rate for Payer: Priority Health Medicare |
$1,230.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,149.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,230.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,448.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,230.48
|
| Rate for Payer: UHC Exchange |
$2,448.27
|
| Rate for Payer: UHC Medicaid |
$778.73
|
| Rate for Payer: UHCCP DNSP |
$1,230.48
|
| Rate for Payer: UHCCP Medicaid |
$778.73
|
|
|
PR REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH
|
Professional
|
Both
|
$4,445.00
|
|
|
Service Code
|
HCPCS 33362
|
| Min. Negotiated Rate |
$749.55 |
| Max. Negotiated Rate |
$3,333.75 |
| Rate for Payer: Aetna Commercial |
$1,587.04
|
| Rate for Payer: Aetna Medicare |
$1,184.36
|
| Rate for Payer: BCBS Complete |
$787.03
|
| Rate for Payer: BCBS MAPPO |
$1,184.36
|
| Rate for Payer: BCN Commercial |
$1,929.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.36
|
| Rate for Payer: Cash Price |
$3,556.00
|
| Rate for Payer: Cash Price |
$3,556.00
|
| Rate for Payer: Cofinity Commercial |
$1,705.48
|
| Rate for Payer: Cofinity Commercial |
$1,587.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.36
|
| Rate for Payer: Healthscope Commercial |
$1,421.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,421.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.58
|
| Rate for Payer: Meridian Medicaid |
$787.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,302.80
|
| Rate for Payer: Nomi Health Commercial |
$1,421.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,333.75
|
| Rate for Payer: PACE SWMI |
$1,184.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,075.13
|
| Rate for Payer: Priority Health Medicare |
$1,184.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,075.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,184.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,184.36
|
| Rate for Payer: UHC Exchange |
$2,361.34
|
| Rate for Payer: UHC Medicaid |
$749.55
|
| Rate for Payer: UHCCP DNSP |
$1,184.36
|
| Rate for Payer: UHCCP Medicaid |
$749.55
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH
|
Professional
|
Both
|
$5,371.00
|
|
|
Service Code
|
HCPCS 33365
|
| Min. Negotiated Rate |
$812.60 |
| Max. Negotiated Rate |
$4,028.25 |
| Rate for Payer: Aetna Commercial |
$1,720.61
|
| Rate for Payer: Aetna Medicare |
$1,284.04
|
| Rate for Payer: BCBS Complete |
$853.23
|
| Rate for Payer: BCBS MAPPO |
$1,284.04
|
| Rate for Payer: BCN Commercial |
$2,081.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,284.04
|
| Rate for Payer: Cash Price |
$4,296.80
|
| Rate for Payer: Cash Price |
$4,296.80
|
| Rate for Payer: Cofinity Commercial |
$1,849.02
|
| Rate for Payer: Cofinity Commercial |
$1,720.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,284.04
|
| Rate for Payer: Healthscope Commercial |
$1,540.85
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,348.24
|
| Rate for Payer: Meridian Medicaid |
$853.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,412.44
|
| Rate for Payer: Nomi Health Commercial |
$1,540.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,028.25
|
| Rate for Payer: PACE SWMI |
$1,284.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,284.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,238.45
|
| Rate for Payer: Priority Health Medicare |
$1,284.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,238.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,284.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,585.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,284.04
|
| Rate for Payer: UHC Exchange |
$2,585.36
|
| Rate for Payer: UHC Medicaid |
$812.60
|
| Rate for Payer: UHCCP DNSP |
$1,284.04
|
| Rate for Payer: UHCCP Medicaid |
$812.60
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSTHORACIC APPROACH
|
Professional
|
Both
|
$3,266.00
|
|
|
Service Code
|
HCPCS 0318T
|
| Min. Negotiated Rate |
$1,306.40 |
| Max. Negotiated Rate |
$2,449.50 |
| Rate for Payer: BCBS Complete |
$1,306.40
|
| Rate for Payer: Cash Price |
$2,612.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,449.50
|
|
|
PR REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH
|
Professional
|
Both
|
$4,063.00
|
|
|
Service Code
|
HCPCS 33361
|
| Min. Negotiated Rate |
$688.20 |
| Max. Negotiated Rate |
$3,047.25 |
| Rate for Payer: Aetna Commercial |
$1,456.46
|
| Rate for Payer: Aetna Medicare |
$1,086.91
|
| Rate for Payer: BCBS Complete |
$722.61
|
| Rate for Payer: BCBS MAPPO |
$1,086.91
|
| Rate for Payer: BCN Commercial |
$1,768.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,086.91
|
| Rate for Payer: Cash Price |
$3,250.40
|
| Rate for Payer: Cash Price |
$3,250.40
|
| Rate for Payer: Cofinity Commercial |
$1,456.46
|
| Rate for Payer: Cofinity Commercial |
$1,565.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.91
|
| Rate for Payer: Healthscope Commercial |
$1,304.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,304.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,141.26
|
| Rate for Payer: Meridian Medicaid |
$722.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,195.60
|
| Rate for Payer: Nomi Health Commercial |
$1,304.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,047.25
|
| Rate for Payer: PACE SWMI |
$1,086.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,086.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$688.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,901.61
|
| Rate for Payer: Priority Health Medicare |
$1,086.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,901.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,086.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,166.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,086.91
|
| Rate for Payer: UHC Exchange |
$2,166.60
|
| Rate for Payer: UHC Medicaid |
$688.20
|
| Rate for Payer: UHCCP DNSP |
$1,086.91
|
| Rate for Payer: UHCCP Medicaid |
$688.20
|
|
|
PR REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 33368
|
| Min. Negotiated Rate |
$431.54 |
| Max. Negotiated Rate |
$1,715.25 |
| Rate for Payer: Aetna Commercial |
$914.91
|
| Rate for Payer: Aetna Medicare |
$682.77
|
| Rate for Payer: BCBS Complete |
$453.12
|
| Rate for Payer: BCBS MAPPO |
$682.77
|
| Rate for Payer: BCN Commercial |
$1,077.13
|
| Rate for Payer: BCN Medicare Advantage |
$682.77
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$983.19
|
| Rate for Payer: Cofinity Commercial |
$914.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.77
|
| Rate for Payer: Healthscope Commercial |
$819.32
|
| Rate for Payer: Healthscope Whirlpool |
$819.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.91
|
| Rate for Payer: Meridian Medicaid |
$453.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$751.05
|
| Rate for Payer: Nomi Health Commercial |
$819.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,715.25
|
| Rate for Payer: PACE SWMI |
$682.77
|
| Rate for Payer: PHP Medicare Advantage |
$682.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,158.31
|
| Rate for Payer: Priority Health Medicare |
$682.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,158.31
|
| Rate for Payer: Railroad Medicare Medicare |
$682.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,333.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$682.77
|
| Rate for Payer: UHC Exchange |
$1,333.33
|
| Rate for Payer: UHC Medicaid |
$431.54
|
| Rate for Payer: UHCCP DNSP |
$682.77
|
| Rate for Payer: UHCCP Medicaid |
$431.54
|
|
|
PR REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 49451
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$1,054.50 |
| Rate for Payer: Aetna Commercial |
$102.17
|
| Rate for Payer: Aetna Medicare |
$76.25
|
| Rate for Payer: BCBS Complete |
$50.99
|
| Rate for Payer: BCBS MAPPO |
$76.25
|
| Rate for Payer: BCN Commercial |
$129.48
|
| Rate for Payer: BCN Medicare Advantage |
$76.25
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$109.80
|
| Rate for Payer: Cofinity Commercial |
$102.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.25
|
| Rate for Payer: Healthscope Commercial |
$91.50
|
| Rate for Payer: Healthscope Whirlpool |
$91.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.06
|
| Rate for Payer: Meridian Medicaid |
$50.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.88
|
| Rate for Payer: Nomi Health Commercial |
$91.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,054.50
|
| Rate for Payer: PACE SWMI |
$76.25
|
| Rate for Payer: PHP Medicare Advantage |
$76.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.76
|
| Rate for Payer: Priority Health Medicare |
$76.25
|
| Rate for Payer: Priority Health Narrow Network |
$157.76
|
| Rate for Payer: Railroad Medicare Medicare |
$76.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.25
|
| Rate for Payer: UHC Exchange |
$160.74
|
| Rate for Payer: UHC Medicaid |
$48.56
|
| Rate for Payer: UHCCP DNSP |
$76.25
|
| Rate for Payer: UHCCP Medicaid |
$48.56
|
|
|
PR REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 49450
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$933.75 |
| Rate for Payer: Aetna Commercial |
$75.68
|
| Rate for Payer: Aetna Medicare |
$56.48
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$56.48
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: BCN Medicare Advantage |
$56.48
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cofinity Commercial |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.48
|
| Rate for Payer: Healthscope Commercial |
$67.78
|
| Rate for Payer: Healthscope Whirlpool |
$67.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.30
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.13
|
| Rate for Payer: Nomi Health Commercial |
$67.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$933.75
|
| Rate for Payer: PACE SWMI |
$56.48
|
| Rate for Payer: PHP Medicare Advantage |
$56.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$117.71
|
| Rate for Payer: Priority Health Medicare |
$56.48
|
| Rate for Payer: Priority Health Narrow Network |
$117.71
|
| Rate for Payer: Railroad Medicare Medicare |
$56.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.48
|
| Rate for Payer: UHC Exchange |
$117.64
|
| Rate for Payer: UHC Medicaid |
$36.00
|
| Rate for Payer: UHCCP DNSP |
$56.48
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
|
|
PR REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,538.00
|
|
|
Service Code
|
HCPCS 49452
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$1,153.50 |
| Rate for Payer: Aetna Commercial |
$156.78
|
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$117.00
|
| Rate for Payer: BCN Commercial |
$199.19
|
| Rate for Payer: BCN Medicare Advantage |
$117.00
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cofinity Commercial |
$168.48
|
| Rate for Payer: Cofinity Commercial |
$156.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.00
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Healthscope Whirlpool |
$140.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.85
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.70
|
| Rate for Payer: Nomi Health Commercial |
$140.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,153.50
|
| Rate for Payer: PACE SWMI |
$117.00
|
| Rate for Payer: PHP Medicare Advantage |
$117.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$242.71
|
| Rate for Payer: Priority Health Medicare |
$117.00
|
| Rate for Payer: Priority Health Narrow Network |
$242.71
|
| Rate for Payer: Railroad Medicare Medicare |
$117.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$117.00
|
| Rate for Payer: UHC Exchange |
$247.62
|
| Rate for Payer: UHC Medicaid |
$74.55
|
| Rate for Payer: UHCCP DNSP |
$117.00
|
| Rate for Payer: UHCCP Medicaid |
$74.55
|
|
|
PR REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$6,040.00
|
|
|
Service Code
|
HCPCS 33430
|
| Min. Negotiated Rate |
$1,672.69 |
| Max. Negotiated Rate |
$4,995.66 |
| Rate for Payer: Aetna Commercial |
$3,520.80
|
| Rate for Payer: Aetna Medicare |
$2,627.46
|
| Rate for Payer: BCBS Complete |
$1,756.32
|
| Rate for Payer: BCBS MAPPO |
$2,627.46
|
| Rate for Payer: BCN Commercial |
$4,116.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,627.46
|
| Rate for Payer: Cash Price |
$4,832.00
|
| Rate for Payer: Cash Price |
$4,832.00
|
| Rate for Payer: Cofinity Commercial |
$3,783.54
|
| Rate for Payer: Cofinity Commercial |
$3,520.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,627.46
|
| Rate for Payer: Healthscope Commercial |
$3,152.95
|
| Rate for Payer: Healthscope Whirlpool |
$3,152.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,758.83
|
| Rate for Payer: Meridian Medicaid |
$1,756.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,890.21
|
| Rate for Payer: Nomi Health Commercial |
$3,152.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,530.00
|
| Rate for Payer: PACE SWMI |
$2,627.46
|
| Rate for Payer: PHP Medicare Advantage |
$2,627.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,672.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,426.57
|
| Rate for Payer: Priority Health Medicare |
$2,627.46
|
| Rate for Payer: Priority Health Narrow Network |
$4,426.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,627.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,995.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,627.46
|
| Rate for Payer: UHC Exchange |
$4,995.66
|
| Rate for Payer: UHC Medicaid |
$1,672.69
|
| Rate for Payer: UHCCP DNSP |
$2,627.46
|
| Rate for Payer: UHCCP Medicaid |
$1,672.69
|
|
|
PR REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 11970
|
| Min. Negotiated Rate |
$329.94 |
| Max. Negotiated Rate |
$1,062.65 |
| Rate for Payer: Aetna Commercial |
$674.45
|
| Rate for Payer: Aetna Medicare |
$503.32
|
| Rate for Payer: BCBS Complete |
$346.44
|
| Rate for Payer: BCBS MAPPO |
$503.32
|
| Rate for Payer: BCN Commercial |
$852.54
|
| Rate for Payer: BCN Medicare Advantage |
$503.32
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$724.78
|
| Rate for Payer: Cofinity Commercial |
$674.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.32
|
| Rate for Payer: Healthscope Commercial |
$603.98
|
| Rate for Payer: Healthscope Whirlpool |
$603.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.49
|
| Rate for Payer: Meridian Medicaid |
$346.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$553.65
|
| Rate for Payer: Nomi Health Commercial |
$603.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.75
|
| Rate for Payer: PACE SWMI |
$503.32
|
| Rate for Payer: PHP Medicare Advantage |
$503.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$780.29
|
| Rate for Payer: Priority Health Medicare |
$503.32
|
| Rate for Payer: Priority Health Narrow Network |
$780.29
|
| Rate for Payer: Railroad Medicare Medicare |
$503.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,062.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$503.32
|
| Rate for Payer: UHC Exchange |
$1,062.65
|
| Rate for Payer: UHC Medicaid |
$329.94
|
| Rate for Payer: UHCCP DNSP |
$503.32
|
| Rate for Payer: UHCCP Medicaid |
$329.94
|
|
|
PR REPLACEMENT TRICUSPID VALVE W/CARD BYPASS
|
Professional
|
Both
|
$9,074.00
|
|
|
Service Code
|
HCPCS 33465
|
| Min. Negotiated Rate |
$1,634.99 |
| Max. Negotiated Rate |
$6,805.50 |
| Rate for Payer: Aetna Commercial |
$3,446.20
|
| Rate for Payer: Aetna Medicare |
$2,571.79
|
| Rate for Payer: BCBS Complete |
$1,716.74
|
| Rate for Payer: BCBS MAPPO |
$2,571.79
|
| Rate for Payer: BCN Commercial |
$4,039.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,571.79
|
| Rate for Payer: Cash Price |
$7,259.20
|
| Rate for Payer: Cash Price |
$7,259.20
|
| Rate for Payer: Cofinity Commercial |
$3,703.38
|
| Rate for Payer: Cofinity Commercial |
$3,446.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,571.79
|
| Rate for Payer: Healthscope Commercial |
$3,086.15
|
| Rate for Payer: Healthscope Whirlpool |
$3,086.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,700.38
|
| Rate for Payer: Meridian Medicaid |
$1,716.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,828.97
|
| Rate for Payer: Nomi Health Commercial |
$3,086.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,805.50
|
| Rate for Payer: PACE SWMI |
$2,571.79
|
| Rate for Payer: PHP Medicare Advantage |
$2,571.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,634.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,344.11
|
| Rate for Payer: Priority Health Medicare |
$2,571.79
|
| Rate for Payer: Priority Health Narrow Network |
$4,344.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,571.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,921.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,571.79
|
| Rate for Payer: UHC Exchange |
$4,921.03
|
| Rate for Payer: UHC Medicaid |
$1,634.99
|
| Rate for Payer: UHCCP DNSP |
$2,571.79
|
| Rate for Payer: UHCCP Medicaid |
$1,634.99
|
|
|
PR REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ
|
Professional
|
Both
|
$509.00
|
|
|
Service Code
|
HCPCS 33993
|
| Min. Negotiated Rate |
$90.74 |
| Max. Negotiated Rate |
$381.75 |
| Rate for Payer: Aetna Commercial |
$191.45
|
| Rate for Payer: Aetna Medicare |
$142.87
|
| Rate for Payer: BCBS Complete |
$95.28
|
| Rate for Payer: BCBS MAPPO |
$142.87
|
| Rate for Payer: BCN Commercial |
$242.02
|
| Rate for Payer: BCN Medicare Advantage |
$142.87
|
| Rate for Payer: Cash Price |
$407.20
|
| Rate for Payer: Cash Price |
$407.20
|
| Rate for Payer: Cofinity Commercial |
$205.73
|
| Rate for Payer: Cofinity Commercial |
$191.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.87
|
| Rate for Payer: Healthscope Commercial |
$171.44
|
| Rate for Payer: Healthscope Whirlpool |
$171.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.01
|
| Rate for Payer: Meridian Medicaid |
$95.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.16
|
| Rate for Payer: Nomi Health Commercial |
$171.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.75
|
| Rate for Payer: PACE SWMI |
$142.87
|
| Rate for Payer: PHP Medicare Advantage |
$142.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$260.25
|
| Rate for Payer: Priority Health Medicare |
$142.87
|
| Rate for Payer: Priority Health Narrow Network |
$260.25
|
| Rate for Payer: Railroad Medicare Medicare |
$142.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$310.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.87
|
| Rate for Payer: UHC Exchange |
$310.47
|
| Rate for Payer: UHC Medicaid |
$90.74
|
| Rate for Payer: UHCCP DNSP |
$142.87
|
| Rate for Payer: UHCCP Medicaid |
$90.74
|
|
