|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,654.25 |
| Max. Negotiated Rate |
$2,545.00 |
| Rate for Payer: Aetna Commercial |
$2,290.50
|
| Rate for Payer: ASR ASR |
$2,468.65
|
| Rate for Payer: ASR Commercial |
$2,468.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.92
|
| Rate for Payer: BCN Commercial |
$1,973.14
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$2,392.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Healthscope Commercial |
$2,545.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,468.65
|
| Rate for Payer: Mclaren Commercial |
$2,290.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: Nomi Health Commercial |
$2,086.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,239.60
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$907.32
|
| Rate for Payer: Aetna Medicare |
$1,272.50
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,147.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,147.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$859.80
|
| Rate for Payer: UHC Exchange |
$859.80
|
| Rate for Payer: UHCCP Medicaid |
$455.82
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$907.32
|
| Rate for Payer: Aetna Medicare |
$1,272.50
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,147.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,147.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$859.80
|
| Rate for Payer: UHC Exchange |
$859.80
|
| Rate for Payer: UHCCP Medicaid |
$455.82
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,437.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$566.87 |
| Max. Negotiated Rate |
$1,521.79 |
| Rate for Payer: Aetna Commercial |
$1,197.71
|
| Rate for Payer: Aetna Medicare |
$718.50
|
| Rate for Payer: BCBS Complete |
$635.39
|
| Rate for Payer: BCBS Trust/PPO |
$566.87
|
| Rate for Payer: BCN Commercial |
$1,368.79
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Meridian Medicaid |
$635.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$605.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,521.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,521.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.43
|
| Rate for Payer: UHC Exchange |
$1,034.43
|
| Rate for Payer: UHCCP Medicaid |
$605.13
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$5,260.17 |
| Rate for Payer: Aetna Commercial |
$4,000.38
|
| Rate for Payer: Aetna Medicare |
$2,787.00
|
| Rate for Payer: BCBS Complete |
$1,975.28
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$4,291.08
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Meridian Medicaid |
$1,975.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,881.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,260.17
|
| Rate for Payer: Priority Health Narrow Network |
$5,260.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,210.50
|
| Rate for Payer: UHC Exchange |
$3,210.50
|
| Rate for Payer: UHCCP Medicaid |
$1,881.22
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,965.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$79.81 |
| Max. Negotiated Rate |
$6,699.15 |
| Rate for Payer: Aetna Commercial |
$5,120.17
|
| Rate for Payer: Aetna Medicare |
$3,982.50
|
| Rate for Payer: BCBS Complete |
$2,517.63
|
| Rate for Payer: BCBS Trust/PPO |
$79.81
|
| Rate for Payer: BCN Commercial |
$5,466.34
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Meridian Medicaid |
$2,517.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,397.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,177.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,699.15
|
| Rate for Payer: Priority Health Narrow Network |
$6,699.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,834.56
|
| Rate for Payer: UHC Exchange |
$4,834.56
|
| Rate for Payer: UHCCP Medicaid |
$2,397.74
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,232.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$800.80 |
| Rate for Payer: Aetna Commercial |
$267.76
|
| Rate for Payer: Aetna Medicare |
$616.00
|
| Rate for Payer: BCBS Complete |
$136.21
|
| Rate for Payer: BCBS Trust/PPO |
$406.79
|
| Rate for Payer: BCN Commercial |
$285.08
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Meridian Medicaid |
$136.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$356.21
|
| Rate for Payer: Priority Health Narrow Network |
$356.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.77
|
| Rate for Payer: UHC Exchange |
$316.77
|
| Rate for Payer: UHCCP Medicaid |
$129.72
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$1,068.75 |
| Rate for Payer: Aetna Commercial |
$62.37
|
| Rate for Payer: Aetna Medicare |
$88.50
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.75
|
| Rate for Payer: BCN Commercial |
$137.81
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.27
|
| Rate for Payer: Priority Health Narrow Network |
$66.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.91
|
| Rate for Payer: UHC Exchange |
$54.91
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$241.33 |
| Max. Negotiated Rate |
$1,900.30 |
| Rate for Payer: Aetna Commercial |
$438.14
|
| Rate for Payer: Aetna Medicare |
$290.50
|
| Rate for Payer: BCBS Complete |
$253.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,900.30
|
| Rate for Payer: BCN Commercial |
$550.25
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Meridian Medicaid |
$253.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$563.52
|
| Rate for Payer: Priority Health Narrow Network |
$563.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$389.92
|
| Rate for Payer: UHC Exchange |
$389.92
|
| Rate for Payer: UHCCP Medicaid |
$241.33
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$393.11
|
| Rate for Payer: Aetna Medicare |
$476.00
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$493.07
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$503.00
|
| Rate for Payer: Priority Health Narrow Network |
$503.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$347.66
|
| Rate for Payer: UHC Exchange |
$347.66
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
|
|
PR TRACHEOBRONCHOSCOPY THRU EST TRACHEOSTOMY INC
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$1,672.60 |
| Rate for Payer: Aetna Commercial |
$145.81
|
| Rate for Payer: Aetna Medicare |
$231.00
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,672.60
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.35
|
| Rate for Payer: Priority Health Narrow Network |
$160.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.07
|
| Rate for Payer: UHC Exchange |
$145.07
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,405.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$863.29 |
| Max. Negotiated Rate |
$2,863.25 |
| Rate for Payer: Aetna Commercial |
$1,748.98
|
| Rate for Payer: Aetna Medicare |
$2,202.50
|
| Rate for Payer: BCBS Complete |
$906.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,349.28
|
| Rate for Payer: BCN Commercial |
$1,995.76
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Meridian Medicaid |
$906.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$863.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,863.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,880.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,880.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,477.83
|
| Rate for Payer: UHC Exchange |
$1,477.83
|
| Rate for Payer: UHCCP Medicaid |
$863.29
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$455.82 |
| Max. Negotiated Rate |
$1,319.17 |
| Rate for Payer: Aetna Commercial |
$924.68
|
| Rate for Payer: Aetna Medicare |
$677.50
|
| Rate for Payer: BCBS Complete |
$478.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.17
|
| Rate for Payer: BCN Commercial |
$1,052.12
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Meridian Medicaid |
$478.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$880.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$995.53
|
| Rate for Payer: Priority Health Narrow Network |
$995.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.37
|
| Rate for Payer: UHC Exchange |
$811.37
|
| Rate for Payer: UHCCP Medicaid |
$455.82
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$1,181.81 |
| Rate for Payer: Aetna Commercial |
$554.79
|
| Rate for Payer: Aetna Medicare |
$456.00
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.81
|
| Rate for Payer: BCN Commercial |
$625.99
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$593.24
|
| Rate for Payer: Priority Health Narrow Network |
$593.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$485.14
|
| Rate for Payer: UHC Exchange |
$485.14
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$525.85 |
| Rate for Payer: Aetna Commercial |
$432.01
|
| Rate for Payer: Aetna Medicare |
$404.50
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS Trust/PPO |
$424.08
|
| Rate for Payer: BCN Commercial |
$481.35
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.73
|
| Rate for Payer: Priority Health Narrow Network |
$453.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.70
|
| Rate for Payer: UHC Exchange |
$213.70
|
| Rate for Payer: UHCCP Medicaid |
$210.23
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$1,439.09 |
| Rate for Payer: Aetna Commercial |
$414.60
|
| Rate for Payer: Aetna Medicare |
$594.50
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.09
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.75
|
| Rate for Payer: Priority Health Narrow Network |
$440.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.35
|
| Rate for Payer: UHC Exchange |
$259.35
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$610.88 |
| Max. Negotiated Rate |
$1,410.81 |
| Rate for Payer: Aetna Commercial |
$1,228.30
|
| Rate for Payer: Aetna Medicare |
$774.50
|
| Rate for Payer: BCBS Complete |
$641.42
|
| Rate for Payer: BCBS Trust/PPO |
$825.73
|
| Rate for Payer: BCN Commercial |
$1,410.81
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Meridian Medicaid |
$641.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,335.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,335.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$783.73
|
| Rate for Payer: UHC Exchange |
$783.73
|
| Rate for Payer: UHCCP Medicaid |
$610.88
|
|
|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$193.40 |
| Max. Negotiated Rate |
$753.88 |
| Rate for Payer: Aetna Commercial |
$396.30
|
| Rate for Payer: Aetna Medicare |
$525.00
|
| Rate for Payer: BCBS Complete |
$203.07
|
| Rate for Payer: BCBS Trust/PPO |
$753.88
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Meridian Medicaid |
$203.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$420.37
|
| Rate for Payer: Priority Health Narrow Network |
$420.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$459.74
|
| Rate for Payer: UHC Exchange |
$459.74
|
| Rate for Payer: UHCCP Medicaid |
$193.40
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$286.27 |
| Max. Negotiated Rate |
$1,079.85 |
| Rate for Payer: Aetna Commercial |
$574.14
|
| Rate for Payer: Aetna Medicare |
$519.00
|
| Rate for Payer: BCBS Complete |
$300.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.85
|
| Rate for Payer: BCN Commercial |
$653.36
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Meridian Medicaid |
$300.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$621.51
|
| Rate for Payer: Priority Health Narrow Network |
$621.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$298.89
|
| Rate for Payer: UHC Exchange |
$298.89
|
| Rate for Payer: UHCCP Medicaid |
$286.27
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$1,778.79 |
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.79
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.20
|
| Rate for Payer: Priority Health Narrow Network |
$48.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.05
|
| Rate for Payer: UHC Exchange |
$40.05
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,385.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,464.98 |
| Rate for Payer: Aetna Commercial |
$882.07
|
| Rate for Payer: Aetna Medicare |
$692.50
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,464.98
|
| Rate for Payer: BCN Commercial |
$936.79
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$915.33
|
| Rate for Payer: UHC Exchange |
$915.33
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
|
|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,665.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$982.14 |
| Max. Negotiated Rate |
$3,682.25 |
| Rate for Payer: Aetna Commercial |
$2,113.97
|
| Rate for Payer: Aetna Medicare |
$2,832.50
|
| Rate for Payer: BCBS Complete |
$1,031.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.66
|
| Rate for Payer: BCN Commercial |
$2,244.00
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Meridian Medicaid |
$1,031.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$982.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,682.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,442.14
|
| Rate for Payer: Priority Health Narrow Network |
$2,442.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,577.90
|
| Rate for Payer: UHC Exchange |
$2,577.90
|
| Rate for Payer: UHCCP Medicaid |
$982.14
|
|
|
PR TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR
|
Professional
|
Both
|
$1,630.00
|
|
|
Service Code
|
HCPCS 0387T
|
| Min. Negotiated Rate |
$652.00 |
| Max. Negotiated Rate |
$1,059.50 |
| Rate for Payer: Aetna Medicare |
$815.00
|
| Rate for Payer: BCBS Complete |
$652.00
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,059.50
|
|
|
PR TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 75960
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$77.35 |
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
|
|
PR TRANSCATH OCCLUSION,PERCUT
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 37204
|
| Min. Negotiated Rate |
$742.40 |
| Max. Negotiated Rate |
$1,206.40 |
| Rate for Payer: Aetna Medicare |
$928.00
|
| Rate for Payer: BCBS Complete |
$742.40
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.40
|
|
