|
PR REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT
|
Professional
|
Both
|
$3,252.00
|
|
|
Service Code
|
HCPCS 27138
|
| Min. Negotiated Rate |
$871.81 |
| Max. Negotiated Rate |
$2,693.66 |
| Rate for Payer: Aetna Commercial |
$1,809.90
|
| Rate for Payer: Aetna Medicare |
$1,350.67
|
| Rate for Payer: BCBS Complete |
$915.40
|
| Rate for Payer: BCBS MAPPO |
$1,350.67
|
| Rate for Payer: BCN Commercial |
$2,293.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,350.67
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cofinity Commercial |
$1,944.96
|
| Rate for Payer: Cofinity Commercial |
$1,809.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,350.67
|
| Rate for Payer: Healthscope Commercial |
$1,620.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,620.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,418.20
|
| Rate for Payer: Meridian Medicaid |
$915.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,485.74
|
| Rate for Payer: Nomi Health Commercial |
$1,620.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,439.00
|
| Rate for Payer: PACE SWMI |
$1,350.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,350.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$871.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,451.38
|
| Rate for Payer: Priority Health Medicare |
$1,350.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,451.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,350.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,693.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,350.67
|
| Rate for Payer: UHC Exchange |
$2,693.66
|
| Rate for Payer: UHC Medicaid |
$871.81
|
| Rate for Payer: UHCCP DNSP |
$1,350.67
|
| Rate for Payer: UHCCP Medicaid |
$871.81
|
|
|
PR REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE
|
Professional
|
Both
|
$6,183.00
|
|
|
Service Code
|
HCPCS 27487
|
| Min. Negotiated Rate |
$1,004.08 |
| Max. Negotiated Rate |
$4,637.25 |
| Rate for Payer: Aetna Commercial |
$2,083.35
|
| Rate for Payer: Aetna Medicare |
$1,554.74
|
| Rate for Payer: BCBS Complete |
$1,054.28
|
| Rate for Payer: BCBS MAPPO |
$1,554.74
|
| Rate for Payer: BCN Commercial |
$2,899.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,554.74
|
| Rate for Payer: Cash Price |
$4,946.40
|
| Rate for Payer: Cash Price |
$4,946.40
|
| Rate for Payer: Cofinity Commercial |
$2,238.83
|
| Rate for Payer: Cofinity Commercial |
$2,083.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,554.74
|
| Rate for Payer: Healthscope Commercial |
$1,865.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,865.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,632.48
|
| Rate for Payer: Meridian Medicaid |
$1,054.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,710.21
|
| Rate for Payer: Nomi Health Commercial |
$1,865.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,637.25
|
| Rate for Payer: PACE SWMI |
$1,554.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,554.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,004.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,821.33
|
| Rate for Payer: Priority Health Medicare |
$1,554.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,821.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,554.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,096.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,554.74
|
| Rate for Payer: UHC Exchange |
$3,096.40
|
| Rate for Payer: UHC Medicaid |
$1,004.08
|
| Rate for Payer: UHCCP DNSP |
$1,554.74
|
| Rate for Payer: UHCCP Medicaid |
$1,004.08
|
|
|
PR REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 50728
|
| Min. Negotiated Rate |
$406.19 |
| Max. Negotiated Rate |
$1,297.43 |
| Rate for Payer: Aetna Commercial |
$840.13
|
| Rate for Payer: Aetna Medicare |
$626.96
|
| Rate for Payer: BCBS Complete |
$426.50
|
| Rate for Payer: BCBS MAPPO |
$626.96
|
| Rate for Payer: BCN Commercial |
$1,050.74
|
| Rate for Payer: BCN Medicare Advantage |
$626.96
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cofinity Commercial |
$902.82
|
| Rate for Payer: Cofinity Commercial |
$840.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.96
|
| Rate for Payer: Healthscope Commercial |
$752.35
|
| Rate for Payer: Healthscope Whirlpool |
$752.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.31
|
| Rate for Payer: Meridian Medicaid |
$426.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$689.66
|
| Rate for Payer: Nomi Health Commercial |
$752.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.50
|
| Rate for Payer: PACE SWMI |
$626.96
|
| Rate for Payer: PHP Medicare Advantage |
$626.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,144.60
|
| Rate for Payer: Priority Health Medicare |
$626.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,144.60
|
| Rate for Payer: Railroad Medicare Medicare |
$626.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,297.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$626.96
|
| Rate for Payer: UHC Exchange |
$1,297.43
|
| Rate for Payer: UHC Medicaid |
$406.19
|
| Rate for Payer: UHCCP DNSP |
$626.96
|
| Rate for Payer: UHCCP Medicaid |
$406.19
|
|
|
PR REVJ URINARY-CUTANEOUS ANASTAMOSIS
|
Professional
|
Both
|
$1,335.00
|
|
|
Service Code
|
HCPCS 50727
|
| Min. Negotiated Rate |
$302.03 |
| Max. Negotiated Rate |
$1,001.25 |
| Rate for Payer: Aetna Commercial |
$621.60
|
| Rate for Payer: Aetna Medicare |
$463.88
|
| Rate for Payer: BCBS Complete |
$317.13
|
| Rate for Payer: BCBS MAPPO |
$463.88
|
| Rate for Payer: BCN Commercial |
$768.38
|
| Rate for Payer: BCN Medicare Advantage |
$463.88
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cofinity Commercial |
$667.99
|
| Rate for Payer: Cofinity Commercial |
$621.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.88
|
| Rate for Payer: Healthscope Commercial |
$556.66
|
| Rate for Payer: Healthscope Whirlpool |
$556.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$487.07
|
| Rate for Payer: Meridian Medicaid |
$317.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$510.27
|
| Rate for Payer: Nomi Health Commercial |
$556.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,001.25
|
| Rate for Payer: PACE SWMI |
$463.88
|
| Rate for Payer: PHP Medicare Advantage |
$463.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$837.03
|
| Rate for Payer: Priority Health Medicare |
$463.88
|
| Rate for Payer: Priority Health Narrow Network |
$837.03
|
| Rate for Payer: Railroad Medicare Medicare |
$463.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$893.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$463.88
|
| Rate for Payer: UHC Exchange |
$893.75
|
| Rate for Payer: UHC Medicaid |
$302.03
|
| Rate for Payer: UHCCP DNSP |
$463.88
|
| Rate for Payer: UHCCP Medicaid |
$302.03
|
|
|
PR REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA
|
Professional
|
Both
|
$717.00
|
|
|
Service Code
|
HCPCS 64595
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$537.75 |
| Rate for Payer: Aetna Commercial |
$276.35
|
| Rate for Payer: Aetna Medicare |
$206.23
|
| Rate for Payer: BCBS Complete |
$140.45
|
| Rate for Payer: BCBS MAPPO |
$206.23
|
| Rate for Payer: BCN Commercial |
$345.59
|
| Rate for Payer: BCN Medicare Advantage |
$206.23
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cofinity Commercial |
$296.97
|
| Rate for Payer: Cofinity Commercial |
$276.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.23
|
| Rate for Payer: Healthscope Commercial |
$247.48
|
| Rate for Payer: Healthscope Whirlpool |
$247.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.54
|
| Rate for Payer: Meridian Medicaid |
$140.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.85
|
| Rate for Payer: Nomi Health Commercial |
$247.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$537.75
|
| Rate for Payer: PACE SWMI |
$206.23
|
| Rate for Payer: PHP Medicare Advantage |
$206.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$401.40
|
| Rate for Payer: Priority Health Medicare |
$206.23
|
| Rate for Payer: Priority Health Narrow Network |
$401.40
|
| Rate for Payer: Railroad Medicare Medicare |
$206.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.23
|
| Rate for Payer: UHC Exchange |
$219.97
|
| Rate for Payer: UHC Medicaid |
$133.76
|
| Rate for Payer: UHCCP DNSP |
$206.23
|
| Rate for Payer: UHCCP Medicaid |
$133.76
|
|
|
PR REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL
|
Professional
|
Both
|
$1,220.00
|
|
|
Service Code
|
HCPCS 37265
|
| Min. Negotiated Rate |
$307.15 |
| Max. Negotiated Rate |
$915.00 |
| Rate for Payer: Aetna Commercial |
$654.11
|
| Rate for Payer: Aetna Medicare |
$488.14
|
| Rate for Payer: BCBS Complete |
$322.51
|
| Rate for Payer: BCBS MAPPO |
$488.14
|
| Rate for Payer: BCN Medicare Advantage |
$488.14
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cofinity Commercial |
$702.92
|
| Rate for Payer: Cofinity Commercial |
$654.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.14
|
| Rate for Payer: Healthscope Commercial |
$585.77
|
| Rate for Payer: Healthscope Whirlpool |
$585.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$512.55
|
| Rate for Payer: Meridian Medicaid |
$322.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$536.95
|
| Rate for Payer: Nomi Health Commercial |
$585.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.00
|
| Rate for Payer: PACE SWMI |
$488.14
|
| Rate for Payer: PHP Medicare Advantage |
$488.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$709.67
|
| Rate for Payer: Priority Health Medicare |
$488.14
|
| Rate for Payer: Priority Health Narrow Network |
$709.67
|
| Rate for Payer: Railroad Medicare Medicare |
$488.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$897.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$488.14
|
| Rate for Payer: UHC Exchange |
$897.68
|
| Rate for Payer: UHC Medicaid |
$307.15
|
| Rate for Payer: UHCCP DNSP |
$488.14
|
| Rate for Payer: UHCCP Medicaid |
$307.15
|
|
|
PR REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL
|
Professional
|
Both
|
$902.00
|
|
|
Service Code
|
HCPCS 37263
|
| Min. Negotiated Rate |
$227.06 |
| Max. Negotiated Rate |
$676.50 |
| Rate for Payer: Aetna Commercial |
$483.47
|
| Rate for Payer: Aetna Medicare |
$360.80
|
| Rate for Payer: BCBS Complete |
$238.41
|
| Rate for Payer: BCBS MAPPO |
$360.80
|
| Rate for Payer: BCN Medicare Advantage |
$360.80
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cofinity Commercial |
$519.55
|
| Rate for Payer: Cofinity Commercial |
$483.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.80
|
| Rate for Payer: Healthscope Commercial |
$432.96
|
| Rate for Payer: Healthscope Whirlpool |
$432.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.84
|
| Rate for Payer: Meridian Medicaid |
$238.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.88
|
| Rate for Payer: Nomi Health Commercial |
$432.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$676.50
|
| Rate for Payer: PACE SWMI |
$360.80
|
| Rate for Payer: PHP Medicare Advantage |
$360.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$524.99
|
| Rate for Payer: Priority Health Medicare |
$360.80
|
| Rate for Payer: Priority Health Narrow Network |
$524.99
|
| Rate for Payer: Railroad Medicare Medicare |
$360.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$663.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$360.80
|
| Rate for Payer: UHC Exchange |
$663.53
|
| Rate for Payer: UHC Medicaid |
$227.06
|
| Rate for Payer: UHCCP DNSP |
$360.80
|
| Rate for Payer: UHCCP Medicaid |
$227.06
|
|
|
PR REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL
|
Professional
|
Both
|
$1,458.00
|
|
|
Service Code
|
HCPCS 37273
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna Commercial |
$781.23
|
| Rate for Payer: Aetna Medicare |
$583.01
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS MAPPO |
$583.01
|
| Rate for Payer: BCN Medicare Advantage |
$583.01
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cash Price |
$1,166.40
|
| Rate for Payer: Cofinity Commercial |
$839.53
|
| Rate for Payer: Cofinity Commercial |
$781.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.01
|
| Rate for Payer: Healthscope Commercial |
$699.61
|
| Rate for Payer: Healthscope Whirlpool |
$699.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.16
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$641.31
|
| Rate for Payer: Nomi Health Commercial |
$699.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.50
|
| Rate for Payer: PACE SWMI |
$583.01
|
| Rate for Payer: PHP Medicare Advantage |
$583.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$849.04
|
| Rate for Payer: Priority Health Medicare |
$583.01
|
| Rate for Payer: Priority Health Narrow Network |
$849.04
|
| Rate for Payer: Railroad Medicare Medicare |
$583.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,073.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$583.01
|
| Rate for Payer: UHC Exchange |
$1,073.39
|
| Rate for Payer: UHC Medicaid |
$367.43
|
| Rate for Payer: UHCCP DNSP |
$583.01
|
| Rate for Payer: UHCCP Medicaid |
$367.43
|
|
|
PR REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 37271
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$766.47 |
| Rate for Payer: Aetna Commercial |
$557.82
|
| Rate for Payer: Aetna Medicare |
$416.28
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$416.28
|
| Rate for Payer: BCN Medicare Advantage |
$416.28
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cofinity Commercial |
$599.44
|
| Rate for Payer: Cofinity Commercial |
$557.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.28
|
| Rate for Payer: Healthscope Commercial |
$499.54
|
| Rate for Payer: Healthscope Whirlpool |
$499.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.09
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.91
|
| Rate for Payer: Nomi Health Commercial |
$499.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$582.00
|
| Rate for Payer: PACE SWMI |
$416.28
|
| Rate for Payer: PHP Medicare Advantage |
$416.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$606.74
|
| Rate for Payer: Priority Health Medicare |
$416.28
|
| Rate for Payer: Priority Health Narrow Network |
$606.74
|
| Rate for Payer: Railroad Medicare Medicare |
$416.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.28
|
| Rate for Payer: UHC Exchange |
$766.47
|
| Rate for Payer: UHC Medicaid |
$262.42
|
| Rate for Payer: UHCCP DNSP |
$416.28
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
|
|
PR REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL
|
Professional
|
Both
|
$9,832.00
|
|
|
Service Code
|
HCPCS 37267
|
| Min. Negotiated Rate |
$256.03 |
| Max. Negotiated Rate |
$7,374.00 |
| Rate for Payer: Aetna Commercial |
$545.46
|
| Rate for Payer: Aetna Medicare |
$407.06
|
| Rate for Payer: BCBS Complete |
$268.83
|
| Rate for Payer: BCBS MAPPO |
$407.06
|
| Rate for Payer: BCN Medicare Advantage |
$407.06
|
| Rate for Payer: Cash Price |
$7,865.60
|
| Rate for Payer: Cash Price |
$7,865.60
|
| Rate for Payer: Cofinity Commercial |
$586.17
|
| Rate for Payer: Cofinity Commercial |
$545.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.06
|
| Rate for Payer: Healthscope Commercial |
$488.47
|
| Rate for Payer: Healthscope Whirlpool |
$488.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.41
|
| Rate for Payer: Meridian Medicaid |
$268.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$447.77
|
| Rate for Payer: Nomi Health Commercial |
$488.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,374.00
|
| Rate for Payer: PACE SWMI |
$407.06
|
| Rate for Payer: PHP Medicare Advantage |
$407.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$591.97
|
| Rate for Payer: Priority Health Medicare |
$407.06
|
| Rate for Payer: Priority Health Narrow Network |
$591.97
|
| Rate for Payer: Railroad Medicare Medicare |
$407.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$748.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$407.06
|
| Rate for Payer: UHC Exchange |
$748.37
|
| Rate for Payer: UHC Medicaid |
$256.03
|
| Rate for Payer: UHCCP DNSP |
$407.06
|
| Rate for Payer: UHCCP Medicaid |
$256.03
|
|
|
PR REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 37296
|
| Min. Negotiated Rate |
$319.71 |
| Max. Negotiated Rate |
$934.71 |
| Rate for Payer: Aetna Commercial |
$681.04
|
| Rate for Payer: Aetna Medicare |
$508.24
|
| Rate for Payer: BCBS Complete |
$335.70
|
| Rate for Payer: BCBS MAPPO |
$508.24
|
| Rate for Payer: BCN Medicare Advantage |
$508.24
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$731.87
|
| Rate for Payer: Cofinity Commercial |
$681.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.24
|
| Rate for Payer: Healthscope Commercial |
$609.89
|
| Rate for Payer: Healthscope Whirlpool |
$609.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.65
|
| Rate for Payer: Meridian Medicaid |
$335.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$559.06
|
| Rate for Payer: Nomi Health Commercial |
$609.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$508.24
|
| Rate for Payer: PHP Medicare Advantage |
$508.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$739.22
|
| Rate for Payer: Priority Health Medicare |
$508.24
|
| Rate for Payer: Priority Health Narrow Network |
$739.22
|
| Rate for Payer: Railroad Medicare Medicare |
$508.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$934.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$508.24
|
| Rate for Payer: UHC Exchange |
$934.71
|
| Rate for Payer: UHC Medicaid |
$319.71
|
| Rate for Payer: UHCCP DNSP |
$508.24
|
| Rate for Payer: UHCCP Medicaid |
$319.71
|
|
|
PR REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL
|
Professional
|
Both
|
$633.00
|
|
|
Service Code
|
HCPCS 37254
|
| Min. Negotiated Rate |
$214.07 |
| Max. Negotiated Rate |
$625.44 |
| Rate for Payer: Aetna Commercial |
$455.63
|
| Rate for Payer: Aetna Medicare |
$340.02
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$340.02
|
| Rate for Payer: BCN Medicare Advantage |
$340.02
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cofinity Commercial |
$489.63
|
| Rate for Payer: Cofinity Commercial |
$455.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.02
|
| Rate for Payer: Healthscope Commercial |
$408.02
|
| Rate for Payer: Healthscope Whirlpool |
$408.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.02
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.02
|
| Rate for Payer: Nomi Health Commercial |
$408.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.75
|
| Rate for Payer: PACE SWMI |
$340.02
|
| Rate for Payer: PHP Medicare Advantage |
$340.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$494.95
|
| Rate for Payer: Priority Health Medicare |
$340.02
|
| Rate for Payer: Priority Health Narrow Network |
$494.95
|
| Rate for Payer: Railroad Medicare Medicare |
$340.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.02
|
| Rate for Payer: UHC Exchange |
$625.44
|
| Rate for Payer: UHC Medicaid |
$214.07
|
| Rate for Payer: UHCCP DNSP |
$340.02
|
| Rate for Payer: UHCCP Medicaid |
$214.07
|
|
|
PR REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 37255
|
| Min. Negotiated Rate |
$86.69 |
| Max. Negotiated Rate |
$253.61 |
| Rate for Payer: Aetna Commercial |
$184.85
|
| Rate for Payer: Aetna Medicare |
$137.95
|
| Rate for Payer: BCBS Complete |
$91.02
|
| Rate for Payer: BCBS MAPPO |
$137.95
|
| Rate for Payer: BCN Medicare Advantage |
$137.95
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$198.65
|
| Rate for Payer: Cofinity Commercial |
$184.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.95
|
| Rate for Payer: Healthscope Commercial |
$165.54
|
| Rate for Payer: Healthscope Whirlpool |
$165.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.85
|
| Rate for Payer: Meridian Medicaid |
$91.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.75
|
| Rate for Payer: Nomi Health Commercial |
$165.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE SWMI |
$137.95
|
| Rate for Payer: PHP Medicare Advantage |
$137.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$200.44
|
| Rate for Payer: Priority Health Medicare |
$137.95
|
| Rate for Payer: Priority Health Narrow Network |
$200.44
|
| Rate for Payer: Railroad Medicare Medicare |
$137.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$137.95
|
| Rate for Payer: UHC Exchange |
$253.61
|
| Rate for Payer: UHC Medicaid |
$86.69
|
| Rate for Payer: UHCCP DNSP |
$137.95
|
| Rate for Payer: UHCCP Medicaid |
$86.69
|
|
|
PR REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL
|
Professional
|
Both
|
$1,470.00
|
|
|
Service Code
|
HCPCS 37260
|
| Min. Negotiated Rate |
$369.77 |
| Max. Negotiated Rate |
$1,102.50 |
| Rate for Payer: Aetna Commercial |
$788.00
|
| Rate for Payer: Aetna Medicare |
$588.06
|
| Rate for Payer: BCBS Complete |
$388.26
|
| Rate for Payer: BCBS MAPPO |
$588.06
|
| Rate for Payer: BCN Medicare Advantage |
$588.06
|
| Rate for Payer: Cash Price |
$1,176.00
|
| Rate for Payer: Cash Price |
$1,176.00
|
| Rate for Payer: Cofinity Commercial |
$846.81
|
| Rate for Payer: Cofinity Commercial |
$788.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.06
|
| Rate for Payer: Healthscope Commercial |
$705.67
|
| Rate for Payer: Healthscope Whirlpool |
$705.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.46
|
| Rate for Payer: Meridian Medicaid |
$388.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$646.87
|
| Rate for Payer: Nomi Health Commercial |
$705.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,102.50
|
| Rate for Payer: PACE SWMI |
$588.06
|
| Rate for Payer: PHP Medicare Advantage |
$588.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$854.95
|
| Rate for Payer: Priority Health Medicare |
$588.06
|
| Rate for Payer: Priority Health Narrow Network |
$854.95
|
| Rate for Payer: Railroad Medicare Medicare |
$588.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,081.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$588.06
|
| Rate for Payer: UHC Exchange |
$1,081.13
|
| Rate for Payer: UHC Medicaid |
$369.77
|
| Rate for Payer: UHCCP DNSP |
$588.06
|
| Rate for Payer: UHCCP Medicaid |
$369.77
|
|
|
PR REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 37258
|
| Min. Negotiated Rate |
$255.81 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$545.04
|
| Rate for Payer: Aetna Medicare |
$406.75
|
| Rate for Payer: BCBS Complete |
$268.60
|
| Rate for Payer: BCBS MAPPO |
$406.75
|
| Rate for Payer: BCN Medicare Advantage |
$406.75
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$585.72
|
| Rate for Payer: Cofinity Commercial |
$545.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.75
|
| Rate for Payer: Healthscope Commercial |
$488.10
|
| Rate for Payer: Healthscope Whirlpool |
$488.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.09
|
| Rate for Payer: Meridian Medicaid |
$268.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$447.43
|
| Rate for Payer: Nomi Health Commercial |
$488.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$762.00
|
| Rate for Payer: PACE SWMI |
$406.75
|
| Rate for Payer: PHP Medicare Advantage |
$406.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$255.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$591.47
|
| Rate for Payer: Priority Health Medicare |
$406.75
|
| Rate for Payer: Priority Health Narrow Network |
$591.47
|
| Rate for Payer: Railroad Medicare Medicare |
$406.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$747.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$406.75
|
| Rate for Payer: UHC Exchange |
$747.80
|
| Rate for Payer: UHC Medicaid |
$255.81
|
| Rate for Payer: UHCCP DNSP |
$406.75
|
| Rate for Payer: UHCCP Medicaid |
$255.81
|
|
|
PR REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 37259
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$338.52 |
| Rate for Payer: Aetna Commercial |
$246.94
|
| Rate for Payer: Aetna Medicare |
$184.28
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS MAPPO |
$184.28
|
| Rate for Payer: BCN Medicare Advantage |
$184.28
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$265.36
|
| Rate for Payer: Cofinity Commercial |
$246.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.28
|
| Rate for Payer: Healthscope Commercial |
$221.14
|
| Rate for Payer: Healthscope Whirlpool |
$221.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.49
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$202.71
|
| Rate for Payer: Nomi Health Commercial |
$221.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.50
|
| Rate for Payer: PACE SWMI |
$184.28
|
| Rate for Payer: PHP Medicare Advantage |
$184.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$267.42
|
| Rate for Payer: Priority Health Medicare |
$184.28
|
| Rate for Payer: Priority Health Narrow Network |
$267.42
|
| Rate for Payer: Railroad Medicare Medicare |
$184.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$338.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$184.28
|
| Rate for Payer: UHC Exchange |
$338.52
|
| Rate for Payer: UHC Medicaid |
$115.66
|
| Rate for Payer: UHCCP DNSP |
$184.28
|
| Rate for Payer: UHCCP Medicaid |
$115.66
|
|
|
PR REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL
|
Professional
|
Both
|
$1,058.00
|
|
|
Service Code
|
HCPCS 37282
|
| Min. Negotiated Rate |
$358.05 |
| Max. Negotiated Rate |
$1,046.87 |
| Rate for Payer: Aetna Commercial |
$762.89
|
| Rate for Payer: Aetna Medicare |
$569.32
|
| Rate for Payer: BCBS Complete |
$375.95
|
| Rate for Payer: BCBS MAPPO |
$569.32
|
| Rate for Payer: BCN Medicare Advantage |
$569.32
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cofinity Commercial |
$819.82
|
| Rate for Payer: Cofinity Commercial |
$762.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$569.32
|
| Rate for Payer: Healthscope Commercial |
$683.18
|
| Rate for Payer: Healthscope Whirlpool |
$683.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$597.79
|
| Rate for Payer: Meridian Medicaid |
$375.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$626.25
|
| Rate for Payer: Nomi Health Commercial |
$683.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$793.50
|
| Rate for Payer: PACE SWMI |
$569.32
|
| Rate for Payer: PHP Medicare Advantage |
$569.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$826.88
|
| Rate for Payer: Priority Health Medicare |
$569.32
|
| Rate for Payer: Priority Health Narrow Network |
$826.88
|
| Rate for Payer: Railroad Medicare Medicare |
$569.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,046.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$569.32
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicaid |
$358.05
|
| Rate for Payer: UHCCP DNSP |
$569.32
|
| Rate for Payer: UHCCP Medicaid |
$358.05
|
|
|
PR REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 37283
|
| Min. Negotiated Rate |
$122.26 |
| Max. Negotiated Rate |
$357.55 |
| Rate for Payer: Aetna Commercial |
$260.32
|
| Rate for Payer: Aetna Medicare |
$194.27
|
| Rate for Payer: BCBS Complete |
$128.37
|
| Rate for Payer: BCBS MAPPO |
$194.27
|
| Rate for Payer: BCN Medicare Advantage |
$194.27
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$279.75
|
| Rate for Payer: Cofinity Commercial |
$260.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.27
|
| Rate for Payer: Healthscope Commercial |
$233.12
|
| Rate for Payer: Healthscope Whirlpool |
$233.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.98
|
| Rate for Payer: Meridian Medicaid |
$128.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$213.70
|
| Rate for Payer: Nomi Health Commercial |
$233.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$270.75
|
| Rate for Payer: PACE SWMI |
$194.27
|
| Rate for Payer: PHP Medicare Advantage |
$194.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$282.19
|
| Rate for Payer: Priority Health Medicare |
$194.27
|
| Rate for Payer: Priority Health Narrow Network |
$282.19
|
| Rate for Payer: Railroad Medicare Medicare |
$194.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$357.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$194.27
|
| Rate for Payer: UHC Exchange |
$357.55
|
| Rate for Payer: UHC Medicaid |
$122.26
|
| Rate for Payer: UHCCP DNSP |
$194.27
|
| Rate for Payer: UHCCP Medicaid |
$122.26
|
|
|
PR REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL
|
Professional
|
Both
|
$1,134.00
|
|
|
Service Code
|
HCPCS 37280
|
| Min. Negotiated Rate |
$285.42 |
| Max. Negotiated Rate |
$850.50 |
| Rate for Payer: Aetna Commercial |
$608.07
|
| Rate for Payer: Aetna Medicare |
$453.78
|
| Rate for Payer: BCBS Complete |
$299.69
|
| Rate for Payer: BCBS MAPPO |
$453.78
|
| Rate for Payer: BCN Medicare Advantage |
$453.78
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cofinity Commercial |
$653.44
|
| Rate for Payer: Cofinity Commercial |
$608.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.78
|
| Rate for Payer: Healthscope Commercial |
$544.54
|
| Rate for Payer: Healthscope Whirlpool |
$544.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.47
|
| Rate for Payer: Meridian Medicaid |
$299.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$499.16
|
| Rate for Payer: Nomi Health Commercial |
$544.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$850.50
|
| Rate for Payer: PACE SWMI |
$453.78
|
| Rate for Payer: PHP Medicare Advantage |
$453.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$659.93
|
| Rate for Payer: Priority Health Medicare |
$453.78
|
| Rate for Payer: Priority Health Narrow Network |
$659.93
|
| Rate for Payer: Railroad Medicare Medicare |
$453.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$834.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$453.78
|
| Rate for Payer: UHC Exchange |
$834.43
|
| Rate for Payer: UHC Medicaid |
$285.42
|
| Rate for Payer: UHCCP DNSP |
$453.78
|
| Rate for Payer: UHCCP Medicaid |
$285.42
|
|
|
PR REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
HCPCS 37281
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$255.75 |
| Rate for Payer: Aetna Commercial |
$182.74
|
| Rate for Payer: Aetna Medicare |
$136.37
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$136.37
|
| Rate for Payer: BCN Medicare Advantage |
$136.37
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cofinity Commercial |
$196.37
|
| Rate for Payer: Cofinity Commercial |
$182.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.37
|
| Rate for Payer: Healthscope Commercial |
$163.64
|
| Rate for Payer: Healthscope Whirlpool |
$163.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.19
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.01
|
| Rate for Payer: Nomi Health Commercial |
$163.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.75
|
| Rate for Payer: PACE SWMI |
$136.37
|
| Rate for Payer: PHP Medicare Advantage |
$136.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$198.47
|
| Rate for Payer: Priority Health Medicare |
$136.37
|
| Rate for Payer: Priority Health Narrow Network |
$198.47
|
| Rate for Payer: Railroad Medicare Medicare |
$136.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.37
|
| Rate for Payer: UHC Exchange |
$251.05
|
| Rate for Payer: UHC Medicaid |
$85.84
|
| Rate for Payer: UHCCP DNSP |
$136.37
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
|
PR REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 37224
|
| Min. Negotiated Rate |
$439.20 |
| Max. Negotiated Rate |
$823.50 |
| Rate for Payer: Aetna Commercial |
$598.07
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCN Commercial |
$645.38
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$823.50
|
|
|
PR REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL
|
Professional
|
Both
|
$2,387.00
|
|
|
Service Code
|
HCPCS 37225
|
| Min. Negotiated Rate |
$809.21 |
| Max. Negotiated Rate |
$1,790.25 |
| Rate for Payer: Aetna Commercial |
$809.21
|
| Rate for Payer: BCBS Complete |
$954.80
|
| Rate for Payer: BCN Commercial |
$865.99
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,790.25
|
|
|
PR REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 37226
|
| Min. Negotiated Rate |
$476.00 |
| Max. Negotiated Rate |
$892.50 |
| Rate for Payer: Aetna Commercial |
$699.45
|
| Rate for Payer: BCBS Complete |
$476.00
|
| Rate for Payer: BCN Commercial |
$753.44
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
|
|
PR REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL
|
Professional
|
Both
|
$2,026.00
|
|
|
Service Code
|
HCPCS 37227
|
| Min. Negotiated Rate |
$810.40 |
| Max. Negotiated Rate |
$1,519.50 |
| Rate for Payer: Aetna Commercial |
$970.23
|
| Rate for Payer: BCBS Complete |
$810.40
|
| Rate for Payer: BCN Commercial |
$1,038.79
|
| Rate for Payer: Cash Price |
$1,620.80
|
| Rate for Payer: Cash Price |
$1,620.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,519.50
|
|
|
PR REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL
|
Professional
|
Both
|
$514.00
|
|
|
Service Code
|
HCPCS 37223
|
| Min. Negotiated Rate |
$205.60 |
| Max. Negotiated Rate |
$385.50 |
| Rate for Payer: Aetna Commercial |
$286.46
|
| Rate for Payer: BCBS Complete |
$205.60
|
| Rate for Payer: BCN Commercial |
$307.76
|
| Rate for Payer: Cash Price |
$411.20
|
| Rate for Payer: Cash Price |
$411.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$385.50
|
|
