|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$292.39 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$391.80
|
| Rate for Payer: Aetna Medicare |
$292.39
|
| Rate for Payer: BCBS Complete |
$420.00
|
| Rate for Payer: BCBS MAPPO |
$292.39
|
| Rate for Payer: BCN Medicare Advantage |
$292.39
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$421.04
|
| Rate for Payer: Cofinity Commercial |
$391.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.39
|
| Rate for Payer: Healthscope Commercial |
$350.87
|
| Rate for Payer: Healthscope Whirlpool |
$350.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.01
|
| Rate for Payer: Nomi Health Commercial |
$350.87
|
| Rate for Payer: PACE SWMI |
$292.39
|
| Rate for Payer: PHP Medicare Advantage |
$292.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health Medicare |
$292.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.39
|
| Rate for Payer: UHC Medicare Advantage |
$292.39
|
| Rate for Payer: UHCCP DNSP |
$292.39
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$415.20 |
| Max. Negotiated Rate |
$674.70 |
| Rate for Payer: Aetna Commercial |
$574.74
|
| Rate for Payer: Aetna Medicare |
$428.91
|
| Rate for Payer: BCBS Complete |
$415.20
|
| Rate for Payer: BCBS MAPPO |
$428.91
|
| Rate for Payer: BCN Medicare Advantage |
$428.91
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$617.63
|
| Rate for Payer: Cofinity Commercial |
$574.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.91
|
| Rate for Payer: Healthscope Commercial |
$514.69
|
| Rate for Payer: Healthscope Whirlpool |
$514.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.36
|
| Rate for Payer: Nomi Health Commercial |
$514.69
|
| Rate for Payer: PACE SWMI |
$428.91
|
| Rate for Payer: PHP Medicare Advantage |
$428.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health Medicare |
$428.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.91
|
| Rate for Payer: UHC Medicare Advantage |
$428.91
|
| Rate for Payer: UHCCP DNSP |
$428.91
|
|
|
PR TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 31502
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Aetna Commercial |
$44.09
|
| Rate for Payer: Aetna Medicare |
$32.90
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$47.38
|
| Rate for Payer: Cofinity Commercial |
$44.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$39.48
|
| Rate for Payer: Healthscope Whirlpool |
$39.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.55
|
| Rate for Payer: Nomi Health Commercial |
$39.48
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Medicare |
$32.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.90
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
| Rate for Payer: UHCCP DNSP |
$32.90
|
|
|
PR TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I
|
Professional
|
Both
|
$1,385.00
|
|
|
Service Code
|
HCPCS 34712
|
| Min. Negotiated Rate |
$554.00 |
| Max. Negotiated Rate |
$900.76 |
| Rate for Payer: Aetna Commercial |
$838.21
|
| Rate for Payer: Aetna Medicare |
$625.53
|
| Rate for Payer: BCBS Complete |
$554.00
|
| Rate for Payer: BCBS MAPPO |
$625.53
|
| Rate for Payer: BCN Medicare Advantage |
$625.53
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cofinity Commercial |
$900.76
|
| Rate for Payer: Cofinity Commercial |
$838.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.53
|
| Rate for Payer: Healthscope Commercial |
$750.64
|
| Rate for Payer: Healthscope Whirlpool |
$750.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.81
|
| Rate for Payer: Nomi Health Commercial |
$750.64
|
| Rate for Payer: PACE SWMI |
$625.53
|
| Rate for Payer: PHP Medicare Advantage |
$625.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.25
|
| Rate for Payer: Priority Health Medicare |
$625.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.53
|
| Rate for Payer: UHC Medicare Advantage |
$625.53
|
| Rate for Payer: UHCCP DNSP |
$625.53
|
|
|
PR TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE
|
Professional
|
Both
|
$5,665.00
|
|
|
Service Code
|
HCPCS 33366
|
| Min. Negotiated Rate |
$1,500.62 |
| Max. Negotiated Rate |
$3,682.25 |
| Rate for Payer: Aetna Commercial |
$2,010.83
|
| Rate for Payer: Aetna Medicare |
$1,500.62
|
| Rate for Payer: BCBS Complete |
$2,266.00
|
| Rate for Payer: BCBS MAPPO |
$1,500.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,500.62
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cash Price |
$4,532.00
|
| Rate for Payer: Cofinity Commercial |
$2,160.89
|
| Rate for Payer: Cofinity Commercial |
$2,010.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,500.62
|
| Rate for Payer: Healthscope Commercial |
$1,800.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,800.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,575.65
|
| Rate for Payer: Nomi Health Commercial |
$1,800.74
|
| Rate for Payer: PACE SWMI |
$1,500.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,500.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,682.25
|
| Rate for Payer: Priority Health Medicare |
$1,500.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,500.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,500.62
|
| Rate for Payer: UHCCP DNSP |
$1,500.62
|
|
|
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
|
|
|
PR TRANSCATH RX INFUSE OTHER
|
Professional
|
Both
|
$1,639.00
|
|
|
Service Code
|
HCPCS 37202
|
| Min. Negotiated Rate |
$655.60 |
| Max. Negotiated Rate |
$1,065.35 |
| Rate for Payer: Aetna Medicare |
$819.50
|
| Rate for Payer: BCBS Complete |
$655.60
|
| Rate for Payer: Cash Price |
$1,311.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.35
|
|
|
PR TRANSCATH STENT EACH ADDN VESSL,PERC
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 37206
|
| Min. Negotiated Rate |
$371.20 |
| Max. Negotiated Rate |
$603.20 |
| Rate for Payer: Aetna Medicare |
$464.00
|
| Rate for Payer: BCBS Complete |
$371.20
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.20
|
|
|
PR TRANSCATH STENT INIT VESSEL,PERCUT
|
Professional
|
Both
|
$1,719.00
|
|
|
Service Code
|
HCPCS 37205
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$1,117.35 |
| Rate for Payer: Aetna Medicare |
$859.50
|
| Rate for Payer: BCBS Complete |
$687.60
|
| Rate for Payer: Cash Price |
$1,375.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,117.35
|
|
|
PR TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART
|
Professional
|
Both
|
$4,519.00
|
|
|
Service Code
|
HCPCS 61596
|
| Min. Negotiated Rate |
$1,807.60 |
| Max. Negotiated Rate |
$3,328.83 |
| Rate for Payer: Aetna Commercial |
$3,097.66
|
| Rate for Payer: Aetna Medicare |
$2,311.69
|
| Rate for Payer: BCBS Complete |
$1,807.60
|
| Rate for Payer: BCBS MAPPO |
$2,311.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,311.69
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cofinity Commercial |
$3,097.66
|
| Rate for Payer: Cofinity Commercial |
$3,328.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,311.69
|
| Rate for Payer: Healthscope Commercial |
$2,774.03
|
| Rate for Payer: Healthscope Whirlpool |
$2,774.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,427.27
|
| Rate for Payer: Nomi Health Commercial |
$2,774.03
|
| Rate for Payer: PACE SWMI |
$2,311.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,311.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,937.35
|
| Rate for Payer: Priority Health Medicare |
$2,311.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,311.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,311.69
|
| Rate for Payer: UHCCP DNSP |
$2,311.69
|
|
|
PR TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 93892
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Aetna Commercial |
$351.75
|
| Rate for Payer: Aetna Medicare |
$262.50
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS MAPPO |
$262.50
|
| Rate for Payer: BCN Medicare Advantage |
$262.50
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$378.00
|
| Rate for Payer: Cofinity Commercial |
$351.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.50
|
| Rate for Payer: Healthscope Commercial |
$315.00
|
| Rate for Payer: Healthscope Whirlpool |
$315.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.62
|
| Rate for Payer: Nomi Health Commercial |
$315.00
|
| Rate for Payer: PACE SWMI |
$262.50
|
| Rate for Payer: PHP Medicare Advantage |
$262.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.95
|
| Rate for Payer: Priority Health Medicare |
$262.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.50
|
| Rate for Payer: UHC Medicare Advantage |
$262.50
|
| Rate for Payer: UHCCP DNSP |
$262.50
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 93886
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$330.48 |
| Rate for Payer: Aetna Commercial |
$307.53
|
| Rate for Payer: Aetna Commercial |
$307.53
|
| Rate for Payer: Aetna Medicare |
$229.50
|
| Rate for Payer: Aetna Medicare |
$229.50
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS Complete |
$252.80
|
| Rate for Payer: BCBS MAPPO |
$229.50
|
| Rate for Payer: BCBS MAPPO |
$229.50
|
| Rate for Payer: BCN Medicare Advantage |
$229.50
|
| Rate for Payer: BCN Medicare Advantage |
$229.50
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cofinity Commercial |
$307.53
|
| Rate for Payer: Cofinity Commercial |
$330.48
|
| Rate for Payer: Cofinity Commercial |
$307.53
|
| Rate for Payer: Cofinity Commercial |
$330.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.50
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Healthscope Whirlpool |
$275.40
|
| Rate for Payer: Healthscope Whirlpool |
$275.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$275.40
|
| Rate for Payer: Nomi Health Commercial |
$275.40
|
| Rate for Payer: PACE SWMI |
$229.50
|
| Rate for Payer: PACE SWMI |
$229.50
|
| Rate for Payer: PHP Medicare Advantage |
$229.50
|
| Rate for Payer: PHP Medicare Advantage |
$229.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.80
|
| Rate for Payer: Priority Health Medicare |
$229.50
|
| Rate for Payer: Priority Health Medicare |
$229.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.50
|
| Rate for Payer: UHC Medicare Advantage |
$229.50
|
| Rate for Payer: UHC Medicare Advantage |
$229.50
|
| Rate for Payer: UHCCP DNSP |
$229.50
|
| Rate for Payer: UHCCP DNSP |
$229.50
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 93888
|
| Min. Negotiated Rate |
$144.94 |
| Max. Negotiated Rate |
$239.20 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$144.94
|
| Rate for Payer: BCBS Complete |
$147.20
|
| Rate for Payer: BCBS MAPPO |
$144.94
|
| Rate for Payer: BCN Medicare Advantage |
$144.94
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$208.71
|
| Rate for Payer: Cofinity Commercial |
$194.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.94
|
| Rate for Payer: Healthscope Commercial |
$173.93
|
| Rate for Payer: Healthscope Whirlpool |
$173.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.19
|
| Rate for Payer: Nomi Health Commercial |
$173.93
|
| Rate for Payer: PACE SWMI |
$144.94
|
| Rate for Payer: PHP Medicare Advantage |
$144.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.20
|
| Rate for Payer: Priority Health Medicare |
$144.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.94
|
| Rate for Payer: UHC Medicare Advantage |
$144.94
|
| Rate for Payer: UHCCP DNSP |
$144.94
|
|
|
PR TRANSECTION/AVULSION GREATER OCCIPITAL NERVE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 64744
|
| Min. Negotiated Rate |
$346.80 |
| Max. Negotiated Rate |
$717.21 |
| Rate for Payer: Aetna Commercial |
$667.40
|
| Rate for Payer: Aetna Medicare |
$498.06
|
| Rate for Payer: BCBS Complete |
$346.80
|
| Rate for Payer: BCBS MAPPO |
$498.06
|
| Rate for Payer: BCN Medicare Advantage |
$498.06
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$717.21
|
| Rate for Payer: Cofinity Commercial |
$667.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.06
|
| Rate for Payer: Healthscope Commercial |
$597.67
|
| Rate for Payer: Healthscope Whirlpool |
$597.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$522.96
|
| Rate for Payer: Nomi Health Commercial |
$597.67
|
| Rate for Payer: PACE SWMI |
$498.06
|
| Rate for Payer: PHP Medicare Advantage |
$498.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health Medicare |
$498.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.06
|
| Rate for Payer: UHC Medicare Advantage |
$498.06
|
| Rate for Payer: UHCCP DNSP |
$498.06
|
|
|
PR TRANSECTION/AVULSION OTH SPINAL NRV XDRL
|
Professional
|
Both
|
$1,307.00
|
|
|
Service Code
|
HCPCS 64772
|
| Min. Negotiated Rate |
$522.80 |
| Max. Negotiated Rate |
$849.55 |
| Rate for Payer: Aetna Commercial |
$718.49
|
| Rate for Payer: Aetna Medicare |
$536.19
|
| Rate for Payer: BCBS Complete |
$522.80
|
| Rate for Payer: BCBS MAPPO |
$536.19
|
| Rate for Payer: BCN Medicare Advantage |
$536.19
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cofinity Commercial |
$772.11
|
| Rate for Payer: Cofinity Commercial |
$718.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.19
|
| Rate for Payer: Healthscope Commercial |
$643.43
|
| Rate for Payer: Healthscope Whirlpool |
$643.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.00
|
| Rate for Payer: Nomi Health Commercial |
$643.43
|
| Rate for Payer: PACE SWMI |
$536.19
|
| Rate for Payer: PHP Medicare Advantage |
$536.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$849.55
|
| Rate for Payer: Priority Health Medicare |
$536.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.19
|
| Rate for Payer: UHC Medicare Advantage |
$536.19
|
| Rate for Payer: UHCCP DNSP |
$536.19
|
|
|
PR TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL
|
Professional
|
Both
|
$1,061.00
|
|
|
Service Code
|
HCPCS 64760
|
| Min. Negotiated Rate |
$424.40 |
| Max. Negotiated Rate |
$728.86 |
| Rate for Payer: Aetna Commercial |
$678.24
|
| Rate for Payer: Aetna Medicare |
$506.15
|
| Rate for Payer: BCBS Complete |
$424.40
|
| Rate for Payer: BCBS MAPPO |
$506.15
|
| Rate for Payer: BCN Medicare Advantage |
$506.15
|
| Rate for Payer: Cash Price |
$848.80
|
| Rate for Payer: Cash Price |
$848.80
|
| Rate for Payer: Cofinity Commercial |
$728.86
|
| Rate for Payer: Cofinity Commercial |
$678.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.15
|
| Rate for Payer: Healthscope Commercial |
$607.38
|
| Rate for Payer: Healthscope Whirlpool |
$607.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.46
|
| Rate for Payer: Nomi Health Commercial |
$607.38
|
| Rate for Payer: PACE SWMI |
$506.15
|
| Rate for Payer: PHP Medicare Advantage |
$506.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.65
|
| Rate for Payer: Priority Health Medicare |
$506.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.15
|
| Rate for Payer: UHC Medicare Advantage |
$506.15
|
| Rate for Payer: UHCCP DNSP |
$506.15
|
|
|
PR TRANSFER ADDUCTOR ISCHIUM
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 27098
|
| Min. Negotiated Rate |
$673.33 |
| Max. Negotiated Rate |
$1,727.05 |
| Rate for Payer: Aetna Commercial |
$902.26
|
| Rate for Payer: Aetna Medicare |
$673.33
|
| Rate for Payer: BCBS Complete |
$1,062.80
|
| Rate for Payer: BCBS MAPPO |
$673.33
|
| Rate for Payer: BCN Medicare Advantage |
$673.33
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cofinity Commercial |
$969.60
|
| Rate for Payer: Cofinity Commercial |
$902.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.33
|
| Rate for Payer: Healthscope Commercial |
$808.00
|
| Rate for Payer: Healthscope Whirlpool |
$808.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$707.00
|
| Rate for Payer: Nomi Health Commercial |
$808.00
|
| Rate for Payer: PACE SWMI |
$673.33
|
| Rate for Payer: PHP Medicare Advantage |
$673.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.05
|
| Rate for Payer: Priority Health Medicare |
$673.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$673.33
|
| Rate for Payer: UHC Medicare Advantage |
$673.33
|
| Rate for Payer: UHCCP DNSP |
$673.33
|
|
|
PR TRANSFER ANY PEDICLE FLAP ANY LOCATION
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 15650
|
| Min. Negotiated Rate |
$294.80 |
| Max. Negotiated Rate |
$553.18 |
| Rate for Payer: Aetna Commercial |
$514.76
|
| Rate for Payer: Aetna Medicare |
$384.15
|
| Rate for Payer: BCBS Complete |
$294.80
|
| Rate for Payer: BCBS MAPPO |
$384.15
|
| Rate for Payer: BCN Medicare Advantage |
$384.15
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$553.18
|
| Rate for Payer: Cofinity Commercial |
$514.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.15
|
| Rate for Payer: Healthscope Commercial |
$460.98
|
| Rate for Payer: Healthscope Whirlpool |
$460.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.36
|
| Rate for Payer: Nomi Health Commercial |
$460.98
|
| Rate for Payer: PACE SWMI |
$384.15
|
| Rate for Payer: PHP Medicare Advantage |
$384.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.05
|
| Rate for Payer: Priority Health Medicare |
$384.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.15
|
| Rate for Payer: UHC Medicare Advantage |
$384.15
|
| Rate for Payer: UHCCP DNSP |
$384.15
|
|
|
PR TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR
|
Professional
|
Both
|
$6,949.00
|
|
|
Service Code
|
HCPCS 27110
|
| Min. Negotiated Rate |
$936.20 |
| Max. Negotiated Rate |
$4,516.85 |
| Rate for Payer: Aetna Commercial |
$1,254.51
|
| Rate for Payer: Aetna Medicare |
$936.20
|
| Rate for Payer: BCBS Complete |
$2,779.60
|
| Rate for Payer: BCBS MAPPO |
$936.20
|
| Rate for Payer: BCN Medicare Advantage |
$936.20
|
| Rate for Payer: Cash Price |
$5,559.20
|
| Rate for Payer: Cash Price |
$5,559.20
|
| Rate for Payer: Cofinity Commercial |
$1,348.13
|
| Rate for Payer: Cofinity Commercial |
$1,254.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.20
|
| Rate for Payer: Healthscope Commercial |
$1,123.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,123.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.01
|
| Rate for Payer: Nomi Health Commercial |
$1,123.44
|
| Rate for Payer: PACE SWMI |
$936.20
|
| Rate for Payer: PHP Medicare Advantage |
$936.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,516.85
|
| Rate for Payer: Priority Health Medicare |
$936.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$936.20
|
| Rate for Payer: UHC Medicare Advantage |
$936.20
|
| Rate for Payer: UHCCP DNSP |
$936.20
|
|
|
PR TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH
|
Professional
|
Both
|
$2,666.00
|
|
|
Service Code
|
HCPCS 26485
|
| Min. Negotiated Rate |
$780.70 |
| Max. Negotiated Rate |
$1,732.90 |
| Rate for Payer: Aetna Commercial |
$1,046.14
|
| Rate for Payer: Aetna Medicare |
$780.70
|
| Rate for Payer: BCBS Complete |
$1,066.40
|
| Rate for Payer: BCBS MAPPO |
$780.70
|
| Rate for Payer: BCN Medicare Advantage |
$780.70
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cofinity Commercial |
$1,124.21
|
| Rate for Payer: Cofinity Commercial |
$1,046.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.70
|
| Rate for Payer: Healthscope Commercial |
$936.84
|
| Rate for Payer: Healthscope Whirlpool |
$936.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$819.74
|
| Rate for Payer: Nomi Health Commercial |
$936.84
|
| Rate for Payer: PACE SWMI |
$780.70
|
| Rate for Payer: PHP Medicare Advantage |
$780.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.90
|
| Rate for Payer: Priority Health Medicare |
$780.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$780.70
|
| Rate for Payer: UHC Medicare Advantage |
$780.70
|
| Rate for Payer: UHCCP DNSP |
$780.70
|
|
|
PR TRANSFUSION BLOOD/BLOOD COMPONENTS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 36430
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$55.11 |
| Rate for Payer: Aetna Commercial |
$51.28
|
| Rate for Payer: Aetna Medicare |
$38.27
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$38.27
|
| Rate for Payer: BCN Medicare Advantage |
$38.27
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$55.11
|
| Rate for Payer: Cofinity Commercial |
$51.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.27
|
| Rate for Payer: Healthscope Commercial |
$45.92
|
| Rate for Payer: Healthscope Whirlpool |
$45.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.18
|
| Rate for Payer: Nomi Health Commercial |
$45.92
|
| Rate for Payer: PACE SWMI |
$38.27
|
| Rate for Payer: PHP Medicare Advantage |
$38.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Medicare |
$38.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.27
|
| Rate for Payer: UHC Medicare Advantage |
$38.27
|
| Rate for Payer: UHCCP DNSP |
$38.27
|
|
|
PR TRANSFUSION INTRAUTERINE FETAL
|
Professional
|
Both
|
$1,416.00
|
|
|
Service Code
|
HCPCS 36460
|
| Min. Negotiated Rate |
$329.80 |
| Max. Negotiated Rate |
$920.40 |
| Rate for Payer: Aetna Commercial |
$441.93
|
| Rate for Payer: Aetna Medicare |
$329.80
|
| Rate for Payer: BCBS Complete |
$566.40
|
| Rate for Payer: BCBS MAPPO |
$329.80
|
| Rate for Payer: BCN Medicare Advantage |
$329.80
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cofinity Commercial |
$474.91
|
| Rate for Payer: Cofinity Commercial |
$441.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.80
|
| Rate for Payer: Healthscope Commercial |
$395.76
|
| Rate for Payer: Healthscope Whirlpool |
$395.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.29
|
| Rate for Payer: Nomi Health Commercial |
$395.76
|
| Rate for Payer: PACE SWMI |
$329.80
|
| Rate for Payer: PHP Medicare Advantage |
$329.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$920.40
|
| Rate for Payer: Priority Health Medicare |
$329.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.80
|
| Rate for Payer: UHC Medicare Advantage |
$329.80
|
| Rate for Payer: UHCCP DNSP |
$329.80
|
|
|
PR TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 99496
|
| Min. Negotiated Rate |
$141.60 |
| Max. Negotiated Rate |
$257.96 |
| Rate for Payer: Aetna Commercial |
$240.05
|
| Rate for Payer: Aetna Medicare |
$179.14
|
| Rate for Payer: BCBS Complete |
$141.60
|
| Rate for Payer: BCBS MAPPO |
$179.14
|
| Rate for Payer: BCN Medicare Advantage |
$179.14
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cofinity Commercial |
$257.96
|
| Rate for Payer: Cofinity Commercial |
$240.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.14
|
| Rate for Payer: Healthscope Commercial |
$197.05
|
| Rate for Payer: Healthscope Whirlpool |
$197.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.10
|
| Rate for Payer: Nomi Health Commercial |
$214.97
|
| Rate for Payer: PACE SWMI |
$179.14
|
| Rate for Payer: PHP Medicare Advantage |
$179.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.10
|
| Rate for Payer: Priority Health Medicare |
$179.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.14
|
| Rate for Payer: UHC Medicare Advantage |
$179.14
|
| Rate for Payer: UHCCP DNSP |
$179.14
|
|
