|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 49555
|
| Hospital Charge Code |
49555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$696.15 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$1,038.87
|
| Rate for Payer: ASR Commercial |
$1,038.87
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$877.04
|
| Rate for Payer: BCN Commercial |
$830.35
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$1,006.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,038.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$963.90
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$910.35
|
| Rate for Payer: Nomi Health Commercial |
$878.22
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$938.41
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$750.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$942.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$1,071.00
|
|
|
Service Code
|
HCPCS 49555
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$2,967.99 |
| Rate for Payer: Aetna Commercial |
$813.50
|
| Rate for Payer: Aetna Medicare |
$535.50
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,967.99
|
| Rate for Payer: BCN Commercial |
$887.93
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,090.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,090.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$713.58
|
| Rate for Payer: UHC Exchange |
$713.58
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
|
|
PR RPR RECRT FEM HRNA INCARCERATED
|
Professional
|
Both
|
$1,481.00
|
|
|
Service Code
|
HCPCS 49557
|
| Min. Negotiated Rate |
$466.26 |
| Max. Negotiated Rate |
$1,663.62 |
| Rate for Payer: Aetna Commercial |
$975.41
|
| Rate for Payer: Aetna Medicare |
$740.50
|
| Rate for Payer: BCBS Complete |
$489.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,663.62
|
| Rate for Payer: BCN Commercial |
$1,060.92
|
| Rate for Payer: Cash Price |
$1,184.80
|
| Rate for Payer: Cash Price |
$1,184.80
|
| Rate for Payer: Meridian Medicaid |
$489.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$962.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,300.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$866.64
|
| Rate for Payer: UHC Exchange |
$866.64
|
| Rate for Payer: UHCCP Medicaid |
$466.26
|
|
|
PR RPR RECRT INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 49566
|
| Min. Negotiated Rate |
$1,060.80 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: BCBS Complete |
$1,060.80
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
|
|
PR RPR RECRT INCAL/VNT HERNIA REDUCIBLE
|
Professional
|
Both
|
$2,295.00
|
|
|
Service Code
|
HCPCS 49565
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$1,491.75 |
| Rate for Payer: Aetna Medicare |
$1,147.50
|
| Rate for Payer: BCBS Complete |
$918.00
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.75
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
49520
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$1,141.88 |
| Rate for Payer: Aetna Commercial |
$853.76
|
| Rate for Payer: Aetna Medicare |
$860.50
|
| Rate for Payer: BCBS Complete |
$430.53
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$928.49
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Meridian Medicaid |
$430.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,141.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,141.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$753.25
|
| Rate for Payer: UHC Exchange |
$753.25
|
| Rate for Payer: UHCCP Medicaid |
$410.03
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,118.65 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$1,548.90
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$1,669.37
|
| Rate for Payer: ASR Commercial |
$1,669.37
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,409.33
|
| Rate for Payer: BCN Commercial |
$1,334.29
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,617.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,721.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,669.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$1,548.90
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.85
|
| Rate for Payer: Nomi Health Commercial |
$1,411.22
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,507.94
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,206.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,514.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,118.65 |
| Max. Negotiated Rate |
$1,721.00 |
| Rate for Payer: Aetna Commercial |
$1,548.90
|
| Rate for Payer: ASR ASR |
$1,669.37
|
| Rate for Payer: ASR Commercial |
$1,669.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,402.44
|
| Rate for Payer: BCN Commercial |
$1,334.29
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,617.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Healthscope Commercial |
$1,721.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,669.37
|
| Rate for Payer: Mclaren Commercial |
$1,548.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.85
|
| Rate for Payer: Nomi Health Commercial |
$1,411.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,514.48
|
|
|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 49520
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$1,141.88 |
| Rate for Payer: Aetna Commercial |
$853.76
|
| Rate for Payer: Aetna Medicare |
$860.50
|
| Rate for Payer: BCBS Complete |
$430.53
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$928.49
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Meridian Medicaid |
$430.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,141.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,141.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$753.25
|
| Rate for Payer: UHC Exchange |
$753.25
|
| Rate for Payer: UHCCP Medicaid |
$410.03
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$2,092.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,359.80 |
| Max. Negotiated Rate |
$2,092.00 |
| Rate for Payer: Aetna Commercial |
$1,882.80
|
| Rate for Payer: ASR ASR |
$2,029.24
|
| Rate for Payer: ASR Commercial |
$2,029.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,704.77
|
| Rate for Payer: BCN Commercial |
$1,621.93
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,966.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.60
|
| Rate for Payer: Healthscope Commercial |
$2,092.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,029.24
|
| Rate for Payer: Mclaren Commercial |
$1,882.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.20
|
| Rate for Payer: Nomi Health Commercial |
$1,715.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,840.96
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$2,092.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,359.80 |
| Max. Negotiated Rate |
$9,476.05 |
| Rate for Payer: Aetna Commercial |
$1,882.80
|
| Rate for Payer: Aetna Medicare |
$6,113.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,641.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,641.98
|
| Rate for Payer: ASR ASR |
$2,029.24
|
| Rate for Payer: ASR Commercial |
$2,029.24
|
| Rate for Payer: BCBS Complete |
$3,440.72
|
| Rate for Payer: BCBS MAPPO |
$6,113.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,713.14
|
| Rate for Payer: BCN Commercial |
$1,621.93
|
| Rate for Payer: BCN Medicare Advantage |
$6,113.58
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,966.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,113.58
|
| Rate for Payer: Healthscope Commercial |
$2,092.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,029.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,113.58
|
| Rate for Payer: Mclaren Commercial |
$1,882.80
|
| Rate for Payer: Mclaren Medicaid |
$3,276.88
|
| Rate for Payer: Mclaren Medicare |
$6,113.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,419.26
|
| Rate for Payer: Meridian Medicaid |
$3,440.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,030.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.20
|
| Rate for Payer: Nomi Health Commercial |
$1,715.44
|
| Rate for Payer: PACE Medicare |
$5,807.90
|
| Rate for Payer: PACE SWMI |
$6,113.58
|
| Rate for Payer: PHP Commercial |
$6,724.94
|
| Rate for Payer: PHP Medicaid |
$3,276.88
|
| Rate for Payer: PHP Medicare Advantage |
$6,113.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,276.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,833.01
|
| Rate for Payer: Priority Health Medicare |
$6,113.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,466.49
|
| Rate for Payer: Railroad Medicare Medicare |
$6,113.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,840.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,113.58
|
| Rate for Payer: UHC Exchange |
$9,476.05
|
| Rate for Payer: UHC Medicare Advantage |
$6,113.58
|
| Rate for Payer: UHCCP DNSP |
$6,113.58
|
| Rate for Payer: UHCCP Medicaid |
$3,276.88
|
| Rate for Payer: VA VA |
$6,113.58
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 49521
|
| Hospital Charge Code |
49521
|
| Min. Negotiated Rate |
$134.72 |
| Max. Negotiated Rate |
$1,359.80 |
| Rate for Payer: Aetna Commercial |
$967.53
|
| Rate for Payer: Aetna Medicare |
$1,046.00
|
| Rate for Payer: BCBS Complete |
$487.56
|
| Rate for Payer: BCBS Trust/PPO |
$134.72
|
| Rate for Payer: BCN Commercial |
$1,050.66
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Meridian Medicaid |
$487.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,289.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,289.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.40
|
| Rate for Payer: UHC Exchange |
$918.40
|
| Rate for Payer: UHCCP Medicaid |
$464.34
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 49521
|
| Min. Negotiated Rate |
$134.72 |
| Max. Negotiated Rate |
$1,359.80 |
| Rate for Payer: Aetna Commercial |
$967.53
|
| Rate for Payer: Aetna Medicare |
$1,046.00
|
| Rate for Payer: BCBS Complete |
$487.56
|
| Rate for Payer: BCBS Trust/PPO |
$134.72
|
| Rate for Payer: BCN Commercial |
$1,050.66
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Meridian Medicaid |
$487.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,289.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,289.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.40
|
| Rate for Payer: UHC Exchange |
$918.40
|
| Rate for Payer: UHCCP Medicaid |
$464.34
|
|
|
PR RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT
|
Professional
|
Both
|
$4,469.00
|
|
|
Service Code
|
HCPCS 38115
|
| Min. Negotiated Rate |
$710.04 |
| Max. Negotiated Rate |
$2,904.85 |
| Rate for Payer: Aetna Commercial |
$1,592.12
|
| Rate for Payer: Aetna Medicare |
$2,234.50
|
| Rate for Payer: BCBS Complete |
$870.00
|
| Rate for Payer: BCBS Trust/PPO |
$710.04
|
| Rate for Payer: BCN Commercial |
$1,882.38
|
| Rate for Payer: Cash Price |
$3,575.20
|
| Rate for Payer: Cash Price |
$3,575.20
|
| Rate for Payer: Meridian Medicaid |
$870.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,904.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,575.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,575.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,412.26
|
| Rate for Payer: UHC Exchange |
$1,412.26
|
| Rate for Payer: UHCCP Medicaid |
$828.57
|
|
|
PR RPR SINUS VALSALVA FISTULA
|
Professional
|
Both
|
$3,229.00
|
|
|
Service Code
|
HCPCS 33702
|
| Min. Negotiated Rate |
$977.88 |
| Max. Negotiated Rate |
$2,432.04 |
| Rate for Payer: Aetna Commercial |
$2,076.08
|
| Rate for Payer: Aetna Medicare |
$1,614.50
|
| Rate for Payer: BCBS Complete |
$1,026.77
|
| Rate for Payer: BCN Commercial |
$2,223.97
|
| Rate for Payer: Cash Price |
$2,583.20
|
| Rate for Payer: Cash Price |
$2,583.20
|
| Rate for Payer: Meridian Medicaid |
$1,026.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$977.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,098.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,432.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,017.23
|
| Rate for Payer: UHC Exchange |
$2,017.23
|
| Rate for Payer: UHCCP Medicaid |
$977.88
|
|
|
PR RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 49600
|
| Min. Negotiated Rate |
$475.63 |
| Max. Negotiated Rate |
$2,035.01 |
| Rate for Payer: Aetna Commercial |
$991.65
|
| Rate for Payer: Aetna Medicare |
$985.50
|
| Rate for Payer: BCBS Complete |
$499.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,035.01
|
| Rate for Payer: BCN Commercial |
$1,077.53
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Meridian Medicaid |
$499.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,323.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$878.04
|
| Rate for Payer: UHC Exchange |
$878.04
|
| Rate for Payer: UHCCP Medicaid |
$475.63
|
|
|
PR RPR SPIGELIAN HERNIA
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 49590
|
| Min. Negotiated Rate |
$650.40 |
| Max. Negotiated Rate |
$1,056.90 |
| Rate for Payer: Aetna Medicare |
$813.00
|
| Rate for Payer: BCBS Complete |
$650.40
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,056.90
|
|
|
PR RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL
|
Professional
|
Both
|
$7,886.00
|
|
|
Service Code
|
HCPCS 38780
|
| Min. Negotiated Rate |
$678.62 |
| Max. Negotiated Rate |
$5,125.90 |
| Rate for Payer: Aetna Commercial |
$1,285.27
|
| Rate for Payer: Aetna Medicare |
$3,943.00
|
| Rate for Payer: BCBS Complete |
$712.55
|
| Rate for Payer: BCBS Trust/PPO |
$957.28
|
| Rate for Payer: BCN Commercial |
$1,513.44
|
| Rate for Payer: Cash Price |
$6,308.80
|
| Rate for Payer: Cash Price |
$6,308.80
|
| Rate for Payer: Meridian Medicaid |
$712.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,125.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,100.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,100.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,190.96
|
| Rate for Payer: UHC Exchange |
$1,190.96
|
| Rate for Payer: UHCCP Medicaid |
$678.62
|
|
|
PR RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 28200
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$1,084.07 |
| Rate for Payer: Aetna Commercial |
$428.78
|
| Rate for Payer: Aetna Medicare |
$626.50
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.07
|
| Rate for Payer: BCN Commercial |
$719.83
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.28
|
| Rate for Payer: Priority Health Narrow Network |
$504.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$368.15
|
| Rate for Payer: UHC Exchange |
$368.15
|
| Rate for Payer: UHCCP Medicaid |
$213.00
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS
|
Professional
|
Both
|
$1,254.00
|
|
|
Service Code
|
HCPCS 25263
|
| Min. Negotiated Rate |
$417.05 |
| Max. Negotiated Rate |
$3,601.42 |
| Rate for Payer: Aetna Commercial |
$843.92
|
| Rate for Payer: Aetna Medicare |
$627.00
|
| Rate for Payer: BCBS Complete |
$437.90
|
| Rate for Payer: BCBS Trust/PPO |
$3,601.42
|
| Rate for Payer: BCN Commercial |
$938.26
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Meridian Medicaid |
$437.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.19
|
| Rate for Payer: Priority Health Narrow Network |
$987.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.70
|
| Rate for Payer: UHC Exchange |
$755.70
|
| Rate for Payer: UHCCP Medicaid |
$417.05
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 25260
|
| Min. Negotiated Rate |
$418.12 |
| Max. Negotiated Rate |
$1,459.69 |
| Rate for Payer: Aetna Commercial |
$841.29
|
| Rate for Payer: Aetna Medicare |
$850.50
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,459.69
|
| Rate for Payer: BCN Commercial |
$940.22
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.19
|
| Rate for Payer: Priority Health Narrow Network |
$987.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.32
|
| Rate for Payer: UHC Exchange |
$755.32
|
| Rate for Payer: UHCCP Medicaid |
$418.12
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 25270
|
| Min. Negotiated Rate |
$326.32 |
| Max. Negotiated Rate |
$3,579.76 |
| Rate for Payer: Aetna Commercial |
$656.88
|
| Rate for Payer: Aetna Medicare |
$709.00
|
| Rate for Payer: BCBS Complete |
$342.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,579.76
|
| Rate for Payer: BCN Commercial |
$733.02
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Meridian Medicaid |
$342.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.44
|
| Rate for Payer: Priority Health Narrow Network |
$771.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$601.06
|
| Rate for Payer: UHC Exchange |
$601.06
|
| Rate for Payer: UHCCP Medicaid |
$326.32
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU
|
Professional
|
Both
|
$1,621.00
|
|
|
Service Code
|
HCPCS 25272
|
| Min. Negotiated Rate |
$368.28 |
| Max. Negotiated Rate |
$3,566.55 |
| Rate for Payer: Aetna Commercial |
$747.23
|
| Rate for Payer: Aetna Medicare |
$810.50
|
| Rate for Payer: BCBS Complete |
$386.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,566.55
|
| Rate for Payer: BCN Commercial |
$829.29
|
| Rate for Payer: Cash Price |
$1,296.80
|
| Rate for Payer: Cash Price |
$1,296.80
|
| Rate for Payer: Meridian Medicaid |
$386.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,053.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$676.24
|
| Rate for Payer: UHC Exchange |
$676.24
|
| Rate for Payer: UHCCP Medicaid |
$368.28
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 25274
|
| Min. Negotiated Rate |
$437.08 |
| Max. Negotiated Rate |
$1,496.30 |
| Rate for Payer: Aetna Commercial |
$886.74
|
| Rate for Payer: Aetna Medicare |
$1,151.00
|
| Rate for Payer: BCBS Complete |
$458.93
|
| Rate for Payer: BCN Commercial |
$983.22
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Meridian Medicaid |
$458.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,031.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,031.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$809.89
|
| Rate for Payer: UHC Exchange |
$809.89
|
| Rate for Payer: UHCCP Medicaid |
$437.08
|
|
|
PR RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 25275
|
| Min. Negotiated Rate |
$441.55 |
| Max. Negotiated Rate |
$1,316.25 |
| Rate for Payer: Aetna Commercial |
$894.15
|
| Rate for Payer: Aetna Medicare |
$1,012.50
|
| Rate for Payer: BCBS Complete |
$463.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.56
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Meridian Medicaid |
$463.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,043.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$766.93
|
| Rate for Payer: UHC Exchange |
$766.93
|
| Rate for Payer: UHCCP Medicaid |
$441.55
|
|
