|
PR REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
HCPCS 49450
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$885.97 |
| Rate for Payer: Aetna Commercial |
$88.08
|
| Rate for Payer: Aetna Medicare |
$604.50
|
| Rate for Payer: BCBS Complete |
$43.39
|
| Rate for Payer: BCBS Trust/PPO |
$631.32
|
| Rate for Payer: BCN Commercial |
$885.97
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Meridian Medicaid |
$43.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.95
|
| Rate for Payer: Priority Health Narrow Network |
$113.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.01
|
| Rate for Payer: UHC Exchange |
$88.01
|
| Rate for Payer: UHCCP Medicaid |
$41.32
|
|
|
PR REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,493.00
|
|
|
Service Code
|
HCPCS 49452
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$2,855.46 |
| Rate for Payer: Aetna Commercial |
$183.16
|
| Rate for Payer: Aetna Medicare |
$746.50
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,855.46
|
| Rate for Payer: BCN Commercial |
$1,148.88
|
| Rate for Payer: Cash Price |
$1,194.40
|
| Rate for Payer: Cash Price |
$1,194.40
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.85
|
| Rate for Payer: Priority Health Narrow Network |
$236.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.80
|
| Rate for Payer: UHC Exchange |
$188.80
|
| Rate for Payer: UHCCP Medicaid |
$85.20
|
|
|
PR REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$5,864.00
|
|
|
Service Code
|
HCPCS 33430
|
| Min. Negotiated Rate |
$545.73 |
| Max. Negotiated Rate |
$4,380.64 |
| Rate for Payer: Aetna Commercial |
$3,761.38
|
| Rate for Payer: Aetna Medicare |
$2,932.00
|
| Rate for Payer: BCBS Complete |
$1,848.69
|
| Rate for Payer: BCBS Trust/PPO |
$545.73
|
| Rate for Payer: BCN Commercial |
$4,011.07
|
| Rate for Payer: Cash Price |
$4,691.20
|
| Rate for Payer: Cash Price |
$4,691.20
|
| Rate for Payer: Meridian Medicaid |
$1,848.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,760.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,811.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,380.64
|
| Rate for Payer: Priority Health Narrow Network |
$4,380.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,679.53
|
| Rate for Payer: UHC Exchange |
$3,679.53
|
| Rate for Payer: UHCCP Medicaid |
$1,760.66
|
|
|
PR REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 11970
|
| Min. Negotiated Rate |
$364.66 |
| Max. Negotiated Rate |
$822.45 |
| Rate for Payer: Aetna Commercial |
$605.68
|
| Rate for Payer: Aetna Medicare |
$552.00
|
| Rate for Payer: BCBS Complete |
$382.89
|
| Rate for Payer: BCBS Trust/PPO |
$381.90
|
| Rate for Payer: BCN Commercial |
$822.45
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Meridian Medicaid |
$382.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.32
|
| Rate for Payer: Priority Health Narrow Network |
$765.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$633.71
|
| Rate for Payer: UHC Exchange |
$633.71
|
| Rate for Payer: UHCCP Medicaid |
$364.66
|
|
|
PR REPLACEMENT TRICUSPID VALVE W/CARD BYPASS
|
Professional
|
Both
|
$8,810.00
|
|
|
Service Code
|
HCPCS 33465
|
| Min. Negotiated Rate |
$447.47 |
| Max. Negotiated Rate |
$5,726.50 |
| Rate for Payer: Aetna Commercial |
$3,697.17
|
| Rate for Payer: Aetna Medicare |
$4,405.00
|
| Rate for Payer: BCBS Complete |
$1,814.25
|
| Rate for Payer: BCBS Trust/PPO |
$447.47
|
| Rate for Payer: BCN Commercial |
$3,939.71
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Meridian Medicaid |
$1,814.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,726.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,301.94
|
| Rate for Payer: Priority Health Narrow Network |
$4,301.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,594.59
|
| Rate for Payer: UHC Exchange |
$3,594.59
|
| Rate for Payer: UHCCP Medicaid |
$1,727.86
|
|
|
PR REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ
|
Professional
|
Both
|
$494.00
|
|
|
Service Code
|
HCPCS 33993
|
| Min. Negotiated Rate |
$103.52 |
| Max. Negotiated Rate |
$1,384.15 |
| Rate for Payer: Aetna Commercial |
$222.32
|
| Rate for Payer: Aetna Medicare |
$247.00
|
| Rate for Payer: BCBS Complete |
$108.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.15
|
| Rate for Payer: BCN Commercial |
$237.01
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Meridian Medicaid |
$108.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.47
|
| Rate for Payer: Priority Health Narrow Network |
$258.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.94
|
| Rate for Payer: UHC Exchange |
$249.94
|
| Rate for Payer: UHCCP Medicaid |
$103.52
|
|
|
PR REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 43761
|
| Min. Negotiated Rate |
$65.60 |
| Max. Negotiated Rate |
$244.40 |
| Rate for Payer: Aetna Commercial |
$139.84
|
| Rate for Payer: Aetna Medicare |
$188.00
|
| Rate for Payer: BCBS Complete |
$68.88
|
| Rate for Payer: BCBS Trust/PPO |
$106.72
|
| Rate for Payer: BCN Commercial |
$181.30
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Meridian Medicaid |
$68.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.35
|
| Rate for Payer: Priority Health Narrow Network |
$184.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.44
|
| Rate for Payer: UHC Exchange |
$134.44
|
| Rate for Payer: UHCCP Medicaid |
$65.60
|
|
|
PR REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 33273
|
| Min. Negotiated Rate |
$253.47 |
| Max. Negotiated Rate |
$1,148.52 |
| Rate for Payer: Aetna Commercial |
$534.44
|
| Rate for Payer: Aetna Medicare |
$421.00
|
| Rate for Payer: BCBS Complete |
$266.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,148.52
|
| Rate for Payer: BCN Commercial |
$576.15
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Meridian Medicaid |
$266.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.34
|
| Rate for Payer: Priority Health Narrow Network |
$632.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$534.93
|
| Rate for Payer: UHC Exchange |
$534.93
|
| Rate for Payer: UHCCP Medicaid |
$253.47
|
|
|
PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 62252
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$1,964.75 |
| Rate for Payer: Aetna Commercial |
$103.38
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,964.75
|
| Rate for Payer: BCN Commercial |
$170.84
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.91
|
| Rate for Payer: Priority Health Narrow Network |
$77.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.22
|
| Rate for Payer: UHC Exchange |
$114.22
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
|
|
PR RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ
|
Professional
|
Both
|
$4,931.00
|
|
|
Service Code
|
HCPCS 32504
|
| Min. Negotiated Rate |
$839.47 |
| Max. Negotiated Rate |
$3,205.15 |
| Rate for Payer: Aetna Commercial |
$2,643.29
|
| Rate for Payer: Aetna Medicare |
$2,465.50
|
| Rate for Payer: BCBS Complete |
$1,352.86
|
| Rate for Payer: BCBS Trust/PPO |
$839.47
|
| Rate for Payer: BCN Commercial |
$2,935.00
|
| Rate for Payer: Cash Price |
$3,944.80
|
| Rate for Payer: Cash Price |
$3,944.80
|
| Rate for Payer: Meridian Medicaid |
$1,352.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,288.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,205.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,797.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,797.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,463.90
|
| Rate for Payer: UHC Exchange |
$2,463.90
|
| Rate for Payer: UHCCP Medicaid |
$1,288.44
|
|
|
PR RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ
|
Professional
|
Both
|
$3,670.00
|
|
|
Service Code
|
HCPCS 32503
|
| Min. Negotiated Rate |
$1,132.52 |
| Max. Negotiated Rate |
$2,578.75 |
| Rate for Payer: Aetna Commercial |
$2,319.27
|
| Rate for Payer: Aetna Medicare |
$1,835.00
|
| Rate for Payer: BCBS Complete |
$1,189.15
|
| Rate for Payer: BCN Commercial |
$2,578.75
|
| Rate for Payer: Cash Price |
$2,936.00
|
| Rate for Payer: Cash Price |
$2,936.00
|
| Rate for Payer: Meridian Medicaid |
$1,189.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,132.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,385.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,456.37
|
| Rate for Payer: Priority Health Narrow Network |
$2,456.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,151.67
|
| Rate for Payer: UHC Exchange |
$2,151.67
|
| Rate for Payer: UHCCP Medicaid |
$1,132.52
|
|
|
PR RESCJ DIAPHRAGM W/COMPLEX REPAIR
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 39561
|
| Min. Negotiated Rate |
$573.73 |
| Max. Negotiated Rate |
$1,995.94 |
| Rate for Payer: Aetna Commercial |
$1,273.41
|
| Rate for Payer: Aetna Medicare |
$1,130.50
|
| Rate for Payer: BCBS Complete |
$846.07
|
| Rate for Payer: BCBS Trust/PPO |
$573.73
|
| Rate for Payer: BCN Commercial |
$1,817.39
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Meridian Medicaid |
$846.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$805.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,995.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,995.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,412.43
|
| Rate for Payer: UHC Exchange |
$1,412.43
|
| Rate for Payer: UHCCP Medicaid |
$805.78
|
|
|
PR RESCJ DIAPHRAGM W/SIMPLE REPAIR
|
Professional
|
Both
|
$3,676.00
|
|
|
Service Code
|
HCPCS 39560
|
| Min. Negotiated Rate |
$479.70 |
| Max. Negotiated Rate |
$2,389.40 |
| Rate for Payer: Aetna Commercial |
$818.99
|
| Rate for Payer: Aetna Medicare |
$1,838.00
|
| Rate for Payer: BCBS Complete |
$541.45
|
| Rate for Payer: BCBS Trust/PPO |
$479.70
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: Cash Price |
$2,940.80
|
| Rate for Payer: Cash Price |
$2,940.80
|
| Rate for Payer: Meridian Medicaid |
$541.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,389.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,279.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,279.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$900.85
|
| Rate for Payer: UHC Exchange |
$900.85
|
| Rate for Payer: UHCCP Medicaid |
$515.67
|
|
|
PR RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL
|
Professional
|
Both
|
$5,417.00
|
|
|
Service Code
|
HCPCS 61600
|
| Min. Negotiated Rate |
$410.49 |
| Max. Negotiated Rate |
$3,634.65 |
| Rate for Payer: Aetna Commercial |
$2,761.75
|
| Rate for Payer: Aetna Medicare |
$2,708.50
|
| Rate for Payer: BCBS Complete |
$1,422.19
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$3,131.93
|
| Rate for Payer: Cash Price |
$4,333.60
|
| Rate for Payer: Cash Price |
$4,333.60
|
| Rate for Payer: Meridian Medicaid |
$1,422.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,354.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,521.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,634.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,634.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,459.48
|
| Rate for Payer: UHC Exchange |
$2,459.48
|
| Rate for Payer: UHCCP Medicaid |
$1,354.47
|
|
|
PR RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF
|
Professional
|
Both
|
$7,464.00
|
|
|
Service Code
|
HCPCS 61601
|
| Min. Negotiated Rate |
$1,560.44 |
| Max. Negotiated Rate |
$4,982.12 |
| Rate for Payer: Aetna Commercial |
$3,136.72
|
| Rate for Payer: Aetna Medicare |
$3,732.00
|
| Rate for Payer: BCBS Complete |
$1,638.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,035.01
|
| Rate for Payer: BCN Commercial |
$4,982.12
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Meridian Medicaid |
$1,638.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,560.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,851.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,196.54
|
| Rate for Payer: Priority Health Narrow Network |
$4,196.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,712.72
|
| Rate for Payer: UHC Exchange |
$2,712.72
|
| Rate for Payer: UHCCP Medicaid |
$1,560.44
|
|
|
PR RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL
|
Professional
|
Both
|
$6,974.00
|
|
|
Service Code
|
HCPCS 61616
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$6,824.07 |
| Rate for Payer: Aetna Commercial |
$4,330.86
|
| Rate for Payer: Aetna Medicare |
$3,487.00
|
| Rate for Payer: BCBS Complete |
$2,249.47
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$6,824.07
|
| Rate for Payer: Cash Price |
$5,579.20
|
| Rate for Payer: Cash Price |
$5,579.20
|
| Rate for Payer: Meridian Medicaid |
$2,249.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,142.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,533.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,752.55
|
| Rate for Payer: Priority Health Narrow Network |
$5,752.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,825.77
|
| Rate for Payer: UHC Exchange |
$3,825.77
|
| Rate for Payer: UHCCP Medicaid |
$2,142.35
|
|
|
PR RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL
|
Professional
|
Both
|
$7,225.00
|
|
|
Service Code
|
HCPCS 61615
|
| Min. Negotiated Rate |
$129.96 |
| Max. Negotiated Rate |
$4,857.41 |
| Rate for Payer: Aetna Commercial |
$3,660.27
|
| Rate for Payer: Aetna Medicare |
$3,612.50
|
| Rate for Payer: BCBS Complete |
$1,908.19
|
| Rate for Payer: BCBS Trust/PPO |
$129.96
|
| Rate for Payer: BCN Commercial |
$4,161.58
|
| Rate for Payer: Cash Price |
$5,780.00
|
| Rate for Payer: Cash Price |
$5,780.00
|
| Rate for Payer: Meridian Medicaid |
$1,908.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,817.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,696.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,857.41
|
| Rate for Payer: Priority Health Narrow Network |
$4,857.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,727.55
|
| Rate for Payer: UHC Exchange |
$2,727.55
|
| Rate for Payer: UHCCP Medicaid |
$1,817.32
|
|
|
PR RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL
|
Professional
|
Both
|
$4,724.00
|
|
|
Service Code
|
HCPCS 61605
|
| Min. Negotiated Rate |
$1,389.19 |
| Max. Negotiated Rate |
$3,700.05 |
| Rate for Payer: Aetna Commercial |
$2,793.41
|
| Rate for Payer: Aetna Medicare |
$2,362.00
|
| Rate for Payer: BCBS Complete |
$1,458.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.48
|
| Rate for Payer: BCN Commercial |
$3,188.13
|
| Rate for Payer: Cash Price |
$3,779.20
|
| Rate for Payer: Cash Price |
$3,779.20
|
| Rate for Payer: Meridian Medicaid |
$1,458.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,389.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,070.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,700.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,700.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,549.47
|
| Rate for Payer: UHC Exchange |
$2,549.47
|
| Rate for Payer: UHCCP Medicaid |
$1,389.19
|
|
|
PR RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR
|
Professional
|
Both
|
$10,219.00
|
|
|
Service Code
|
HCPCS 61606
|
| Min. Negotiated Rate |
$202.34 |
| Max. Negotiated Rate |
$6,642.35 |
| Rate for Payer: Aetna Commercial |
$3,798.94
|
| Rate for Payer: Aetna Medicare |
$5,109.50
|
| Rate for Payer: BCBS Complete |
$1,967.90
|
| Rate for Payer: BCBS Trust/PPO |
$202.34
|
| Rate for Payer: BCN Commercial |
$5,966.48
|
| Rate for Payer: Cash Price |
$8,175.20
|
| Rate for Payer: Cash Price |
$8,175.20
|
| Rate for Payer: Meridian Medicaid |
$1,967.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,874.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,642.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,995.03
|
| Rate for Payer: Priority Health Narrow Network |
$4,995.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,481.27
|
| Rate for Payer: UHC Exchange |
$3,481.27
|
| Rate for Payer: UHCCP Medicaid |
$1,874.19
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL
|
Professional
|
Both
|
$10,653.00
|
|
|
Service Code
|
HCPCS 61608
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$6,924.45 |
| Rate for Payer: Aetna Commercial |
$4,229.44
|
| Rate for Payer: Aetna Medicare |
$5,326.50
|
| Rate for Payer: BCBS Complete |
$2,220.39
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$6,712.21
|
| Rate for Payer: Cash Price |
$8,522.40
|
| Rate for Payer: Cash Price |
$8,522.40
|
| Rate for Payer: Meridian Medicaid |
$2,220.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,924.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,653.60
|
| Rate for Payer: Priority Health Narrow Network |
$5,653.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,743.70
|
| Rate for Payer: UHC Exchange |
$3,743.70
|
| Rate for Payer: UHCCP Medicaid |
$2,114.66
|
|
|
PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL
|
Professional
|
Both
|
$6,021.00
|
|
|
Service Code
|
HCPCS 61607
|
| Min. Negotiated Rate |
$156.91 |
| Max. Negotiated Rate |
$5,239.58 |
| Rate for Payer: Aetna Commercial |
$3,949.87
|
| Rate for Payer: Aetna Medicare |
$3,010.50
|
| Rate for Payer: BCBS Complete |
$2,060.71
|
| Rate for Payer: BCBS Trust/PPO |
$156.91
|
| Rate for Payer: BCN Commercial |
$3,905.03
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Cash Price |
$4,816.80
|
| Rate for Payer: Meridian Medicaid |
$2,060.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,962.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,913.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,239.58
|
| Rate for Payer: Priority Health Narrow Network |
$5,239.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,356.51
|
| Rate for Payer: UHC Exchange |
$3,356.51
|
| Rate for Payer: UHCCP Medicaid |
$1,962.58
|
|
|
PR RESCJ PALATE/EXTENSIVE RESCJ LESION
|
Professional
|
Both
|
$2,052.00
|
|
|
Service Code
|
HCPCS 42120
|
| Min. Negotiated Rate |
$418.41 |
| Max. Negotiated Rate |
$1,793.97 |
| Rate for Payer: Aetna Commercial |
$1,336.73
|
| Rate for Payer: Aetna Medicare |
$1,026.00
|
| Rate for Payer: BCBS Complete |
$674.31
|
| Rate for Payer: BCBS Trust/PPO |
$418.41
|
| Rate for Payer: BCN Commercial |
$1,474.34
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Meridian Medicaid |
$674.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,793.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,793.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,175.59
|
| Rate for Payer: UHC Exchange |
$1,175.59
|
| Rate for Payer: UHCCP Medicaid |
$642.20
|
|
|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING
|
Professional
|
Both
|
$3,468.00
|
|
|
Service Code
|
HCPCS 58952
|
| Min. Negotiated Rate |
$1,056.69 |
| Max. Negotiated Rate |
$2,463.86 |
| Rate for Payer: Aetna Commercial |
$1,952.00
|
| Rate for Payer: Aetna Medicare |
$1,734.00
|
| Rate for Payer: BCBS Complete |
$1,109.52
|
| Rate for Payer: BCN Commercial |
$2,406.74
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Meridian Medicaid |
$1,109.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,056.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,463.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,463.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,782.05
|
| Rate for Payer: UHC Exchange |
$1,782.05
|
| Rate for Payer: UHCCP Medicaid |
$1,056.69
|
|
|
PR RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD
|
Professional
|
Both
|
$4,936.00
|
|
|
Service Code
|
HCPCS 58951
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$3,208.40 |
| Rate for Payer: Aetna Commercial |
$1,713.00
|
| Rate for Payer: Aetna Medicare |
$2,468.00
|
| Rate for Payer: BCBS Complete |
$973.10
|
| Rate for Payer: BCBS Trust/PPO |
$149.51
|
| Rate for Payer: BCN Commercial |
$2,107.18
|
| Rate for Payer: Cash Price |
$3,948.80
|
| Rate for Payer: Cash Price |
$3,948.80
|
| Rate for Payer: Meridian Medicaid |
$973.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,208.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,156.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,156.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,579.66
|
| Rate for Payer: UHC Exchange |
$1,579.66
|
| Rate for Payer: UHCCP Medicaid |
$926.76
|
|
|
PR RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS
|
Professional
|
Both
|
$6,636.00
|
|
|
Service Code
|
HCPCS 48105
|
| Min. Negotiated Rate |
$1,805.39 |
| Max. Negotiated Rate |
$5,018.54 |
| Rate for Payer: Aetna Commercial |
$3,842.31
|
| Rate for Payer: Aetna Medicare |
$3,318.00
|
| Rate for Payer: BCBS Complete |
$1,895.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,408.52
|
| Rate for Payer: BCN Commercial |
$4,107.33
|
| Rate for Payer: Cash Price |
$5,308.80
|
| Rate for Payer: Cash Price |
$5,308.80
|
| Rate for Payer: Meridian Medicaid |
$1,895.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,805.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,313.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,018.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,018.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,456.63
|
| Rate for Payer: UHC Exchange |
$3,456.63
|
| Rate for Payer: UHCCP Medicaid |
$1,805.39
|
|
