|
PR TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC
|
Professional
|
Both
|
$7,455.00
|
|
|
Service Code
|
HCPCS 63055
|
| Min. Negotiated Rate |
$470.19 |
| Max. Negotiated Rate |
$4,845.75 |
| Rate for Payer: Aetna Commercial |
$2,102.90
|
| Rate for Payer: Aetna Medicare |
$3,727.50
|
| Rate for Payer: BCBS Complete |
$1,109.08
|
| Rate for Payer: BCBS Trust/PPO |
$470.19
|
| Rate for Payer: BCN Commercial |
$2,636.56
|
| Rate for Payer: Cash Price |
$5,964.00
|
| Rate for Payer: Cash Price |
$5,964.00
|
| Rate for Payer: Meridian Medicaid |
$1,109.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,056.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,845.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,808.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,808.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,891.14
|
| Rate for Payer: UHC Exchange |
$1,891.14
|
| Rate for Payer: UHCCP Medicaid |
$1,056.27
|
|
|
PR TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX
|
Professional
|
Both
|
$6,685.00
|
|
|
Service Code
|
HCPCS 55874
|
| Min. Negotiated Rate |
$104.58 |
| Max. Negotiated Rate |
$4,345.25 |
| Rate for Payer: Aetna Commercial |
$210.18
|
| Rate for Payer: Aetna Medicare |
$3,342.50
|
| Rate for Payer: BCBS Complete |
$109.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,585.43
|
| Rate for Payer: BCN Commercial |
$4,253.94
|
| Rate for Payer: Cash Price |
$5,348.00
|
| Rate for Payer: Cash Price |
$5,348.00
|
| Rate for Payer: Meridian Medicaid |
$109.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,345.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.38
|
| Rate for Payer: Priority Health Narrow Network |
$259.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.09
|
| Rate for Payer: UHC Exchange |
$203.09
|
| Rate for Payer: UHCCP Medicaid |
$104.58
|
|
|
PR TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ
|
Professional
|
Both
|
$2,721.00
|
|
|
Service Code
|
HCPCS 55875
|
| Min. Negotiated Rate |
$502.47 |
| Max. Negotiated Rate |
$2,345.12 |
| Rate for Payer: Aetna Commercial |
$989.72
|
| Rate for Payer: Aetna Medicare |
$1,360.50
|
| Rate for Payer: BCBS Complete |
$527.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,345.12
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: Cash Price |
$2,176.80
|
| Rate for Payer: Cash Price |
$2,176.80
|
| Rate for Payer: Meridian Medicaid |
$527.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,768.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,241.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,241.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$919.10
|
| Rate for Payer: UHC Exchange |
$919.10
|
| Rate for Payer: UHCCP Medicaid |
$502.47
|
|
|
PR TRANSPLANTATION TESTIS TO THIGH
|
Professional
|
Both
|
$1,420.00
|
|
|
Service Code
|
HCPCS 54680
|
| Min. Negotiated Rate |
$504.38 |
| Max. Negotiated Rate |
$2,125.35 |
| Rate for Payer: Aetna Commercial |
$1,011.30
|
| Rate for Payer: Aetna Medicare |
$710.00
|
| Rate for Payer: BCBS Complete |
$529.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,125.35
|
| Rate for Payer: BCN Commercial |
$1,135.69
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Meridian Medicaid |
$529.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,252.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,252.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$939.87
|
| Rate for Payer: UHC Exchange |
$939.87
|
| Rate for Payer: UHCCP Medicaid |
$504.38
|
|
|
PR TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN
|
Professional
|
Both
|
$1,880.00
|
|
|
Service Code
|
HCPCS 27397
|
| Min. Negotiated Rate |
$597.04 |
| Max. Negotiated Rate |
$1,413.62 |
| Rate for Payer: Aetna Commercial |
$1,220.27
|
| Rate for Payer: Aetna Medicare |
$940.00
|
| Rate for Payer: BCBS Complete |
$626.89
|
| Rate for Payer: BCBS Trust/PPO |
$629.21
|
| Rate for Payer: BCN Commercial |
$1,344.35
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Meridian Medicaid |
$626.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,413.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,413.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,040.70
|
| Rate for Payer: UHC Exchange |
$1,040.70
|
| Rate for Payer: UHCCP Medicaid |
$597.04
|
|
|
PR TRANSPOSITION OVARY
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 58825
|
| Min. Negotiated Rate |
$82.94 |
| Max. Negotiated Rate |
$1,062.53 |
| Rate for Payer: Aetna Commercial |
$848.39
|
| Rate for Payer: Aetna Medicare |
$731.50
|
| Rate for Payer: BCBS Complete |
$477.72
|
| Rate for Payer: BCBS Trust/PPO |
$82.94
|
| Rate for Payer: BCN Commercial |
$1,042.35
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Meridian Medicaid |
$477.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$950.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,062.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,062.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$794.13
|
| Rate for Payer: UHC Exchange |
$794.13
|
| Rate for Payer: UHCCP Medicaid |
$454.97
|
|
|
PR TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM
|
Professional
|
Both
|
$5,079.00
|
|
|
Service Code
|
HCPCS 61598
|
| Min. Negotiated Rate |
$1,835.31 |
| Max. Negotiated Rate |
$4,923.37 |
| Rate for Payer: Aetna Commercial |
$3,710.93
|
| Rate for Payer: Aetna Medicare |
$2,539.50
|
| Rate for Payer: BCBS Complete |
$1,933.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,835.31
|
| Rate for Payer: BCN Commercial |
$4,216.80
|
| Rate for Payer: Cash Price |
$4,063.20
|
| Rate for Payer: Cash Price |
$4,063.20
|
| Rate for Payer: Meridian Medicaid |
$1,933.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,841.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,301.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,923.37
|
| Rate for Payer: Priority Health Narrow Network |
$4,923.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,103.25
|
| Rate for Payer: UHC Exchange |
$3,103.25
|
| Rate for Payer: UHCCP Medicaid |
$1,841.60
|
|
|
PR TRANSRECTAL DRAINAGE OF PELVIC ABSCESS
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 45000
|
| Min. Negotiated Rate |
$277.11 |
| Max. Negotiated Rate |
$2,674.78 |
| Rate for Payer: Aetna Commercial |
$567.64
|
| Rate for Payer: Aetna Medicare |
$409.00
|
| Rate for Payer: BCBS Complete |
$290.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,674.78
|
| Rate for Payer: BCN Commercial |
$627.46
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Meridian Medicaid |
$290.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$772.58
|
| Rate for Payer: Priority Health Narrow Network |
$772.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$497.46
|
| Rate for Payer: UHC Exchange |
$497.46
|
| Rate for Payer: UHCCP Medicaid |
$277.11
|
|
|
PR TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 93293
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$525.66 |
| Rate for Payer: Aetna Commercial |
$64.88
|
| Rate for Payer: Aetna Medicare |
$90.50
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$66.46
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.77
|
| Rate for Payer: Priority Health Narrow Network |
$19.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.81
|
| Rate for Payer: UHC Exchange |
$56.81
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
|
|
PR TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV
|
Professional
|
Both
|
$6,249.00
|
|
|
Service Code
|
HCPCS 61595
|
| Min. Negotiated Rate |
$1,535.52 |
| Max. Negotiated Rate |
$4,103.86 |
| Rate for Payer: Aetna Commercial |
$3,082.40
|
| Rate for Payer: Aetna Medicare |
$3,124.50
|
| Rate for Payer: BCBS Complete |
$1,612.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,960.52
|
| Rate for Payer: BCN Commercial |
$3,505.29
|
| Rate for Payer: Cash Price |
$4,999.20
|
| Rate for Payer: Cash Price |
$4,999.20
|
| Rate for Payer: Meridian Medicaid |
$1,612.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,535.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,061.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,103.86
|
| Rate for Payer: Priority Health Narrow Network |
$4,103.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,735.86
|
| Rate for Payer: UHC Exchange |
$2,735.86
|
| Rate for Payer: UHCCP Medicaid |
$1,535.52
|
|
|
PR TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR
|
Professional
|
Both
|
$2,160.00
|
|
|
Service Code
|
HCPCS 50770
|
| Min. Negotiated Rate |
$734.64 |
| Max. Negotiated Rate |
$2,761.42 |
| Rate for Payer: Aetna Commercial |
$1,480.02
|
| Rate for Payer: Aetna Medicare |
$1,080.00
|
| Rate for Payer: BCBS Complete |
$771.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,761.42
|
| Rate for Payer: BCN Commercial |
$1,655.64
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Meridian Medicaid |
$771.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,404.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,825.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,825.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,363.97
|
| Rate for Payer: UHC Exchange |
$1,363.97
|
| Rate for Payer: UHCCP Medicaid |
$734.64
|
|
|
PR TRANSURETHRAL INCISION PROSTATE
|
Professional
|
Both
|
$1,465.00
|
|
|
Service Code
|
HCPCS 52450
|
| Min. Negotiated Rate |
$356.60 |
| Max. Negotiated Rate |
$952.25 |
| Rate for Payer: Aetna Commercial |
$604.49
|
| Rate for Payer: Aetna Medicare |
$732.50
|
| Rate for Payer: BCBS Complete |
$586.00
|
| Rate for Payer: BCBS Trust/PPO |
$356.60
|
| Rate for Payer: BCN Commercial |
$685.61
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.56
|
| Rate for Payer: Priority Health Narrow Network |
$760.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$561.57
|
| Rate for Payer: UHC Exchange |
$561.57
|
|
|
PR TRANSURETHRAL RESECTION BLADDER NECK
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 52500
|
| Min. Negotiated Rate |
$318.01 |
| Max. Negotiated Rate |
$1,096.55 |
| Rate for Payer: Aetna Commercial |
$627.52
|
| Rate for Payer: Aetna Medicare |
$843.50
|
| Rate for Payer: BCBS Complete |
$333.91
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$712.00
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Meridian Medicaid |
$333.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$789.31
|
| Rate for Payer: Priority Health Narrow Network |
$789.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$585.10
|
| Rate for Payer: UHC Exchange |
$585.10
|
| Rate for Payer: UHCCP Medicaid |
$318.01
|
|
|
PR TRANSV AORTIC ARCH GRAFT W BYPASS
|
Professional
|
Both
|
$10,285.00
|
|
|
Service Code
|
HCPCS 33870
|
| Min. Negotiated Rate |
$4,114.00 |
| Max. Negotiated Rate |
$6,685.25 |
| Rate for Payer: Aetna Medicare |
$5,142.50
|
| Rate for Payer: BCBS Complete |
$4,114.00
|
| Rate for Payer: Cash Price |
$8,228.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,685.25
|
|
|
PR TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA
|
Professional
|
Both
|
$5,629.00
|
|
|
Service Code
|
HCPCS 33871
|
| Min. Negotiated Rate |
$972.07 |
| Max. Negotiated Rate |
$5,074.67 |
| Rate for Payer: Aetna Commercial |
$4,382.46
|
| Rate for Payer: Aetna Medicare |
$2,814.50
|
| Rate for Payer: BCBS Complete |
$2,138.99
|
| Rate for Payer: BCBS Trust/PPO |
$972.07
|
| Rate for Payer: BCN Commercial |
$4,652.69
|
| Rate for Payer: Cash Price |
$4,503.20
|
| Rate for Payer: Cash Price |
$4,503.20
|
| Rate for Payer: Meridian Medicaid |
$2,138.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,037.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,658.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,074.67
|
| Rate for Payer: Priority Health Narrow Network |
$5,074.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,385.73
|
| Rate for Payer: UHC Exchange |
$4,385.73
|
| Rate for Payer: UHCCP Medicaid |
$2,037.13
|
|
|
PR TRAY FEE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 00521
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION REQ ANES
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 24605
|
| Min. Negotiated Rate |
$213.96 |
| Max. Negotiated Rate |
$852.80 |
| Rate for Payer: Aetna Commercial |
$635.25
|
| Rate for Payer: Aetna Medicare |
$656.00
|
| Rate for Payer: BCBS Complete |
$331.22
|
| Rate for Payer: BCBS Trust/PPO |
$213.96
|
| Rate for Payer: BCN Commercial |
$711.51
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Meridian Medicaid |
$331.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$750.06
|
| Rate for Payer: Priority Health Narrow Network |
$750.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$516.05
|
| Rate for Payer: UHC Exchange |
$516.05
|
| Rate for Payer: UHCCP Medicaid |
$315.45
|
|
|
PR TREATMENT CLOSED ELBOW DISLOCATION W/O ANES
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 24600
|
| Min. Negotiated Rate |
$229.61 |
| Max. Negotiated Rate |
$567.84 |
| Rate for Payer: Aetna Commercial |
$450.64
|
| Rate for Payer: Aetna Medicare |
$375.00
|
| Rate for Payer: BCBS Complete |
$241.09
|
| Rate for Payer: BCBS Trust/PPO |
$525.13
|
| Rate for Payer: BCN Commercial |
$567.84
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Meridian Medicaid |
$241.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.44
|
| Rate for Payer: Priority Health Narrow Network |
$542.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$366.62
|
| Rate for Payer: UHC Exchange |
$366.62
|
| Rate for Payer: UHCCP Medicaid |
$229.61
|
|
|
PR TRIAMCINOLONE ACET INJ NOS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J3301
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$0.97
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.55
|
| Rate for Payer: BCN Commercial |
$0.73
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.03
|
| Rate for Payer: UHC Exchange |
$1.03
|
|
|
PR TRIMETHOBENZAMIDE HCL INJ
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS J3250
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$49.27 |
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS Trust/PPO |
$48.74
|
| Rate for Payer: BCN Commercial |
$45.78
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.36
|
| Rate for Payer: UHC Exchange |
$48.36
|
|
|
PR TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 11719
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Commercial |
$7.92
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS Trust/PPO |
$12.00
|
| Rate for Payer: BCN Commercial |
$16.49
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.93
|
| Rate for Payer: Priority Health Narrow Network |
$9.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.28
|
| Rate for Payer: UHC Exchange |
$9.28
|
|
|
PR TRIM NAIL(S)
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0127
|
| Min. Negotiated Rate |
$7.62 |
| Max. Negotiated Rate |
$1,929.35 |
| Rate for Payer: Aetna Commercial |
$7.62
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,929.35
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.93
|
| Rate for Payer: Priority Health Narrow Network |
$9.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.28
|
| Rate for Payer: UHC Exchange |
$9.28
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 37246
|
| Min. Negotiated Rate |
$217.26 |
| Max. Negotiated Rate |
$2,674.54 |
| Rate for Payer: Aetna Commercial |
$465.79
|
| Rate for Payer: Aetna Medicare |
$549.00
|
| Rate for Payer: BCBS Complete |
$228.12
|
| Rate for Payer: BCBS Trust/PPO |
$786.64
|
| Rate for Payer: BCN Commercial |
$2,674.54
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Meridian Medicaid |
$228.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.28
|
| Rate for Payer: Priority Health Narrow Network |
$539.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$475.21
|
| Rate for Payer: UHC Exchange |
$475.21
|
| Rate for Payer: UHCCP Medicaid |
$217.26
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART
|
Professional
|
Both
|
$836.00
|
|
|
Service Code
|
HCPCS 37247
|
| Min. Negotiated Rate |
$108.42 |
| Max. Negotiated Rate |
$1,142.18 |
| Rate for Payer: Aetna Commercial |
$228.48
|
| Rate for Payer: Aetna Medicare |
$418.00
|
| Rate for Payer: BCBS Complete |
$113.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,142.18
|
| Rate for Payer: BCN Commercial |
$828.80
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Cash Price |
$668.80
|
| Rate for Payer: Meridian Medicaid |
$113.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.57
|
| Rate for Payer: Priority Health Narrow Network |
$268.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$235.61
|
| Rate for Payer: UHC Exchange |
$235.61
|
| Rate for Payer: UHCCP Medicaid |
$108.42
|
|
|
PR TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
HCPCS 37248
|
| Min. Negotiated Rate |
$184.88 |
| Max. Negotiated Rate |
$1,997.22 |
| Rate for Payer: Aetna Commercial |
$397.26
|
| Rate for Payer: Aetna Medicare |
$472.00
|
| Rate for Payer: BCBS Complete |
$194.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,245.73
|
| Rate for Payer: BCN Commercial |
$1,997.22
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Meridian Medicaid |
$194.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$460.03
|
| Rate for Payer: Priority Health Narrow Network |
$460.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$408.66
|
| Rate for Payer: UHC Exchange |
$408.66
|
| Rate for Payer: UHCCP Medicaid |
$184.88
|
|
