|
PR SIGMOIDOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 45345
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
|
|
PR SIGMOIDOSCOPY W/STENT
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS G6023
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
|
|
PR SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 93278
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$981.33 |
| Rate for Payer: Aetna Commercial |
$38.45
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS Trust/PPO |
$981.33
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.43
|
| Rate for Payer: Priority Health Narrow Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.00
|
| Rate for Payer: UHC Exchange |
$44.00
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
|
|
PR SIMPLE CYSTOMETROGRAM
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 51725
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$642.41 |
| Rate for Payer: Aetna Commercial |
$283.90
|
| Rate for Payer: Aetna Medicare |
$268.50
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS Trust/PPO |
$642.41
|
| Rate for Payer: BCN Commercial |
$335.23
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.30
|
| Rate for Payer: Priority Health Narrow Network |
$119.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.43
|
| Rate for Payer: UHC Exchange |
$244.43
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
|
|
PR SIMPLE IMPLANT REMOVAL, BILATERAL
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 00522
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$612.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Aetna Medicare |
$765.00
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
|
|
PR SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION
|
Professional
|
Both
|
$9,729.00
|
|
|
Service Code
|
HCPCS 61700
|
| Min. Negotiated Rate |
$1,257.35 |
| Max. Negotiated Rate |
$6,912.88 |
| Rate for Payer: Aetna Commercial |
$4,404.66
|
| Rate for Payer: Aetna Medicare |
$4,864.50
|
| Rate for Payer: BCBS Complete |
$2,319.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,257.35
|
| Rate for Payer: BCN Commercial |
$6,912.88
|
| Rate for Payer: Cash Price |
$7,783.20
|
| Rate for Payer: Cash Price |
$7,783.20
|
| Rate for Payer: Meridian Medicaid |
$2,319.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,209.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,323.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,882.79
|
| Rate for Payer: Priority Health Narrow Network |
$5,882.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,011.79
|
| Rate for Payer: UHC Exchange |
$4,011.79
|
| Rate for Payer: UHCCP Medicaid |
$2,209.45
|
|
|
PR SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ
|
Professional
|
Both
|
$8,669.00
|
|
|
Service Code
|
HCPCS 61702
|
| Min. Negotiated Rate |
$1,072.45 |
| Max. Negotiated Rate |
$8,192.82 |
| Rate for Payer: Aetna Commercial |
$5,197.31
|
| Rate for Payer: Aetna Medicare |
$4,334.50
|
| Rate for Payer: BCBS Complete |
$2,733.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.45
|
| Rate for Payer: BCN Commercial |
$8,192.82
|
| Rate for Payer: Cash Price |
$6,935.20
|
| Rate for Payer: Cash Price |
$6,935.20
|
| Rate for Payer: Meridian Medicaid |
$2,733.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,602.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,634.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,921.83
|
| Rate for Payer: Priority Health Narrow Network |
$6,921.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,673.87
|
| Rate for Payer: UHC Exchange |
$4,673.87
|
| Rate for Payer: UHCCP Medicaid |
$2,602.86
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 12016
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$431.60 |
| Rate for Payer: Aetna Commercial |
$142.66
|
| Rate for Payer: Aetna Medicare |
$332.00
|
| Rate for Payer: BCBS Complete |
$85.21
|
| Rate for Payer: BCBS Trust/PPO |
$117.56
|
| Rate for Payer: BCN Commercial |
$322.53
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Meridian Medicaid |
$85.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.57
|
| Rate for Payer: UHC Exchange |
$239.57
|
| Rate for Payer: UHCCP Medicaid |
$81.15
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 12017
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$281.11 |
| Rate for Payer: Aetna Commercial |
$169.53
|
| Rate for Payer: Aetna Medicare |
$162.50
|
| Rate for Payer: BCBS Complete |
$102.88
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$223.32
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Meridian Medicaid |
$102.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.69
|
| Rate for Payer: Priority Health Narrow Network |
$207.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.11
|
| Rate for Payer: UHC Exchange |
$281.11
|
| Rate for Payer: UHCCP Medicaid |
$97.98
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 12011
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$212.16 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$165.18
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.96
|
| Rate for Payer: Priority Health Narrow Network |
$74.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.51
|
| Rate for Payer: UHC Exchange |
$115.51
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 12013
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$351.25 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$179.00
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS Trust/PPO |
$351.25
|
| Rate for Payer: BCN Commercial |
$172.99
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.12
|
| Rate for Payer: Priority Health Narrow Network |
$78.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.19
|
| Rate for Payer: UHC Exchange |
$131.19
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M >30.0 CM
|
Professional
|
Both
|
$1,360.00
|
|
|
Service Code
|
HCPCS 12018
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$884.00 |
| Rate for Payer: Aetna Commercial |
$192.24
|
| Rate for Payer: Aetna Medicare |
$680.00
|
| Rate for Payer: BCBS Complete |
$116.52
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$252.16
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Meridian Medicaid |
$116.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.89
|
| Rate for Payer: Priority Health Narrow Network |
$233.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.32
|
| Rate for Payer: UHC Exchange |
$340.32
|
| Rate for Payer: UHCCP Medicaid |
$110.97
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM
|
Professional
|
Both
|
$491.00
|
|
|
Service Code
|
HCPCS 12014
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$319.15 |
| Rate for Payer: Aetna Commercial |
$83.07
|
| Rate for Payer: Aetna Medicare |
$245.50
|
| Rate for Payer: BCBS Complete |
$49.65
|
| Rate for Payer: BCBS Trust/PPO |
$117.56
|
| Rate for Payer: BCN Commercial |
$210.13
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Meridian Medicaid |
$49.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.13
|
| Rate for Payer: Priority Health Narrow Network |
$101.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.18
|
| Rate for Payer: UHC Exchange |
$157.18
|
| Rate for Payer: UHCCP Medicaid |
$47.29
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 12015
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$412.10 |
| Rate for Payer: Aetna Commercial |
$104.96
|
| Rate for Payer: Aetna Medicare |
$317.00
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS Trust/PPO |
$117.56
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Meridian Medicaid |
$62.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.88
|
| Rate for Payer: Priority Health Narrow Network |
$126.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.98
|
| Rate for Payer: UHC Exchange |
$196.98
|
| Rate for Payer: UHCCP Medicaid |
$59.85
|
|
|
PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 12001
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$556.23 |
| Rate for Payer: Aetna Commercial |
$48.72
|
| Rate for Payer: Aetna Medicare |
$127.00
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS Trust/PPO |
$556.23
|
| Rate for Payer: BCN Commercial |
$138.30
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.51
|
| Rate for Payer: Priority Health Narrow Network |
$60.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.82
|
| Rate for Payer: UHC Exchange |
$111.82
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
|
|
PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM
|
Professional
|
Both
|
$551.00
|
|
|
Service Code
|
HCPCS 12007
|
| Min. Negotiated Rate |
$92.23 |
| Max. Negotiated Rate |
$358.15 |
| Rate for Payer: Aetna Commercial |
$161.43
|
| Rate for Payer: Aetna Medicare |
$275.50
|
| Rate for Payer: BCBS Complete |
$96.84
|
| Rate for Payer: BCBS Trust/PPO |
$305.57
|
| Rate for Payer: BCN Commercial |
$339.63
|
| Rate for Payer: Cash Price |
$440.80
|
| Rate for Payer: Cash Price |
$440.80
|
| Rate for Payer: Meridian Medicaid |
$96.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$358.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.16
|
| Rate for Payer: Priority Health Narrow Network |
$194.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.17
|
| Rate for Payer: UHC Exchange |
$257.17
|
| Rate for Payer: UHCCP Medicaid |
$92.23
|
|
|
PR SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 12004
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$246.35 |
| Rate for Payer: Aetna Commercial |
$80.43
|
| Rate for Payer: Aetna Medicare |
$189.50
|
| Rate for Payer: BCBS Complete |
$48.98
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$194.01
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Meridian Medicaid |
$48.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.33
|
| Rate for Payer: Priority Health Narrow Network |
$99.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$144.98
|
| Rate for Payer: UHC Exchange |
$144.98
|
| Rate for Payer: UHCCP Medicaid |
$46.65
|
|
|
PR SIMPLE UROFLOMETRY
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 51736
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$3,043.01 |
| Rate for Payer: Aetna Commercial |
$16.86
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,043.01
|
| Rate for Payer: BCN Commercial |
$19.55
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.78
|
| Rate for Payer: Priority Health Narrow Network |
$12.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.97
|
| Rate for Payer: UHC Exchange |
$61.97
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
PR SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC
|
Professional
|
Both
|
$2,143.00
|
|
|
Service Code
|
HCPCS 31087
|
| Min. Negotiated Rate |
$717.38 |
| Max. Negotiated Rate |
$1,656.13 |
| Rate for Payer: Aetna Commercial |
$1,421.59
|
| Rate for Payer: Aetna Medicare |
$1,071.50
|
| Rate for Payer: BCBS Complete |
$753.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.53
|
| Rate for Payer: BCN Commercial |
$1,656.13
|
| Rate for Payer: Cash Price |
$1,714.40
|
| Rate for Payer: Cash Price |
$1,714.40
|
| Rate for Payer: Meridian Medicaid |
$753.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$717.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,567.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,567.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,200.03
|
| Rate for Payer: UHC Exchange |
$1,200.03
|
| Rate for Payer: UHCCP Medicaid |
$717.38
|
|
|
PR SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 31081
|
| Min. Negotiated Rate |
$745.93 |
| Max. Negotiated Rate |
$1,727.96 |
| Rate for Payer: Aetna Commercial |
$1,479.82
|
| Rate for Payer: Aetna Medicare |
$1,042.50
|
| Rate for Payer: BCBS Complete |
$783.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,196.07
|
| Rate for Payer: BCN Commercial |
$1,727.96
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Meridian Medicaid |
$783.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,633.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,633.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,451.44
|
| Rate for Payer: UHC Exchange |
$1,451.44
|
| Rate for Payer: UHCCP Medicaid |
$745.93
|
|
|
PR SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC
|
Professional
|
Both
|
$2,667.00
|
|
|
Service Code
|
HCPCS 31085
|
| Min. Negotiated Rate |
$792.45 |
| Max. Negotiated Rate |
$1,843.29 |
| Rate for Payer: Aetna Commercial |
$1,581.37
|
| Rate for Payer: Aetna Medicare |
$1,333.50
|
| Rate for Payer: BCBS Complete |
$835.34
|
| Rate for Payer: BCBS Trust/PPO |
$792.45
|
| Rate for Payer: BCN Commercial |
$1,843.29
|
| Rate for Payer: Cash Price |
$2,133.60
|
| Rate for Payer: Cash Price |
$2,133.60
|
| Rate for Payer: Meridian Medicaid |
$835.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,733.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,741.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,741.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,518.60
|
| Rate for Payer: UHC Exchange |
$1,518.60
|
| Rate for Payer: UHCCP Medicaid |
$795.56
|
|
|
PR SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS
|
Professional
|
Both
|
$1,124.00
|
|
|
Service Code
|
HCPCS 31032
|
| Min. Negotiated Rate |
$382.34 |
| Max. Negotiated Rate |
$880.60 |
| Rate for Payer: Aetna Commercial |
$753.09
|
| Rate for Payer: Aetna Medicare |
$562.00
|
| Rate for Payer: BCBS Complete |
$401.46
|
| Rate for Payer: BCBS Trust/PPO |
$854.26
|
| Rate for Payer: BCN Commercial |
$880.60
|
| Rate for Payer: Cash Price |
$899.20
|
| Rate for Payer: Cash Price |
$899.20
|
| Rate for Payer: Meridian Medicaid |
$401.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$382.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.38
|
| Rate for Payer: Priority Health Narrow Network |
$832.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$617.79
|
| Rate for Payer: UHC Exchange |
$617.79
|
| Rate for Payer: UHCCP Medicaid |
$382.34
|
|
|
PR SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC
|
Professional
|
Both
|
$2,264.00
|
|
|
Service Code
|
HCPCS 31080
|
| Min. Negotiated Rate |
$695.87 |
| Max. Negotiated Rate |
$1,613.62 |
| Rate for Payer: Aetna Commercial |
$1,380.05
|
| Rate for Payer: Aetna Medicare |
$1,132.00
|
| Rate for Payer: BCBS Complete |
$730.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.34
|
| Rate for Payer: BCN Commercial |
$1,613.62
|
| Rate for Payer: Cash Price |
$1,811.20
|
| Rate for Payer: Cash Price |
$1,811.20
|
| Rate for Payer: Meridian Medicaid |
$730.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$695.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,524.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,524.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,105.64
|
| Rate for Payer: UHC Exchange |
$1,105.64
|
| Rate for Payer: UHCCP Medicaid |
$695.87
|
|
|
PR SINUSOTOMY FRONTAL EXTERNAL SIMPLE
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 31070
|
| Min. Negotiated Rate |
$304.59 |
| Max. Negotiated Rate |
$1,016.45 |
| Rate for Payer: Aetna Commercial |
$597.38
|
| Rate for Payer: Aetna Medicare |
$443.00
|
| Rate for Payer: BCBS Complete |
$319.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,016.45
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Meridian Medicaid |
$319.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$667.39
|
| Rate for Payer: Priority Health Narrow Network |
$667.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$467.81
|
| Rate for Payer: UHC Exchange |
$467.81
|
| Rate for Payer: UHCCP Medicaid |
$304.59
|
|
|
PR SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 31020
|
| Min. Negotiated Rate |
$113.58 |
| Max. Negotiated Rate |
$645.06 |
| Rate for Payer: Aetna Commercial |
$488.09
|
| Rate for Payer: Aetna Medicare |
$357.00
|
| Rate for Payer: BCBS Complete |
$232.14
|
| Rate for Payer: BCBS Trust/PPO |
$113.58
|
| Rate for Payer: BCN Commercial |
$645.06
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Meridian Medicaid |
$232.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.83
|
| Rate for Payer: Priority Health Narrow Network |
$477.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.98
|
| Rate for Payer: UHC Exchange |
$373.98
|
| Rate for Payer: UHCCP Medicaid |
$221.09
|
|
