|
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 |
$757.05 |
| Max. Negotiated Rate |
$4,157.32 |
| Rate for Payer: Aetna Commercial |
$3,130.65
|
| Rate for Payer: Aetna Medicare |
$2,259.50
|
| Rate for Payer: BCBS Complete |
$1,631.75
|
| Rate for Payer: BCBS Trust/PPO |
$757.05
|
| Rate for Payer: BCN Commercial |
$3,574.19
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Cash Price |
$3,615.20
|
| Rate for Payer: Meridian Medicaid |
$1,631.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,554.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,937.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,157.32
|
| Rate for Payer: Priority Health Narrow Network |
$4,157.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,933.03
|
| Rate for Payer: UHC Exchange |
$2,933.03
|
| Rate for Payer: UHCCP Medicaid |
$1,554.05
|
|
|
PR TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 93892
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$477.58 |
| Rate for Payer: Aetna Commercial |
$176.14
|
| Rate for Payer: Aetna Medicare |
$61.50
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS Trust/PPO |
$477.58
|
| Rate for Payer: BCN Commercial |
$466.20
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.70
|
| Rate for Payer: Priority Health Narrow Network |
$78.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.46
|
| Rate for Payer: UHC Exchange |
$308.46
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 93886
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$395.34 |
| Rate for Payer: Aetna Commercial |
$293.15
|
| Rate for Payer: Aetna Commercial |
$293.15
|
| Rate for Payer: Aetna Medicare |
$316.00
|
| Rate for Payer: Aetna Medicare |
$58.50
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCN Commercial |
$395.34
|
| Rate for Payer: BCN Commercial |
$395.34
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| 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 HMO/PPO/Tiered Network |
$61.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.51
|
| Rate for Payer: Priority Health Narrow Network |
$61.51
|
| Rate for Payer: Priority Health Narrow Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$306.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$306.61
|
| Rate for Payer: UHC Exchange |
$306.61
|
| Rate for Payer: UHC Exchange |
$306.61
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
|
|
PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 93888
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$239.20 |
| Rate for Payer: Aetna Commercial |
$139.30
|
| Rate for Payer: Aetna Medicare |
$184.00
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: BCN Commercial |
$233.10
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.02
|
| Rate for Payer: Priority Health Narrow Network |
$33.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.09
|
| Rate for Payer: UHC Exchange |
$204.09
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
|
|
PR TRANSECTION/AVULSION GREATER OCCIPITAL NERVE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 64744
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$885.50 |
| Rate for Payer: Aetna Commercial |
$643.70
|
| Rate for Payer: Aetna Medicare |
$433.50
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCBS Trust/PPO |
$864.83
|
| Rate for Payer: BCN Commercial |
$827.01
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$885.50
|
| Rate for Payer: Priority Health Narrow Network |
$885.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$510.98
|
| Rate for Payer: UHC Exchange |
$510.98
|
| Rate for Payer: UHCCP Medicaid |
$333.77
|
|
|
PR TRANSECTION/AVULSION OTH SPINAL NRV XDRL
|
Professional
|
Both
|
$1,307.00
|
|
|
Service Code
|
HCPCS 64772
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$962.84 |
| Rate for Payer: Aetna Commercial |
$720.45
|
| Rate for Payer: Aetna Medicare |
$653.50
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS Trust/PPO |
$267.32
|
| Rate for Payer: BCN Commercial |
$906.65
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$849.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$962.84
|
| Rate for Payer: Priority Health Narrow Network |
$962.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$655.39
|
| Rate for Payer: UHC Exchange |
$655.39
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL
|
Professional
|
Both
|
$1,061.00
|
|
|
Service Code
|
HCPCS 64760
|
| Min. Negotiated Rate |
$244.60 |
| Max. Negotiated Rate |
$896.86 |
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: Aetna Medicare |
$530.50
|
| Rate for Payer: BCBS Complete |
$355.15
|
| Rate for Payer: BCBS Trust/PPO |
$244.60
|
| Rate for Payer: BCN Commercial |
$765.27
|
| Rate for Payer: Cash Price |
$848.80
|
| Rate for Payer: Cash Price |
$848.80
|
| Rate for Payer: Meridian Medicaid |
$355.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.86
|
| Rate for Payer: Priority Health Narrow Network |
$896.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$570.31
|
| Rate for Payer: UHC Exchange |
$570.31
|
| Rate for Payer: UHCCP Medicaid |
$338.24
|
|
|
PR TRANSFER ADDUCTOR ISCHIUM
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 27098
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$1,727.05 |
| Rate for Payer: Aetna Commercial |
$926.87
|
| Rate for Payer: Aetna Medicare |
$1,328.50
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,106.26
|
| Rate for Payer: BCN Commercial |
$1,026.22
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,077.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$723.96
|
| Rate for Payer: UHC Exchange |
$723.96
|
| Rate for Payer: UHCCP Medicaid |
$455.61
|
|
|
PR TRANSFER ANY PEDICLE FLAP ANY LOCATION
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 15650
|
| Min. Negotiated Rate |
$75.69 |
| Max. Negotiated Rate |
$794.59 |
| Rate for Payer: Aetna Commercial |
$403.21
|
| Rate for Payer: Aetna Medicare |
$368.50
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS Trust/PPO |
$75.69
|
| Rate for Payer: BCN Commercial |
$794.59
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.85
|
| Rate for Payer: Priority Health Narrow Network |
$550.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$405.02
|
| Rate for Payer: UHC Exchange |
$405.02
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
|
|
PR TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR
|
Professional
|
Both
|
$6,949.00
|
|
|
Service Code
|
HCPCS 27110
|
| Min. Negotiated Rate |
$630.91 |
| Max. Negotiated Rate |
$4,516.85 |
| Rate for Payer: Aetna Commercial |
$1,296.83
|
| Rate for Payer: Aetna Medicare |
$3,474.50
|
| Rate for Payer: BCBS Complete |
$662.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.22
|
| Rate for Payer: BCN Commercial |
$1,425.47
|
| Rate for Payer: Cash Price |
$5,559.20
|
| Rate for Payer: Cash Price |
$5,559.20
|
| Rate for Payer: Meridian Medicaid |
$662.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,516.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,495.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,495.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,103.98
|
| Rate for Payer: UHC Exchange |
$1,103.98
|
| Rate for Payer: UHCCP Medicaid |
$630.91
|
|
|
PR TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH
|
Professional
|
Both
|
$2,666.00
|
|
|
Service Code
|
HCPCS 26485
|
| Min. Negotiated Rate |
$538.89 |
| Max. Negotiated Rate |
$1,732.90 |
| Rate for Payer: Aetna Commercial |
$1,113.10
|
| Rate for Payer: Aetna Medicare |
$1,333.00
|
| Rate for Payer: BCBS Complete |
$565.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,205.05
|
| Rate for Payer: BCN Commercial |
$1,242.71
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Cash Price |
$2,132.80
|
| Rate for Payer: Meridian Medicaid |
$565.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,292.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,292.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$894.79
|
| Rate for Payer: UHC Exchange |
$894.79
|
| Rate for Payer: UHCCP Medicaid |
$538.89
|
|
|
PR TRANSFUSION BLOOD/BLOOD COMPONENTS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 36430
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$795.09 |
| Rate for Payer: Aetna Commercial |
$46.41
|
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS Trust/PPO |
$795.09
|
| Rate for Payer: BCN Commercial |
$57.17
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.55
|
| Rate for Payer: Priority Health Narrow Network |
$67.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.85
|
| Rate for Payer: UHC Exchange |
$40.85
|
|
|
PR TRANSFUSION INTRAUTERINE FETAL
|
Professional
|
Both
|
$1,416.00
|
|
|
Service Code
|
HCPCS 36460
|
| Min. Negotiated Rate |
$217.90 |
| Max. Negotiated Rate |
$1,124.75 |
| Rate for Payer: Aetna Commercial |
$465.17
|
| Rate for Payer: Aetna Medicare |
$708.00
|
| Rate for Payer: BCBS Complete |
$228.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.75
|
| Rate for Payer: BCN Commercial |
$499.92
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Cash Price |
$1,132.80
|
| Rate for Payer: Meridian Medicaid |
$228.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$920.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$544.58
|
| Rate for Payer: Priority Health Narrow Network |
$544.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.93
|
| Rate for Payer: UHC Exchange |
$446.93
|
| Rate for Payer: UHCCP Medicaid |
$217.90
|
|
|
PR TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 99496
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$294.12 |
| Rate for Payer: Aetna Commercial |
$194.16
|
| Rate for Payer: Aetna Medicare |
$177.00
|
| Rate for Payer: BCBS Complete |
$126.14
|
| Rate for Payer: BCBS Trust/PPO |
$204.98
|
| Rate for Payer: BCN Commercial |
$294.12
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Meridian Medicaid |
$126.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.51
|
| Rate for Payer: Priority Health Narrow Network |
$253.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.39
|
| Rate for Payer: UHC Exchange |
$232.39
|
| Rate for Payer: UHCCP Medicaid |
$120.13
|
|
|
PR TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 99495
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$935.09 |
| Rate for Payer: Aetna Commercial |
$142.69
|
| Rate for Payer: Aetna Medicare |
$125.50
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$217.10
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.67
|
| Rate for Payer: Priority Health Narrow Network |
$186.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.46
|
| Rate for Payer: UHC Exchange |
$158.46
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 75962
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Medicare |
$58.00
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
|
|
PR TRANSMASTOID ANTROTOMY
|
Professional
|
Both
|
$1,780.00
|
|
|
Service Code
|
HCPCS 69501
|
| Min. Negotiated Rate |
$454.76 |
| Max. Negotiated Rate |
$3,498.40 |
| Rate for Payer: Aetna Commercial |
$813.51
|
| Rate for Payer: Aetna Medicare |
$890.00
|
| Rate for Payer: BCBS Complete |
$477.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,498.40
|
| Rate for Payer: BCN Commercial |
$1,049.68
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Meridian Medicaid |
$477.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,043.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$804.97
|
| Rate for Payer: UHC Exchange |
$804.97
|
| Rate for Payer: UHCCP Medicaid |
$454.76
|
|
|
PR TRANSMETACARPAL AMPUTATION RE-AMPUTATION
|
Professional
|
Both
|
$2,264.00
|
|
|
Service Code
|
HCPCS 25931
|
| Min. Negotiated Rate |
$125.23 |
| Max. Negotiated Rate |
$1,471.60 |
| Rate for Payer: Aetna Commercial |
$1,057.63
|
| Rate for Payer: Aetna Medicare |
$1,132.00
|
| Rate for Payer: BCBS Complete |
$540.12
|
| Rate for Payer: BCBS Trust/PPO |
$125.23
|
| Rate for Payer: BCN Commercial |
$1,185.54
|
| Rate for Payer: Cash Price |
$1,811.20
|
| Rate for Payer: Cash Price |
$1,811.20
|
| Rate for Payer: Meridian Medicaid |
$540.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,233.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$796.62
|
| Rate for Payer: UHC Exchange |
$796.62
|
| Rate for Payer: UHCCP Medicaid |
$514.40
|
|
|
PR TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
HCPCS 25929
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$931.72 |
| Rate for Payer: Aetna Commercial |
$799.06
|
| Rate for Payer: Aetna Medicare |
$533.50
|
| Rate for Payer: BCBS Complete |
$413.30
|
| Rate for Payer: BCBS Trust/PPO |
$2.55
|
| Rate for Payer: BCN Commercial |
$885.48
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Meridian Medicaid |
$413.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$693.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.72
|
| Rate for Payer: Priority Health Narrow Network |
$931.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$650.45
|
| Rate for Payer: UHC Exchange |
$650.45
|
| Rate for Payer: UHCCP Medicaid |
$393.62
|
|
|
PR TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 33141
|
| Min. Negotiated Rate |
$82.64 |
| Max. Negotiated Rate |
$1,088.30 |
| Rate for Payer: Aetna Commercial |
$178.18
|
| Rate for Payer: Aetna Medicare |
$290.50
|
| Rate for Payer: BCBS Complete |
$86.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,088.30
|
| Rate for Payer: BCN Commercial |
$188.15
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Meridian Medicaid |
$86.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.28
|
| Rate for Payer: Priority Health Narrow Network |
$205.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.43
|
| Rate for Payer: UHC Exchange |
$183.43
|
| Rate for Payer: UHCCP Medicaid |
$82.64
|
|
|
PR TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR
|
Professional
|
Both
|
$2,474.00
|
|
|
Service Code
|
HCPCS 63057
|
| Min. Negotiated Rate |
$206.40 |
| Max. Negotiated Rate |
$1,608.10 |
| Rate for Payer: Aetna Commercial |
$415.78
|
| Rate for Payer: Aetna Medicare |
$1,237.00
|
| Rate for Payer: BCBS Complete |
$216.72
|
| Rate for Payer: BCBS Trust/PPO |
$543.09
|
| Rate for Payer: BCN Commercial |
$515.47
|
| Rate for Payer: Cash Price |
$1,979.20
|
| Rate for Payer: Cash Price |
$1,979.20
|
| Rate for Payer: Meridian Medicaid |
$216.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,608.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.11
|
| Rate for Payer: Priority Health Narrow Network |
$547.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.09
|
| Rate for Payer: UHC Exchange |
$385.09
|
| Rate for Payer: UHCCP Medicaid |
$206.40
|
|
|
PR TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR
|
Professional
|
Both
|
$7,074.00
|
|
|
Service Code
|
HCPCS 63056
|
| Min. Negotiated Rate |
$545.21 |
| Max. Negotiated Rate |
$4,598.10 |
| Rate for Payer: Aetna Commercial |
$1,927.37
|
| Rate for Payer: Aetna Medicare |
$3,537.00
|
| Rate for Payer: BCBS Complete |
$1,013.81
|
| Rate for Payer: BCBS Trust/PPO |
$545.21
|
| Rate for Payer: BCN Commercial |
$2,415.94
|
| Rate for Payer: Cash Price |
$5,659.20
|
| Rate for Payer: Cash Price |
$5,659.20
|
| Rate for Payer: Meridian Medicaid |
$1,013.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$965.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,598.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,569.46
|
| Rate for Payer: Priority Health Narrow Network |
$2,569.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,720.76
|
| Rate for Payer: UHC Exchange |
$1,720.76
|
| Rate for Payer: UHCCP Medicaid |
$965.53
|
|
