|
PR THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$2,559.00
|
|
|
Service Code
|
HCPCS 60522
|
| Min. Negotiated Rate |
$603.85 |
| Max. Negotiated Rate |
$2,178.76 |
| Rate for Payer: Aetna Commercial |
$1,766.25
|
| Rate for Payer: Aetna Medicare |
$1,279.50
|
| Rate for Payer: BCBS Complete |
$909.58
|
| Rate for Payer: BCBS Trust/PPO |
$603.85
|
| Rate for Payer: BCN Commercial |
$1,968.88
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Meridian Medicaid |
$909.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$866.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,663.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,178.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,178.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,618.72
|
| Rate for Payer: UHC Exchange |
$1,618.72
|
| Rate for Payer: UHCCP Medicaid |
$866.27
|
|
|
PR THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX
|
Professional
|
Both
|
$3,531.00
|
|
|
Service Code
|
HCPCS 60520
|
| Min. Negotiated Rate |
$250.94 |
| Max. Negotiated Rate |
$2,295.15 |
| Rate for Payer: Aetna Commercial |
$1,354.31
|
| Rate for Payer: Aetna Medicare |
$1,765.50
|
| Rate for Payer: BCBS Complete |
$708.52
|
| Rate for Payer: BCBS Trust/PPO |
$250.94
|
| Rate for Payer: BCN Commercial |
$1,531.51
|
| Rate for Payer: Cash Price |
$2,824.80
|
| Rate for Payer: Cash Price |
$2,824.80
|
| Rate for Payer: Meridian Medicaid |
$708.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,295.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,697.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,697.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,168.64
|
| Rate for Payer: UHC Exchange |
$1,168.64
|
| Rate for Payer: UHCCP Medicaid |
$674.78
|
|
|
PR THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$3,947.00
|
|
|
Service Code
|
HCPCS 60521
|
| Min. Negotiated Rate |
$373.51 |
| Max. Negotiated Rate |
$2,565.55 |
| Rate for Payer: Aetna Commercial |
$1,448.43
|
| Rate for Payer: Aetna Medicare |
$1,973.50
|
| Rate for Payer: BCBS Complete |
$752.14
|
| Rate for Payer: BCBS Trust/PPO |
$373.51
|
| Rate for Payer: BCN Commercial |
$1,625.35
|
| Rate for Payer: Cash Price |
$3,157.60
|
| Rate for Payer: Cash Price |
$3,157.60
|
| Rate for Payer: Meridian Medicaid |
$752.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,565.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,800.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,337.04
|
| Rate for Payer: UHC Exchange |
$1,337.04
|
| Rate for Payer: UHCCP Medicaid |
$716.32
|
|
|
PR THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL
|
Professional
|
Both
|
$3,191.00
|
|
|
Service Code
|
HCPCS 60260
|
| Min. Negotiated Rate |
$317.51 |
| Max. Negotiated Rate |
$2,074.15 |
| Rate for Payer: Aetna Commercial |
$1,402.16
|
| Rate for Payer: Aetna Medicare |
$1,595.50
|
| Rate for Payer: BCBS Complete |
$733.57
|
| Rate for Payer: BCBS Trust/PPO |
$317.51
|
| Rate for Payer: BCN Commercial |
$1,591.13
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Meridian Medicaid |
$733.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$698.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,760.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,760.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,231.55
|
| Rate for Payer: UHC Exchange |
$1,231.55
|
| Rate for Payer: UHCCP Medicaid |
$698.64
|
|
|
PR THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH
|
Professional
|
Both
|
$2,186.00
|
|
|
Service Code
|
HCPCS 60271
|
| Min. Negotiated Rate |
$677.98 |
| Max. Negotiated Rate |
$3,645.80 |
| Rate for Payer: Aetna Commercial |
$1,358.54
|
| Rate for Payer: Aetna Medicare |
$1,093.00
|
| Rate for Payer: BCBS Complete |
$711.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,645.80
|
| Rate for Payer: BCN Commercial |
$1,542.26
|
| Rate for Payer: Cash Price |
$1,748.80
|
| Rate for Payer: Cash Price |
$1,748.80
|
| Rate for Payer: Meridian Medicaid |
$711.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,420.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,706.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,706.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,192.12
|
| Rate for Payer: UHC Exchange |
$1,192.12
|
| Rate for Payer: UHCCP Medicaid |
$677.98
|
|
|
PR THYROIDECTOMY TOTAL/COMPLETE
|
Professional
|
Both
|
$3,110.00
|
|
|
Service Code
|
HCPCS 60240
|
| Min. Negotiated Rate |
$590.01 |
| Max. Negotiated Rate |
$2,021.50 |
| Rate for Payer: Aetna Commercial |
$1,181.69
|
| Rate for Payer: Aetna Medicare |
$1,555.00
|
| Rate for Payer: BCBS Complete |
$619.51
|
| Rate for Payer: BCBS Trust/PPO |
$681.51
|
| Rate for Payer: BCN Commercial |
$1,341.91
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Meridian Medicaid |
$619.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,021.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,485.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,485.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,092.17
|
| Rate for Payer: UHC Exchange |
$1,092.17
|
| Rate for Payer: UHCCP Medicaid |
$590.01
|
|
|
PR THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT
|
Professional
|
Both
|
$2,397.00
|
|
|
Service Code
|
HCPCS 60252
|
| Min. Negotiated Rate |
$785.58 |
| Max. Negotiated Rate |
$2,134.61 |
| Rate for Payer: Aetna Commercial |
$1,701.55
|
| Rate for Payer: Aetna Medicare |
$1,198.50
|
| Rate for Payer: BCBS Complete |
$888.56
|
| Rate for Payer: BCBS Trust/PPO |
$785.58
|
| Rate for Payer: BCN Commercial |
$1,930.76
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Meridian Medicaid |
$888.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,134.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,134.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,481.50
|
| Rate for Payer: UHC Exchange |
$1,481.50
|
| Rate for Payer: UHCCP Medicaid |
$846.25
|
|
|
PR THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT
|
Professional
|
Both
|
$3,161.00
|
|
|
Service Code
|
HCPCS 60254
|
| Min. Negotiated Rate |
$225.06 |
| Max. Negotiated Rate |
$2,693.03 |
| Rate for Payer: Aetna Commercial |
$2,140.95
|
| Rate for Payer: Aetna Medicare |
$1,580.50
|
| Rate for Payer: BCBS Complete |
$1,121.16
|
| Rate for Payer: BCBS Trust/PPO |
$225.06
|
| Rate for Payer: BCN Commercial |
$2,438.50
|
| Rate for Payer: Cash Price |
$2,528.80
|
| Rate for Payer: Cash Price |
$2,528.80
|
| Rate for Payer: Meridian Medicaid |
$1,121.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,067.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,054.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,693.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,693.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,899.36
|
| Rate for Payer: UHC Exchange |
$1,899.36
|
| Rate for Payer: UHCCP Medicaid |
$1,067.77
|
|
|
PR THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC
|
Professional
|
Both
|
$5,453.00
|
|
|
Service Code
|
HCPCS 60270
|
| Min. Negotiated Rate |
$309.58 |
| Max. Negotiated Rate |
$3,544.45 |
| Rate for Payer: Aetna Commercial |
$1,762.15
|
| Rate for Payer: Aetna Medicare |
$2,726.50
|
| Rate for Payer: BCBS Complete |
$915.85
|
| Rate for Payer: BCBS Trust/PPO |
$309.58
|
| Rate for Payer: BCN Commercial |
$1,991.36
|
| Rate for Payer: Cash Price |
$4,362.40
|
| Rate for Payer: Cash Price |
$4,362.40
|
| Rate for Payer: Meridian Medicaid |
$915.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$872.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,544.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,201.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,201.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,564.86
|
| Rate for Payer: UHC Exchange |
$1,564.86
|
| Rate for Payer: UHCCP Medicaid |
$872.24
|
|
|
PR TIS CLTR SKN AGRFT F/S/N/H/F/G/M/DGT 1ST 25SQCM/
|
Professional
|
Both
|
$1,325.00
|
|
|
Service Code
|
HCPCS 15155
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$1,166.47 |
| Rate for Payer: Aetna Commercial |
$787.97
|
| Rate for Payer: Aetna Medicare |
$662.50
|
| Rate for Payer: BCBS Complete |
$494.27
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Meridian Medicaid |
$494.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.01
|
| Rate for Payer: Priority Health Narrow Network |
$987.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$664.14
|
| Rate for Payer: UHC Exchange |
$664.14
|
| Rate for Payer: UHCCP Medicaid |
$470.73
|
|
|
PR TIS CLTR SKN AGRFT F/S/N/H/F/G/M/DGT AD 1-75SQCM
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 15156
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$166.77
|
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: BCBS Complete |
$100.64
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$231.63
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Meridian Medicaid |
$100.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.83
|
| Rate for Payer: Priority Health Narrow Network |
$201.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.20
|
| Rate for Payer: UHC Exchange |
$179.20
|
| Rate for Payer: UHCCP Medicaid |
$95.85
|
|
|
PR TISS CLTR SKIN AGRFT T/A/L EA ADD 100 SQCM/EA 1%
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 15152
|
| Min. Negotiated Rate |
$92.23 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$151.77
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$96.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$218.44
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Meridian Medicaid |
$96.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.48
|
| Rate for Payer: Priority Health Narrow Network |
$186.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.52
|
| Rate for Payer: UHC Exchange |
$160.52
|
| Rate for Payer: UHCCP Medicaid |
$92.23
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L 1ST 25 SQ CM/<
|
Professional
|
Both
|
$1,205.00
|
|
|
Service Code
|
HCPCS 15150
|
| Min. Negotiated Rate |
$212.16 |
| Max. Negotiated Rate |
$1,035.02 |
| Rate for Payer: Aetna Commercial |
$698.22
|
| Rate for Payer: Aetna Medicare |
$602.50
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$1,035.02
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$869.16
|
| Rate for Payer: Priority Health Narrow Network |
$869.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$676.38
|
| Rate for Payer: UHC Exchange |
$676.38
|
| Rate for Payer: UHCCP Medicaid |
$412.58
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L ADDL 1-75 SQCM
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 15151
|
| Min. Negotiated Rate |
$69.44 |
| Max. Negotiated Rate |
$206.12 |
| Rate for Payer: Aetna Commercial |
$120.68
|
| Rate for Payer: Aetna Medicare |
$115.00
|
| Rate for Payer: BCBS Complete |
$72.91
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$172.50
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Meridian Medicaid |
$72.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.29
|
| Rate for Payer: Priority Health Narrow Network |
$146.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$124.78
|
| Rate for Payer: UHC Exchange |
$124.78
|
| Rate for Payer: UHCCP Medicaid |
$69.44
|
|
|
PR TISSUE EXPANDER PLACEMENT BREAST RECONSTRUCTION
|
Professional
|
Both
|
$2,448.00
|
|
|
Service Code
|
HCPCS 19357
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$1,696.69 |
| Rate for Payer: Aetna Commercial |
$1,253.56
|
| Rate for Payer: Aetna Medicare |
$1,224.00
|
| Rate for Payer: BCBS Complete |
$788.59
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$1,696.69
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Meridian Medicaid |
$788.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,576.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,576.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,638.14
|
| Rate for Payer: UHC Exchange |
$1,638.14
|
| Rate for Payer: UHCCP Medicaid |
$751.04
|
|
|
PR TIXAGEV AND CILGAV INJ
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS M0220
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$2,507.84 |
| Rate for Payer: Aetna Commercial |
$150.50
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.84
|
| Rate for Payer: BCN Commercial |
$99.03
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.93
|
| Rate for Payer: Priority Health Narrow Network |
$144.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.93
|
| Rate for Payer: UHC Exchange |
$162.93
|
|
|
PR TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP
|
Professional
|
Both
|
$3,605.00
|
|
|
Service Code
|
HCPCS 69637
|
| Min. Negotiated Rate |
$896.94 |
| Max. Negotiated Rate |
$2,372.93 |
| Rate for Payer: Aetna Commercial |
$1,624.04
|
| Rate for Payer: Aetna Medicare |
$1,802.50
|
| Rate for Payer: BCBS Complete |
$941.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,372.93
|
| Rate for Payer: BCN Commercial |
$2,072.97
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Meridian Medicaid |
$941.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$896.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,343.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,052.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,052.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,503.61
|
| Rate for Payer: UHC Exchange |
$1,503.61
|
| Rate for Payer: UHCCP Medicaid |
$896.94
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR
|
Professional
|
Both
|
$4,310.00
|
|
|
Service Code
|
HCPCS 69644
|
| Min. Negotiated Rate |
$964.89 |
| Max. Negotiated Rate |
$2,801.50 |
| Rate for Payer: Aetna Commercial |
$1,699.51
|
| Rate for Payer: Aetna Medicare |
$2,155.00
|
| Rate for Payer: BCBS Complete |
$1,013.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,406.93
|
| Rate for Payer: BCN Commercial |
$2,226.41
|
| Rate for Payer: Cash Price |
$3,448.00
|
| Rate for Payer: Cash Price |
$3,448.00
|
| Rate for Payer: Meridian Medicaid |
$1,013.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$964.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,801.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,203.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,203.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,625.40
|
| Rate for Payer: UHC Exchange |
$1,625.40
|
| Rate for Payer: UHCCP Medicaid |
$964.89
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR
|
Professional
|
Both
|
$4,076.00
|
|
|
Service Code
|
HCPCS 69643
|
| Min. Negotiated Rate |
$780.01 |
| Max. Negotiated Rate |
$2,649.40 |
| Rate for Payer: Aetna Commercial |
$1,396.70
|
| Rate for Payer: Aetna Medicare |
$2,038.00
|
| Rate for Payer: BCBS Complete |
$819.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,123.77
|
| Rate for Payer: BCN Commercial |
$1,808.60
|
| Rate for Payer: Cash Price |
$3,260.80
|
| Rate for Payer: Cash Price |
$3,260.80
|
| Rate for Payer: Meridian Medicaid |
$819.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,649.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,792.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,792.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,349.44
|
| Rate for Payer: UHC Exchange |
$1,349.44
|
| Rate for Payer: UHCCP Medicaid |
$780.01
|
|
|
PR TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$3,931.00
|
|
|
Service Code
|
HCPCS 69641
|
| Min. Negotiated Rate |
$664.77 |
| Max. Negotiated Rate |
$2,555.15 |
| Rate for Payer: Aetna Commercial |
$1,185.92
|
| Rate for Payer: Aetna Medicare |
$1,965.50
|
| Rate for Payer: BCBS Complete |
$698.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,242.56
|
| Rate for Payer: BCN Commercial |
$1,541.29
|
| Rate for Payer: Cash Price |
$3,144.80
|
| Rate for Payer: Cash Price |
$3,144.80
|
| Rate for Payer: Meridian Medicaid |
$698.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,555.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,528.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,528.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,145.61
|
| Rate for Payer: UHC Exchange |
$1,145.61
|
| Rate for Payer: UHCCP Medicaid |
$664.77
|
|
|
PR TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$2,684.00
|
|
|
Service Code
|
HCPCS 69642
|
| Min. Negotiated Rate |
$852.64 |
| Max. Negotiated Rate |
$1,975.73 |
| Rate for Payer: Aetna Commercial |
$1,523.27
|
| Rate for Payer: Aetna Medicare |
$1,342.00
|
| Rate for Payer: BCBS Complete |
$895.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,237.81
|
| Rate for Payer: BCN Commercial |
$1,975.73
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Meridian Medicaid |
$895.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,962.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,962.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,477.36
|
| Rate for Payer: UHC Exchange |
$1,477.36
|
| Rate for Payer: UHCCP Medicaid |
$852.64
|
|
|
PR TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH
|
Professional
|
Both
|
$3,759.00
|
|
|
Service Code
|
HCPCS 0483T
|
| Min. Negotiated Rate |
$131.11 |
| Max. Negotiated Rate |
$2,443.35 |
| Rate for Payer: Aetna Commercial |
$1,415.73
|
| Rate for Payer: Aetna Medicare |
$1,879.50
|
| Rate for Payer: BCBS Complete |
$1,503.60
|
| Rate for Payer: BCBS Trust/PPO |
$131.11
|
| Rate for Payer: Cash Price |
$3,007.20
|
| Rate for Payer: Cash Price |
$3,007.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,892.38
|
| Rate for Payer: UHC Exchange |
$1,892.38
|
|
|
PR TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN
|
Professional
|
Both
|
$1,735.00
|
|
|
Service Code
|
HCPCS 27681
|
| Min. Negotiated Rate |
$332.49 |
| Max. Negotiated Rate |
$1,127.75 |
| Rate for Payer: Aetna Commercial |
$686.91
|
| Rate for Payer: Aetna Medicare |
$867.50
|
| Rate for Payer: BCBS Complete |
$349.11
|
| Rate for Payer: BCBS Trust/PPO |
$924.00
|
| Rate for Payer: BCN Commercial |
$742.30
|
| Rate for Payer: Cash Price |
$1,388.00
|
| Rate for Payer: Cash Price |
$1,388.00
|
| Rate for Payer: Meridian Medicaid |
$349.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$785.68
|
| Rate for Payer: Priority Health Narrow Network |
$785.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$601.75
|
| Rate for Payer: UHC Exchange |
$601.75
|
| Rate for Payer: UHCCP Medicaid |
$332.49
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Facility
|
IP
|
$1,474.00
|
|
|
Service Code
|
CPT 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$958.10 |
| Max. Negotiated Rate |
$1,474.00 |
| Rate for Payer: Aetna Commercial |
$1,326.60
|
| Rate for Payer: ASR ASR |
$1,429.78
|
| Rate for Payer: ASR Commercial |
$1,429.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.16
|
| Rate for Payer: BCN Commercial |
$1,142.79
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$1,385.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.20
|
| Rate for Payer: Healthscope Commercial |
$1,474.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,429.78
|
| Rate for Payer: Mclaren Commercial |
$1,326.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,252.90
|
| Rate for Payer: Nomi Health Commercial |
$1,208.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,297.12
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Facility
|
OP
|
$1,474.00
|
|
|
Service Code
|
CPT 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$958.10 |
| Max. Negotiated Rate |
$4,927.45 |
| Rate for Payer: Aetna Commercial |
$1,326.60
|
| Rate for Payer: Aetna Medicare |
$3,179.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: ASR ASR |
$1,429.78
|
| Rate for Payer: ASR Commercial |
$1,429.78
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,207.06
|
| Rate for Payer: BCN Commercial |
$1,142.79
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$1,385.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,474.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,429.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,179.00
|
| Rate for Payer: Mclaren Commercial |
$1,326.60
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,252.90
|
| Rate for Payer: Nomi Health Commercial |
$1,208.68
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,496.90
|
| Rate for Payer: PHP Medicaid |
$1,703.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,291.52
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,297.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$4,927.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP DNSP |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
