|
PR REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 44340
|
| Min. Negotiated Rate |
$387.23 |
| Max. Negotiated Rate |
$1,153.45 |
| Rate for Payer: Aetna Commercial |
$797.57
|
| Rate for Payer: Aetna Medicare |
$595.20
|
| Rate for Payer: BCBS Complete |
$406.59
|
| Rate for Payer: BCBS MAPPO |
$595.20
|
| Rate for Payer: BCN Commercial |
$946.66
|
| Rate for Payer: BCN Medicare Advantage |
$595.20
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$857.09
|
| Rate for Payer: Cofinity Commercial |
$797.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.20
|
| Rate for Payer: Healthscope Commercial |
$714.24
|
| Rate for Payer: Healthscope Whirlpool |
$714.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.96
|
| Rate for Payer: Meridian Medicaid |
$406.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$654.72
|
| Rate for Payer: Nomi Health Commercial |
$714.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PACE SWMI |
$595.20
|
| Rate for Payer: PHP Medicare Advantage |
$595.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,153.45
|
| Rate for Payer: Priority Health Medicare |
$595.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,153.45
|
| Rate for Payer: Railroad Medicare Medicare |
$595.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,097.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$595.20
|
| Rate for Payer: UHC Exchange |
$1,097.57
|
| Rate for Payer: UHC Medicaid |
$387.23
|
| Rate for Payer: UHCCP DNSP |
$595.20
|
| Rate for Payer: UHCCP Medicaid |
$387.23
|
|
|
PR REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX
|
Professional
|
Both
|
$2,947.00
|
|
|
Service Code
|
HCPCS 44346
|
| Min. Negotiated Rate |
$701.62 |
| Max. Negotiated Rate |
$2,210.25 |
| Rate for Payer: Aetna Commercial |
$1,461.36
|
| Rate for Payer: Aetna Medicare |
$1,090.57
|
| Rate for Payer: BCBS Complete |
$736.70
|
| Rate for Payer: BCBS MAPPO |
$1,090.57
|
| Rate for Payer: BCN Commercial |
$1,773.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.57
|
| Rate for Payer: Cash Price |
$2,357.60
|
| Rate for Payer: Cash Price |
$2,357.60
|
| Rate for Payer: Cofinity Commercial |
$1,570.42
|
| Rate for Payer: Cofinity Commercial |
$1,461.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.57
|
| Rate for Payer: Healthscope Commercial |
$1,308.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.10
|
| Rate for Payer: Meridian Medicaid |
$736.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,199.63
|
| Rate for Payer: Nomi Health Commercial |
$1,308.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,210.25
|
| Rate for Payer: PACE SWMI |
$1,090.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,160.67
|
| Rate for Payer: Priority Health Medicare |
$1,090.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,160.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,090.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,100.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,090.57
|
| Rate for Payer: UHC Exchange |
$2,100.93
|
| Rate for Payer: UHC Medicaid |
$701.62
|
| Rate for Payer: UHCCP DNSP |
$1,090.57
|
| Rate for Payer: UHCCP Medicaid |
$701.62
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/AUTOG VN PATCH GRF
|
Professional
|
Both
|
$2,698.00
|
|
|
Service Code
|
HCPCS 35884
|
| Min. Negotiated Rate |
$718.88 |
| Max. Negotiated Rate |
$2,232.45 |
| Rate for Payer: Aetna Commercial |
$1,532.16
|
| Rate for Payer: Aetna Medicare |
$1,143.40
|
| Rate for Payer: BCBS Complete |
$754.82
|
| Rate for Payer: BCBS MAPPO |
$1,143.40
|
| Rate for Payer: BCN Commercial |
$1,810.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,143.40
|
| Rate for Payer: Cash Price |
$2,158.40
|
| Rate for Payer: Cash Price |
$2,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,646.50
|
| Rate for Payer: Cofinity Commercial |
$1,532.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,143.40
|
| Rate for Payer: Healthscope Commercial |
$1,372.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,372.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,200.57
|
| Rate for Payer: Meridian Medicaid |
$754.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,257.74
|
| Rate for Payer: Nomi Health Commercial |
$1,372.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,023.50
|
| Rate for Payer: PACE SWMI |
$1,143.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,143.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,947.14
|
| Rate for Payer: Priority Health Medicare |
$1,143.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,947.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,143.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,232.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,143.40
|
| Rate for Payer: UHC Exchange |
$2,232.45
|
| Rate for Payer: UHC Medicaid |
$718.88
|
| Rate for Payer: UHCCP DNSP |
$1,143.40
|
| Rate for Payer: UHCCP Medicaid |
$718.88
|
|
|
PR REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF
|
Professional
|
Both
|
$2,433.00
|
|
|
Service Code
|
HCPCS 35883
|
| Min. Negotiated Rate |
$690.97 |
| Max. Negotiated Rate |
$2,160.12 |
| Rate for Payer: Aetna Commercial |
$1,468.99
|
| Rate for Payer: Aetna Medicare |
$1,096.26
|
| Rate for Payer: BCBS Complete |
$725.52
|
| Rate for Payer: BCBS MAPPO |
$1,096.26
|
| Rate for Payer: BCN Commercial |
$1,741.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.26
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cash Price |
$1,946.40
|
| Rate for Payer: Cofinity Commercial |
$1,578.61
|
| Rate for Payer: Cofinity Commercial |
$1,468.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.26
|
| Rate for Payer: Healthscope Commercial |
$1,315.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,315.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,151.07
|
| Rate for Payer: Meridian Medicaid |
$725.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,205.89
|
| Rate for Payer: Nomi Health Commercial |
$1,315.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,824.75
|
| Rate for Payer: PACE SWMI |
$1,096.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,873.23
|
| Rate for Payer: Priority Health Medicare |
$1,096.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,873.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,096.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,160.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,096.26
|
| Rate for Payer: UHC Exchange |
$2,160.12
|
| Rate for Payer: UHC Medicaid |
$690.97
|
| Rate for Payer: UHCCP DNSP |
$1,096.26
|
| Rate for Payer: UHCCP Medicaid |
$690.97
|
|
|
PR REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY
|
Professional
|
Both
|
$5,546.00
|
|
|
Service Code
|
HCPCS 43860
|
| Min. Negotiated Rate |
$966.81 |
| Max. Negotiated Rate |
$4,159.50 |
| Rate for Payer: Aetna Commercial |
$2,027.46
|
| Rate for Payer: Aetna Medicare |
$1,513.03
|
| Rate for Payer: BCBS Complete |
$1,015.15
|
| Rate for Payer: BCBS MAPPO |
$1,513.03
|
| Rate for Payer: BCN Commercial |
$2,455.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,513.03
|
| Rate for Payer: Cash Price |
$4,436.80
|
| Rate for Payer: Cash Price |
$4,436.80
|
| Rate for Payer: Cofinity Commercial |
$2,178.76
|
| Rate for Payer: Cofinity Commercial |
$2,027.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,513.03
|
| Rate for Payer: Healthscope Commercial |
$1,815.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,815.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,588.68
|
| Rate for Payer: Meridian Medicaid |
$1,015.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,664.33
|
| Rate for Payer: Nomi Health Commercial |
$1,815.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,159.50
|
| Rate for Payer: PACE SWMI |
$1,513.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,513.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$966.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,991.31
|
| Rate for Payer: Priority Health Medicare |
$1,513.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,991.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,513.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,924.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,513.03
|
| Rate for Payer: UHC Exchange |
$2,924.75
|
| Rate for Payer: UHC Medicaid |
$966.81
|
| Rate for Payer: UHCCP DNSP |
$1,513.03
|
| Rate for Payer: UHCCP Medicaid |
$966.81
|
|
|
PR REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX
|
Professional
|
Both
|
$2,665.00
|
|
|
Service Code
|
HCPCS 44314
|
| Min. Negotiated Rate |
$596.61 |
| Max. Negotiated Rate |
$1,998.75 |
| Rate for Payer: Aetna Commercial |
$1,240.61
|
| Rate for Payer: Aetna Medicare |
$925.83
|
| Rate for Payer: BCBS Complete |
$626.44
|
| Rate for Payer: BCBS MAPPO |
$925.83
|
| Rate for Payer: BCN Commercial |
$1,502.40
|
| Rate for Payer: BCN Medicare Advantage |
$925.83
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cofinity Commercial |
$1,333.20
|
| Rate for Payer: Cofinity Commercial |
$1,240.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.83
|
| Rate for Payer: Healthscope Commercial |
$1,111.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,111.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.12
|
| Rate for Payer: Meridian Medicaid |
$626.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,018.41
|
| Rate for Payer: Nomi Health Commercial |
$1,111.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,998.75
|
| Rate for Payer: PACE SWMI |
$925.83
|
| Rate for Payer: PHP Medicare Advantage |
$925.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$596.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,830.58
|
| Rate for Payer: Priority Health Medicare |
$925.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,830.58
|
| Rate for Payer: Railroad Medicare Medicare |
$925.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,783.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$925.83
|
| Rate for Payer: UHC Exchange |
$1,783.19
|
| Rate for Payer: UHC Medicaid |
$596.61
|
| Rate for Payer: UHCCP DNSP |
$925.83
|
| Rate for Payer: UHCCP Medicaid |
$596.61
|
|
|
PR REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 44312
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,095.19 |
| Rate for Payer: Aetna Commercial |
$750.11
|
| Rate for Payer: Aetna Medicare |
$559.78
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$559.78
|
| Rate for Payer: BCN Commercial |
$898.85
|
| Rate for Payer: BCN Medicare Advantage |
$559.78
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$806.08
|
| Rate for Payer: Cofinity Commercial |
$750.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.78
|
| Rate for Payer: Healthscope Commercial |
$671.74
|
| Rate for Payer: Healthscope Whirlpool |
$671.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.77
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$615.76
|
| Rate for Payer: Nomi Health Commercial |
$671.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$956.25
|
| Rate for Payer: PACE SWMI |
$559.78
|
| Rate for Payer: PHP Medicare Advantage |
$559.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,095.19
|
| Rate for Payer: Priority Health Medicare |
$559.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,095.19
|
| Rate for Payer: Railroad Medicare Medicare |
$559.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,049.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$559.78
|
| Rate for Payer: UHC Exchange |
$1,049.46
|
| Rate for Payer: UHC Medicaid |
$362.31
|
| Rate for Payer: UHCCP DNSP |
$559.78
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR
|
Professional
|
Both
|
$4,252.00
|
|
|
Service Code
|
HCPCS 63664
|
| Min. Negotiated Rate |
$565.30 |
| Max. Negotiated Rate |
$3,189.00 |
| Rate for Payer: Aetna Commercial |
$1,167.97
|
| Rate for Payer: Aetna Medicare |
$871.62
|
| Rate for Payer: BCBS Complete |
$593.57
|
| Rate for Payer: BCBS MAPPO |
$871.62
|
| Rate for Payer: BCN Commercial |
$1,356.50
|
| Rate for Payer: BCN Medicare Advantage |
$871.62
|
| Rate for Payer: Cash Price |
$3,401.60
|
| Rate for Payer: Cash Price |
$3,401.60
|
| Rate for Payer: Cofinity Commercial |
$1,255.13
|
| Rate for Payer: Cofinity Commercial |
$1,167.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$871.62
|
| Rate for Payer: Healthscope Commercial |
$1,045.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,045.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.20
|
| Rate for Payer: Meridian Medicaid |
$593.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$958.78
|
| Rate for Payer: Nomi Health Commercial |
$1,045.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,189.00
|
| Rate for Payer: PACE SWMI |
$871.62
|
| Rate for Payer: PHP Medicare Advantage |
$871.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$565.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,575.55
|
| Rate for Payer: Priority Health Medicare |
$871.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.55
|
| Rate for Payer: Railroad Medicare Medicare |
$871.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,534.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$871.62
|
| Rate for Payer: UHC Exchange |
$1,534.28
|
| Rate for Payer: UHC Medicaid |
$565.30
|
| Rate for Payer: UHCCP DNSP |
$871.62
|
| Rate for Payer: UHCCP Medicaid |
$565.30
|
|
|
PR REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR
|
Professional
|
Both
|
$4,962.00
|
|
|
Service Code
|
HCPCS 63663
|
| Min. Negotiated Rate |
$261.14 |
| Max. Negotiated Rate |
$3,721.50 |
| Rate for Payer: Aetna Commercial |
$540.86
|
| Rate for Payer: Aetna Medicare |
$403.63
|
| Rate for Payer: BCBS Complete |
$274.20
|
| Rate for Payer: BCBS MAPPO |
$403.63
|
| Rate for Payer: BCN Commercial |
$676.26
|
| Rate for Payer: BCN Medicare Advantage |
$403.63
|
| Rate for Payer: Cash Price |
$3,969.60
|
| Rate for Payer: Cash Price |
$3,969.60
|
| Rate for Payer: Cofinity Commercial |
$581.23
|
| Rate for Payer: Cofinity Commercial |
$540.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.63
|
| Rate for Payer: Healthscope Commercial |
$484.36
|
| Rate for Payer: Healthscope Whirlpool |
$484.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.81
|
| Rate for Payer: Meridian Medicaid |
$274.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.99
|
| Rate for Payer: Nomi Health Commercial |
$484.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,721.50
|
| Rate for Payer: PACE SWMI |
$403.63
|
| Rate for Payer: PHP Medicare Advantage |
$403.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$785.47
|
| Rate for Payer: Priority Health Medicare |
$403.63
|
| Rate for Payer: Priority Health Narrow Network |
$785.47
|
| Rate for Payer: Railroad Medicare Medicare |
$403.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$793.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$403.63
|
| Rate for Payer: UHC Exchange |
$793.81
|
| Rate for Payer: UHC Medicaid |
$261.14
|
| Rate for Payer: UHCCP DNSP |
$403.63
|
| Rate for Payer: UHCCP Medicaid |
$261.14
|
|
|
PR REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP
|
Professional
|
Both
|
$1,880.00
|
|
|
Service Code
|
HCPCS 35879
|
| Min. Negotiated Rate |
$536.33 |
| Max. Negotiated Rate |
$1,660.50 |
| Rate for Payer: Aetna Commercial |
$1,136.78
|
| Rate for Payer: Aetna Medicare |
$848.34
|
| Rate for Payer: BCBS Complete |
$563.15
|
| Rate for Payer: BCBS MAPPO |
$848.34
|
| Rate for Payer: BCN Commercial |
$1,348.53
|
| Rate for Payer: BCN Medicare Advantage |
$848.34
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cofinity Commercial |
$1,221.61
|
| Rate for Payer: Cofinity Commercial |
$1,136.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.34
|
| Rate for Payer: Healthscope Commercial |
$1,018.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,018.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$890.76
|
| Rate for Payer: Meridian Medicaid |
$563.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$933.17
|
| Rate for Payer: Nomi Health Commercial |
$1,018.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,410.00
|
| Rate for Payer: PACE SWMI |
$848.34
|
| Rate for Payer: PHP Medicare Advantage |
$848.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,450.17
|
| Rate for Payer: Priority Health Medicare |
$848.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,450.17
|
| Rate for Payer: Railroad Medicare Medicare |
$848.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,660.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$848.34
|
| Rate for Payer: UHC Exchange |
$1,660.50
|
| Rate for Payer: UHC Medicaid |
$536.33
|
| Rate for Payer: UHCCP DNSP |
$848.34
|
| Rate for Payer: UHCCP Medicaid |
$536.33
|
|
|
PR REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS
|
Professional
|
Both
|
$2,183.00
|
|
|
Service Code
|
HCPCS 35881
|
| Min. Negotiated Rate |
$595.97 |
| Max. Negotiated Rate |
$1,833.07 |
| Rate for Payer: Aetna Commercial |
$1,262.86
|
| Rate for Payer: Aetna Medicare |
$942.43
|
| Rate for Payer: BCBS Complete |
$625.77
|
| Rate for Payer: BCBS MAPPO |
$942.43
|
| Rate for Payer: BCN Commercial |
$1,495.93
|
| Rate for Payer: BCN Medicare Advantage |
$942.43
|
| Rate for Payer: Cash Price |
$1,746.40
|
| Rate for Payer: Cash Price |
$1,746.40
|
| Rate for Payer: Cofinity Commercial |
$1,357.10
|
| Rate for Payer: Cofinity Commercial |
$1,262.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$942.43
|
| Rate for Payer: Healthscope Commercial |
$1,130.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,130.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$989.55
|
| Rate for Payer: Meridian Medicaid |
$625.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,036.67
|
| Rate for Payer: Nomi Health Commercial |
$1,130.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,637.25
|
| Rate for Payer: PACE SWMI |
$942.43
|
| Rate for Payer: PHP Medicare Advantage |
$942.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,608.69
|
| Rate for Payer: Priority Health Medicare |
$942.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,608.69
|
| Rate for Payer: Railroad Medicare Medicare |
$942.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,833.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$942.43
|
| Rate for Payer: UHC Exchange |
$1,833.07
|
| Rate for Payer: UHC Medicaid |
$595.97
|
| Rate for Payer: UHCCP DNSP |
$942.43
|
| Rate for Payer: UHCCP Medicaid |
$595.97
|
|
|
PR REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 69601
|
| Min. Negotiated Rate |
$577.23 |
| Max. Negotiated Rate |
$1,759.85 |
| Rate for Payer: Aetna Commercial |
$1,176.91
|
| Rate for Payer: Aetna Medicare |
$878.29
|
| Rate for Payer: BCBS Complete |
$606.09
|
| Rate for Payer: BCBS MAPPO |
$878.29
|
| Rate for Payer: BCN Commercial |
$1,519.84
|
| Rate for Payer: BCN Medicare Advantage |
$878.29
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,264.74
|
| Rate for Payer: Cofinity Commercial |
$1,176.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$878.29
|
| Rate for Payer: Healthscope Commercial |
$1,053.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,053.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.20
|
| Rate for Payer: Meridian Medicaid |
$606.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$966.12
|
| Rate for Payer: Nomi Health Commercial |
$1,053.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.50
|
| Rate for Payer: PACE SWMI |
$878.29
|
| Rate for Payer: PHP Medicare Advantage |
$878.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$577.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,501.76
|
| Rate for Payer: Priority Health Medicare |
$878.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.76
|
| Rate for Payer: Railroad Medicare Medicare |
$878.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,759.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$878.29
|
| Rate for Payer: UHC Exchange |
$1,759.85
|
| Rate for Payer: UHC Medicaid |
$577.23
|
| Rate for Payer: UHCCP DNSP |
$878.29
|
| Rate for Payer: UHCCP Medicaid |
$577.23
|
|
|
PR REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY
|
Professional
|
Both
|
$2,306.00
|
|
|
Service Code
|
HCPCS 69604
|
| Min. Negotiated Rate |
$628.99 |
| Max. Negotiated Rate |
$1,899.99 |
| Rate for Payer: Aetna Commercial |
$1,280.16
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: BCBS Complete |
$660.44
|
| Rate for Payer: BCBS MAPPO |
$955.34
|
| Rate for Payer: BCN Commercial |
$1,658.77
|
| Rate for Payer: BCN Medicare Advantage |
$955.34
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cofinity Commercial |
$1,375.69
|
| Rate for Payer: Cofinity Commercial |
$1,280.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$955.34
|
| Rate for Payer: Healthscope Commercial |
$1,146.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,146.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,003.11
|
| Rate for Payer: Meridian Medicaid |
$660.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,050.87
|
| Rate for Payer: Nomi Health Commercial |
$1,146.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,729.50
|
| Rate for Payer: PACE SWMI |
$955.34
|
| Rate for Payer: PHP Medicare Advantage |
$955.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,639.03
|
| Rate for Payer: Priority Health Medicare |
$955.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,639.03
|
| Rate for Payer: Railroad Medicare Medicare |
$955.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,899.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$955.34
|
| Rate for Payer: UHC Exchange |
$1,899.99
|
| Rate for Payer: UHC Medicaid |
$628.99
|
| Rate for Payer: UHCCP DNSP |
$955.34
|
| Rate for Payer: UHCCP Medicaid |
$628.99
|
|
|
PR REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF
|
Professional
|
Both
|
$1,261.00
|
|
|
Service Code
|
HCPCS 36832
|
| Min. Negotiated Rate |
$438.99 |
| Max. Negotiated Rate |
$1,351.25 |
| Rate for Payer: Aetna Commercial |
$925.54
|
| Rate for Payer: Aetna Medicare |
$690.70
|
| Rate for Payer: BCBS Complete |
$460.94
|
| Rate for Payer: BCBS MAPPO |
$690.70
|
| Rate for Payer: BCN Commercial |
$1,108.01
|
| Rate for Payer: BCN Medicare Advantage |
$690.70
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cofinity Commercial |
$994.61
|
| Rate for Payer: Cofinity Commercial |
$925.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$690.70
|
| Rate for Payer: Healthscope Commercial |
$828.84
|
| Rate for Payer: Healthscope Whirlpool |
$828.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$725.24
|
| Rate for Payer: Meridian Medicaid |
$460.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$759.77
|
| Rate for Payer: Nomi Health Commercial |
$828.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$945.75
|
| Rate for Payer: PACE SWMI |
$690.70
|
| Rate for Payer: PHP Medicare Advantage |
$690.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,191.52
|
| Rate for Payer: Priority Health Medicare |
$690.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,191.52
|
| Rate for Payer: Railroad Medicare Medicare |
$690.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,351.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$690.70
|
| Rate for Payer: UHC Exchange |
$1,351.25
|
| Rate for Payer: UHC Medicaid |
$438.99
|
| Rate for Payer: UHCCP DNSP |
$690.70
|
| Rate for Payer: UHCCP Medicaid |
$438.99
|
|
|
PR REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 36833
|
| Min. Negotiated Rate |
$469.67 |
| Max. Negotiated Rate |
$1,802.25 |
| Rate for Payer: Aetna Commercial |
$991.00
|
| Rate for Payer: Aetna Medicare |
$739.55
|
| Rate for Payer: BCBS Complete |
$493.15
|
| Rate for Payer: BCBS MAPPO |
$739.55
|
| Rate for Payer: BCN Commercial |
$1,182.20
|
| Rate for Payer: BCN Medicare Advantage |
$739.55
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cofinity Commercial |
$991.00
|
| Rate for Payer: Cofinity Commercial |
$1,064.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.55
|
| Rate for Payer: Healthscope Commercial |
$887.46
|
| Rate for Payer: Healthscope Whirlpool |
$887.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.53
|
| Rate for Payer: Meridian Medicaid |
$493.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$813.50
|
| Rate for Payer: Nomi Health Commercial |
$887.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,802.25
|
| Rate for Payer: PACE SWMI |
$739.55
|
| Rate for Payer: PHP Medicare Advantage |
$739.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$469.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,271.32
|
| Rate for Payer: Priority Health Medicare |
$739.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,271.32
|
| Rate for Payer: Railroad Medicare Medicare |
$739.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,449.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$739.55
|
| Rate for Payer: UHC Exchange |
$1,449.32
|
| Rate for Payer: UHC Medicaid |
$469.67
|
| Rate for Payer: UHCCP DNSP |
$739.55
|
| Rate for Payer: UHCCP Medicaid |
$469.67
|
|
|
PR REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA
|
Professional
|
Both
|
$1,874.00
|
|
|
Service Code
|
HCPCS 63688
|
| Min. Negotiated Rate |
$194.90 |
| Max. Negotiated Rate |
$1,405.50 |
| Rate for Payer: Aetna Commercial |
$400.66
|
| Rate for Payer: Aetna Medicare |
$299.00
|
| Rate for Payer: BCBS Complete |
$204.65
|
| Rate for Payer: BCBS MAPPO |
$299.00
|
| Rate for Payer: BCN Commercial |
$453.17
|
| Rate for Payer: BCN Medicare Advantage |
$299.00
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cash Price |
$1,499.20
|
| Rate for Payer: Cofinity Commercial |
$430.56
|
| Rate for Payer: Cofinity Commercial |
$400.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.00
|
| Rate for Payer: Healthscope Commercial |
$358.80
|
| Rate for Payer: Healthscope Whirlpool |
$358.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.95
|
| Rate for Payer: Meridian Medicaid |
$204.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$328.90
|
| Rate for Payer: Nomi Health Commercial |
$358.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,405.50
|
| Rate for Payer: PACE SWMI |
$299.00
|
| Rate for Payer: PHP Medicare Advantage |
$299.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$526.33
|
| Rate for Payer: Priority Health Medicare |
$299.00
|
| Rate for Payer: Priority Health Narrow Network |
$526.33
|
| Rate for Payer: Railroad Medicare Medicare |
$299.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$649.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$299.00
|
| Rate for Payer: UHC Exchange |
$649.00
|
| Rate for Payer: UHC Medicaid |
$194.90
|
| Rate for Payer: UHCCP DNSP |
$299.00
|
| Rate for Payer: UHCCP Medicaid |
$194.90
|
|
|
PR REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS
|
Professional
|
Both
|
$3,280.00
|
|
|
Service Code
|
HCPCS 61880
|
| Min. Negotiated Rate |
$395.12 |
| Max. Negotiated Rate |
$2,460.00 |
| Rate for Payer: Aetna Commercial |
$811.87
|
| Rate for Payer: Aetna Medicare |
$605.87
|
| Rate for Payer: BCBS Complete |
$414.88
|
| Rate for Payer: BCBS MAPPO |
$605.87
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: BCN Medicare Advantage |
$605.87
|
| Rate for Payer: Cash Price |
$2,624.00
|
| Rate for Payer: Cash Price |
$2,624.00
|
| Rate for Payer: Cofinity Commercial |
$872.45
|
| Rate for Payer: Cofinity Commercial |
$811.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.87
|
| Rate for Payer: Healthscope Commercial |
$727.04
|
| Rate for Payer: Healthscope Whirlpool |
$727.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.16
|
| Rate for Payer: Meridian Medicaid |
$414.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$666.46
|
| Rate for Payer: Nomi Health Commercial |
$727.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,460.00
|
| Rate for Payer: PACE SWMI |
$605.87
|
| Rate for Payer: PHP Medicare Advantage |
$605.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,050.95
|
| Rate for Payer: Priority Health Medicare |
$605.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,050.95
|
| Rate for Payer: Railroad Medicare Medicare |
$605.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,005.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$605.87
|
| Rate for Payer: UHC Exchange |
$1,005.51
|
| Rate for Payer: UHC Medicaid |
$395.12
|
| Rate for Payer: UHCCP DNSP |
$605.87
|
| Rate for Payer: UHCCP Medicaid |
$395.12
|
|
|
PR REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR
|
Professional
|
Both
|
$1,079.00
|
|
|
Service Code
|
HCPCS 61888
|
| Min. Negotiated Rate |
$257.09 |
| Max. Negotiated Rate |
$840.01 |
| Rate for Payer: Aetna Commercial |
$532.80
|
| Rate for Payer: Aetna Medicare |
$397.61
|
| Rate for Payer: BCBS Complete |
$269.94
|
| Rate for Payer: BCBS MAPPO |
$397.61
|
| Rate for Payer: BCN Commercial |
$840.01
|
| Rate for Payer: BCN Medicare Advantage |
$397.61
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cofinity Commercial |
$572.56
|
| Rate for Payer: Cofinity Commercial |
$532.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.61
|
| Rate for Payer: Healthscope Commercial |
$477.13
|
| Rate for Payer: Healthscope Whirlpool |
$477.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.49
|
| Rate for Payer: Meridian Medicaid |
$269.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.37
|
| Rate for Payer: Nomi Health Commercial |
$477.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$809.25
|
| Rate for Payer: PACE SWMI |
$397.61
|
| Rate for Payer: PHP Medicare Advantage |
$397.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$257.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$706.22
|
| Rate for Payer: Priority Health Medicare |
$397.61
|
| Rate for Payer: Priority Health Narrow Network |
$706.22
|
| Rate for Payer: Railroad Medicare Medicare |
$397.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$691.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$397.61
|
| Rate for Payer: UHC Exchange |
$691.96
|
| Rate for Payer: UHC Medicaid |
$257.09
|
| Rate for Payer: UHCCP DNSP |
$397.61
|
| Rate for Payer: UHCCP Medicaid |
$257.09
|
|
|
PR REVJ/RMVL PERPH NEUROSTIMULATOR ELECTRODE ARRAY
|
Professional
|
Both
|
$1,378.00
|
|
|
Service Code
|
HCPCS 64585
|
| Min. Negotiated Rate |
$86.69 |
| Max. Negotiated Rate |
$1,033.50 |
| Rate for Payer: Aetna Commercial |
$177.13
|
| Rate for Payer: Aetna Medicare |
$132.19
|
| Rate for Payer: BCBS Complete |
$91.02
|
| Rate for Payer: BCBS MAPPO |
$132.19
|
| Rate for Payer: BCN Commercial |
$216.62
|
| Rate for Payer: BCN Medicare Advantage |
$132.19
|
| Rate for Payer: Cash Price |
$1,102.40
|
| Rate for Payer: Cash Price |
$1,102.40
|
| Rate for Payer: Cofinity Commercial |
$190.35
|
| Rate for Payer: Cofinity Commercial |
$177.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.19
|
| Rate for Payer: Healthscope Commercial |
$158.63
|
| Rate for Payer: Healthscope Whirlpool |
$158.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.80
|
| Rate for Payer: Meridian Medicaid |
$91.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.41
|
| Rate for Payer: Nomi Health Commercial |
$158.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,033.50
|
| Rate for Payer: PACE SWMI |
$132.19
|
| Rate for Payer: PHP Medicare Advantage |
$132.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$251.61
|
| Rate for Payer: Priority Health Medicare |
$132.19
|
| Rate for Payer: Priority Health Narrow Network |
$251.61
|
| Rate for Payer: Railroad Medicare Medicare |
$132.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.19
|
| Rate for Payer: UHC Exchange |
$250.61
|
| Rate for Payer: UHC Medicaid |
$86.69
|
| Rate for Payer: UHCCP DNSP |
$132.19
|
| Rate for Payer: UHCCP Medicaid |
$86.69
|
|
|
PR REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 57295
|
| Min. Negotiated Rate |
$286.06 |
| Max. Negotiated Rate |
$1,097.25 |
| Rate for Payer: Aetna Commercial |
$590.46
|
| Rate for Payer: Aetna Medicare |
$440.64
|
| Rate for Payer: BCBS Complete |
$300.36
|
| Rate for Payer: BCBS MAPPO |
$440.64
|
| Rate for Payer: BCN Commercial |
$1,041.59
|
| Rate for Payer: BCN Medicare Advantage |
$440.64
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cofinity Commercial |
$634.52
|
| Rate for Payer: Cofinity Commercial |
$590.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.64
|
| Rate for Payer: Healthscope Commercial |
$528.77
|
| Rate for Payer: Healthscope Whirlpool |
$528.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.67
|
| Rate for Payer: Meridian Medicaid |
$300.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$484.70
|
| Rate for Payer: Nomi Health Commercial |
$528.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,097.25
|
| Rate for Payer: PACE SWMI |
$440.64
|
| Rate for Payer: PHP Medicare Advantage |
$440.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$763.59
|
| Rate for Payer: Priority Health Medicare |
$440.64
|
| Rate for Payer: Priority Health Narrow Network |
$763.59
|
| Rate for Payer: Railroad Medicare Medicare |
$440.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$865.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$440.64
|
| Rate for Payer: UHC Exchange |
$865.34
|
| Rate for Payer: UHC Medicaid |
$286.06
|
| Rate for Payer: UHCCP DNSP |
$440.64
|
| Rate for Payer: UHCCP Medicaid |
$286.06
|
|
|
PR REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$1,807.00
|
|
|
Service Code
|
HCPCS 64583
|
| Min. Negotiated Rate |
$475.20 |
| Max. Negotiated Rate |
$1,506.73 |
| Rate for Payer: Aetna Commercial |
$986.64
|
| Rate for Payer: Aetna Medicare |
$736.30
|
| Rate for Payer: BCBS Complete |
$498.96
|
| Rate for Payer: BCBS MAPPO |
$736.30
|
| Rate for Payer: BCN Commercial |
$1,297.24
|
| Rate for Payer: BCN Medicare Advantage |
$736.30
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cofinity Commercial |
$986.64
|
| Rate for Payer: Cofinity Commercial |
$1,060.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.30
|
| Rate for Payer: Healthscope Commercial |
$883.56
|
| Rate for Payer: Healthscope Whirlpool |
$883.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.12
|
| Rate for Payer: Meridian Medicaid |
$498.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$809.93
|
| Rate for Payer: Nomi Health Commercial |
$883.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,355.25
|
| Rate for Payer: PACE SWMI |
$736.30
|
| Rate for Payer: PHP Medicare Advantage |
$736.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,506.73
|
| Rate for Payer: Priority Health Medicare |
$736.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,506.73
|
| Rate for Payer: Railroad Medicare Medicare |
$736.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,424.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.30
|
| Rate for Payer: UHC Exchange |
$1,424.22
|
| Rate for Payer: UHC Medicaid |
$475.20
|
| Rate for Payer: UHCCP DNSP |
$736.30
|
| Rate for Payer: UHCCP Medicaid |
$475.20
|
|
|
PR REVJ/RPLMNT CH WAL RESPIR ELTRD & CONJ PULSE GEN
|
Professional
|
Both
|
$840.00
|
|
|
Service Code
|
HCPCS 0467T
|
| Min. Negotiated Rate |
$336.00 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: BCBS Complete |
$336.00
|
| Rate for Payer: Cash Price |
$672.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$630.00
|
|
|
PR REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT
|
Professional
|
Both
|
$4,705.00
|
|
|
Service Code
|
HCPCS 27486
|
| Min. Negotiated Rate |
$813.02 |
| Max. Negotiated Rate |
$3,528.75 |
| Rate for Payer: Aetna Commercial |
$1,681.98
|
| Rate for Payer: Aetna Medicare |
$1,255.21
|
| Rate for Payer: BCBS Complete |
$853.67
|
| Rate for Payer: BCBS MAPPO |
$1,255.21
|
| Rate for Payer: BCN Commercial |
$2,121.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,255.21
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cash Price |
$3,764.00
|
| Rate for Payer: Cofinity Commercial |
$1,681.98
|
| Rate for Payer: Cofinity Commercial |
$1,807.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,255.21
|
| Rate for Payer: Healthscope Commercial |
$1,506.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,506.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,317.97
|
| Rate for Payer: Meridian Medicaid |
$853.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,380.73
|
| Rate for Payer: Nomi Health Commercial |
$1,506.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,528.75
|
| Rate for Payer: PACE SWMI |
$1,255.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,255.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$813.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,267.71
|
| Rate for Payer: Priority Health Medicare |
$1,255.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,267.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,255.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,472.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,255.21
|
| Rate for Payer: UHC Exchange |
$2,472.07
|
| Rate for Payer: UHC Medicaid |
$813.02
|
| Rate for Payer: UHCCP DNSP |
$1,255.21
|
| Rate for Payer: UHCCP Medicaid |
$813.02
|
|
|
PR REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,129.00
|
|
|
Service Code
|
HCPCS 27137
|
| Min. Negotiated Rate |
$840.29 |
| Max. Negotiated Rate |
$2,590.84 |
| Rate for Payer: Aetna Commercial |
$1,743.77
|
| Rate for Payer: Aetna Medicare |
$1,301.32
|
| Rate for Payer: BCBS Complete |
$882.30
|
| Rate for Payer: BCBS MAPPO |
$1,301.32
|
| Rate for Payer: BCN Commercial |
$2,208.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,301.32
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cash Price |
$2,503.20
|
| Rate for Payer: Cofinity Commercial |
$1,873.90
|
| Rate for Payer: Cofinity Commercial |
$1,743.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,301.32
|
| Rate for Payer: Healthscope Commercial |
$1,561.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,366.39
|
| Rate for Payer: Meridian Medicaid |
$882.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,431.45
|
| Rate for Payer: Nomi Health Commercial |
$1,561.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,346.75
|
| Rate for Payer: PACE SWMI |
$1,301.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,301.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,360.33
|
| Rate for Payer: Priority Health Medicare |
$1,301.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,360.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,301.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,590.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,301.32
|
| Rate for Payer: UHC Exchange |
$2,590.84
|
| Rate for Payer: UHC Medicaid |
$840.29
|
| Rate for Payer: UHCCP DNSP |
$1,301.32
|
| Rate for Payer: UHCCP Medicaid |
$840.29
|
|
|
PR REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$4,077.00
|
|
|
Service Code
|
HCPCS 27134
|
| Min. Negotiated Rate |
$1,081.19 |
| Max. Negotiated Rate |
$3,375.67 |
| Rate for Payer: Aetna Commercial |
$2,249.89
|
| Rate for Payer: Aetna Medicare |
$1,679.02
|
| Rate for Payer: BCBS Complete |
$1,135.25
|
| Rate for Payer: BCBS MAPPO |
$1,679.02
|
| Rate for Payer: BCN Commercial |
$3,143.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,679.02
|
| Rate for Payer: Cash Price |
$3,261.60
|
| Rate for Payer: Cash Price |
$3,261.60
|
| Rate for Payer: Cofinity Commercial |
$2,417.79
|
| Rate for Payer: Cofinity Commercial |
$2,249.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,679.02
|
| Rate for Payer: Healthscope Commercial |
$2,014.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,014.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,762.97
|
| Rate for Payer: Meridian Medicaid |
$1,135.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,846.92
|
| Rate for Payer: Nomi Health Commercial |
$2,014.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,057.75
|
| Rate for Payer: PACE SWMI |
$1,679.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,679.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,081.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,058.76
|
| Rate for Payer: Priority Health Medicare |
$1,679.02
|
| Rate for Payer: Priority Health Narrow Network |
$3,058.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,679.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,375.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,679.02
|
| Rate for Payer: UHC Exchange |
$3,375.67
|
| Rate for Payer: UHC Medicaid |
$1,081.19
|
| Rate for Payer: UHCCP DNSP |
$1,679.02
|
| Rate for Payer: UHCCP Medicaid |
$1,081.19
|
|
