|
PR VASOVASOSTOMY VASOVASORRHAPHY
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 55400
|
| Min. Negotiated Rate |
$392.40 |
| Max. Negotiated Rate |
$879.73 |
| Rate for Payer: Aetna Commercial |
$601.71
|
| Rate for Payer: Aetna Medicare |
$449.04
|
| Rate for Payer: BCBS Complete |
$392.40
|
| Rate for Payer: BCBS MAPPO |
$449.04
|
| Rate for Payer: BCN Commercial |
$751.45
|
| Rate for Payer: BCN Medicare Advantage |
$449.04
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$646.62
|
| Rate for Payer: Cofinity Commercial |
$601.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.04
|
| Rate for Payer: Healthscope Commercial |
$538.85
|
| Rate for Payer: Healthscope Whirlpool |
$538.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$493.94
|
| Rate for Payer: Nomi Health Commercial |
$538.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$735.75
|
| Rate for Payer: PACE SWMI |
$449.04
|
| Rate for Payer: PHP Medicare Advantage |
$449.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$818.58
|
| Rate for Payer: Priority Health Medicare |
$449.04
|
| Rate for Payer: Priority Health Narrow Network |
$818.58
|
| Rate for Payer: Railroad Medicare Medicare |
$449.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$879.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$449.04
|
| Rate for Payer: UHC Exchange |
$879.73
|
| Rate for Payer: UHCCP DNSP |
$449.04
|
|
|
PR VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG
|
Professional
|
Both
|
$2,853.00
|
|
|
Service Code
|
HCPCS 63103
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$2,139.75 |
| Rate for Payer: Aetna Commercial |
$355.26
|
| Rate for Payer: Aetna Medicare |
$265.12
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS MAPPO |
$265.12
|
| Rate for Payer: BCN Commercial |
$438.23
|
| Rate for Payer: BCN Medicare Advantage |
$265.12
|
| Rate for Payer: Cash Price |
$2,282.40
|
| Rate for Payer: Cash Price |
$2,282.40
|
| Rate for Payer: Cofinity Commercial |
$381.77
|
| Rate for Payer: Cofinity Commercial |
$355.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.12
|
| Rate for Payer: Healthscope Commercial |
$318.14
|
| Rate for Payer: Healthscope Whirlpool |
$318.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.38
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$291.63
|
| Rate for Payer: Nomi Health Commercial |
$318.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,139.75
|
| Rate for Payer: PACE SWMI |
$265.12
|
| Rate for Payer: PHP Medicare Advantage |
$265.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$508.99
|
| Rate for Payer: Priority Health Medicare |
$265.12
|
| Rate for Payer: Priority Health Narrow Network |
$508.99
|
| Rate for Payer: Railroad Medicare Medicare |
$265.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$523.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$265.12
|
| Rate for Payer: UHC Exchange |
$523.34
|
| Rate for Payer: UHC Medicaid |
$167.63
|
| Rate for Payer: UHCCP DNSP |
$265.12
|
| Rate for Payer: UHCCP Medicaid |
$167.63
|
|
|
PR VCRPEC LES 1 SGM XDRL CERVICAL
|
Professional
|
Both
|
$4,846.00
|
|
|
Service Code
|
HCPCS 63300
|
| Min. Negotiated Rate |
$1,110.37 |
| Max. Negotiated Rate |
$3,634.50 |
| Rate for Payer: Aetna Commercial |
$2,324.08
|
| Rate for Payer: Aetna Medicare |
$1,734.39
|
| Rate for Payer: BCBS Complete |
$1,165.89
|
| Rate for Payer: BCBS MAPPO |
$1,734.39
|
| Rate for Payer: BCN Commercial |
$3,036.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,734.39
|
| Rate for Payer: Cash Price |
$3,876.80
|
| Rate for Payer: Cash Price |
$3,876.80
|
| Rate for Payer: Cofinity Commercial |
$2,497.52
|
| Rate for Payer: Cofinity Commercial |
$2,324.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,734.39
|
| Rate for Payer: Healthscope Commercial |
$2,081.27
|
| Rate for Payer: Healthscope Whirlpool |
$2,081.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,821.11
|
| Rate for Payer: Meridian Medicaid |
$1,165.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,907.83
|
| Rate for Payer: Nomi Health Commercial |
$2,081.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,634.50
|
| Rate for Payer: PACE SWMI |
$1,734.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,734.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,110.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,210.67
|
| Rate for Payer: Priority Health Medicare |
$1,734.39
|
| Rate for Payer: Priority Health Narrow Network |
$3,210.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,734.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,243.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,734.39
|
| Rate for Payer: UHC Exchange |
$3,243.74
|
| Rate for Payer: UHC Medicaid |
$1,110.37
|
| Rate for Payer: UHCCP DNSP |
$1,734.39
|
| Rate for Payer: UHCCP Medicaid |
$1,110.37
|
|
|
PR VCRPEC LES 1 SGM XDRL THORACIC TTHRC
|
Professional
|
Both
|
$4,795.00
|
|
|
Service Code
|
HCPCS 63301
|
| Min. Negotiated Rate |
$1,370.87 |
| Max. Negotiated Rate |
$3,890.88 |
| Rate for Payer: Aetna Commercial |
$2,875.40
|
| Rate for Payer: Aetna Medicare |
$2,145.82
|
| Rate for Payer: BCBS Complete |
$1,439.41
|
| Rate for Payer: BCBS MAPPO |
$2,145.82
|
| Rate for Payer: BCN Commercial |
$3,541.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,145.82
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cofinity Commercial |
$3,089.98
|
| Rate for Payer: Cofinity Commercial |
$2,875.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,145.82
|
| Rate for Payer: Healthscope Commercial |
$2,574.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,574.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,253.11
|
| Rate for Payer: Meridian Medicaid |
$1,439.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,360.40
|
| Rate for Payer: Nomi Health Commercial |
$2,574.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,596.25
|
| Rate for Payer: PACE SWMI |
$2,145.82
|
| Rate for Payer: PHP Medicare Advantage |
$2,145.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,370.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,743.96
|
| Rate for Payer: Priority Health Medicare |
$2,145.82
|
| Rate for Payer: Priority Health Narrow Network |
$3,743.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2,145.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,890.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,145.82
|
| Rate for Payer: UHC Exchange |
$3,890.88
|
| Rate for Payer: UHC Medicaid |
$1,370.87
|
| Rate for Payer: UHCCP DNSP |
$2,145.82
|
| Rate for Payer: UHCCP Medicaid |
$1,370.87
|
|
|
PR VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG
|
Professional
|
Both
|
$9,500.00
|
|
|
Service Code
|
HCPCS 63087
|
| Min. Negotiated Rate |
$1,443.93 |
| Max. Negotiated Rate |
$7,125.00 |
| Rate for Payer: Aetna Commercial |
$3,029.97
|
| Rate for Payer: Aetna Medicare |
$2,261.17
|
| Rate for Payer: BCBS Complete |
$1,516.13
|
| Rate for Payer: BCBS MAPPO |
$2,261.17
|
| Rate for Payer: BCN Commercial |
$4,027.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,261.17
|
| Rate for Payer: Cash Price |
$7,600.00
|
| Rate for Payer: Cash Price |
$7,600.00
|
| Rate for Payer: Cofinity Commercial |
$3,256.08
|
| Rate for Payer: Cofinity Commercial |
$3,029.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,261.17
|
| Rate for Payer: Healthscope Commercial |
$2,713.40
|
| Rate for Payer: Healthscope Whirlpool |
$2,713.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,374.23
|
| Rate for Payer: Meridian Medicaid |
$1,516.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,487.29
|
| Rate for Payer: Nomi Health Commercial |
$2,713.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,125.00
|
| Rate for Payer: PACE SWMI |
$2,261.17
|
| Rate for Payer: PHP Medicare Advantage |
$2,261.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,443.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,258.15
|
| Rate for Payer: Priority Health Medicare |
$2,261.17
|
| Rate for Payer: Priority Health Narrow Network |
$4,258.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,261.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,267.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,261.17
|
| Rate for Payer: UHC Exchange |
$4,267.66
|
| Rate for Payer: UHC Medicaid |
$1,443.93
|
| Rate for Payer: UHCCP DNSP |
$2,261.17
|
| Rate for Payer: UHCCP Medicaid |
$1,443.93
|
|
|
PR VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG
|
Professional
|
Both
|
$3,257.00
|
|
|
Service Code
|
HCPCS 63088
|
| Min. Negotiated Rate |
$149.53 |
| Max. Negotiated Rate |
$2,442.75 |
| Rate for Payer: Aetna Commercial |
$317.18
|
| Rate for Payer: Aetna Medicare |
$236.70
|
| Rate for Payer: BCBS Complete |
$157.01
|
| Rate for Payer: BCBS MAPPO |
$236.70
|
| Rate for Payer: BCN Commercial |
$386.44
|
| Rate for Payer: BCN Medicare Advantage |
$236.70
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cofinity Commercial |
$340.85
|
| Rate for Payer: Cofinity Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.70
|
| Rate for Payer: Healthscope Commercial |
$284.04
|
| Rate for Payer: Healthscope Whirlpool |
$284.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.53
|
| Rate for Payer: Meridian Medicaid |
$157.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$260.37
|
| Rate for Payer: Nomi Health Commercial |
$284.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.75
|
| Rate for Payer: PACE SWMI |
$236.70
|
| Rate for Payer: PHP Medicare Advantage |
$236.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$448.84
|
| Rate for Payer: Priority Health Medicare |
$236.70
|
| Rate for Payer: Priority Health Narrow Network |
$448.84
|
| Rate for Payer: Railroad Medicare Medicare |
$236.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$456.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.70
|
| Rate for Payer: UHC Exchange |
$456.09
|
| Rate for Payer: UHC Medicaid |
$149.53
|
| Rate for Payer: UHCCP DNSP |
$236.70
|
| Rate for Payer: UHCCP Medicaid |
$149.53
|
|
|
PR VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG
|
Professional
|
Both
|
$7,492.00
|
|
|
Service Code
|
HCPCS 63090
|
| Min. Negotiated Rate |
$1,161.92 |
| Max. Negotiated Rate |
$5,619.00 |
| Rate for Payer: Aetna Commercial |
$2,430.93
|
| Rate for Payer: Aetna Medicare |
$1,814.13
|
| Rate for Payer: BCBS Complete |
$1,220.02
|
| Rate for Payer: BCBS MAPPO |
$1,814.13
|
| Rate for Payer: BCN Commercial |
$3,218.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,814.13
|
| Rate for Payer: Cash Price |
$5,993.60
|
| Rate for Payer: Cash Price |
$5,993.60
|
| Rate for Payer: Cofinity Commercial |
$2,612.35
|
| Rate for Payer: Cofinity Commercial |
$2,430.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,814.13
|
| Rate for Payer: Healthscope Commercial |
$2,176.96
|
| Rate for Payer: Healthscope Whirlpool |
$2,176.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,904.84
|
| Rate for Payer: Meridian Medicaid |
$1,220.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,995.54
|
| Rate for Payer: Nomi Health Commercial |
$2,176.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,619.00
|
| Rate for Payer: PACE SWMI |
$1,814.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,814.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,161.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,403.28
|
| Rate for Payer: Priority Health Medicare |
$1,814.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,403.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,814.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,473.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,814.13
|
| Rate for Payer: UHC Exchange |
$3,473.51
|
| Rate for Payer: UHC Medicaid |
$1,161.92
|
| Rate for Payer: UHCCP DNSP |
$1,814.13
|
| Rate for Payer: UHCCP Medicaid |
$1,161.92
|
|
|
PR VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG
|
Professional
|
Both
|
$2,552.00
|
|
|
Service Code
|
HCPCS 63091
|
| Min. Negotiated Rate |
$100.75 |
| Max. Negotiated Rate |
$1,914.00 |
| Rate for Payer: Aetna Commercial |
$212.99
|
| Rate for Payer: Aetna Medicare |
$158.95
|
| Rate for Payer: BCBS Complete |
$105.79
|
| Rate for Payer: BCBS MAPPO |
$158.95
|
| Rate for Payer: BCN Commercial |
$286.66
|
| Rate for Payer: BCN Medicare Advantage |
$158.95
|
| Rate for Payer: Cash Price |
$2,041.60
|
| Rate for Payer: Cash Price |
$2,041.60
|
| Rate for Payer: Cofinity Commercial |
$228.89
|
| Rate for Payer: Cofinity Commercial |
$212.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.95
|
| Rate for Payer: Healthscope Commercial |
$190.74
|
| Rate for Payer: Healthscope Whirlpool |
$190.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.90
|
| Rate for Payer: Meridian Medicaid |
$105.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.84
|
| Rate for Payer: Nomi Health Commercial |
$190.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,914.00
|
| Rate for Payer: PACE SWMI |
$158.95
|
| Rate for Payer: PHP Medicare Advantage |
$158.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$303.09
|
| Rate for Payer: Priority Health Medicare |
$158.95
|
| Rate for Payer: Priority Health Narrow Network |
$303.09
|
| Rate for Payer: Railroad Medicare Medicare |
$158.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.95
|
| Rate for Payer: UHC Exchange |
$317.71
|
| Rate for Payer: UHC Medicaid |
$100.75
|
| Rate for Payer: UHCCP DNSP |
$158.95
|
| Rate for Payer: UHCCP Medicaid |
$100.75
|
|
|
PR VEIN SCREEN
|
Professional
|
Both
|
$21.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
|
|
PR VEN CATHJ SLCTV ORGAN BLD SAMPLING
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 36500
|
| Min. Negotiated Rate |
$102.24 |
| Max. Negotiated Rate |
$325.85 |
| Rate for Payer: Aetna Commercial |
$215.94
|
| Rate for Payer: Aetna Medicare |
$161.15
|
| Rate for Payer: BCBS Complete |
$107.35
|
| Rate for Payer: BCBS MAPPO |
$161.15
|
| Rate for Payer: BCN Commercial |
$267.91
|
| Rate for Payer: BCN Medicare Advantage |
$161.15
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$215.94
|
| Rate for Payer: Cofinity Commercial |
$232.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.15
|
| Rate for Payer: Healthscope Commercial |
$193.38
|
| Rate for Payer: Healthscope Whirlpool |
$193.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.21
|
| Rate for Payer: Meridian Medicaid |
$107.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$177.26
|
| Rate for Payer: Nomi Health Commercial |
$193.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.25
|
| Rate for Payer: PACE SWMI |
$161.15
|
| Rate for Payer: PHP Medicare Advantage |
$161.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$288.10
|
| Rate for Payer: Priority Health Medicare |
$161.15
|
| Rate for Payer: Priority Health Narrow Network |
$288.10
|
| Rate for Payer: Railroad Medicare Medicare |
$161.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$325.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.15
|
| Rate for Payer: UHC Exchange |
$325.85
|
| Rate for Payer: UHC Medicaid |
$102.24
|
| Rate for Payer: UHCCP DNSP |
$161.15
|
| Rate for Payer: UHCCP Medicaid |
$102.24
|
|
|
PR VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL
|
Professional
|
Both
|
$4,498.00
|
|
|
Service Code
|
HCPCS 37180
|
| Min. Negotiated Rate |
$1,250.74 |
| Max. Negotiated Rate |
$3,803.55 |
| Rate for Payer: Aetna Commercial |
$2,630.31
|
| Rate for Payer: Aetna Medicare |
$1,962.92
|
| Rate for Payer: BCBS Complete |
$1,313.28
|
| Rate for Payer: BCBS MAPPO |
$1,962.92
|
| Rate for Payer: BCN Commercial |
$3,176.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,962.92
|
| Rate for Payer: Cash Price |
$3,598.40
|
| Rate for Payer: Cash Price |
$3,598.40
|
| Rate for Payer: Cofinity Commercial |
$2,826.60
|
| Rate for Payer: Cofinity Commercial |
$2,630.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,962.92
|
| Rate for Payer: Healthscope Commercial |
$2,355.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,355.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,061.07
|
| Rate for Payer: Meridian Medicaid |
$1,313.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,159.21
|
| Rate for Payer: Nomi Health Commercial |
$2,355.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,373.50
|
| Rate for Payer: PACE SWMI |
$1,962.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,962.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,250.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,415.52
|
| Rate for Payer: Priority Health Medicare |
$1,962.92
|
| Rate for Payer: Priority Health Narrow Network |
$3,415.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,962.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,803.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,962.92
|
| Rate for Payer: UHC Exchange |
$3,803.55
|
| Rate for Payer: UHC Medicaid |
$1,250.74
|
| Rate for Payer: UHCCP DNSP |
$1,962.92
|
| Rate for Payer: UHCCP Medicaid |
$1,250.74
|
|
|
PR VENTILATING TUBE RMVL REQUIRING GENERAL ANES
|
Professional
|
Both
|
$631.00
|
|
|
Service Code
|
HCPCS 69424
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$473.25 |
| Rate for Payer: Aetna Commercial |
$71.93
|
| Rate for Payer: Aetna Medicare |
$53.68
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCBS MAPPO |
$53.68
|
| Rate for Payer: BCN Commercial |
$92.13
|
| Rate for Payer: BCN Medicare Advantage |
$53.68
|
| Rate for Payer: Cash Price |
$504.80
|
| Rate for Payer: Cash Price |
$504.80
|
| Rate for Payer: Cofinity Commercial |
$77.30
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.68
|
| Rate for Payer: Healthscope Commercial |
$64.42
|
| Rate for Payer: Healthscope Whirlpool |
$64.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.36
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.05
|
| Rate for Payer: Nomi Health Commercial |
$64.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$473.25
|
| Rate for Payer: PACE SWMI |
$53.68
|
| Rate for Payer: PHP Medicare Advantage |
$53.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$91.03
|
| Rate for Payer: Priority Health Medicare |
$53.68
|
| Rate for Payer: Priority Health Narrow Network |
$91.03
|
| Rate for Payer: Railroad Medicare Medicare |
$53.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53.68
|
| Rate for Payer: UHC Exchange |
$104.52
|
| Rate for Payer: UHC Medicaid |
$35.36
|
| Rate for Payer: UHCCP DNSP |
$53.68
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
|
|
PR VENTILATION ASSIST & MGMT INPATIENT 1ST DAY
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 94002
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$150.39 |
| Rate for Payer: Aetna Commercial |
$114.50
|
| Rate for Payer: Aetna Medicare |
$85.45
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: BCBS MAPPO |
$85.45
|
| Rate for Payer: BCN Commercial |
$135.45
|
| Rate for Payer: BCN Medicare Advantage |
$85.45
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$123.05
|
| Rate for Payer: Cofinity Commercial |
$114.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.45
|
| Rate for Payer: Healthscope Commercial |
$102.54
|
| Rate for Payer: Healthscope Whirlpool |
$102.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.72
|
| Rate for Payer: Meridian Medicaid |
$57.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.00
|
| Rate for Payer: Nomi Health Commercial |
$102.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.75
|
| Rate for Payer: PACE SWMI |
$85.45
|
| Rate for Payer: PHP Medicare Advantage |
$85.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$124.91
|
| Rate for Payer: Priority Health Medicare |
$85.45
|
| Rate for Payer: Priority Health Narrow Network |
$124.91
|
| Rate for Payer: Railroad Medicare Medicare |
$85.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.45
|
| Rate for Payer: UHC Exchange |
$150.39
|
| Rate for Payer: UHC Medicaid |
$54.74
|
| Rate for Payer: UHCCP DNSP |
$85.45
|
| Rate for Payer: UHCCP Medicaid |
$54.74
|
|
|
PR VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 94003
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$108.32 |
| Rate for Payer: Aetna Commercial |
$78.82
|
| Rate for Payer: Aetna Medicare |
$58.82
|
| Rate for Payer: BCBS Complete |
$39.59
|
| Rate for Payer: BCBS MAPPO |
$58.82
|
| Rate for Payer: BCN Commercial |
$95.12
|
| Rate for Payer: BCN Medicare Advantage |
$58.82
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$84.70
|
| Rate for Payer: Cofinity Commercial |
$78.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.82
|
| Rate for Payer: Healthscope Commercial |
$70.58
|
| Rate for Payer: Healthscope Whirlpool |
$70.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.76
|
| Rate for Payer: Meridian Medicaid |
$39.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.70
|
| Rate for Payer: Nomi Health Commercial |
$70.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE SWMI |
$58.82
|
| Rate for Payer: PHP Medicare Advantage |
$58.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$87.71
|
| Rate for Payer: Priority Health Medicare |
$58.82
|
| Rate for Payer: Priority Health Narrow Network |
$87.71
|
| Rate for Payer: Railroad Medicare Medicare |
$58.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.82
|
| Rate for Payer: UHC Exchange |
$108.32
|
| Rate for Payer: UHC Medicaid |
$37.70
|
| Rate for Payer: UHCCP DNSP |
$58.82
|
| Rate for Payer: UHCCP Medicaid |
$37.70
|
|
|
PR VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 61026
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna Medicare |
$104.01
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: BCBS MAPPO |
$104.01
|
| Rate for Payer: BCN Commercial |
$170.31
|
| Rate for Payer: BCN Medicare Advantage |
$104.01
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$149.77
|
| Rate for Payer: Cofinity Commercial |
$139.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.01
|
| Rate for Payer: Healthscope Commercial |
$124.81
|
| Rate for Payer: Healthscope Whirlpool |
$124.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.21
|
| Rate for Payer: Meridian Medicaid |
$70.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.41
|
| Rate for Payer: Nomi Health Commercial |
$124.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.00
|
| Rate for Payer: PACE SWMI |
$104.01
|
| Rate for Payer: PHP Medicare Advantage |
$104.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$197.82
|
| Rate for Payer: Priority Health Medicare |
$104.01
|
| Rate for Payer: Priority Health Narrow Network |
$197.82
|
| Rate for Payer: Railroad Medicare Medicare |
$104.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.01
|
| Rate for Payer: UHC Exchange |
$187.83
|
| Rate for Payer: UHC Medicaid |
$66.88
|
| Rate for Payer: UHCCP DNSP |
$104.01
|
| Rate for Payer: UHCCP Medicaid |
$66.88
|
|
|
PR VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 61020
|
| Min. Negotiated Rate |
$62.84 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Aetna Commercial |
$131.20
|
| Rate for Payer: Aetna Medicare |
$97.91
|
| Rate for Payer: BCBS Complete |
$65.98
|
| Rate for Payer: BCBS MAPPO |
$97.91
|
| Rate for Payer: BCN Commercial |
$160.35
|
| Rate for Payer: BCN Medicare Advantage |
$97.91
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$140.99
|
| Rate for Payer: Cofinity Commercial |
$131.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.91
|
| Rate for Payer: Healthscope Commercial |
$117.49
|
| Rate for Payer: Healthscope Whirlpool |
$117.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.81
|
| Rate for Payer: Meridian Medicaid |
$65.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.70
|
| Rate for Payer: Nomi Health Commercial |
$117.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.00
|
| Rate for Payer: PACE SWMI |
$97.91
|
| Rate for Payer: PHP Medicare Advantage |
$97.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$186.25
|
| Rate for Payer: Priority Health Medicare |
$97.91
|
| Rate for Payer: Priority Health Narrow Network |
$186.25
|
| Rate for Payer: Railroad Medicare Medicare |
$97.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.91
|
| Rate for Payer: UHC Exchange |
$184.74
|
| Rate for Payer: UHC Medicaid |
$62.84
|
| Rate for Payer: UHCCP DNSP |
$97.91
|
| Rate for Payer: UHCCP Medicaid |
$62.84
|
|
|
PR VENTRICULOCISTERNOSTOMY
|
Professional
|
Both
|
$4,896.00
|
|
|
Service Code
|
HCPCS 62180
|
| Min. Negotiated Rate |
$1,003.02 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$2,099.71
|
| Rate for Payer: Aetna Medicare |
$1,566.95
|
| Rate for Payer: BCBS Complete |
$1,053.17
|
| Rate for Payer: BCBS MAPPO |
$1,566.95
|
| Rate for Payer: BCN Commercial |
$3,375.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,566.95
|
| Rate for Payer: Cash Price |
$3,916.80
|
| Rate for Payer: Cash Price |
$3,916.80
|
| Rate for Payer: Cofinity Commercial |
$2,256.41
|
| Rate for Payer: Cofinity Commercial |
$2,099.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,566.95
|
| Rate for Payer: Healthscope Commercial |
$1,880.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,880.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,645.30
|
| Rate for Payer: Meridian Medicaid |
$1,053.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,723.64
|
| Rate for Payer: Nomi Health Commercial |
$1,880.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,672.00
|
| Rate for Payer: PACE SWMI |
$1,566.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,566.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,003.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,837.61
|
| Rate for Payer: Priority Health Medicare |
$1,566.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,837.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,566.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,816.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,566.95
|
| Rate for Payer: UHC Exchange |
$2,816.73
|
| Rate for Payer: UHC Medicaid |
$1,003.02
|
| Rate for Payer: UHCCP DNSP |
$1,566.95
|
| Rate for Payer: UHCCP Medicaid |
$1,003.02
|
|
|
PR VENTRICULOCISTERNOSTOMY 3RD VENTRICLE
|
Professional
|
Both
|
$6,744.00
|
|
|
Service Code
|
HCPCS 62200
|
| Min. Negotiated Rate |
$866.91 |
| Max. Negotiated Rate |
$5,058.00 |
| Rate for Payer: Aetna Commercial |
$1,813.05
|
| Rate for Payer: Aetna Medicare |
$1,353.02
|
| Rate for Payer: BCBS Complete |
$910.26
|
| Rate for Payer: BCBS MAPPO |
$1,353.02
|
| Rate for Payer: BCN Commercial |
$2,907.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,353.02
|
| Rate for Payer: Cash Price |
$5,395.20
|
| Rate for Payer: Cash Price |
$5,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,948.35
|
| Rate for Payer: Cofinity Commercial |
$1,813.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.02
|
| Rate for Payer: Healthscope Commercial |
$1,623.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,623.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,420.67
|
| Rate for Payer: Meridian Medicaid |
$910.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,488.32
|
| Rate for Payer: Nomi Health Commercial |
$1,623.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,058.00
|
| Rate for Payer: PACE SWMI |
$1,353.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,353.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$866.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,444.29
|
| Rate for Payer: Priority Health Medicare |
$1,353.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,444.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,353.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,422.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,353.02
|
| Rate for Payer: UHC Exchange |
$2,422.76
|
| Rate for Payer: UHC Medicaid |
$866.91
|
| Rate for Payer: UHCCP DNSP |
$1,353.02
|
| Rate for Payer: UHCCP Medicaid |
$866.91
|
|
|
PR VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC
|
Professional
|
Both
|
$6,129.00
|
|
|
Service Code
|
HCPCS 62201
|
| Min. Negotiated Rate |
$782.14 |
| Max. Negotiated Rate |
$4,596.75 |
| Rate for Payer: Aetna Commercial |
$1,624.72
|
| Rate for Payer: Aetna Medicare |
$1,212.48
|
| Rate for Payer: BCBS Complete |
$821.25
|
| Rate for Payer: BCBS MAPPO |
$1,212.48
|
| Rate for Payer: BCN Commercial |
$2,572.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,212.48
|
| Rate for Payer: Cash Price |
$4,903.20
|
| Rate for Payer: Cash Price |
$4,903.20
|
| Rate for Payer: Cofinity Commercial |
$1,745.97
|
| Rate for Payer: Cofinity Commercial |
$1,624.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,212.48
|
| Rate for Payer: Healthscope Commercial |
$1,454.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,454.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.10
|
| Rate for Payer: Meridian Medicaid |
$821.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,333.73
|
| Rate for Payer: Nomi Health Commercial |
$1,454.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,596.75
|
| Rate for Payer: PACE SWMI |
$1,212.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,212.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$782.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,162.63
|
| Rate for Payer: Priority Health Medicare |
$1,212.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,162.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,212.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,116.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,212.48
|
| Rate for Payer: UHC Exchange |
$2,116.12
|
| Rate for Payer: UHC Medicaid |
$782.14
|
| Rate for Payer: UHCCP DNSP |
$1,212.48
|
| Rate for Payer: UHCCP Medicaid |
$782.14
|
|
|
PR VENTRICULOMYOTOMY-MYECTOMY
|
Professional
|
Both
|
$9,371.00
|
|
|
Service Code
|
HCPCS 33416
|
| Min. Negotiated Rate |
$1,213.04 |
| Max. Negotiated Rate |
$7,028.25 |
| Rate for Payer: Aetna Commercial |
$2,550.77
|
| Rate for Payer: Aetna Medicare |
$1,903.56
|
| Rate for Payer: BCBS Complete |
$1,273.69
|
| Rate for Payer: BCBS MAPPO |
$1,903.56
|
| Rate for Payer: BCN Commercial |
$2,975.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,903.56
|
| Rate for Payer: Cash Price |
$7,496.80
|
| Rate for Payer: Cash Price |
$7,496.80
|
| Rate for Payer: Cofinity Commercial |
$2,741.13
|
| Rate for Payer: Cofinity Commercial |
$2,550.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,903.56
|
| Rate for Payer: Healthscope Commercial |
$2,284.27
|
| Rate for Payer: Healthscope Whirlpool |
$2,284.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,998.74
|
| Rate for Payer: Meridian Medicaid |
$1,273.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,093.92
|
| Rate for Payer: Nomi Health Commercial |
$2,284.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,028.25
|
| Rate for Payer: PACE SWMI |
$1,903.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,903.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,213.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,200.25
|
| Rate for Payer: Priority Health Medicare |
$1,903.56
|
| Rate for Payer: Priority Health Narrow Network |
$3,200.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,903.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,602.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,903.56
|
| Rate for Payer: UHC Exchange |
$3,602.22
|
| Rate for Payer: UHC Medicaid |
$1,213.04
|
| Rate for Payer: UHCCP DNSP |
$1,903.56
|
| Rate for Payer: UHCCP Medicaid |
$1,213.04
|
|
|
PR VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT
|
Professional
|
Both
|
$771.00
|
|
|
Service Code
|
HCPCS 40500
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$683.82 |
| Rate for Payer: Aetna Commercial |
$429.90
|
| Rate for Payer: Aetna Medicare |
$320.82
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$320.82
|
| Rate for Payer: BCN Commercial |
$561.22
|
| Rate for Payer: BCN Medicare Advantage |
$320.82
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cofinity Commercial |
$461.98
|
| Rate for Payer: Cofinity Commercial |
$429.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.82
|
| Rate for Payer: Healthscope Commercial |
$384.98
|
| Rate for Payer: Healthscope Whirlpool |
$384.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.86
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$352.90
|
| Rate for Payer: Nomi Health Commercial |
$384.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$578.25
|
| Rate for Payer: PACE SWMI |
$320.82
|
| Rate for Payer: PHP Medicare Advantage |
$320.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$683.82
|
| Rate for Payer: Priority Health Medicare |
$320.82
|
| Rate for Payer: Priority Health Narrow Network |
$683.82
|
| Rate for Payer: Railroad Medicare Medicare |
$320.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$624.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$320.82
|
| Rate for Payer: UHC Exchange |
$624.43
|
| Rate for Payer: UHC Medicaid |
$212.36
|
| Rate for Payer: UHCCP DNSP |
$320.82
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
|
|
PR VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG
|
Professional
|
Both
|
$8,831.00
|
|
|
Service Code
|
HCPCS 63102
|
| Min. Negotiated Rate |
$1,386.42 |
| Max. Negotiated Rate |
$6,623.25 |
| Rate for Payer: Aetna Commercial |
$2,901.02
|
| Rate for Payer: Aetna Medicare |
$2,164.94
|
| Rate for Payer: BCBS Complete |
$1,455.74
|
| Rate for Payer: BCBS MAPPO |
$2,164.94
|
| Rate for Payer: BCN Commercial |
$3,479.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,164.94
|
| Rate for Payer: Cash Price |
$7,064.80
|
| Rate for Payer: Cash Price |
$7,064.80
|
| Rate for Payer: Cofinity Commercial |
$3,117.51
|
| Rate for Payer: Cofinity Commercial |
$2,901.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,164.94
|
| Rate for Payer: Healthscope Commercial |
$2,597.93
|
| Rate for Payer: Healthscope Whirlpool |
$2,597.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,273.19
|
| Rate for Payer: Meridian Medicaid |
$1,455.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,381.43
|
| Rate for Payer: Nomi Health Commercial |
$2,597.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,623.25
|
| Rate for Payer: PACE SWMI |
$2,164.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,164.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,386.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,041.82
|
| Rate for Payer: Priority Health Medicare |
$2,164.94
|
| Rate for Payer: Priority Health Narrow Network |
$4,041.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,164.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,997.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,164.94
|
| Rate for Payer: UHC Exchange |
$3,997.95
|
| Rate for Payer: UHC Medicaid |
$1,386.42
|
| Rate for Payer: UHCCP DNSP |
$2,164.94
|
| Rate for Payer: UHCCP Medicaid |
$1,386.42
|
|
|
PR VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG
|
Professional
|
Both
|
$5,017.00
|
|
|
Service Code
|
HCPCS 63101
|
| Min. Negotiated Rate |
$1,414.11 |
| Max. Negotiated Rate |
$4,105.15 |
| Rate for Payer: Aetna Commercial |
$2,960.53
|
| Rate for Payer: Aetna Medicare |
$2,209.35
|
| Rate for Payer: BCBS Complete |
$1,484.82
|
| Rate for Payer: BCBS MAPPO |
$2,209.35
|
| Rate for Payer: BCN Commercial |
$3,517.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,209.35
|
| Rate for Payer: Cash Price |
$4,013.60
|
| Rate for Payer: Cash Price |
$4,013.60
|
| Rate for Payer: Cofinity Commercial |
$3,181.46
|
| Rate for Payer: Cofinity Commercial |
$2,960.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,209.35
|
| Rate for Payer: Healthscope Commercial |
$2,651.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,651.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,319.82
|
| Rate for Payer: Meridian Medicaid |
$1,484.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,430.28
|
| Rate for Payer: Nomi Health Commercial |
$2,651.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,762.75
|
| Rate for Payer: PACE SWMI |
$2,209.35
|
| Rate for Payer: PHP Medicare Advantage |
$2,209.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,414.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,085.20
|
| Rate for Payer: Priority Health Medicare |
$2,209.35
|
| Rate for Payer: Priority Health Narrow Network |
$4,085.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,209.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,105.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,209.35
|
| Rate for Payer: UHC Exchange |
$4,105.15
|
| Rate for Payer: UHC Medicaid |
$1,414.11
|
| Rate for Payer: UHCCP DNSP |
$2,209.35
|
| Rate for Payer: UHCCP Medicaid |
$1,414.11
|
|
|
PR VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG
|
Professional
|
Both
|
$6,630.00
|
|
|
Service Code
|
HCPCS 63081
|
| Min. Negotiated Rate |
$1,058.61 |
| Max. Negotiated Rate |
$4,972.50 |
| Rate for Payer: Aetna Commercial |
$2,213.53
|
| Rate for Payer: Aetna Medicare |
$1,651.89
|
| Rate for Payer: BCBS Complete |
$1,111.54
|
| Rate for Payer: BCBS MAPPO |
$1,651.89
|
| Rate for Payer: BCN Commercial |
$2,936.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,651.89
|
| Rate for Payer: Cash Price |
$5,304.00
|
| Rate for Payer: Cash Price |
$5,304.00
|
| Rate for Payer: Cofinity Commercial |
$2,378.72
|
| Rate for Payer: Cofinity Commercial |
$2,213.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,651.89
|
| Rate for Payer: Healthscope Commercial |
$1,982.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,982.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,734.48
|
| Rate for Payer: Meridian Medicaid |
$1,111.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,817.08
|
| Rate for Payer: Nomi Health Commercial |
$1,982.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,972.50
|
| Rate for Payer: PACE SWMI |
$1,651.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,651.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,058.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,104.25
|
| Rate for Payer: Priority Health Medicare |
$1,651.89
|
| Rate for Payer: Priority Health Narrow Network |
$3,104.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,651.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,107.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,651.89
|
| Rate for Payer: UHC Exchange |
$3,107.90
|
| Rate for Payer: UHC Medicaid |
$1,058.61
|
| Rate for Payer: UHCCP DNSP |
$1,651.89
|
| Rate for Payer: UHCCP Medicaid |
$1,058.61
|
|
|
PR VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG
|
Professional
|
Both
|
$2,210.00
|
|
|
Service Code
|
HCPCS 63082
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$1,657.50 |
| Rate for Payer: Aetna Commercial |
$320.92
|
| Rate for Payer: Aetna Medicare |
$239.49
|
| Rate for Payer: BCBS Complete |
$159.01
|
| Rate for Payer: BCBS MAPPO |
$239.49
|
| Rate for Payer: BCN Commercial |
$437.10
|
| Rate for Payer: BCN Medicare Advantage |
$239.49
|
| Rate for Payer: Cash Price |
$1,768.00
|
| Rate for Payer: Cash Price |
$1,768.00
|
| Rate for Payer: Cofinity Commercial |
$344.87
|
| Rate for Payer: Cofinity Commercial |
$320.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.49
|
| Rate for Payer: Healthscope Commercial |
$287.39
|
| Rate for Payer: Healthscope Whirlpool |
$287.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.46
|
| Rate for Payer: Meridian Medicaid |
$159.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$263.44
|
| Rate for Payer: Nomi Health Commercial |
$287.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,657.50
|
| Rate for Payer: PACE SWMI |
$239.49
|
| Rate for Payer: PHP Medicare Advantage |
$239.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$462.14
|
| Rate for Payer: Priority Health Medicare |
$239.49
|
| Rate for Payer: Priority Health Narrow Network |
$462.14
|
| Rate for Payer: Railroad Medicare Medicare |
$239.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$473.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$239.49
|
| Rate for Payer: UHC Exchange |
$473.59
|
| Rate for Payer: UHC Medicaid |
$151.44
|
| Rate for Payer: UHCCP DNSP |
$239.49
|
| Rate for Payer: UHCCP Medicaid |
$151.44
|
|
