|
PR THROMBOLYSIS CEREBRAL IV INFUSION
|
Professional
|
Both
|
$1,451.00
|
|
|
Service Code
|
HCPCS 37195
|
| Min. Negotiated Rate |
$241.57 |
| Max. Negotiated Rate |
$1,273.46 |
| Rate for Payer: Aetna Commercial |
$1,244.65
|
| Rate for Payer: BCBS Complete |
$253.65
|
| Rate for Payer: BCN Commercial |
$310.13
|
| Rate for Payer: Cash Price |
$1,160.80
|
| Rate for Payer: Cash Price |
$1,160.80
|
| Rate for Payer: Meridian Medicaid |
$253.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,088.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,273.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$683.42
|
| Rate for Payer: UHC Exchange |
$683.42
|
| Rate for Payer: UHC Medicaid |
$241.57
|
| Rate for Payer: UHCCP Medicaid |
$241.57
|
|
|
PR THROMBOLYSIS CORONARY INTRAVENOUS INFUSION
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 92977
|
| Min. Negotiated Rate |
$68.22 |
| Max. Negotiated Rate |
$492.75 |
| Rate for Payer: Aetna Commercial |
$68.22
|
| Rate for Payer: BCBS Complete |
$262.80
|
| Rate for Payer: BCN Commercial |
$83.66
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$492.75
|
|
|
PR THROMBOLYSIS INTRACORONARY NFS SLCTV ANGRPH
|
Professional
|
Both
|
$817.00
|
|
|
Service Code
|
HCPCS 92975
|
| Min. Negotiated Rate |
$326.80 |
| Max. Negotiated Rate |
$612.75 |
| Rate for Payer: Aetna Commercial |
$505.09
|
| Rate for Payer: BCBS Complete |
$326.80
|
| Rate for Payer: BCN Commercial |
$547.78
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.75
|
|
|
PR THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX
|
Professional
|
Both
|
$1,659.00
|
|
|
Service Code
|
HCPCS 37212
|
| Min. Negotiated Rate |
$187.87 |
| Max. Negotiated Rate |
$1,244.25 |
| Rate for Payer: Aetna Commercial |
$397.97
|
| Rate for Payer: Aetna Medicare |
$296.99
|
| Rate for Payer: BCBS Complete |
$197.26
|
| Rate for Payer: BCBS MAPPO |
$296.99
|
| Rate for Payer: BCN Commercial |
$492.50
|
| Rate for Payer: BCN Medicare Advantage |
$296.99
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cofinity Commercial |
$397.97
|
| Rate for Payer: Cofinity Commercial |
$427.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.99
|
| Rate for Payer: Healthscope Commercial |
$356.39
|
| Rate for Payer: Healthscope Whirlpool |
$356.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.84
|
| Rate for Payer: Meridian Medicaid |
$197.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.69
|
| Rate for Payer: Nomi Health Commercial |
$356.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,244.25
|
| Rate for Payer: PACE SWMI |
$296.99
|
| Rate for Payer: PHP Medicare Advantage |
$296.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$529.63
|
| Rate for Payer: Priority Health Medicare |
$296.99
|
| Rate for Payer: Priority Health Narrow Network |
$529.63
|
| Rate for Payer: Railroad Medicare Medicare |
$296.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$296.99
|
| Rate for Payer: UHC Exchange |
$605.66
|
| Rate for Payer: UHC Medicaid |
$187.87
|
| Rate for Payer: UHCCP DNSP |
$296.99
|
| Rate for Payer: UHCCP Medicaid |
$187.87
|
|
|
PR THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC
|
Professional
|
Both
|
$3,819.00
|
|
|
Service Code
|
HCPCS 32659
|
| Min. Negotiated Rate |
$456.89 |
| Max. Negotiated Rate |
$2,864.25 |
| Rate for Payer: Aetna Commercial |
$949.98
|
| Rate for Payer: Aetna Medicare |
$708.94
|
| Rate for Payer: BCBS Complete |
$479.73
|
| Rate for Payer: BCBS MAPPO |
$708.94
|
| Rate for Payer: BCN Commercial |
$1,092.57
|
| Rate for Payer: BCN Medicare Advantage |
$708.94
|
| Rate for Payer: Cash Price |
$3,055.20
|
| Rate for Payer: Cash Price |
$3,055.20
|
| Rate for Payer: Cofinity Commercial |
$949.98
|
| Rate for Payer: Cofinity Commercial |
$1,020.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.94
|
| Rate for Payer: Healthscope Commercial |
$850.73
|
| Rate for Payer: Healthscope Whirlpool |
$850.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$744.39
|
| Rate for Payer: Meridian Medicaid |
$479.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$779.83
|
| Rate for Payer: Nomi Health Commercial |
$850.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,864.25
|
| Rate for Payer: PACE SWMI |
$708.94
|
| Rate for Payer: PHP Medicare Advantage |
$708.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,028.87
|
| Rate for Payer: Priority Health Medicare |
$708.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,028.87
|
| Rate for Payer: Railroad Medicare Medicare |
$708.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,291.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$708.94
|
| Rate for Payer: UHC Exchange |
$1,291.08
|
| Rate for Payer: UHC Medicaid |
$456.89
|
| Rate for Payer: UHCCP DNSP |
$708.94
|
| Rate for Payer: UHCCP Medicaid |
$456.89
|
|
|
PR THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS
|
Professional
|
Both
|
$4,593.00
|
|
|
Service Code
|
HCPCS 32652
|
| Min. Negotiated Rate |
$1,001.10 |
| Max. Negotiated Rate |
$3,444.75 |
| Rate for Payer: Aetna Commercial |
$2,099.90
|
| Rate for Payer: Aetna Medicare |
$1,567.09
|
| Rate for Payer: BCBS Complete |
$1,051.15
|
| Rate for Payer: BCBS MAPPO |
$1,567.09
|
| Rate for Payer: BCN Commercial |
$2,455.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,567.09
|
| Rate for Payer: Cash Price |
$3,674.40
|
| Rate for Payer: Cash Price |
$3,674.40
|
| Rate for Payer: Cofinity Commercial |
$2,256.61
|
| Rate for Payer: Cofinity Commercial |
$2,099.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,567.09
|
| Rate for Payer: Healthscope Commercial |
$1,880.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,880.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,645.44
|
| Rate for Payer: Meridian Medicaid |
$1,051.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,723.80
|
| Rate for Payer: Nomi Health Commercial |
$1,880.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,444.75
|
| Rate for Payer: PACE SWMI |
$1,567.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,567.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,001.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,311.92
|
| Rate for Payer: Priority Health Medicare |
$1,567.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,311.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,567.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,948.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,567.09
|
| Rate for Payer: UHC Exchange |
$2,948.50
|
| Rate for Payer: UHC Medicaid |
$1,001.10
|
| Rate for Payer: UHCCP DNSP |
$1,567.09
|
| Rate for Payer: UHCCP Medicaid |
$1,001.10
|
|
|
PR THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$2,636.00
|
|
|
Service Code
|
HCPCS 60522
|
| Min. Negotiated Rate |
$829.21 |
| Max. Negotiated Rate |
$2,420.58 |
| Rate for Payer: Aetna Commercial |
$1,734.66
|
| Rate for Payer: Aetna Medicare |
$1,294.52
|
| Rate for Payer: BCBS Complete |
$870.67
|
| Rate for Payer: BCBS MAPPO |
$1,294.52
|
| Rate for Payer: BCN Commercial |
$2,025.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,294.52
|
| Rate for Payer: Cash Price |
$2,108.80
|
| Rate for Payer: Cash Price |
$2,108.80
|
| Rate for Payer: Cofinity Commercial |
$1,864.11
|
| Rate for Payer: Cofinity Commercial |
$1,734.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,294.52
|
| Rate for Payer: Healthscope Commercial |
$1,553.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,553.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,359.25
|
| Rate for Payer: Meridian Medicaid |
$870.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,423.97
|
| Rate for Payer: Nomi Health Commercial |
$1,553.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,977.00
|
| Rate for Payer: PACE SWMI |
$1,294.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,294.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,196.10
|
| Rate for Payer: Priority Health Medicare |
$1,294.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,196.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,294.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,420.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,294.52
|
| Rate for Payer: UHC Exchange |
$2,420.58
|
| Rate for Payer: UHC Medicaid |
$829.21
|
| Rate for Payer: UHCCP DNSP |
$1,294.52
|
| Rate for Payer: UHCCP Medicaid |
$829.21
|
|
|
PR THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX
|
Professional
|
Both
|
$3,637.00
|
|
|
Service Code
|
HCPCS 60520
|
| Min. Negotiated Rate |
$626.86 |
| Max. Negotiated Rate |
$2,727.75 |
| Rate for Payer: Aetna Commercial |
$1,307.10
|
| Rate for Payer: Aetna Medicare |
$975.45
|
| Rate for Payer: BCBS Complete |
$658.20
|
| Rate for Payer: BCBS MAPPO |
$975.45
|
| Rate for Payer: BCN Commercial |
$1,577.61
|
| Rate for Payer: BCN Medicare Advantage |
$975.45
|
| Rate for Payer: Cash Price |
$2,909.60
|
| Rate for Payer: Cash Price |
$2,909.60
|
| Rate for Payer: Cofinity Commercial |
$1,404.65
|
| Rate for Payer: Cofinity Commercial |
$1,307.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$975.45
|
| Rate for Payer: Healthscope Commercial |
$1,170.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,170.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,024.22
|
| Rate for Payer: Meridian Medicaid |
$658.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,072.99
|
| Rate for Payer: Nomi Health Commercial |
$1,170.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,727.75
|
| Rate for Payer: PACE SWMI |
$975.45
|
| Rate for Payer: PHP Medicare Advantage |
$975.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,710.66
|
| Rate for Payer: Priority Health Medicare |
$975.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,710.66
|
| Rate for Payer: Railroad Medicare Medicare |
$975.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,859.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$975.45
|
| Rate for Payer: UHC Exchange |
$1,859.00
|
| Rate for Payer: UHC Medicaid |
$626.86
|
| Rate for Payer: UHCCP DNSP |
$975.45
|
| Rate for Payer: UHCCP Medicaid |
$626.86
|
|
|
PR THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$4,065.00
|
|
|
Service Code
|
HCPCS 60521
|
| Min. Negotiated Rate |
$689.48 |
| Max. Negotiated Rate |
$3,048.75 |
| Rate for Payer: Aetna Commercial |
$1,440.81
|
| Rate for Payer: Aetna Medicare |
$1,075.23
|
| Rate for Payer: BCBS Complete |
$723.95
|
| Rate for Payer: BCBS MAPPO |
$1,075.23
|
| Rate for Payer: BCN Commercial |
$1,674.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,075.23
|
| Rate for Payer: Cash Price |
$3,252.00
|
| Rate for Payer: Cash Price |
$3,252.00
|
| Rate for Payer: Cofinity Commercial |
$1,548.33
|
| Rate for Payer: Cofinity Commercial |
$1,440.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,075.23
|
| Rate for Payer: Healthscope Commercial |
$1,290.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,290.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,128.99
|
| Rate for Payer: Meridian Medicaid |
$723.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,182.75
|
| Rate for Payer: Nomi Health Commercial |
$1,290.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,048.75
|
| Rate for Payer: PACE SWMI |
$1,075.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,075.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$689.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,815.95
|
| Rate for Payer: Priority Health Medicare |
$1,075.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,815.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,075.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,988.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,075.23
|
| Rate for Payer: UHC Exchange |
$1,988.59
|
| Rate for Payer: UHC Medicaid |
$689.48
|
| Rate for Payer: UHCCP DNSP |
$1,075.23
|
| Rate for Payer: UHCCP Medicaid |
$689.48
|
|
|
PR THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL
|
Professional
|
Both
|
$3,287.00
|
|
|
Service Code
|
HCPCS 60260
|
| Min. Negotiated Rate |
$618.55 |
| Max. Negotiated Rate |
$2,465.25 |
| Rate for Payer: Aetna Commercial |
$1,289.52
|
| Rate for Payer: Aetna Medicare |
$962.33
|
| Rate for Payer: BCBS Complete |
$649.48
|
| Rate for Payer: BCBS MAPPO |
$962.33
|
| Rate for Payer: BCN Commercial |
$1,633.38
|
| Rate for Payer: BCN Medicare Advantage |
$962.33
|
| Rate for Payer: Cash Price |
$2,629.60
|
| Rate for Payer: Cash Price |
$2,629.60
|
| Rate for Payer: Cofinity Commercial |
$1,385.76
|
| Rate for Payer: Cofinity Commercial |
$1,289.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.33
|
| Rate for Payer: Healthscope Commercial |
$1,154.80
|
| Rate for Payer: Healthscope Whirlpool |
$1,154.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,010.45
|
| Rate for Payer: Meridian Medicaid |
$649.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,058.56
|
| Rate for Payer: Nomi Health Commercial |
$1,154.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,465.25
|
| Rate for Payer: PACE SWMI |
$962.33
|
| Rate for Payer: PHP Medicare Advantage |
$962.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,771.15
|
| Rate for Payer: Priority Health Medicare |
$962.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,771.15
|
| Rate for Payer: Railroad Medicare Medicare |
$962.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,921.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$962.33
|
| Rate for Payer: UHC Exchange |
$1,921.88
|
| Rate for Payer: UHC Medicaid |
$618.55
|
| Rate for Payer: UHCCP DNSP |
$962.33
|
| Rate for Payer: UHCCP Medicaid |
$618.55
|
|
|
PR THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH
|
Professional
|
Both
|
$2,252.00
|
|
|
Service Code
|
HCPCS 60271
|
| Min. Negotiated Rate |
$603.64 |
| Max. Negotiated Rate |
$1,862.57 |
| Rate for Payer: Aetna Commercial |
$1,258.01
|
| Rate for Payer: Aetna Medicare |
$938.81
|
| Rate for Payer: BCBS Complete |
$633.82
|
| Rate for Payer: BCBS MAPPO |
$938.81
|
| Rate for Payer: BCN Commercial |
$1,585.08
|
| Rate for Payer: BCN Medicare Advantage |
$938.81
|
| Rate for Payer: Cash Price |
$1,801.60
|
| Rate for Payer: Cash Price |
$1,801.60
|
| Rate for Payer: Cofinity Commercial |
$1,351.89
|
| Rate for Payer: Cofinity Commercial |
$1,258.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.81
|
| Rate for Payer: Healthscope Commercial |
$1,126.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,126.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.75
|
| Rate for Payer: Meridian Medicaid |
$633.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,032.69
|
| Rate for Payer: Nomi Health Commercial |
$1,126.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,689.00
|
| Rate for Payer: PACE SWMI |
$938.81
|
| Rate for Payer: PHP Medicare Advantage |
$938.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$603.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,718.76
|
| Rate for Payer: Priority Health Medicare |
$938.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.76
|
| Rate for Payer: Railroad Medicare Medicare |
$938.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,862.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$938.81
|
| Rate for Payer: UHC Exchange |
$1,862.57
|
| Rate for Payer: UHC Medicaid |
$603.64
|
| Rate for Payer: UHCCP DNSP |
$938.81
|
| Rate for Payer: UHCCP Medicaid |
$603.64
|
|
|
PR THYROIDECTOMY TOTAL/COMPLETE
|
Professional
|
Both
|
$3,203.00
|
|
|
Service Code
|
HCPCS 60240
|
| Min. Negotiated Rate |
$529.09 |
| Max. Negotiated Rate |
$2,402.25 |
| Rate for Payer: Aetna Commercial |
$1,101.43
|
| Rate for Payer: Aetna Medicare |
$821.96
|
| Rate for Payer: BCBS Complete |
$555.54
|
| Rate for Payer: BCBS MAPPO |
$821.96
|
| Rate for Payer: BCN Commercial |
$1,379.41
|
| Rate for Payer: BCN Medicare Advantage |
$821.96
|
| Rate for Payer: Cash Price |
$2,562.40
|
| Rate for Payer: Cash Price |
$2,562.40
|
| Rate for Payer: Cofinity Commercial |
$1,183.62
|
| Rate for Payer: Cofinity Commercial |
$1,101.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$821.96
|
| Rate for Payer: Healthscope Commercial |
$986.35
|
| Rate for Payer: Healthscope Whirlpool |
$986.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.06
|
| Rate for Payer: Meridian Medicaid |
$555.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$904.16
|
| Rate for Payer: Nomi Health Commercial |
$986.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,402.25
|
| Rate for Payer: PACE SWMI |
$821.96
|
| Rate for Payer: PHP Medicare Advantage |
$821.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,495.75
|
| Rate for Payer: Priority Health Medicare |
$821.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,495.75
|
| Rate for Payer: Railroad Medicare Medicare |
$821.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,619.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$821.96
|
| Rate for Payer: UHC Exchange |
$1,619.99
|
| Rate for Payer: UHC Medicaid |
$529.09
|
| Rate for Payer: UHCCP DNSP |
$821.96
|
| Rate for Payer: UHCCP Medicaid |
$529.09
|
|
|
PR THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT
|
Professional
|
Both
|
$2,469.00
|
|
|
Service Code
|
HCPCS 60252
|
| Min. Negotiated Rate |
$751.68 |
| Max. Negotiated Rate |
$2,330.31 |
| Rate for Payer: Aetna Commercial |
$1,566.92
|
| Rate for Payer: Aetna Medicare |
$1,169.34
|
| Rate for Payer: BCBS Complete |
$789.26
|
| Rate for Payer: BCBS MAPPO |
$1,169.34
|
| Rate for Payer: BCN Commercial |
$1,978.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,169.34
|
| Rate for Payer: Cash Price |
$1,975.20
|
| Rate for Payer: Cash Price |
$1,975.20
|
| Rate for Payer: Cofinity Commercial |
$1,683.85
|
| Rate for Payer: Cofinity Commercial |
$1,566.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,169.34
|
| Rate for Payer: Healthscope Commercial |
$1,403.21
|
| Rate for Payer: Healthscope Whirlpool |
$1,403.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,227.81
|
| Rate for Payer: Meridian Medicaid |
$789.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,286.27
|
| Rate for Payer: Nomi Health Commercial |
$1,403.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,851.75
|
| Rate for Payer: PACE SWMI |
$1,169.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,169.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,145.35
|
| Rate for Payer: Priority Health Medicare |
$1,169.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,145.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,169.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,330.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,169.34
|
| Rate for Payer: UHC Exchange |
$2,330.31
|
| Rate for Payer: UHC Medicaid |
$751.68
|
| Rate for Payer: UHCCP DNSP |
$1,169.34
|
| Rate for Payer: UHCCP Medicaid |
$751.68
|
|
|
PR THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT
|
Professional
|
Both
|
$3,256.00
|
|
|
Service Code
|
HCPCS 60254
|
| Min. Negotiated Rate |
$944.87 |
| Max. Negotiated Rate |
$2,948.08 |
| Rate for Payer: Aetna Commercial |
$1,973.97
|
| Rate for Payer: Aetna Medicare |
$1,473.11
|
| Rate for Payer: BCBS Complete |
$992.11
|
| Rate for Payer: BCBS MAPPO |
$1,473.11
|
| Rate for Payer: BCN Commercial |
$2,496.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,473.11
|
| Rate for Payer: Cash Price |
$2,604.80
|
| Rate for Payer: Cash Price |
$2,604.80
|
| Rate for Payer: Cofinity Commercial |
$2,121.28
|
| Rate for Payer: Cofinity Commercial |
$1,973.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,473.11
|
| Rate for Payer: Healthscope Commercial |
$1,767.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,767.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,546.77
|
| Rate for Payer: Meridian Medicaid |
$992.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,620.42
|
| Rate for Payer: Nomi Health Commercial |
$1,767.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.00
|
| Rate for Payer: PACE SWMI |
$1,473.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,473.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$944.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,706.92
|
| Rate for Payer: Priority Health Medicare |
$1,473.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,706.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,473.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,948.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,473.11
|
| Rate for Payer: UHC Exchange |
$2,948.08
|
| Rate for Payer: UHC Medicaid |
$944.87
|
| Rate for Payer: UHCCP DNSP |
$1,473.11
|
| Rate for Payer: UHCCP Medicaid |
$944.87
|
|
|
PR THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC
|
Professional
|
Both
|
$5,617.00
|
|
|
Service Code
|
HCPCS 60270
|
| Min. Negotiated Rate |
$783.63 |
| Max. Negotiated Rate |
$4,212.75 |
| Rate for Payer: Aetna Commercial |
$1,636.78
|
| Rate for Payer: Aetna Medicare |
$1,221.48
|
| Rate for Payer: BCBS Complete |
$822.81
|
| Rate for Payer: BCBS MAPPO |
$1,221.48
|
| Rate for Payer: BCN Commercial |
$2,039.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,221.48
|
| Rate for Payer: Cash Price |
$4,493.60
|
| Rate for Payer: Cash Price |
$4,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,758.93
|
| Rate for Payer: Cofinity Commercial |
$1,636.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,221.48
|
| Rate for Payer: Healthscope Commercial |
$1,465.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,465.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,282.55
|
| Rate for Payer: Meridian Medicaid |
$822.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,343.63
|
| Rate for Payer: Nomi Health Commercial |
$1,465.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,212.75
|
| Rate for Payer: PACE SWMI |
$1,221.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,221.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$783.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,211.22
|
| Rate for Payer: Priority Health Medicare |
$1,221.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,211.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,221.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,415.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,221.48
|
| Rate for Payer: UHC Exchange |
$2,415.82
|
| Rate for Payer: UHC Medicaid |
$783.63
|
| Rate for Payer: UHCCP DNSP |
$1,221.48
|
| Rate for Payer: UHCCP Medicaid |
$783.63
|
|
|
PR TIS CLTR SKN AGRFT F/S/N/H/F/G/M/DGT 1ST 25SQCM/
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 15155
|
| Min. Negotiated Rate |
$418.97 |
| Max. Negotiated Rate |
$1,280.59 |
| Rate for Payer: Aetna Commercial |
$859.99
|
| Rate for Payer: Aetna Medicare |
$641.78
|
| Rate for Payer: BCBS Complete |
$439.92
|
| Rate for Payer: BCBS MAPPO |
$641.78
|
| Rate for Payer: BCN Commercial |
$1,100.54
|
| Rate for Payer: BCN Medicare Advantage |
$641.78
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cofinity Commercial |
$924.16
|
| Rate for Payer: Cofinity Commercial |
$859.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.78
|
| Rate for Payer: Healthscope Commercial |
$770.14
|
| Rate for Payer: Healthscope Whirlpool |
$770.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.87
|
| Rate for Payer: Meridian Medicaid |
$439.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.96
|
| Rate for Payer: Nomi Health Commercial |
$770.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,023.75
|
| Rate for Payer: PACE SWMI |
$641.78
|
| Rate for Payer: PHP Medicare Advantage |
$641.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,007.28
|
| Rate for Payer: Priority Health Medicare |
$641.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,007.28
|
| Rate for Payer: Railroad Medicare Medicare |
$641.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,280.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.78
|
| Rate for Payer: UHC Exchange |
$1,280.59
|
| Rate for Payer: UHC Medicaid |
$418.97
|
| Rate for Payer: UHCCP DNSP |
$641.78
|
| Rate for Payer: UHCCP Medicaid |
$418.97
|
|
|
PR TIS CLTR SKN AGRFT F/S/N/H/F/G/M/DGT AD 1-75SQCM
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 15156
|
| Min. Negotiated Rate |
$86.05 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Commercial |
$182.39
|
| Rate for Payer: Aetna Medicare |
$136.11
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCBS MAPPO |
$136.11
|
| Rate for Payer: BCN Commercial |
$224.09
|
| Rate for Payer: BCN Medicare Advantage |
$136.11
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$182.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.11
|
| Rate for Payer: Healthscope Commercial |
$163.33
|
| Rate for Payer: Healthscope Whirlpool |
$163.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.92
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.72
|
| Rate for Payer: Nomi Health Commercial |
$163.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
| Rate for Payer: PACE SWMI |
$136.11
|
| Rate for Payer: PHP Medicare Advantage |
$136.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$205.10
|
| Rate for Payer: Priority Health Medicare |
$136.11
|
| Rate for Payer: Priority Health Narrow Network |
$205.10
|
| Rate for Payer: Railroad Medicare Medicare |
$136.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$270.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.11
|
| Rate for Payer: UHC Exchange |
$270.34
|
| Rate for Payer: UHC Medicaid |
$86.05
|
| Rate for Payer: UHCCP DNSP |
$136.11
|
| Rate for Payer: UHCCP Medicaid |
$86.05
|
|
|
PR TISS CLTR SKIN AGRFT T/A/L EA ADD 100 SQCM/EA 1%
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 15152
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$258.56 |
| Rate for Payer: Aetna Commercial |
$165.65
|
| Rate for Payer: Aetna Medicare |
$123.62
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$123.62
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$123.62
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$178.01
|
| Rate for Payer: Cofinity Commercial |
$165.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.62
|
| Rate for Payer: Healthscope Commercial |
$148.34
|
| Rate for Payer: Healthscope Whirlpool |
$148.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.80
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.98
|
| Rate for Payer: Nomi Health Commercial |
$148.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: PACE SWMI |
$123.62
|
| Rate for Payer: PHP Medicare Advantage |
$123.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$197.35
|
| Rate for Payer: Priority Health Medicare |
$123.62
|
| Rate for Payer: Priority Health Narrow Network |
$197.35
|
| Rate for Payer: Railroad Medicare Medicare |
$123.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.62
|
| Rate for Payer: UHC Exchange |
$258.56
|
| Rate for Payer: UHC Medicaid |
$78.17
|
| Rate for Payer: UHCCP DNSP |
$123.62
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L 1ST 25 SQ CM/<
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 15150
|
| Min. Negotiated Rate |
$393.62 |
| Max. Negotiated Rate |
$1,121.67 |
| Rate for Payer: Aetna Commercial |
$814.60
|
| Rate for Payer: Aetna Medicare |
$607.91
|
| Rate for Payer: BCBS Complete |
$413.30
|
| Rate for Payer: BCBS MAPPO |
$607.91
|
| Rate for Payer: BCN Commercial |
$964.59
|
| Rate for Payer: BCN Medicare Advantage |
$607.91
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cofinity Commercial |
$875.39
|
| Rate for Payer: Cofinity Commercial |
$814.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.91
|
| Rate for Payer: Healthscope Commercial |
$729.49
|
| Rate for Payer: Healthscope Whirlpool |
$729.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$638.31
|
| Rate for Payer: Meridian Medicaid |
$413.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$668.70
|
| Rate for Payer: Nomi Health Commercial |
$729.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$930.75
|
| Rate for Payer: PACE SWMI |
$607.91
|
| Rate for Payer: PHP Medicare Advantage |
$607.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$882.85
|
| Rate for Payer: Priority Health Medicare |
$607.91
|
| Rate for Payer: Priority Health Narrow Network |
$882.85
|
| Rate for Payer: Railroad Medicare Medicare |
$607.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,121.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$607.91
|
| Rate for Payer: UHC Exchange |
$1,121.67
|
| Rate for Payer: UHC Medicaid |
$393.62
|
| Rate for Payer: UHCCP DNSP |
$607.91
|
| Rate for Payer: UHCCP Medicaid |
$393.62
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L ADDL 1-75 SQCM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 15151
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$197.70 |
| Rate for Payer: Aetna Commercial |
$131.75
|
| Rate for Payer: Aetna Medicare |
$98.32
|
| Rate for Payer: BCBS Complete |
$65.31
|
| Rate for Payer: BCBS MAPPO |
$98.32
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: BCN Medicare Advantage |
$98.32
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$131.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.32
|
| Rate for Payer: Healthscope Commercial |
$117.98
|
| Rate for Payer: Healthscope Whirlpool |
$117.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.24
|
| Rate for Payer: Meridian Medicaid |
$65.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.15
|
| Rate for Payer: Nomi Health Commercial |
$117.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: PACE SWMI |
$98.32
|
| Rate for Payer: PHP Medicare Advantage |
$98.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$148.59
|
| Rate for Payer: Priority Health Medicare |
$98.32
|
| Rate for Payer: Priority Health Narrow Network |
$148.59
|
| Rate for Payer: Railroad Medicare Medicare |
$98.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.32
|
| Rate for Payer: UHC Exchange |
$197.70
|
| Rate for Payer: UHC Medicaid |
$62.20
|
| Rate for Payer: UHCCP DNSP |
$98.32
|
| Rate for Payer: UHCCP Medicaid |
$62.20
|
|
|
PR TISSUE EXPANDER PLACEMENT BREAST RECONSTRUCTION
|
Professional
|
Both
|
$2,521.00
|
|
|
Service Code
|
HCPCS 19357
|
| Min. Negotiated Rate |
$684.16 |
| Max. Negotiated Rate |
$2,607.91 |
| Rate for Payer: Aetna Commercial |
$1,395.17
|
| Rate for Payer: Aetna Medicare |
$1,041.17
|
| Rate for Payer: BCBS Complete |
$718.37
|
| Rate for Payer: BCBS MAPPO |
$1,041.17
|
| Rate for Payer: BCN Commercial |
$1,755.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.17
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cofinity Commercial |
$1,395.17
|
| Rate for Payer: Cofinity Commercial |
$1,499.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.17
|
| Rate for Payer: Healthscope Commercial |
$1,249.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,249.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,093.23
|
| Rate for Payer: Meridian Medicaid |
$718.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,145.29
|
| Rate for Payer: Nomi Health Commercial |
$1,249.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,890.75
|
| Rate for Payer: PACE SWMI |
$1,041.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$684.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,607.09
|
| Rate for Payer: Priority Health Medicare |
$1,041.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,607.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,041.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,607.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,041.17
|
| Rate for Payer: UHC Exchange |
$2,607.91
|
| Rate for Payer: UHC Medicaid |
$684.16
|
| Rate for Payer: UHCCP DNSP |
$1,041.17
|
| Rate for Payer: UHCCP Medicaid |
$684.16
|
|
|
PR TIXAGEV AND CILGAV INJ
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS M0220
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$150.50
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCN Commercial |
$97.45
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
|
|
PR TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP
|
Professional
|
Both
|
$3,713.00
|
|
|
Service Code
|
HCPCS 69637
|
| Min. Negotiated Rate |
$819.20 |
| Max. Negotiated Rate |
$2,784.75 |
| Rate for Payer: Aetna Commercial |
$1,650.85
|
| Rate for Payer: Aetna Medicare |
$1,231.98
|
| Rate for Payer: BCBS Complete |
$860.16
|
| Rate for Payer: BCBS MAPPO |
$1,231.98
|
| Rate for Payer: BCN Commercial |
$2,097.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.98
|
| Rate for Payer: Cash Price |
$2,970.40
|
| Rate for Payer: Cash Price |
$2,970.40
|
| Rate for Payer: Cofinity Commercial |
$1,774.05
|
| Rate for Payer: Cofinity Commercial |
$1,650.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.98
|
| Rate for Payer: Healthscope Commercial |
$1,478.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,478.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,293.58
|
| Rate for Payer: Meridian Medicaid |
$860.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,355.18
|
| Rate for Payer: Nomi Health Commercial |
$1,478.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,784.75
|
| Rate for Payer: PACE SWMI |
$1,231.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$819.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,072.04
|
| Rate for Payer: Priority Health Medicare |
$1,231.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,072.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,337.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,231.98
|
| Rate for Payer: UHC Exchange |
$2,337.64
|
| Rate for Payer: UHC Medicaid |
$819.20
|
| Rate for Payer: UHCCP DNSP |
$1,231.98
|
| Rate for Payer: UHCCP Medicaid |
$819.20
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR
|
Professional
|
Both
|
$4,439.00
|
|
|
Service Code
|
HCPCS 69644
|
| Min. Negotiated Rate |
$874.58 |
| Max. Negotiated Rate |
$3,329.25 |
| Rate for Payer: Aetna Commercial |
$1,767.04
|
| Rate for Payer: Aetna Medicare |
$1,318.69
|
| Rate for Payer: BCBS Complete |
$918.31
|
| Rate for Payer: BCBS MAPPO |
$1,318.69
|
| Rate for Payer: BCN Commercial |
$2,255.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,318.69
|
| Rate for Payer: Cash Price |
$3,551.20
|
| Rate for Payer: Cash Price |
$3,551.20
|
| Rate for Payer: Cofinity Commercial |
$1,898.91
|
| Rate for Payer: Cofinity Commercial |
$1,767.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,318.69
|
| Rate for Payer: Healthscope Commercial |
$1,582.43
|
| Rate for Payer: Healthscope Whirlpool |
$1,582.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,384.62
|
| Rate for Payer: Meridian Medicaid |
$918.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,450.56
|
| Rate for Payer: Nomi Health Commercial |
$1,582.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,329.25
|
| Rate for Payer: PACE SWMI |
$1,318.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,318.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$874.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,229.01
|
| Rate for Payer: Priority Health Medicare |
$1,318.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,229.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,318.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,519.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,318.69
|
| Rate for Payer: UHC Exchange |
$2,519.33
|
| Rate for Payer: UHC Medicaid |
$874.58
|
| Rate for Payer: UHCCP DNSP |
$1,318.69
|
| Rate for Payer: UHCCP Medicaid |
$874.58
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR
|
Professional
|
Both
|
$4,198.00
|
|
|
Service Code
|
HCPCS 69643
|
| Min. Negotiated Rate |
$693.53 |
| Max. Negotiated Rate |
$3,148.50 |
| Rate for Payer: Aetna Commercial |
$1,411.64
|
| Rate for Payer: Aetna Medicare |
$1,053.46
|
| Rate for Payer: BCBS Complete |
$728.21
|
| Rate for Payer: BCBS MAPPO |
$1,053.46
|
| Rate for Payer: BCN Commercial |
$1,823.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,053.46
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cofinity Commercial |
$1,516.98
|
| Rate for Payer: Cofinity Commercial |
$1,411.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,053.46
|
| Rate for Payer: Healthscope Commercial |
$1,264.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,264.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,106.13
|
| Rate for Payer: Meridian Medicaid |
$728.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,158.81
|
| Rate for Payer: Nomi Health Commercial |
$1,264.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.50
|
| Rate for Payer: PACE SWMI |
$1,053.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,053.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$693.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,801.91
|
| Rate for Payer: Priority Health Medicare |
$1,053.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,801.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,053.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,087.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,053.46
|
| Rate for Payer: UHC Exchange |
$2,087.67
|
| Rate for Payer: UHC Medicaid |
$693.53
|
| Rate for Payer: UHCCP DNSP |
$1,053.46
|
| Rate for Payer: UHCCP Medicaid |
$693.53
|
|
