|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,621.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,965.75 |
| Max. Negotiated Rate |
$2,621.00 |
| Rate for Payer: Aetna Commercial |
$2,358.90
|
| Rate for Payer: ASR ASR |
$2,542.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,152.37
|
| Rate for Payer: BCN Commercial |
$2,152.37
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$2,463.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,096.80
|
| Rate for Payer: Healthscope Commercial |
$2,542.37
|
| Rate for Payer: Healthscope Whirlpool |
$2,621.00
|
| Rate for Payer: Mclaren Commercial |
$2,358.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,227.85
|
| Rate for Payer: Nomi Health Commercial |
$2,149.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.75
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,621.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$1,965.75 |
| Rate for Payer: Aetna Commercial |
$846.42
|
| Rate for Payer: Aetna Medicare |
$631.66
|
| Rate for Payer: BCBS Complete |
$428.74
|
| Rate for Payer: BCBS MAPPO |
$631.66
|
| Rate for Payer: BCN Commercial |
$1,065.68
|
| Rate for Payer: BCN Medicare Advantage |
$631.66
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$909.59
|
| Rate for Payer: Cofinity Commercial |
$846.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.66
|
| Rate for Payer: Healthscope Commercial |
$757.99
|
| Rate for Payer: Healthscope Whirlpool |
$757.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.24
|
| Rate for Payer: Meridian Medicaid |
$428.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.83
|
| Rate for Payer: Nomi Health Commercial |
$757.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.75
|
| Rate for Payer: PACE SWMI |
$631.66
|
| Rate for Payer: PHP Medicare Advantage |
$631.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,155.57
|
| Rate for Payer: Priority Health Medicare |
$631.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.57
|
| Rate for Payer: Railroad Medicare Medicare |
$631.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.66
|
| Rate for Payer: UHC Exchange |
$1,239.09
|
| Rate for Payer: UHC Medicaid |
$408.32
|
| Rate for Payer: UHCCP DNSP |
$631.66
|
| Rate for Payer: UHCCP Medicaid |
$408.32
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,621.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$1,965.75 |
| Rate for Payer: Aetna Commercial |
$846.42
|
| Rate for Payer: Aetna Medicare |
$631.66
|
| Rate for Payer: BCBS Complete |
$428.74
|
| Rate for Payer: BCBS MAPPO |
$631.66
|
| Rate for Payer: BCN Commercial |
$1,065.68
|
| Rate for Payer: BCN Medicare Advantage |
$631.66
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$909.59
|
| Rate for Payer: Cofinity Commercial |
$846.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.66
|
| Rate for Payer: Healthscope Commercial |
$757.99
|
| Rate for Payer: Healthscope Whirlpool |
$757.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.24
|
| Rate for Payer: Meridian Medicaid |
$428.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.83
|
| Rate for Payer: Nomi Health Commercial |
$757.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.75
|
| Rate for Payer: PACE SWMI |
$631.66
|
| Rate for Payer: PHP Medicare Advantage |
$631.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,155.57
|
| Rate for Payer: Priority Health Medicare |
$631.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.57
|
| Rate for Payer: Railroad Medicare Medicare |
$631.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,239.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.66
|
| Rate for Payer: UHC Exchange |
$1,239.09
|
| Rate for Payer: UHC Medicaid |
$408.32
|
| Rate for Payer: UHCCP DNSP |
$631.66
|
| Rate for Payer: UHCCP Medicaid |
$408.32
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,480.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$541.66 |
| Max. Negotiated Rate |
$1,637.04 |
| Rate for Payer: Aetna Commercial |
$1,123.34
|
| Rate for Payer: Aetna Medicare |
$838.31
|
| Rate for Payer: BCBS Complete |
$568.74
|
| Rate for Payer: BCBS MAPPO |
$838.31
|
| Rate for Payer: BCN Commercial |
$1,414.77
|
| Rate for Payer: BCN Medicare Advantage |
$838.31
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cofinity Commercial |
$1,207.17
|
| Rate for Payer: Cofinity Commercial |
$1,123.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$838.31
|
| Rate for Payer: Healthscope Commercial |
$1,005.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,005.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$880.23
|
| Rate for Payer: Meridian Medicaid |
$568.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$922.14
|
| Rate for Payer: Nomi Health Commercial |
$1,005.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,110.00
|
| Rate for Payer: PACE SWMI |
$838.31
|
| Rate for Payer: PHP Medicare Advantage |
$838.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,534.08
|
| Rate for Payer: Priority Health Medicare |
$838.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.08
|
| Rate for Payer: Railroad Medicare Medicare |
$838.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,637.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$838.31
|
| Rate for Payer: UHC Exchange |
$1,637.04
|
| Rate for Payer: UHC Medicaid |
$541.66
|
| Rate for Payer: UHCCP DNSP |
$838.31
|
| Rate for Payer: UHCCP Medicaid |
$541.66
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,741.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$1,759.38 |
| Max. Negotiated Rate |
$5,358.88 |
| Rate for Payer: Aetna Commercial |
$3,696.86
|
| Rate for Payer: Aetna Medicare |
$2,758.85
|
| Rate for Payer: BCBS Complete |
$1,847.35
|
| Rate for Payer: BCBS MAPPO |
$2,758.85
|
| Rate for Payer: BCN Commercial |
$4,398.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,758.85
|
| Rate for Payer: Cash Price |
$4,592.80
|
| Rate for Payer: Cash Price |
$4,592.80
|
| Rate for Payer: Cofinity Commercial |
$3,972.74
|
| Rate for Payer: Cofinity Commercial |
$3,696.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,758.85
|
| Rate for Payer: Healthscope Commercial |
$3,310.62
|
| Rate for Payer: Healthscope Whirlpool |
$3,310.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,896.79
|
| Rate for Payer: Meridian Medicaid |
$1,847.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,034.74
|
| Rate for Payer: Nomi Health Commercial |
$3,310.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,305.75
|
| Rate for Payer: PACE SWMI |
$2,758.85
|
| Rate for Payer: PHP Medicare Advantage |
$2,758.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,759.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,358.88
|
| Rate for Payer: Priority Health Medicare |
$2,758.85
|
| Rate for Payer: Priority Health Narrow Network |
$5,358.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,758.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,315.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,758.85
|
| Rate for Payer: UHC Exchange |
$5,315.91
|
| Rate for Payer: UHC Medicaid |
$1,759.38
|
| Rate for Payer: UHCCP DNSP |
$2,758.85
|
| Rate for Payer: UHCCP Medicaid |
$1,759.38
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$8,204.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$2,266.11 |
| Max. Negotiated Rate |
$6,830.28 |
| Rate for Payer: Aetna Commercial |
$4,773.90
|
| Rate for Payer: Aetna Medicare |
$3,562.61
|
| Rate for Payer: BCBS Complete |
$2,379.42
|
| Rate for Payer: BCBS MAPPO |
$3,562.61
|
| Rate for Payer: BCN Commercial |
$5,605.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,562.61
|
| Rate for Payer: Cash Price |
$6,563.20
|
| Rate for Payer: Cash Price |
$6,563.20
|
| Rate for Payer: Cofinity Commercial |
$5,130.16
|
| Rate for Payer: Cofinity Commercial |
$4,773.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,562.61
|
| Rate for Payer: Healthscope Commercial |
$4,275.13
|
| Rate for Payer: Healthscope Whirlpool |
$4,275.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,740.74
|
| Rate for Payer: Meridian Medicaid |
$2,379.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,918.87
|
| Rate for Payer: Nomi Health Commercial |
$4,275.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,153.00
|
| Rate for Payer: PACE SWMI |
$3,562.61
|
| Rate for Payer: PHP Medicare Advantage |
$3,562.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,266.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,830.28
|
| Rate for Payer: Priority Health Medicare |
$3,562.61
|
| Rate for Payer: Priority Health Narrow Network |
$6,830.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,562.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,804.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,562.61
|
| Rate for Payer: UHC Exchange |
$6,804.72
|
| Rate for Payer: UHC Medicaid |
$2,266.11
|
| Rate for Payer: UHCCP DNSP |
$3,562.61
|
| Rate for Payer: UHCCP Medicaid |
$2,266.11
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$951.75 |
| Rate for Payer: Aetna Commercial |
$223.16
|
| Rate for Payer: Aetna Medicare |
$166.54
|
| Rate for Payer: BCBS Complete |
$114.73
|
| Rate for Payer: BCBS MAPPO |
$166.54
|
| Rate for Payer: BCN Commercial |
$239.15
|
| Rate for Payer: BCN Medicare Advantage |
$166.54
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$239.82
|
| Rate for Payer: Cofinity Commercial |
$223.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.54
|
| Rate for Payer: Healthscope Commercial |
$199.85
|
| Rate for Payer: Healthscope Whirlpool |
$199.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.87
|
| Rate for Payer: Meridian Medicaid |
$114.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.19
|
| Rate for Payer: Nomi Health Commercial |
$199.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$951.75
|
| Rate for Payer: PACE SWMI |
$166.54
|
| Rate for Payer: PHP Medicare Advantage |
$166.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$355.23
|
| Rate for Payer: Priority Health Medicare |
$166.54
|
| Rate for Payer: Priority Health Narrow Network |
$355.23
|
| Rate for Payer: Railroad Medicare Medicare |
$166.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$354.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$166.54
|
| Rate for Payer: UHC Exchange |
$354.51
|
| Rate for Payer: UHC Medicaid |
$109.27
|
| Rate for Payer: UHCCP DNSP |
$166.54
|
| Rate for Payer: UHCCP Medicaid |
$109.27
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$136.50 |
| Rate for Payer: Aetna Commercial |
$55.90
|
| Rate for Payer: Aetna Medicare |
$41.72
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.72
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$41.72
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$60.08
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.72
|
| Rate for Payer: Healthscope Commercial |
$50.06
|
| Rate for Payer: Healthscope Whirlpool |
$50.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.81
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.89
|
| Rate for Payer: Nomi Health Commercial |
$50.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.50
|
| Rate for Payer: PACE SWMI |
$41.72
|
| Rate for Payer: PHP Medicare Advantage |
$41.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.99
|
| Rate for Payer: Priority Health Medicare |
$41.72
|
| Rate for Payer: Priority Health Narrow Network |
$67.99
|
| Rate for Payer: Railroad Medicare Medicare |
$41.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.72
|
| Rate for Payer: UHC Exchange |
$84.22
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP DNSP |
$41.72
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$216.62 |
| Max. Negotiated Rate |
$631.17 |
| Rate for Payer: Aetna Commercial |
$444.77
|
| Rate for Payer: Aetna Medicare |
$331.92
|
| Rate for Payer: BCBS Complete |
$227.45
|
| Rate for Payer: BCBS MAPPO |
$331.92
|
| Rate for Payer: BCN Commercial |
$564.22
|
| Rate for Payer: BCN Medicare Advantage |
$331.92
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$477.96
|
| Rate for Payer: Cofinity Commercial |
$444.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.92
|
| Rate for Payer: Healthscope Commercial |
$398.30
|
| Rate for Payer: Healthscope Whirlpool |
$398.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.52
|
| Rate for Payer: Meridian Medicaid |
$227.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.11
|
| Rate for Payer: Nomi Health Commercial |
$398.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$448.50
|
| Rate for Payer: PACE SWMI |
$331.92
|
| Rate for Payer: PHP Medicare Advantage |
$331.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$571.43
|
| Rate for Payer: Priority Health Medicare |
$331.92
|
| Rate for Payer: Priority Health Narrow Network |
$571.43
|
| Rate for Payer: Railroad Medicare Medicare |
$331.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$631.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$331.92
|
| Rate for Payer: UHC Exchange |
$631.17
|
| Rate for Payer: UHC Medicaid |
$216.62
|
| Rate for Payer: UHCCP DNSP |
$331.92
|
| Rate for Payer: UHCCP Medicaid |
$216.62
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$190.85 |
| Max. Negotiated Rate |
$735.75 |
| Rate for Payer: Aetna Commercial |
$391.25
|
| Rate for Payer: Aetna Medicare |
$291.98
|
| Rate for Payer: BCBS Complete |
$200.39
|
| Rate for Payer: BCBS MAPPO |
$291.98
|
| Rate for Payer: BCN Commercial |
$503.46
|
| Rate for Payer: BCN Medicare Advantage |
$291.98
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$420.45
|
| Rate for Payer: Cofinity Commercial |
$391.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.98
|
| Rate for Payer: Healthscope Commercial |
$350.38
|
| Rate for Payer: Healthscope Whirlpool |
$350.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.58
|
| Rate for Payer: Meridian Medicaid |
$200.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.18
|
| Rate for Payer: Nomi Health Commercial |
$350.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$735.75
|
| Rate for Payer: PACE SWMI |
$291.98
|
| Rate for Payer: PHP Medicare Advantage |
$291.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$509.89
|
| Rate for Payer: Priority Health Medicare |
$291.98
|
| Rate for Payer: Priority Health Narrow Network |
$509.89
|
| Rate for Payer: Railroad Medicare Medicare |
$291.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$564.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$291.98
|
| Rate for Payer: UHC Exchange |
$564.49
|
| Rate for Payer: UHC Medicaid |
$190.85
|
| Rate for Payer: UHCCP DNSP |
$291.98
|
| Rate for Payer: UHCCP Medicaid |
$190.85
|
|
|
PR TRACHEOBRONCHOSCOPY THRU EST TRACHEOSTOMY INC
|
Professional
|
Both
|
$476.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$134.01
|
| Rate for Payer: Aetna Medicare |
$100.01
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$100.01
|
| Rate for Payer: BCN Commercial |
$173.29
|
| Rate for Payer: BCN Medicare Advantage |
$100.01
|
| Rate for Payer: Cash Price |
$380.80
|
| Rate for Payer: Cash Price |
$380.80
|
| Rate for Payer: Cofinity Commercial |
$144.01
|
| Rate for Payer: Cofinity Commercial |
$134.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.01
|
| Rate for Payer: Healthscope Commercial |
$120.01
|
| Rate for Payer: Healthscope Whirlpool |
$120.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.01
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.01
|
| Rate for Payer: Nomi Health Commercial |
$120.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$357.00
|
| Rate for Payer: PACE SWMI |
$100.01
|
| Rate for Payer: PHP Medicare Advantage |
$100.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$163.20
|
| Rate for Payer: Priority Health Medicare |
$100.01
|
| Rate for Payer: Priority Health Narrow Network |
$163.20
|
| Rate for Payer: Railroad Medicare Medicare |
$100.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$199.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.01
|
| Rate for Payer: UHC Exchange |
$199.60
|
| Rate for Payer: UHC Medicaid |
$64.97
|
| Rate for Payer: UHCCP DNSP |
$100.01
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,537.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$795.34 |
| Max. Negotiated Rate |
$3,402.75 |
| Rate for Payer: Aetna Commercial |
$1,606.81
|
| Rate for Payer: Aetna Medicare |
$1,199.11
|
| Rate for Payer: BCBS Complete |
$835.11
|
| Rate for Payer: BCBS MAPPO |
$1,199.11
|
| Rate for Payer: BCN Commercial |
$2,018.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,199.11
|
| Rate for Payer: Cash Price |
$3,629.60
|
| Rate for Payer: Cash Price |
$3,629.60
|
| Rate for Payer: Cofinity Commercial |
$1,726.72
|
| Rate for Payer: Cofinity Commercial |
$1,606.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,199.11
|
| Rate for Payer: Healthscope Commercial |
$1,438.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,438.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,259.07
|
| Rate for Payer: Meridian Medicaid |
$835.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,319.02
|
| Rate for Payer: Nomi Health Commercial |
$1,438.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,402.75
|
| Rate for Payer: PACE SWMI |
$1,199.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,199.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,900.65
|
| Rate for Payer: Priority Health Medicare |
$1,199.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,900.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,199.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,342.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,199.11
|
| Rate for Payer: UHC Exchange |
$2,342.88
|
| Rate for Payer: UHC Medicaid |
$795.34
|
| Rate for Payer: UHCCP DNSP |
$1,199.11
|
| Rate for Payer: UHCCP Medicaid |
$795.34
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,396.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,244.34 |
| Rate for Payer: Aetna Commercial |
$830.44
|
| Rate for Payer: Aetna Medicare |
$619.73
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS MAPPO |
$619.73
|
| Rate for Payer: BCN Commercial |
$1,065.68
|
| Rate for Payer: BCN Medicare Advantage |
$619.73
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cofinity Commercial |
$892.41
|
| Rate for Payer: Cofinity Commercial |
$830.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.73
|
| Rate for Payer: Healthscope Commercial |
$743.68
|
| Rate for Payer: Healthscope Whirlpool |
$743.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.72
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$681.70
|
| Rate for Payer: Nomi Health Commercial |
$743.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.00
|
| Rate for Payer: PACE SWMI |
$619.73
|
| Rate for Payer: PHP Medicare Advantage |
$619.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,003.56
|
| Rate for Payer: Priority Health Medicare |
$619.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.56
|
| Rate for Payer: Railroad Medicare Medicare |
$619.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,244.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$619.73
|
| Rate for Payer: UHC Exchange |
$1,244.34
|
| Rate for Payer: UHC Medicaid |
$409.60
|
| Rate for Payer: UHCCP DNSP |
$619.73
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$939.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$252.62 |
| Max. Negotiated Rate |
$744.35 |
| Rate for Payer: Aetna Commercial |
$509.76
|
| Rate for Payer: Aetna Medicare |
$380.42
|
| Rate for Payer: BCBS Complete |
$265.25
|
| Rate for Payer: BCBS MAPPO |
$380.42
|
| Rate for Payer: BCN Commercial |
$632.43
|
| Rate for Payer: BCN Medicare Advantage |
$380.42
|
| Rate for Payer: Cash Price |
$751.20
|
| Rate for Payer: Cash Price |
$751.20
|
| Rate for Payer: Cofinity Commercial |
$547.80
|
| Rate for Payer: Cofinity Commercial |
$509.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.42
|
| Rate for Payer: Healthscope Commercial |
$456.50
|
| Rate for Payer: Healthscope Whirlpool |
$456.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.44
|
| Rate for Payer: Meridian Medicaid |
$265.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.46
|
| Rate for Payer: Nomi Health Commercial |
$456.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$704.25
|
| Rate for Payer: PACE SWMI |
$380.42
|
| Rate for Payer: PHP Medicare Advantage |
$380.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$595.57
|
| Rate for Payer: Priority Health Medicare |
$380.42
|
| Rate for Payer: Priority Health Narrow Network |
$595.57
|
| Rate for Payer: Railroad Medicare Medicare |
$380.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$744.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.42
|
| Rate for Payer: UHC Exchange |
$744.35
|
| Rate for Payer: UHC Medicaid |
$252.62
|
| Rate for Payer: UHCCP DNSP |
$380.42
|
| Rate for Payer: UHCCP Medicaid |
$252.62
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$624.75 |
| Rate for Payer: Aetna Commercial |
$407.96
|
| Rate for Payer: Aetna Medicare |
$304.45
|
| Rate for Payer: BCBS Complete |
$202.63
|
| Rate for Payer: BCBS MAPPO |
$304.45
|
| Rate for Payer: BCN Commercial |
$491.51
|
| Rate for Payer: BCN Medicare Advantage |
$304.45
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$438.41
|
| Rate for Payer: Cofinity Commercial |
$407.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.45
|
| Rate for Payer: Healthscope Commercial |
$365.34
|
| Rate for Payer: Healthscope Whirlpool |
$365.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.67
|
| Rate for Payer: Meridian Medicaid |
$202.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.89
|
| Rate for Payer: Nomi Health Commercial |
$365.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.75
|
| Rate for Payer: PACE SWMI |
$304.45
|
| Rate for Payer: PHP Medicare Advantage |
$304.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$462.85
|
| Rate for Payer: Priority Health Medicare |
$304.45
|
| Rate for Payer: Priority Health Narrow Network |
$462.85
|
| Rate for Payer: Railroad Medicare Medicare |
$304.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$598.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.45
|
| Rate for Payer: UHC Exchange |
$598.32
|
| Rate for Payer: UHC Medicaid |
$192.98
|
| Rate for Payer: UHCCP DNSP |
$304.45
|
| Rate for Payer: UHCCP Medicaid |
$192.98
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,225.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$177.64 |
| Max. Negotiated Rate |
$918.75 |
| Rate for Payer: Aetna Commercial |
$374.02
|
| Rate for Payer: Aetna Medicare |
$279.12
|
| Rate for Payer: BCBS Complete |
$186.52
|
| Rate for Payer: BCBS MAPPO |
$279.12
|
| Rate for Payer: BCN Commercial |
$473.58
|
| Rate for Payer: BCN Medicare Advantage |
$279.12
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cofinity Commercial |
$401.93
|
| Rate for Payer: Cofinity Commercial |
$374.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.12
|
| Rate for Payer: Healthscope Commercial |
$334.94
|
| Rate for Payer: Healthscope Whirlpool |
$334.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.08
|
| Rate for Payer: Meridian Medicaid |
$186.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.03
|
| Rate for Payer: Nomi Health Commercial |
$334.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$918.75
|
| Rate for Payer: PACE SWMI |
$279.12
|
| Rate for Payer: PHP Medicare Advantage |
$279.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$445.98
|
| Rate for Payer: Priority Health Medicare |
$279.12
|
| Rate for Payer: Priority Health Narrow Network |
$445.98
|
| Rate for Payer: Railroad Medicare Medicare |
$279.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$571.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$279.12
|
| Rate for Payer: UHC Exchange |
$571.71
|
| Rate for Payer: UHC Medicaid |
$177.64
|
| Rate for Payer: UHCCP DNSP |
$279.12
|
| Rate for Payer: UHCCP Medicaid |
$177.64
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$548.90 |
| Max. Negotiated Rate |
$1,640.80 |
| Rate for Payer: Aetna Commercial |
$1,117.17
|
| Rate for Payer: Aetna Medicare |
$833.71
|
| Rate for Payer: BCBS Complete |
$576.35
|
| Rate for Payer: BCBS MAPPO |
$833.71
|
| Rate for Payer: BCN Commercial |
$1,428.21
|
| Rate for Payer: BCN Medicare Advantage |
$833.71
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$1,200.54
|
| Rate for Payer: Cofinity Commercial |
$1,117.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$833.71
|
| Rate for Payer: Healthscope Commercial |
$1,000.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,000.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$875.40
|
| Rate for Payer: Meridian Medicaid |
$576.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$917.08
|
| Rate for Payer: Nomi Health Commercial |
$1,000.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,196.25
|
| Rate for Payer: PACE SWMI |
$833.71
|
| Rate for Payer: PHP Medicare Advantage |
$833.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,344.95
|
| Rate for Payer: Priority Health Medicare |
$833.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,344.95
|
| Rate for Payer: Railroad Medicare Medicare |
$833.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,640.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$833.71
|
| Rate for Payer: UHC Exchange |
$1,640.80
|
| Rate for Payer: UHC Medicaid |
$548.90
|
| Rate for Payer: UHCCP DNSP |
$833.71
|
| Rate for Payer: UHCCP Medicaid |
$548.90
|
|
|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$811.50 |
| Rate for Payer: Aetna Commercial |
$365.71
|
| Rate for Payer: Aetna Medicare |
$272.92
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$272.92
|
| Rate for Payer: BCN Commercial |
$452.17
|
| Rate for Payer: BCN Medicare Advantage |
$272.92
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$393.00
|
| Rate for Payer: Cofinity Commercial |
$365.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.92
|
| Rate for Payer: Healthscope Commercial |
$327.50
|
| Rate for Payer: Healthscope Whirlpool |
$327.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.57
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.21
|
| Rate for Payer: Nomi Health Commercial |
$327.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$811.50
|
| Rate for Payer: PACE SWMI |
$272.92
|
| Rate for Payer: PHP Medicare Advantage |
$272.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$425.81
|
| Rate for Payer: Priority Health Medicare |
$272.92
|
| Rate for Payer: Priority Health Narrow Network |
$425.81
|
| Rate for Payer: Railroad Medicare Medicare |
$272.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$545.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$272.92
|
| Rate for Payer: UHC Exchange |
$545.80
|
| Rate for Payer: UHC Medicaid |
$174.23
|
| Rate for Payer: UHCCP DNSP |
$272.92
|
| Rate for Payer: UHCCP Medicaid |
$174.23
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,069.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$241.97 |
| Max. Negotiated Rate |
$801.75 |
| Rate for Payer: Aetna Commercial |
$505.60
|
| Rate for Payer: Aetna Medicare |
$377.31
|
| Rate for Payer: BCBS Complete |
$254.07
|
| Rate for Payer: BCBS MAPPO |
$377.31
|
| Rate for Payer: BCN Commercial |
$669.28
|
| Rate for Payer: BCN Medicare Advantage |
$377.31
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cash Price |
$855.20
|
| Rate for Payer: Cofinity Commercial |
$543.33
|
| Rate for Payer: Cofinity Commercial |
$505.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.31
|
| Rate for Payer: Healthscope Commercial |
$452.77
|
| Rate for Payer: Healthscope Whirlpool |
$452.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$396.18
|
| Rate for Payer: Meridian Medicaid |
$254.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$415.04
|
| Rate for Payer: Nomi Health Commercial |
$452.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.75
|
| Rate for Payer: PACE SWMI |
$377.31
|
| Rate for Payer: PHP Medicare Advantage |
$377.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$630.27
|
| Rate for Payer: Priority Health Medicare |
$377.31
|
| Rate for Payer: Priority Health Narrow Network |
$630.27
|
| Rate for Payer: Railroad Medicare Medicare |
$377.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$790.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$377.31
|
| Rate for Payer: UHC Exchange |
$790.81
|
| Rate for Payer: UHC Medicaid |
$241.97
|
| Rate for Payer: UHCCP DNSP |
$377.31
|
| Rate for Payer: UHCCP Medicaid |
$241.97
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$61.98 |
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: Aetna Medicare |
$30.16
|
| Rate for Payer: BCBS Complete |
$20.35
|
| Rate for Payer: BCBS MAPPO |
$30.16
|
| Rate for Payer: BCN Commercial |
$51.29
|
| Rate for Payer: BCN Medicare Advantage |
$30.16
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$43.43
|
| Rate for Payer: Cofinity Commercial |
$40.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.16
|
| Rate for Payer: Healthscope Commercial |
$36.19
|
| Rate for Payer: Healthscope Whirlpool |
$36.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.67
|
| Rate for Payer: Meridian Medicaid |
$20.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.18
|
| Rate for Payer: Nomi Health Commercial |
$36.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: PACE SWMI |
$30.16
|
| Rate for Payer: PHP Medicare Advantage |
$30.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.31
|
| Rate for Payer: Priority Health Medicare |
$30.16
|
| Rate for Payer: Priority Health Narrow Network |
$48.31
|
| Rate for Payer: Railroad Medicare Medicare |
$30.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.16
|
| Rate for Payer: UHC Exchange |
$61.98
|
| Rate for Payer: UHC Medicaid |
$19.38
|
| Rate for Payer: UHCCP DNSP |
$30.16
|
| Rate for Payer: UHCCP Medicaid |
$19.38
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,427.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$378.71 |
| Max. Negotiated Rate |
$1,181.55 |
| Rate for Payer: Aetna Commercial |
$800.23
|
| Rate for Payer: Aetna Medicare |
$597.19
|
| Rate for Payer: BCBS Complete |
$397.65
|
| Rate for Payer: BCBS MAPPO |
$597.19
|
| Rate for Payer: BCN Commercial |
$957.62
|
| Rate for Payer: BCN Medicare Advantage |
$597.19
|
| Rate for Payer: Cash Price |
$1,141.60
|
| Rate for Payer: Cash Price |
$1,141.60
|
| Rate for Payer: Cofinity Commercial |
$859.95
|
| Rate for Payer: Cofinity Commercial |
$800.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.19
|
| Rate for Payer: Healthscope Commercial |
$716.63
|
| Rate for Payer: Healthscope Whirlpool |
$716.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.05
|
| Rate for Payer: Meridian Medicaid |
$397.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$656.91
|
| Rate for Payer: Nomi Health Commercial |
$716.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,070.25
|
| Rate for Payer: PACE SWMI |
$597.19
|
| Rate for Payer: PHP Medicare Advantage |
$597.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,029.79
|
| Rate for Payer: Priority Health Medicare |
$597.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,029.79
|
| Rate for Payer: Railroad Medicare Medicare |
$597.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,181.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$597.19
|
| Rate for Payer: UHC Exchange |
$1,181.55
|
| Rate for Payer: UHC Medicaid |
$378.71
|
| Rate for Payer: UHCCP DNSP |
$597.19
|
| Rate for Payer: UHCCP Medicaid |
$378.71
|
|
|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,835.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$893.11 |
| Max. Negotiated Rate |
$4,376.25 |
| Rate for Payer: Aetna Commercial |
$1,891.16
|
| Rate for Payer: Aetna Medicare |
$1,411.31
|
| Rate for Payer: BCBS Complete |
$937.77
|
| Rate for Payer: BCBS MAPPO |
$1,411.31
|
| Rate for Payer: BCN Commercial |
$2,296.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,411.31
|
| Rate for Payer: Cash Price |
$4,668.00
|
| Rate for Payer: Cash Price |
$4,668.00
|
| Rate for Payer: Cofinity Commercial |
$1,891.16
|
| Rate for Payer: Cofinity Commercial |
$2,032.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,411.31
|
| Rate for Payer: Healthscope Commercial |
$1,693.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,693.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,481.88
|
| Rate for Payer: Meridian Medicaid |
$937.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,552.44
|
| Rate for Payer: Nomi Health Commercial |
$1,693.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,376.25
|
| Rate for Payer: PACE SWMI |
$1,411.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,411.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$893.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,469.27
|
| Rate for Payer: Priority Health Medicare |
$1,411.31
|
| Rate for Payer: Priority Health Narrow Network |
$2,469.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,411.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,818.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,411.31
|
| Rate for Payer: UHC Exchange |
$2,818.57
|
| Rate for Payer: UHC Medicaid |
$893.11
|
| Rate for Payer: UHCCP DNSP |
$1,411.31
|
| Rate for Payer: UHCCP Medicaid |
$893.11
|
|
|
PR TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 0387T
|
| Min. Negotiated Rate |
$671.60 |
| Max. Negotiated Rate |
$1,259.25 |
| Rate for Payer: BCBS Complete |
$671.60
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.25
|
|
|
PR TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 75960
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$92.25 |
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.25
|
|
|
PR TRANSCATH OCCLUSION,PERCUT
|
Professional
|
Both
|
$1,912.00
|
|
|
Service Code
|
HCPCS 37204
|
| Min. Negotiated Rate |
$764.80 |
| Max. Negotiated Rate |
$1,434.00 |
| Rate for Payer: BCBS Complete |
$764.80
|
| Rate for Payer: Cash Price |
$1,529.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,434.00
|
|
