|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Facility
|
IP
|
$312.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
57505
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$196.56 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Aetna Commercial |
$265.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.80
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Commercial |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$268.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$218.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.60
|
| Rate for Payer: Healthscope Commercial |
$280.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.20
|
| Rate for Payer: PHP Commercial |
$265.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.80
|
| Rate for Payer: Priority Health SBD |
$196.56
|
|
|
PR END OF LIFE COUNSELING
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS S0257
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$206.57 |
| Rate for Payer: Aetna Commercial |
$3.85
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.85
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: BCN Commercial |
$28.73
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.64
|
| Rate for Payer: Priority Health Narrow Network |
$47.64
|
| Rate for Payer: Priority Health SBD |
$47.64
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 92979
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$23,114.00 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$153.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.41
|
| Rate for Payer: BCBS Complete |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$230.34
|
| Rate for Payer: BCN Commercial |
$233.10
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Mclaren Medicaid |
$47.07
|
| Rate for Payer: Meridian Medicaid |
$49.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,114.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.12
|
| Rate for Payer: Priority Health Narrow Network |
$224.12
|
| Rate for Payer: Priority Health SBD |
$103.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.47
|
| Rate for Payer: UHC Exchange |
$191.47
|
| Rate for Payer: UHCCP Medicaid |
$47.07
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL
|
Professional
|
Both
|
$501.00
|
|
|
Service Code
|
HCPCS 92978
|
| Min. Negotiated Rate |
$59.00 |
| Max. Negotiated Rate |
$37,854.00 |
| Rate for Payer: Aetna Commercial |
$348.91
|
| Rate for Payer: Aetna Medicare |
$250.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.91
|
| Rate for Payer: BCBS Complete |
$61.95
|
| Rate for Payer: BCBS Trust/PPO |
$154.26
|
| Rate for Payer: BCN Commercial |
$386.06
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Mclaren Medicaid |
$59.00
|
| Rate for Payer: Meridian Medicaid |
$61.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,854.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.49
|
| Rate for Payer: Priority Health Narrow Network |
$371.49
|
| Rate for Payer: Priority Health SBD |
$129.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.37
|
| Rate for Payer: UHC Exchange |
$310.37
|
| Rate for Payer: UHCCP Medicaid |
$59.00
|
|
|
PR ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID
|
Professional
|
Both
|
$2,043.00
|
|
|
Service Code
|
HCPCS 58353
|
| Min. Negotiated Rate |
$148.04 |
| Max. Negotiated Rate |
$41,224.00 |
| Rate for Payer: Aetna Commercial |
$295.14
|
| Rate for Payer: Aetna Medicare |
$229.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.16
|
| Rate for Payer: BCBS Complete |
$155.44
|
| Rate for Payer: BCBS MAPPO |
$220.25
|
| Rate for Payer: BCBS Trust/PPO |
$572.15
|
| Rate for Payer: BCN Commercial |
$1,387.35
|
| Rate for Payer: BCN Medicare Advantage |
$220.25
|
| Rate for Payer: Cash Price |
$1,634.40
|
| Rate for Payer: Cash Price |
$1,634.40
|
| Rate for Payer: Cofinity Commercial |
$317.16
|
| Rate for Payer: Cofinity Commercial |
$295.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.25
|
| Rate for Payer: Healthscope Commercial |
$407.46
|
| Rate for Payer: Healthscope Commercial |
$352.40
|
| Rate for Payer: Mclaren Medicaid |
$148.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.26
|
| Rate for Payer: Meridian Medicaid |
$155.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,224.00
|
| Rate for Payer: Nomi Health Commercial |
$264.30
|
| Rate for Payer: PACE SWMI |
$220.25
|
| Rate for Payer: PHP Medicare Advantage |
$220.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,327.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$345.74
|
| Rate for Payer: Priority Health Medicare |
$220.25
|
| Rate for Payer: Priority Health Narrow Network |
$345.74
|
| Rate for Payer: Priority Health SBD |
$345.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$220.25
|
| Rate for Payer: UHC Exchange |
$270.64
|
| Rate for Payer: UHC Medicare Advantage |
$220.25
|
| Rate for Payer: UHCCP Medicaid |
$148.04
|
|
|
PR ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 58110
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$7,151.00 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$40.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.12
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$38.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.88
|
| Rate for Payer: BCN Commercial |
$72.82
|
| Rate for Payer: BCN Medicare Advantage |
$38.97
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$56.12
|
| Rate for Payer: Cofinity Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.97
|
| Rate for Payer: Healthscope Commercial |
$72.09
|
| Rate for Payer: Healthscope Commercial |
$62.35
|
| Rate for Payer: Mclaren Medicaid |
$25.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.92
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,151.00
|
| Rate for Payer: Nomi Health Commercial |
$46.76
|
| Rate for Payer: PACE SWMI |
$38.97
|
| Rate for Payer: PHP Medicare Advantage |
$38.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.53
|
| Rate for Payer: Priority Health Medicare |
$38.97
|
| Rate for Payer: Priority Health Narrow Network |
$59.53
|
| Rate for Payer: Priority Health SBD |
$59.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.97
|
| Rate for Payer: UHC Exchange |
$56.77
|
| Rate for Payer: UHC Medicare Advantage |
$38.97
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
58100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$135.45 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health SBD |
$135.45
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
58100
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$11,295.00 |
| Rate for Payer: Aetna Commercial |
$81.57
|
| Rate for Payer: Aetna Medicare |
$63.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.65
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$60.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.09
|
| Rate for Payer: BCN Commercial |
$120.16
|
| Rate for Payer: BCN Medicare Advantage |
$60.87
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.87
|
| Rate for Payer: Healthscope Commercial |
$97.39
|
| Rate for Payer: Healthscope Commercial |
$112.61
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,295.00
|
| Rate for Payer: Nomi Health Commercial |
$73.04
|
| Rate for Payer: PACE SWMI |
$60.87
|
| Rate for Payer: PHP Medicare Advantage |
$60.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.75
|
| Rate for Payer: Priority Health Medicare |
$60.87
|
| Rate for Payer: Priority Health Narrow Network |
$93.75
|
| Rate for Payer: Priority Health SBD |
$93.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.87
|
| Rate for Payer: UHC Exchange |
$140.57
|
| Rate for Payer: UHC Medicare Advantage |
$60.87
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
58100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$67.78 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna Medicare |
$204.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.38
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$197.10
|
| Rate for Payer: BCBS Trust/PPO |
$75.89
|
| Rate for Payer: BCCCP Commercial |
$97.15
|
| Rate for Payer: BCN Commercial |
$75.89
|
| Rate for Payer: BCN Medicare Advantage |
$197.10
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Mclaren Medicaid |
$105.65
|
| Rate for Payer: Mclaren Medicare |
$197.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.96
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: Nomi Health Commercial |
$413.91
|
| Rate for Payer: PACE Medicare |
$187.24
|
| Rate for Payer: PACE SWMI |
$197.10
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: PHP Medicare Advantage |
$197.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.50
|
| Rate for Payer: Priority Health Medicare |
$197.10
|
| Rate for Payer: Priority Health Narrow Network |
$495.60
|
| Rate for Payer: Priority Health SBD |
$135.45
|
| Rate for Payer: Railroad Medicare Medicare |
$197.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.78
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.10
|
| Rate for Payer: UHC Medicare Advantage |
$197.10
|
| Rate for Payer: UHCCP Medicaid |
$110.97
|
| Rate for Payer: VA VA |
$197.10
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 58100
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$11,295.00 |
| Rate for Payer: Aetna Commercial |
$81.57
|
| Rate for Payer: Aetna Medicare |
$63.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.65
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$60.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.09
|
| Rate for Payer: BCN Commercial |
$120.16
|
| Rate for Payer: BCN Medicare Advantage |
$60.87
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Cofinity Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.87
|
| Rate for Payer: Healthscope Commercial |
$97.39
|
| Rate for Payer: Healthscope Commercial |
$112.61
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,295.00
|
| Rate for Payer: Nomi Health Commercial |
$73.04
|
| Rate for Payer: PACE SWMI |
$60.87
|
| Rate for Payer: PHP Medicare Advantage |
$60.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.75
|
| Rate for Payer: Priority Health Medicare |
$60.87
|
| Rate for Payer: Priority Health Narrow Network |
$93.75
|
| Rate for Payer: Priority Health SBD |
$93.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.87
|
| Rate for Payer: UHC Exchange |
$140.57
|
| Rate for Payer: UHC Medicare Advantage |
$60.87
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
PR ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR
|
Professional
|
Both
|
$2,813.00
|
|
|
Service Code
|
HCPCS 58356
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$63,560.00 |
| Rate for Payer: Aetna Commercial |
$454.25
|
| Rate for Payer: Aetna Medicare |
$352.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.15
|
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: BCBS MAPPO |
$338.99
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: BCN Commercial |
$2,491.27
|
| Rate for Payer: BCN Medicare Advantage |
$338.99
|
| Rate for Payer: Cash Price |
$2,250.40
|
| Rate for Payer: Cash Price |
$2,250.40
|
| Rate for Payer: Cofinity Commercial |
$488.15
|
| Rate for Payer: Cofinity Commercial |
$454.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.99
|
| Rate for Payer: Healthscope Commercial |
$627.13
|
| Rate for Payer: Healthscope Commercial |
$542.38
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.94
|
| Rate for Payer: Meridian Medicaid |
$236.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,560.00
|
| Rate for Payer: Nomi Health Commercial |
$406.79
|
| Rate for Payer: PACE SWMI |
$338.99
|
| Rate for Payer: PHP Medicare Advantage |
$338.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,828.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.30
|
| Rate for Payer: Priority Health Medicare |
$338.99
|
| Rate for Payer: Priority Health Narrow Network |
$527.30
|
| Rate for Payer: Priority Health SBD |
$527.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,598.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.99
|
| Rate for Payer: UHC Exchange |
$2,598.01
|
| Rate for Payer: UHC Medicare Advantage |
$338.99
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
|
|
PR ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS 43273
|
| Min. Negotiated Rate |
$74.76 |
| Max. Negotiated Rate |
$20,750.00 |
| Rate for Payer: Aetna Commercial |
$150.31
|
| Rate for Payer: Aetna Medicare |
$116.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.52
|
| Rate for Payer: BCBS Complete |
$78.50
|
| Rate for Payer: BCBS MAPPO |
$112.17
|
| Rate for Payer: BCBS Trust/PPO |
$786.11
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: BCN Medicare Advantage |
$112.17
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cofinity Commercial |
$161.52
|
| Rate for Payer: Cofinity Commercial |
$150.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.17
|
| Rate for Payer: Healthscope Commercial |
$179.47
|
| Rate for Payer: Healthscope Commercial |
$207.51
|
| Rate for Payer: Mclaren Medicaid |
$74.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.78
|
| Rate for Payer: Meridian Medicaid |
$78.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,750.00
|
| Rate for Payer: Nomi Health Commercial |
$134.60
|
| Rate for Payer: PACE SWMI |
$112.17
|
| Rate for Payer: PHP Medicare Advantage |
$112.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.81
|
| Rate for Payer: Priority Health Medicare |
$112.17
|
| Rate for Payer: Priority Health Narrow Network |
$208.81
|
| Rate for Payer: Priority Health SBD |
$208.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.17
|
| Rate for Payer: UHC Medicare Advantage |
$112.17
|
| Rate for Payer: UHCCP Medicaid |
$74.76
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE
|
Professional
|
Both
|
$935.00
|
|
|
Service Code
|
HCPCS 44360
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$25,038.00 |
| Rate for Payer: Aetna Commercial |
$180.71
|
| Rate for Payer: Aetna Medicare |
$140.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.20
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$134.86
|
| Rate for Payer: BCBS Trust/PPO |
$381.96
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: BCN Medicare Advantage |
$134.86
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cash Price |
$748.00
|
| Rate for Payer: Cofinity Commercial |
$194.20
|
| Rate for Payer: Cofinity Commercial |
$180.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.86
|
| Rate for Payer: Healthscope Commercial |
$249.49
|
| Rate for Payer: Healthscope Commercial |
$215.78
|
| Rate for Payer: Mclaren Medicaid |
$90.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.60
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,038.00
|
| Rate for Payer: Nomi Health Commercial |
$161.83
|
| Rate for Payer: PACE SWMI |
$134.86
|
| Rate for Payer: PHP Medicare Advantage |
$134.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.55
|
| Rate for Payer: Priority Health Medicare |
$134.86
|
| Rate for Payer: Priority Health Narrow Network |
$253.55
|
| Rate for Payer: Priority Health SBD |
$253.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.86
|
| Rate for Payer: UHC Exchange |
$195.01
|
| Rate for Payer: UHC Medicare Advantage |
$134.86
|
| Rate for Payer: UHCCP Medicaid |
$90.53
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY
|
Professional
|
Both
|
$988.00
|
|
|
Service Code
|
HCPCS 44361
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$27,599.00 |
| Rate for Payer: Aetna Commercial |
$200.02
|
| Rate for Payer: Aetna Medicare |
$155.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.95
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$149.27
|
| Rate for Payer: BCBS Trust/PPO |
$508.22
|
| Rate for Payer: BCN Commercial |
$226.75
|
| Rate for Payer: BCN Medicare Advantage |
$149.27
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cash Price |
$790.40
|
| Rate for Payer: Cofinity Commercial |
$214.95
|
| Rate for Payer: Cofinity Commercial |
$200.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.27
|
| Rate for Payer: Healthscope Commercial |
$276.15
|
| Rate for Payer: Healthscope Commercial |
$238.83
|
| Rate for Payer: Mclaren Medicaid |
$100.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.73
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,599.00
|
| Rate for Payer: Nomi Health Commercial |
$179.12
|
| Rate for Payer: PACE SWMI |
$149.27
|
| Rate for Payer: PHP Medicare Advantage |
$149.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$642.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.21
|
| Rate for Payer: Priority Health Medicare |
$149.27
|
| Rate for Payer: Priority Health Narrow Network |
$279.21
|
| Rate for Payer: Priority Health SBD |
$279.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.27
|
| Rate for Payer: UHC Exchange |
$245.94
|
| Rate for Payer: UHC Medicare Advantage |
$149.27
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
|
PR ENDOVASC ABDO REPAIR W/PROS
|
Professional
|
Both
|
$5,333.00
|
|
|
Service Code
|
HCPCS 34805
|
| Min. Negotiated Rate |
$2,133.20 |
| Max. Negotiated Rate |
$3,466.45 |
| Rate for Payer: Aetna Medicare |
$2,666.50
|
| Rate for Payer: BCBS Complete |
$2,133.20
|
| Rate for Payer: Cash Price |
$4,266.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,466.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,466.45
|
|
|
PR ENDOVASCULAR REPAIR ILIAC ARTERY W ILIO-ILIAC PROSTHESIS
|
Professional
|
Both
|
$1,766.00
|
|
|
Service Code
|
HCPCS 34900
|
| Min. Negotiated Rate |
$706.40 |
| Max. Negotiated Rate |
$1,147.90 |
| Rate for Payer: Aetna Medicare |
$883.00
|
| Rate for Payer: BCBS Complete |
$706.40
|
| Rate for Payer: Cash Price |
$1,412.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,147.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.90
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,741.00
|
|
|
Service Code
|
HCPCS 36478
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$49,066.00 |
| Rate for Payer: Aetna Commercial |
$355.60
|
| Rate for Payer: Aetna Medicare |
$275.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.13
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$265.37
|
| Rate for Payer: BCBS Trust/PPO |
$288.45
|
| Rate for Payer: BCN Commercial |
$1,440.13
|
| Rate for Payer: BCN Medicare Advantage |
$265.37
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cofinity Commercial |
$355.60
|
| Rate for Payer: Cofinity Commercial |
$382.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.37
|
| Rate for Payer: Healthscope Commercial |
$424.59
|
| Rate for Payer: Healthscope Commercial |
$490.93
|
| Rate for Payer: Mclaren Medicaid |
$174.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.64
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49,066.00
|
| Rate for Payer: Nomi Health Commercial |
$318.44
|
| Rate for Payer: PACE SWMI |
$265.37
|
| Rate for Payer: PHP Medicare Advantage |
$265.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,781.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$433.43
|
| Rate for Payer: Priority Health Medicare |
$265.37
|
| Rate for Payer: Priority Health Narrow Network |
$433.43
|
| Rate for Payer: Priority Health SBD |
$433.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,037.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.37
|
| Rate for Payer: UHC Exchange |
$2,037.93
|
| Rate for Payer: UHC Medicare Advantage |
$265.37
|
| Rate for Payer: UHCCP Medicaid |
$174.23
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,741.00
|
|
|
Service Code
|
HCPCS 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$49,066.00 |
| Rate for Payer: Aetna Commercial |
$355.60
|
| Rate for Payer: Aetna Medicare |
$275.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.13
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$265.37
|
| Rate for Payer: BCBS Trust/PPO |
$288.45
|
| Rate for Payer: BCN Commercial |
$1,440.13
|
| Rate for Payer: BCN Medicare Advantage |
$265.37
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cofinity Commercial |
$382.13
|
| Rate for Payer: Cofinity Commercial |
$355.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.37
|
| Rate for Payer: Healthscope Commercial |
$490.93
|
| Rate for Payer: Healthscope Commercial |
$424.59
|
| Rate for Payer: Mclaren Medicaid |
$174.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.64
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49,066.00
|
| Rate for Payer: Nomi Health Commercial |
$318.44
|
| Rate for Payer: PACE SWMI |
$265.37
|
| Rate for Payer: PHP Medicare Advantage |
$265.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,781.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$433.43
|
| Rate for Payer: Priority Health Medicare |
$265.37
|
| Rate for Payer: Priority Health Narrow Network |
$433.43
|
| Rate for Payer: Priority Health SBD |
$433.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,037.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.37
|
| Rate for Payer: UHC Exchange |
$2,037.93
|
| Rate for Payer: UHC Medicare Advantage |
$265.37
|
| Rate for Payer: UHCCP Medicaid |
$174.23
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
OP
|
$2,741.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$294.70 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Commercial |
$2,329.85
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.80
|
| Rate for Payer: BCN Commercial |
$1,487.80
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cofinity Commercial |
$2,357.26
|
| Rate for Payer: Cofinity Commercial |
$1,918.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,918.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,192.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,466.90
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,329.85
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,329.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,781.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$1,726.83
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.70
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,736.21
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
IP
|
$2,741.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$1,726.83 |
| Max. Negotiated Rate |
$2,466.90 |
| Rate for Payer: Aetna Commercial |
$2,329.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.65
|
| Rate for Payer: Cash Price |
$2,192.80
|
| Rate for Payer: Cofinity Commercial |
$1,918.70
|
| Rate for Payer: Cofinity Commercial |
$2,357.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,918.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,192.80
|
| Rate for Payer: Healthscope Commercial |
$2,466.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,329.85
|
| Rate for Payer: PHP Commercial |
$2,329.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,781.65
|
| Rate for Payer: Priority Health SBD |
$1,726.83
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN
|
Professional
|
Both
|
$3,149.00
|
|
|
Service Code
|
HCPCS 36475
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$49,171.00 |
| Rate for Payer: Aetna Commercial |
$355.72
|
| Rate for Payer: Aetna Medicare |
$276.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.26
|
| Rate for Payer: BCBS Complete |
$182.50
|
| Rate for Payer: BCBS MAPPO |
$265.46
|
| Rate for Payer: BCBS Trust/PPO |
$621.81
|
| Rate for Payer: BCN Commercial |
$1,586.74
|
| Rate for Payer: BCN Medicare Advantage |
$265.46
|
| Rate for Payer: Cash Price |
$2,519.20
|
| Rate for Payer: Cash Price |
$2,519.20
|
| Rate for Payer: Cofinity Commercial |
$382.26
|
| Rate for Payer: Cofinity Commercial |
$355.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.46
|
| Rate for Payer: Healthscope Commercial |
$491.10
|
| Rate for Payer: Healthscope Commercial |
$424.74
|
| Rate for Payer: Mclaren Medicaid |
$173.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.73
|
| Rate for Payer: Meridian Medicaid |
$182.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49,171.00
|
| Rate for Payer: Nomi Health Commercial |
$318.55
|
| Rate for Payer: PACE SWMI |
$265.46
|
| Rate for Payer: PHP Medicare Advantage |
$265.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,046.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$433.43
|
| Rate for Payer: Priority Health Medicare |
$265.46
|
| Rate for Payer: Priority Health Narrow Network |
$433.43
|
| Rate for Payer: Priority Health SBD |
$433.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,210.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.46
|
| Rate for Payer: UHC Exchange |
$2,210.34
|
| Rate for Payer: UHC Medicare Advantage |
$265.46
|
| Rate for Payer: UHCCP Medicaid |
$173.81
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 36476
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$23,785.00 |
| Rate for Payer: Aetna Commercial |
$171.99
|
| Rate for Payer: Aetna Medicare |
$133.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.82
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS MAPPO |
$128.35
|
| Rate for Payer: BCBS Trust/PPO |
$510.87
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Medicare Advantage |
$128.35
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cofinity Commercial |
$184.82
|
| Rate for Payer: Cofinity Commercial |
$171.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.35
|
| Rate for Payer: Healthscope Commercial |
$237.45
|
| Rate for Payer: Healthscope Commercial |
$205.36
|
| Rate for Payer: Mclaren Medicaid |
$83.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.77
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,785.00
|
| Rate for Payer: Nomi Health Commercial |
$154.02
|
| Rate for Payer: PACE SWMI |
$128.35
|
| Rate for Payer: PHP Medicare Advantage |
$128.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.41
|
| Rate for Payer: Priority Health Medicare |
$128.35
|
| Rate for Payer: Priority Health Narrow Network |
$207.41
|
| Rate for Payer: Priority Health SBD |
$207.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.35
|
| Rate for Payer: UHC Exchange |
$189.29
|
| Rate for Payer: UHC Medicare Advantage |
$128.35
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA
|
Professional
|
Both
|
$1,659.00
|
|
|
Service Code
|
HCPCS 44121
|
| Min. Negotiated Rate |
$152.72 |
| Max. Negotiated Rate |
$43,067.00 |
| Rate for Payer: Aetna Commercial |
$312.06
|
| Rate for Payer: Aetna Medicare |
$242.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.35
|
| Rate for Payer: BCBS Complete |
$160.36
|
| Rate for Payer: BCBS MAPPO |
$232.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.90
|
| Rate for Payer: BCN Commercial |
$348.43
|
| Rate for Payer: BCN Medicare Advantage |
$232.88
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cofinity Commercial |
$335.35
|
| Rate for Payer: Cofinity Commercial |
$312.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.88
|
| Rate for Payer: Healthscope Commercial |
$430.83
|
| Rate for Payer: Healthscope Commercial |
$372.61
|
| Rate for Payer: Mclaren Medicaid |
$152.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.52
|
| Rate for Payer: Meridian Medicaid |
$160.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,067.00
|
| Rate for Payer: Nomi Health Commercial |
$279.46
|
| Rate for Payer: PACE SWMI |
$232.88
|
| Rate for Payer: PHP Medicare Advantage |
$232.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,078.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$426.57
|
| Rate for Payer: Priority Health Medicare |
$232.88
|
| Rate for Payer: Priority Health Narrow Network |
$426.57
|
| Rate for Payer: Priority Health SBD |
$426.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.88
|
| Rate for Payer: UHC Exchange |
$355.01
|
| Rate for Payer: UHC Medicare Advantage |
$232.88
|
| Rate for Payer: UHCCP Medicaid |
$152.72
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY
|
Professional
|
Both
|
$3,497.00
|
|
|
Service Code
|
HCPCS 44125
|
| Min. Negotiated Rate |
$754.02 |
| Max. Negotiated Rate |
$209,655.00 |
| Rate for Payer: Aetna Commercial |
$1,526.65
|
| Rate for Payer: Aetna Medicare |
$1,184.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,526.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,640.58
|
| Rate for Payer: BCBS Complete |
$791.72
|
| Rate for Payer: BCBS MAPPO |
$1,139.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,185.51
|
| Rate for Payer: BCN Commercial |
$1,708.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,139.29
|
| Rate for Payer: Cash Price |
$2,797.60
|
| Rate for Payer: Cash Price |
$2,797.60
|
| Rate for Payer: Cofinity Commercial |
$1,640.58
|
| Rate for Payer: Cofinity Commercial |
$1,526.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,139.29
|
| Rate for Payer: Healthscope Commercial |
$2,107.69
|
| Rate for Payer: Healthscope Commercial |
$1,822.86
|
| Rate for Payer: Mclaren Medicaid |
$754.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,196.25
|
| Rate for Payer: Meridian Medicaid |
$791.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209,655.00
|
| Rate for Payer: Nomi Health Commercial |
$1,367.15
|
| Rate for Payer: PACE SWMI |
$1,139.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,139.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$754.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,273.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,100.01
|
| Rate for Payer: Priority Health Medicare |
$1,139.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,100.01
|
| Rate for Payer: Priority Health SBD |
$2,100.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,390.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,139.29
|
| Rate for Payer: UHC Exchange |
$1,390.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.29
|
| Rate for Payer: UHCCP Medicaid |
$754.02
|
|
|
PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS
|
Professional
|
Both
|
$2,877.00
|
|
|
Service Code
|
HCPCS 51960
|
| Min. Negotiated Rate |
$881.61 |
| Max. Negotiated Rate |
$242,935.00 |
| Rate for Payer: Aetna Commercial |
$1,766.98
|
| Rate for Payer: Aetna Medicare |
$1,371.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,766.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,898.84
|
| Rate for Payer: BCBS Complete |
$925.69
|
| Rate for Payer: BCBS MAPPO |
$1,318.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.99
|
| Rate for Payer: BCN Commercial |
$1,988.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,318.64
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cofinity Commercial |
$1,898.84
|
| Rate for Payer: Cofinity Commercial |
$1,766.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,318.64
|
| Rate for Payer: Healthscope Commercial |
$2,439.48
|
| Rate for Payer: Healthscope Commercial |
$2,109.82
|
| Rate for Payer: Mclaren Medicaid |
$881.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,384.57
|
| Rate for Payer: Meridian Medicaid |
$925.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242,935.00
|
| Rate for Payer: Nomi Health Commercial |
$1,582.37
|
| Rate for Payer: PACE SWMI |
$1,318.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,318.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$881.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,870.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,191.65
|
| Rate for Payer: Priority Health Medicare |
$1,318.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,191.65
|
| Rate for Payer: Priority Health SBD |
$2,191.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,749.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,318.64
|
| Rate for Payer: UHC Exchange |
$1,749.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,318.64
|
| Rate for Payer: UHCCP Medicaid |
$881.61
|
|
