|
PR SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 31030
|
| Min. Negotiated Rate |
$331.43 |
| Max. Negotiated Rate |
$938.26 |
| Rate for Payer: Aetna Commercial |
$651.88
|
| Rate for Payer: Aetna Medicare |
$578.00
|
| Rate for Payer: BCBS Complete |
$348.00
|
| Rate for Payer: BCBS Trust/PPO |
$665.66
|
| Rate for Payer: BCN Commercial |
$938.26
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Meridian Medicaid |
$348.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$718.38
|
| Rate for Payer: Priority Health Narrow Network |
$718.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$561.17
|
| Rate for Payer: UHC Exchange |
$561.17
|
| Rate for Payer: UHCCP Medicaid |
$331.43
|
|
|
PR SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP
|
Professional
|
Both
|
$1,867.00
|
|
|
Service Code
|
HCPCS 31051
|
| Min. Negotiated Rate |
$442.61 |
| Max. Negotiated Rate |
$1,213.55 |
| Rate for Payer: Aetna Commercial |
$876.60
|
| Rate for Payer: Aetna Medicare |
$933.50
|
| Rate for Payer: BCBS Complete |
$464.74
|
| Rate for Payer: BCBS Trust/PPO |
$695.24
|
| Rate for Payer: BCN Commercial |
$1,029.65
|
| Rate for Payer: Cash Price |
$1,493.60
|
| Rate for Payer: Cash Price |
$1,493.60
|
| Rate for Payer: Meridian Medicaid |
$464.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,213.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$972.35
|
| Rate for Payer: Priority Health Narrow Network |
$972.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$695.13
|
| Rate for Payer: UHC Exchange |
$695.13
|
| Rate for Payer: UHCCP Medicaid |
$442.61
|
|
|
PR SKIN LESION SHAVE/EXCISION (15 MIN)
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00367
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
|
|
PR SKIN LESION SHAVE/EXCISION (30 MIN)
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 00368
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Medicare |
$255.00
|
| Rate for Payer: BCBS Complete |
$204.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
|
|
PR SKYLA, 13.5 MG
|
Professional
|
Both
|
$1,462.00
|
|
|
Service Code
|
HCPCS J7301
|
| Min. Negotiated Rate |
$731.00 |
| Max. Negotiated Rate |
$1,125.66 |
| Rate for Payer: Aetna Commercial |
$917.35
|
| Rate for Payer: Aetna Medicare |
$731.00
|
| Rate for Payer: BCBS Complete |
$1,125.66
|
| Rate for Payer: BCBS Trust/PPO |
$925.78
|
| Rate for Payer: BCN Commercial |
$925.78
|
| Rate for Payer: Cash Price |
$1,169.60
|
| Rate for Payer: Cash Price |
$1,169.60
|
| Rate for Payer: Meridian Medicaid |
$1,125.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,072.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$950.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$992.12
|
| Rate for Payer: UHC Exchange |
$992.12
|
| Rate for Payer: UHCCP Medicaid |
$1,072.06
|
|
|
PR SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN
|
Professional
|
Both
|
$514.00
|
|
|
Service Code
|
HCPCS 36251
|
| Min. Negotiated Rate |
$158.90 |
| Max. Negotiated Rate |
$1,894.60 |
| Rate for Payer: Aetna Commercial |
$344.70
|
| Rate for Payer: Aetna Medicare |
$257.00
|
| Rate for Payer: BCBS Complete |
$166.84
|
| Rate for Payer: BCBS Trust/PPO |
$555.24
|
| Rate for Payer: BCN Commercial |
$1,894.60
|
| Rate for Payer: Cash Price |
$411.20
|
| Rate for Payer: Cash Price |
$411.20
|
| Rate for Payer: Meridian Medicaid |
$166.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$334.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.73
|
| Rate for Payer: Priority Health Narrow Network |
$396.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$382.96
|
| Rate for Payer: UHC Exchange |
$382.96
|
| Rate for Payer: UHCCP Medicaid |
$158.90
|
|
|
PR SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 36252
|
| Min. Negotiated Rate |
$222.59 |
| Max. Negotiated Rate |
$2,039.26 |
| Rate for Payer: Aetna Commercial |
$481.35
|
| Rate for Payer: Aetna Medicare |
$334.50
|
| Rate for Payer: BCBS Complete |
$233.72
|
| Rate for Payer: BCBS Trust/PPO |
$787.70
|
| Rate for Payer: BCN Commercial |
$2,039.26
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Meridian Medicaid |
$233.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.70
|
| Rate for Payer: Priority Health Narrow Network |
$554.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.80
|
| Rate for Payer: UHC Exchange |
$498.80
|
| Rate for Payer: UHCCP Medicaid |
$222.59
|
|
|
PR SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART
|
Professional
|
Both
|
$1,801.00
|
|
|
Service Code
|
HCPCS 36223
|
| Min. Negotiated Rate |
$209.38 |
| Max. Negotiated Rate |
$2,411.13 |
| Rate for Payer: Aetna Commercial |
$429.37
|
| Rate for Payer: Aetna Medicare |
$900.50
|
| Rate for Payer: BCBS Complete |
$219.85
|
| Rate for Payer: BCBS Trust/PPO |
$927.17
|
| Rate for Payer: BCN Commercial |
$2,411.13
|
| Rate for Payer: Cash Price |
$1,440.80
|
| Rate for Payer: Cash Price |
$1,440.80
|
| Rate for Payer: Meridian Medicaid |
$219.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,170.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$517.47
|
| Rate for Payer: Priority Health Narrow Network |
$517.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$430.55
|
| Rate for Payer: UHC Exchange |
$430.55
|
| Rate for Payer: UHCCP Medicaid |
$209.38
|
|
|
PR SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 36222
|
| Min. Negotiated Rate |
$179.99 |
| Max. Negotiated Rate |
$1,787.58 |
| Rate for Payer: Aetna Commercial |
$380.48
|
| Rate for Payer: Aetna Medicare |
$827.50
|
| Rate for Payer: BCBS Complete |
$188.99
|
| Rate for Payer: BCBS Trust/PPO |
$470.19
|
| Rate for Payer: BCN Commercial |
$1,787.58
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Meridian Medicaid |
$188.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$447.80
|
| Rate for Payer: Priority Health Narrow Network |
$447.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$398.25
|
| Rate for Payer: UHC Exchange |
$398.25
|
| Rate for Payer: UHCCP Medicaid |
$179.99
|
|
|
PR SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY
|
Professional
|
Both
|
$1,009.00
|
|
|
Service Code
|
HCPCS 36014
|
| Min. Negotiated Rate |
$95.00 |
| Max. Negotiated Rate |
$1,156.70 |
| Rate for Payer: Aetna Commercial |
$203.35
|
| Rate for Payer: Aetna Medicare |
$504.50
|
| Rate for Payer: BCBS Complete |
$99.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,081.43
|
| Rate for Payer: BCN Commercial |
$1,156.70
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Meridian Medicaid |
$99.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$655.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.54
|
| Rate for Payer: Priority Health Narrow Network |
$234.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.28
|
| Rate for Payer: UHC Exchange |
$201.28
|
| Rate for Payer: UHCCP Medicaid |
$95.00
|
|
|
PR SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT
|
Professional
|
Both
|
$1,360.00
|
|
|
Service Code
|
HCPCS 36228
|
| Min. Negotiated Rate |
$159.32 |
| Max. Negotiated Rate |
$1,848.67 |
| Rate for Payer: Aetna Commercial |
$325.23
|
| Rate for Payer: Aetna Medicare |
$680.00
|
| Rate for Payer: BCBS Complete |
$167.29
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,848.67
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Meridian Medicaid |
$167.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.48
|
| Rate for Payer: Priority Health Narrow Network |
$392.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$302.05
|
| Rate for Payer: UHC Exchange |
$302.05
|
| Rate for Payer: UHCCP Medicaid |
$159.32
|
|
|
PR SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART
|
Professional
|
Both
|
$1,258.00
|
|
|
Service Code
|
HCPCS 36224
|
| Min. Negotiated Rate |
$235.15 |
| Max. Negotiated Rate |
$2,995.59 |
| Rate for Payer: Aetna Commercial |
$484.13
|
| Rate for Payer: Aetna Medicare |
$629.00
|
| Rate for Payer: BCBS Complete |
$246.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,419.54
|
| Rate for Payer: BCN Commercial |
$2,995.59
|
| Rate for Payer: Cash Price |
$1,006.40
|
| Rate for Payer: Cash Price |
$1,006.40
|
| Rate for Payer: Meridian Medicaid |
$246.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$581.28
|
| Rate for Payer: Priority Health Narrow Network |
$581.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.45
|
| Rate for Payer: UHC Exchange |
$468.45
|
| Rate for Payer: UHCCP Medicaid |
$235.15
|
|
|
PR SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$2,344.00
|
|
|
Service Code
|
HCPCS 36216
|
| Min. Negotiated Rate |
$170.83 |
| Max. Negotiated Rate |
$1,562.31 |
| Rate for Payer: Aetna Commercial |
$363.29
|
| Rate for Payer: Aetna Medicare |
$1,172.00
|
| Rate for Payer: BCBS Complete |
$179.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.56
|
| Rate for Payer: BCN Commercial |
$1,562.31
|
| Rate for Payer: Cash Price |
$1,875.20
|
| Rate for Payer: Cash Price |
$1,875.20
|
| Rate for Payer: Meridian Medicaid |
$179.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,523.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.86
|
| Rate for Payer: Priority Health Narrow Network |
$423.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.30
|
| Rate for Payer: UHC Exchange |
$367.30
|
| Rate for Payer: UHCCP Medicaid |
$170.83
|
|
|
PR SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$1,042.00
|
|
|
Service Code
|
HCPCS 36246
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$1,388.37 |
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: Aetna Medicare |
$521.00
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.37
|
| Rate for Payer: BCN Commercial |
$1,224.14
|
| Rate for Payer: Cash Price |
$833.60
|
| Rate for Payer: Cash Price |
$833.60
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.48
|
| Rate for Payer: Priority Health Narrow Network |
$392.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.19
|
| Rate for Payer: UHC Exchange |
$366.19
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH
|
Professional
|
Both
|
$1,304.00
|
|
|
Service Code
|
HCPCS 36247
|
| Min. Negotiated Rate |
$185.52 |
| Max. Negotiated Rate |
$2,090.07 |
| Rate for Payer: Aetna Commercial |
$402.83
|
| Rate for Payer: Aetna Medicare |
$652.00
|
| Rate for Payer: BCBS Complete |
$194.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.94
|
| Rate for Payer: BCN Commercial |
$2,090.07
|
| Rate for Payer: Cash Price |
$1,043.20
|
| Rate for Payer: Cash Price |
$1,043.20
|
| Rate for Payer: Meridian Medicaid |
$194.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$462.16
|
| Rate for Payer: Priority Health Narrow Network |
$462.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$436.21
|
| Rate for Payer: UHC Exchange |
$436.21
|
| Rate for Payer: UHCCP Medicaid |
$185.52
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$1,377.00
|
|
|
Service Code
|
HCPCS 36217
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$2,617.35 |
| Rate for Payer: Aetna Commercial |
$438.91
|
| Rate for Payer: Aetna Medicare |
$688.50
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,410.56
|
| Rate for Payer: BCN Commercial |
$2,617.35
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.12
|
| Rate for Payer: Priority Health Narrow Network |
$520.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$436.59
|
| Rate for Payer: UHC Exchange |
$436.59
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
|
|
PR SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 36245
|
| Min. Negotiated Rate |
$147.61 |
| Max. Negotiated Rate |
$1,828.14 |
| Rate for Payer: Aetna Commercial |
$315.46
|
| Rate for Payer: Aetna Medicare |
$417.50
|
| Rate for Payer: BCBS Complete |
$154.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.22
|
| Rate for Payer: BCN Commercial |
$1,828.14
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Meridian Medicaid |
$154.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$365.90
|
| Rate for Payer: Priority Health Narrow Network |
$365.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.65
|
| Rate for Payer: UHC Exchange |
$333.65
|
| Rate for Payer: UHCCP Medicaid |
$147.61
|
|
|
PR SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 36215
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$1,519.78 |
| Rate for Payer: Aetna Commercial |
$283.13
|
| Rate for Payer: Aetna Medicare |
$459.00
|
| Rate for Payer: BCBS Complete |
$140.45
|
| Rate for Payer: BCBS Trust/PPO |
$781.36
|
| Rate for Payer: BCN Commercial |
$1,519.78
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Meridian Medicaid |
$140.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.27
|
| Rate for Payer: Priority Health Narrow Network |
$330.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$325.90
|
| Rate for Payer: UHC Exchange |
$325.90
|
| Rate for Payer: UHCCP Medicaid |
$133.76
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 36248
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$1,877.58 |
| Rate for Payer: Aetna Commercial |
$65.59
|
| Rate for Payer: Aetna Medicare |
$121.50
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,877.58
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.45
|
| Rate for Payer: Priority Health Narrow Network |
$74.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.95
|
| Rate for Payer: UHC Exchange |
$68.95
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 36218
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$489.73 |
| Rate for Payer: Aetna Commercial |
$67.37
|
| Rate for Payer: Aetna Medicare |
$164.00
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS Trust/PPO |
$489.73
|
| Rate for Payer: BCN Commercial |
$304.94
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.90
|
| Rate for Payer: Priority Health Narrow Network |
$81.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.39
|
| Rate for Payer: UHC Exchange |
$69.39
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
|
|
PR SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 36015
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$1,252.48 |
| Rate for Payer: Aetna Commercial |
$228.81
|
| Rate for Payer: Aetna Medicare |
$478.00
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,087.24
|
| Rate for Payer: BCN Commercial |
$1,252.48
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.37
|
| Rate for Payer: Priority Health Narrow Network |
$265.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.45
|
| Rate for Payer: UHC Exchange |
$232.45
|
| Rate for Payer: UHCCP Medicaid |
$107.99
|
|
|
PR SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 36011
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$2,329.71 |
| Rate for Payer: Aetna Commercial |
$211.77
|
| Rate for Payer: Aetna Medicare |
$373.50
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,329.71
|
| Rate for Payer: BCN Commercial |
$1,185.05
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.98
|
| Rate for Payer: Priority Health Narrow Network |
$241.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$208.59
|
| Rate for Payer: UHC Exchange |
$208.59
|
| Rate for Payer: UHCCP Medicaid |
$97.55
|
|
|
PR SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC
|
Professional
|
Both
|
$980.00
|
|
|
Service Code
|
HCPCS 36012
|
| Min. Negotiated Rate |
$109.48 |
| Max. Negotiated Rate |
$1,531.54 |
| Rate for Payer: Aetna Commercial |
$232.79
|
| Rate for Payer: Aetna Medicare |
$490.00
|
| Rate for Payer: BCBS Complete |
$114.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.54
|
| Rate for Payer: BCN Commercial |
$1,227.56
|
| Rate for Payer: Cash Price |
$784.00
|
| Rate for Payer: Cash Price |
$784.00
|
| Rate for Payer: Meridian Medicaid |
$114.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.64
|
| Rate for Payer: Priority Health Narrow Network |
$269.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.06
|
| Rate for Payer: UHC Exchange |
$237.06
|
| Rate for Payer: UHCCP Medicaid |
$109.48
|
|
|
PR SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,788.00
|
|
|
Service Code
|
HCPCS 36225
|
| Min. Negotiated Rate |
$208.10 |
| Max. Negotiated Rate |
$2,276.75 |
| Rate for Payer: Aetna Commercial |
$427.29
|
| Rate for Payer: Aetna Medicare |
$894.00
|
| Rate for Payer: BCBS Complete |
$218.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,878.11
|
| Rate for Payer: BCN Commercial |
$2,276.75
|
| Rate for Payer: Cash Price |
$1,430.40
|
| Rate for Payer: Cash Price |
$1,430.40
|
| Rate for Payer: Meridian Medicaid |
$218.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.20
|
| Rate for Payer: Priority Health Narrow Network |
$513.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$428.73
|
| Rate for Payer: UHC Exchange |
$428.73
|
| Rate for Payer: UHCCP Medicaid |
$208.10
|
|
|
PR SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 36226
|
| Min. Negotiated Rate |
$233.45 |
| Max. Negotiated Rate |
$2,912.03 |
| Rate for Payer: Aetna Commercial |
$479.28
|
| Rate for Payer: Aetna Medicare |
$630.00
|
| Rate for Payer: BCBS Complete |
$245.12
|
| Rate for Payer: BCBS Trust/PPO |
$726.41
|
| Rate for Payer: BCN Commercial |
$2,912.03
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Meridian Medicaid |
$245.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$577.56
|
| Rate for Payer: Priority Health Narrow Network |
$577.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$469.34
|
| Rate for Payer: UHC Exchange |
$469.34
|
| Rate for Payer: UHCCP Medicaid |
$233.45
|
|
