расценки на услуги на примере конкретной страховой компании

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DP
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Post by DP »

Office Procedures/Surgeries Expected Costs = Digestive System


ANUS HEMORRHOIDECTOMY, BY SIMPLE LIGATURE (EG, RUBBER BAND) $176.00

ANUS ANOSCOPY; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE) $75.00

ANUS DESTRUCTION OF HEMORRHOIDS, ANY METHOD; INTERNAL $238.00

ESOPHAGUS UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) $269.00

ESOPHAGUS UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; WITH BIOPSY, SINGLE OR MULTIPLE $306.00

HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER; REDUCIBLE $462.74

RECTUM PROCTOSIGMOIDOSCOPY, RIGID; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE) $70.00

RECTUM SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE) $82.51

RECTUM COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) $325.00

RECTUM COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) $485.00
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Office Procedures/Surgeries Expected Costs = Endocrine System


THYROID GLAND BIOPSY THYROID, PERCUTANEOUS CORE NEEDLE $76.13
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Office Procedures/Surgeries Expected Costs = Eye & Ocular Adnexa


EYEBALL REMOVAL FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL SUPERFICIAL $53.50

EYEBALL REMOVAL FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITH SLIT LAMP $69.00

EYELIDS EXCISION CHALAZION; SINGLE $118.25

EYELIDS CORRECTION TRICHIASIS; EPILATION, FORCEPS ONLY $70.00

EYELIDS EXCISION OF LESION OF EYELID (EXCEPT CHALAZION) WITHOUT CLOSURE OR WITH SIMPLE DIRECT CLOSURE $275.00
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Office Procedures/Surgeries Expected Costs = Female Genital System


CERVIX UTERI BIOPSY, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, WITH OR WITHOUT FULGURATION (SEPARATE PROCEDURE) $108.00

CERVIX UTERI CAUTERY OF CERVIX; CRYOCAUTERY, INITIAL OR REPEAT $114.58

CORPUS UTERI ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WITHOUT ENDOCERVICAL SAMPLING (BIOPSY), WITHOUT CERVICAL DILATION $117.00

CORPUS UTERI DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL) $239.31

CORPUS UTERI ARTIFICIAL INSEMINATION; INTRA-UTERINE $78.12

OVIDUCT/OVARY LAPAROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BY DEVICE (EG, BAND, CLIP, OR FALOPE RING) $373.00

VAGINA COLPOSCOPY (VAGINOSCOPY); (SEPARATE PROCEDURE) $130.00

VAGINA COLPOSCOPY (VAGINOSCOPY); WITH BIOPSY(S) OF THE CERVIX AND/OR ENDOCERVICAL CURETTAGE $173.00

VAGINA COLPOSCOPY (VAGINOSCOPY); WITH LOOP ELECTRODE EXCISION PROCEDURE OF THE CERVIX $283.00

VULVA, PERINEUM & INTROITUS DESTRUCTION OF LESION(S), VULVA; SIMPLE $125.00

VULVA, PERINEUM & INTROITUS BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); ONE LESION $97.72
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Office Procedures/Surgeries Expected Costs = Integumentary System


BREAST PUNCTURE ASPIRATION OF CYST OF BREAST; $103.00

BREAST BIOPSY OF BREAST; PERCUTANEOUS, NEEDLE CORE, NOT USING IMAGING GUIDANCE (SEPARATE PROCEDURE) $134.00

BREAST BIOPSY OF BREAST; PERCUTANEOUS, NEEDLE CORE, USING IMAGING GUIDANCE $248.00

BURNS DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; WITHOUT ANESTHESIA, OFFICE OR HOSPITAL, SMALL $69.50

DESTRUCTION BENIGN OR PREMALIGNANT LESIONS DESTRUCTION , ALL BENIGN OR PREMALIGNANT LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PROLIFERATIVE LESIONS; FIRST LESION $64.00

DESTRUCTION BENIGN OR PREMALIGNANT LESIONS DESTRUCTION, ALL BENIGN OR PREMALIGNANT LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PROLIFERATIVE LESIONS; SECOND THROUGH 14 LESIONS, EA $11.00

DESTRUCTION BENIGN OR PREMALIGNANT LESIONS DESTRUCTION, ALL BENIGN OR PREMALIGNANT LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PROLIFERATIVE LESIONS; 15 OR MORE LESIONS $189.00

DESTRUCTION BENIGN OR PREMALIGNANT LESIONS DESTRUCTION OF FLAT WARTS, MOLLUSCUM CONTAGIOSUM, OR MILIA; UP TO 14 LESIONS $84.00

DESTRUCTION MALIGNANT LESIONS DESTRUCTION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6-1.0 CM $104.87

DESTRUCTION MALIGNANT LESIONS DESTRUCTION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1-2.0 CM $139.86

EXCISION - BENIGN LESIONS EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS $104.00

EXCISION - BENIGN LESIONS EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM $120.00

EXCISION - BENIGN LESIONS EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM $137.00

EXCISION - BENIGN LESIONS EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM $90.27

EXCISION - BENIGN LESIONS EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.5 CM OR LESS $90.00

EXCISION - BENIGN LESIONS EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.6 TO 1.0 CM $113.00

EXCISION - MALIGNANT LESIONS EXCISION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM $135.25

EXCISION - MALIGNANT LESIONS EXCISION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM $160.36

EXCISION - MALIGNANT LESIONS EXCISION, MALIGNANT LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 2.1 TO 3.0 CM $189.84

EXCISION - MALIGNANT LESIONS EXCISION MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 0.6 TO 1.0 CM $185.86

GENERAL FINE NEEDLE ASPIRATION; WITHOUT IMAGING GUIDANCE $125.00

GENERAL FINE NEEDLE ASPIRATION; WITH IMAGING GUIDANCE $130.00

INTRODUCTION INJECTION, INTRALESIONAL; UP TO AND INCLUDING SEVEN LESIONS $36.00

INTRODUCTION INJECTION, INTRALESIONAL; MORE THAN SEVEN LESIONS $52.00

MOHS MICROGRAPHIC SURGERY CHEMOSURGERY (MOHS' MICROGRAPHIC TECHNIQUE), INCLUDING REMOVAL OF ALL GROSS TUMOR, SURGICAL EXCISION OF TISSUE SPECIMENS, MAPPING, COLOR CODING OF SPECIMENS, MICROSCOPIC EXAMINATION OF SPECIMENS BY THE SURGEON, AND COMPLETE HISTOPATHOLOGIC PREPARATIO $575.00

MOHS MICROGRAPHIC SURGERY CHEMOSURGERY (MOHS' MICROGRAPHIC TECHNIQUE), INCLUDING REMOVAL OF ALL GROSS TUMOR, SURGICAL EXCISION OF TISSUE SPECIMENS, MAPPING, COLOR CODING OF SPECIMENS, MICROSCOPIC EXAMINATION OF SPECIMENS BY THE SURGEON, AND COMPLETE HISTOPATHOLOGIC PREPARATIO $300.00

NAILS TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER $15.50

NAILS DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); ONE TO FIVE $28.00

NAILS DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); SIX OR MORE $45.50

NAILS AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE $75.00

NAILS EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANENT REMOVAL; $141.50

REPAIR - COMPLEX REPAIR COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS, AND/OR FEET; 2.6 CM TO 7.5 CM $400.00

REPAIR - COMPLEX ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS $625.00

REPAIR - COMPLEX ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10 SQ CM OR LESS $675.00

REPAIR - INTERMEDIATE LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 2.5 CM OR LESS $161.00

REPAIR - INTERMEDIATE LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 2.6 CM TO 7.5 CM $196.00

REPAIR - INTERMEDIATE LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR LESS $210.00

REPAIR - SIMPLE SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 2.5 CM OR LESS $140.00

REPAIR - SIMPLE SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR LESS $146.00

SHAVING OF EPIDERMAL OR DERMAL LESIONS SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS $54.50

SHAVING OF EPIDERMAL OR DERMAL LESIONS SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM $70.00

SHAVING OF EPIDERMAL OR DERMAL LESIONS SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM $80.99

SHAVING OF EPIDERMAL OR DERMAL LESIONS SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.5 CM OR LESS $49.46

SHAVING OF EPIDERMAL OR DERMAL LESIONS SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM $70.60

SHAVING OF EPIDERMAL OR DERMAL LESIONS SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.5 CM OR LESS $59.04

SHAVING OF EPIDERMAL OR DERMAL LESIONS SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.6 TO 1.0 CM $78.99

SKIN GRAFTS SURGICAL PREPARATION OR CREATION OF RECIPIENT SITE BY EXCISION OF OPEN WOUNDS, BURN ESCHAR, OR SCAR; FIRST 100 SQ CM OR ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN $256.50

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES INCISION AND DRAINAGE OF ABSCESS; SIMPLE OR SINGLE $96.00

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES INCISION AND DRAINAGE OF ABSCESS; COMPLICATED OR MULTIPLE $157.00

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES DEBRIDEMENT; SKIN, PARTIAL THICKNESS $39.00

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES DEBRIDEMENT; SKIN, FULL THICKNESS $57.46

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES DEBRIDEMENT; SKIN AND SUBCUTANEOUS TISSUE $95.00

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION $28.50

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); TWO TO FOUR LESIONS $36.50

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THAN FOUR LESIONS $45.00

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), UNLESS OTHERWISE LISTED (SEPARATE PROCEDURE); SINGLE LESION $73.00

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), UNLESS OTHERWISE LISTED (SEPARATE PROCEDURE); EACH SEPARATE/ADDITIONAL LESION $27.00

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS $78.50
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DP
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Post by DP »

Office Procedures/Surgeries Expected Costs = Male Gential System


PENIS DESTRUCTION OF LESION(S), PENIS $107.00

PENIS CIRCUMCISION, USING CLAMP OR OTHER DEVICE; NEWBORN $257.00

PROSTATE BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH $263.00
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Post by DP »

stay tuned... продолжу.
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thinker
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Post by thinker »

DP wrote:stay tuned... продолжу.


а зачем? Все эти расценки справедливы только для Вас, вашей страховки и конкретной больници.
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Post by DP »

thinker wrote:
DP wrote:stay tuned... продолжу.


а зачем? Все эти расценки справедливы только для Вас, вашей страховки и конкретной больници.


конкретная больница здесь как раз роли не играет и я тоже.. и конкретный план внутри страховки тоже роли не играет...

цены приведены для того чтобы можно было понять порядок цен которые может получить страховка размера Blue Cross Blue Shield...
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Post by thinker »

DP wrote:цены приведены для того чтобы можно было понять порядок цен которые может получить страховка размера Blue Cross Blue Shield...


Данная страховка имеет совершенно разные планы в каждом штате (все разное, начиная с премиумом и копеев и кончая скидками на конкретные услуги) . Кроме этого, расценки на услуги исходят от конкретного госпиталя. В другом месте все будет иначе.
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Post by koan »

thinker wrote:
DP wrote:цены приведены для того чтобы можно было понять порядок цен которые может получить страховка размера Blue Cross Blue Shield...


Данная страховка имеет совершенно разные планы в каждом штате (все разное, начиная с премиумом и копеев и кончая скидками на конкретные услуги) . Кроме этого, расценки на услуги исходят от конкретного госпиталя. В другом месте все будет иначе.


И вообще непонятно, что это за цены? HMO? PPO? HSA?

А ежели интересно цены узнать, то сходите тогда уж на сайт Медикара, на CMS.gov, там уж должны быть расценки на все процедуры.

Вот, например... http://www.cms.hhs.gov/FeeScheduleGenInfo/
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Post by DP »

koan wrote:
thinker wrote:
DP wrote:цены приведены для того чтобы можно было понять порядок цен которые может получить страховка размера Blue Cross Blue Shield...


Данная страховка имеет совершенно разные планы в каждом штате (все разное, начиная с премиумом и копеев и кончая скидками на конкретные услуги) . Кроме этого, расценки на услуги исходят от конкретного госпиталя. В другом месте все будет иначе.


И вообще непонятно, что это за цены? HMO? PPO? HSA?
Вот, например... http://www.cms.hhs.gov/FeeScheduleGenInfo/


это цены которые страховка имеет от тех кто согласился быть в network и быть оплачивамым по ее расценкам для PPO планов...
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Post by DP »

thinker wrote: Кроме этого, расценки на услуги исходят от конкретного госпиталя. В другом месте все будет иначе.


чукча не читатель, да ??? в самом начале был поставлен комментарий

The prices included are typically what Highmark would pay a professional network provider. They do not include any facility prices that may apply.


данные цифры могут быть полезны людям без страховки которые хотели бы понять сколько примерно за нужные им процедуры платит страховка (PPO план).
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Post by thinker »

DP wrote:данные цифры могут быть полезны людям без страховки которые хотели бы понять сколько примерно за нужные им процедуры платит страховка (PPO план).


Еще раз. Ваш топик называется: "расценки на услуги на примере конкретной страховой компании". Вот именно, что конкретной страховой компании. Более того, эта конкретная страховка платит такие рас-ценки в госпиталях, которые входят в данную network. В других госпиталях из другой network будет по-другому. В других страховках и планах тоже будет по-другому. В других штатах, где даже есть ваша PPO страховка, - тоже будет по-другому. Приведенные цифры еще хуже чем средняя температура по больнице. :pain1: Люди без страховки будут платит вообще по-другому (обычно в разы больше, чем когда оплачивает страховка). Я не отговариваю Вас продолжать писать эти расценки. Просто говорю, что они бесполезны. :hat: В отличие от цен в магазине, цены на мед услуги сознательно держатся в тайне от пациентов. Поэтому здесь:

1) ни кто не шопиться по госпиталям или врачам и
2) ни кто не знает сколько будет платить до того, как услуги оказаны
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Post by DP »

thinker wrote:Еще раз. Ваш топик называется: "расценки на услуги на примере конкретной страховой компании". Вот именно, что конкретной страховой компании.


мой топик называется

расценки на услуги на примере конкретной страховой компании.


thinker wrote:Просто говорю, что они бесполезны. :hat:


Thinker, я вас умоляю - не читайте пожалуйста, не огорчайте себя так...

thinker wrote: В отличие от цен в магазине, цены на мед услуги сознательно держатся в тайне от пациентов. Поэтому здесь:

1) ни кто не шопиться по госпиталям или врачам и
2) ни кто не знает сколько будет платить до того, как услуги оказаны


давайте не обобщать...
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Post by T_D »

Планы разные и контракты с медикал провайдером все разные.
Например МРИ в госпитале стоило страховке 1100. Тоже МРИ в поликлинике обошлось страховке в 2400. Оба МРИ были одиналовыми и с контрастом. Как врач договорится со страховкой столько страховка и платит. Например недавно страховка моя разослал всем своим хиропракторам новые расценки и никто не захотел с ней заключать контракты, тогда страховка пошла на уступки и оставила старые расценки.
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Post by DP »

T_D wrote:Планы разные и контракты с медикал провайдером все разные.
Например МРИ в госпитале стоило страховке 1100. Тоже МРИ в поликлинике обошлось страховке в 2400. Оба МРИ были одиналовыми и с контрастом. Как врач договорится со страховкой столько страховка и платит. Например недавно страховка моя разослал всем своим хиропракторам новые расценки и никто не захотел с ней заключать контракты, тогда страховка пошла на уступки и оставила старые расценки.


это просто значит что страховка плохая... и при чем здесь планы ??? вы серьезно думаете что если у страховки есть PPO1, PPO2, PPO3, etc то она для всех этих планов имеет разные договорные цены с провайдером который in network... ну-ну.
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Office Procedures/Surgeries Expected Costs = Maternity Care



ABORTION INDUCED ABORTION, BY DILATION AND CURETTAGE $274.06
ABORTION INDUCED ABORTION, BY DILATION AND EVACUATION $411.00
MATERNITY TESTING AMNIOCENTESIS, DIAGNOSTIC $126.00
MATERNITY TESTING FETAL NON-STRESS TEST $52.81
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Office Procedures/Surgeries Expected Costs = Musculoskeletal System


APPLICATION OF CASTS & STRAPPING APPLICATION CAST; ELBOW TO FINGER (SHORT ARM) $70.00

APPLICATION OF CASTS & STRAPPING APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STATIC $60.00

APPLICATION OF CASTS & STRAPPING APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES); $80.00

APPLICATION OF CASTS & STRAPPING APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES); WALKING OR AMBULATORY TYPE $90.00

APPLICATION OF CASTS & STRAPPING STRAPPING; ANKLE $33.53

APPLICATION OF CASTS & STRAPPING STRAPPING; UNNA BOOT $44.41

BACK & FLANK EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK $407.00

ENDOSCOPY/ARTHROSCOPY ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY WITH OR WITHOUT CORACA-ACROMIAL RELEASE $895.01

ENDOSCOPY/ARTHROSCOPY ARTHROSCOPY, KNEE, SURGICAL; WITH MENISECTOMY (MEDIAL OR LATERAL) INCLUDING ANY MENISCAL SHAVING $758.85

FOOT CORRECTION, HAMMERTOE $365.21

FOOT CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION, EACH $267.00

FOOT CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE; WITHOUT MANIPULATION, EACH $105.50

FOREARM & WRIST CLOSED TREATMENT OF DISTAL RADIAL FRACTURE WITHOUT MANIPULATION $295.00

FOREARM & WRIST CLOSED TREATMENT OF DISTAL RADIAL FRACTURE WITH MANIPULATION $578.00

GENERAL INJECTION; TENDON SHEATH, LIGAMENT, GANGLION CYST $65.50

GENERAL ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SMALL JOINT, BURSA OR GANGLION CYST $53.00

GENERAL ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; INTERMEDIATE JOINT, BURSA OR GANGLION CYST $57.50

GENERAL ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT OR BURSA $69.00

HAND & FINGERS CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHOUT MANIPULATION, EACH BONE $228.00

HAND & FINGERS CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB; WITHOUT MANIPULATION, EACH $177.00

HUMERUS & ELBOW CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHOUT MANIPULATION $251.00

LEG (TIBIA & FIBULA) & ANKLE JOINT CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS); WITHOUT MANIPULATION $338.00

NECK & THORAX EXCISION, TUMOR, SOFT TISSUE OF NECK OR THORAX; SUBCUTANEOUS $373.00

PELVIS & HIP JOINT LATERAL RETINACULAR RELEASE (ANY METHOD) $505.77

SHOULDER CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITHOUT MANIPULATION $223.00

SHOULDER CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITHOUT MANIPULATION $320.00
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Office Procedures/Surgeries Expected Costs = Nervous System


NERVES - EXTRACRANIAL OR PERIPHERAL & AUTONOMIC NERVOUS SYSTEM INJECTION, ANESTHETIC AGENT; GREATER OCCIPITAL NERVE $109.00

NERVES - EXTRACRANIAL OR PERIPHERAL & AUTONOMIC NERVOUS SYSTEM INJECTION, ANESTHETIC AGENT; OTHER PERIPHERAL NERVE OR BRANCH $93.00

NERVES - EXTRACRANIAL OR PERIPHERAL & AUTONOMIC NERVOUS SYSTEM INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; LUMBAR OR SACRAL, SINGLE LEVEL $233.00

NERVES - EXTRACRANIAL OR PERIPHERAL & AUTONOMIC NERVOUS SYSTEM INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL $90.50

SPINE & SPINAL CORD INJECTION, SINGLE , NOT INCLUDING NEUROLYTIC SUBSTANCES, WITH OR WITHOUT CONTRAST OF DIAGNOSTIC OR THERAPEUTIC SUBSTANCE(S) $189.50

SPINE & SPINAL CORD INJECTION, SINGLE, NOT INCLUDING NEUROLYTIC SUBSTANCES, WITH OR WITHOUT CONTRAST OF DIAGNOSTIC OR THERAPEUTIC SUBSTANCE(S) $242.00

SPINE & SPINAL CORD ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FOR INTRATHECAL OR EPIDURAL DRUG INFUSION WITH REPROGRAMMING $73.36
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Office Procedures/Surgeries Expected Costs = Respiratory System


LARYNX LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; DIAGNOSTIC $125.00

LARYNX LARYNGOSCOPY, FLEXIBLE OR RIGID FIBEROPTIC, WITH STROBOSCOPY $200.00

NOSE SUBMUCOUS RESECTION TURBINATE, PARTIAL OR COMPLETE, ANY METHOD $317.00

NOSE CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERY AND/OR PACKING) ANY METHOD $97.00

NOSE NASAL ENDOSCOPY, DIAGNOSTIC, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE) $122.00

NOSE NASAL/SINUS ENDOSCOPY, SURGICAL; WITH BIOPSY, POLYPECTOMY OR DEBRIDEMENT (SEPARATE PROCEDURE) $267.83

TRACHEA & BRONCHI BRONCHOSCOPY, (RIGID OR FLEXIBLE); DIAGNOSTIC, WITH OR WITHOUT CELL WASHING (SEPARATE PROCEDURE) $243.95
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Office Procedures/Surgeries Expected Costs = Urinary System


BLADDER BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT $185.50

BLADDER COMPLEX CYSTOMETROGRAM $185.00

BLADDER COMPLEX UROFLOMETRY $74.57

BLADDER CYSTOURETHROSCOPY; SEPARATE PROCEDURE $251.50

BLADDER CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS, OR URETERAL STENT FROM URETHRA OR BLADDER; SIMPLE $245.50

KIDNEY LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE $703.00

URETER & PELVIS CYSTOURETHROSCOPY, WITH INSERTION OF INDWELLING URETERAL STENT $573.52

URETHRA CATHETERIZATION URETHRA; SIMPLE $93.00

URETHRA DILATION OF FEMALE URETHRA INCLUDING SUPPOSITORY AND/OR INSTILLATION; SUBSEQUENT $82.17
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Office Visit - Preventive/Well Checks Expected Costs = Annual Gyne Exam


All Ages $90.00
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Ophthalmologic Services Expected Costs


DETERMINATION OF REFRACTIVE STATE $18.00

FLUORESCEIN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETATION AND REPORT $135.00

FUNDUS PHOTOGRAPHY WITH INTERPRETATION AND REPORT $77.00

OPHTHALMIC BIOMETRY BY PARTIAL COHERENCE INTERFEROMETRY WITH INTRAOCULAR LENS POWER CALCULATION $74.50

OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION COMPREHENSIVE, NEW PATIENT, ONE OR MORE VISITS $125.00

OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION, COMPREHENSIVE, ESTABLISHED PATIENT, ONE OR MORE VISITS $90.00

OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION, INTERMEDIATE, ESTABLISHED PATIENT $67.00

OPHTHALMOLOGICAL SERVICES: MEDICAL EXAMINATION AND EVALUATION, INTERMEDIATE, NEW PATIENT $70.00

OPHTHALMOSCOPY, EXTENDED, WITH RETINAL DRAWING , WITH INTERPRETATION AND REPORT; INITIAL $28.00

OPHTHALMOSCOPY, EXTENDED, WITH RETINAL DRAWING, WITH INTERPRETATION AND REPORT; SUBSEQUENT $22.00

ORTHOPTIC AND/OR PLEOPTIC TRAINING, WITH CONTINUING MEDICAL DIRECTION AND EVALUATION $25.86

SCANNING COMPUTERIZED OPHTHALMIC DIAGNOSTIC IMAGING (EG, SCANNING LASER) WITH INTERPRETATION AND REPORT, UNILATERAL $53.00

SENSORIMOTOR EXAMINATION WITH MULTIPLE MEASUREMENTS OF OCULAR DEVIATION WITH INTERPRETATION AND REPORT $53.00

VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; EXTENDED EXAMINATION $70.00
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Physical Medicine/Therapy Services Expected Costs


APPLICATION OF A MODALITY TO ONE OR MORE AREAS; DIATHERMY $5.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ELECTRICAL STIMULATION (MANUAL), EACH 15 MINUTES $19.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ELECTRICAL STIMULATION (UNATTENDED) $14.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; HOT OR COLD PACKS $5.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; INFRARED $5.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; IONTOPHORESIS, EACH 15 MINUTES $22.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; PARAFFIN BATH $7.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; TRACTION, MECHANICAL $14.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ULTRASOUND, EACH 15 MINUTES $14.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; VASOPNEUMATIC DEVICES $14.00

APPLICATION OF A MODALITY TO ONE OR MORE AREAS; WHIRLPOOL $14.00

MANUAL THERAPY TECHNIQUES , ONE OR MORE REGIONS, EACH 15 MINUTES $23.50

OCCUPATIONAL THERAPY EVALUATION $64.10

PHYSICAL PERFORMANCE TEST OR MEASUREMENT, WITH WRITTEN REPORT, EACH 15 MINUTES $23.50

PHYSICAL THERAPY EVALUATION $64.80

PHYSICAL THERAPY RE-EVALUATION $24.11

SELF-CARE/HOME MANAGEMENT TRAINING DIRECT ONE-ON- ONE CONTACT BY PROVIDER, $23.50

THERAPEUTIC ACTIVITIES, DIRECT (ONE ON ONE) PATIENT CONTACT BY THE PROVIDER, EACH 15 MINUTES $23.50

THERAPEUTIC PROCEDURE(S), GROUP (2 OR MORE INDIVIDUALS) $19.00

THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; ENDURANCE, RANGE OF MOTION AND FLEXIBILITY $23.50

THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; AQUATIC THERAPY WITH THERAPEUTIC EXERCISES $23.50

THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBING) $22.00

THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; MASSAGE, INCLUDING EFFLEURAGE, PETRISSAGE AND/OR TAPOTEMENT $22.00

THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; NEUROMUSCULAR REEDUCATION OF MOVEMENT, BALANCE ETC. $23.50

THERAPEUTIC PROCEDURE, ONE OR MORE AREAS, EACH 15 MINUTES; UNLISTED THERAPEUTIC PROCEDURE (SPECIFY) $19.00

UNLISTED MODALITY (SPECIFY TYPE AND TIME IF CONSTANT ATTENDANCE) $14.00

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