|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE
|
Professional
|
Both
|
$951.00
|
|
|
Service Code
|
HCPCS 53505
|
| Min. Negotiated Rate |
$284.78 |
| Max. Negotiated Rate |
$853.42 |
| Rate for Payer: Aetna Commercial |
$587.84
|
| Rate for Payer: Aetna Medicare |
$438.69
|
| Rate for Payer: BCBS Complete |
$299.02
|
| Rate for Payer: BCBS MAPPO |
$438.69
|
| Rate for Payer: BCN Commercial |
$732.03
|
| Rate for Payer: BCN Medicare Advantage |
$438.69
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cofinity Commercial |
$631.71
|
| Rate for Payer: Cofinity Commercial |
$587.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.69
|
| Rate for Payer: Healthscope Commercial |
$526.43
|
| Rate for Payer: Healthscope Whirlpool |
$526.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$460.62
|
| Rate for Payer: Meridian Medicaid |
$299.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$482.56
|
| Rate for Payer: Nomi Health Commercial |
$526.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.25
|
| Rate for Payer: PACE SWMI |
$438.69
|
| Rate for Payer: PHP Medicare Advantage |
$438.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$797.41
|
| Rate for Payer: Priority Health Medicare |
$438.69
|
| Rate for Payer: Priority Health Narrow Network |
$797.41
|
| Rate for Payer: Railroad Medicare Medicare |
$438.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$853.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$438.69
|
| Rate for Payer: UHC Exchange |
$853.42
|
| Rate for Payer: UHC Medicaid |
$284.78
|
| Rate for Payer: UHCCP DNSP |
$438.69
|
| Rate for Payer: UHCCP Medicaid |
$284.78
|
|
|
PR URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 53010
|
| Min. Negotiated Rate |
$179.35 |
| Max. Negotiated Rate |
$514.26 |
| Rate for Payer: Aetna Commercial |
$366.48
|
| Rate for Payer: Aetna Medicare |
$273.49
|
| Rate for Payer: BCBS Complete |
$188.32
|
| Rate for Payer: BCBS MAPPO |
$273.49
|
| Rate for Payer: BCN Commercial |
$451.17
|
| Rate for Payer: BCN Medicare Advantage |
$273.49
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$393.83
|
| Rate for Payer: Cofinity Commercial |
$366.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.49
|
| Rate for Payer: Healthscope Commercial |
$328.19
|
| Rate for Payer: Healthscope Whirlpool |
$328.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.16
|
| Rate for Payer: Meridian Medicaid |
$188.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.84
|
| Rate for Payer: Nomi Health Commercial |
$328.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$427.50
|
| Rate for Payer: PACE SWMI |
$273.49
|
| Rate for Payer: PHP Medicare Advantage |
$273.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$491.47
|
| Rate for Payer: Priority Health Medicare |
$273.49
|
| Rate for Payer: Priority Health Narrow Network |
$491.47
|
| Rate for Payer: Railroad Medicare Medicare |
$273.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$273.49
|
| Rate for Payer: UHC Exchange |
$514.26
|
| Rate for Payer: UHC Medicaid |
$179.35
|
| Rate for Payer: UHCCP DNSP |
$273.49
|
| Rate for Payer: UHCCP Medicaid |
$179.35
|
|
|
PR URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,451.00
|
|
|
Service Code
|
HCPCS 50650
|
| Min. Negotiated Rate |
$593.84 |
| Max. Negotiated Rate |
$2,588.25 |
| Rate for Payer: Aetna Commercial |
$1,234.80
|
| Rate for Payer: Aetna Medicare |
$921.49
|
| Rate for Payer: BCBS Complete |
$623.53
|
| Rate for Payer: BCBS MAPPO |
$921.49
|
| Rate for Payer: BCN Commercial |
$1,548.72
|
| Rate for Payer: BCN Medicare Advantage |
$921.49
|
| Rate for Payer: Cash Price |
$2,760.80
|
| Rate for Payer: Cash Price |
$2,760.80
|
| Rate for Payer: Cofinity Commercial |
$1,326.95
|
| Rate for Payer: Cofinity Commercial |
$1,234.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$921.49
|
| Rate for Payer: Healthscope Commercial |
$1,105.79
|
| Rate for Payer: Healthscope Whirlpool |
$1,105.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$967.56
|
| Rate for Payer: Meridian Medicaid |
$623.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,013.64
|
| Rate for Payer: Nomi Health Commercial |
$1,105.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,588.25
|
| Rate for Payer: PACE SWMI |
$921.49
|
| Rate for Payer: PHP Medicare Advantage |
$921.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,687.07
|
| Rate for Payer: Priority Health Medicare |
$921.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,687.07
|
| Rate for Payer: Railroad Medicare Medicare |
$921.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,836.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$921.49
|
| Rate for Payer: UHC Exchange |
$1,836.22
|
| Rate for Payer: UHC Medicaid |
$593.84
|
| Rate for Payer: UHCCP DNSP |
$921.49
|
| Rate for Payer: UHCCP Medicaid |
$593.84
|
|
|
PR URINARY LEG OR ABDOMEN BAG
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS A4358
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$12.02 |
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$8.35
|
| Rate for Payer: BCN Commercial |
$8.00
|
| Rate for Payer: BCN Medicare Advantage |
$8.35
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$12.02
|
| Rate for Payer: Cofinity Commercial |
$11.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.35
|
| Rate for Payer: Healthscope Commercial |
$10.02
|
| Rate for Payer: Healthscope Whirlpool |
$10.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.19
|
| Rate for Payer: Nomi Health Commercial |
$10.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: PACE SWMI |
$8.35
|
| Rate for Payer: PHP Medicare Advantage |
$8.35
|
| Rate for Payer: Priority Health Medicare |
$8.35
|
| Rate for Payer: Railroad Medicare Medicare |
$8.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.35
|
| Rate for Payer: UHC Exchange |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$8.35
|
|
|
PR URINARY SUSPENSORY
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS A5105
|
| Min. Negotiated Rate |
$18.95 |
| Max. Negotiated Rate |
$83.68 |
| Rate for Payer: Aetna Commercial |
$77.87
|
| Rate for Payer: Aetna Medicare |
$58.11
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: BCBS MAPPO |
$58.11
|
| Rate for Payer: BCN Commercial |
$55.63
|
| Rate for Payer: BCN Medicare Advantage |
$58.11
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$83.68
|
| Rate for Payer: Cofinity Commercial |
$77.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.11
|
| Rate for Payer: Healthscope Commercial |
$69.73
|
| Rate for Payer: Healthscope Whirlpool |
$69.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.92
|
| Rate for Payer: Nomi Health Commercial |
$69.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
| Rate for Payer: PACE SWMI |
$58.11
|
| Rate for Payer: PHP Medicare Advantage |
$58.11
|
| Rate for Payer: Priority Health Medicare |
$58.11
|
| Rate for Payer: Railroad Medicare Medicare |
$58.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.11
|
| Rate for Payer: UHC Exchange |
$18.95
|
| Rate for Payer: UHCCP DNSP |
$58.11
|
|
|
PR URTP W/TUBULARIZATION POST URT&/LWR BLDR
|
Professional
|
Both
|
$2,272.00
|
|
|
Service Code
|
HCPCS 53431
|
| Min. Negotiated Rate |
$657.11 |
| Max. Negotiated Rate |
$2,040.32 |
| Rate for Payer: Aetna Commercial |
$1,366.67
|
| Rate for Payer: Aetna Medicare |
$1,019.90
|
| Rate for Payer: BCBS Complete |
$689.97
|
| Rate for Payer: BCBS MAPPO |
$1,019.90
|
| Rate for Payer: BCN Commercial |
$1,717.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,019.90
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cofinity Commercial |
$1,468.66
|
| Rate for Payer: Cofinity Commercial |
$1,366.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,019.90
|
| Rate for Payer: Healthscope Commercial |
$1,223.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,223.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,070.89
|
| Rate for Payer: Meridian Medicaid |
$689.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,121.89
|
| Rate for Payer: Nomi Health Commercial |
$1,223.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,704.00
|
| Rate for Payer: PACE SWMI |
$1,019.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,019.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,870.95
|
| Rate for Payer: Priority Health Medicare |
$1,019.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,870.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,019.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,040.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,019.90
|
| Rate for Payer: UHC Exchange |
$2,040.32
|
| Rate for Payer: UHC Medicaid |
$657.11
|
| Rate for Payer: UHCCP DNSP |
$1,019.90
|
| Rate for Payer: UHCCP Medicaid |
$657.11
|
|
|
PR URTROLITHOTOMY MIDDLE ONE-THIRD URETER
|
Professional
|
Both
|
$1,675.00
|
|
|
Service Code
|
HCPCS 50620
|
| Min. Negotiated Rate |
$517.38 |
| Max. Negotiated Rate |
$1,597.32 |
| Rate for Payer: Aetna Commercial |
$1,074.87
|
| Rate for Payer: Aetna Medicare |
$802.14
|
| Rate for Payer: BCBS Complete |
$543.25
|
| Rate for Payer: BCBS MAPPO |
$802.14
|
| Rate for Payer: BCN Commercial |
$1,348.04
|
| Rate for Payer: BCN Medicare Advantage |
$802.14
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cofinity Commercial |
$1,155.08
|
| Rate for Payer: Cofinity Commercial |
$1,074.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.14
|
| Rate for Payer: Healthscope Commercial |
$962.57
|
| Rate for Payer: Healthscope Whirlpool |
$962.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.25
|
| Rate for Payer: Meridian Medicaid |
$543.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$882.35
|
| Rate for Payer: Nomi Health Commercial |
$962.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.25
|
| Rate for Payer: PACE SWMI |
$802.14
|
| Rate for Payer: PHP Medicare Advantage |
$802.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,468.45
|
| Rate for Payer: Priority Health Medicare |
$802.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,468.45
|
| Rate for Payer: Railroad Medicare Medicare |
$802.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,597.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.14
|
| Rate for Payer: UHC Exchange |
$1,597.32
|
| Rate for Payer: UHC Medicaid |
$517.38
|
| Rate for Payer: UHCCP DNSP |
$802.14
|
| Rate for Payer: UHCCP Medicaid |
$517.38
|
|
|
PR URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP
|
Professional
|
Both
|
$4,792.00
|
|
|
Service Code
|
HCPCS 50785
|
| Min. Negotiated Rate |
$691.82 |
| Max. Negotiated Rate |
$3,594.00 |
| Rate for Payer: Aetna Commercial |
$1,440.34
|
| Rate for Payer: Aetna Medicare |
$1,074.88
|
| Rate for Payer: BCBS Complete |
$726.41
|
| Rate for Payer: BCBS MAPPO |
$1,074.88
|
| Rate for Payer: BCN Commercial |
$1,812.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,074.88
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cofinity Commercial |
$1,547.83
|
| Rate for Payer: Cofinity Commercial |
$1,440.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,074.88
|
| Rate for Payer: Healthscope Commercial |
$1,289.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,289.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,128.62
|
| Rate for Payer: Meridian Medicaid |
$726.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,182.37
|
| Rate for Payer: Nomi Health Commercial |
$1,289.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,594.00
|
| Rate for Payer: PACE SWMI |
$1,074.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,074.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,974.03
|
| Rate for Payer: Priority Health Medicare |
$1,074.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,974.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,074.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,146.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,074.88
|
| Rate for Payer: UHC Exchange |
$2,146.86
|
| Rate for Payer: UHC Medicaid |
$691.82
|
| Rate for Payer: UHCCP DNSP |
$1,074.88
|
| Rate for Payer: UHCCP Medicaid |
$691.82
|
|
|
PR URTT/URTS XTRNL SPX PENDULOUS URETHRA
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 53000
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$259.21 |
| Rate for Payer: Aetna Commercial |
$181.13
|
| Rate for Payer: Aetna Medicare |
$135.17
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$135.17
|
| Rate for Payer: BCN Commercial |
$223.60
|
| Rate for Payer: BCN Medicare Advantage |
$135.17
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cofinity Commercial |
$194.64
|
| Rate for Payer: Cofinity Commercial |
$181.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.17
|
| Rate for Payer: Healthscope Commercial |
$162.20
|
| Rate for Payer: Healthscope Whirlpool |
$162.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.93
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.69
|
| Rate for Payer: Nomi Health Commercial |
$162.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: PACE SWMI |
$135.17
|
| Rate for Payer: PHP Medicare Advantage |
$135.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$243.57
|
| Rate for Payer: Priority Health Medicare |
$135.17
|
| Rate for Payer: Priority Health Narrow Network |
$243.57
|
| Rate for Payer: Railroad Medicare Medicare |
$135.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.17
|
| Rate for Payer: UHC Exchange |
$259.21
|
| Rate for Payer: UHC Medicaid |
$88.40
|
| Rate for Payer: UHCCP DNSP |
$135.17
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR USE OF ECHO CONTRAST AGENT DURING STRESS ECHO
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 93352
|
| Min. Negotiated Rate |
$33.33 |
| Max. Negotiated Rate |
$52.29 |
| Rate for Payer: Aetna Commercial |
$44.66
|
| Rate for Payer: Aetna Medicare |
$33.33
|
| Rate for Payer: BCBS MAPPO |
$33.33
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$33.33
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.33
|
| Rate for Payer: Healthscope Commercial |
$40.00
|
| Rate for Payer: Healthscope Whirlpool |
$40.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.66
|
| Rate for Payer: Nomi Health Commercial |
$40.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.25
|
| Rate for Payer: PACE SWMI |
$33.33
|
| Rate for Payer: PHP Medicare Advantage |
$33.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.69
|
| Rate for Payer: Priority Health Medicare |
$33.33
|
| Rate for Payer: Priority Health Narrow Network |
$49.69
|
| Rate for Payer: Railroad Medicare Medicare |
$33.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.33
|
| Rate for Payer: UHC Exchange |
$51.54
|
| Rate for Payer: UHCCP DNSP |
$33.33
|
|
|
PR USE VERTICAL ELECTRODES
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 92547
|
| Min. Negotiated Rate |
$10.06 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Aetna Commercial |
$13.48
|
| Rate for Payer: Aetna Medicare |
$10.06
|
| Rate for Payer: BCBS MAPPO |
$10.06
|
| Rate for Payer: BCN Commercial |
$15.44
|
| Rate for Payer: BCN Medicare Advantage |
$10.06
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$13.48
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.06
|
| Rate for Payer: Healthscope Commercial |
$12.07
|
| Rate for Payer: Healthscope Whirlpool |
$12.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.07
|
| Rate for Payer: Nomi Health Commercial |
$12.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.25
|
| Rate for Payer: PACE SWMI |
$10.06
|
| Rate for Payer: PHP Medicare Advantage |
$10.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14.24
|
| Rate for Payer: Priority Health Medicare |
$10.06
|
| Rate for Payer: Priority Health Narrow Network |
$14.24
|
| Rate for Payer: Railroad Medicare Medicare |
$10.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.06
|
| Rate for Payer: UHC Exchange |
$12.77
|
| Rate for Payer: UHCCP DNSP |
$10.06
|
|
|
PR UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 59870
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$889.82 |
| Rate for Payer: Aetna Commercial |
$635.25
|
| Rate for Payer: Aetna Medicare |
$474.07
|
| Rate for Payer: BCBS Complete |
$323.18
|
| Rate for Payer: BCBS MAPPO |
$474.07
|
| Rate for Payer: BCN Commercial |
$806.23
|
| Rate for Payer: BCN Medicare Advantage |
$474.07
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$682.66
|
| Rate for Payer: Cofinity Commercial |
$635.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.07
|
| Rate for Payer: Healthscope Commercial |
$568.88
|
| Rate for Payer: Healthscope Whirlpool |
$568.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.77
|
| Rate for Payer: Meridian Medicaid |
$323.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$521.48
|
| Rate for Payer: Nomi Health Commercial |
$568.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.75
|
| Rate for Payer: PACE SWMI |
$474.07
|
| Rate for Payer: PHP Medicare Advantage |
$474.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$761.09
|
| Rate for Payer: Priority Health Medicare |
$474.07
|
| Rate for Payer: Priority Health Narrow Network |
$761.09
|
| Rate for Payer: Railroad Medicare Medicare |
$474.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$889.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$474.07
|
| Rate for Payer: UHC Exchange |
$889.82
|
| Rate for Payer: UHC Medicaid |
$307.79
|
| Rate for Payer: UHCCP DNSP |
$474.07
|
| Rate for Payer: UHCCP Medicaid |
$307.79
|
|
|
PR UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 58400
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$798.59 |
| Rate for Payer: Aetna Commercial |
$546.77
|
| Rate for Payer: Aetna Medicare |
$408.04
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCBS MAPPO |
$408.04
|
| Rate for Payer: BCN Commercial |
$693.19
|
| Rate for Payer: BCN Medicare Advantage |
$408.04
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$546.77
|
| Rate for Payer: Cofinity Commercial |
$587.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.04
|
| Rate for Payer: Healthscope Commercial |
$489.65
|
| Rate for Payer: Healthscope Whirlpool |
$489.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.44
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$448.84
|
| Rate for Payer: Nomi Health Commercial |
$489.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$408.04
|
| Rate for Payer: PHP Medicare Advantage |
$408.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$702.05
|
| Rate for Payer: Priority Health Medicare |
$408.04
|
| Rate for Payer: Priority Health Narrow Network |
$702.05
|
| Rate for Payer: Railroad Medicare Medicare |
$408.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$798.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$408.04
|
| Rate for Payer: UHC Exchange |
$798.59
|
| Rate for Payer: UHC Medicaid |
$265.19
|
| Rate for Payer: UHCCP DNSP |
$408.04
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
|
|
PR U-TUBE HEPATICOENTEROSTOMY
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 47802
|
| Min. Negotiated Rate |
$1,126.40 |
| Max. Negotiated Rate |
$2,253.40 |
| Rate for Payer: Aetna Commercial |
$2,068.89
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: BCN Commercial |
$2,253.40
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,112.00
|
|
|
PR UVULECTOMY EXCISION UVULA
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 42140
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$442.50 |
| Rate for Payer: Aetna Commercial |
$194.62
|
| Rate for Payer: Aetna Medicare |
$145.24
|
| Rate for Payer: BCBS Complete |
$101.77
|
| Rate for Payer: BCBS MAPPO |
$145.24
|
| Rate for Payer: BCN Commercial |
$247.99
|
| Rate for Payer: BCN Medicare Advantage |
$145.24
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cofinity Commercial |
$209.15
|
| Rate for Payer: Cofinity Commercial |
$194.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.24
|
| Rate for Payer: Healthscope Commercial |
$174.29
|
| Rate for Payer: Healthscope Whirlpool |
$174.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.50
|
| Rate for Payer: Meridian Medicaid |
$101.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.76
|
| Rate for Payer: Nomi Health Commercial |
$174.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
| Rate for Payer: PACE SWMI |
$145.24
|
| Rate for Payer: PHP Medicare Advantage |
$145.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$302.17
|
| Rate for Payer: Priority Health Medicare |
$145.24
|
| Rate for Payer: Priority Health Narrow Network |
$302.17
|
| Rate for Payer: Railroad Medicare Medicare |
$145.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$266.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$145.24
|
| Rate for Payer: UHC Exchange |
$266.60
|
| Rate for Payer: UHC Medicaid |
$96.92
|
| Rate for Payer: UHCCP DNSP |
$145.24
|
| Rate for Payer: UHCCP Medicaid |
$96.92
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,218.00
|
|
|
Service Code
|
HCPCS 58291
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$1,456.85
|
| Rate for Payer: Aetna Medicare |
$1,087.20
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS MAPPO |
$1,087.20
|
| Rate for Payer: BCN Commercial |
$1,859.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,087.20
|
| Rate for Payer: Cash Price |
$2,574.40
|
| Rate for Payer: Cash Price |
$2,574.40
|
| Rate for Payer: Cofinity Commercial |
$1,565.57
|
| Rate for Payer: Cofinity Commercial |
$1,456.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,087.20
|
| Rate for Payer: Healthscope Commercial |
$1,304.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,304.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,141.56
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,195.92
|
| Rate for Payer: Nomi Health Commercial |
$1,304.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,413.50
|
| Rate for Payer: PACE SWMI |
$1,087.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,087.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,883.23
|
| Rate for Payer: Priority Health Medicare |
$1,087.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,883.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,087.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,218.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,087.20
|
| Rate for Payer: UHC Exchange |
$2,218.50
|
| Rate for Payer: UHC Medicaid |
$696.72
|
| Rate for Payer: UHCCP DNSP |
$1,087.20
|
| Rate for Payer: UHCCP Medicaid |
$696.72
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE
|
Professional
|
Both
|
$3,561.00
|
|
|
Service Code
|
HCPCS 58292
|
| Min. Negotiated Rate |
$733.79 |
| Max. Negotiated Rate |
$2,670.75 |
| Rate for Payer: Aetna Commercial |
$1,534.98
|
| Rate for Payer: Aetna Medicare |
$1,145.51
|
| Rate for Payer: BCBS Complete |
$770.48
|
| Rate for Payer: BCBS MAPPO |
$1,145.51
|
| Rate for Payer: BCN Commercial |
$1,958.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,145.51
|
| Rate for Payer: Cash Price |
$2,848.80
|
| Rate for Payer: Cash Price |
$2,848.80
|
| Rate for Payer: Cofinity Commercial |
$1,649.53
|
| Rate for Payer: Cofinity Commercial |
$1,534.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,145.51
|
| Rate for Payer: Healthscope Commercial |
$1,374.61
|
| Rate for Payer: Healthscope Whirlpool |
$1,374.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,202.79
|
| Rate for Payer: Meridian Medicaid |
$770.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,260.06
|
| Rate for Payer: Nomi Health Commercial |
$1,374.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,670.75
|
| Rate for Payer: PACE SWMI |
$1,145.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,145.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,983.60
|
| Rate for Payer: Priority Health Medicare |
$1,145.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,983.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,145.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,339.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,145.51
|
| Rate for Payer: UHC Exchange |
$2,339.52
|
| Rate for Payer: UHC Medicaid |
$733.79
|
| Rate for Payer: UHCCP DNSP |
$1,145.51
|
| Rate for Payer: UHCCP Medicaid |
$733.79
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,062.00
|
|
|
Service Code
|
HCPCS 58262
|
| Min. Negotiated Rate |
$522.06 |
| Max. Negotiated Rate |
$2,296.50 |
| Rate for Payer: Aetna Commercial |
$1,087.99
|
| Rate for Payer: Aetna Medicare |
$811.93
|
| Rate for Payer: BCBS Complete |
$548.16
|
| Rate for Payer: BCBS MAPPO |
$811.93
|
| Rate for Payer: BCN Commercial |
$1,390.36
|
| Rate for Payer: BCN Medicare Advantage |
$811.93
|
| Rate for Payer: Cash Price |
$2,449.60
|
| Rate for Payer: Cash Price |
$2,449.60
|
| Rate for Payer: Cofinity Commercial |
$1,169.18
|
| Rate for Payer: Cofinity Commercial |
$1,087.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$811.93
|
| Rate for Payer: Healthscope Commercial |
$974.32
|
| Rate for Payer: Healthscope Whirlpool |
$974.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$852.53
|
| Rate for Payer: Meridian Medicaid |
$548.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$893.12
|
| Rate for Payer: Nomi Health Commercial |
$974.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,296.50
|
| Rate for Payer: PACE SWMI |
$811.93
|
| Rate for Payer: PHP Medicare Advantage |
$811.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$522.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,408.13
|
| Rate for Payer: Priority Health Medicare |
$811.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,408.13
|
| Rate for Payer: Railroad Medicare Medicare |
$811.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,642.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$811.93
|
| Rate for Payer: UHC Exchange |
$1,642.07
|
| Rate for Payer: UHC Medicaid |
$522.06
|
| Rate for Payer: UHCCP DNSP |
$811.93
|
| Rate for Payer: UHCCP Medicaid |
$522.06
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL
|
Professional
|
Both
|
$3,342.00
|
|
|
Service Code
|
HCPCS 58263
|
| Min. Negotiated Rate |
$559.55 |
| Max. Negotiated Rate |
$2,506.50 |
| Rate for Payer: Aetna Commercial |
$1,167.13
|
| Rate for Payer: Aetna Medicare |
$870.99
|
| Rate for Payer: BCBS Complete |
$587.53
|
| Rate for Payer: BCBS MAPPO |
$870.99
|
| Rate for Payer: BCN Commercial |
$1,491.46
|
| Rate for Payer: BCN Medicare Advantage |
$870.99
|
| Rate for Payer: Cash Price |
$2,673.60
|
| Rate for Payer: Cash Price |
$2,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,254.23
|
| Rate for Payer: Cofinity Commercial |
$1,167.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.99
|
| Rate for Payer: Healthscope Commercial |
$1,045.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,045.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.54
|
| Rate for Payer: Meridian Medicaid |
$587.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$958.09
|
| Rate for Payer: Nomi Health Commercial |
$1,045.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,506.50
|
| Rate for Payer: PACE SWMI |
$870.99
|
| Rate for Payer: PHP Medicare Advantage |
$870.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,510.52
|
| Rate for Payer: Priority Health Medicare |
$870.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,510.52
|
| Rate for Payer: Railroad Medicare Medicare |
$870.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,765.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$870.99
|
| Rate for Payer: UHC Exchange |
$1,765.09
|
| Rate for Payer: UHC Medicaid |
$559.55
|
| Rate for Payer: UHCCP DNSP |
$870.99
|
| Rate for Payer: UHCCP Medicaid |
$559.55
|
|
|
PR VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE
|
Professional
|
Both
|
$3,844.00
|
|
|
Service Code
|
HCPCS 58280
|
| Min. Negotiated Rate |
$594.70 |
| Max. Negotiated Rate |
$2,883.00 |
| Rate for Payer: Aetna Commercial |
$1,240.75
|
| Rate for Payer: Aetna Medicare |
$925.93
|
| Rate for Payer: BCBS Complete |
$624.43
|
| Rate for Payer: BCBS MAPPO |
$925.93
|
| Rate for Payer: BCN Commercial |
$1,586.07
|
| Rate for Payer: BCN Medicare Advantage |
$925.93
|
| Rate for Payer: Cash Price |
$3,075.20
|
| Rate for Payer: Cash Price |
$3,075.20
|
| Rate for Payer: Cofinity Commercial |
$1,333.34
|
| Rate for Payer: Cofinity Commercial |
$1,240.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.93
|
| Rate for Payer: Healthscope Commercial |
$1,111.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,111.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.23
|
| Rate for Payer: Meridian Medicaid |
$624.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,018.52
|
| Rate for Payer: Nomi Health Commercial |
$1,111.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,883.00
|
| Rate for Payer: PACE SWMI |
$925.93
|
| Rate for Payer: PHP Medicare Advantage |
$925.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,606.35
|
| Rate for Payer: Priority Health Medicare |
$925.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,606.35
|
| Rate for Payer: Railroad Medicare Medicare |
$925.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,878.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$925.93
|
| Rate for Payer: UHC Exchange |
$1,878.21
|
| Rate for Payer: UHC Medicaid |
$594.70
|
| Rate for Payer: UHCCP DNSP |
$925.93
|
| Rate for Payer: UHCCP Medicaid |
$594.70
|
|
|
PR VAGINAL DELIVERY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$2,209.00
|
|
|
Service Code
|
HCPCS 59612
|
| Min. Negotiated Rate |
$793.18 |
| Max. Negotiated Rate |
$1,674.98 |
| Rate for Payer: Aetna Commercial |
$1,119.72
|
| Rate for Payer: Aetna Medicare |
$835.61
|
| Rate for Payer: BCBS Complete |
$832.84
|
| Rate for Payer: BCBS MAPPO |
$835.61
|
| Rate for Payer: BCN Commercial |
$1,674.98
|
| Rate for Payer: BCN Medicare Advantage |
$835.61
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cash Price |
$1,767.20
|
| Rate for Payer: Cofinity Commercial |
$1,203.28
|
| Rate for Payer: Cofinity Commercial |
$1,119.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.61
|
| Rate for Payer: Healthscope Commercial |
$1,002.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.39
|
| Rate for Payer: Meridian Medicaid |
$832.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$919.17
|
| Rate for Payer: Nomi Health Commercial |
$1,002.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.75
|
| Rate for Payer: PACE SWMI |
$835.61
|
| Rate for Payer: PHP Medicare Advantage |
$835.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$793.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,278.19
|
| Rate for Payer: Priority Health Medicare |
$835.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,278.19
|
| Rate for Payer: Railroad Medicare Medicare |
$835.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,166.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$835.61
|
| Rate for Payer: UHC Exchange |
$1,166.64
|
| Rate for Payer: UHC Medicaid |
$793.18
|
| Rate for Payer: UHCCP DNSP |
$835.61
|
| Rate for Payer: UHCCP Medicaid |
$793.18
|
|
|
PR VAGINAL DELIVERY ONLY
|
Professional
|
Both
|
$2,029.00
|
|
|
Service Code
|
HCPCS 59409
|
| Min. Negotiated Rate |
$693.27 |
| Max. Negotiated Rate |
$1,595.20 |
| Rate for Payer: Aetna Commercial |
$977.88
|
| Rate for Payer: Aetna Medicare |
$729.76
|
| Rate for Payer: BCBS Complete |
$727.93
|
| Rate for Payer: BCBS MAPPO |
$729.76
|
| Rate for Payer: BCN Commercial |
$1,595.20
|
| Rate for Payer: BCN Medicare Advantage |
$729.76
|
| Rate for Payer: Cash Price |
$1,623.20
|
| Rate for Payer: Cash Price |
$1,623.20
|
| Rate for Payer: Cofinity Commercial |
$977.88
|
| Rate for Payer: Cofinity Commercial |
$1,050.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$729.76
|
| Rate for Payer: Healthscope Commercial |
$875.71
|
| Rate for Payer: Healthscope Whirlpool |
$875.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$766.25
|
| Rate for Payer: Meridian Medicaid |
$727.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$802.74
|
| Rate for Payer: Nomi Health Commercial |
$875.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,521.75
|
| Rate for Payer: PACE SWMI |
$729.76
|
| Rate for Payer: PHP Medicare Advantage |
$729.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$693.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,127.76
|
| Rate for Payer: Priority Health Medicare |
$729.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,127.76
|
| Rate for Payer: Railroad Medicare Medicare |
$729.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,031.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$729.76
|
| Rate for Payer: UHC Exchange |
$1,031.64
|
| Rate for Payer: UHC Medicaid |
$693.27
|
| Rate for Payer: UHCCP DNSP |
$729.76
|
| Rate for Payer: UHCCP Medicaid |
$693.27
|
|
|
PR VAGINAL DELIVERY ONLY W/POSTPARTUM CARE
|
Professional
|
Both
|
$2,309.00
|
|
|
Service Code
|
HCPCS 59410
|
| Min. Negotiated Rate |
$934.83 |
| Max. Negotiated Rate |
$1,851.61 |
| Rate for Payer: Aetna Commercial |
$1,319.11
|
| Rate for Payer: Aetna Medicare |
$984.41
|
| Rate for Payer: BCBS Complete |
$981.57
|
| Rate for Payer: BCBS MAPPO |
$984.41
|
| Rate for Payer: BCN Commercial |
$1,851.61
|
| Rate for Payer: BCN Medicare Advantage |
$984.41
|
| Rate for Payer: Cash Price |
$1,847.20
|
| Rate for Payer: Cash Price |
$1,847.20
|
| Rate for Payer: Cofinity Commercial |
$1,417.55
|
| Rate for Payer: Cofinity Commercial |
$1,319.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$984.41
|
| Rate for Payer: Healthscope Commercial |
$1,181.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,181.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,033.63
|
| Rate for Payer: Meridian Medicaid |
$981.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,082.85
|
| Rate for Payer: Nomi Health Commercial |
$1,181.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,731.75
|
| Rate for Payer: PACE SWMI |
$984.41
|
| Rate for Payer: PHP Medicare Advantage |
$984.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$934.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,527.34
|
| Rate for Payer: Priority Health Medicare |
$984.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,527.34
|
| Rate for Payer: Railroad Medicare Medicare |
$984.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,325.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$984.41
|
| Rate for Payer: UHC Exchange |
$1,325.76
|
| Rate for Payer: UHC Medicaid |
$934.83
|
| Rate for Payer: UHCCP DNSP |
$984.41
|
| Rate for Payer: UHCCP Medicaid |
$934.83
|
|
|
PR VAGINAL DELIVERY & POSTPARTUM CARE VBAC
|
Professional
|
Both
|
$2,490.00
|
|
|
Service Code
|
HCPCS 59614
|
| Min. Negotiated Rate |
$1,026.23 |
| Max. Negotiated Rate |
$1,944.19 |
| Rate for Payer: Aetna Commercial |
$1,448.03
|
| Rate for Payer: Aetna Medicare |
$1,080.62
|
| Rate for Payer: BCBS Complete |
$1,077.54
|
| Rate for Payer: BCBS MAPPO |
$1,080.62
|
| Rate for Payer: BCN Commercial |
$1,944.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,080.62
|
| Rate for Payer: Cash Price |
$1,992.00
|
| Rate for Payer: Cash Price |
$1,992.00
|
| Rate for Payer: Cofinity Commercial |
$1,556.09
|
| Rate for Payer: Cofinity Commercial |
$1,448.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,080.62
|
| Rate for Payer: Healthscope Commercial |
$1,296.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,296.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,134.65
|
| Rate for Payer: Meridian Medicaid |
$1,077.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,188.68
|
| Rate for Payer: Nomi Health Commercial |
$1,296.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,867.50
|
| Rate for Payer: PACE SWMI |
$1,080.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,080.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,026.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,651.92
|
| Rate for Payer: Priority Health Medicare |
$1,080.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,651.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,080.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,448.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,080.62
|
| Rate for Payer: UHC Exchange |
$1,448.84
|
| Rate for Payer: UHC Medicaid |
$1,026.23
|
| Rate for Payer: UHCCP DNSP |
$1,080.62
|
| Rate for Payer: UHCCP Medicaid |
$1,026.23
|
|
|
PR VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE
|
Professional
|
Both
|
$2,305.00
|
|
|
Service Code
|
HCPCS 58294
|
| Min. Negotiated Rate |
$682.03 |
| Max. Negotiated Rate |
$2,169.22 |
| Rate for Payer: Aetna Commercial |
$1,425.83
|
| Rate for Payer: Aetna Medicare |
$1,064.05
|
| Rate for Payer: BCBS Complete |
$716.13
|
| Rate for Payer: BCBS MAPPO |
$1,064.05
|
| Rate for Payer: BCN Commercial |
$1,820.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,064.05
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cofinity Commercial |
$1,532.23
|
| Rate for Payer: Cofinity Commercial |
$1,425.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,064.05
|
| Rate for Payer: Healthscope Commercial |
$1,276.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,117.25
|
| Rate for Payer: Meridian Medicaid |
$716.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,276.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,728.75
|
| Rate for Payer: PACE SWMI |
$1,064.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,064.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,843.38
|
| Rate for Payer: Priority Health Medicare |
$1,064.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,843.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,064.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,169.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,064.05
|
| Rate for Payer: UHC Exchange |
$2,169.22
|
| Rate for Payer: UHC Medicaid |
$682.03
|
| Rate for Payer: UHCCP DNSP |
$1,064.05
|
| Rate for Payer: UHCCP Medicaid |
$682.03
|
|
