|
PR REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 15853
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$20.80 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$10.10
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$10.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.10
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$13.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.10
|
| Rate for Payer: Healthscope Commercial |
$12.12
|
| Rate for Payer: Healthscope Whirlpool |
$12.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$12.12
|
| Rate for Payer: PACE SWMI |
$10.10
|
| Rate for Payer: PHP Medicare Advantage |
$10.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$10.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.10
|
| Rate for Payer: UHC Medicare Advantage |
$10.10
|
| Rate for Payer: UHCCP DNSP |
$10.10
|
|
|
PR REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 15851
|
| Min. Negotiated Rate |
$62.32 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Aetna Commercial |
$83.51
|
| Rate for Payer: Aetna Medicare |
$62.32
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS MAPPO |
$62.32
|
| Rate for Payer: BCN Medicare Advantage |
$62.32
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$89.74
|
| Rate for Payer: Cofinity Commercial |
$83.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.32
|
| Rate for Payer: Healthscope Commercial |
$74.78
|
| Rate for Payer: Healthscope Whirlpool |
$74.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.44
|
| Rate for Payer: Nomi Health Commercial |
$74.78
|
| Rate for Payer: PACE SWMI |
$62.32
|
| Rate for Payer: PHP Medicare Advantage |
$62.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: Priority Health Medicare |
$62.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.32
|
| Rate for Payer: UHC Medicare Advantage |
$62.32
|
| Rate for Payer: UHCCP DNSP |
$62.32
|
|
|
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 |
$372.00 |
| Max. Negotiated Rate |
$760.28 |
| Rate for Payer: Aetna Commercial |
$707.48
|
| Rate for Payer: Aetna Medicare |
$527.97
|
| Rate for Payer: BCBS Complete |
$372.00
|
| Rate for Payer: BCBS MAPPO |
$527.97
|
| Rate for Payer: BCN Medicare Advantage |
$527.97
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$760.28
|
| Rate for Payer: Cofinity Commercial |
$707.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.97
|
| Rate for Payer: Healthscope Commercial |
$633.56
|
| Rate for Payer: Healthscope Whirlpool |
$633.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.37
|
| Rate for Payer: Nomi Health Commercial |
$633.56
|
| Rate for Payer: PACE SWMI |
$527.97
|
| Rate for Payer: PHP Medicare Advantage |
$527.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health Medicare |
$527.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.97
|
| Rate for Payer: UHC Medicare Advantage |
$527.97
|
| Rate for Payer: UHCCP DNSP |
$527.97
|
|
|
PR REMOVAL TUNNELED INTRAPERITONEAL CATHETER
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 49422
|
| Min. Negotiated Rate |
$213.50 |
| Max. Negotiated Rate |
$637.65 |
| Rate for Payer: Aetna Commercial |
$286.09
|
| Rate for Payer: Aetna Medicare |
$213.50
|
| Rate for Payer: BCBS Complete |
$392.40
|
| Rate for Payer: BCBS MAPPO |
$213.50
|
| Rate for Payer: BCN Medicare Advantage |
$213.50
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$307.44
|
| Rate for Payer: Cofinity Commercial |
$286.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.50
|
| Rate for Payer: Healthscope Commercial |
$256.20
|
| Rate for Payer: Healthscope Whirlpool |
$256.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.18
|
| Rate for Payer: Nomi Health Commercial |
$256.20
|
| Rate for Payer: PACE SWMI |
$213.50
|
| Rate for Payer: PHP Medicare Advantage |
$213.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.65
|
| Rate for Payer: Priority Health Medicare |
$213.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.50
|
| Rate for Payer: UHC Medicare Advantage |
$213.50
|
| Rate for Payer: UHCCP DNSP |
$213.50
|
|
|
PR REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE
|
Professional
|
Both
|
$3,380.00
|
|
|
Service Code
|
HCPCS 33977
|
| Min. Negotiated Rate |
$1,077.13 |
| Max. Negotiated Rate |
$2,197.00 |
| Rate for Payer: Aetna Commercial |
$1,443.35
|
| Rate for Payer: Aetna Medicare |
$1,077.13
|
| Rate for Payer: BCBS Complete |
$1,352.00
|
| Rate for Payer: BCBS MAPPO |
$1,077.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.13
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cash Price |
$2,704.00
|
| Rate for Payer: Cofinity Commercial |
$1,551.07
|
| Rate for Payer: Cofinity Commercial |
$1,443.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.13
|
| Rate for Payer: Healthscope Commercial |
$1,292.56
|
| Rate for Payer: Healthscope Whirlpool |
$1,292.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,130.99
|
| Rate for Payer: Nomi Health Commercial |
$1,292.56
|
| Rate for Payer: PACE SWMI |
$1,077.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,197.00
|
| Rate for Payer: Priority Health Medicare |
$1,077.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.13
|
| Rate for Payer: UHCCP DNSP |
$1,077.13
|
|
|
PR REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST
|
Professional
|
Both
|
$1,352.00
|
|
|
Service Code
|
HCPCS 25251
|
| Min. Negotiated Rate |
$540.80 |
| Max. Negotiated Rate |
$1,002.90 |
| Rate for Payer: Aetna Commercial |
$933.26
|
| Rate for Payer: Aetna Medicare |
$696.46
|
| Rate for Payer: BCBS Complete |
$540.80
|
| Rate for Payer: BCBS MAPPO |
$696.46
|
| Rate for Payer: BCN Medicare Advantage |
$696.46
|
| Rate for Payer: Cash Price |
$1,081.60
|
| Rate for Payer: Cash Price |
$1,081.60
|
| Rate for Payer: Cofinity Commercial |
$933.26
|
| Rate for Payer: Cofinity Commercial |
$1,002.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.46
|
| Rate for Payer: Healthscope Commercial |
$835.75
|
| Rate for Payer: Healthscope Whirlpool |
$835.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.28
|
| Rate for Payer: Nomi Health Commercial |
$835.75
|
| Rate for Payer: PACE SWMI |
$696.46
|
| Rate for Payer: PHP Medicare Advantage |
$696.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$878.80
|
| Rate for Payer: Priority Health Medicare |
$696.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$696.46
|
| Rate for Payer: UHC Medicare Advantage |
$696.46
|
| Rate for Payer: UHCCP DNSP |
$696.46
|
|
|
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
|
|
|
PR REMOVE DEEP SHOULDER FOREIGN BODY
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 23331
|
| Min. Negotiated Rate |
$415.60 |
| Max. Negotiated Rate |
$675.35 |
| Rate for Payer: Aetna Medicare |
$519.50
|
| Rate for Payer: BCBS Complete |
$415.60
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.35
|
|
|
PR REMOVE INT DWELL URETERAL STENT TRANSURETHRAL
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 50386
|
| Min. Negotiated Rate |
$154.62 |
| Max. Negotiated Rate |
$1,028.30 |
| Rate for Payer: Aetna Commercial |
$207.19
|
| Rate for Payer: Aetna Medicare |
$154.62
|
| Rate for Payer: BCBS Complete |
$632.80
|
| Rate for Payer: BCBS MAPPO |
$154.62
|
| Rate for Payer: BCN Medicare Advantage |
$154.62
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$222.65
|
| Rate for Payer: Cofinity Commercial |
$207.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.62
|
| Rate for Payer: Healthscope Commercial |
$185.54
|
| Rate for Payer: Healthscope Whirlpool |
$185.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.35
|
| Rate for Payer: Nomi Health Commercial |
$185.54
|
| Rate for Payer: PACE SWMI |
$154.62
|
| Rate for Payer: PHP Medicare Advantage |
$154.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,028.30
|
| Rate for Payer: Priority Health Medicare |
$154.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.62
|
| Rate for Payer: UHC Medicare Advantage |
$154.62
|
| Rate for Payer: UHCCP DNSP |
$154.62
|
|
|
PR REMOVE NAIL BED/FINGER TIP
|
Professional
|
Both
|
$530.00
|
|
|
Service Code
|
HCPCS 11752
|
| Min. Negotiated Rate |
$212.00 |
| Max. Negotiated Rate |
$344.50 |
| Rate for Payer: Aetna Medicare |
$265.00
|
| Rate for Payer: BCBS Complete |
$212.00
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.50
|
|
|
PR REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL
|
Professional
|
Both
|
$2,093.00
|
|
|
Service Code
|
HCPCS 50385
|
| Min. Negotiated Rate |
$204.60 |
| Max. Negotiated Rate |
$1,360.45 |
| Rate for Payer: Aetna Commercial |
$274.16
|
| Rate for Payer: Aetna Medicare |
$204.60
|
| Rate for Payer: BCBS Complete |
$837.20
|
| Rate for Payer: BCBS MAPPO |
$204.60
|
| Rate for Payer: BCN Medicare Advantage |
$204.60
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cash Price |
$1,674.40
|
| Rate for Payer: Cofinity Commercial |
$294.62
|
| Rate for Payer: Cofinity Commercial |
$274.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.60
|
| Rate for Payer: Healthscope Commercial |
$245.52
|
| Rate for Payer: Healthscope Whirlpool |
$245.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.83
|
| Rate for Payer: Nomi Health Commercial |
$245.52
|
| Rate for Payer: PACE SWMI |
$204.60
|
| Rate for Payer: PHP Medicare Advantage |
$204.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.45
|
| Rate for Payer: Priority Health Medicare |
$204.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.60
|
| Rate for Payer: UHC Medicare Advantage |
$204.60
|
| Rate for Payer: UHCCP DNSP |
$204.60
|
|
|
PR REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,924.00
|
|
|
Service Code
|
HCPCS 53446
|
| Min. Negotiated Rate |
$614.46 |
| Max. Negotiated Rate |
$1,250.60 |
| Rate for Payer: Aetna Commercial |
$823.38
|
| Rate for Payer: Aetna Medicare |
$614.46
|
| Rate for Payer: BCBS Complete |
$769.60
|
| Rate for Payer: BCBS MAPPO |
$614.46
|
| Rate for Payer: BCN Medicare Advantage |
$614.46
|
| Rate for Payer: Cash Price |
$1,539.20
|
| Rate for Payer: Cash Price |
$1,539.20
|
| Rate for Payer: Cofinity Commercial |
$884.82
|
| Rate for Payer: Cofinity Commercial |
$823.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.46
|
| Rate for Payer: Healthscope Commercial |
$737.35
|
| Rate for Payer: Healthscope Whirlpool |
$737.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.18
|
| Rate for Payer: Nomi Health Commercial |
$737.35
|
| Rate for Payer: PACE SWMI |
$614.46
|
| Rate for Payer: PHP Medicare Advantage |
$614.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,250.60
|
| Rate for Payer: Priority Health Medicare |
$614.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.46
|
| Rate for Payer: UHC Medicare Advantage |
$614.46
|
| Rate for Payer: UHCCP DNSP |
$614.46
|
|
|
PR REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 33227
|
| Min. Negotiated Rate |
$280.80 |
| Max. Negotiated Rate |
$462.61 |
| Rate for Payer: Aetna Commercial |
$430.49
|
| Rate for Payer: Aetna Medicare |
$321.26
|
| Rate for Payer: BCBS Complete |
$280.80
|
| Rate for Payer: BCBS MAPPO |
$321.26
|
| Rate for Payer: BCN Medicare Advantage |
$321.26
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$462.61
|
| Rate for Payer: Cofinity Commercial |
$430.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.26
|
| Rate for Payer: Healthscope Commercial |
$385.51
|
| Rate for Payer: Healthscope Whirlpool |
$385.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.32
|
| Rate for Payer: Nomi Health Commercial |
$385.51
|
| Rate for Payer: PACE SWMI |
$321.26
|
| Rate for Payer: PHP Medicare Advantage |
$321.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$456.30
|
| Rate for Payer: Priority Health Medicare |
$321.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$321.26
|
| Rate for Payer: UHC Medicare Advantage |
$321.26
|
| Rate for Payer: UHCCP DNSP |
$321.26
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 33228
|
| Min. Negotiated Rate |
$290.80 |
| Max. Negotiated Rate |
$484.66 |
| Rate for Payer: Aetna Commercial |
$451.00
|
| Rate for Payer: Aetna Medicare |
$336.57
|
| Rate for Payer: BCBS Complete |
$290.80
|
| Rate for Payer: BCBS MAPPO |
$336.57
|
| Rate for Payer: BCN Medicare Advantage |
$336.57
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$484.66
|
| Rate for Payer: Cofinity Commercial |
$451.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.57
|
| Rate for Payer: Healthscope Commercial |
$403.88
|
| Rate for Payer: Healthscope Whirlpool |
$403.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.40
|
| Rate for Payer: Nomi Health Commercial |
$403.88
|
| Rate for Payer: PACE SWMI |
$336.57
|
| Rate for Payer: PHP Medicare Advantage |
$336.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.55
|
| Rate for Payer: Priority Health Medicare |
$336.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.57
|
| Rate for Payer: UHC Medicare Advantage |
$336.57
|
| Rate for Payer: UHCCP DNSP |
$336.57
|
|
|
PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD
|
Professional
|
Both
|
$578.00
|
|
|
Service Code
|
HCPCS 33229
|
| Min. Negotiated Rate |
$231.20 |
| Max. Negotiated Rate |
$507.90 |
| Rate for Payer: Aetna Commercial |
$472.63
|
| Rate for Payer: Aetna Medicare |
$352.71
|
| Rate for Payer: BCBS Complete |
$231.20
|
| Rate for Payer: BCBS MAPPO |
$352.71
|
| Rate for Payer: BCN Medicare Advantage |
$352.71
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cofinity Commercial |
$507.90
|
| Rate for Payer: Cofinity Commercial |
$472.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.71
|
| Rate for Payer: Healthscope Commercial |
$423.25
|
| Rate for Payer: Healthscope Whirlpool |
$423.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.35
|
| Rate for Payer: Nomi Health Commercial |
$423.25
|
| Rate for Payer: PACE SWMI |
$352.71
|
| Rate for Payer: PHP Medicare Advantage |
$352.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.70
|
| Rate for Payer: Priority Health Medicare |
$352.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.71
|
| Rate for Payer: UHC Medicare Advantage |
$352.71
|
| Rate for Payer: UHCCP DNSP |
$352.71
|
|
|
PR REMV TISSUE FOR GRAFT OTHR
|
Professional
|
Both
|
$819.00
|
|
|
Service Code
|
HCPCS 20926
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$532.35 |
| Rate for Payer: Aetna Medicare |
$409.50
|
| Rate for Payer: BCBS Complete |
$327.60
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.35
|
|
|
PR RENAL ANGIO, CARDIAC CATH
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G0275
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
|
|
PR RENAL BIOPSY PRQ TROCAR/NEEDLE
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 50200
|
| Min. Negotiated Rate |
$119.01 |
| Max. Negotiated Rate |
$684.45 |
| Rate for Payer: Aetna Commercial |
$159.47
|
| Rate for Payer: Aetna Medicare |
$119.01
|
| Rate for Payer: BCBS Complete |
$421.20
|
| Rate for Payer: BCBS MAPPO |
$119.01
|
| Rate for Payer: BCN Medicare Advantage |
$119.01
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$171.37
|
| Rate for Payer: Cofinity Commercial |
$159.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.01
|
| Rate for Payer: Healthscope Commercial |
$142.81
|
| Rate for Payer: Healthscope Whirlpool |
$142.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.96
|
| Rate for Payer: Nomi Health Commercial |
$142.81
|
| Rate for Payer: PACE SWMI |
$119.01
|
| Rate for Payer: PHP Medicare Advantage |
$119.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health Medicare |
$119.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.01
|
| Rate for Payer: UHC Medicare Advantage |
$119.01
|
| Rate for Payer: UHCCP DNSP |
$119.01
|
|
|
PR RENAL BIOPSY SURG EXPOSURE KIDNEY
|
Professional
|
Both
|
$1,699.00
|
|
|
Service Code
|
HCPCS 50205
|
| Min. Negotiated Rate |
$679.60 |
| Max. Negotiated Rate |
$1,104.35 |
| Rate for Payer: Aetna Commercial |
$982.61
|
| Rate for Payer: Aetna Medicare |
$733.29
|
| Rate for Payer: BCBS Complete |
$679.60
|
| Rate for Payer: BCBS MAPPO |
$733.29
|
| Rate for Payer: BCN Medicare Advantage |
$733.29
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$982.61
|
| Rate for Payer: Cofinity Commercial |
$1,055.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.29
|
| Rate for Payer: Healthscope Commercial |
$879.95
|
| Rate for Payer: Healthscope Whirlpool |
$879.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.95
|
| Rate for Payer: Nomi Health Commercial |
$879.95
|
| Rate for Payer: PACE SWMI |
$733.29
|
| Rate for Payer: PHP Medicare Advantage |
$733.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,104.35
|
| Rate for Payer: Priority Health Medicare |
$733.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$733.29
|
| Rate for Payer: UHC Medicare Advantage |
$733.29
|
| Rate for Payer: UHCCP DNSP |
$733.29
|
|
|
PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 50551
|
| Min. Negotiated Rate |
$278.73 |
| Max. Negotiated Rate |
$471.90 |
| Rate for Payer: Aetna Commercial |
$373.50
|
| Rate for Payer: Aetna Medicare |
$278.73
|
| Rate for Payer: BCBS Complete |
$290.40
|
| Rate for Payer: BCBS MAPPO |
$278.73
|
| Rate for Payer: BCN Medicare Advantage |
$278.73
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$401.37
|
| Rate for Payer: Cofinity Commercial |
$373.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.73
|
| Rate for Payer: Healthscope Commercial |
$334.48
|
| Rate for Payer: Healthscope Whirlpool |
$334.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.67
|
| Rate for Payer: Nomi Health Commercial |
$334.48
|
| Rate for Payer: PACE SWMI |
$278.73
|
| Rate for Payer: PHP Medicare Advantage |
$278.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.90
|
| Rate for Payer: Priority Health Medicare |
$278.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.73
|
| Rate for Payer: UHC Medicare Advantage |
$278.73
|
| Rate for Payer: UHCCP DNSP |
$278.73
|
|
|
PR RENAL EXPLORATION NOT NECESSITATING OTH SPEC PX
|
Professional
|
Both
|
$2,514.00
|
|
|
Service Code
|
HCPCS 50010
|
| Min. Negotiated Rate |
$673.41 |
| Max. Negotiated Rate |
$1,634.10 |
| Rate for Payer: Aetna Commercial |
$902.37
|
| Rate for Payer: Aetna Medicare |
$673.41
|
| Rate for Payer: BCBS Complete |
$1,005.60
|
| Rate for Payer: BCBS MAPPO |
$673.41
|
| Rate for Payer: BCN Medicare Advantage |
$673.41
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cash Price |
$2,011.20
|
| Rate for Payer: Cofinity Commercial |
$969.71
|
| Rate for Payer: Cofinity Commercial |
$902.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.41
|
| Rate for Payer: Healthscope Commercial |
$808.09
|
| Rate for Payer: Healthscope Whirlpool |
$808.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$707.08
|
| Rate for Payer: Nomi Health Commercial |
$808.09
|
| Rate for Payer: PACE SWMI |
$673.41
|
| Rate for Payer: PHP Medicare Advantage |
$673.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.10
|
| Rate for Payer: Priority Health Medicare |
$673.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$673.41
|
| Rate for Payer: UHC Medicare Advantage |
$673.41
|
| Rate for Payer: UHCCP DNSP |
$673.41
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY
|
Professional
|
Both
|
$784.00
|
|
|
Service Code
|
HCPCS 50555
|
| Min. Negotiated Rate |
$313.60 |
| Max. Negotiated Rate |
$509.60 |
| Rate for Payer: Aetna Commercial |
$434.24
|
| Rate for Payer: Aetna Medicare |
$324.06
|
| Rate for Payer: BCBS Complete |
$313.60
|
| Rate for Payer: BCBS MAPPO |
$324.06
|
| Rate for Payer: BCN Medicare Advantage |
$324.06
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Cofinity Commercial |
$466.65
|
| Rate for Payer: Cofinity Commercial |
$434.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.06
|
| Rate for Payer: Healthscope Commercial |
$388.87
|
| Rate for Payer: Healthscope Whirlpool |
$388.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.26
|
| Rate for Payer: Nomi Health Commercial |
$388.87
|
| Rate for Payer: PACE SWMI |
$324.06
|
| Rate for Payer: PHP Medicare Advantage |
$324.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.60
|
| Rate for Payer: Priority Health Medicare |
$324.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.06
|
| Rate for Payer: UHC Medicare Advantage |
$324.06
|
| Rate for Payer: UHCCP DNSP |
$324.06
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 50557
|
| Min. Negotiated Rate |
$327.85 |
| Max. Negotiated Rate |
$540.15 |
| Rate for Payer: Aetna Commercial |
$439.32
|
| Rate for Payer: Aetna Medicare |
$327.85
|
| Rate for Payer: BCBS Complete |
$332.40
|
| Rate for Payer: BCBS MAPPO |
$327.85
|
| Rate for Payer: BCN Medicare Advantage |
$327.85
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cofinity Commercial |
$472.10
|
| Rate for Payer: Cofinity Commercial |
$439.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.85
|
| Rate for Payer: Healthscope Commercial |
$393.42
|
| Rate for Payer: Healthscope Whirlpool |
$393.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.24
|
| Rate for Payer: Nomi Health Commercial |
$393.42
|
| Rate for Payer: PACE SWMI |
$327.85
|
| Rate for Payer: PHP Medicare Advantage |
$327.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$540.15
|
| Rate for Payer: Priority Health Medicare |
$327.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.85
|
| Rate for Payer: UHC Medicare Advantage |
$327.85
|
| Rate for Payer: UHCCP DNSP |
$327.85
|
|
|
PR RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$908.00
|
|
|
Service Code
|
HCPCS 50561
|
| Min. Negotiated Rate |
$363.20 |
| Max. Negotiated Rate |
$590.20 |
| Rate for Payer: Aetna Commercial |
$500.78
|
| Rate for Payer: Aetna Medicare |
$373.72
|
| Rate for Payer: BCBS Complete |
$363.20
|
| Rate for Payer: BCBS MAPPO |
$373.72
|
| Rate for Payer: BCN Medicare Advantage |
$373.72
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cash Price |
$726.40
|
| Rate for Payer: Cofinity Commercial |
$538.16
|
| Rate for Payer: Cofinity Commercial |
$500.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.72
|
| Rate for Payer: Healthscope Commercial |
$448.46
|
| Rate for Payer: Healthscope Whirlpool |
$448.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.41
|
| Rate for Payer: Nomi Health Commercial |
$448.46
|
| Rate for Payer: PACE SWMI |
$373.72
|
| Rate for Payer: PHP Medicare Advantage |
$373.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.20
|
| Rate for Payer: Priority Health Medicare |
$373.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.72
|
| Rate for Payer: UHC Medicare Advantage |
$373.72
|
| Rate for Payer: UHCCP DNSP |
$373.72
|
|
