|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON
|
Professional
|
Both
|
$2,790.00
|
|
|
Service Code
|
HCPCS 26358
|
| Min. Negotiated Rate |
$595.12 |
| Max. Negotiated Rate |
$2,092.50 |
| Rate for Payer: Aetna Commercial |
$1,214.80
|
| Rate for Payer: Aetna Medicare |
$906.57
|
| Rate for Payer: BCBS Complete |
$624.88
|
| Rate for Payer: BCBS MAPPO |
$906.57
|
| Rate for Payer: BCN Commercial |
$1,499.42
|
| Rate for Payer: BCN Medicare Advantage |
$906.57
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cash Price |
$2,232.00
|
| Rate for Payer: Cofinity Commercial |
$1,305.46
|
| Rate for Payer: Cofinity Commercial |
$1,214.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$906.57
|
| Rate for Payer: Healthscope Commercial |
$1,087.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,087.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$951.90
|
| Rate for Payer: Meridian Medicaid |
$624.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$997.23
|
| Rate for Payer: Nomi Health Commercial |
$1,087.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,092.50
|
| Rate for Payer: PACE SWMI |
$906.57
|
| Rate for Payer: PHP Medicare Advantage |
$906.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,602.83
|
| Rate for Payer: Priority Health Medicare |
$906.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,602.83
|
| Rate for Payer: Railroad Medicare Medicare |
$906.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,709.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$906.57
|
| Rate for Payer: UHC Exchange |
$1,709.95
|
| Rate for Payer: UHC Medicaid |
$595.12
|
| Rate for Payer: UHCCP DNSP |
$906.57
|
| Rate for Payer: UHCCP Medicaid |
$595.12
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,858.00
|
|
|
Service Code
|
HCPCS 26357
|
| Min. Negotiated Rate |
$544.22 |
| Max. Negotiated Rate |
$2,143.50 |
| Rate for Payer: Aetna Commercial |
$1,107.89
|
| Rate for Payer: Aetna Medicare |
$826.78
|
| Rate for Payer: BCBS Complete |
$571.43
|
| Rate for Payer: BCBS MAPPO |
$826.78
|
| Rate for Payer: BCN Commercial |
$1,360.99
|
| Rate for Payer: BCN Medicare Advantage |
$826.78
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cofinity Commercial |
$1,190.56
|
| Rate for Payer: Cofinity Commercial |
$1,107.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$826.78
|
| Rate for Payer: Healthscope Commercial |
$992.14
|
| Rate for Payer: Healthscope Whirlpool |
$992.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$868.12
|
| Rate for Payer: Meridian Medicaid |
$571.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$909.46
|
| Rate for Payer: Nomi Health Commercial |
$992.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,143.50
|
| Rate for Payer: PACE SWMI |
$826.78
|
| Rate for Payer: PHP Medicare Advantage |
$826.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,454.85
|
| Rate for Payer: Priority Health Medicare |
$826.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,454.85
|
| Rate for Payer: Railroad Medicare Medicare |
$826.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,542.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$826.78
|
| Rate for Payer: UHC Exchange |
$1,542.25
|
| Rate for Payer: UHC Medicaid |
$544.22
|
| Rate for Payer: UHCCP DNSP |
$826.78
|
| Rate for Payer: UHCCP Medicaid |
$544.22
|
|
|
PR RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON
|
Professional
|
Both
|
$2,737.00
|
|
|
Service Code
|
HCPCS 26356
|
| Min. Negotiated Rate |
$480.53 |
| Max. Negotiated Rate |
$2,052.75 |
| Rate for Payer: Aetna Commercial |
$975.47
|
| Rate for Payer: Aetna Medicare |
$727.96
|
| Rate for Payer: BCBS Complete |
$504.56
|
| Rate for Payer: BCBS MAPPO |
$727.96
|
| Rate for Payer: BCN Commercial |
$1,218.56
|
| Rate for Payer: BCN Medicare Advantage |
$727.96
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cash Price |
$2,189.60
|
| Rate for Payer: Cofinity Commercial |
$975.47
|
| Rate for Payer: Cofinity Commercial |
$1,048.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.96
|
| Rate for Payer: Healthscope Commercial |
$873.55
|
| Rate for Payer: Healthscope Whirlpool |
$873.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.36
|
| Rate for Payer: Meridian Medicaid |
$504.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$800.76
|
| Rate for Payer: Nomi Health Commercial |
$873.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.75
|
| Rate for Payer: PACE SWMI |
$727.96
|
| Rate for Payer: PHP Medicare Advantage |
$727.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,302.61
|
| Rate for Payer: Priority Health Medicare |
$727.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,302.61
|
| Rate for Payer: Railroad Medicare Medicare |
$727.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,373.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$727.96
|
| Rate for Payer: UHC Exchange |
$1,373.49
|
| Rate for Payer: UHC Medicaid |
$480.53
|
| Rate for Payer: UHCCP DNSP |
$727.96
|
| Rate for Payer: UHCCP Medicaid |
$480.53
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 26370
|
| Min. Negotiated Rate |
$484.58 |
| Max. Negotiated Rate |
$1,807.50 |
| Rate for Payer: Aetna Commercial |
$970.24
|
| Rate for Payer: Aetna Medicare |
$724.06
|
| Rate for Payer: BCBS Complete |
$508.81
|
| Rate for Payer: BCBS MAPPO |
$724.06
|
| Rate for Payer: BCN Commercial |
$1,181.21
|
| Rate for Payer: BCN Medicare Advantage |
$724.06
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$970.24
|
| Rate for Payer: Cofinity Commercial |
$1,042.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.06
|
| Rate for Payer: Healthscope Commercial |
$868.87
|
| Rate for Payer: Healthscope Whirlpool |
$868.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$760.26
|
| Rate for Payer: Meridian Medicaid |
$508.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$796.47
|
| Rate for Payer: Nomi Health Commercial |
$868.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,807.50
|
| Rate for Payer: PACE SWMI |
$724.06
|
| Rate for Payer: PHP Medicare Advantage |
$724.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,262.68
|
| Rate for Payer: Priority Health Medicare |
$724.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,262.68
|
| Rate for Payer: Railroad Medicare Medicare |
$724.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,308.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$724.06
|
| Rate for Payer: UHC Exchange |
$1,308.71
|
| Rate for Payer: UHC Medicaid |
$484.58
|
| Rate for Payer: UHCCP DNSP |
$724.06
|
| Rate for Payer: UHCCP Medicaid |
$484.58
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA
|
Professional
|
Both
|
$3,199.00
|
|
|
Service Code
|
HCPCS 26372
|
| Min. Negotiated Rate |
$572.54 |
| Max. Negotiated Rate |
$2,399.25 |
| Rate for Payer: Aetna Commercial |
$1,150.67
|
| Rate for Payer: Aetna Medicare |
$858.71
|
| Rate for Payer: BCBS Complete |
$601.17
|
| Rate for Payer: BCBS MAPPO |
$858.71
|
| Rate for Payer: BCN Commercial |
$1,376.42
|
| Rate for Payer: BCN Medicare Advantage |
$858.71
|
| Rate for Payer: Cash Price |
$2,559.20
|
| Rate for Payer: Cash Price |
$2,559.20
|
| Rate for Payer: Cofinity Commercial |
$1,236.54
|
| Rate for Payer: Cofinity Commercial |
$1,150.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.71
|
| Rate for Payer: Healthscope Commercial |
$1,030.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,030.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$901.65
|
| Rate for Payer: Meridian Medicaid |
$601.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$944.58
|
| Rate for Payer: Nomi Health Commercial |
$1,030.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,399.25
|
| Rate for Payer: PACE SWMI |
$858.71
|
| Rate for Payer: PHP Medicare Advantage |
$858.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,471.36
|
| Rate for Payer: Priority Health Medicare |
$858.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.36
|
| Rate for Payer: Railroad Medicare Medicare |
$858.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,536.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$858.71
|
| Rate for Payer: UHC Exchange |
$1,536.56
|
| Rate for Payer: UHC Medicaid |
$572.54
|
| Rate for Payer: UHCCP DNSP |
$858.71
|
| Rate for Payer: UHCCP Medicaid |
$572.54
|
|
|
PR RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA
|
Professional
|
Both
|
$2,940.00
|
|
|
Service Code
|
HCPCS 26373
|
| Min. Negotiated Rate |
$553.80 |
| Max. Negotiated Rate |
$2,205.00 |
| Rate for Payer: Aetna Commercial |
$1,111.19
|
| Rate for Payer: Aetna Medicare |
$829.25
|
| Rate for Payer: BCBS Complete |
$581.49
|
| Rate for Payer: BCBS MAPPO |
$829.25
|
| Rate for Payer: BCN Commercial |
$1,324.63
|
| Rate for Payer: BCN Medicare Advantage |
$829.25
|
| Rate for Payer: Cash Price |
$2,352.00
|
| Rate for Payer: Cash Price |
$2,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,194.12
|
| Rate for Payer: Cofinity Commercial |
$1,111.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.25
|
| Rate for Payer: Healthscope Commercial |
$995.10
|
| Rate for Payer: Healthscope Whirlpool |
$995.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.71
|
| Rate for Payer: Meridian Medicaid |
$581.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$912.17
|
| Rate for Payer: Nomi Health Commercial |
$995.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,205.00
|
| Rate for Payer: PACE SWMI |
$829.25
|
| Rate for Payer: PHP Medicare Advantage |
$829.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,416.00
|
| Rate for Payer: Priority Health Medicare |
$829.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,416.00
|
| Rate for Payer: Railroad Medicare Medicare |
$829.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,473.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$829.25
|
| Rate for Payer: UHC Exchange |
$1,473.48
|
| Rate for Payer: UHC Medicaid |
$553.80
|
| Rate for Payer: UHCCP DNSP |
$829.25
|
| Rate for Payer: UHCCP Medicaid |
$553.80
|
|
|
PR RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ
|
Professional
|
Both
|
$3,710.00
|
|
|
Service Code
|
HCPCS 33507
|
| Min. Negotiated Rate |
$1,022.61 |
| Max. Negotiated Rate |
$3,071.97 |
| Rate for Payer: Aetna Commercial |
$2,155.71
|
| Rate for Payer: Aetna Medicare |
$1,608.74
|
| Rate for Payer: BCBS Complete |
$1,073.74
|
| Rate for Payer: BCBS MAPPO |
$1,608.74
|
| Rate for Payer: BCN Commercial |
$2,530.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,608.74
|
| Rate for Payer: Cash Price |
$2,968.00
|
| Rate for Payer: Cash Price |
$2,968.00
|
| Rate for Payer: Cofinity Commercial |
$2,316.59
|
| Rate for Payer: Cofinity Commercial |
$2,155.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,608.74
|
| Rate for Payer: Healthscope Commercial |
$1,930.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,930.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,689.18
|
| Rate for Payer: Meridian Medicaid |
$1,073.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,769.61
|
| Rate for Payer: Nomi Health Commercial |
$1,930.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,782.50
|
| Rate for Payer: PACE SWMI |
$1,608.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,608.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,022.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,720.96
|
| Rate for Payer: Priority Health Medicare |
$1,608.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,720.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,608.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,071.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,608.74
|
| Rate for Payer: UHC Exchange |
$3,071.97
|
| Rate for Payer: UHC Medicaid |
$1,022.61
|
| Rate for Payer: UHCCP DNSP |
$1,608.74
|
| Rate for Payer: UHCCP Medicaid |
$1,022.61
|
|
|
PR RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP
|
Professional
|
Both
|
$5,192.00
|
|
|
Service Code
|
HCPCS 33504
|
| Min. Negotiated Rate |
$890.77 |
| Max. Negotiated Rate |
$3,894.00 |
| Rate for Payer: Aetna Commercial |
$1,865.98
|
| Rate for Payer: Aetna Medicare |
$1,392.52
|
| Rate for Payer: BCBS Complete |
$935.31
|
| Rate for Payer: BCBS MAPPO |
$1,392.52
|
| Rate for Payer: BCN Commercial |
$2,171.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,392.52
|
| Rate for Payer: Cash Price |
$4,153.60
|
| Rate for Payer: Cash Price |
$4,153.60
|
| Rate for Payer: Cofinity Commercial |
$2,005.23
|
| Rate for Payer: Cofinity Commercial |
$1,865.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,392.52
|
| Rate for Payer: Healthscope Commercial |
$1,671.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,671.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,462.15
|
| Rate for Payer: Meridian Medicaid |
$935.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,531.77
|
| Rate for Payer: Nomi Health Commercial |
$1,671.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,894.00
|
| Rate for Payer: PACE SWMI |
$1,392.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,392.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$890.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,335.38
|
| Rate for Payer: Priority Health Medicare |
$1,392.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,335.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,392.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,601.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,392.52
|
| Rate for Payer: UHC Exchange |
$2,601.53
|
| Rate for Payer: UHC Medicaid |
$890.77
|
| Rate for Payer: UHCCP DNSP |
$1,392.52
|
| Rate for Payer: UHCCP Medicaid |
$890.77
|
|
|
PR RPR ATRIAL SEPTAL DFCT SECUNDUM W/BYP W/WO PATCH
|
Professional
|
Both
|
$5,223.00
|
|
|
Service Code
|
HCPCS 33641
|
| Min. Negotiated Rate |
$978.31 |
| Max. Negotiated Rate |
$3,917.25 |
| Rate for Payer: Aetna Commercial |
$2,059.53
|
| Rate for Payer: Aetna Medicare |
$1,536.96
|
| Rate for Payer: BCBS Complete |
$1,027.23
|
| Rate for Payer: BCBS MAPPO |
$1,536.96
|
| Rate for Payer: BCN Commercial |
$2,412.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,536.96
|
| Rate for Payer: Cash Price |
$4,178.40
|
| Rate for Payer: Cash Price |
$4,178.40
|
| Rate for Payer: Cofinity Commercial |
$2,213.22
|
| Rate for Payer: Cofinity Commercial |
$2,059.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,536.96
|
| Rate for Payer: Healthscope Commercial |
$1,844.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,844.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,613.81
|
| Rate for Payer: Meridian Medicaid |
$1,027.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,690.66
|
| Rate for Payer: Nomi Health Commercial |
$1,844.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,917.25
|
| Rate for Payer: PACE SWMI |
$1,536.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,536.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$978.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,594.03
|
| Rate for Payer: Priority Health Medicare |
$1,536.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,594.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,536.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,920.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,536.96
|
| Rate for Payer: UHC Exchange |
$2,920.47
|
| Rate for Payer: UHC Medicaid |
$978.31
|
| Rate for Payer: UHCCP DNSP |
$1,536.96
|
| Rate for Payer: UHCCP Medicaid |
$978.31
|
|
|
PR RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL
|
Professional
|
Both
|
$1,173.00
|
|
|
Service Code
|
HCPCS 67903
|
| Min. Negotiated Rate |
$260.50 |
| Max. Negotiated Rate |
$879.75 |
| Rate for Payer: Aetna Commercial |
$529.31
|
| Rate for Payer: Aetna Medicare |
$395.01
|
| Rate for Payer: BCBS Complete |
$273.52
|
| Rate for Payer: BCBS MAPPO |
$395.01
|
| Rate for Payer: BCN Commercial |
$711.62
|
| Rate for Payer: BCN Medicare Advantage |
$395.01
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cofinity Commercial |
$568.81
|
| Rate for Payer: Cofinity Commercial |
$529.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.01
|
| Rate for Payer: Healthscope Commercial |
$474.01
|
| Rate for Payer: Healthscope Whirlpool |
$474.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.76
|
| Rate for Payer: Meridian Medicaid |
$273.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$434.51
|
| Rate for Payer: Nomi Health Commercial |
$474.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$879.75
|
| Rate for Payer: PACE SWMI |
$395.01
|
| Rate for Payer: PHP Medicare Advantage |
$395.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$833.54
|
| Rate for Payer: Priority Health Medicare |
$395.01
|
| Rate for Payer: Priority Health Narrow Network |
$833.54
|
| Rate for Payer: Railroad Medicare Medicare |
$395.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$822.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$395.01
|
| Rate for Payer: UHC Exchange |
$822.38
|
| Rate for Payer: UHC Medicaid |
$260.50
|
| Rate for Payer: UHCCP DNSP |
$395.01
|
| Rate for Payer: UHCCP Medicaid |
$260.50
|
|
|
PR RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 67904
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,032.45 |
| Rate for Payer: Aetna Commercial |
$658.07
|
| Rate for Payer: Aetna Medicare |
$491.10
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$491.10
|
| Rate for Payer: BCN Commercial |
$881.42
|
| Rate for Payer: BCN Medicare Advantage |
$491.10
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$707.18
|
| Rate for Payer: Cofinity Commercial |
$658.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.10
|
| Rate for Payer: Healthscope Commercial |
$589.32
|
| Rate for Payer: Healthscope Whirlpool |
$589.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$515.65
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$540.21
|
| Rate for Payer: Nomi Health Commercial |
$589.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$748.50
|
| Rate for Payer: PACE SWMI |
$491.10
|
| Rate for Payer: PHP Medicare Advantage |
$491.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,032.45
|
| Rate for Payer: Priority Health Medicare |
$491.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,032.45
|
| Rate for Payer: Railroad Medicare Medicare |
$491.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,015.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$491.10
|
| Rate for Payer: UHC Exchange |
$1,015.76
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP DNSP |
$491.10
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
|
|
PR RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS
|
Professional
|
Both
|
$2,980.00
|
|
|
Service Code
|
HCPCS 35211
|
| Min. Negotiated Rate |
$841.99 |
| Max. Negotiated Rate |
$2,472.59 |
| Rate for Payer: Aetna Commercial |
$1,765.99
|
| Rate for Payer: Aetna Medicare |
$1,317.90
|
| Rate for Payer: BCBS Complete |
$884.09
|
| Rate for Payer: BCBS MAPPO |
$1,317.90
|
| Rate for Payer: BCN Commercial |
$2,051.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,317.90
|
| Rate for Payer: Cash Price |
$2,384.00
|
| Rate for Payer: Cash Price |
$2,384.00
|
| Rate for Payer: Cofinity Commercial |
$1,897.78
|
| Rate for Payer: Cofinity Commercial |
$1,765.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,317.90
|
| Rate for Payer: Healthscope Commercial |
$1,581.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,581.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,383.80
|
| Rate for Payer: Meridian Medicaid |
$884.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,449.69
|
| Rate for Payer: Nomi Health Commercial |
$1,581.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,235.00
|
| Rate for Payer: PACE SWMI |
$1,317.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,317.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,205.78
|
| Rate for Payer: Priority Health Medicare |
$1,317.90
|
| Rate for Payer: Priority Health Narrow Network |
$2,205.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,317.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,472.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,317.90
|
| Rate for Payer: UHC Exchange |
$2,472.59
|
| Rate for Payer: UHC Medicaid |
$841.99
|
| Rate for Payer: UHCCP DNSP |
$1,317.90
|
| Rate for Payer: UHCCP Medicaid |
$841.99
|
|
|
PR RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS
|
Professional
|
Both
|
$5,486.00
|
|
|
Service Code
|
HCPCS 35216
|
| Min. Negotiated Rate |
$1,216.44 |
| Max. Negotiated Rate |
$4,114.50 |
| Rate for Payer: Aetna Commercial |
$2,555.82
|
| Rate for Payer: Aetna Medicare |
$1,907.33
|
| Rate for Payer: BCBS Complete |
$1,277.26
|
| Rate for Payer: BCBS MAPPO |
$1,907.33
|
| Rate for Payer: BCN Commercial |
$3,069.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,907.33
|
| Rate for Payer: Cash Price |
$4,388.80
|
| Rate for Payer: Cash Price |
$4,388.80
|
| Rate for Payer: Cofinity Commercial |
$2,746.56
|
| Rate for Payer: Cofinity Commercial |
$2,555.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,907.33
|
| Rate for Payer: Healthscope Commercial |
$2,288.80
|
| Rate for Payer: Healthscope Whirlpool |
$2,288.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,002.70
|
| Rate for Payer: Meridian Medicaid |
$1,277.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,098.06
|
| Rate for Payer: Nomi Health Commercial |
$2,288.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,114.50
|
| Rate for Payer: PACE SWMI |
$1,907.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,907.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,216.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,300.92
|
| Rate for Payer: Priority Health Medicare |
$1,907.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,300.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,907.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,691.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,907.33
|
| Rate for Payer: UHC Exchange |
$3,691.50
|
| Rate for Payer: UHC Medicaid |
$1,216.44
|
| Rate for Payer: UHCCP DNSP |
$1,907.33
|
| Rate for Payer: UHCCP Medicaid |
$1,216.44
|
|
|
PR RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP
|
Professional
|
Both
|
$6,715.00
|
|
|
Service Code
|
HCPCS 35241
|
| Min. Negotiated Rate |
$873.73 |
| Max. Negotiated Rate |
$5,036.25 |
| Rate for Payer: Aetna Commercial |
$1,831.14
|
| Rate for Payer: Aetna Medicare |
$1,366.52
|
| Rate for Payer: BCBS Complete |
$917.42
|
| Rate for Payer: BCBS MAPPO |
$1,366.52
|
| Rate for Payer: BCN Commercial |
$2,110.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,366.52
|
| Rate for Payer: Cash Price |
$5,372.00
|
| Rate for Payer: Cash Price |
$5,372.00
|
| Rate for Payer: Cofinity Commercial |
$1,967.79
|
| Rate for Payer: Cofinity Commercial |
$1,831.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,366.52
|
| Rate for Payer: Healthscope Commercial |
$1,639.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,639.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,434.85
|
| Rate for Payer: Meridian Medicaid |
$917.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,503.17
|
| Rate for Payer: Nomi Health Commercial |
$1,639.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,036.25
|
| Rate for Payer: PACE SWMI |
$1,366.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,366.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,269.51
|
| Rate for Payer: Priority Health Medicare |
$1,366.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,269.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,366.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,552.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,366.52
|
| Rate for Payer: UHC Exchange |
$2,552.48
|
| Rate for Payer: UHC Medicaid |
$873.73
|
| Rate for Payer: UHCCP DNSP |
$1,366.52
|
| Rate for Payer: UHCCP Medicaid |
$873.73
|
|
|
PR RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP
|
Professional
|
Both
|
$6,946.00
|
|
|
Service Code
|
HCPCS 35271
|
| Min. Negotiated Rate |
$843.27 |
| Max. Negotiated Rate |
$5,209.50 |
| Rate for Payer: Aetna Commercial |
$1,766.51
|
| Rate for Payer: Aetna Medicare |
$1,318.29
|
| Rate for Payer: BCBS Complete |
$885.43
|
| Rate for Payer: BCBS MAPPO |
$1,318.29
|
| Rate for Payer: BCN Commercial |
$2,033.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,318.29
|
| Rate for Payer: Cash Price |
$5,556.80
|
| Rate for Payer: Cash Price |
$5,556.80
|
| Rate for Payer: Cofinity Commercial |
$1,898.34
|
| Rate for Payer: Cofinity Commercial |
$1,766.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,318.29
|
| Rate for Payer: Healthscope Commercial |
$1,581.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,581.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,384.20
|
| Rate for Payer: Meridian Medicaid |
$885.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,450.12
|
| Rate for Payer: Nomi Health Commercial |
$1,581.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,209.50
|
| Rate for Payer: PACE SWMI |
$1,318.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,318.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$843.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,187.04
|
| Rate for Payer: Priority Health Medicare |
$1,318.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,187.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,318.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,456.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,318.29
|
| Rate for Payer: UHC Exchange |
$2,456.34
|
| Rate for Payer: UHC Medicaid |
$843.27
|
| Rate for Payer: UHCCP DNSP |
$1,318.29
|
| Rate for Payer: UHCCP Medicaid |
$843.27
|
|
|
PR RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 35266
|
| Min. Negotiated Rate |
$502.47 |
| Max. Negotiated Rate |
$1,547.10 |
| Rate for Payer: Aetna Commercial |
$1,061.95
|
| Rate for Payer: Aetna Medicare |
$792.50
|
| Rate for Payer: BCBS Complete |
$527.59
|
| Rate for Payer: BCBS MAPPO |
$792.50
|
| Rate for Payer: BCN Commercial |
$1,271.84
|
| Rate for Payer: BCN Medicare Advantage |
$792.50
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,141.20
|
| Rate for Payer: Cofinity Commercial |
$1,061.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$792.50
|
| Rate for Payer: Healthscope Commercial |
$951.00
|
| Rate for Payer: Healthscope Whirlpool |
$951.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$832.12
|
| Rate for Payer: Meridian Medicaid |
$527.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$871.75
|
| Rate for Payer: Nomi Health Commercial |
$951.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.25
|
| Rate for Payer: PACE SWMI |
$792.50
|
| Rate for Payer: PHP Medicare Advantage |
$792.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,367.71
|
| Rate for Payer: Priority Health Medicare |
$792.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,367.71
|
| Rate for Payer: Railroad Medicare Medicare |
$792.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,547.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$792.50
|
| Rate for Payer: UHC Exchange |
$1,547.10
|
| Rate for Payer: UHC Medicaid |
$502.47
|
| Rate for Payer: UHCCP DNSP |
$792.50
|
| Rate for Payer: UHCCP Medicaid |
$502.47
|
|
|
PR RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY
|
Professional
|
Both
|
$3,906.00
|
|
|
Service Code
|
HCPCS 35286
|
| Min. Negotiated Rate |
$536.76 |
| Max. Negotiated Rate |
$2,929.50 |
| Rate for Payer: Aetna Commercial |
$1,136.20
|
| Rate for Payer: Aetna Medicare |
$847.91
|
| Rate for Payer: BCBS Complete |
$563.60
|
| Rate for Payer: BCBS MAPPO |
$847.91
|
| Rate for Payer: BCN Commercial |
$1,357.50
|
| Rate for Payer: BCN Medicare Advantage |
$847.91
|
| Rate for Payer: Cash Price |
$3,124.80
|
| Rate for Payer: Cash Price |
$3,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,220.99
|
| Rate for Payer: Cofinity Commercial |
$1,136.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$847.91
|
| Rate for Payer: Healthscope Commercial |
$1,017.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,017.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$890.31
|
| Rate for Payer: Meridian Medicaid |
$563.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$932.70
|
| Rate for Payer: Nomi Health Commercial |
$1,017.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,929.50
|
| Rate for Payer: PACE SWMI |
$847.91
|
| Rate for Payer: PHP Medicare Advantage |
$847.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,459.82
|
| Rate for Payer: Priority Health Medicare |
$847.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,459.82
|
| Rate for Payer: Railroad Medicare Medicare |
$847.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,673.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$847.91
|
| Rate for Payer: UHC Exchange |
$1,673.64
|
| Rate for Payer: UHC Medicaid |
$536.76
|
| Rate for Payer: UHCCP DNSP |
$847.91
|
| Rate for Payer: UHCCP Medicaid |
$536.76
|
|
|
PR RPR CLOACAL ANOMALY SACROPERINEAL
|
Professional
|
Both
|
$6,780.00
|
|
|
Service Code
|
HCPCS 46744
|
| Min. Negotiated Rate |
$2,107.00 |
| Max. Negotiated Rate |
$6,461.36 |
| Rate for Payer: Aetna Commercial |
$4,414.76
|
| Rate for Payer: Aetna Medicare |
$3,294.60
|
| Rate for Payer: BCBS Complete |
$2,212.35
|
| Rate for Payer: BCBS MAPPO |
$3,294.60
|
| Rate for Payer: BCN Commercial |
$5,303.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,294.60
|
| Rate for Payer: Cash Price |
$5,424.00
|
| Rate for Payer: Cash Price |
$5,424.00
|
| Rate for Payer: Cofinity Commercial |
$4,744.22
|
| Rate for Payer: Cofinity Commercial |
$4,414.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,294.60
|
| Rate for Payer: Healthscope Commercial |
$3,953.52
|
| Rate for Payer: Healthscope Whirlpool |
$3,953.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,459.33
|
| Rate for Payer: Meridian Medicaid |
$2,212.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,624.06
|
| Rate for Payer: Nomi Health Commercial |
$3,953.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,085.00
|
| Rate for Payer: PACE SWMI |
$3,294.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,294.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,107.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,461.36
|
| Rate for Payer: Priority Health Medicare |
$3,294.60
|
| Rate for Payer: Priority Health Narrow Network |
$6,461.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3,294.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,312.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,294.60
|
| Rate for Payer: UHC Exchange |
$6,312.63
|
| Rate for Payer: UHC Medicaid |
$2,107.00
|
| Rate for Payer: UHCCP DNSP |
$3,294.60
|
| Rate for Payer: UHCCP Medicaid |
$2,107.00
|
|
|
PR RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 26540
|
| Min. Negotiated Rate |
$433.24 |
| Max. Negotiated Rate |
$1,531.50 |
| Rate for Payer: Aetna Commercial |
$868.23
|
| Rate for Payer: Aetna Medicare |
$647.93
|
| Rate for Payer: BCBS Complete |
$454.90
|
| Rate for Payer: BCBS MAPPO |
$647.93
|
| Rate for Payer: BCN Commercial |
$1,057.21
|
| Rate for Payer: BCN Medicare Advantage |
$647.93
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cofinity Commercial |
$933.02
|
| Rate for Payer: Cofinity Commercial |
$868.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.93
|
| Rate for Payer: Healthscope Commercial |
$777.52
|
| Rate for Payer: Healthscope Whirlpool |
$777.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.33
|
| Rate for Payer: Meridian Medicaid |
$454.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$712.72
|
| Rate for Payer: Nomi Health Commercial |
$777.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: PACE SWMI |
$647.93
|
| Rate for Payer: PHP Medicare Advantage |
$647.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,130.14
|
| Rate for Payer: Priority Health Medicare |
$647.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,130.14
|
| Rate for Payer: Railroad Medicare Medicare |
$647.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,151.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$647.93
|
| Rate for Payer: UHC Exchange |
$1,151.60
|
| Rate for Payer: UHC Medicaid |
$433.24
|
| Rate for Payer: UHCCP DNSP |
$647.93
|
| Rate for Payer: UHCCP Medicaid |
$433.24
|
|
|
PR RPR COMPONENT INFLATABLE PENILE PROSTHESIS
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 54408
|
| Min. Negotiated Rate |
$457.95 |
| Max. Negotiated Rate |
$1,394.51 |
| Rate for Payer: Aetna Commercial |
$948.28
|
| Rate for Payer: Aetna Medicare |
$707.67
|
| Rate for Payer: BCBS Complete |
$480.85
|
| Rate for Payer: BCBS MAPPO |
$707.67
|
| Rate for Payer: BCN Commercial |
$1,186.69
|
| Rate for Payer: BCN Medicare Advantage |
$707.67
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$948.28
|
| Rate for Payer: Cofinity Commercial |
$1,019.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.67
|
| Rate for Payer: Healthscope Commercial |
$849.20
|
| Rate for Payer: Healthscope Whirlpool |
$849.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.05
|
| Rate for Payer: Meridian Medicaid |
$480.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$778.44
|
| Rate for Payer: Nomi Health Commercial |
$849.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,162.50
|
| Rate for Payer: PACE SWMI |
$707.67
|
| Rate for Payer: PHP Medicare Advantage |
$707.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,292.69
|
| Rate for Payer: Priority Health Medicare |
$707.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,292.69
|
| Rate for Payer: Railroad Medicare Medicare |
$707.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,394.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$707.67
|
| Rate for Payer: UHC Exchange |
$1,394.51
|
| Rate for Payer: UHC Medicaid |
$457.95
|
| Rate for Payer: UHCCP DNSP |
$707.67
|
| Rate for Payer: UHCCP Medicaid |
$457.95
|
|
|
PR RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS
|
Professional
|
Both
|
$5,983.00
|
|
|
Service Code
|
HCPCS 33500
|
| Min. Negotiated Rate |
$948.92 |
| Max. Negotiated Rate |
$4,487.25 |
| Rate for Payer: Aetna Commercial |
$1,989.66
|
| Rate for Payer: Aetna Medicare |
$1,484.82
|
| Rate for Payer: BCBS Complete |
$996.37
|
| Rate for Payer: BCBS MAPPO |
$1,484.82
|
| Rate for Payer: BCN Commercial |
$2,294.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,484.82
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Cofinity Commercial |
$2,138.14
|
| Rate for Payer: Cofinity Commercial |
$1,989.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,484.82
|
| Rate for Payer: Healthscope Commercial |
$1,781.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,781.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,559.06
|
| Rate for Payer: Meridian Medicaid |
$996.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,633.30
|
| Rate for Payer: Nomi Health Commercial |
$1,781.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,487.25
|
| Rate for Payer: PACE SWMI |
$1,484.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,484.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$948.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,467.11
|
| Rate for Payer: Priority Health Medicare |
$1,484.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,467.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,484.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,779.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,484.82
|
| Rate for Payer: UHC Exchange |
$2,779.48
|
| Rate for Payer: UHC Medicaid |
$948.92
|
| Rate for Payer: UHCCP DNSP |
$1,484.82
|
| Rate for Payer: UHCCP Medicaid |
$948.92
|
|
|
PR RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT
|
Professional
|
Both
|
$878.00
|
|
|
Service Code
|
HCPCS 36576
|
| Min. Negotiated Rate |
$108.84 |
| Max. Negotiated Rate |
$658.50 |
| Rate for Payer: Aetna Commercial |
$225.70
|
| Rate for Payer: Aetna Medicare |
$168.43
|
| Rate for Payer: BCBS Complete |
$114.28
|
| Rate for Payer: BCBS MAPPO |
$168.43
|
| Rate for Payer: BCN Commercial |
$270.90
|
| Rate for Payer: BCN Medicare Advantage |
$168.43
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cofinity Commercial |
$242.54
|
| Rate for Payer: Cofinity Commercial |
$225.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.43
|
| Rate for Payer: Healthscope Commercial |
$202.12
|
| Rate for Payer: Healthscope Whirlpool |
$202.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.85
|
| Rate for Payer: Meridian Medicaid |
$114.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.27
|
| Rate for Payer: Nomi Health Commercial |
$202.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.50
|
| Rate for Payer: PACE SWMI |
$168.43
|
| Rate for Payer: PHP Medicare Advantage |
$168.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$291.31
|
| Rate for Payer: Priority Health Medicare |
$168.43
|
| Rate for Payer: Priority Health Narrow Network |
$291.31
|
| Rate for Payer: Railroad Medicare Medicare |
$168.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$326.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.43
|
| Rate for Payer: UHC Exchange |
$326.32
|
| Rate for Payer: UHC Medicaid |
$108.84
|
| Rate for Payer: UHCCP DNSP |
$168.43
|
| Rate for Payer: UHCCP Medicaid |
$108.84
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT
|
Professional
|
Both
|
$6,173.00
|
|
|
Service Code
|
HCPCS 39540
|
| Min. Negotiated Rate |
$521.85 |
| Max. Negotiated Rate |
$4,629.75 |
| Rate for Payer: Aetna Commercial |
$1,091.39
|
| Rate for Payer: Aetna Medicare |
$814.47
|
| Rate for Payer: BCBS Complete |
$547.94
|
| Rate for Payer: BCBS MAPPO |
$814.47
|
| Rate for Payer: BCN Commercial |
$1,290.77
|
| Rate for Payer: BCN Medicare Advantage |
$814.47
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cofinity Commercial |
$1,172.84
|
| Rate for Payer: Cofinity Commercial |
$1,091.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$814.47
|
| Rate for Payer: Healthscope Commercial |
$977.36
|
| Rate for Payer: Healthscope Whirlpool |
$977.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$855.19
|
| Rate for Payer: Meridian Medicaid |
$547.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$895.92
|
| Rate for Payer: Nomi Health Commercial |
$977.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,629.75
|
| Rate for Payer: PACE SWMI |
$814.47
|
| Rate for Payer: PHP Medicare Advantage |
$814.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,388.05
|
| Rate for Payer: Priority Health Medicare |
$814.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,388.05
|
| Rate for Payer: Railroad Medicare Medicare |
$814.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,549.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$814.47
|
| Rate for Payer: UHC Exchange |
$1,549.66
|
| Rate for Payer: UHC Medicaid |
$521.85
|
| Rate for Payer: UHCCP DNSP |
$814.47
|
| Rate for Payer: UHCCP Medicaid |
$521.85
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC
|
Professional
|
Both
|
$1,763.00
|
|
|
Service Code
|
HCPCS 39541
|
| Min. Negotiated Rate |
$566.37 |
| Max. Negotiated Rate |
$1,673.71 |
| Rate for Payer: Aetna Commercial |
$1,184.84
|
| Rate for Payer: Aetna Medicare |
$884.21
|
| Rate for Payer: BCBS Complete |
$594.69
|
| Rate for Payer: BCBS MAPPO |
$884.21
|
| Rate for Payer: BCN Commercial |
$1,401.82
|
| Rate for Payer: BCN Medicare Advantage |
$884.21
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Cash Price |
$1,410.40
|
| Rate for Payer: Cofinity Commercial |
$1,273.26
|
| Rate for Payer: Cofinity Commercial |
$1,184.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.21
|
| Rate for Payer: Healthscope Commercial |
$1,061.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,061.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.42
|
| Rate for Payer: Meridian Medicaid |
$594.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$972.63
|
| Rate for Payer: Nomi Health Commercial |
$1,061.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,322.25
|
| Rate for Payer: PACE SWMI |
$884.21
|
| Rate for Payer: PHP Medicare Advantage |
$884.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,507.47
|
| Rate for Payer: Priority Health Medicare |
$884.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,507.47
|
| Rate for Payer: Railroad Medicare Medicare |
$884.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,673.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$884.21
|
| Rate for Payer: UHC Exchange |
$1,673.71
|
| Rate for Payer: UHC Medicaid |
$566.37
|
| Rate for Payer: UHCCP DNSP |
$884.21
|
| Rate for Payer: UHCCP Medicaid |
$566.37
|
|
|
PR RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 27675
|
| Min. Negotiated Rate |
$299.27 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Aetna Commercial |
$612.39
|
| Rate for Payer: Aetna Medicare |
$457.01
|
| Rate for Payer: BCBS Complete |
$314.23
|
| Rate for Payer: BCBS MAPPO |
$457.01
|
| Rate for Payer: BCN Commercial |
$756.93
|
| Rate for Payer: BCN Medicare Advantage |
$457.01
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$658.09
|
| Rate for Payer: Cofinity Commercial |
$612.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.01
|
| Rate for Payer: Healthscope Commercial |
$548.41
|
| Rate for Payer: Healthscope Whirlpool |
$548.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.86
|
| Rate for Payer: Meridian Medicaid |
$314.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.71
|
| Rate for Payer: Nomi Health Commercial |
$548.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.00
|
| Rate for Payer: PACE SWMI |
$457.01
|
| Rate for Payer: PHP Medicare Advantage |
$457.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$809.14
|
| Rate for Payer: Priority Health Medicare |
$457.01
|
| Rate for Payer: Priority Health Narrow Network |
$809.14
|
| Rate for Payer: Railroad Medicare Medicare |
$457.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$856.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.01
|
| Rate for Payer: UHC Exchange |
$856.81
|
| Rate for Payer: UHC Medicaid |
$299.27
|
| Rate for Payer: UHCCP DNSP |
$457.01
|
| Rate for Payer: UHCCP Medicaid |
$299.27
|
|
