|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE
|
Professional
|
Both
|
$977.00
|
|
|
Service Code
|
HCPCS 53502
|
| Min. Negotiated Rate |
$313.32 |
| Max. Negotiated Rate |
$778.13 |
| Rate for Payer: Aetna Commercial |
$622.66
|
| Rate for Payer: Aetna Medicare |
$488.50
|
| Rate for Payer: BCBS Complete |
$328.99
|
| Rate for Payer: BCBS Trust/PPO |
$701.05
|
| Rate for Payer: BCN Commercial |
$702.72
|
| Rate for Payer: Cash Price |
$781.60
|
| Rate for Payer: Cash Price |
$781.60
|
| Rate for Payer: Meridian Medicaid |
$328.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$635.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$778.13
|
| Rate for Payer: Priority Health Narrow Network |
$778.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$580.50
|
| Rate for Payer: UHC Exchange |
$580.50
|
| Rate for Payer: UHCCP Medicaid |
$313.32
|
|
|
PR URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE
|
Professional
|
Both
|
$923.00
|
|
|
Service Code
|
HCPCS 53505
|
| Min. Negotiated Rate |
$288.98 |
| Max. Negotiated Rate |
$777.60 |
| Rate for Payer: Aetna Commercial |
$622.25
|
| Rate for Payer: Aetna Medicare |
$461.50
|
| Rate for Payer: BCBS Complete |
$328.77
|
| Rate for Payer: BCBS Trust/PPO |
$288.98
|
| Rate for Payer: BCN Commercial |
$702.23
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Meridian Medicaid |
$328.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$777.60
|
| Rate for Payer: Priority Health Narrow Network |
$777.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$584.17
|
| Rate for Payer: UHC Exchange |
$584.17
|
| Rate for Payer: UHCCP Medicaid |
$313.11
|
|
|
PR URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 53010
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$478.27 |
| Rate for Payer: Aetna Commercial |
$376.16
|
| Rate for Payer: Aetna Medicare |
$276.50
|
| Rate for Payer: BCBS Complete |
$202.63
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$430.52
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Meridian Medicaid |
$202.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$478.27
|
| Rate for Payer: Priority Health Narrow Network |
$478.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$349.78
|
| Rate for Payer: UHC Exchange |
$349.78
|
| Rate for Payer: UHCCP Medicaid |
$192.98
|
|
|
PR URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,350.00
|
|
|
Service Code
|
HCPCS 50650
|
| Min. Negotiated Rate |
$662.43 |
| Max. Negotiated Rate |
$2,177.50 |
| Rate for Payer: Aetna Commercial |
$1,331.38
|
| Rate for Payer: Aetna Medicare |
$1,675.00
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS Trust/PPO |
$809.36
|
| Rate for Payer: BCN Commercial |
$1,491.44
|
| Rate for Payer: Cash Price |
$2,680.00
|
| Rate for Payer: Cash Price |
$2,680.00
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,177.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,648.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,648.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,248.18
|
| Rate for Payer: UHC Exchange |
$1,248.18
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
|
|
PR URINARY LEG OR ABDOMEN BAG
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS A4358
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$6.46 |
| Rate for Payer: Aetna Commercial |
$5.46
|
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.70
|
| Rate for Payer: UHC Exchange |
$3.70
|
|
|
PR URINARY SUSPENSORY
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS A5105
|
| Min. Negotiated Rate |
$25.68 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$37.97
|
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCN Commercial |
$44.89
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.68
|
| Rate for Payer: UHC Exchange |
$25.68
|
|
|
PR URTP W/TUBULARIZATION POST URT&/LWR BLDR
|
Professional
|
Both
|
$2,206.00
|
|
|
Service Code
|
HCPCS 53431
|
| Min. Negotiated Rate |
$734.64 |
| Max. Negotiated Rate |
$2,997.57 |
| Rate for Payer: Aetna Commercial |
$1,480.28
|
| Rate for Payer: Aetna Medicare |
$1,103.00
|
| Rate for Payer: BCBS Complete |
$771.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,997.57
|
| Rate for Payer: BCN Commercial |
$1,656.13
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Meridian Medicaid |
$771.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.90
|
| 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 |
$1,393.69
|
| Rate for Payer: UHC Exchange |
$1,393.69
|
| Rate for Payer: UHCCP Medicaid |
$734.64
|
|
|
PR URTROLITHOTOMY MIDDLE ONE-THIRD URETER
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 50620
|
| Min. Negotiated Rate |
$576.59 |
| Max. Negotiated Rate |
$1,432.69 |
| Rate for Payer: Aetna Commercial |
$1,159.84
|
| Rate for Payer: Aetna Medicare |
$813.00
|
| Rate for Payer: BCBS Complete |
$605.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,273.73
|
| Rate for Payer: BCN Commercial |
$1,299.39
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Meridian Medicaid |
$605.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,056.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,432.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,432.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,091.45
|
| Rate for Payer: UHC Exchange |
$1,091.45
|
| Rate for Payer: UHCCP Medicaid |
$576.59
|
|
|
PR URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP
|
Professional
|
Both
|
$4,652.00
|
|
|
Service Code
|
HCPCS 50785
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$3,101.12 |
| Rate for Payer: Aetna Commercial |
$1,558.20
|
| Rate for Payer: Aetna Medicare |
$2,326.00
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,101.12
|
| Rate for Payer: BCN Commercial |
$1,747.51
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Cash Price |
$3,721.60
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,920.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,458.97
|
| Rate for Payer: UHC Exchange |
$1,458.97
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
|
|
PR URTT/URTS XTRNL SPX PENDULOUS URETHRA
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 53000
|
| Min. Negotiated Rate |
$95.64 |
| Max. Negotiated Rate |
$283.70 |
| Rate for Payer: Aetna Commercial |
$189.14
|
| Rate for Payer: Aetna Medicare |
$140.50
|
| Rate for Payer: BCBS Complete |
$100.42
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: BCN Commercial |
$214.53
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Meridian Medicaid |
$100.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.08
|
| Rate for Payer: Priority Health Narrow Network |
$238.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$178.04
|
| Rate for Payer: UHC Exchange |
$178.04
|
| Rate for Payer: UHCCP Medicaid |
$95.64
|
|
|
PR USE OF ECHO CONTRAST AGENT DURING STRESS ECHO
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 93352
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$1,312.83 |
| Rate for Payer: Aetna Commercial |
$42.92
|
| Rate for Payer: Aetna Medicare |
$32.50
|
| Rate for Payer: BCBS Complete |
$26.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.83
|
| Rate for Payer: BCN Commercial |
$49.36
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.97
|
| Rate for Payer: Priority Health Narrow Network |
$48.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.29
|
| Rate for Payer: UHC Exchange |
$44.29
|
|
|
PR USE VERTICAL ELECTRODES
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 92547
|
| Min. Negotiated Rate |
$2.72 |
| Max. Negotiated Rate |
$1,085.66 |
| Rate for Payer: Aetna Commercial |
$10.32
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.66
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.72
|
| Rate for Payer: Priority Health Narrow Network |
$2.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.52
|
| Rate for Payer: UHC Exchange |
$4.52
|
|
|
PR UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE
|
Professional
|
Both
|
$785.00
|
|
|
Service Code
|
HCPCS 59870
|
| Min. Negotiated Rate |
$344.85 |
| Max. Negotiated Rate |
$794.10 |
| Rate for Payer: Aetna Commercial |
$572.00
|
| Rate for Payer: Aetna Medicare |
$392.50
|
| Rate for Payer: BCBS Complete |
$362.09
|
| Rate for Payer: BCBS Trust/PPO |
$547.32
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Meridian Medicaid |
$362.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.12
|
| Rate for Payer: Priority Health Narrow Network |
$760.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$535.79
|
| Rate for Payer: UHC Exchange |
$535.79
|
| Rate for Payer: UHCCP Medicaid |
$344.85
|
|
|
PR UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 58400
|
| Min. Negotiated Rate |
$296.50 |
| Max. Negotiated Rate |
$695.95 |
| Rate for Payer: Aetna Commercial |
$547.93
|
| Rate for Payer: Aetna Medicare |
$432.00
|
| Rate for Payer: BCBS Complete |
$311.32
|
| Rate for Payer: BCBS Trust/PPO |
$568.45
|
| Rate for Payer: BCN Commercial |
$680.73
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Meridian Medicaid |
$311.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$695.95
|
| Rate for Payer: Priority Health Narrow Network |
$695.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$505.47
|
| Rate for Payer: UHC Exchange |
$505.47
|
| Rate for Payer: UHCCP Medicaid |
$296.50
|
|
|
PR U-TUBE HEPATICOENTEROSTOMY
|
Professional
|
Both
|
$2,734.00
|
|
|
Service Code
|
HCPCS 47802
|
| Min. Negotiated Rate |
$1,093.60 |
| Max. Negotiated Rate |
$3,097.42 |
| Rate for Payer: Aetna Commercial |
$2,068.89
|
| Rate for Payer: Aetna Medicare |
$1,367.00
|
| Rate for Payer: BCBS Complete |
$1,093.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.42
|
| Rate for Payer: BCN Commercial |
$2,226.41
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,777.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,827.09
|
| Rate for Payer: UHC Exchange |
$1,827.09
|
|
|
PR UVULECTOMY EXCISION UVULA
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 42140
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$596.98 |
| Rate for Payer: Aetna Commercial |
$205.69
|
| Rate for Payer: Aetna Medicare |
$286.50
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCBS Trust/PPO |
$596.98
|
| Rate for Payer: BCN Commercial |
$461.32
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.31
|
| Rate for Payer: Priority Health Narrow Network |
$295.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.84
|
| Rate for Payer: UHC Exchange |
$184.84
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY
|
Professional
|
Both
|
$3,124.00
|
|
|
Service Code
|
HCPCS 58291
|
| Min. Negotiated Rate |
$190.19 |
| Max. Negotiated Rate |
$2,030.60 |
| Rate for Payer: Aetna Commercial |
$1,495.94
|
| Rate for Payer: Aetna Medicare |
$1,562.00
|
| Rate for Payer: BCBS Complete |
$835.11
|
| Rate for Payer: BCBS Trust/PPO |
$190.19
|
| Rate for Payer: BCN Commercial |
$1,823.26
|
| Rate for Payer: Cash Price |
$2,499.20
|
| Rate for Payer: Cash Price |
$2,499.20
|
| Rate for Payer: Meridian Medicaid |
$835.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,030.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,855.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,855.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,436.14
|
| Rate for Payer: UHC Exchange |
$1,436.14
|
| Rate for Payer: UHCCP Medicaid |
$795.34
|
|
|
PR VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE
|
Professional
|
Both
|
$3,457.00
|
|
|
Service Code
|
HCPCS 58292
|
| Min. Negotiated Rate |
$213.96 |
| Max. Negotiated Rate |
$2,247.05 |
| Rate for Payer: Aetna Commercial |
$1,577.26
|
| Rate for Payer: Aetna Medicare |
$1,728.50
|
| Rate for Payer: BCBS Complete |
$879.62
|
| Rate for Payer: BCBS Trust/PPO |
$213.96
|
| Rate for Payer: BCN Commercial |
$1,921.48
|
| Rate for Payer: Cash Price |
$2,765.60
|
| Rate for Payer: Cash Price |
$2,765.60
|
| Rate for Payer: Meridian Medicaid |
$879.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,955.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,955.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,513.64
|
| Rate for Payer: UHC Exchange |
$1,513.64
|
| Rate for Payer: UHCCP Medicaid |
$837.73
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE&/OVARY
|
Professional
|
Both
|
$2,973.00
|
|
|
Service Code
|
HCPCS 58262
|
| Min. Negotiated Rate |
$266.26 |
| Max. Negotiated Rate |
$1,932.45 |
| Rate for Payer: Aetna Commercial |
$1,109.35
|
| Rate for Payer: Aetna Medicare |
$1,486.50
|
| Rate for Payer: BCBS Complete |
$624.44
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$1,359.01
|
| Rate for Payer: Cash Price |
$2,378.40
|
| Rate for Payer: Cash Price |
$2,378.40
|
| Rate for Payer: Meridian Medicaid |
$624.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,386.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,386.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,056.88
|
| Rate for Payer: UHC Exchange |
$1,056.88
|
| Rate for Payer: UHCCP Medicaid |
$594.70
|
|
|
PR VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL
|
Professional
|
Both
|
$3,245.00
|
|
|
Service Code
|
HCPCS 58263
|
| Min. Negotiated Rate |
$192.83 |
| Max. Negotiated Rate |
$2,109.25 |
| Rate for Payer: Aetna Commercial |
$1,191.05
|
| Rate for Payer: Aetna Medicare |
$1,622.50
|
| Rate for Payer: BCBS Complete |
$669.84
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$1,457.73
|
| Rate for Payer: Cash Price |
$2,596.00
|
| Rate for Payer: Cash Price |
$2,596.00
|
| Rate for Payer: Meridian Medicaid |
$669.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,109.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,486.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,486.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,138.51
|
| Rate for Payer: UHC Exchange |
$1,138.51
|
| Rate for Payer: UHCCP Medicaid |
$637.94
|
|
|
PR VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE
|
Professional
|
Both
|
$3,732.00
|
|
|
Service Code
|
HCPCS 58280
|
| Min. Negotiated Rate |
$237.74 |
| Max. Negotiated Rate |
$2,425.80 |
| Rate for Payer: Aetna Commercial |
$1,269.75
|
| Rate for Payer: Aetna Medicare |
$1,866.00
|
| Rate for Payer: BCBS Complete |
$712.33
|
| Rate for Payer: BCBS Trust/PPO |
$237.74
|
| Rate for Payer: BCN Commercial |
$1,554.97
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Cash Price |
$2,985.60
|
| Rate for Payer: Meridian Medicaid |
$712.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,425.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,584.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,584.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,206.57
|
| Rate for Payer: UHC Exchange |
$1,206.57
|
| Rate for Payer: UHCCP Medicaid |
$678.41
|
|
|
PR VAGINAL DELIVERY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 59612
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,636.60 |
| Rate for Payer: Aetna Commercial |
$1,000.61
|
| Rate for Payer: Aetna Medicare |
$1,072.50
|
| Rate for Payer: BCBS Complete |
$886.77
|
| Rate for Payer: BCBS Trust/PPO |
$187.55
|
| Rate for Payer: BCN Commercial |
$1,636.60
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Meridian Medicaid |
$886.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$844.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,267.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,267.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,039.21
|
| Rate for Payer: UHC Exchange |
$1,039.21
|
| Rate for Payer: UHCCP Medicaid |
$844.54
|
|
|
PR VAGINAL DELIVERY ONLY
|
Professional
|
Both
|
$1,970.00
|
|
|
Service Code
|
HCPCS 59409
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$1,558.66 |
| Rate for Payer: Aetna Commercial |
$885.09
|
| Rate for Payer: Aetna Medicare |
$985.00
|
| Rate for Payer: BCBS Complete |
$779.06
|
| Rate for Payer: BCBS Trust/PPO |
$45.96
|
| Rate for Payer: BCN Commercial |
$1,558.66
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Meridian Medicaid |
$779.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,118.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,118.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$923.14
|
| Rate for Payer: UHC Exchange |
$923.14
|
| Rate for Payer: UHCCP Medicaid |
$741.96
|
|
|
PR VAGINAL DELIVERY ONLY W/POSTPARTUM CARE
|
Professional
|
Both
|
$2,242.00
|
|
|
Service Code
|
HCPCS 59410
|
| Min. Negotiated Rate |
$52.30 |
| Max. Negotiated Rate |
$1,809.19 |
| Rate for Payer: Aetna Commercial |
$1,164.53
|
| Rate for Payer: Aetna Medicare |
$1,121.00
|
| Rate for Payer: BCBS Complete |
$1,052.16
|
| Rate for Payer: BCBS Trust/PPO |
$52.30
|
| Rate for Payer: BCN Commercial |
$1,809.19
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Meridian Medicaid |
$1,052.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,002.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,514.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,514.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,079.09
|
| Rate for Payer: UHC Exchange |
$1,079.09
|
| Rate for Payer: UHCCP Medicaid |
$1,002.06
|
|
|
PR VAGINAL DELIVERY & POSTPARTUM CARE VBAC
|
Professional
|
Both
|
$2,417.00
|
|
|
Service Code
|
HCPCS 59614
|
| Min. Negotiated Rate |
$325.96 |
| Max. Negotiated Rate |
$1,899.65 |
| Rate for Payer: Aetna Commercial |
$1,263.20
|
| Rate for Payer: Aetna Medicare |
$1,208.50
|
| Rate for Payer: BCBS Complete |
$1,144.38
|
| Rate for Payer: BCBS Trust/PPO |
$325.96
|
| Rate for Payer: BCN Commercial |
$1,899.65
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Cash Price |
$1,933.60
|
| Rate for Payer: Meridian Medicaid |
$1,144.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,637.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,637.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,167.54
|
| Rate for Payer: UHC Exchange |
$1,167.54
|
| Rate for Payer: UHCCP Medicaid |
$1,089.89
|
|
