|
PR CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK
|
Professional
|
Both
|
$2,738.00
|
|
|
Service Code
|
HCPCS 23460
|
| Min. Negotiated Rate |
$208.43 |
| Max. Negotiated Rate |
$1,916.60 |
| Rate for Payer: Aetna Commercial |
$1,456.90
|
| Rate for Payer: BCBS Complete |
$736.93
|
| Rate for Payer: BCBS Trust/PPO |
$208.43
|
| Rate for Payer: Cash Price |
$2,190.40
|
| Rate for Payer: Cash Price |
$2,190.40
|
| Rate for Payer: Mclaren Medicaid |
$701.84
|
| Rate for Payer: Meridian Medicaid |
$736.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,916.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,670.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,670.34
|
| Rate for Payer: Priority Health SBD |
$1,670.34
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR
|
Professional
|
Both
|
$3,140.00
|
|
|
Service Code
|
HCPCS 23455
|
| Min. Negotiated Rate |
$188.90 |
| Max. Negotiated Rate |
$2,198.00 |
| Rate for Payer: Aetna Commercial |
$1,328.69
|
| Rate for Payer: BCBS Complete |
$666.48
|
| Rate for Payer: BCBS Trust/PPO |
$188.90
|
| Rate for Payer: Cash Price |
$2,512.00
|
| Rate for Payer: Cash Price |
$2,512.00
|
| Rate for Payer: Mclaren Medicaid |
$634.74
|
| Rate for Payer: Meridian Medicaid |
$666.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,198.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,514.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,514.58
|
| Rate for Payer: Priority Health SBD |
$1,514.58
|
|
|
PR CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK
|
Professional
|
Both
|
$3,431.00
|
|
|
Service Code
|
HCPCS 23465
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$2,401.70 |
| Rate for Payer: Aetna Commercial |
$1,495.78
|
| Rate for Payer: BCBS Complete |
$755.49
|
| Rate for Payer: BCBS Trust/PPO |
$104.00
|
| Rate for Payer: Cash Price |
$2,744.80
|
| Rate for Payer: Cash Price |
$2,744.80
|
| Rate for Payer: Mclaren Medicaid |
$719.51
|
| Rate for Payer: Meridian Medicaid |
$755.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$719.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,401.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,712.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,712.73
|
| Rate for Payer: Priority Health SBD |
$1,712.73
|
|
|
PR CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 23466
|
| Min. Negotiated Rate |
$138.81 |
| Max. Negotiated Rate |
$1,718.33 |
| Rate for Payer: Aetna Commercial |
$1,490.07
|
| Rate for Payer: BCBS Complete |
$759.74
|
| Rate for Payer: BCBS Trust/PPO |
$138.81
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Mclaren Medicaid |
$723.56
|
| Rate for Payer: Meridian Medicaid |
$759.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$723.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,378.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.33
|
| Rate for Payer: Priority Health SBD |
$1,718.33
|
|
|
PR CAPSULOTOMY WRIST
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 25085
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$1,125.60 |
| Rate for Payer: Aetna Commercial |
$597.69
|
| Rate for Payer: BCBS Complete |
$308.19
|
| Rate for Payer: BCBS Trust/PPO |
$119.92
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Mclaren Medicaid |
$293.51
|
| Rate for Payer: Meridian Medicaid |
$308.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$694.49
|
| Rate for Payer: Priority Health Narrow Network |
$694.49
|
| Rate for Payer: Priority Health SBD |
$694.49
|
|
|
PR CARDIOPULMONARY EXERCISE TESTING
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 94621
|
| Min. Negotiated Rate |
$89.39 |
| Max. Negotiated Rate |
$256.23 |
| Rate for Payer: Aetna Commercial |
$168.62
|
| Rate for Payer: BCBS Complete |
$110.80
|
| Rate for Payer: BCBS Trust/PPO |
$256.23
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.39
|
| Rate for Payer: Priority Health Narrow Network |
$89.39
|
| Rate for Payer: Priority Health SBD |
$204.81
|
|
|
PR CARDIOPULMONARY RESUSCITATION
|
Professional
|
Both
|
$548.00
|
|
|
Service Code
|
HCPCS 92950
|
| Min. Negotiated Rate |
$115.23 |
| Max. Negotiated Rate |
$2,166.03 |
| Rate for Payer: Aetna Commercial |
$248.46
|
| Rate for Payer: BCBS Complete |
$120.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,166.03
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Mclaren Medicaid |
$115.23
|
| Rate for Payer: Meridian Medicaid |
$120.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$383.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.40
|
| Rate for Payer: Priority Health Narrow Network |
$254.40
|
| Rate for Payer: Priority Health SBD |
$254.40
|
|
|
PR CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP
|
Professional
|
Both
|
$6,712.00
|
|
|
Service Code
|
HCPCS 33315
|
| Min. Negotiated Rate |
$1,201.32 |
| Max. Negotiated Rate |
$4,698.40 |
| Rate for Payer: Aetna Commercial |
$2,572.47
|
| Rate for Payer: BCBS Complete |
$1,261.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.77
|
| Rate for Payer: Cash Price |
$5,369.60
|
| Rate for Payer: Cash Price |
$5,369.60
|
| Rate for Payer: Mclaren Medicaid |
$1,201.32
|
| Rate for Payer: Meridian Medicaid |
$1,261.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,201.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,698.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,988.53
|
| Rate for Payer: Priority Health Narrow Network |
$2,988.53
|
| Rate for Payer: Priority Health SBD |
$2,988.53
|
|
|
PR CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP
|
Professional
|
Both
|
$4,528.00
|
|
|
Service Code
|
HCPCS 33310
|
| Min. Negotiated Rate |
$733.15 |
| Max. Negotiated Rate |
$3,169.60 |
| Rate for Payer: Aetna Commercial |
$1,565.46
|
| Rate for Payer: BCBS Complete |
$769.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.64
|
| Rate for Payer: Cash Price |
$3,622.40
|
| Rate for Payer: Cash Price |
$3,622.40
|
| Rate for Payer: Mclaren Medicaid |
$733.15
|
| Rate for Payer: Meridian Medicaid |
$769.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,169.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,827.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,827.28
|
| Rate for Payer: Priority Health SBD |
$1,827.28
|
|
|
PR CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 93660
|
| Min. Negotiated Rate |
$99.30 |
| Max. Negotiated Rate |
$3,564.97 |
| Rate for Payer: Aetna Commercial |
$205.18
|
| Rate for Payer: BCBS Complete |
$224.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,564.97
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.30
|
| Rate for Payer: Priority Health Narrow Network |
$99.30
|
| Rate for Payer: Priority Health SBD |
$226.03
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Professional
|
Both
|
$491.00
|
|
|
Service Code
|
HCPCS 92960
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$343.70 |
| Rate for Payer: Aetna Commercial |
$144.47
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Mclaren Medicaid |
$67.73
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.84
|
| Rate for Payer: Priority Health Narrow Network |
$150.84
|
| Rate for Payer: Priority Health SBD |
$150.84
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Facility
|
IP
|
$491.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
92960
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$309.33 |
| Max. Negotiated Rate |
$441.90 |
| Rate for Payer: Aetna Commercial |
$417.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.15
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cofinity Commercial |
$343.70
|
| Rate for Payer: Cofinity Commercial |
$422.26
|
| Rate for Payer: Healthscope Commercial |
$441.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$417.35
|
| Rate for Payer: PHP Commercial |
$417.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.70
|
| Rate for Payer: Priority Health SBD |
$309.33
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Facility
|
OP
|
$491.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
92960
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$104.13 |
| Max. Negotiated Rate |
$1,749.11 |
| Rate for Payer: Aetna Commercial |
$417.35
|
| Rate for Payer: Aetna Medicare |
$602.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$723.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$723.88
|
| Rate for Payer: BCBS Complete |
$332.64
|
| Rate for Payer: BCBS MAPPO |
$579.10
|
| Rate for Payer: BCBS Trust/PPO |
$349.37
|
| Rate for Payer: BCN Medicare Advantage |
$579.10
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cofinity Commercial |
$343.70
|
| Rate for Payer: Cofinity Commercial |
$422.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.10
|
| Rate for Payer: Healthscope Commercial |
$441.90
|
| Rate for Payer: Mclaren Medicaid |
$316.77
|
| Rate for Payer: Mclaren Medicare |
$579.10
|
| Rate for Payer: Meridian Medicaid |
$332.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$608.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$665.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$417.35
|
| Rate for Payer: PACE Medicare |
$550.14
|
| Rate for Payer: PACE SWMI |
$579.10
|
| Rate for Payer: PHP Commercial |
$417.35
|
| Rate for Payer: PHP Medicare Advantage |
$579.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,749.11
|
| Rate for Payer: Priority Health Medicare |
$579.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,399.29
|
| Rate for Payer: Priority Health SBD |
$309.33
|
| Rate for Payer: Railroad Medicare Medicare |
$579.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.10
|
| Rate for Payer: UHC Exchange |
$104.13
|
| Rate for Payer: UHC Medicare Advantage |
$596.47
|
| Rate for Payer: VA VA |
$579.10
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Professional
|
Both
|
$491.00
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
92960
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$343.70 |
| Rate for Payer: Aetna Commercial |
$144.47
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Mclaren Medicaid |
$67.73
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.84
|
| Rate for Payer: Priority Health Narrow Network |
$150.84
|
| Rate for Payer: Priority Health SBD |
$150.84
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX
|
Professional
|
Both
|
$492.00
|
|
|
Service Code
|
HCPCS 92961
|
| Min. Negotiated Rate |
$101.96 |
| Max. Negotiated Rate |
$344.40 |
| Rate for Payer: Aetna Commercial |
$330.21
|
| Rate for Payer: BCBS Complete |
$160.14
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: Cash Price |
$393.60
|
| Rate for Payer: Cash Price |
$393.60
|
| Rate for Payer: Mclaren Medicaid |
$152.51
|
| Rate for Payer: Meridian Medicaid |
$160.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.57
|
| Rate for Payer: Priority Health Narrow Network |
$338.57
|
| Rate for Payer: Priority Health SBD |
$338.57
|
|
|
PR CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 96161
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$179.62 |
| Rate for Payer: Aetna Commercial |
$2.85
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS Trust/PPO |
$179.62
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.43
|
| Rate for Payer: Priority Health Narrow Network |
$5.43
|
| Rate for Payer: Priority Health SBD |
$5.43
|
|
|
PR CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS 99484
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$594.87 |
| Rate for Payer: Aetna Commercial |
$30.26
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS Trust/PPO |
$594.87
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.26
|
| Rate for Payer: Priority Health Narrow Network |
$37.26
|
| Rate for Payer: Priority Health SBD |
$37.26
|
|
|
PR CARPECTOMY 1 BONE
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 25210
|
| Min. Negotiated Rate |
$322.48 |
| Max. Negotiated Rate |
$1,167.60 |
| Rate for Payer: Aetna Commercial |
$654.43
|
| Rate for Payer: BCBS Complete |
$338.60
|
| Rate for Payer: BCBS Trust/PPO |
$637.66
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Mclaren Medicaid |
$322.48
|
| Rate for Payer: Meridian Medicaid |
$338.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$764.44
|
| Rate for Payer: Priority Health Narrow Network |
$764.44
|
| Rate for Payer: Priority Health SBD |
$764.44
|
|
|
PR CARPECTOMY 1 BONE
|
Facility
|
IP
|
$1,668.00
|
|
|
Service Code
|
CPT 25210
|
| Hospital Charge Code |
25210
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$1,050.84 |
| Max. Negotiated Rate |
$1,501.20 |
| Rate for Payer: Aetna Commercial |
$1,417.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.20
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cofinity Commercial |
$1,167.60
|
| Rate for Payer: Cofinity Commercial |
$1,434.48
|
| Rate for Payer: Healthscope Commercial |
$1,501.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,417.80
|
| Rate for Payer: PHP Commercial |
$1,417.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.60
|
| Rate for Payer: Priority Health SBD |
$1,050.84
|
|
|
PR CARPECTOMY 1 BONE
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 25210
|
| Hospital Charge Code |
25210
|
| Min. Negotiated Rate |
$322.48 |
| Max. Negotiated Rate |
$1,167.60 |
| Rate for Payer: Aetna Commercial |
$654.43
|
| Rate for Payer: BCBS Complete |
$338.60
|
| Rate for Payer: BCBS Trust/PPO |
$637.66
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Mclaren Medicaid |
$322.48
|
| Rate for Payer: Meridian Medicaid |
$338.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$764.44
|
| Rate for Payer: Priority Health Narrow Network |
$764.44
|
| Rate for Payer: Priority Health SBD |
$764.44
|
|
|
PR CARPECTOMY 1 BONE
|
Facility
|
OP
|
$1,668.00
|
|
|
Service Code
|
CPT 25210
|
| Hospital Charge Code |
25210
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$495.75 |
| Max. Negotiated Rate |
$8,817.68 |
| Rate for Payer: Aetna Commercial |
$1,417.80
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,234.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cofinity Commercial |
$1,434.48
|
| Rate for Payer: Cofinity Commercial |
$1,167.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$1,501.20
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,417.80
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$1,417.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,817.68
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health Narrow Network |
$7,054.14
|
| Rate for Payer: Priority Health SBD |
$1,050.84
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.32
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$495.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
PR CARPECTOMY ALL BONES PROXIMAL ROW
|
Professional
|
Both
|
$2,244.00
|
|
|
Service Code
|
HCPCS 25215
|
| Min. Negotiated Rate |
$403.21 |
| Max. Negotiated Rate |
$1,570.80 |
| Rate for Payer: Aetna Commercial |
$824.12
|
| Rate for Payer: BCBS Complete |
$423.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.98
|
| Rate for Payer: Cash Price |
$1,795.20
|
| Rate for Payer: Cash Price |
$1,795.20
|
| Rate for Payer: Mclaren Medicaid |
$403.21
|
| Rate for Payer: Meridian Medicaid |
$423.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.48
|
| Rate for Payer: Priority Health Narrow Network |
$957.48
|
| Rate for Payer: Priority Health SBD |
$957.48
|
|
|
PR CARTILAGE GRAFT COSTOCHONDRAL
|
Professional
|
Both
|
$921.00
|
|
|
Service Code
|
HCPCS 20910
|
| Min. Negotiated Rate |
$309.92 |
| Max. Negotiated Rate |
$8,557.53 |
| Rate for Payer: Aetna Commercial |
$625.78
|
| Rate for Payer: BCBS Complete |
$325.42
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Mclaren Medicaid |
$309.92
|
| Rate for Payer: Meridian Medicaid |
$325.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.78
|
| Rate for Payer: Priority Health Narrow Network |
$732.78
|
| Rate for Payer: Priority Health SBD |
$732.78
|
|
|
PR CARTILAGE GRAFT NASAL SEPTUM
|
Professional
|
Both
|
$1,035.00
|
|
|
Service Code
|
HCPCS 20912
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$739.43 |
| Rate for Payer: Aetna Commercial |
$630.42
|
| Rate for Payer: BCBS Complete |
$326.98
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Mclaren Medicaid |
$311.41
|
| Rate for Payer: Meridian Medicaid |
$326.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$739.43
|
| Rate for Payer: Priority Health Narrow Network |
$739.43
|
| Rate for Payer: Priority Health SBD |
$739.43
|
|
|
PR CA SCREEN;FLEXI SIGMOIDSCOPE
|
Facility
|
OP
|
$402.00
|
|
|
Service Code
|
HCPCS G0104
|
| Hospital Charge Code |
G0104
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$2,491.90 |
| Rate for Payer: Aetna Commercial |
$341.70
|
| Rate for Payer: Aetna Medicare |
$845.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,016.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,016.54
|
| Rate for Payer: BCBS Complete |
$467.12
|
| Rate for Payer: BCBS MAPPO |
$813.23
|
| Rate for Payer: BCBS Trust/PPO |
$519.48
|
| Rate for Payer: BCN Medicare Advantage |
$813.23
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$345.72
|
| Rate for Payer: Cofinity Commercial |
$281.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.23
|
| Rate for Payer: Healthscope Commercial |
$361.80
|
| Rate for Payer: Mclaren Medicaid |
$444.84
|
| Rate for Payer: Mclaren Medicare |
$813.23
|
| Rate for Payer: Meridian Medicaid |
$467.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$935.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$341.70
|
| Rate for Payer: PACE Medicare |
$772.57
|
| Rate for Payer: PACE SWMI |
$813.23
|
| Rate for Payer: PHP Commercial |
$341.70
|
| Rate for Payer: PHP Medicare Advantage |
$813.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,491.90
|
| Rate for Payer: Priority Health Medicare |
$813.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,993.52
|
| Rate for Payer: Priority Health SBD |
$253.26
|
| Rate for Payer: Railroad Medicare Medicare |
$813.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.23
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$837.63
|
| Rate for Payer: VA VA |
$813.23
|
|
