|
PR REMOVAL INDWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$1,695.00
|
|
|
Service Code
|
HCPCS 50384
|
| Min. Negotiated Rate |
$142.07 |
| Max. Negotiated Rate |
$3,794.78 |
| Rate for Payer: Aetna Commercial |
$294.10
|
| Rate for Payer: Aetna Medicare |
$847.50
|
| Rate for Payer: BCBS Complete |
$149.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,794.78
|
| Rate for Payer: BCN Commercial |
$1,270.56
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Meridian Medicaid |
$149.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,101.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.05
|
| Rate for Payer: Priority Health Narrow Network |
$352.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$306.42
|
| Rate for Payer: UHC Exchange |
$306.42
|
| Rate for Payer: UHCCP Medicaid |
$142.07
|
|
|
PR REMOVAL INTACT BREAST IMPLANT
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 19328
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Aetna Commercial |
$597.87
|
| Rate for Payer: Aetna Medicare |
$765.00
|
| Rate for Payer: BCBS Complete |
$377.97
|
| Rate for Payer: BCBS Trust/PPO |
$14.00
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Meridian Medicaid |
$377.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.48
|
| Rate for Payer: Priority Health Narrow Network |
$754.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.04
|
| Rate for Payer: UHC Exchange |
$514.04
|
| Rate for Payer: UHCCP Medicaid |
$359.97
|
|
|
PR REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 33968
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$267.85 |
| Rate for Payer: Aetna Commercial |
$45.62
|
| Rate for Payer: Aetna Medicare |
$48.00
|
| Rate for Payer: BCBS Complete |
$22.36
|
| Rate for Payer: BCBS Trust/PPO |
$267.85
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Meridian Medicaid |
$22.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.64
|
| Rate for Payer: Priority Health Narrow Network |
$52.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.58
|
| Rate for Payer: UHC Exchange |
$45.58
|
| Rate for Payer: UHCCP Medicaid |
$21.30
|
|
|
PR REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 20705
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$187.77 |
| Rate for Payer: Aetna Commercial |
$161.32
|
| Rate for Payer: Aetna Medicare |
$128.00
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCN Commercial |
$180.81
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.77
|
| Rate for Payer: Priority Health Narrow Network |
$187.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.78
|
| Rate for Payer: UHC Exchange |
$153.78
|
| Rate for Payer: UHCCP Medicaid |
$79.24
|
|
|
PR REMOVAL INTRAUTERINE DEVICE IUD
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 58301
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$510.34 |
| Rate for Payer: Aetna Commercial |
$80.07
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS Trust/PPO |
$510.34
|
| Rate for Payer: BCN Commercial |
$130.36
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.22
|
| Rate for Payer: Priority Health Narrow Network |
$98.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.74
|
| Rate for Payer: UHC Exchange |
$78.74
|
| Rate for Payer: UHCCP Medicaid |
$42.17
|
|
|
PR REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA
|
Professional
|
Both
|
$6,102.00
|
|
|
Service Code
|
HCPCS 32442
|
| Min. Negotiated Rate |
$640.30 |
| Max. Negotiated Rate |
$4,375.62 |
| Rate for Payer: Aetna Commercial |
$3,956.55
|
| Rate for Payer: Aetna Medicare |
$3,051.00
|
| Rate for Payer: BCBS Complete |
$2,013.30
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$4,375.62
|
| Rate for Payer: Cash Price |
$4,881.60
|
| Rate for Payer: Cash Price |
$4,881.60
|
| Rate for Payer: Meridian Medicaid |
$2,013.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,917.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,966.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,163.32
|
| Rate for Payer: Priority Health Narrow Network |
$4,163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,278.62
|
| Rate for Payer: UHC Exchange |
$3,278.62
|
| Rate for Payer: UHCCP Medicaid |
$1,917.43
|
|
|
PR REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 11982
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$438.68 |
| Rate for Payer: Aetna Commercial |
$82.16
|
| Rate for Payer: Aetna Medicare |
$127.00
|
| Rate for Payer: BCBS Complete |
$48.75
|
| Rate for Payer: BCBS Trust/PPO |
$438.68
|
| Rate for Payer: BCN Commercial |
$164.69
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Meridian Medicaid |
$48.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.44
|
| Rate for Payer: Priority Health Narrow Network |
$98.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.14
|
| Rate for Payer: UHC Exchange |
$110.14
|
| Rate for Payer: UHCCP Medicaid |
$46.43
|
|
|
PR REMOVAL OF LUNG PNEUMONECTOMY
|
Professional
|
Both
|
$5,503.00
|
|
|
Service Code
|
HCPCS 32440
|
| Min. Negotiated Rate |
$544.68 |
| Max. Negotiated Rate |
$3,576.95 |
| Rate for Payer: Aetna Commercial |
$2,027.10
|
| Rate for Payer: Aetna Medicare |
$2,751.50
|
| Rate for Payer: BCBS Complete |
$1,042.21
|
| Rate for Payer: BCBS Trust/PPO |
$544.68
|
| Rate for Payer: BCN Commercial |
$2,254.76
|
| Rate for Payer: Cash Price |
$4,402.40
|
| Rate for Payer: Cash Price |
$4,402.40
|
| Rate for Payer: Meridian Medicaid |
$1,042.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$992.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,576.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,150.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,150.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,867.68
|
| Rate for Payer: UHC Exchange |
$1,867.68
|
| Rate for Payer: UHCCP Medicaid |
$992.58
|
|
|
PR REMOVAL OF SUTURES
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS S0630
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$66.04 |
| Rate for Payer: Aetna Commercial |
$27.32
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Trust/PPO |
$66.04
|
| Rate for Payer: BCN Commercial |
$37.93
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
|
|
PR REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
HCPCS 49402
|
| Min. Negotiated Rate |
$551.46 |
| Max. Negotiated Rate |
$2,108.97 |
| Rate for Payer: Aetna Commercial |
$1,153.44
|
| Rate for Payer: Aetna Medicare |
$1,128.50
|
| Rate for Payer: BCBS Complete |
$579.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.97
|
| Rate for Payer: BCN Commercial |
$1,247.10
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Meridian Medicaid |
$579.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,532.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,532.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,029.76
|
| Rate for Payer: UHC Exchange |
$1,029.76
|
| Rate for Payer: UHCCP Medicaid |
$551.46
|
|
|
PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 33233
|
| Min. Negotiated Rate |
$147.82 |
| Max. Negotiated Rate |
$702.64 |
| Rate for Payer: Aetna Commercial |
$309.82
|
| Rate for Payer: Aetna Medicare |
$317.50
|
| Rate for Payer: BCBS Complete |
$155.21
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Meridian Medicaid |
$155.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.02
|
| Rate for Payer: Priority Health Narrow Network |
$368.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.00
|
| Rate for Payer: UHC Exchange |
$318.00
|
| Rate for Payer: UHCCP Medicaid |
$147.82
|
|
|
PR REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 33992
|
| Min. Negotiated Rate |
$117.36 |
| Max. Negotiated Rate |
$1,321.81 |
| Rate for Payer: Aetna Commercial |
$252.98
|
| Rate for Payer: Aetna Medicare |
$281.50
|
| Rate for Payer: BCBS Complete |
$123.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.81
|
| Rate for Payer: BCN Commercial |
$267.31
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Meridian Medicaid |
$123.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.50
|
| Rate for Payer: Priority Health Narrow Network |
$292.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.66
|
| Rate for Payer: UHC Exchange |
$284.66
|
| Rate for Payer: UHCCP Medicaid |
$117.36
|
|
|
PR REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$2,102.00
|
|
|
Service Code
|
HCPCS 22850
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$1,366.30 |
| Rate for Payer: Aetna Commercial |
$979.88
|
| Rate for Payer: Aetna Medicare |
$1,051.00
|
| Rate for Payer: BCBS Complete |
$505.45
|
| Rate for Payer: BCBS Trust/PPO |
$89.99
|
| Rate for Payer: BCN Commercial |
$1,082.91
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Meridian Medicaid |
$505.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,138.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,138.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$825.76
|
| Rate for Payer: UHC Exchange |
$825.76
|
| Rate for Payer: UHCCP Medicaid |
$481.38
|
|
|
PR REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION
|
Professional
|
Both
|
$2,232.00
|
|
|
Service Code
|
HCPCS 22852
|
| Min. Negotiated Rate |
$463.28 |
| Max. Negotiated Rate |
$1,450.80 |
| Rate for Payer: Aetna Commercial |
$941.89
|
| Rate for Payer: Aetna Medicare |
$1,116.00
|
| Rate for Payer: BCBS Complete |
$486.44
|
| Rate for Payer: BCBS Trust/PPO |
$648.97
|
| Rate for Payer: BCN Commercial |
$1,042.35
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Meridian Medicaid |
$486.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,098.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,098.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$788.44
|
| Rate for Payer: UHC Exchange |
$788.44
|
| Rate for Payer: UHCCP Medicaid |
$463.28
|
|
|
PR REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 23333
|
| Min. Negotiated Rate |
$75.14 |
| Max. Negotiated Rate |
$737.35 |
| Rate for Payer: Aetna Commercial |
$630.21
|
| Rate for Payer: Aetna Medicare |
$474.00
|
| Rate for Payer: BCBS Complete |
$328.09
|
| Rate for Payer: BCBS Trust/PPO |
$75.14
|
| Rate for Payer: BCN Commercial |
$699.30
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Meridian Medicaid |
$328.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$616.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$737.35
|
| Rate for Payer: Priority Health Narrow Network |
$737.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$569.87
|
| Rate for Payer: UHC Exchange |
$569.87
|
| Rate for Payer: UHCCP Medicaid |
$312.47
|
|
|
PR REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 33286
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$2,454.48 |
| Rate for Payer: Aetna Commercial |
$116.81
|
| Rate for Payer: Aetna Medicare |
$134.00
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,454.48
|
| Rate for Payer: BCN Commercial |
$192.54
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.01
|
| Rate for Payer: Priority Health Narrow Network |
$134.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.20
|
| Rate for Payer: UHC Exchange |
$117.20
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
PR REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 15854
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$452.03 |
| Rate for Payer: Aetna Commercial |
$16.42
|
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS Trust/PPO |
$452.03
|
| Rate for Payer: BCN Commercial |
$23.46
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.68
|
| Rate for Payer: Priority Health Narrow Network |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.83
|
| Rate for Payer: UHC Exchange |
$18.83
|
|
|
PR REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 15853
|
| Min. Negotiated Rate |
$11.61 |
| Max. Negotiated Rate |
$10,615.31 |
| Rate for Payer: Aetna Commercial |
$11.61
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.31
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.80
|
| Rate for Payer: Priority Health Narrow Network |
$15.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.32
|
| Rate for Payer: UHC Exchange |
$13.32
|
|
|
PR REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 15851
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$272.27 |
| Rate for Payer: Aetna Commercial |
$49.70
|
| Rate for Payer: Aetna Medicare |
$80.00
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: BCBS Trust/PPO |
$272.27
|
| Rate for Payer: BCN Commercial |
$82.58
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Meridian Medicaid |
$44.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.04
|
| Rate for Payer: Priority Health Narrow Network |
$88.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.15
|
| Rate for Payer: UHC Exchange |
$50.15
|
| Rate for Payer: UHCCP Medicaid |
$41.96
|
|
|
PR REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS 15850
|
| Min. Negotiated Rate |
$90.40 |
| Max. Negotiated Rate |
$146.90 |
| Rate for Payer: Aetna Medicare |
$113.00
|
| Rate for Payer: BCBS Complete |
$90.40
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
|
|
PR REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11971
|
| Min. Negotiated Rate |
$321.28 |
| Max. Negotiated Rate |
$807.78 |
| Rate for Payer: Aetna Commercial |
$589.15
|
| Rate for Payer: Aetna Medicare |
$465.00
|
| Rate for Payer: BCBS Complete |
$377.08
|
| Rate for Payer: BCBS Trust/PPO |
$394.67
|
| Rate for Payer: BCN Commercial |
$807.78
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Meridian Medicaid |
$377.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$753.58
|
| Rate for Payer: Priority Health Narrow Network |
$753.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.28
|
| Rate for Payer: UHC Exchange |
$321.28
|
| Rate for Payer: UHCCP Medicaid |
$359.12
|
|
|
PR REMOVAL TUNNELED INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 49422
|
| Min. Negotiated Rate |
$140.37 |
| Max. Negotiated Rate |
$906.56 |
| Rate for Payer: Aetna Commercial |
$299.91
|
| Rate for Payer: Aetna Medicare |
$490.50
|
| Rate for Payer: BCBS Complete |
$147.39
|
| Rate for Payer: BCBS Trust/PPO |
$906.56
|
| Rate for Payer: BCN Commercial |
$320.09
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Meridian Medicaid |
$147.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.56
|
| Rate for Payer: Priority Health Narrow Network |
$392.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$467.69
|
| Rate for Payer: UHC Exchange |
$467.69
|
| Rate for Payer: UHCCP Medicaid |
$140.37
|
|
|
PR REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE
|
Professional
|
Both
|
$3,380.00
|
|
|
Service Code
|
HCPCS 33977
|
| Min. Negotiated Rate |
$107.24 |
| Max. Negotiated Rate |
$2,197.00 |
| Rate for Payer: Aetna Commercial |
$1,503.29
|
| Rate for Payer: Aetna Medicare |
$1,690.00
|
| Rate for Payer: BCBS Complete |
$740.28
|
| Rate for Payer: BCBS Trust/PPO |
$107.24
|
| Rate for Payer: BCN Commercial |
$1,602.86
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Meridian Medicaid |
$740.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,197.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,750.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,750.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,571.68
|
| Rate for Payer: UHC Exchange |
$1,571.68
|
| Rate for Payer: UHCCP Medicaid |
$705.03
|
|
|
PR REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST
|
Professional
|
Both
|
$1,352.00
|
|
|
Service Code
|
HCPCS 25251
|
| Min. Negotiated Rate |
$470.73 |
| Max. Negotiated Rate |
$2,000.67 |
| Rate for Payer: Aetna Commercial |
$960.15
|
| Rate for Payer: Aetna Medicare |
$676.00
|
| Rate for Payer: BCBS Complete |
$494.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,000.67
|
| Rate for Payer: BCN Commercial |
$1,061.41
|
| Rate for Payer: Cash Price |
$1,081.60
|
| Rate for Payer: Cash Price |
$1,081.60
|
| Rate for Payer: Meridian Medicaid |
$494.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$878.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$819.67
|
| Rate for Payer: UHC Exchange |
$819.67
|
| Rate for Payer: UHCCP Medicaid |
$470.73
|
|
|
PR REMOVE BILE DUCT STONE, PERCUT
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 47630
|
| Min. Negotiated Rate |
$361.60 |
| Max. Negotiated Rate |
$587.60 |
| Rate for Payer: Aetna Medicare |
$452.00
|
| Rate for Payer: BCBS Complete |
$361.60
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.60
|
|
