PR CRANIOTOMY EXCISION/COAGULATION CHOROID PLEXUS
|
Professional
|
Both
|
$9,169.76
|
|
Service Code
|
HCPCS 61544
|
Min. Negotiated Rate |
$6,877.32 |
Max. Negotiated Rate |
$6,877.32 |
Rate for Payer: Cash Price |
$2,417.01
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$6,877.32
|
Rate for Payer: SOMOS Essential |
$6,877.32
|
|
PR CRANIOTOMY EXCISION CRANIOPHARYNGIOMA
|
Professional
|
Both
|
$15,386.81
|
|
Service Code
|
HCPCS 61545
|
Min. Negotiated Rate |
$11,540.11 |
Max. Negotiated Rate |
$11,540.11 |
Rate for Payer: Cash Price |
$4,048.97
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$11,540.11
|
Rate for Payer: SOMOS Essential |
$11,540.11
|
|
PR CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE
|
Professional
|
Both
|
$7,064.79
|
|
Service Code
|
HCPCS 62121
|
Min. Negotiated Rate |
$5,298.59 |
Max. Negotiated Rate |
$5,298.59 |
Rate for Payer: Cash Price |
$1,885.33
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5,298.59
|
Rate for Payer: SOMOS Essential |
$5,298.59
|
|
PR CRANIOTOMY MULTIPLE SUBPIAL TRANSECTIONS W/ECOG
|
Professional
|
Both
|
$12,324.13
|
|
Service Code
|
HCPCS 61567
|
Min. Negotiated Rate |
$9,243.10 |
Max. Negotiated Rate |
$9,243.10 |
Rate for Payer: Cash Price |
$3,245.92
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$9,243.10
|
Rate for Payer: SOMOS Essential |
$9,243.10
|
|
PR CRANIOTOMY PARTIAL/SUBTOTAL HEMISPHERECTOMY
|
Professional
|
Both
|
$10,497.59
|
|
Service Code
|
HCPCS 61543
|
Min. Negotiated Rate |
$7,873.19 |
Max. Negotiated Rate |
$7,873.19 |
Rate for Payer: Cash Price |
$2,765.43
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7,873.19
|
Rate for Payer: SOMOS Essential |
$7,873.19
|
|
PR CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY
|
Professional
|
Both
|
$10,819.55
|
|
Service Code
|
HCPCS 61566
|
Min. Negotiated Rate |
$8,114.66 |
Max. Negotiated Rate |
$8,114.66 |
Rate for Payer: Cash Price |
$2,849.92
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$8,114.66
|
Rate for Payer: SOMOS Essential |
$8,114.66
|
|
PR CRANIOTOMY TRANSECTION CORPUS CALLOSUM
|
Professional
|
Both
|
$10,389.79
|
|
Service Code
|
HCPCS 61541
|
Min. Negotiated Rate |
$7,792.34 |
Max. Negotiated Rate |
$7,792.34 |
Rate for Payer: Cash Price |
$2,735.45
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7,792.34
|
Rate for Payer: SOMOS Essential |
$7,792.34
|
|
PR CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX
|
Professional
|
Both
|
$4,830.67
|
|
Service Code
|
HCPCS 61535
|
Min. Negotiated Rate |
$3,623.00 |
Max. Negotiated Rate |
$3,623.00 |
Rate for Payer: Cash Price |
$1,281.80
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,623.00
|
Rate for Payer: SOMOS Essential |
$3,623.00
|
|
PR CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING
|
Professional
|
Both
|
$7,371.32
|
|
Service Code
|
HCPCS 61533
|
Min. Negotiated Rate |
$5,528.49 |
Max. Negotiated Rate |
$5,528.49 |
Rate for Payer: Cash Price |
$1,945.11
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5,528.49
|
Rate for Payer: SOMOS Essential |
$5,528.49
|
|
PR CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY
|
Professional
|
Both
|
$11,888.45
|
|
Service Code
|
HCPCS 61537
|
Min. Negotiated Rate |
$8,916.34 |
Max. Negotiated Rate |
$8,916.34 |
Rate for Payer: Cash Price |
$3,123.54
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$8,916.34
|
Rate for Payer: SOMOS Essential |
$8,916.34
|
|
PR CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN
|
Professional
|
Both
|
$4,239.17
|
|
Service Code
|
HCPCS 61790
|
Min. Negotiated Rate |
$3,179.38 |
Max. Negotiated Rate |
$3,179.38 |
Rate for Payer: Cash Price |
$1,119.45
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,179.38
|
Rate for Payer: SOMOS Essential |
$3,179.38
|
|
PR CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC
|
Professional
|
Both
|
$5,434.49
|
|
Service Code
|
HCPCS 61791
|
Min. Negotiated Rate |
$4,075.87 |
Max. Negotiated Rate |
$4,075.87 |
Rate for Payer: Cash Price |
$1,436.10
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4,075.87
|
Rate for Payer: SOMOS Essential |
$4,075.87
|
|
PR CREATION LES SPINAL CORD STEREOTACTIC METHOD PRQ
|
Professional
|
Both
|
$5,274.75
|
|
Service Code
|
HCPCS 63600
|
Min. Negotiated Rate |
$3,956.06 |
Max. Negotiated Rate |
$3,956.06 |
Rate for Payer: Cash Price |
$1,394.51
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,956.06
|
Rate for Payer: SOMOS Essential |
$3,956.06
|
|
PR CRICOPHARYNGEAL MYOTOMY
|
Professional
|
Both
|
$2,269.19
|
|
Service Code
|
HCPCS 43030
|
Min. Negotiated Rate |
$1,701.89 |
Max. Negotiated Rate |
$1,701.89 |
Rate for Payer: Cash Price |
$616.34
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,701.89
|
Rate for Payer: SOMOS Essential |
$1,701.89
|
|
PR CRICOTRACHEAL RESECTION
|
Professional
|
Both
|
$7,488.99
|
|
Service Code
|
HCPCS 31592
|
Min. Negotiated Rate |
$5,616.74 |
Max. Negotiated Rate |
$5,616.74 |
Rate for Payer: Cash Price |
$2,020.61
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5,616.74
|
Rate for Payer: SOMOS Essential |
$5,616.74
|
|
PR CRIT CARE TELEHEA CONSULT 50
|
Professional
|
Both
|
$771.09
|
|
Service Code
|
HCPCS G0509
|
Min. Negotiated Rate |
$578.32 |
Max. Negotiated Rate |
$578.32 |
Rate for Payer: Cash Price |
$212.23
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$578.32
|
Rate for Payer: SOMOS Essential |
$578.32
|
|
PR CRIT CARE TELEHEA CONSULT 60
|
Professional
|
Both
|
$845.57
|
|
Service Code
|
HCPCS G0508
|
Min. Negotiated Rate |
$634.18 |
Max. Negotiated Rate |
$634.18 |
Rate for Payer: Cash Price |
$230.71
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$634.18
|
Rate for Payer: SOMOS Essential |
$634.18
|
|
PR CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN
|
Professional
|
Both
|
$442.61
|
|
Service Code
|
HCPCS 99292
|
Min. Negotiated Rate |
$331.96 |
Max. Negotiated Rate |
$331.96 |
Rate for Payer: Cash Price |
$120.36
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$331.96
|
Rate for Payer: SOMOS Essential |
$331.96
|
|
PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN
|
Professional
|
Both
|
$878.36
|
|
Service Code
|
HCPCS 99291
|
Min. Negotiated Rate |
$658.77 |
Max. Negotiated Rate |
$658.77 |
Rate for Payer: Cash Price |
$237.83
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$658.77
|
Rate for Payer: SOMOS Essential |
$658.77
|
|
PR CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN
|
Professional
|
Both
|
$934.89
|
|
Service Code
|
HCPCS 99466
|
Min. Negotiated Rate |
$701.17 |
Max. Negotiated Rate |
$701.17 |
Rate for Payer: Cash Price |
$256.45
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$701.17
|
Rate for Payer: SOMOS Essential |
$701.17
|
|
PR CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN
|
Professional
|
Both
|
$476.35
|
|
Service Code
|
HCPCS 99467
|
Min. Negotiated Rate |
$357.26 |
Max. Negotiated Rate |
$357.26 |
Rate for Payer: Cash Price |
$128.91
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$357.26
|
Rate for Payer: SOMOS Essential |
$357.26
|
|
PR CRNEC/CRX IMPLTJ NSTIM ELTRD CERE CORTICAL
|
Professional
|
Both
|
$7,553.32
|
|
Service Code
|
HCPCS 61860
|
Min. Negotiated Rate |
$5,664.99 |
Max. Negotiated Rate |
$5,664.99 |
Rate for Payer: Cash Price |
$1,990.68
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5,664.99
|
Rate for Payer: SOMOS Essential |
$5,664.99
|
|
PR CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA
|
Professional
|
Both
|
$13,346.76
|
|
Service Code
|
HCPCS 61518
|
Min. Negotiated Rate |
$10,010.07 |
Max. Negotiated Rate |
$10,010.07 |
Rate for Payer: Cash Price |
$3,519.73
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$10,010.07
|
Rate for Payer: SOMOS Essential |
$10,010.07
|
|
PR CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA
|
Professional
|
Both
|
$14,852.74
|
|
Service Code
|
HCPCS 61530
|
Min. Negotiated Rate |
$11,139.56 |
Max. Negotiated Rate |
$11,139.56 |
Rate for Payer: Cash Price |
$3,902.59
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$11,139.56
|
Rate for Payer: SOMOS Essential |
$11,139.56
|
|
PR CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA
|
Professional
|
Both
|
$14,230.41
|
|
Service Code
|
HCPCS 61519
|
Min. Negotiated Rate |
$10,672.81 |
Max. Negotiated Rate |
$10,672.81 |
Rate for Payer: Cash Price |
$3,732.38
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$10,672.81
|
Rate for Payer: SOMOS Essential |
$10,672.81
|
|