|
PR REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA TDN/MUSC
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 24341
|
| Min. Negotiated Rate |
$722.69 |
| Max. Negotiated Rate |
$1,517.75 |
| Rate for Payer: Aetna Commercial |
$968.40
|
| Rate for Payer: Aetna Medicare |
$722.69
|
| Rate for Payer: BCBS Complete |
$934.00
|
| Rate for Payer: BCBS MAPPO |
$722.69
|
| Rate for Payer: BCN Medicare Advantage |
$722.69
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cofinity Commercial |
$968.40
|
| Rate for Payer: Cofinity Commercial |
$1,040.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.69
|
| Rate for Payer: Healthscope Commercial |
$867.23
|
| Rate for Payer: Healthscope Whirlpool |
$867.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.82
|
| Rate for Payer: Nomi Health Commercial |
$867.23
|
| Rate for Payer: PACE SWMI |
$722.69
|
| Rate for Payer: PHP Medicare Advantage |
$722.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,517.75
|
| Rate for Payer: Priority Health Medicare |
$722.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.69
|
| Rate for Payer: UHC Medicare Advantage |
$722.69
|
| Rate for Payer: UHCCP DNSP |
$722.69
|
|
|
PR REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 33363
|
| Min. Negotiated Rate |
$1,029.60 |
| Max. Negotiated Rate |
$1,880.68 |
| Rate for Payer: Aetna Commercial |
$1,750.08
|
| Rate for Payer: Aetna Medicare |
$1,306.03
|
| Rate for Payer: BCBS Complete |
$1,029.60
|
| Rate for Payer: BCBS MAPPO |
$1,306.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.03
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$1,880.68
|
| Rate for Payer: Cofinity Commercial |
$1,750.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.03
|
| Rate for Payer: Healthscope Commercial |
$1,567.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,567.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,371.33
|
| Rate for Payer: Nomi Health Commercial |
$1,567.24
|
| Rate for Payer: PACE SWMI |
$1,306.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.10
|
| Rate for Payer: Priority Health Medicare |
$1,306.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,306.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,306.03
|
| Rate for Payer: UHCCP DNSP |
$1,306.03
|
|
|
PR REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH
|
Professional
|
Both
|
$4,316.00
|
|
|
Service Code
|
HCPCS 33362
|
| Min. Negotiated Rate |
$1,260.99 |
| Max. Negotiated Rate |
$2,805.40 |
| Rate for Payer: Aetna Commercial |
$1,689.73
|
| Rate for Payer: Aetna Medicare |
$1,260.99
|
| Rate for Payer: BCBS Complete |
$1,726.40
|
| Rate for Payer: BCBS MAPPO |
$1,260.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,260.99
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cash Price |
$3,452.80
|
| Rate for Payer: Cofinity Commercial |
$1,815.83
|
| Rate for Payer: Cofinity Commercial |
$1,689.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,260.99
|
| Rate for Payer: Healthscope Commercial |
$1,513.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,513.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,324.04
|
| Rate for Payer: Nomi Health Commercial |
$1,513.19
|
| Rate for Payer: PACE SWMI |
$1,260.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,260.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,805.40
|
| Rate for Payer: Priority Health Medicare |
$1,260.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,260.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,260.99
|
| Rate for Payer: UHCCP DNSP |
$1,260.99
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH
|
Professional
|
Both
|
$5,215.00
|
|
|
Service Code
|
HCPCS 33365
|
| Min. Negotiated Rate |
$1,360.42 |
| Max. Negotiated Rate |
$3,389.75 |
| Rate for Payer: Aetna Commercial |
$1,822.96
|
| Rate for Payer: Aetna Medicare |
$1,360.42
|
| Rate for Payer: BCBS Complete |
$2,086.00
|
| Rate for Payer: BCBS MAPPO |
$1,360.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,360.42
|
| Rate for Payer: Cash Price |
$4,172.00
|
| Rate for Payer: Cash Price |
$4,172.00
|
| Rate for Payer: Cofinity Commercial |
$1,959.00
|
| Rate for Payer: Cofinity Commercial |
$1,822.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,360.42
|
| Rate for Payer: Healthscope Commercial |
$1,632.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,632.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,428.44
|
| Rate for Payer: Nomi Health Commercial |
$1,632.50
|
| Rate for Payer: PACE SWMI |
$1,360.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,360.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,389.75
|
| Rate for Payer: Priority Health Medicare |
$1,360.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,360.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,360.42
|
| Rate for Payer: UHCCP DNSP |
$1,360.42
|
|
|
PR REPLACE AORTIC VALVE OPEN TRANSTHORACIC APPROACH
|
Professional
|
Both
|
$3,171.00
|
|
|
Service Code
|
HCPCS 0318T
|
| Min. Negotiated Rate |
$1,268.40 |
| Max. Negotiated Rate |
$2,061.15 |
| Rate for Payer: Aetna Medicare |
$1,585.50
|
| Rate for Payer: BCBS Complete |
$1,268.40
|
| Rate for Payer: Cash Price |
$2,536.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,061.15
|
|
|
PR REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH
|
Professional
|
Both
|
$3,945.00
|
|
|
Service Code
|
HCPCS 33361
|
| Min. Negotiated Rate |
$1,155.07 |
| Max. Negotiated Rate |
$2,564.25 |
| Rate for Payer: Aetna Commercial |
$1,547.79
|
| Rate for Payer: Aetna Medicare |
$1,155.07
|
| Rate for Payer: BCBS Complete |
$1,578.00
|
| Rate for Payer: BCBS MAPPO |
$1,155.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.07
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cofinity Commercial |
$1,663.30
|
| Rate for Payer: Cofinity Commercial |
$1,547.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.07
|
| Rate for Payer: Healthscope Commercial |
$1,386.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,386.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,212.82
|
| Rate for Payer: Nomi Health Commercial |
$1,386.08
|
| Rate for Payer: PACE SWMI |
$1,155.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.25
|
| Rate for Payer: Priority Health Medicare |
$1,155.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.07
|
| Rate for Payer: UHCCP DNSP |
$1,155.07
|
|
|
PR REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 33368
|
| Min. Negotiated Rate |
$706.69 |
| Max. Negotiated Rate |
$1,443.00 |
| Rate for Payer: Aetna Commercial |
$946.96
|
| Rate for Payer: Aetna Medicare |
$706.69
|
| Rate for Payer: BCBS Complete |
$888.00
|
| Rate for Payer: BCBS MAPPO |
$706.69
|
| Rate for Payer: BCN Medicare Advantage |
$706.69
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$946.96
|
| Rate for Payer: Cofinity Commercial |
$1,017.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.69
|
| Rate for Payer: Healthscope Commercial |
$848.03
|
| Rate for Payer: Healthscope Whirlpool |
$848.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.02
|
| Rate for Payer: Nomi Health Commercial |
$848.03
|
| Rate for Payer: PACE SWMI |
$706.69
|
| Rate for Payer: PHP Medicare Advantage |
$706.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health Medicare |
$706.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$706.69
|
| Rate for Payer: UHC Medicare Advantage |
$706.69
|
| Rate for Payer: UHCCP DNSP |
$706.69
|
|
|
PR REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 49451
|
| Min. Negotiated Rate |
$83.61 |
| Max. Negotiated Rate |
$887.25 |
| Rate for Payer: Aetna Commercial |
$112.04
|
| Rate for Payer: Aetna Medicare |
$83.61
|
| Rate for Payer: BCBS Complete |
$546.00
|
| Rate for Payer: BCBS MAPPO |
$83.61
|
| Rate for Payer: BCN Medicare Advantage |
$83.61
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cofinity Commercial |
$120.40
|
| Rate for Payer: Cofinity Commercial |
$112.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.61
|
| Rate for Payer: Healthscope Commercial |
$100.33
|
| Rate for Payer: Healthscope Whirlpool |
$100.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.79
|
| Rate for Payer: Nomi Health Commercial |
$100.33
|
| Rate for Payer: PACE SWMI |
$83.61
|
| Rate for Payer: PHP Medicare Advantage |
$83.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$887.25
|
| Rate for Payer: Priority Health Medicare |
$83.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.61
|
| Rate for Payer: UHC Medicare Advantage |
$83.61
|
| Rate for Payer: UHCCP DNSP |
$83.61
|
|
|
PR REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
HCPCS 49450
|
| Min. Negotiated Rate |
$62.44 |
| Max. Negotiated Rate |
$785.85 |
| Rate for Payer: Aetna Commercial |
$83.67
|
| Rate for Payer: Aetna Medicare |
$62.44
|
| Rate for Payer: BCBS Complete |
$483.60
|
| Rate for Payer: BCBS MAPPO |
$62.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.44
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$89.91
|
| Rate for Payer: Cofinity Commercial |
$83.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.44
|
| Rate for Payer: Healthscope Commercial |
$74.93
|
| Rate for Payer: Healthscope Whirlpool |
$74.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.56
|
| Rate for Payer: Nomi Health Commercial |
$74.93
|
| Rate for Payer: PACE SWMI |
$62.44
|
| Rate for Payer: PHP Medicare Advantage |
$62.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.85
|
| Rate for Payer: Priority Health Medicare |
$62.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.44
|
| Rate for Payer: UHC Medicare Advantage |
$62.44
|
| Rate for Payer: UHCCP DNSP |
$62.44
|
|
|
PR REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$1,493.00
|
|
|
Service Code
|
HCPCS 49452
|
| Min. Negotiated Rate |
$128.56 |
| Max. Negotiated Rate |
$970.45 |
| Rate for Payer: Aetna Commercial |
$172.27
|
| Rate for Payer: Aetna Medicare |
$128.56
|
| Rate for Payer: BCBS Complete |
$597.20
|
| Rate for Payer: BCBS MAPPO |
$128.56
|
| Rate for Payer: BCN Medicare Advantage |
$128.56
|
| Rate for Payer: Cash Price |
$1,194.40
|
| Rate for Payer: Cash Price |
$1,194.40
|
| Rate for Payer: Cofinity Commercial |
$185.13
|
| Rate for Payer: Cofinity Commercial |
$172.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.56
|
| Rate for Payer: Healthscope Commercial |
$154.27
|
| Rate for Payer: Healthscope Whirlpool |
$154.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.99
|
| Rate for Payer: Nomi Health Commercial |
$154.27
|
| Rate for Payer: PACE SWMI |
$128.56
|
| Rate for Payer: PHP Medicare Advantage |
$128.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.45
|
| Rate for Payer: Priority Health Medicare |
$128.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.56
|
| Rate for Payer: UHC Medicare Advantage |
$128.56
|
| Rate for Payer: UHCCP DNSP |
$128.56
|
|
|
PR REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$5,864.00
|
|
|
Service Code
|
HCPCS 33430
|
| Min. Negotiated Rate |
$2,345.60 |
| Max. Negotiated Rate |
$3,865.61 |
| Rate for Payer: Aetna Commercial |
$3,597.16
|
| Rate for Payer: Aetna Medicare |
$2,684.45
|
| Rate for Payer: BCBS Complete |
$2,345.60
|
| Rate for Payer: BCBS MAPPO |
$2,684.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,684.45
|
| Rate for Payer: Cash Price |
$4,691.20
|
| Rate for Payer: Cash Price |
$4,691.20
|
| Rate for Payer: Cofinity Commercial |
$3,865.61
|
| Rate for Payer: Cofinity Commercial |
$3,597.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,684.45
|
| Rate for Payer: Healthscope Commercial |
$3,221.34
|
| Rate for Payer: Healthscope Whirlpool |
$3,221.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,818.67
|
| Rate for Payer: Nomi Health Commercial |
$3,221.34
|
| Rate for Payer: PACE SWMI |
$2,684.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,684.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,811.60
|
| Rate for Payer: Priority Health Medicare |
$2,684.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,684.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,684.45
|
| Rate for Payer: UHCCP DNSP |
$2,684.45
|
|
|
PR REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 11970
|
| Min. Negotiated Rate |
$441.60 |
| Max. Negotiated Rate |
$774.35 |
| Rate for Payer: Aetna Commercial |
$720.57
|
| Rate for Payer: Aetna Medicare |
$537.74
|
| Rate for Payer: BCBS Complete |
$441.60
|
| Rate for Payer: BCBS MAPPO |
$537.74
|
| Rate for Payer: BCN Medicare Advantage |
$537.74
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$774.35
|
| Rate for Payer: Cofinity Commercial |
$720.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.74
|
| Rate for Payer: Healthscope Commercial |
$645.29
|
| Rate for Payer: Healthscope Whirlpool |
$645.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.63
|
| Rate for Payer: Nomi Health Commercial |
$645.29
|
| Rate for Payer: PACE SWMI |
$537.74
|
| Rate for Payer: PHP Medicare Advantage |
$537.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health Medicare |
$537.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$537.74
|
| Rate for Payer: UHC Medicare Advantage |
$537.74
|
| Rate for Payer: UHCCP DNSP |
$537.74
|
|
|
PR REPLACEMENT TRICUSPID VALVE W/CARD BYPASS
|
Professional
|
Both
|
$8,810.00
|
|
|
Service Code
|
HCPCS 33465
|
| Min. Negotiated Rate |
$2,636.94 |
| Max. Negotiated Rate |
$5,726.50 |
| Rate for Payer: Aetna Commercial |
$3,533.50
|
| Rate for Payer: Aetna Medicare |
$2,636.94
|
| Rate for Payer: BCBS Complete |
$3,524.00
|
| Rate for Payer: BCBS MAPPO |
$2,636.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,636.94
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Cofinity Commercial |
$3,797.19
|
| Rate for Payer: Cofinity Commercial |
$3,533.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,636.94
|
| Rate for Payer: Healthscope Commercial |
$3,164.33
|
| Rate for Payer: Healthscope Whirlpool |
$3,164.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,768.79
|
| Rate for Payer: Nomi Health Commercial |
$3,164.33
|
| Rate for Payer: PACE SWMI |
$2,636.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,636.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,726.50
|
| Rate for Payer: Priority Health Medicare |
$2,636.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,636.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,636.94
|
| Rate for Payer: UHCCP DNSP |
$2,636.94
|
|
|
PR REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ
|
Professional
|
Both
|
$494.00
|
|
|
Service Code
|
HCPCS 33993
|
| Min. Negotiated Rate |
$157.48 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Aetna Commercial |
$211.02
|
| Rate for Payer: Aetna Medicare |
$157.48
|
| Rate for Payer: BCBS Complete |
$197.60
|
| Rate for Payer: BCBS MAPPO |
$157.48
|
| Rate for Payer: BCN Medicare Advantage |
$157.48
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cofinity Commercial |
$226.77
|
| Rate for Payer: Cofinity Commercial |
$211.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.48
|
| Rate for Payer: Healthscope Commercial |
$188.98
|
| Rate for Payer: Healthscope Whirlpool |
$188.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.35
|
| Rate for Payer: Nomi Health Commercial |
$188.98
|
| Rate for Payer: PACE SWMI |
$157.48
|
| Rate for Payer: PHP Medicare Advantage |
$157.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.10
|
| Rate for Payer: Priority Health Medicare |
$157.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.48
|
| Rate for Payer: UHC Medicare Advantage |
$157.48
|
| Rate for Payer: UHCCP DNSP |
$157.48
|
|
|
PR REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 43761
|
| Min. Negotiated Rate |
$99.43 |
| Max. Negotiated Rate |
$244.40 |
| Rate for Payer: Aetna Commercial |
$133.24
|
| Rate for Payer: Aetna Medicare |
$99.43
|
| Rate for Payer: BCBS Complete |
$150.40
|
| Rate for Payer: BCBS MAPPO |
$99.43
|
| Rate for Payer: BCN Medicare Advantage |
$99.43
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$143.18
|
| Rate for Payer: Cofinity Commercial |
$133.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.43
|
| Rate for Payer: Healthscope Commercial |
$119.32
|
| Rate for Payer: Healthscope Whirlpool |
$119.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.40
|
| Rate for Payer: Nomi Health Commercial |
$119.32
|
| Rate for Payer: PACE SWMI |
$99.43
|
| Rate for Payer: PHP Medicare Advantage |
$99.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.40
|
| Rate for Payer: Priority Health Medicare |
$99.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.43
|
| Rate for Payer: UHC Medicare Advantage |
$99.43
|
| Rate for Payer: UHCCP DNSP |
$99.43
|
|
|
PR REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 33273
|
| Min. Negotiated Rate |
$336.80 |
| Max. Negotiated Rate |
$549.85 |
| Rate for Payer: Aetna Commercial |
$511.67
|
| Rate for Payer: Aetna Medicare |
$381.84
|
| Rate for Payer: BCBS Complete |
$336.80
|
| Rate for Payer: BCBS MAPPO |
$381.84
|
| Rate for Payer: BCN Medicare Advantage |
$381.84
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$549.85
|
| Rate for Payer: Cofinity Commercial |
$511.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.84
|
| Rate for Payer: Healthscope Commercial |
$458.21
|
| Rate for Payer: Healthscope Whirlpool |
$458.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.93
|
| Rate for Payer: Nomi Health Commercial |
$458.21
|
| Rate for Payer: PACE SWMI |
$381.84
|
| Rate for Payer: PHP Medicare Advantage |
$381.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health Medicare |
$381.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.84
|
| Rate for Payer: UHC Medicare Advantage |
$381.84
|
| Rate for Payer: UHCCP DNSP |
$381.84
|
|
|
PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 62252
|
| Min. Negotiated Rate |
$82.68 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$110.79
|
| Rate for Payer: Aetna Medicare |
$82.68
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS MAPPO |
$82.68
|
| Rate for Payer: BCN Medicare Advantage |
$82.68
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$119.06
|
| Rate for Payer: Cofinity Commercial |
$110.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.68
|
| Rate for Payer: Healthscope Commercial |
$99.22
|
| Rate for Payer: Healthscope Whirlpool |
$99.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.81
|
| Rate for Payer: Nomi Health Commercial |
$99.22
|
| Rate for Payer: PACE SWMI |
$82.68
|
| Rate for Payer: PHP Medicare Advantage |
$82.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health Medicare |
$82.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.68
|
| Rate for Payer: UHC Medicare Advantage |
$82.68
|
| Rate for Payer: UHCCP DNSP |
$82.68
|
|
|
PR RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ
|
Professional
|
Both
|
$4,931.00
|
|
|
Service Code
|
HCPCS 32504
|
| Min. Negotiated Rate |
$1,963.37 |
| Max. Negotiated Rate |
$3,205.15 |
| Rate for Payer: Aetna Commercial |
$2,630.92
|
| Rate for Payer: Aetna Medicare |
$1,963.37
|
| Rate for Payer: BCBS Complete |
$1,972.40
|
| Rate for Payer: BCBS MAPPO |
$1,963.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,963.37
|
| Rate for Payer: Cash Price |
$3,944.80
|
| Rate for Payer: Cash Price |
$3,944.80
|
| Rate for Payer: Cofinity Commercial |
$2,827.25
|
| Rate for Payer: Cofinity Commercial |
$2,630.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,963.37
|
| Rate for Payer: Healthscope Commercial |
$2,356.04
|
| Rate for Payer: Healthscope Whirlpool |
$2,356.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,061.54
|
| Rate for Payer: Nomi Health Commercial |
$2,356.04
|
| Rate for Payer: PACE SWMI |
$1,963.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,963.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,205.15
|
| Rate for Payer: Priority Health Medicare |
$1,963.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,963.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,963.37
|
| Rate for Payer: UHCCP DNSP |
$1,963.37
|
|
|
PR RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ
|
Professional
|
Both
|
$3,670.00
|
|
|
Service Code
|
HCPCS 32503
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$2,482.46 |
| Rate for Payer: Aetna Commercial |
$2,310.07
|
| Rate for Payer: Aetna Medicare |
$1,723.93
|
| Rate for Payer: BCBS Complete |
$1,468.00
|
| Rate for Payer: BCBS MAPPO |
$1,723.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,723.93
|
| Rate for Payer: Cash Price |
$2,936.00
|
| Rate for Payer: Cash Price |
$2,936.00
|
| Rate for Payer: Cofinity Commercial |
$2,482.46
|
| Rate for Payer: Cofinity Commercial |
$2,310.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,723.93
|
| Rate for Payer: Healthscope Commercial |
$2,068.72
|
| Rate for Payer: Healthscope Whirlpool |
$2,068.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,810.13
|
| Rate for Payer: Nomi Health Commercial |
$2,068.72
|
| Rate for Payer: PACE SWMI |
$1,723.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,723.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,385.50
|
| Rate for Payer: Priority Health Medicare |
$1,723.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,723.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,723.93
|
| Rate for Payer: UHCCP DNSP |
$1,723.93
|
|
|
PR RESCJ DIAPHRAGM W/COMPLEX REPAIR
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 39561
|
| Min. Negotiated Rate |
$904.40 |
| Max. Negotiated Rate |
$1,746.71 |
| Rate for Payer: Aetna Commercial |
$1,625.41
|
| Rate for Payer: Aetna Medicare |
$1,212.99
|
| Rate for Payer: BCBS Complete |
$904.40
|
| Rate for Payer: BCBS MAPPO |
$1,212.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,212.99
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,746.71
|
| Rate for Payer: Cofinity Commercial |
$1,625.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,212.99
|
| Rate for Payer: Healthscope Commercial |
$1,455.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,455.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.64
|
| Rate for Payer: Nomi Health Commercial |
$1,455.59
|
| Rate for Payer: PACE SWMI |
$1,212.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,212.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health Medicare |
$1,212.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,212.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,212.99
|
| Rate for Payer: UHCCP DNSP |
$1,212.99
|
|
|
PR RESCJ DIAPHRAGM W/SIMPLE REPAIR
|
Professional
|
Both
|
$3,676.00
|
|
|
Service Code
|
HCPCS 39560
|
| Min. Negotiated Rate |
$775.59 |
| Max. Negotiated Rate |
$2,389.40 |
| Rate for Payer: Aetna Commercial |
$1,039.29
|
| Rate for Payer: Aetna Medicare |
$775.59
|
| Rate for Payer: BCBS Complete |
$1,470.40
|
| Rate for Payer: BCBS MAPPO |
$775.59
|
| Rate for Payer: BCN Medicare Advantage |
$775.59
|
| Rate for Payer: Cash Price |
$2,940.80
|
| Rate for Payer: Cash Price |
$2,940.80
|
| Rate for Payer: Cofinity Commercial |
$1,116.85
|
| Rate for Payer: Cofinity Commercial |
$1,039.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.59
|
| Rate for Payer: Healthscope Commercial |
$930.71
|
| Rate for Payer: Healthscope Whirlpool |
$930.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.37
|
| Rate for Payer: Nomi Health Commercial |
$930.71
|
| Rate for Payer: PACE SWMI |
$775.59
|
| Rate for Payer: PHP Medicare Advantage |
$775.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,389.40
|
| Rate for Payer: Priority Health Medicare |
$775.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.59
|
| Rate for Payer: UHC Medicare Advantage |
$775.59
|
| Rate for Payer: UHCCP DNSP |
$775.59
|
|
|
PR RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL
|
Professional
|
Both
|
$5,417.00
|
|
|
Service Code
|
HCPCS 61600
|
| Min. Negotiated Rate |
$2,014.99 |
| Max. Negotiated Rate |
$3,521.05 |
| Rate for Payer: Aetna Commercial |
$2,700.09
|
| Rate for Payer: Aetna Medicare |
$2,014.99
|
| Rate for Payer: BCBS Complete |
$2,166.80
|
| Rate for Payer: BCBS MAPPO |
$2,014.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,014.99
|
| Rate for Payer: Cash Price |
$4,333.60
|
| Rate for Payer: Cash Price |
$4,333.60
|
| Rate for Payer: Cofinity Commercial |
$2,901.59
|
| Rate for Payer: Cofinity Commercial |
$2,700.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,014.99
|
| Rate for Payer: Healthscope Commercial |
$2,417.99
|
| Rate for Payer: Healthscope Whirlpool |
$2,417.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.74
|
| Rate for Payer: Nomi Health Commercial |
$2,417.99
|
| Rate for Payer: PACE SWMI |
$2,014.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,014.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,521.05
|
| Rate for Payer: Priority Health Medicare |
$2,014.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,014.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,014.99
|
| Rate for Payer: UHCCP DNSP |
$2,014.99
|
|
|
PR RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF
|
Professional
|
Both
|
$7,464.00
|
|
|
Service Code
|
HCPCS 61601
|
| Min. Negotiated Rate |
$2,348.54 |
| Max. Negotiated Rate |
$4,851.60 |
| Rate for Payer: Aetna Commercial |
$3,147.04
|
| Rate for Payer: Aetna Medicare |
$2,348.54
|
| Rate for Payer: BCBS Complete |
$2,985.60
|
| Rate for Payer: BCBS MAPPO |
$2,348.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,348.54
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cofinity Commercial |
$3,381.90
|
| Rate for Payer: Cofinity Commercial |
$3,147.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,348.54
|
| Rate for Payer: Healthscope Commercial |
$2,818.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,818.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,465.97
|
| Rate for Payer: Nomi Health Commercial |
$2,818.25
|
| Rate for Payer: PACE SWMI |
$2,348.54
|
| Rate for Payer: PHP Medicare Advantage |
$2,348.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,851.60
|
| Rate for Payer: Priority Health Medicare |
$2,348.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,348.54
|
| Rate for Payer: UHC Medicare Advantage |
$2,348.54
|
| Rate for Payer: UHCCP DNSP |
$2,348.54
|
|
|
PR RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL
|
Professional
|
Both
|
$6,974.00
|
|
|
Service Code
|
HCPCS 61616
|
| Min. Negotiated Rate |
$2,789.60 |
| Max. Negotiated Rate |
$4,666.25 |
| Rate for Payer: Aetna Commercial |
$4,342.20
|
| Rate for Payer: Aetna Medicare |
$3,240.45
|
| Rate for Payer: BCBS Complete |
$2,789.60
|
| Rate for Payer: BCBS MAPPO |
$3,240.45
|
| Rate for Payer: BCN Medicare Advantage |
$3,240.45
|
| Rate for Payer: Cash Price |
$5,579.20
|
| Rate for Payer: Cash Price |
$5,579.20
|
| Rate for Payer: Cofinity Commercial |
$4,666.25
|
| Rate for Payer: Cofinity Commercial |
$4,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,240.45
|
| Rate for Payer: Healthscope Commercial |
$3,888.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,888.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,402.47
|
| Rate for Payer: Nomi Health Commercial |
$3,888.54
|
| Rate for Payer: PACE SWMI |
$3,240.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,240.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,533.10
|
| Rate for Payer: Priority Health Medicare |
$3,240.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,240.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,240.45
|
| Rate for Payer: UHCCP DNSP |
$3,240.45
|
|
|
PR RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL
|
Professional
|
Both
|
$7,225.00
|
|
|
Service Code
|
HCPCS 61615
|
| Min. Negotiated Rate |
$2,741.82 |
| Max. Negotiated Rate |
$4,696.25 |
| Rate for Payer: Aetna Commercial |
$3,674.04
|
| Rate for Payer: Aetna Medicare |
$2,741.82
|
| Rate for Payer: BCBS Complete |
$2,890.00
|
| Rate for Payer: BCBS MAPPO |
$2,741.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,741.82
|
| Rate for Payer: Cash Price |
$5,780.00
|
| Rate for Payer: Cash Price |
$5,780.00
|
| Rate for Payer: Cofinity Commercial |
$3,948.22
|
| Rate for Payer: Cofinity Commercial |
$3,674.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,741.82
|
| Rate for Payer: Healthscope Commercial |
$3,290.18
|
| Rate for Payer: Healthscope Whirlpool |
$3,290.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,878.91
|
| Rate for Payer: Nomi Health Commercial |
$3,290.18
|
| Rate for Payer: PACE SWMI |
$2,741.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,741.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,696.25
|
| Rate for Payer: Priority Health Medicare |
$2,741.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,741.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,741.82
|
| Rate for Payer: UHCCP DNSP |
$2,741.82
|
|
