|
PR RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ
|
Professional
|
Both
|
$1,902.00
|
|
|
Service Code
|
HCPCS 69150
|
| Min. Negotiated Rate |
$642.41 |
| Max. Negotiated Rate |
$2,143.84 |
| Rate for Payer: Aetna Commercial |
$1,163.90
|
| Rate for Payer: Aetna Medicare |
$951.00
|
| Rate for Payer: BCBS Complete |
$674.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,143.84
|
| Rate for Payer: BCN Commercial |
$1,486.07
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Cash Price |
$1,521.60
|
| Rate for Payer: Meridian Medicaid |
$674.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,474.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,474.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,161.26
|
| Rate for Payer: UHC Exchange |
$1,161.26
|
| Rate for Payer: UHCCP Medicaid |
$642.41
|
|
|
PR RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP
|
Professional
|
Both
|
$3,040.00
|
|
|
Service Code
|
HCPCS 42844
|
| Min. Negotiated Rate |
$526.72 |
| Max. Negotiated Rate |
$2,462.15 |
| Rate for Payer: Aetna Commercial |
$1,833.58
|
| Rate for Payer: Aetna Medicare |
$1,520.00
|
| Rate for Payer: BCBS Complete |
$922.11
|
| Rate for Payer: BCBS Trust/PPO |
$526.72
|
| Rate for Payer: BCN Commercial |
$2,018.24
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Cash Price |
$2,432.00
|
| Rate for Payer: Meridian Medicaid |
$922.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,462.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,462.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,645.11
|
| Rate for Payer: UHC Exchange |
$1,645.11
|
| Rate for Payer: UHCCP Medicaid |
$878.20
|
|
|
PR RADICAL RESECTION STERNUM
|
Professional
|
Both
|
$2,674.00
|
|
|
Service Code
|
HCPCS 21630
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,006.44 |
| Rate for Payer: Aetna Commercial |
$1,601.13
|
| Rate for Payer: Aetna Medicare |
$1,337.00
|
| Rate for Payer: BCBS Complete |
$889.68
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,920.50
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: Cash Price |
$2,139.20
|
| Rate for Payer: Meridian Medicaid |
$889.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,738.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,006.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,483.06
|
| Rate for Payer: UHC Exchange |
$1,483.06
|
| Rate for Payer: UHCCP Medicaid |
$847.31
|
|
|
PR RADICAL RESECTION TONSIL W/O CLOSURE
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 42842
|
| Min. Negotiated Rate |
$645.39 |
| Max. Negotiated Rate |
$1,810.67 |
| Rate for Payer: Aetna Commercial |
$1,341.57
|
| Rate for Payer: Aetna Medicare |
$901.00
|
| Rate for Payer: BCBS Complete |
$677.66
|
| Rate for Payer: BCBS Trust/PPO |
$911.85
|
| Rate for Payer: BCN Commercial |
$1,484.61
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Meridian Medicaid |
$677.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,810.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,179.39
|
| Rate for Payer: UHC Exchange |
$1,179.39
|
| Rate for Payer: UHCCP Medicaid |
$645.39
|
|
|
PR RADICAL RESECTION TUMOR CLAVICLE
|
Professional
|
Both
|
$2,630.00
|
|
|
Service Code
|
HCPCS 23200
|
| Min. Negotiated Rate |
$42.87 |
| Max. Negotiated Rate |
$2,302.60 |
| Rate for Payer: Aetna Commercial |
$2,014.21
|
| Rate for Payer: Aetna Medicare |
$1,315.00
|
| Rate for Payer: BCBS Complete |
$1,020.52
|
| Rate for Payer: BCBS Trust/PPO |
$42.87
|
| Rate for Payer: BCN Commercial |
$2,197.59
|
| Rate for Payer: Cash Price |
$2,104.00
|
| Rate for Payer: Cash Price |
$2,104.00
|
| Rate for Payer: Meridian Medicaid |
$1,020.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$971.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,709.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,302.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,302.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,589.03
|
| Rate for Payer: UHC Exchange |
$1,589.03
|
| Rate for Payer: UHCCP Medicaid |
$971.92
|
|
|
PR RADICAL RESECTION TUMOR FEMOR OR KNEE
|
Professional
|
Both
|
$5,511.00
|
|
|
Service Code
|
HCPCS 27365
|
| Min. Negotiated Rate |
$1,321.03 |
| Max. Negotiated Rate |
$3,832.29 |
| Rate for Payer: Aetna Commercial |
$2,752.84
|
| Rate for Payer: Aetna Medicare |
$2,755.50
|
| Rate for Payer: BCBS Complete |
$1,387.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,832.29
|
| Rate for Payer: BCN Commercial |
$2,988.26
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Cash Price |
$4,408.80
|
| Rate for Payer: Meridian Medicaid |
$1,387.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,321.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,582.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,129.49
|
| Rate for Payer: Priority Health Narrow Network |
$3,129.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,221.08
|
| Rate for Payer: UHC Exchange |
$2,221.08
|
| Rate for Payer: UHCCP Medicaid |
$1,321.03
|
|
|
PR RADICAL RESECTION TUMOR METACARPAL
|
Professional
|
Both
|
$3,029.00
|
|
|
Service Code
|
HCPCS 26250
|
| Min. Negotiated Rate |
$120.98 |
| Max. Negotiated Rate |
$1,968.85 |
| Rate for Payer: Aetna Commercial |
$1,422.27
|
| Rate for Payer: Aetna Medicare |
$1,514.50
|
| Rate for Payer: BCBS Complete |
$726.86
|
| Rate for Payer: BCBS Trust/PPO |
$120.98
|
| Rate for Payer: BCN Commercial |
$1,561.33
|
| Rate for Payer: Cash Price |
$2,423.20
|
| Rate for Payer: Cash Price |
$2,423.20
|
| Rate for Payer: Meridian Medicaid |
$726.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,640.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,640.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,097.72
|
| Rate for Payer: UHC Exchange |
$1,097.72
|
| Rate for Payer: UHCCP Medicaid |
$692.25
|
|
|
PR RADICAL RESECTION TUMOR METATARSAL
|
Professional
|
Both
|
$1,379.00
|
|
|
Service Code
|
HCPCS 28173
|
| Min. Negotiated Rate |
$466.04 |
| Max. Negotiated Rate |
$1,110.49 |
| Rate for Payer: Aetna Commercial |
$974.37
|
| Rate for Payer: Aetna Medicare |
$689.50
|
| Rate for Payer: BCBS Complete |
$489.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,110.49
|
| Rate for Payer: BCN Commercial |
$1,049.68
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Cash Price |
$1,103.20
|
| Rate for Payer: Meridian Medicaid |
$489.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$896.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,106.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,106.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$905.98
|
| Rate for Payer: UHC Exchange |
$905.98
|
| Rate for Payer: UHCCP Medicaid |
$466.04
|
|
|
PR RADICAL RESECTION TUMOR RADIUS OR ULNA
|
Professional
|
Both
|
$2,595.00
|
|
|
Service Code
|
HCPCS 25170
|
| Min. Negotiated Rate |
$542.04 |
| Max. Negotiated Rate |
$2,246.11 |
| Rate for Payer: Aetna Commercial |
$1,965.45
|
| Rate for Payer: Aetna Medicare |
$1,297.50
|
| Rate for Payer: BCBS Complete |
$995.02
|
| Rate for Payer: BCBS Trust/PPO |
$542.04
|
| Rate for Payer: BCN Commercial |
$2,143.34
|
| Rate for Payer: Cash Price |
$2,076.00
|
| Rate for Payer: Cash Price |
$2,076.00
|
| Rate for Payer: Meridian Medicaid |
$995.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$947.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,686.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,246.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,606.92
|
| Rate for Payer: UHC Exchange |
$1,606.92
|
| Rate for Payer: UHCCP Medicaid |
$947.64
|
|
|
PR RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,314.00
|
|
|
Service Code
|
HCPCS 24150
|
| Min. Negotiated Rate |
$145.81 |
| Max. Negotiated Rate |
$2,362.64 |
| Rate for Payer: Aetna Commercial |
$2,068.51
|
| Rate for Payer: Aetna Medicare |
$1,157.00
|
| Rate for Payer: BCBS Complete |
$1,046.46
|
| Rate for Payer: BCBS Trust/PPO |
$145.81
|
| Rate for Payer: BCN Commercial |
$2,253.78
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Meridian Medicaid |
$1,046.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,362.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,362.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,663.24
|
| Rate for Payer: UHC Exchange |
$1,663.24
|
| Rate for Payer: UHCCP Medicaid |
$996.63
|
|
|
PR RADICAL STYLOIDECTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,539.00
|
|
|
Service Code
|
HCPCS 25230
|
| Min. Negotiated Rate |
$286.91 |
| Max. Negotiated Rate |
$1,572.75 |
| Rate for Payer: Aetna Commercial |
$574.91
|
| Rate for Payer: Aetna Medicare |
$769.50
|
| Rate for Payer: BCBS Complete |
$301.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,572.75
|
| Rate for Payer: BCN Commercial |
$642.61
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Meridian Medicaid |
$301.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,000.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$677.30
|
| Rate for Payer: Priority Health Narrow Network |
$677.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$488.03
|
| Rate for Payer: UHC Exchange |
$488.03
|
| Rate for Payer: UHCCP Medicaid |
$286.91
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 64625
|
| Min. Negotiated Rate |
$125.67 |
| Max. Negotiated Rate |
$1,208.22 |
| Rate for Payer: Aetna Commercial |
$248.15
|
| Rate for Payer: Aetna Medicare |
$467.00
|
| Rate for Payer: BCBS Complete |
$131.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.22
|
| Rate for Payer: BCN Commercial |
$690.50
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Meridian Medicaid |
$131.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.13
|
| Rate for Payer: Priority Health Narrow Network |
$332.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$245.35
|
| Rate for Payer: UHC Exchange |
$245.35
|
| Rate for Payer: UHCCP Medicaid |
$125.67
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Facility
|
OP
|
$934.00
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$607.10 |
| Max. Negotiated Rate |
$2,965.58 |
| Rate for Payer: Aetna Commercial |
$840.60
|
| Rate for Payer: Aetna Medicare |
$1,913.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: ASR ASR |
$905.98
|
| Rate for Payer: ASR Commercial |
$905.98
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$764.85
|
| Rate for Payer: BCN Commercial |
$724.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$877.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$934.00
|
| Rate for Payer: Healthscope Whirlpool |
$905.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,913.28
|
| Rate for Payer: Mclaren Commercial |
$840.60
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.90
|
| Rate for Payer: Nomi Health Commercial |
$765.88
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,104.61
|
| Rate for Payer: PHP Medicaid |
$1,025.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.27
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,574.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$2,965.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP DNSP |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Facility
|
IP
|
$934.00
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$607.10 |
| Max. Negotiated Rate |
$934.00 |
| Rate for Payer: Aetna Commercial |
$840.60
|
| Rate for Payer: ASR ASR |
$905.98
|
| Rate for Payer: ASR Commercial |
$905.98
|
| Rate for Payer: BCBS Trust/PPO |
$761.12
|
| Rate for Payer: BCN Commercial |
$724.13
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$877.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.20
|
| Rate for Payer: Healthscope Commercial |
$934.00
|
| Rate for Payer: Healthscope Whirlpool |
$905.98
|
| Rate for Payer: Mclaren Commercial |
$840.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.90
|
| Rate for Payer: Nomi Health Commercial |
$765.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.92
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$125.67 |
| Max. Negotiated Rate |
$1,208.22 |
| Rate for Payer: Aetna Commercial |
$248.15
|
| Rate for Payer: Aetna Medicare |
$467.00
|
| Rate for Payer: BCBS Complete |
$131.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.22
|
| Rate for Payer: BCN Commercial |
$690.50
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Meridian Medicaid |
$131.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.13
|
| Rate for Payer: Priority Health Narrow Network |
$332.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$245.35
|
| Rate for Payer: UHC Exchange |
$245.35
|
| Rate for Payer: UHCCP Medicaid |
$125.67
|
|
|
PR RAD RESCJ CAPSL TISS&HTRTPC B1 ELBW CONTRCT RLS
|
Professional
|
Both
|
$2,668.00
|
|
|
Service Code
|
HCPCS 24149
|
| Min. Negotiated Rate |
$768.29 |
| Max. Negotiated Rate |
$1,820.71 |
| Rate for Payer: Aetna Commercial |
$1,566.80
|
| Rate for Payer: Aetna Medicare |
$1,334.00
|
| Rate for Payer: BCBS Complete |
$806.70
|
| Rate for Payer: BCBS Trust/PPO |
$873.28
|
| Rate for Payer: BCN Commercial |
$1,732.85
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Meridian Medicaid |
$806.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$768.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,734.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,820.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,820.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,329.18
|
| Rate for Payer: UHC Exchange |
$1,329.18
|
| Rate for Payer: UHCCP Medicaid |
$768.29
|
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW <5CM
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 24077
|
| Min. Negotiated Rate |
$662.86 |
| Max. Negotiated Rate |
$1,576.46 |
| Rate for Payer: Aetna Commercial |
$1,376.78
|
| Rate for Payer: Aetna Medicare |
$923.50
|
| Rate for Payer: BCBS Complete |
$696.00
|
| Rate for Payer: BCBS Trust/PPO |
$712.15
|
| Rate for Payer: BCN Commercial |
$1,512.46
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Meridian Medicaid |
$696.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,576.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,576.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,151.21
|
| Rate for Payer: UHC Exchange |
$1,151.21
|
| Rate for Payer: UHCCP Medicaid |
$662.86
|
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW 5CM+
|
Professional
|
Both
|
$3,117.00
|
|
|
Service Code
|
HCPCS 24079
|
| Min. Negotiated Rate |
$856.47 |
| Max. Negotiated Rate |
$2,029.85 |
| Rate for Payer: Aetna Commercial |
$1,771.40
|
| Rate for Payer: Aetna Medicare |
$1,558.50
|
| Rate for Payer: BCBS Complete |
$899.29
|
| Rate for Payer: BCBS Trust/PPO |
$918.19
|
| Rate for Payer: BCN Commercial |
$1,935.66
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Meridian Medicaid |
$899.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,029.85
|
| Rate for Payer: Priority Health Narrow Network |
$2,029.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,545.96
|
| Rate for Payer: UHC Exchange |
$1,545.96
|
| Rate for Payer: UHCCP Medicaid |
$856.47
|
|
|
PR RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>
|
Professional
|
Both
|
$3,940.00
|
|
|
Service Code
|
HCPCS 25078
|
| Min. Negotiated Rate |
$754.87 |
| Max. Negotiated Rate |
$2,561.00 |
| Rate for Payer: Aetna Commercial |
$1,555.32
|
| Rate for Payer: Aetna Medicare |
$1,970.00
|
| Rate for Payer: BCBS Complete |
$792.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.71
|
| Rate for Payer: BCN Commercial |
$1,706.95
|
| Rate for Payer: Cash Price |
$3,152.00
|
| Rate for Payer: Cash Price |
$3,152.00
|
| Rate for Payer: Meridian Medicaid |
$792.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$754.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,561.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,789.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,789.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,349.70
|
| Rate for Payer: UHC Exchange |
$1,349.70
|
| Rate for Payer: UHCCP Medicaid |
$754.87
|
|
|
PR RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>
|
Professional
|
Both
|
$3,509.00
|
|
|
Service Code
|
HCPCS 26118
|
| Min. Negotiated Rate |
$213.95 |
| Max. Negotiated Rate |
$2,280.85 |
| Rate for Payer: Aetna Commercial |
$1,403.39
|
| Rate for Payer: Aetna Medicare |
$1,754.50
|
| Rate for Payer: BCBS Complete |
$719.70
|
| Rate for Payer: BCBS Trust/PPO |
$213.95
|
| Rate for Payer: BCN Commercial |
$1,547.65
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Meridian Medicaid |
$719.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,280.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,613.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,613.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,262.80
|
| Rate for Payer: UHC Exchange |
$1,262.80
|
| Rate for Payer: UHCCP Medicaid |
$685.43
|
|
|
PR RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL
|
Professional
|
Both
|
$4,271.00
|
|
|
Service Code
|
HCPCS 27075
|
| Min. Negotiated Rate |
$572.15 |
| Max. Negotiated Rate |
$3,174.27 |
| Rate for Payer: Aetna Commercial |
$2,792.00
|
| Rate for Payer: Aetna Medicare |
$2,135.50
|
| Rate for Payer: BCBS Complete |
$1,405.65
|
| Rate for Payer: BCBS Trust/PPO |
$572.15
|
| Rate for Payer: BCN Commercial |
$3,031.75
|
| Rate for Payer: Cash Price |
$3,416.80
|
| Rate for Payer: Cash Price |
$3,416.80
|
| Rate for Payer: Meridian Medicaid |
$1,405.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,338.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,174.27
|
| Rate for Payer: Priority Health Narrow Network |
$3,174.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,458.49
|
| Rate for Payer: UHC Exchange |
$2,458.49
|
| Rate for Payer: UHCCP Medicaid |
$1,338.71
|
|
|
PR RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,646.00
|
|
|
Service Code
|
HCPCS 26260
|
| Min. Negotiated Rate |
$278.41 |
| Max. Negotiated Rate |
$1,230.42 |
| Rate for Payer: Aetna Commercial |
$1,064.51
|
| Rate for Payer: Aetna Medicare |
$823.00
|
| Rate for Payer: BCBS Complete |
$545.93
|
| Rate for Payer: BCBS Trust/PPO |
$278.41
|
| Rate for Payer: BCN Commercial |
$1,171.85
|
| Rate for Payer: Cash Price |
$1,316.80
|
| Rate for Payer: Cash Price |
$1,316.80
|
| Rate for Payer: Meridian Medicaid |
$545.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,069.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,230.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$849.76
|
| Rate for Payer: UHC Exchange |
$849.76
|
| Rate for Payer: UHCCP Medicaid |
$519.93
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>
|
Professional
|
Both
|
$1,757.00
|
|
|
Service Code
|
HCPCS 21016
|
| Min. Negotiated Rate |
$87.70 |
| Max. Negotiated Rate |
$1,541.85 |
| Rate for Payer: Aetna Commercial |
$1,337.87
|
| Rate for Payer: Aetna Medicare |
$878.50
|
| Rate for Payer: BCBS Complete |
$680.12
|
| Rate for Payer: BCBS Trust/PPO |
$87.70
|
| Rate for Payer: BCN Commercial |
$1,474.83
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Meridian Medicaid |
$680.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$647.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,541.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,541.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,242.16
|
| Rate for Payer: UHC Exchange |
$1,242.16
|
| Rate for Payer: UHCCP Medicaid |
$647.73
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 21015
|
| Min. Negotiated Rate |
$448.00 |
| Max. Negotiated Rate |
$6,178.65 |
| Rate for Payer: Aetna Commercial |
$930.36
|
| Rate for Payer: Aetna Medicare |
$448.00
|
| Rate for Payer: BCBS Complete |
$475.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,178.65
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Meridian Medicaid |
$475.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$582.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,070.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,070.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$736.94
|
| Rate for Payer: UHC Exchange |
$736.94
|
| Rate for Payer: UHCCP Medicaid |
$453.05
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>
|
Professional
|
Both
|
$2,420.00
|
|
|
Service Code
|
HCPCS 22905
|
| Min. Negotiated Rate |
$149.00 |
| Max. Negotiated Rate |
$2,033.41 |
| Rate for Payer: Aetna Commercial |
$1,775.84
|
| Rate for Payer: Aetna Medicare |
$1,210.00
|
| Rate for Payer: BCBS Complete |
$901.53
|
| Rate for Payer: BCBS Trust/PPO |
$149.00
|
| Rate for Payer: BCN Commercial |
$1,936.14
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Meridian Medicaid |
$901.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$858.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,573.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,033.41
|
| Rate for Payer: Priority Health Narrow Network |
$2,033.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,611.88
|
| Rate for Payer: UHC Exchange |
$1,611.88
|
| Rate for Payer: UHCCP Medicaid |
$858.60
|
|
