|
PR RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS
|
Professional
|
Both
|
$418.00
|
|
|
Service Code
|
HCPCS 27086
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$313.50 |
| Rate for Payer: Aetna Commercial |
$215.87
|
| Rate for Payer: Aetna Medicare |
$161.10
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS MAPPO |
$161.10
|
| Rate for Payer: BCN Commercial |
$258.45
|
| Rate for Payer: BCN Medicare Advantage |
$161.10
|
| Rate for Payer: Cash Price |
$334.40
|
| Rate for Payer: Cash Price |
$334.40
|
| Rate for Payer: Cofinity Commercial |
$231.98
|
| Rate for Payer: Cofinity Commercial |
$215.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.10
|
| Rate for Payer: Healthscope Commercial |
$193.32
|
| Rate for Payer: Healthscope Whirlpool |
$193.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.16
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$177.21
|
| Rate for Payer: Nomi Health Commercial |
$193.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$313.50
|
| Rate for Payer: PACE SWMI |
$161.10
|
| Rate for Payer: PHP Medicare Advantage |
$161.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$276.28
|
| Rate for Payer: Priority Health Medicare |
$161.10
|
| Rate for Payer: Priority Health Narrow Network |
$276.28
|
| Rate for Payer: Railroad Medicare Medicare |
$161.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.10
|
| Rate for Payer: UHC Exchange |
$289.26
|
| Rate for Payer: UHC Medicaid |
$106.71
|
| Rate for Payer: UHCCP DNSP |
$161.10
|
| Rate for Payer: UHCCP Medicaid |
$106.71
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 24200
|
| Min. Negotiated Rate |
$91.38 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$185.64
|
| Rate for Payer: Aetna Medicare |
$138.54
|
| Rate for Payer: BCBS Complete |
$95.95
|
| Rate for Payer: BCBS MAPPO |
$138.54
|
| Rate for Payer: BCN Commercial |
$218.61
|
| Rate for Payer: BCN Medicare Advantage |
$138.54
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$199.50
|
| Rate for Payer: Cofinity Commercial |
$185.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.54
|
| Rate for Payer: Healthscope Commercial |
$166.25
|
| Rate for Payer: Healthscope Whirlpool |
$166.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.47
|
| Rate for Payer: Meridian Medicaid |
$95.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.39
|
| Rate for Payer: Nomi Health Commercial |
$166.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$138.54
|
| Rate for Payer: PHP Medicare Advantage |
$138.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$233.69
|
| Rate for Payer: Priority Health Medicare |
$138.54
|
| Rate for Payer: Priority Health Narrow Network |
$233.69
|
| Rate for Payer: Railroad Medicare Medicare |
$138.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.54
|
| Rate for Payer: UHC Exchange |
$244.00
|
| Rate for Payer: UHC Medicaid |
$91.38
|
| Rate for Payer: UHCCP DNSP |
$138.54
|
| Rate for Payer: UHCCP Medicaid |
$91.38
|
|
|
PR RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA
|
Professional
|
Both
|
$3,391.00
|
|
|
Service Code
|
HCPCS 27091
|
| Min. Negotiated Rate |
$916.54 |
| Max. Negotiated Rate |
$2,808.24 |
| Rate for Payer: Aetna Commercial |
$1,899.42
|
| Rate for Payer: Aetna Medicare |
$1,417.48
|
| Rate for Payer: BCBS Complete |
$962.37
|
| Rate for Payer: BCBS MAPPO |
$1,417.48
|
| Rate for Payer: BCN Commercial |
$2,401.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,417.48
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cofinity Commercial |
$2,041.17
|
| Rate for Payer: Cofinity Commercial |
$1,899.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,417.48
|
| Rate for Payer: Healthscope Commercial |
$1,700.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,700.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,488.35
|
| Rate for Payer: Meridian Medicaid |
$962.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,559.23
|
| Rate for Payer: Nomi Health Commercial |
$1,700.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,543.25
|
| Rate for Payer: PACE SWMI |
$1,417.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,417.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$916.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,567.41
|
| Rate for Payer: Priority Health Medicare |
$1,417.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,567.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,417.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,808.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,417.48
|
| Rate for Payer: UHC Exchange |
$2,808.24
|
| Rate for Payer: UHC Medicaid |
$916.54
|
| Rate for Payer: UHCCP DNSP |
$1,417.48
|
| Rate for Payer: UHCCP Medicaid |
$916.54
|
|
|
PR RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF
|
Professional
|
Both
|
$2,704.00
|
|
|
Service Code
|
HCPCS 33971
|
| Min. Negotiated Rate |
$428.13 |
| Max. Negotiated Rate |
$2,028.00 |
| Rate for Payer: Aetna Commercial |
$893.65
|
| Rate for Payer: Aetna Medicare |
$666.90
|
| Rate for Payer: BCBS Complete |
$449.54
|
| Rate for Payer: BCBS MAPPO |
$666.90
|
| Rate for Payer: BCN Commercial |
$1,044.26
|
| Rate for Payer: BCN Medicare Advantage |
$666.90
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cofinity Commercial |
$893.65
|
| Rate for Payer: Cofinity Commercial |
$960.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.90
|
| Rate for Payer: Healthscope Commercial |
$800.28
|
| Rate for Payer: Healthscope Whirlpool |
$800.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.25
|
| Rate for Payer: Meridian Medicaid |
$449.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$733.59
|
| Rate for Payer: Nomi Health Commercial |
$800.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,028.00
|
| Rate for Payer: PACE SWMI |
$666.90
|
| Rate for Payer: PHP Medicare Advantage |
$666.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,122.98
|
| Rate for Payer: Priority Health Medicare |
$666.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,122.98
|
| Rate for Payer: Railroad Medicare Medicare |
$666.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,248.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$666.90
|
| Rate for Payer: UHC Exchange |
$1,248.61
|
| Rate for Payer: UHC Medicaid |
$428.13
|
| Rate for Payer: UHCCP DNSP |
$666.90
|
| Rate for Payer: UHCCP Medicaid |
$428.13
|
|
|
PR RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 33284
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.75
|
|
|
PR RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 33262
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$660.03 |
| Rate for Payer: Aetna Commercial |
$437.80
|
| Rate for Payer: Aetna Medicare |
$326.72
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$326.72
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$326.72
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$470.48
|
| Rate for Payer: Cofinity Commercial |
$437.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.72
|
| Rate for Payer: Healthscope Commercial |
$392.06
|
| Rate for Payer: Healthscope Whirlpool |
$392.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.06
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.39
|
| Rate for Payer: Nomi Health Commercial |
$392.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$518.25
|
| Rate for Payer: PACE SWMI |
$326.72
|
| Rate for Payer: PHP Medicare Advantage |
$326.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$590.14
|
| Rate for Payer: Priority Health Medicare |
$326.72
|
| Rate for Payer: Priority Health Narrow Network |
$590.14
|
| Rate for Payer: Railroad Medicare Medicare |
$326.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$660.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.72
|
| Rate for Payer: UHC Exchange |
$660.03
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP DNSP |
$326.72
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
|
|
PR RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 33263
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$686.45 |
| Rate for Payer: Aetna Commercial |
$455.48
|
| Rate for Payer: Aetna Medicare |
$339.91
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS MAPPO |
$339.91
|
| Rate for Payer: BCN Commercial |
$570.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.91
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cofinity Commercial |
$489.47
|
| Rate for Payer: Cofinity Commercial |
$455.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.91
|
| Rate for Payer: Healthscope Commercial |
$407.89
|
| Rate for Payer: Healthscope Whirlpool |
$407.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.91
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$373.90
|
| Rate for Payer: Nomi Health Commercial |
$407.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$608.25
|
| Rate for Payer: PACE SWMI |
$339.91
|
| Rate for Payer: PHP Medicare Advantage |
$339.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$613.70
|
| Rate for Payer: Priority Health Medicare |
$339.91
|
| Rate for Payer: Priority Health Narrow Network |
$613.70
|
| Rate for Payer: Railroad Medicare Medicare |
$339.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$686.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$339.91
|
| Rate for Payer: UHC Exchange |
$686.45
|
| Rate for Payer: UHC Medicaid |
$218.33
|
| Rate for Payer: UHCCP DNSP |
$339.91
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
|
|
PR RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD
|
Professional
|
Both
|
$847.00
|
|
|
Service Code
|
HCPCS 33264
|
| Min. Negotiated Rate |
$226.63 |
| Max. Negotiated Rate |
$717.66 |
| Rate for Payer: Aetna Commercial |
$473.01
|
| Rate for Payer: Aetna Medicare |
$352.99
|
| Rate for Payer: BCBS Complete |
$237.96
|
| Rate for Payer: BCBS MAPPO |
$352.99
|
| Rate for Payer: BCN Commercial |
$594.59
|
| Rate for Payer: BCN Medicare Advantage |
$352.99
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cofinity Commercial |
$508.31
|
| Rate for Payer: Cofinity Commercial |
$473.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.99
|
| Rate for Payer: Healthscope Commercial |
$423.59
|
| Rate for Payer: Healthscope Whirlpool |
$423.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.64
|
| Rate for Payer: Meridian Medicaid |
$237.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$388.29
|
| Rate for Payer: Nomi Health Commercial |
$423.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$635.25
|
| Rate for Payer: PACE SWMI |
$352.99
|
| Rate for Payer: PHP Medicare Advantage |
$352.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$639.41
|
| Rate for Payer: Priority Health Medicare |
$352.99
|
| Rate for Payer: Priority Health Narrow Network |
$639.41
|
| Rate for Payer: Railroad Medicare Medicare |
$352.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$717.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$352.99
|
| Rate for Payer: UHC Exchange |
$717.66
|
| Rate for Payer: UHC Medicaid |
$226.63
|
| Rate for Payer: UHCCP DNSP |
$352.99
|
| Rate for Payer: UHCCP Medicaid |
$226.63
|
|
|
PR RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH
|
Professional
|
Both
|
$1,434.00
|
|
|
Service Code
|
HCPCS 54406
|
| Min. Negotiated Rate |
$423.44 |
| Max. Negotiated Rate |
$1,289.55 |
| Rate for Payer: Aetna Commercial |
$877.07
|
| Rate for Payer: Aetna Medicare |
$654.53
|
| Rate for Payer: BCBS Complete |
$444.61
|
| Rate for Payer: BCBS MAPPO |
$654.53
|
| Rate for Payer: BCN Commercial |
$1,097.05
|
| Rate for Payer: BCN Medicare Advantage |
$654.53
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cofinity Commercial |
$942.52
|
| Rate for Payer: Cofinity Commercial |
$877.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.53
|
| Rate for Payer: Healthscope Commercial |
$785.44
|
| Rate for Payer: Healthscope Whirlpool |
$785.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$687.26
|
| Rate for Payer: Meridian Medicaid |
$444.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$719.98
|
| Rate for Payer: Nomi Health Commercial |
$785.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,075.50
|
| Rate for Payer: PACE SWMI |
$654.53
|
| Rate for Payer: PHP Medicare Advantage |
$654.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,195.04
|
| Rate for Payer: Priority Health Medicare |
$654.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,195.04
|
| Rate for Payer: Railroad Medicare Medicare |
$654.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,289.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$654.53
|
| Rate for Payer: UHC Exchange |
$1,289.55
|
| Rate for Payer: UHC Medicaid |
$423.44
|
| Rate for Payer: UHCCP DNSP |
$654.53
|
| Rate for Payer: UHCCP Medicaid |
$423.44
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY
|
Professional
|
Both
|
$3,802.00
|
|
|
Service Code
|
HCPCS 32484
|
| Min. Negotiated Rate |
$862.86 |
| Max. Negotiated Rate |
$2,851.50 |
| Rate for Payer: Aetna Commercial |
$1,811.79
|
| Rate for Payer: Aetna Medicare |
$1,352.08
|
| Rate for Payer: BCBS Complete |
$906.00
|
| Rate for Payer: BCBS MAPPO |
$1,352.08
|
| Rate for Payer: BCN Commercial |
$2,118.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,352.08
|
| Rate for Payer: Cash Price |
$3,041.60
|
| Rate for Payer: Cash Price |
$3,041.60
|
| Rate for Payer: Cofinity Commercial |
$1,947.00
|
| Rate for Payer: Cofinity Commercial |
$1,811.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,352.08
|
| Rate for Payer: Healthscope Commercial |
$1,622.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,622.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,419.68
|
| Rate for Payer: Meridian Medicaid |
$906.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,487.29
|
| Rate for Payer: Nomi Health Commercial |
$1,622.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,851.50
|
| Rate for Payer: PACE SWMI |
$1,352.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,352.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$862.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,995.38
|
| Rate for Payer: Priority Health Medicare |
$1,352.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,995.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,352.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,546.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,352.08
|
| Rate for Payer: UHC Exchange |
$2,546.51
|
| Rate for Payer: UHC Medicaid |
$862.86
|
| Rate for Payer: UHCCP DNSP |
$1,352.08
|
| Rate for Payer: UHCCP Medicaid |
$862.86
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC
|
Professional
|
Both
|
$5,523.00
|
|
|
Service Code
|
HCPCS 32482
|
| Min. Negotiated Rate |
$959.14 |
| Max. Negotiated Rate |
$4,142.25 |
| Rate for Payer: Aetna Commercial |
$2,009.01
|
| Rate for Payer: Aetna Medicare |
$1,499.26
|
| Rate for Payer: BCBS Complete |
$1,007.10
|
| Rate for Payer: BCBS MAPPO |
$1,499.26
|
| Rate for Payer: BCN Commercial |
$2,341.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,499.26
|
| Rate for Payer: Cash Price |
$4,418.40
|
| Rate for Payer: Cash Price |
$4,418.40
|
| Rate for Payer: Cofinity Commercial |
$2,158.93
|
| Rate for Payer: Cofinity Commercial |
$2,009.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,499.26
|
| Rate for Payer: Healthscope Commercial |
$1,799.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,799.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,574.22
|
| Rate for Payer: Meridian Medicaid |
$1,007.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,649.19
|
| Rate for Payer: Nomi Health Commercial |
$1,799.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,142.25
|
| Rate for Payer: PACE SWMI |
$1,499.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,499.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$959.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,204.54
|
| Rate for Payer: Priority Health Medicare |
$1,499.26
|
| Rate for Payer: Priority Health Narrow Network |
$2,204.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,499.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,811.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,499.26
|
| Rate for Payer: UHC Exchange |
$2,811.65
|
| Rate for Payer: UHC Medicaid |
$959.14
|
| Rate for Payer: UHCCP DNSP |
$1,499.26
|
| Rate for Payer: UHCCP Medicaid |
$959.14
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT
|
Professional
|
Both
|
$4,909.00
|
|
|
Service Code
|
HCPCS 32480
|
| Min. Negotiated Rate |
$894.39 |
| Max. Negotiated Rate |
$3,681.75 |
| Rate for Payer: Aetna Commercial |
$1,874.67
|
| Rate for Payer: Aetna Medicare |
$1,399.01
|
| Rate for Payer: BCBS Complete |
$939.11
|
| Rate for Payer: BCBS MAPPO |
$1,399.01
|
| Rate for Payer: BCN Commercial |
$2,187.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,399.01
|
| Rate for Payer: Cash Price |
$3,927.20
|
| Rate for Payer: Cash Price |
$3,927.20
|
| Rate for Payer: Cofinity Commercial |
$2,014.57
|
| Rate for Payer: Cofinity Commercial |
$1,874.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,399.01
|
| Rate for Payer: Healthscope Commercial |
$1,678.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,678.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,468.96
|
| Rate for Payer: Meridian Medicaid |
$939.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,538.91
|
| Rate for Payer: Nomi Health Commercial |
$1,678.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,681.75
|
| Rate for Payer: PACE SWMI |
$1,399.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,399.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$894.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,059.63
|
| Rate for Payer: Priority Health Medicare |
$1,399.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,059.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,399.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,624.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,399.01
|
| Rate for Payer: UHC Exchange |
$2,624.55
|
| Rate for Payer: UHC Medicaid |
$894.39
|
| Rate for Payer: UHCCP DNSP |
$1,399.01
|
| Rate for Payer: UHCCP Medicaid |
$894.39
|
|
|
PR RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC
|
Professional
|
Both
|
$4,617.00
|
|
|
Service Code
|
HCPCS 32488
|
| Min. Negotiated Rate |
$1,427.95 |
| Max. Negotiated Rate |
$4,256.86 |
| Rate for Payer: Aetna Commercial |
$3,004.90
|
| Rate for Payer: Aetna Medicare |
$2,242.46
|
| Rate for Payer: BCBS Complete |
$1,499.35
|
| Rate for Payer: BCBS MAPPO |
$2,242.46
|
| Rate for Payer: BCN Commercial |
$3,521.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,242.46
|
| Rate for Payer: Cash Price |
$3,693.60
|
| Rate for Payer: Cash Price |
$3,693.60
|
| Rate for Payer: Cofinity Commercial |
$3,229.14
|
| Rate for Payer: Cofinity Commercial |
$3,004.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,242.46
|
| Rate for Payer: Healthscope Commercial |
$2,690.95
|
| Rate for Payer: Healthscope Whirlpool |
$2,690.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,354.58
|
| Rate for Payer: Meridian Medicaid |
$1,499.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,466.71
|
| Rate for Payer: Nomi Health Commercial |
$2,690.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,462.75
|
| Rate for Payer: PACE SWMI |
$2,242.46
|
| Rate for Payer: PHP Medicare Advantage |
$2,242.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,427.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,315.95
|
| Rate for Payer: Priority Health Medicare |
$2,242.46
|
| Rate for Payer: Priority Health Narrow Network |
$3,315.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,242.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,256.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,242.46
|
| Rate for Payer: UHC Exchange |
$4,256.86
|
| Rate for Payer: UHC Medicaid |
$1,427.95
|
| Rate for Payer: UHCCP DNSP |
$2,242.46
|
| Rate for Payer: UHCCP Medicaid |
$1,427.95
|
|
|
PR RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY
|
Professional
|
Both
|
$4,569.00
|
|
|
Service Code
|
HCPCS 32486
|
| Min. Negotiated Rate |
$1,387.70 |
| Max. Negotiated Rate |
$4,192.63 |
| Rate for Payer: Aetna Commercial |
$2,927.04
|
| Rate for Payer: Aetna Medicare |
$2,184.36
|
| Rate for Payer: BCBS Complete |
$1,457.09
|
| Rate for Payer: BCBS MAPPO |
$2,184.36
|
| Rate for Payer: BCN Commercial |
$3,440.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,184.36
|
| Rate for Payer: Cash Price |
$3,655.20
|
| Rate for Payer: Cash Price |
$3,655.20
|
| Rate for Payer: Cofinity Commercial |
$3,145.48
|
| Rate for Payer: Cofinity Commercial |
$2,927.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,184.36
|
| Rate for Payer: Healthscope Commercial |
$2,621.23
|
| Rate for Payer: Healthscope Whirlpool |
$2,621.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,293.58
|
| Rate for Payer: Meridian Medicaid |
$1,457.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,402.80
|
| Rate for Payer: Nomi Health Commercial |
$2,621.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,426.75
|
| Rate for Payer: PACE SWMI |
$2,184.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,184.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,387.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,239.98
|
| Rate for Payer: Priority Health Medicare |
$2,184.36
|
| Rate for Payer: Priority Health Narrow Network |
$3,239.98
|
| Rate for Payer: Railroad Medicare Medicare |
$2,184.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,192.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,184.36
|
| Rate for Payer: UHC Exchange |
$4,192.63
|
| Rate for Payer: UHC Medicaid |
$1,387.70
|
| Rate for Payer: UHCCP DNSP |
$2,184.36
|
| Rate for Payer: UHCCP Medicaid |
$1,387.70
|
|
|
PR RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 32552
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$276.78 |
| Rate for Payer: Aetna Commercial |
$193.71
|
| Rate for Payer: Aetna Medicare |
$144.56
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$144.56
|
| Rate for Payer: BCN Commercial |
$232.55
|
| Rate for Payer: BCN Medicare Advantage |
$144.56
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cofinity Commercial |
$208.17
|
| Rate for Payer: Cofinity Commercial |
$193.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.56
|
| Rate for Payer: Healthscope Commercial |
$173.47
|
| Rate for Payer: Healthscope Whirlpool |
$173.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.79
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.02
|
| Rate for Payer: Nomi Health Commercial |
$173.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.00
|
| Rate for Payer: PACE SWMI |
$144.56
|
| Rate for Payer: PHP Medicare Advantage |
$144.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$219.00
|
| Rate for Payer: Priority Health Medicare |
$144.56
|
| Rate for Payer: Priority Health Narrow Network |
$219.00
|
| Rate for Payer: Railroad Medicare Medicare |
$144.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.56
|
| Rate for Payer: UHC Exchange |
$276.78
|
| Rate for Payer: UHC Medicaid |
$94.15
|
| Rate for Payer: UHCCP DNSP |
$144.56
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
|
|
PR RMVL NFROS TUBE REQ FLUORO GUIDANCE
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 50389
|
| Min. Negotiated Rate |
$29.18 |
| Max. Negotiated Rate |
$233.25 |
| Rate for Payer: Aetna Commercial |
$61.30
|
| Rate for Payer: Aetna Medicare |
$45.75
|
| Rate for Payer: BCBS Complete |
$30.64
|
| Rate for Payer: BCBS MAPPO |
$45.75
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$45.75
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$65.88
|
| Rate for Payer: Cofinity Commercial |
$61.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.75
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Healthscope Whirlpool |
$54.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.04
|
| Rate for Payer: Meridian Medicaid |
$30.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.33
|
| Rate for Payer: Nomi Health Commercial |
$54.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.25
|
| Rate for Payer: PACE SWMI |
$45.75
|
| Rate for Payer: PHP Medicare Advantage |
$45.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$85.71
|
| Rate for Payer: Priority Health Medicare |
$45.75
|
| Rate for Payer: Priority Health Narrow Network |
$85.71
|
| Rate for Payer: Railroad Medicare Medicare |
$45.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45.75
|
| Rate for Payer: UHC Exchange |
$95.40
|
| Rate for Payer: UHC Medicaid |
$29.18
|
| Rate for Payer: UHCCP DNSP |
$45.75
|
| Rate for Payer: UHCCP Medicaid |
$29.18
|
|
|
PR RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 49623
|
| Min. Negotiated Rate |
$117.36 |
| Max. Negotiated Rate |
$368.91 |
| Rate for Payer: Aetna Commercial |
$248.60
|
| Rate for Payer: Aetna Medicare |
$185.52
|
| Rate for Payer: BCBS Complete |
$123.23
|
| Rate for Payer: BCBS MAPPO |
$185.52
|
| Rate for Payer: BCN Commercial |
$302.77
|
| Rate for Payer: BCN Medicare Advantage |
$185.52
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$267.15
|
| Rate for Payer: Cofinity Commercial |
$248.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.52
|
| Rate for Payer: Healthscope Commercial |
$222.62
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.80
|
| Rate for Payer: Meridian Medicaid |
$123.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$204.07
|
| Rate for Payer: Nomi Health Commercial |
$222.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.50
|
| Rate for Payer: PACE SWMI |
$185.52
|
| Rate for Payer: PHP Medicare Advantage |
$185.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$368.91
|
| Rate for Payer: Priority Health Medicare |
$185.52
|
| Rate for Payer: Priority Health Narrow Network |
$368.91
|
| Rate for Payer: Railroad Medicare Medicare |
$185.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$362.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.52
|
| Rate for Payer: UHC Exchange |
$362.04
|
| Rate for Payer: UHC Medicaid |
$117.36
|
| Rate for Payer: UHCCP DNSP |
$185.52
|
| Rate for Payer: UHCCP Medicaid |
$117.36
|
|
|
PR RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT
|
Professional
|
Both
|
$1,117.00
|
|
|
Service Code
|
HCPCS 54415
|
| Min. Negotiated Rate |
$312.26 |
| Max. Negotiated Rate |
$930.17 |
| Rate for Payer: Aetna Commercial |
$643.70
|
| Rate for Payer: Aetna Medicare |
$480.37
|
| Rate for Payer: BCBS Complete |
$327.87
|
| Rate for Payer: BCBS MAPPO |
$480.37
|
| Rate for Payer: BCN Commercial |
$800.75
|
| Rate for Payer: BCN Medicare Advantage |
$480.37
|
| Rate for Payer: Cash Price |
$893.60
|
| Rate for Payer: Cash Price |
$893.60
|
| Rate for Payer: Cofinity Commercial |
$691.73
|
| Rate for Payer: Cofinity Commercial |
$643.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.37
|
| Rate for Payer: Healthscope Commercial |
$576.44
|
| Rate for Payer: Healthscope Whirlpool |
$576.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$504.39
|
| Rate for Payer: Meridian Medicaid |
$327.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$528.41
|
| Rate for Payer: Nomi Health Commercial |
$576.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$837.75
|
| Rate for Payer: PACE SWMI |
$480.37
|
| Rate for Payer: PHP Medicare Advantage |
$480.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$872.28
|
| Rate for Payer: Priority Health Medicare |
$480.37
|
| Rate for Payer: Priority Health Narrow Network |
$872.28
|
| Rate for Payer: Railroad Medicare Medicare |
$480.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$930.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$480.37
|
| Rate for Payer: UHC Exchange |
$930.17
|
| Rate for Payer: UHC Medicaid |
$312.26
|
| Rate for Payer: UHCCP DNSP |
$480.37
|
| Rate for Payer: UHCCP Medicaid |
$312.26
|
|
|
PR RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
HCPCS 33272
|
| Min. Negotiated Rate |
$197.88 |
| Max. Negotiated Rate |
$613.82 |
| Rate for Payer: Aetna Commercial |
$412.08
|
| Rate for Payer: Aetna Medicare |
$307.52
|
| Rate for Payer: BCBS Complete |
$207.77
|
| Rate for Payer: BCBS MAPPO |
$307.52
|
| Rate for Payer: BCN Commercial |
$514.91
|
| Rate for Payer: BCN Medicare Advantage |
$307.52
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cofinity Commercial |
$442.83
|
| Rate for Payer: Cofinity Commercial |
$412.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.52
|
| Rate for Payer: Healthscope Commercial |
$369.02
|
| Rate for Payer: Healthscope Whirlpool |
$369.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.90
|
| Rate for Payer: Meridian Medicaid |
$207.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.27
|
| Rate for Payer: Nomi Health Commercial |
$369.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$556.50
|
| Rate for Payer: PACE SWMI |
$307.52
|
| Rate for Payer: PHP Medicare Advantage |
$307.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$553.72
|
| Rate for Payer: Priority Health Medicare |
$307.52
|
| Rate for Payer: Priority Health Narrow Network |
$553.72
|
| Rate for Payer: Railroad Medicare Medicare |
$307.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$613.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.52
|
| Rate for Payer: UHC Exchange |
$613.82
|
| Rate for Payer: UHC Medicaid |
$197.88
|
| Rate for Payer: UHCCP DNSP |
$307.52
|
| Rate for Payer: UHCCP Medicaid |
$197.88
|
|
|
PR RMVL PERITONEAL-VENOUS SHUNT
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 49429
|
| Min. Negotiated Rate |
$277.11 |
| Max. Negotiated Rate |
$1,235.25 |
| Rate for Payer: Aetna Commercial |
$578.61
|
| Rate for Payer: Aetna Medicare |
$431.80
|
| Rate for Payer: BCBS Complete |
$290.97
|
| Rate for Payer: BCBS MAPPO |
$431.80
|
| Rate for Payer: BCN Commercial |
$689.70
|
| Rate for Payer: BCN Medicare Advantage |
$431.80
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cofinity Commercial |
$621.79
|
| Rate for Payer: Cofinity Commercial |
$578.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.80
|
| Rate for Payer: Healthscope Commercial |
$518.16
|
| Rate for Payer: Healthscope Whirlpool |
$518.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$453.39
|
| Rate for Payer: Meridian Medicaid |
$290.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$474.98
|
| Rate for Payer: Nomi Health Commercial |
$518.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,235.25
|
| Rate for Payer: PACE SWMI |
$431.80
|
| Rate for Payer: PHP Medicare Advantage |
$431.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$840.36
|
| Rate for Payer: Priority Health Medicare |
$431.80
|
| Rate for Payer: Priority Health Narrow Network |
$840.36
|
| Rate for Payer: Railroad Medicare Medicare |
$431.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$816.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$431.80
|
| Rate for Payer: UHC Exchange |
$816.84
|
| Rate for Payer: UHC Medicaid |
$277.11
|
| Rate for Payer: UHCCP DNSP |
$431.80
|
| Rate for Payer: UHCCP Medicaid |
$277.11
|
|
|
PR RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH
|
Professional
|
Both
|
$2,365.00
|
|
|
Service Code
|
HCPCS 62355
|
| Min. Negotiated Rate |
$179.13 |
| Max. Negotiated Rate |
$1,773.75 |
| Rate for Payer: Aetna Commercial |
$365.44
|
| Rate for Payer: Aetna Medicare |
$272.72
|
| Rate for Payer: BCBS Complete |
$188.09
|
| Rate for Payer: BCBS MAPPO |
$272.72
|
| Rate for Payer: BCN Commercial |
$426.28
|
| Rate for Payer: BCN Medicare Advantage |
$272.72
|
| Rate for Payer: Cash Price |
$1,892.00
|
| Rate for Payer: Cash Price |
$1,892.00
|
| Rate for Payer: Cofinity Commercial |
$392.72
|
| Rate for Payer: Cofinity Commercial |
$365.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.72
|
| Rate for Payer: Healthscope Commercial |
$327.26
|
| Rate for Payer: Healthscope Whirlpool |
$327.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.36
|
| Rate for Payer: Meridian Medicaid |
$188.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$299.99
|
| Rate for Payer: Nomi Health Commercial |
$327.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,773.75
|
| Rate for Payer: PACE SWMI |
$272.72
|
| Rate for Payer: PHP Medicare Advantage |
$272.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$495.11
|
| Rate for Payer: Priority Health Medicare |
$272.72
|
| Rate for Payer: Priority Health Narrow Network |
$495.11
|
| Rate for Payer: Railroad Medicare Medicare |
$272.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$272.72
|
| Rate for Payer: UHC Exchange |
$470.67
|
| Rate for Payer: UHC Medicaid |
$179.13
|
| Rate for Payer: UHCCP DNSP |
$272.72
|
| Rate for Payer: UHCCP Medicaid |
$179.13
|
|
|
PR RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY
|
Professional
|
Both
|
$2,719.00
|
|
|
Service Code
|
HCPCS 33237
|
| Min. Negotiated Rate |
$529.52 |
| Max. Negotiated Rate |
$2,039.25 |
| Rate for Payer: Aetna Commercial |
$1,099.52
|
| Rate for Payer: Aetna Medicare |
$820.54
|
| Rate for Payer: BCBS Complete |
$556.00
|
| Rate for Payer: BCBS MAPPO |
$820.54
|
| Rate for Payer: BCN Commercial |
$1,246.94
|
| Rate for Payer: BCN Medicare Advantage |
$820.54
|
| Rate for Payer: Cash Price |
$2,175.20
|
| Rate for Payer: Cash Price |
$2,175.20
|
| Rate for Payer: Cofinity Commercial |
$1,181.58
|
| Rate for Payer: Cofinity Commercial |
$1,099.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.54
|
| Rate for Payer: Healthscope Commercial |
$984.65
|
| Rate for Payer: Healthscope Whirlpool |
$984.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.57
|
| Rate for Payer: Meridian Medicaid |
$556.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$902.59
|
| Rate for Payer: Nomi Health Commercial |
$984.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,039.25
|
| Rate for Payer: PACE SWMI |
$820.54
|
| Rate for Payer: PHP Medicare Advantage |
$820.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,340.94
|
| Rate for Payer: Priority Health Medicare |
$820.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,340.94
|
| Rate for Payer: Railroad Medicare Medicare |
$820.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,480.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$820.54
|
| Rate for Payer: UHC Exchange |
$1,480.15
|
| Rate for Payer: UHC Medicaid |
$529.52
|
| Rate for Payer: UHCCP DNSP |
$820.54
|
| Rate for Payer: UHCCP Medicaid |
$529.52
|
|
|
PR RMVL PROSTC MATRL/MESH ABDL WALL FOR INFECTION
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 11008
|
| Min. Negotiated Rate |
$155.92 |
| Max. Negotiated Rate |
$637.50 |
| Rate for Payer: Aetna Commercial |
$330.20
|
| Rate for Payer: Aetna Medicare |
$246.42
|
| Rate for Payer: BCBS Complete |
$163.72
|
| Rate for Payer: BCBS MAPPO |
$246.42
|
| Rate for Payer: BCN Commercial |
$403.86
|
| Rate for Payer: BCN Medicare Advantage |
$246.42
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cofinity Commercial |
$354.84
|
| Rate for Payer: Cofinity Commercial |
$330.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.42
|
| Rate for Payer: Healthscope Commercial |
$295.70
|
| Rate for Payer: Healthscope Whirlpool |
$295.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.74
|
| Rate for Payer: Meridian Medicaid |
$163.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.06
|
| Rate for Payer: Nomi Health Commercial |
$295.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$637.50
|
| Rate for Payer: PACE SWMI |
$246.42
|
| Rate for Payer: PHP Medicare Advantage |
$246.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$369.64
|
| Rate for Payer: Priority Health Medicare |
$246.42
|
| Rate for Payer: Priority Health Narrow Network |
$369.64
|
| Rate for Payer: Railroad Medicare Medicare |
$246.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$491.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$246.42
|
| Rate for Payer: UHC Exchange |
$491.90
|
| Rate for Payer: UHC Medicaid |
$155.92
|
| Rate for Payer: UHCCP DNSP |
$246.42
|
| Rate for Payer: UHCCP Medicaid |
$155.92
|
|
|
PR RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER
|
Professional
|
Both
|
$3,468.00
|
|
|
Service Code
|
HCPCS 27488
|
| Min. Negotiated Rate |
$701.41 |
| Max. Negotiated Rate |
$2,601.00 |
| Rate for Payer: Aetna Commercial |
$1,447.54
|
| Rate for Payer: Aetna Medicare |
$1,080.25
|
| Rate for Payer: BCBS Complete |
$736.48
|
| Rate for Payer: BCBS MAPPO |
$1,080.25
|
| Rate for Payer: BCN Commercial |
$1,817.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,080.25
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cofinity Commercial |
$1,555.56
|
| Rate for Payer: Cofinity Commercial |
$1,447.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,080.25
|
| Rate for Payer: Healthscope Commercial |
$1,296.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,296.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,134.26
|
| Rate for Payer: Meridian Medicaid |
$736.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,188.28
|
| Rate for Payer: Nomi Health Commercial |
$1,296.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,601.00
|
| Rate for Payer: PACE SWMI |
$1,080.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,080.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,943.00
|
| Rate for Payer: Priority Health Medicare |
$1,080.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,943.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,080.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,105.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,080.25
|
| Rate for Payer: UHC Exchange |
$2,105.99
|
| Rate for Payer: UHC Medicaid |
$701.41
|
| Rate for Payer: UHCCP DNSP |
$1,080.25
|
| Rate for Payer: UHCCP Medicaid |
$701.41
|
|
|
PR RMVL/REVJ SLING MALE URINARY INCONTINENCE
|
Professional
|
Both
|
$1,635.00
|
|
|
Service Code
|
HCPCS 53442
|
| Min. Negotiated Rate |
$456.89 |
| Max. Negotiated Rate |
$1,379.89 |
| Rate for Payer: Aetna Commercial |
$944.06
|
| Rate for Payer: Aetna Medicare |
$704.52
|
| Rate for Payer: BCBS Complete |
$479.73
|
| Rate for Payer: BCBS MAPPO |
$704.52
|
| Rate for Payer: BCN Commercial |
$1,180.71
|
| Rate for Payer: BCN Medicare Advantage |
$704.52
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Commercial |
$944.06
|
| Rate for Payer: Cofinity Commercial |
$1,014.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.52
|
| Rate for Payer: Healthscope Commercial |
$845.42
|
| Rate for Payer: Healthscope Whirlpool |
$845.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.75
|
| Rate for Payer: Meridian Medicaid |
$479.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$774.97
|
| Rate for Payer: Nomi Health Commercial |
$845.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| Rate for Payer: PACE SWMI |
$704.52
|
| Rate for Payer: PHP Medicare Advantage |
$704.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,286.19
|
| Rate for Payer: Priority Health Medicare |
$704.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,286.19
|
| Rate for Payer: Railroad Medicare Medicare |
$704.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,379.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$704.52
|
| Rate for Payer: UHC Exchange |
$1,379.89
|
| Rate for Payer: UHC Medicaid |
$456.89
|
| Rate for Payer: UHCCP DNSP |
$704.52
|
| Rate for Payer: UHCCP Medicaid |
$456.89
|
|
