|
PR CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 47620
|
| Min. Negotiated Rate |
$818.13 |
| Max. Negotiated Rate |
$2,512.59 |
| Rate for Payer: Aetna Commercial |
$1,715.33
|
| Rate for Payer: Aetna Medicare |
$1,331.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,715.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,843.34
|
| Rate for Payer: BCBS Complete |
$859.04
|
| Rate for Payer: BCBS MAPPO |
$1,280.10
|
| Rate for Payer: BCN Commercial |
$2,062.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,280.10
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$1,843.34
|
| Rate for Payer: Cofinity Commercial |
$1,715.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,280.10
|
| Rate for Payer: Healthscope Commercial |
$2,368.18
|
| Rate for Payer: Healthscope Commercial |
$2,048.16
|
| Rate for Payer: Mclaren Medicaid |
$818.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,344.11
|
| Rate for Payer: Meridian Medicaid |
$859.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,408.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,465.60
|
| Rate for Payer: Nomi Health Commercial |
$1,536.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.00
|
| Rate for Payer: PACE SWMI |
$1,280.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,280.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,512.59
|
| Rate for Payer: Priority Health Medicare |
$1,280.10
|
| Rate for Payer: Priority Health SBD |
$2,512.59
|
| Rate for Payer: Priority Health Tiered Network |
$2,512.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,280.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,462.40
|
| Rate for Payer: UHC Core |
$2,462.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,280.10
|
| Rate for Payer: UHC Exchange |
$2,462.40
|
| Rate for Payer: UHC Medicaid |
$818.13
|
| Rate for Payer: UHCCP Medicaid |
$818.13
|
|
|
PR CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM
|
Professional
|
Both
|
$2,723.00
|
|
|
Service Code
|
HCPCS 47741
|
| Min. Negotiated Rate |
$883.10 |
| Max. Negotiated Rate |
$2,698.85 |
| Rate for Payer: Aetna Commercial |
$1,847.10
|
| Rate for Payer: Aetna Medicare |
$1,433.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,847.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.94
|
| Rate for Payer: BCBS Complete |
$927.25
|
| Rate for Payer: BCBS MAPPO |
$1,378.43
|
| Rate for Payer: BCN Commercial |
$2,215.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,378.43
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cofinity Commercial |
$1,984.94
|
| Rate for Payer: Cofinity Commercial |
$1,847.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,378.43
|
| Rate for Payer: Healthscope Commercial |
$2,550.10
|
| Rate for Payer: Healthscope Commercial |
$2,205.49
|
| Rate for Payer: Mclaren Medicaid |
$883.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,447.35
|
| Rate for Payer: Meridian Medicaid |
$927.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,516.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,642.98
|
| Rate for Payer: Nomi Health Commercial |
$1,654.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,042.25
|
| Rate for Payer: PACE SWMI |
$1,378.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,378.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$883.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,698.85
|
| Rate for Payer: Priority Health Medicare |
$1,378.43
|
| Rate for Payer: Priority Health SBD |
$2,698.85
|
| Rate for Payer: Priority Health Tiered Network |
$2,698.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,378.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,636.64
|
| Rate for Payer: UHC Core |
$2,636.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,378.43
|
| Rate for Payer: UHC Exchange |
$2,636.64
|
| Rate for Payer: UHC Medicaid |
$883.10
|
| Rate for Payer: UHCCP Medicaid |
$883.10
|
|
|
PR CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX
|
Professional
|
Both
|
$2,702.00
|
|
|
Service Code
|
HCPCS 47480
|
| Min. Negotiated Rate |
$534.20 |
| Max. Negotiated Rate |
$2,026.50 |
| Rate for Payer: Aetna Commercial |
$1,105.90
|
| Rate for Payer: Aetna Medicare |
$858.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.43
|
| Rate for Payer: BCBS Complete |
$560.91
|
| Rate for Payer: BCBS MAPPO |
$825.30
|
| Rate for Payer: BCN Commercial |
$1,325.13
|
| Rate for Payer: BCN Medicare Advantage |
$825.30
|
| Rate for Payer: Cash Price |
$2,161.60
|
| Rate for Payer: Cash Price |
$2,161.60
|
| Rate for Payer: Cofinity Commercial |
$1,188.43
|
| Rate for Payer: Cofinity Commercial |
$1,105.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$825.30
|
| Rate for Payer: Healthscope Commercial |
$1,526.81
|
| Rate for Payer: Healthscope Commercial |
$1,320.48
|
| Rate for Payer: Mclaren Medicaid |
$534.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$866.57
|
| Rate for Payer: Meridian Medicaid |
$560.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$907.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,563.41
|
| Rate for Payer: Nomi Health Commercial |
$990.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,026.50
|
| Rate for Payer: PACE SWMI |
$825.30
|
| Rate for Payer: PHP Medicare Advantage |
$825.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,614.58
|
| Rate for Payer: Priority Health Medicare |
$825.30
|
| Rate for Payer: Priority Health SBD |
$1,614.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,614.58
|
| Rate for Payer: Railroad Medicare Medicare |
$825.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,559.16
|
| Rate for Payer: UHC Core |
$1,559.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$825.30
|
| Rate for Payer: UHC Exchange |
$1,559.16
|
| Rate for Payer: UHC Medicaid |
$534.20
|
| Rate for Payer: UHCCP Medicaid |
$534.20
|
|
|
PR CHOLECYSTECTOMY
|
Professional
|
Both
|
$2,696.00
|
|
|
Service Code
|
HCPCS 47600
|
| Min. Negotiated Rate |
$644.33 |
| Max. Negotiated Rate |
$2,022.00 |
| Rate for Payer: Aetna Commercial |
$1,344.52
|
| Rate for Payer: Aetna Medicare |
$1,043.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.85
|
| Rate for Payer: BCBS Complete |
$676.55
|
| Rate for Payer: BCBS MAPPO |
$1,003.37
|
| Rate for Payer: BCN Commercial |
$1,613.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,003.37
|
| Rate for Payer: Cash Price |
$2,156.80
|
| Rate for Payer: Cash Price |
$2,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,444.85
|
| Rate for Payer: Cofinity Commercial |
$1,344.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,003.37
|
| Rate for Payer: Healthscope Commercial |
$1,856.23
|
| Rate for Payer: Healthscope Commercial |
$1,605.39
|
| Rate for Payer: Mclaren Medicaid |
$644.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,053.54
|
| Rate for Payer: Meridian Medicaid |
$676.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,103.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.44
|
| Rate for Payer: Nomi Health Commercial |
$1,204.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,022.00
|
| Rate for Payer: PACE SWMI |
$1,003.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,003.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,965.90
|
| Rate for Payer: Priority Health Medicare |
$1,003.37
|
| Rate for Payer: Priority Health SBD |
$1,965.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,965.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,003.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,906.07
|
| Rate for Payer: UHC Core |
$1,906.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,003.37
|
| Rate for Payer: UHC Exchange |
$1,906.07
|
| Rate for Payer: UHC Medicaid |
$644.33
|
| Rate for Payer: UHCCP Medicaid |
$644.33
|
|
|
PR CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY
|
Professional
|
Both
|
$4,851.00
|
|
|
Service Code
|
HCPCS 47612
|
| Min. Negotiated Rate |
$759.77 |
| Max. Negotiated Rate |
$3,638.25 |
| Rate for Payer: Aetna Commercial |
$1,591.59
|
| Rate for Payer: Aetna Medicare |
$1,235.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,591.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,710.36
|
| Rate for Payer: BCBS Complete |
$797.76
|
| Rate for Payer: BCBS MAPPO |
$1,187.75
|
| Rate for Payer: BCN Commercial |
$1,910.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,187.75
|
| Rate for Payer: Cash Price |
$3,880.80
|
| Rate for Payer: Cash Price |
$3,880.80
|
| Rate for Payer: Cofinity Commercial |
$1,710.36
|
| Rate for Payer: Cofinity Commercial |
$1,591.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,187.75
|
| Rate for Payer: Healthscope Commercial |
$2,197.34
|
| Rate for Payer: Healthscope Commercial |
$1,900.40
|
| Rate for Payer: Mclaren Medicaid |
$759.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,247.14
|
| Rate for Payer: Meridian Medicaid |
$797.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,306.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,282.40
|
| Rate for Payer: Nomi Health Commercial |
$1,425.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,638.25
|
| Rate for Payer: PACE SWMI |
$1,187.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,187.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$759.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,328.14
|
| Rate for Payer: Priority Health Medicare |
$1,187.75
|
| Rate for Payer: Priority Health SBD |
$2,328.14
|
| Rate for Payer: Priority Health Tiered Network |
$2,328.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,187.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,280.13
|
| Rate for Payer: UHC Core |
$2,280.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,187.75
|
| Rate for Payer: UHC Exchange |
$2,280.13
|
| Rate for Payer: UHC Medicaid |
$759.77
|
| Rate for Payer: UHCCP Medicaid |
$759.77
|
|
|
PR CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$3,099.00
|
|
|
Service Code
|
HCPCS 47605
|
| Min. Negotiated Rate |
$676.91 |
| Max. Negotiated Rate |
$2,324.25 |
| Rate for Payer: Aetna Commercial |
$1,413.86
|
| Rate for Payer: Aetna Medicare |
$1,097.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,519.37
|
| Rate for Payer: BCBS Complete |
$710.76
|
| Rate for Payer: BCBS MAPPO |
$1,055.12
|
| Rate for Payer: BCN Commercial |
$1,696.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,055.12
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cofinity Commercial |
$1,519.37
|
| Rate for Payer: Cofinity Commercial |
$1,413.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,055.12
|
| Rate for Payer: Healthscope Commercial |
$1,951.97
|
| Rate for Payer: Healthscope Commercial |
$1,688.19
|
| Rate for Payer: Mclaren Medicaid |
$676.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,107.88
|
| Rate for Payer: Meridian Medicaid |
$710.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,160.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,020.34
|
| Rate for Payer: Nomi Health Commercial |
$1,266.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,324.25
|
| Rate for Payer: PACE SWMI |
$1,055.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,055.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,067.23
|
| Rate for Payer: Priority Health Medicare |
$1,055.12
|
| Rate for Payer: Priority Health SBD |
$2,067.23
|
| Rate for Payer: Priority Health Tiered Network |
$2,067.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,055.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,006.43
|
| Rate for Payer: UHC Core |
$2,006.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,055.12
|
| Rate for Payer: UHC Exchange |
$2,006.43
|
| Rate for Payer: UHC Medicaid |
$676.91
|
| Rate for Payer: UHCCP Medicaid |
$676.91
|
|
|
PR CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT
|
Professional
|
Both
|
$3,409.00
|
|
|
Service Code
|
HCPCS 47610
|
| Min. Negotiated Rate |
$748.48 |
| Max. Negotiated Rate |
$2,556.75 |
| Rate for Payer: Aetna Commercial |
$1,566.61
|
| Rate for Payer: Aetna Medicare |
$1,215.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,566.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,683.52
|
| Rate for Payer: BCBS Complete |
$785.90
|
| Rate for Payer: BCBS MAPPO |
$1,169.11
|
| Rate for Payer: BCN Commercial |
$1,885.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,169.11
|
| Rate for Payer: Cash Price |
$2,727.20
|
| Rate for Payer: Cash Price |
$2,727.20
|
| Rate for Payer: Cofinity Commercial |
$1,683.52
|
| Rate for Payer: Cofinity Commercial |
$1,566.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,169.11
|
| Rate for Payer: Healthscope Commercial |
$2,162.85
|
| Rate for Payer: Healthscope Commercial |
$1,870.58
|
| Rate for Payer: Mclaren Medicaid |
$748.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,227.57
|
| Rate for Payer: Meridian Medicaid |
$785.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,286.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,245.21
|
| Rate for Payer: Nomi Health Commercial |
$1,402.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,556.75
|
| Rate for Payer: PACE SWMI |
$1,169.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,169.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$748.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,297.19
|
| Rate for Payer: Priority Health Medicare |
$1,169.11
|
| Rate for Payer: Priority Health SBD |
$2,297.19
|
| Rate for Payer: Priority Health Tiered Network |
$2,297.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1,169.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,242.16
|
| Rate for Payer: UHC Core |
$2,242.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,169.11
|
| Rate for Payer: UHC Exchange |
$2,242.16
|
| Rate for Payer: UHC Medicaid |
$748.48
|
| Rate for Payer: UHCCP Medicaid |
$748.48
|
|
|
PR CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT
|
Professional
|
Both
|
$697.00
|
|
|
Service Code
|
HCPCS 47490
|
| Min. Negotiated Rate |
$190.21 |
| Max. Negotiated Rate |
$598.87 |
| Rate for Payer: Aetna Commercial |
$387.72
|
| Rate for Payer: Aetna Medicare |
$300.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.65
|
| Rate for Payer: BCBS Complete |
$199.72
|
| Rate for Payer: BCBS MAPPO |
$289.34
|
| Rate for Payer: BCN Commercial |
$491.51
|
| Rate for Payer: BCN Medicare Advantage |
$289.34
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cofinity Commercial |
$416.65
|
| Rate for Payer: Cofinity Commercial |
$387.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.34
|
| Rate for Payer: Healthscope Commercial |
$535.28
|
| Rate for Payer: Healthscope Commercial |
$462.94
|
| Rate for Payer: Mclaren Medicaid |
$190.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.81
|
| Rate for Payer: Meridian Medicaid |
$199.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$576.70
|
| Rate for Payer: Nomi Health Commercial |
$347.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$522.75
|
| Rate for Payer: PACE SWMI |
$289.34
|
| Rate for Payer: PHP Medicare Advantage |
$289.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$598.87
|
| Rate for Payer: Priority Health Medicare |
$289.34
|
| Rate for Payer: Priority Health SBD |
$598.87
|
| Rate for Payer: Priority Health Tiered Network |
$598.87
|
| Rate for Payer: Railroad Medicare Medicare |
$289.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.60
|
| Rate for Payer: UHC Core |
$578.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$289.34
|
| Rate for Payer: UHC Exchange |
$578.60
|
| Rate for Payer: UHC Medicaid |
$190.21
|
| Rate for Payer: UHCCP Medicaid |
$190.21
|
|
|
PR CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,477.00
|
|
|
Service Code
|
HCPCS 47420
|
| Min. Negotiated Rate |
$790.02 |
| Max. Negotiated Rate |
$2,440.39 |
| Rate for Payer: Aetna Commercial |
$1,651.27
|
| Rate for Payer: Aetna Medicare |
$1,281.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,651.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,774.50
|
| Rate for Payer: BCBS Complete |
$829.52
|
| Rate for Payer: BCBS MAPPO |
$1,232.29
|
| Rate for Payer: BCN Commercial |
$2,002.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,232.29
|
| Rate for Payer: Cash Price |
$1,981.60
|
| Rate for Payer: Cash Price |
$1,981.60
|
| Rate for Payer: Cofinity Commercial |
$1,774.50
|
| Rate for Payer: Cofinity Commercial |
$1,651.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,232.29
|
| Rate for Payer: Healthscope Commercial |
$2,279.74
|
| Rate for Payer: Healthscope Commercial |
$1,971.66
|
| Rate for Payer: Mclaren Medicaid |
$790.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,293.90
|
| Rate for Payer: Meridian Medicaid |
$829.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,355.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,383.43
|
| Rate for Payer: Nomi Health Commercial |
$1,478.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,857.75
|
| Rate for Payer: PACE SWMI |
$1,232.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,232.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$790.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,440.39
|
| Rate for Payer: Priority Health Medicare |
$1,232.29
|
| Rate for Payer: Priority Health SBD |
$2,440.39
|
| Rate for Payer: Priority Health Tiered Network |
$2,440.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,232.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,391.53
|
| Rate for Payer: UHC Core |
$2,391.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,232.29
|
| Rate for Payer: UHC Exchange |
$2,391.53
|
| Rate for Payer: UHC Medicaid |
$790.02
|
| Rate for Payer: UHCCP Medicaid |
$790.02
|
|
|
PR CHOLERA IMMUNIZATION,INJECTABLE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 90725
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
|
|
PR CHOLINESTERASE INHIBITOR CHALLENGE TEST
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 95857
|
| Min. Negotiated Rate |
$15.12 |
| Max. Negotiated Rate |
$124.50 |
| Rate for Payer: Aetna Commercial |
$31.42
|
| Rate for Payer: Aetna Medicare |
$24.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.77
|
| Rate for Payer: BCBS Complete |
$15.88
|
| Rate for Payer: BCBS MAPPO |
$23.45
|
| Rate for Payer: BCN Commercial |
$41.83
|
| Rate for Payer: BCN Medicare Advantage |
$23.45
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$33.77
|
| Rate for Payer: Cofinity Commercial |
$31.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.45
|
| Rate for Payer: Healthscope Commercial |
$37.52
|
| Rate for Payer: Healthscope Commercial |
$43.38
|
| Rate for Payer: Mclaren Medicaid |
$15.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.62
|
| Rate for Payer: Meridian Medicaid |
$15.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.63
|
| Rate for Payer: Nomi Health Commercial |
$28.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.50
|
| Rate for Payer: PACE SWMI |
$23.45
|
| Rate for Payer: PHP Medicare Advantage |
$23.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.58
|
| Rate for Payer: Priority Health Medicare |
$23.45
|
| Rate for Payer: Priority Health SBD |
$38.58
|
| Rate for Payer: Priority Health Tiered Network |
$38.58
|
| Rate for Payer: Railroad Medicare Medicare |
$23.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.59
|
| Rate for Payer: UHC Core |
$48.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.45
|
| Rate for Payer: UHC Exchange |
$48.59
|
| Rate for Payer: UHC Medicaid |
$15.12
|
| Rate for Payer: UHCCP Medicaid |
$15.12
|
|
|
PR CHORIONIC VILLUS SAMPLING
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 59015
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$158.79
|
| Rate for Payer: Aetna Medicare |
$123.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.64
|
| Rate for Payer: BCBS Complete |
$78.73
|
| Rate for Payer: BCBS MAPPO |
$118.50
|
| Rate for Payer: BCN Commercial |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$118.50
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$170.64
|
| Rate for Payer: Cofinity Commercial |
$158.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.50
|
| Rate for Payer: Healthscope Commercial |
$219.22
|
| Rate for Payer: Healthscope Commercial |
$189.60
|
| Rate for Payer: Mclaren Medicaid |
$74.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.42
|
| Rate for Payer: Meridian Medicaid |
$78.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.85
|
| Rate for Payer: Nomi Health Commercial |
$142.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.50
|
| Rate for Payer: PACE SWMI |
$118.50
|
| Rate for Payer: PHP Medicare Advantage |
$118.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$185.22
|
| Rate for Payer: Priority Health Medicare |
$118.50
|
| Rate for Payer: Priority Health SBD |
$185.22
|
| Rate for Payer: Priority Health Tiered Network |
$185.22
|
| Rate for Payer: Railroad Medicare Medicare |
$118.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.40
|
| Rate for Payer: UHC Core |
$234.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.50
|
| Rate for Payer: UHC Exchange |
$234.40
|
| Rate for Payer: UHC Medicaid |
$74.98
|
| Rate for Payer: UHCCP Medicaid |
$74.98
|
|
|
PR CHROMOTUBATION OVIDUCT W/MATERIALS
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 58350
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$167.60 |
| Rate for Payer: Aetna Commercial |
$108.31
|
| Rate for Payer: Aetna Medicare |
$84.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.40
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$80.83
|
| Rate for Payer: BCN Commercial |
$141.92
|
| Rate for Payer: BCN Medicare Advantage |
$80.83
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$116.40
|
| Rate for Payer: Cofinity Commercial |
$108.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.83
|
| Rate for Payer: Healthscope Commercial |
$149.54
|
| Rate for Payer: Healthscope Commercial |
$129.33
|
| Rate for Payer: Mclaren Medicaid |
$53.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.87
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.60
|
| Rate for Payer: Nomi Health Commercial |
$97.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$80.83
|
| Rate for Payer: PHP Medicare Advantage |
$80.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$143.74
|
| Rate for Payer: Priority Health Medicare |
$80.83
|
| Rate for Payer: Priority Health SBD |
$143.74
|
| Rate for Payer: Priority Health Tiered Network |
$143.74
|
| Rate for Payer: Railroad Medicare Medicare |
$80.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.72
|
| Rate for Payer: UHC Core |
$150.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.83
|
| Rate for Payer: UHC Exchange |
$150.72
|
| Rate for Payer: UHC Medicaid |
$53.46
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
PR CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 99490
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Aetna Commercial |
$58.10
|
| Rate for Payer: Aetna Medicare |
$45.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.44
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$43.36
|
| Rate for Payer: BCN Commercial |
$73.70
|
| Rate for Payer: BCN Medicare Advantage |
$43.36
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$62.44
|
| Rate for Payer: Cofinity Commercial |
$58.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.36
|
| Rate for Payer: Healthscope Commercial |
$80.22
|
| Rate for Payer: Healthscope Commercial |
$69.38
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.53
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.12
|
| Rate for Payer: Nomi Health Commercial |
$52.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.25
|
| Rate for Payer: PACE SWMI |
$43.36
|
| Rate for Payer: PHP Medicare Advantage |
$43.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.29
|
| Rate for Payer: Priority Health Medicare |
$43.36
|
| Rate for Payer: Priority Health SBD |
$66.29
|
| Rate for Payer: Priority Health Tiered Network |
$66.29
|
| Rate for Payer: Railroad Medicare Medicare |
$43.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.54
|
| Rate for Payer: UHC Core |
$45.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.36
|
| Rate for Payer: UHC Exchange |
$45.54
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE
|
Professional
|
Both
|
$3,641.00
|
|
|
Service Code
|
HCPCS 24940
|
| Min. Negotiated Rate |
$602.42 |
| Max. Negotiated Rate |
$11,802.16 |
| Rate for Payer: Aetna Commercial |
$1,439.82
|
| Rate for Payer: Aetna Medicare |
$1,820.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,439.82
|
| Rate for Payer: BCBS Complete |
$632.54
|
| Rate for Payer: BCN Commercial |
$11,802.16
|
| Rate for Payer: Cash Price |
$2,912.80
|
| Rate for Payer: Cash Price |
$2,912.80
|
| Rate for Payer: Mclaren Medicaid |
$602.42
|
| Rate for Payer: Meridian Medicaid |
$632.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,930.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,730.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,773.72
|
| Rate for Payer: Priority Health SBD |
$1,773.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,773.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,704.31
|
| Rate for Payer: UHC Core |
$1,704.31
|
| Rate for Payer: UHC Exchange |
$1,704.31
|
| Rate for Payer: UHC Medicaid |
$602.42
|
| Rate for Payer: UHCCP Medicaid |
$602.42
|
|
|
PR CIRCADIAN RESPIRATORY PATTERN REC 12-24 HR INFT
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 94772
|
| Min. Negotiated Rate |
$98.71 |
| Max. Negotiated Rate |
$498.75 |
| Rate for Payer: Aetna Commercial |
$318.52
|
| Rate for Payer: Aetna Medicare |
$332.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.52
|
| Rate for Payer: BCN Commercial |
$98.71
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$436.28
|
| Rate for Payer: Priority Health SBD |
$436.28
|
| Rate for Payer: Priority Health Tiered Network |
$436.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.11
|
| Rate for Payer: UHC Core |
$440.11
|
| Rate for Payer: UHC Exchange |
$440.11
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
OP
|
$1,589.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,001.07 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna Commercial |
$1,350.65
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,032.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,190.20
|
| Rate for Payer: BCN Commercial |
$2,190.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Advantage |
$1,112.30
|
| Rate for Payer: Cofinity Commercial |
$1,366.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$1,430.10
|
| Rate for Payer: Mclaren Medicaid |
$1,089.34
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.65
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.75
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$1,350.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$1,001.07
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 54161
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$1,191.75 |
| Rate for Payer: Aetna Commercial |
$238.16
|
| Rate for Payer: Aetna Medicare |
$184.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.93
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.73
|
| Rate for Payer: BCN Commercial |
$297.29
|
| Rate for Payer: BCN Medicare Advantage |
$177.73
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$255.93
|
| Rate for Payer: Cofinity Commercial |
$238.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.73
|
| Rate for Payer: Healthscope Commercial |
$328.80
|
| Rate for Payer: Healthscope Commercial |
$284.37
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.62
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.57
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.75
|
| Rate for Payer: PACE SWMI |
$177.73
|
| Rate for Payer: PHP Medicare Advantage |
$177.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$323.85
|
| Rate for Payer: Priority Health Medicare |
$177.73
|
| Rate for Payer: Priority Health SBD |
$323.85
|
| Rate for Payer: Priority Health Tiered Network |
$323.85
|
| Rate for Payer: Railroad Medicare Medicare |
$177.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.14
|
| Rate for Payer: UHC Core |
$346.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.73
|
| Rate for Payer: UHC Exchange |
$346.14
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 54161
|
| Hospital Charge Code |
54161
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$1,191.75 |
| Rate for Payer: Aetna Commercial |
$238.16
|
| Rate for Payer: Aetna Medicare |
$184.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.93
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.73
|
| Rate for Payer: BCN Commercial |
$297.29
|
| Rate for Payer: BCN Medicare Advantage |
$177.73
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$255.93
|
| Rate for Payer: Cofinity Commercial |
$238.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.73
|
| Rate for Payer: Healthscope Commercial |
$328.80
|
| Rate for Payer: Healthscope Commercial |
$284.37
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.62
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.57
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.75
|
| Rate for Payer: PACE SWMI |
$177.73
|
| Rate for Payer: PHP Medicare Advantage |
$177.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$323.85
|
| Rate for Payer: Priority Health Medicare |
$177.73
|
| Rate for Payer: Priority Health SBD |
$323.85
|
| Rate for Payer: Priority Health Tiered Network |
$323.85
|
| Rate for Payer: Railroad Medicare Medicare |
$177.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.14
|
| Rate for Payer: UHC Core |
$346.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.73
|
| Rate for Payer: UHC Exchange |
$346.14
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
IP
|
$1,589.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,001.07 |
| Max. Negotiated Rate |
$1,430.10 |
| Rate for Payer: Aetna Commercial |
$1,350.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,032.85
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Advantage |
$1,112.30
|
| Rate for Payer: Cofinity Commercial |
$1,366.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.20
|
| Rate for Payer: Healthscope Commercial |
$1,430.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,350.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,191.75
|
| Rate for Payer: PHP Commercial |
$1,350.65
|
| Rate for Payer: Priority Health SBD |
$1,001.07
|
|
|
PR CIRCUMCISION NEONATE
|
Professional
|
Both
|
$624.00
|
|
|
Service Code
|
HCPCS 54160
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$174.63
|
| Rate for Payer: Aetna Medicare |
$135.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.66
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$130.32
|
| Rate for Payer: BCN Commercial |
$217.62
|
| Rate for Payer: BCN Medicare Advantage |
$130.32
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cofinity Commercial |
$187.66
|
| Rate for Payer: Cofinity Commercial |
$174.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.32
|
| Rate for Payer: Healthscope Commercial |
$241.09
|
| Rate for Payer: Healthscope Commercial |
$208.51
|
| Rate for Payer: Mclaren Medicaid |
$84.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.84
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.69
|
| Rate for Payer: Nomi Health Commercial |
$156.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.00
|
| Rate for Payer: PACE SWMI |
$130.32
|
| Rate for Payer: PHP Medicare Advantage |
$130.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$237.05
|
| Rate for Payer: Priority Health Medicare |
$130.32
|
| Rate for Payer: Priority Health SBD |
$237.05
|
| Rate for Payer: Priority Health Tiered Network |
$237.05
|
| Rate for Payer: Railroad Medicare Medicare |
$130.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.58
|
| Rate for Payer: UHC Core |
$254.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.32
|
| Rate for Payer: UHC Exchange |
$254.58
|
| Rate for Payer: UHC Medicaid |
$84.35
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
|
|
PR CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 54150
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$402.75 |
| Rate for Payer: Aetna Commercial |
$112.49
|
| Rate for Payer: Aetna Medicare |
$87.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.89
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$83.95
|
| Rate for Payer: BCN Commercial |
$142.92
|
| Rate for Payer: BCN Medicare Advantage |
$83.95
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$120.89
|
| Rate for Payer: Cofinity Commercial |
$112.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.95
|
| Rate for Payer: Healthscope Commercial |
$155.31
|
| Rate for Payer: Healthscope Commercial |
$134.32
|
| Rate for Payer: Mclaren Medicaid |
$53.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.15
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.20
|
| Rate for Payer: Nomi Health Commercial |
$100.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE SWMI |
$83.95
|
| Rate for Payer: PHP Medicare Advantage |
$83.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$155.68
|
| Rate for Payer: Priority Health Medicare |
$83.95
|
| Rate for Payer: Priority Health SBD |
$155.68
|
| Rate for Payer: Priority Health Tiered Network |
$155.68
|
| Rate for Payer: Railroad Medicare Medicare |
$83.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.64
|
| Rate for Payer: UHC Core |
$174.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$83.95
|
| Rate for Payer: UHC Exchange |
$174.64
|
| Rate for Payer: UHC Medicaid |
$53.68
|
| Rate for Payer: UHCCP Medicaid |
$53.68
|
|
|
PR CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX
|
Professional
|
Both
|
$493.00
|
|
|
Service Code
|
HCPCS 61050
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$369.75 |
| Rate for Payer: Aetna Commercial |
$91.67
|
| Rate for Payer: Aetna Medicare |
$71.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.51
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$68.41
|
| Rate for Payer: BCN Commercial |
$120.02
|
| Rate for Payer: BCN Medicare Advantage |
$68.41
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$98.51
|
| Rate for Payer: Cofinity Commercial |
$91.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.41
|
| Rate for Payer: Healthscope Commercial |
$126.56
|
| Rate for Payer: Healthscope Commercial |
$109.46
|
| Rate for Payer: Mclaren Medicaid |
$44.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.83
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.10
|
| Rate for Payer: Nomi Health Commercial |
$82.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.75
|
| Rate for Payer: PACE SWMI |
$68.41
|
| Rate for Payer: PHP Medicare Advantage |
$68.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$139.40
|
| Rate for Payer: Priority Health Medicare |
$68.41
|
| Rate for Payer: Priority Health SBD |
$139.40
|
| Rate for Payer: Priority Health Tiered Network |
$139.40
|
| Rate for Payer: Railroad Medicare Medicare |
$68.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.05
|
| Rate for Payer: UHC Core |
$149.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$68.41
|
| Rate for Payer: UHC Exchange |
$149.05
|
| Rate for Payer: UHC Medicaid |
$44.09
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR CLAVICULECTOMY PARTIAL
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 23120
|
| Min. Negotiated Rate |
$360.18 |
| Max. Negotiated Rate |
$1,043.01 |
| Rate for Payer: Aetna Commercial |
$733.38
|
| Rate for Payer: Aetna Medicare |
$569.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.11
|
| Rate for Payer: BCBS Complete |
$378.19
|
| Rate for Payer: BCBS MAPPO |
$547.30
|
| Rate for Payer: BCN Commercial |
$991.29
|
| Rate for Payer: BCN Medicare Advantage |
$547.30
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$788.11
|
| Rate for Payer: Cofinity Commercial |
$733.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.30
|
| Rate for Payer: Healthscope Commercial |
$875.68
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: Mclaren Medicaid |
$360.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.66
|
| Rate for Payer: Meridian Medicaid |
$378.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,043.01
|
| Rate for Payer: Nomi Health Commercial |
$656.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PACE SWMI |
$547.30
|
| Rate for Payer: PHP Medicare Advantage |
$547.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$964.58
|
| Rate for Payer: Priority Health Medicare |
$547.30
|
| Rate for Payer: Priority Health SBD |
$964.58
|
| Rate for Payer: Priority Health Tiered Network |
$964.58
|
| Rate for Payer: Railroad Medicare Medicare |
$547.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.74
|
| Rate for Payer: UHC Core |
$1,015.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.30
|
| Rate for Payer: UHC Exchange |
$1,015.74
|
| Rate for Payer: UHC Medicaid |
$360.18
|
| Rate for Payer: UHCCP Medicaid |
$360.18
|
|
|
PR CLAVICULECTOMY TOTAL
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 23125
|
| Min. Negotiated Rate |
$426.64 |
| Max. Negotiated Rate |
$1,262.68 |
| Rate for Payer: Aetna Commercial |
$874.43
|
| Rate for Payer: Aetna Medicare |
$678.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$874.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.69
|
| Rate for Payer: BCBS Complete |
$447.97
|
| Rate for Payer: BCBS MAPPO |
$652.56
|
| Rate for Payer: BCN Commercial |
$1,086.10
|
| Rate for Payer: BCN Medicare Advantage |
$652.56
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cofinity Commercial |
$939.69
|
| Rate for Payer: Cofinity Commercial |
$874.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.56
|
| Rate for Payer: Healthscope Commercial |
$1,207.24
|
| Rate for Payer: Healthscope Commercial |
$1,044.10
|
| Rate for Payer: Mclaren Medicaid |
$426.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.19
|
| Rate for Payer: Meridian Medicaid |
$447.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$717.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,262.68
|
| Rate for Payer: Nomi Health Commercial |
$783.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,235.25
|
| Rate for Payer: PACE SWMI |
$652.56
|
| Rate for Payer: PHP Medicare Advantage |
$652.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,161.01
|
| Rate for Payer: Priority Health Medicare |
$652.56
|
| Rate for Payer: Priority Health SBD |
$1,161.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,161.01
|
| Rate for Payer: Railroad Medicare Medicare |
$652.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.27
|
| Rate for Payer: UHC Core |
$1,238.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$652.56
|
| Rate for Payer: UHC Exchange |
$1,238.27
|
| Rate for Payer: UHC Medicaid |
$426.64
|
| Rate for Payer: UHCCP Medicaid |
$426.64
|
|
