|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$56.45 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$117.57
|
| Rate for Payer: Aetna Medicare |
$91.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.35
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS MAPPO |
$87.74
|
| Rate for Payer: BCN Commercial |
$151.39
|
| Rate for Payer: BCN Medicare Advantage |
$87.74
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$126.35
|
| Rate for Payer: Cofinity Commercial |
$117.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.74
|
| Rate for Payer: Healthscope Commercial |
$162.32
|
| Rate for Payer: Healthscope Commercial |
$140.38
|
| Rate for Payer: Mclaren Medicaid |
$56.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.13
|
| Rate for Payer: Meridian Medicaid |
$59.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.48
|
| Rate for Payer: Nomi Health Commercial |
$105.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PACE SWMI |
$87.74
|
| Rate for Payer: PHP Medicare Advantage |
$87.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$139.61
|
| Rate for Payer: Priority Health Medicare |
$87.74
|
| Rate for Payer: Priority Health SBD |
$139.61
|
| Rate for Payer: Priority Health Tiered Network |
$139.61
|
| Rate for Payer: Railroad Medicare Medicare |
$87.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.91
|
| Rate for Payer: UHC Core |
$168.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$87.74
|
| Rate for Payer: UHC Exchange |
$168.91
|
| Rate for Payer: UHC Medicaid |
$56.45
|
| Rate for Payer: UHCCP Medicaid |
$56.45
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$427.00
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$125.67 |
| Max. Negotiated Rate |
$357.38 |
| Rate for Payer: Aetna Commercial |
$253.53
|
| Rate for Payer: Aetna Medicare |
$196.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.45
|
| Rate for Payer: BCBS Complete |
$131.95
|
| Rate for Payer: BCBS MAPPO |
$189.20
|
| Rate for Payer: BCN Commercial |
$231.30
|
| Rate for Payer: BCN Medicare Advantage |
$189.20
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Cofinity Commercial |
$272.45
|
| Rate for Payer: Cofinity Commercial |
$253.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.20
|
| Rate for Payer: Healthscope Commercial |
$350.02
|
| Rate for Payer: Healthscope Commercial |
$302.72
|
| Rate for Payer: Mclaren Medicaid |
$125.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.66
|
| Rate for Payer: Meridian Medicaid |
$131.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$208.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.96
|
| Rate for Payer: Nomi Health Commercial |
$227.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$320.25
|
| Rate for Payer: PACE SWMI |
$189.20
|
| Rate for Payer: PHP Medicare Advantage |
$189.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$357.38
|
| Rate for Payer: Priority Health Medicare |
$189.20
|
| Rate for Payer: Priority Health SBD |
$357.38
|
| Rate for Payer: Priority Health Tiered Network |
$357.38
|
| Rate for Payer: Railroad Medicare Medicare |
$189.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.45
|
| Rate for Payer: UHC Core |
$331.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$189.20
|
| Rate for Payer: UHC Exchange |
$331.45
|
| Rate for Payer: UHC Medicaid |
$125.67
|
| Rate for Payer: UHCCP Medicaid |
$125.67
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,662.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$305.87 |
| Max. Negotiated Rate |
$1,246.50 |
| Rate for Payer: Aetna Commercial |
$625.30
|
| Rate for Payer: Aetna Medicare |
$485.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.96
|
| Rate for Payer: BCBS Complete |
$321.16
|
| Rate for Payer: BCBS MAPPO |
$466.64
|
| Rate for Payer: BCN Commercial |
$731.04
|
| Rate for Payer: BCN Medicare Advantage |
$466.64
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Commercial |
$671.96
|
| Rate for Payer: Cofinity Commercial |
$625.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.64
|
| Rate for Payer: Healthscope Commercial |
$863.28
|
| Rate for Payer: Healthscope Commercial |
$746.62
|
| Rate for Payer: Mclaren Medicaid |
$305.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.97
|
| Rate for Payer: Meridian Medicaid |
$321.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$513.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$854.24
|
| Rate for Payer: Nomi Health Commercial |
$559.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.50
|
| Rate for Payer: PACE SWMI |
$466.64
|
| Rate for Payer: PHP Medicare Advantage |
$466.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$890.73
|
| Rate for Payer: Priority Health Medicare |
$466.64
|
| Rate for Payer: Priority Health SBD |
$890.73
|
| Rate for Payer: Priority Health Tiered Network |
$890.73
|
| Rate for Payer: Railroad Medicare Medicare |
$466.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$839.62
|
| Rate for Payer: UHC Core |
$839.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$466.64
|
| Rate for Payer: UHC Exchange |
$839.62
|
| Rate for Payer: UHC Medicaid |
$305.87
|
| Rate for Payer: UHCCP Medicaid |
$305.87
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
OP
|
$1,662.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,047.06 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Commercial |
$1,412.70
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,080.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.41
|
| Rate for Payer: BCN Commercial |
$2,124.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Advantage |
$1,163.40
|
| Rate for Payer: Cofinity Commercial |
$1,429.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,329.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$1,495.80
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,412.70
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.50
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$1,412.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health SBD |
$1,047.06
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,662.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$305.87 |
| Max. Negotiated Rate |
$1,246.50 |
| Rate for Payer: Aetna Commercial |
$625.30
|
| Rate for Payer: Aetna Medicare |
$485.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.96
|
| Rate for Payer: BCBS Complete |
$321.16
|
| Rate for Payer: BCBS MAPPO |
$466.64
|
| Rate for Payer: BCN Commercial |
$731.04
|
| Rate for Payer: BCN Medicare Advantage |
$466.64
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Commercial |
$671.96
|
| Rate for Payer: Cofinity Commercial |
$625.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.64
|
| Rate for Payer: Healthscope Commercial |
$863.28
|
| Rate for Payer: Healthscope Commercial |
$746.62
|
| Rate for Payer: Mclaren Medicaid |
$305.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.97
|
| Rate for Payer: Meridian Medicaid |
$321.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$513.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$854.24
|
| Rate for Payer: Nomi Health Commercial |
$559.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.50
|
| Rate for Payer: PACE SWMI |
$466.64
|
| Rate for Payer: PHP Medicare Advantage |
$466.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$890.73
|
| Rate for Payer: Priority Health Medicare |
$466.64
|
| Rate for Payer: Priority Health SBD |
$890.73
|
| Rate for Payer: Priority Health Tiered Network |
$890.73
|
| Rate for Payer: Railroad Medicare Medicare |
$466.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$839.62
|
| Rate for Payer: UHC Core |
$839.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$466.64
|
| Rate for Payer: UHC Exchange |
$839.62
|
| Rate for Payer: UHC Medicaid |
$305.87
|
| Rate for Payer: UHCCP Medicaid |
$305.87
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,662.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,047.06 |
| Max. Negotiated Rate |
$1,495.80 |
| Rate for Payer: Aetna Commercial |
$1,412.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,080.30
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Advantage |
$1,163.40
|
| Rate for Payer: Cofinity Commercial |
$1,429.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,329.60
|
| Rate for Payer: Healthscope Commercial |
$1,495.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,412.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.50
|
| Rate for Payer: PHP Commercial |
$1,412.70
|
| Rate for Payer: Priority Health SBD |
$1,047.06
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,131.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$712.53 |
| Max. Negotiated Rate |
$1,017.90 |
| Rate for Payer: Aetna Commercial |
$961.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.15
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Advantage |
$791.70
|
| Rate for Payer: Cofinity Commercial |
$972.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$904.80
|
| Rate for Payer: Healthscope Commercial |
$1,017.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$961.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PHP Commercial |
$961.35
|
| Rate for Payer: Priority Health SBD |
$712.53
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,131.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$712.53 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Commercial |
$961.35
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,091.48
|
| Rate for Payer: BCN Commercial |
$2,091.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Advantage |
$791.70
|
| Rate for Payer: Cofinity Commercial |
$972.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$904.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$1,017.90
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$961.35
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$961.35
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health SBD |
$712.53
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,131.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$223.65 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$456.71
|
| Rate for Payer: Aetna Medicare |
$354.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$490.80
|
| Rate for Payer: BCBS Complete |
$234.83
|
| Rate for Payer: BCBS MAPPO |
$340.83
|
| Rate for Payer: BCN Commercial |
$537.33
|
| Rate for Payer: BCN Medicare Advantage |
$340.83
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$490.80
|
| Rate for Payer: Cofinity Commercial |
$456.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.83
|
| Rate for Payer: Healthscope Commercial |
$630.54
|
| Rate for Payer: Healthscope Commercial |
$545.33
|
| Rate for Payer: Mclaren Medicaid |
$223.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.87
|
| Rate for Payer: Meridian Medicaid |
$234.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.99
|
| Rate for Payer: Nomi Health Commercial |
$409.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PACE SWMI |
$340.83
|
| Rate for Payer: PHP Medicare Advantage |
$340.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$654.69
|
| Rate for Payer: Priority Health Medicare |
$340.83
|
| Rate for Payer: Priority Health SBD |
$654.69
|
| Rate for Payer: Priority Health Tiered Network |
$654.69
|
| Rate for Payer: Railroad Medicare Medicare |
$340.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.20
|
| Rate for Payer: UHC Core |
$623.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.83
|
| Rate for Payer: UHC Exchange |
$623.20
|
| Rate for Payer: UHC Medicaid |
$223.65
|
| Rate for Payer: UHCCP Medicaid |
$223.65
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,131.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$223.65 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$456.71
|
| Rate for Payer: Aetna Medicare |
$354.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$490.80
|
| Rate for Payer: BCBS Complete |
$234.83
|
| Rate for Payer: BCBS MAPPO |
$340.83
|
| Rate for Payer: BCN Commercial |
$537.33
|
| Rate for Payer: BCN Medicare Advantage |
$340.83
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$490.80
|
| Rate for Payer: Cofinity Commercial |
$456.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.83
|
| Rate for Payer: Healthscope Commercial |
$630.54
|
| Rate for Payer: Healthscope Commercial |
$545.33
|
| Rate for Payer: Mclaren Medicaid |
$223.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.87
|
| Rate for Payer: Meridian Medicaid |
$234.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.99
|
| Rate for Payer: Nomi Health Commercial |
$409.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PACE SWMI |
$340.83
|
| Rate for Payer: PHP Medicare Advantage |
$340.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$654.69
|
| Rate for Payer: Priority Health Medicare |
$340.83
|
| Rate for Payer: Priority Health SBD |
$654.69
|
| Rate for Payer: Priority Health Tiered Network |
$654.69
|
| Rate for Payer: Railroad Medicare Medicare |
$340.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.20
|
| Rate for Payer: UHC Core |
$623.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.83
|
| Rate for Payer: UHC Exchange |
$623.20
|
| Rate for Payer: UHC Medicaid |
$223.65
|
| Rate for Payer: UHCCP Medicaid |
$223.65
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
OP
|
$1,163.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$732.69 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Commercial |
$988.55
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,199.69
|
| Rate for Payer: BCN Commercial |
$2,199.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Advantage |
$814.10
|
| Rate for Payer: Cofinity Commercial |
$1,000.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$930.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$1,046.70
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.55
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$988.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health SBD |
$732.69
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,163.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$872.25 |
| Rate for Payer: Aetna Commercial |
$414.07
|
| Rate for Payer: Aetna Medicare |
$321.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.97
|
| Rate for Payer: BCBS Complete |
$213.36
|
| Rate for Payer: BCBS MAPPO |
$309.01
|
| Rate for Payer: BCN Commercial |
$486.03
|
| Rate for Payer: BCN Medicare Advantage |
$309.01
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$444.97
|
| Rate for Payer: Cofinity Commercial |
$414.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.01
|
| Rate for Payer: Healthscope Commercial |
$571.67
|
| Rate for Payer: Healthscope Commercial |
$494.42
|
| Rate for Payer: Mclaren Medicaid |
$203.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.46
|
| Rate for Payer: Meridian Medicaid |
$213.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.36
|
| Rate for Payer: Nomi Health Commercial |
$370.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE SWMI |
$309.01
|
| Rate for Payer: PHP Medicare Advantage |
$309.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$592.19
|
| Rate for Payer: Priority Health Medicare |
$309.01
|
| Rate for Payer: Priority Health SBD |
$592.19
|
| Rate for Payer: Priority Health Tiered Network |
$592.19
|
| Rate for Payer: Railroad Medicare Medicare |
$309.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.89
|
| Rate for Payer: UHC Core |
$554.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.01
|
| Rate for Payer: UHC Exchange |
$554.89
|
| Rate for Payer: UHC Medicaid |
$203.20
|
| Rate for Payer: UHCCP Medicaid |
$203.20
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,163.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$872.25 |
| Rate for Payer: Aetna Commercial |
$414.07
|
| Rate for Payer: Aetna Medicare |
$321.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.97
|
| Rate for Payer: BCBS Complete |
$213.36
|
| Rate for Payer: BCBS MAPPO |
$309.01
|
| Rate for Payer: BCN Commercial |
$486.03
|
| Rate for Payer: BCN Medicare Advantage |
$309.01
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$444.97
|
| Rate for Payer: Cofinity Commercial |
$414.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.01
|
| Rate for Payer: Healthscope Commercial |
$571.67
|
| Rate for Payer: Healthscope Commercial |
$494.42
|
| Rate for Payer: Mclaren Medicaid |
$203.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.46
|
| Rate for Payer: Meridian Medicaid |
$213.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.36
|
| Rate for Payer: Nomi Health Commercial |
$370.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE SWMI |
$309.01
|
| Rate for Payer: PHP Medicare Advantage |
$309.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$592.19
|
| Rate for Payer: Priority Health Medicare |
$309.01
|
| Rate for Payer: Priority Health SBD |
$592.19
|
| Rate for Payer: Priority Health Tiered Network |
$592.19
|
| Rate for Payer: Railroad Medicare Medicare |
$309.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.89
|
| Rate for Payer: UHC Core |
$554.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.01
|
| Rate for Payer: UHC Exchange |
$554.89
|
| Rate for Payer: UHC Medicaid |
$203.20
|
| Rate for Payer: UHCCP Medicaid |
$203.20
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
IP
|
$1,163.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$732.69 |
| Max. Negotiated Rate |
$1,046.70 |
| Rate for Payer: Aetna Commercial |
$988.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.95
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Advantage |
$814.10
|
| Rate for Payer: Cofinity Commercial |
$1,000.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$930.40
|
| Rate for Payer: Healthscope Commercial |
$1,046.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PHP Commercial |
$988.55
|
| Rate for Payer: Priority Health SBD |
$732.69
|
|
|
PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 46257
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$770.58 |
| Rate for Payer: Aetna Commercial |
$538.47
|
| Rate for Payer: Aetna Medicare |
$417.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.65
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCBS MAPPO |
$401.84
|
| Rate for Payer: BCN Commercial |
$632.43
|
| Rate for Payer: BCN Medicare Advantage |
$401.84
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$578.65
|
| Rate for Payer: Cofinity Commercial |
$538.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.84
|
| Rate for Payer: Healthscope Commercial |
$743.40
|
| Rate for Payer: Healthscope Commercial |
$642.94
|
| Rate for Payer: Mclaren Medicaid |
$265.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.93
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$442.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$732.87
|
| Rate for Payer: Nomi Health Commercial |
$482.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$573.75
|
| Rate for Payer: PACE SWMI |
$401.84
|
| Rate for Payer: PHP Medicare Advantage |
$401.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$770.58
|
| Rate for Payer: Priority Health Medicare |
$401.84
|
| Rate for Payer: Priority Health SBD |
$770.58
|
| Rate for Payer: Priority Health Tiered Network |
$770.58
|
| Rate for Payer: Railroad Medicare Medicare |
$401.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$745.99
|
| Rate for Payer: UHC Core |
$745.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$401.84
|
| Rate for Payer: UHC Exchange |
$745.99
|
| Rate for Payer: UHC Medicaid |
$265.19
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
|
|
PR HEMORRHOIDOPEXY STAPLING
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 46947
|
| Min. Negotiated Rate |
$241.97 |
| Max. Negotiated Rate |
$717.20 |
| Rate for Payer: Aetna Commercial |
$497.14
|
| Rate for Payer: Aetna Medicare |
$385.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.24
|
| Rate for Payer: BCBS Complete |
$254.07
|
| Rate for Payer: BCBS MAPPO |
$371.00
|
| Rate for Payer: BCN Commercial |
$588.61
|
| Rate for Payer: BCN Medicare Advantage |
$371.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$534.24
|
| Rate for Payer: Cofinity Commercial |
$497.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.00
|
| Rate for Payer: Healthscope Commercial |
$686.35
|
| Rate for Payer: Healthscope Commercial |
$593.60
|
| Rate for Payer: Mclaren Medicaid |
$241.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.55
|
| Rate for Payer: Meridian Medicaid |
$254.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$408.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.70
|
| Rate for Payer: Nomi Health Commercial |
$445.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.75
|
| Rate for Payer: PACE SWMI |
$371.00
|
| Rate for Payer: PHP Medicare Advantage |
$371.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$717.20
|
| Rate for Payer: Priority Health Medicare |
$371.00
|
| Rate for Payer: Priority Health SBD |
$717.20
|
| Rate for Payer: Priority Health Tiered Network |
$717.20
|
| Rate for Payer: Railroad Medicare Medicare |
$371.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.51
|
| Rate for Payer: UHC Core |
$676.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.00
|
| Rate for Payer: UHC Exchange |
$676.51
|
| Rate for Payer: UHC Medicaid |
$241.97
|
| Rate for Payer: UHCCP Medicaid |
$241.97
|
|
|
PR HEPATECTOMY RESCJ PARTIAL LOBECTOMY
|
Professional
|
Both
|
$4,772.00
|
|
|
Service Code
|
HCPCS 47120
|
| Min. Negotiated Rate |
$1,381.73 |
| Max. Negotiated Rate |
$4,259.43 |
| Rate for Payer: Aetna Commercial |
$2,891.02
|
| Rate for Payer: Aetna Medicare |
$2,243.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,891.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,106.77
|
| Rate for Payer: BCBS Complete |
$1,450.82
|
| Rate for Payer: BCBS MAPPO |
$2,157.48
|
| Rate for Payer: BCN Commercial |
$3,495.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,157.48
|
| Rate for Payer: Cash Price |
$3,817.60
|
| Rate for Payer: Cash Price |
$3,817.60
|
| Rate for Payer: Cofinity Commercial |
$3,106.77
|
| Rate for Payer: Cofinity Commercial |
$2,891.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,157.48
|
| Rate for Payer: Healthscope Commercial |
$3,991.34
|
| Rate for Payer: Healthscope Commercial |
$3,451.97
|
| Rate for Payer: Mclaren Medicaid |
$1,381.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,265.35
|
| Rate for Payer: Meridian Medicaid |
$1,450.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,373.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,175.44
|
| Rate for Payer: Nomi Health Commercial |
$2,588.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,579.00
|
| Rate for Payer: PACE SWMI |
$2,157.48
|
| Rate for Payer: PHP Medicare Advantage |
$2,157.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,259.43
|
| Rate for Payer: Priority Health Medicare |
$2,157.48
|
| Rate for Payer: Priority Health SBD |
$4,259.43
|
| Rate for Payer: Priority Health Tiered Network |
$4,259.43
|
| Rate for Payer: Railroad Medicare Medicare |
$2,157.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,164.38
|
| Rate for Payer: UHC Core |
$4,164.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,157.48
|
| Rate for Payer: UHC Exchange |
$4,164.38
|
| Rate for Payer: UHC Medicaid |
$1,381.73
|
| Rate for Payer: UHCCP Medicaid |
$1,381.73
|
|
|
PR HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY
|
Professional
|
Both
|
$6,344.00
|
|
|
Service Code
|
HCPCS 47130
|
| Min. Negotiated Rate |
$1,927.86 |
| Max. Negotiated Rate |
$6,008.11 |
| Rate for Payer: Aetna Commercial |
$4,052.84
|
| Rate for Payer: Aetna Medicare |
$3,145.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,052.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,355.29
|
| Rate for Payer: BCBS Complete |
$2,024.25
|
| Rate for Payer: BCBS MAPPO |
$3,024.51
|
| Rate for Payer: BCN Commercial |
$4,931.01
|
| Rate for Payer: BCN Medicare Advantage |
$3,024.51
|
| Rate for Payer: Cash Price |
$5,075.20
|
| Rate for Payer: Cash Price |
$5,075.20
|
| Rate for Payer: Cofinity Commercial |
$4,355.29
|
| Rate for Payer: Cofinity Commercial |
$4,052.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,024.51
|
| Rate for Payer: Healthscope Commercial |
$5,595.34
|
| Rate for Payer: Healthscope Commercial |
$4,839.22
|
| Rate for Payer: Mclaren Medicaid |
$1,927.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,175.74
|
| Rate for Payer: Meridian Medicaid |
$2,024.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,326.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,914.28
|
| Rate for Payer: Nomi Health Commercial |
$3,629.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,758.00
|
| Rate for Payer: PACE SWMI |
$3,024.51
|
| Rate for Payer: PHP Medicare Advantage |
$3,024.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,927.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,008.11
|
| Rate for Payer: Priority Health Medicare |
$3,024.51
|
| Rate for Payer: Priority Health SBD |
$6,008.11
|
| Rate for Payer: Priority Health Tiered Network |
$6,008.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3,024.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,919.01
|
| Rate for Payer: UHC Core |
$5,919.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,024.51
|
| Rate for Payer: UHC Exchange |
$5,919.01
|
| Rate for Payer: UHC Medicaid |
$1,927.86
|
| Rate for Payer: UHCCP Medicaid |
$1,927.86
|
|
|
PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 90636
|
| Min. Negotiated Rate |
$79.00 |
| Max. Negotiated Rate |
$132.43 |
| Rate for Payer: Aetna Commercial |
$123.57
|
| Rate for Payer: Aetna Medicare |
$79.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.57
|
| Rate for Payer: BCBS Trust/PPO |
$132.43
|
| Rate for Payer: BCN Commercial |
$130.06
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.43
|
| Rate for Payer: UHC Core |
$132.43
|
| Rate for Payer: UHC Exchange |
$132.43
|
|
|
PR HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 90371
|
| Min. Negotiated Rate |
$137.58 |
| Max. Negotiated Rate |
$259.39 |
| Rate for Payer: Aetna Commercial |
$187.88
|
| Rate for Payer: Aetna Medicare |
$145.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.90
|
| Rate for Payer: BCBS MAPPO |
$140.21
|
| Rate for Payer: BCBS Trust/PPO |
$158.07
|
| Rate for Payer: BCN Commercial |
$174.06
|
| Rate for Payer: BCN Medicare Advantage |
$140.21
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$201.90
|
| Rate for Payer: Cofinity Commercial |
$187.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.21
|
| Rate for Payer: Healthscope Commercial |
$259.39
|
| Rate for Payer: Healthscope Commercial |
$224.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.58
|
| Rate for Payer: Nomi Health Commercial |
$168.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: PACE SWMI |
$140.21
|
| Rate for Payer: PHP Medicare Advantage |
$140.21
|
| Rate for Payer: Priority Health Medicare |
$140.21
|
| Rate for Payer: Railroad Medicare Medicare |
$140.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.83
|
| Rate for Payer: UHC Core |
$137.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.21
|
| Rate for Payer: UHC Exchange |
$137.83
|
|
|
PR HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 47010
|
| Min. Negotiated Rate |
$728.89 |
| Max. Negotiated Rate |
$2,223.17 |
| Rate for Payer: Aetna Commercial |
$1,519.00
|
| Rate for Payer: Aetna Medicare |
$1,178.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,519.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,632.36
|
| Rate for Payer: BCBS Complete |
$765.33
|
| Rate for Payer: BCBS MAPPO |
$1,133.58
|
| Rate for Payer: BCN Commercial |
$1,824.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,133.58
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cofinity Commercial |
$1,632.36
|
| Rate for Payer: Cofinity Commercial |
$1,519.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,133.58
|
| Rate for Payer: Healthscope Commercial |
$2,097.12
|
| Rate for Payer: Healthscope Commercial |
$1,813.73
|
| Rate for Payer: Mclaren Medicaid |
$728.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,190.26
|
| Rate for Payer: Meridian Medicaid |
$765.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,246.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,166.97
|
| Rate for Payer: Nomi Health Commercial |
$1,360.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,732.50
|
| Rate for Payer: PACE SWMI |
$1,133.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,133.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$728.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,223.17
|
| Rate for Payer: Priority Health Medicare |
$1,133.58
|
| Rate for Payer: Priority Health SBD |
$2,223.17
|
| Rate for Payer: Priority Health Tiered Network |
$2,223.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,133.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,152.07
|
| Rate for Payer: UHC Core |
$2,152.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,133.58
|
| Rate for Payer: UHC Exchange |
$2,152.07
|
| Rate for Payer: UHC Medicaid |
$728.89
|
| Rate for Payer: UHCCP Medicaid |
$728.89
|
|
|
PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 90633
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Commercial |
$38.42
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.42
|
| Rate for Payer: BCBS Trust/PPO |
$39.13
|
| Rate for Payer: BCN Commercial |
$38.37
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.56
|
| Rate for Payer: UHC Core |
$39.56
|
| Rate for Payer: UHC Exchange |
$39.56
|
|
|
PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
HCPCS 90632
|
| Min. Negotiated Rate |
$69.75 |
| Max. Negotiated Rate |
$136.40 |
| Rate for Payer: Aetna Commercial |
$98.80
|
| Rate for Payer: Aetna Medicare |
$76.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.80
|
| Rate for Payer: BCBS MAPPO |
$73.73
|
| Rate for Payer: BCBS Trust/PPO |
$83.73
|
| Rate for Payer: BCN Commercial |
$84.64
|
| Rate for Payer: BCN Medicare Advantage |
$73.73
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cofinity Commercial |
$98.80
|
| Rate for Payer: Cofinity Commercial |
$106.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.73
|
| Rate for Payer: Healthscope Commercial |
$136.40
|
| Rate for Payer: Healthscope Commercial |
$117.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.08
|
| Rate for Payer: Nomi Health Commercial |
$88.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.75
|
| Rate for Payer: PACE SWMI |
$73.73
|
| Rate for Payer: PHP Medicare Advantage |
$73.73
|
| Rate for Payer: Priority Health Medicare |
$73.73
|
| Rate for Payer: Railroad Medicare Medicare |
$73.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.94
|
| Rate for Payer: UHC Core |
$84.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.73
|
| Rate for Payer: UHC Exchange |
$84.94
|
|
|
PR HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 90743
|
| Min. Negotiated Rate |
$67.58 |
| Max. Negotiated Rate |
$139.03 |
| Rate for Payer: Aetna Commercial |
$100.70
|
| Rate for Payer: Aetna Medicare |
$78.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.22
|
| Rate for Payer: BCBS MAPPO |
$75.15
|
| Rate for Payer: BCBS Trust/PPO |
$72.21
|
| Rate for Payer: BCN Commercial |
$67.58
|
| Rate for Payer: BCN Medicare Advantage |
$75.15
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$100.70
|
| Rate for Payer: Cofinity Commercial |
$108.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.15
|
| Rate for Payer: Healthscope Commercial |
$139.03
|
| Rate for Payer: Healthscope Commercial |
$120.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.03
|
| Rate for Payer: Nomi Health Commercial |
$90.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$75.15
|
| Rate for Payer: PHP Medicare Advantage |
$75.15
|
| Rate for Payer: Priority Health Medicare |
$75.15
|
| Rate for Payer: Railroad Medicare Medicare |
$75.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.21
|
| Rate for Payer: UHC Core |
$72.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.15
|
| Rate for Payer: UHC Exchange |
$72.21
|
|
|
PR HEPB VACCINE ADULT 2/4 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 90739
|
| Min. Negotiated Rate |
$143.41 |
| Max. Negotiated Rate |
$328.49 |
| Rate for Payer: Aetna Commercial |
$237.93
|
| Rate for Payer: Aetna Medicare |
$184.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.69
|
| Rate for Payer: BCBS MAPPO |
$177.56
|
| Rate for Payer: BCBS Trust/PPO |
$155.75
|
| Rate for Payer: BCN Commercial |
$153.25
|
| Rate for Payer: BCN Medicare Advantage |
$177.56
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$255.69
|
| Rate for Payer: Cofinity Commercial |
$237.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.56
|
| Rate for Payer: Healthscope Commercial |
$284.10
|
| Rate for Payer: Healthscope Commercial |
$328.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.41
|
| Rate for Payer: Nomi Health Commercial |
$213.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.00
|
| Rate for Payer: PACE SWMI |
$177.56
|
| Rate for Payer: PHP Medicare Advantage |
$177.56
|
| Rate for Payer: Priority Health Medicare |
$177.56
|
| Rate for Payer: Railroad Medicare Medicare |
$177.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.75
|
| Rate for Payer: UHC Core |
$155.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.56
|
| Rate for Payer: UHC Exchange |
$155.75
|
|
