|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$201.18 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna Commercial |
$352.75
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$365.84
|
| Rate for Payer: BCN Commercial |
$365.84
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$356.90
|
| Rate for Payer: Cofinity Commercial |
$290.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Mclaren Medicaid |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: Nomi Health Commercial |
$1,875.89
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Commercial |
$352.75
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,807.55
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.04
|
| Rate for Payer: Priority Health SBD |
$261.45
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.18
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$502.92
|
| Rate for Payer: VA VA |
$893.28
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,016.82 |
| Max. Negotiated Rate |
$1,452.60 |
| Rate for Payer: Aetna Commercial |
$1,371.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.10
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,129.80
|
| Rate for Payer: Cofinity Commercial |
$1,388.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,129.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Healthscope Commercial |
$1,452.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: PHP Commercial |
$1,371.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health SBD |
$1,016.82
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
OP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$511.88 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Commercial |
$1,371.90
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.56
|
| Rate for Payer: BCN Commercial |
$1,658.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,388.04
|
| Rate for Payer: Cofinity Commercial |
$1,129.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,129.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$1,452.60
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$1,371.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$1,016.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$511.88
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,512.75
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$312.68 |
| Max. Negotiated Rate |
$85,424.00 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$481.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.69
|
| Rate for Payer: BCBS Complete |
$328.31
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Healthscope Commercial |
$856.51
|
| Rate for Payer: Healthscope Commercial |
$740.77
|
| Rate for Payer: Mclaren Medicaid |
$312.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Meridian Medicaid |
$328.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,424.00
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$868.65
|
| Rate for Payer: Priority Health Medicare |
$462.98
|
| Rate for Payer: Priority Health Narrow Network |
$868.65
|
| Rate for Payer: Priority Health SBD |
$868.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Exchange |
$530.63
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
| Rate for Payer: UHCCP Medicaid |
$312.68
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$312.68 |
| Max. Negotiated Rate |
$85,424.00 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$481.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.69
|
| Rate for Payer: BCBS Complete |
$328.31
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Healthscope Commercial |
$856.51
|
| Rate for Payer: Healthscope Commercial |
$740.77
|
| Rate for Payer: Mclaren Medicaid |
$312.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Meridian Medicaid |
$328.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,424.00
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$868.65
|
| Rate for Payer: Priority Health Medicare |
$462.98
|
| Rate for Payer: Priority Health Narrow Network |
$868.65
|
| Rate for Payer: Priority Health SBD |
$868.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Exchange |
$530.63
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
| Rate for Payer: UHCCP Medicaid |
$312.68
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$229.83 |
| Max. Negotiated Rate |
$62,899.00 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$353.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.15
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Healthscope Commercial |
$628.43
|
| Rate for Payer: Healthscope Commercial |
$543.50
|
| Rate for Payer: Mclaren Medicaid |
$229.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,899.00
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$639.55
|
| Rate for Payer: Priority Health Medicare |
$339.69
|
| Rate for Payer: Priority Health Narrow Network |
$639.55
|
| Rate for Payer: Priority Health SBD |
$639.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$526.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Exchange |
$526.77
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
| Rate for Payer: UHCCP Medicaid |
$229.83
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$229.83 |
| Max. Negotiated Rate |
$62,899.00 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$353.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.15
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Healthscope Commercial |
$628.43
|
| Rate for Payer: Healthscope Commercial |
$543.50
|
| Rate for Payer: Mclaren Medicaid |
$229.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,899.00
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$639.55
|
| Rate for Payer: Priority Health Medicare |
$339.69
|
| Rate for Payer: Priority Health Narrow Network |
$639.55
|
| Rate for Payer: Priority Health SBD |
$639.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$526.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Exchange |
$526.77
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
| Rate for Payer: UHCCP Medicaid |
$229.83
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$376.43 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Commercial |
$933.30
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.85
|
| Rate for Payer: BCN Commercial |
$1,632.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$944.28
|
| Rate for Payer: Cofinity Commercial |
$768.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$768.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$988.20
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$933.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$691.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.43
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,512.75
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$691.74 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Aetna Commercial |
$933.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.70
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$768.60
|
| Rate for Payer: Cofinity Commercial |
$944.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$768.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Healthscope Commercial |
$988.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: PHP Commercial |
$933.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health SBD |
$691.74
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$207.89 |
| Max. Negotiated Rate |
$56,336.00 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$319.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.78
|
| Rate for Payer: BCBS Complete |
$218.28
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.13
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Healthscope Commercial |
$567.56
|
| Rate for Payer: Healthscope Commercial |
$490.86
|
| Rate for Payer: Mclaren Medicaid |
$207.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Meridian Medicaid |
$218.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,336.00
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.52
|
| Rate for Payer: Priority Health Medicare |
$306.79
|
| Rate for Payer: Priority Health Narrow Network |
$574.52
|
| Rate for Payer: Priority Health SBD |
$574.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Exchange |
$457.40
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
| Rate for Payer: UHCCP Medicaid |
$207.89
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
IP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$711.27 |
| Max. Negotiated Rate |
$1,016.10 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.85
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$790.30
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$790.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health SBD |
$711.27
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
OP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$337.35 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,717.33
|
| Rate for Payer: BCN Commercial |
$1,717.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Cofinity Commercial |
$790.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$790.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$711.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.35
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,512.75
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$207.89 |
| Max. Negotiated Rate |
$56,336.00 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$319.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.78
|
| Rate for Payer: BCBS Complete |
$218.28
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.13
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Healthscope Commercial |
$567.56
|
| Rate for Payer: Healthscope Commercial |
$490.86
|
| Rate for Payer: Mclaren Medicaid |
$207.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Meridian Medicaid |
$218.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,336.00
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.52
|
| Rate for Payer: Priority Health Medicare |
$306.79
|
| Rate for Payer: Priority Health Narrow Network |
$574.52
|
| Rate for Payer: Priority Health SBD |
$574.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Exchange |
$457.40
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
| Rate for Payer: UHCCP Medicaid |
$207.89
|
|
|
PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
HCPCS 46257
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$73,287.00 |
| Rate for Payer: Aetna Commercial |
$532.68
|
| Rate for Payer: Aetna Medicare |
$413.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.43
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$397.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,554.26
|
| Rate for Payer: BCN Commercial |
$610.36
|
| Rate for Payer: BCN Medicare Advantage |
$397.52
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cofinity Commercial |
$572.43
|
| Rate for Payer: Cofinity Commercial |
$532.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.52
|
| Rate for Payer: Healthscope Commercial |
$735.41
|
| Rate for Payer: Healthscope Commercial |
$636.03
|
| Rate for Payer: Mclaren Medicaid |
$270.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.40
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73,287.00
|
| Rate for Payer: Nomi Health Commercial |
$477.02
|
| Rate for Payer: PACE SWMI |
$397.52
|
| Rate for Payer: PHP Medicare Advantage |
$397.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$750.52
|
| Rate for Payer: Priority Health Medicare |
$397.52
|
| Rate for Payer: Priority Health Narrow Network |
$750.52
|
| Rate for Payer: Priority Health SBD |
$750.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.52
|
| Rate for Payer: UHC Exchange |
$438.59
|
| Rate for Payer: UHC Medicare Advantage |
$397.52
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR HEMORRHOIDOPEXY STAPLING
|
Professional
|
Both
|
$646.00
|
|
|
Service Code
|
HCPCS 46947
|
| Min. Negotiated Rate |
$251.77 |
| Max. Negotiated Rate |
$69,070.00 |
| Rate for Payer: Aetna Commercial |
$501.51
|
| Rate for Payer: Aetna Medicare |
$389.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.93
|
| Rate for Payer: BCBS Complete |
$264.36
|
| Rate for Payer: BCBS MAPPO |
$374.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,172.37
|
| Rate for Payer: BCN Commercial |
$570.29
|
| Rate for Payer: BCN Medicare Advantage |
$374.26
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Cofinity Commercial |
$538.93
|
| Rate for Payer: Cofinity Commercial |
$501.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.26
|
| Rate for Payer: Healthscope Commercial |
$692.38
|
| Rate for Payer: Healthscope Commercial |
$598.82
|
| Rate for Payer: Mclaren Medicaid |
$251.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.97
|
| Rate for Payer: Meridian Medicaid |
$264.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69,070.00
|
| Rate for Payer: Nomi Health Commercial |
$449.11
|
| Rate for Payer: PACE SWMI |
$374.26
|
| Rate for Payer: PHP Medicare Advantage |
$374.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$702.79
|
| Rate for Payer: Priority Health Medicare |
$374.26
|
| Rate for Payer: Priority Health Narrow Network |
$702.79
|
| Rate for Payer: Priority Health SBD |
$702.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.26
|
| Rate for Payer: UHC Exchange |
$385.96
|
| Rate for Payer: UHC Medicare Advantage |
$374.26
|
| Rate for Payer: UHCCP Medicaid |
$251.77
|
|
|
PR HEPATECTOMY RESCJ PARTIAL LOBECTOMY
|
Professional
|
Both
|
$4,633.00
|
|
|
Service Code
|
HCPCS 47120
|
| Min. Negotiated Rate |
$1,495.26 |
| Max. Negotiated Rate |
$417,544.00 |
| Rate for Payer: Aetna Commercial |
$3,030.91
|
| Rate for Payer: Aetna Medicare |
$2,352.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,030.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,257.09
|
| Rate for Payer: BCBS Complete |
$1,570.02
|
| Rate for Payer: BCBS MAPPO |
$2,261.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,491.46
|
| Rate for Payer: BCN Commercial |
$3,402.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,261.87
|
| Rate for Payer: Cash Price |
$3,706.40
|
| Rate for Payer: Cash Price |
$3,706.40
|
| Rate for Payer: Cofinity Commercial |
$3,257.09
|
| Rate for Payer: Cofinity Commercial |
$3,030.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,261.87
|
| Rate for Payer: Healthscope Commercial |
$4,184.46
|
| Rate for Payer: Healthscope Commercial |
$3,618.99
|
| Rate for Payer: Mclaren Medicaid |
$1,495.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,374.96
|
| Rate for Payer: Meridian Medicaid |
$1,570.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417,544.00
|
| Rate for Payer: Nomi Health Commercial |
$2,714.24
|
| Rate for Payer: PACE SWMI |
$2,261.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,261.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,495.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,011.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,170.79
|
| Rate for Payer: Priority Health Medicare |
$2,261.87
|
| Rate for Payer: Priority Health Narrow Network |
$4,170.79
|
| Rate for Payer: Priority Health SBD |
$4,170.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,125.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,261.87
|
| Rate for Payer: UHC Exchange |
$2,125.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,261.87
|
| Rate for Payer: UHCCP Medicaid |
$1,495.26
|
|
|
PR HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY
|
Professional
|
Both
|
$6,159.00
|
|
|
Service Code
|
HCPCS 47130
|
| Min. Negotiated Rate |
$2,109.13 |
| Max. Negotiated Rate |
$591,428.00 |
| Rate for Payer: Aetna Commercial |
$4,292.53
|
| Rate for Payer: Aetna Medicare |
$3,331.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,292.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,612.87
|
| Rate for Payer: BCBS Complete |
$2,214.59
|
| Rate for Payer: BCBS MAPPO |
$3,203.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.86
|
| Rate for Payer: BCN Commercial |
$4,804.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,203.38
|
| Rate for Payer: Cash Price |
$4,927.20
|
| Rate for Payer: Cash Price |
$4,927.20
|
| Rate for Payer: Cofinity Commercial |
$4,612.87
|
| Rate for Payer: Cofinity Commercial |
$4,292.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,203.38
|
| Rate for Payer: Healthscope Commercial |
$5,926.25
|
| Rate for Payer: Healthscope Commercial |
$5,125.41
|
| Rate for Payer: Mclaren Medicaid |
$2,109.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,363.55
|
| Rate for Payer: Meridian Medicaid |
$2,214.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591,428.00
|
| Rate for Payer: Nomi Health Commercial |
$3,844.06
|
| Rate for Payer: PACE SWMI |
$3,203.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,203.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,109.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,003.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,882.42
|
| Rate for Payer: Priority Health Medicare |
$3,203.38
|
| Rate for Payer: Priority Health Narrow Network |
$5,882.42
|
| Rate for Payer: Priority Health SBD |
$5,882.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,123.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,203.38
|
| Rate for Payer: UHC Exchange |
$3,123.43
|
| Rate for Payer: UHC Medicare Advantage |
$3,203.38
|
| Rate for Payer: UHCCP Medicaid |
$2,109.13
|
|
|
PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 90636
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$12,357.00 |
| Rate for Payer: Aetna Commercial |
$123.57
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.57
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$134.53
|
| Rate for Payer: BCN Commercial |
$134.53
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,357.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.77
|
| Rate for Payer: UHC Exchange |
$133.77
|
|
|
PR HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 90371
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$13,758.00 |
| Rate for Payer: Aetna Commercial |
$175.09
|
| Rate for Payer: Aetna Medicare |
$135.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.16
|
| Rate for Payer: BCBS Complete |
$72.80
|
| Rate for Payer: BCBS MAPPO |
$130.66
|
| Rate for Payer: BCBS Trust/PPO |
$151.61
|
| Rate for Payer: BCN Commercial |
$146.22
|
| Rate for Payer: BCN Medicare Advantage |
$130.66
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$175.09
|
| Rate for Payer: Cofinity Commercial |
$188.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.66
|
| Rate for Payer: Healthscope Commercial |
$241.73
|
| Rate for Payer: Healthscope Commercial |
$209.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,758.00
|
| Rate for Payer: Nomi Health Commercial |
$156.80
|
| Rate for Payer: PACE SWMI |
$130.66
|
| Rate for Payer: PHP Medicare Advantage |
$130.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health Medicare |
$130.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.66
|
| Rate for Payer: UHC Exchange |
$155.09
|
| Rate for Payer: UHC Medicare Advantage |
$130.66
|
|
|
PR HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 47010
|
| Min. Negotiated Rate |
$241.96 |
| Max. Negotiated Rate |
$216,697.00 |
| Rate for Payer: Aetna Commercial |
$1,576.36
|
| Rate for Payer: Aetna Medicare |
$1,223.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,576.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,694.00
|
| Rate for Payer: BCBS Complete |
$819.45
|
| Rate for Payer: BCBS MAPPO |
$1,176.39
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$1,771.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,176.39
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cofinity Commercial |
$1,694.00
|
| Rate for Payer: Cofinity Commercial |
$1,576.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,176.39
|
| Rate for Payer: Healthscope Commercial |
$2,176.32
|
| Rate for Payer: Healthscope Commercial |
$1,882.22
|
| Rate for Payer: Mclaren Medicaid |
$780.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,235.21
|
| Rate for Payer: Meridian Medicaid |
$819.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216,697.00
|
| Rate for Payer: Nomi Health Commercial |
$1,411.67
|
| Rate for Payer: PACE SWMI |
$1,176.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,176.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,172.79
|
| Rate for Payer: Priority Health Medicare |
$1,176.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,172.79
|
| Rate for Payer: Priority Health SBD |
$2,172.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,176.39
|
| Rate for Payer: UHC Exchange |
$1,015.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,176.39
|
| Rate for Payer: UHCCP Medicaid |
$780.43
|
|
|
PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 90633
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$3,754.00 |
| Rate for Payer: Aetna Commercial |
$38.42
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.42
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$31.32
|
| Rate for Payer: BCN Commercial |
$31.32
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,754.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Exchange |
$40.29
|
|
|
PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 90632
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$7,008.00 |
| Rate for Payer: Aetna Commercial |
$97.40
|
| Rate for Payer: Aetna Medicare |
$75.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.40
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$72.68
|
| Rate for Payer: BCBS Trust/PPO |
$72.34
|
| Rate for Payer: BCN Commercial |
$73.37
|
| Rate for Payer: BCN Medicare Advantage |
$72.68
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$104.66
|
| Rate for Payer: Cofinity Commercial |
$97.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.68
|
| Rate for Payer: Healthscope Commercial |
$134.47
|
| Rate for Payer: Healthscope Commercial |
$116.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,008.00
|
| Rate for Payer: Nomi Health Commercial |
$87.22
|
| Rate for Payer: PACE SWMI |
$72.68
|
| Rate for Payer: PHP Medicare Advantage |
$72.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
| Rate for Payer: Priority Health Medicare |
$72.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.68
|
| Rate for Payer: UHC Exchange |
$75.91
|
| Rate for Payer: UHC Medicare Advantage |
$72.68
|
|
|
PR HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 90743
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$6,803.00 |
| Rate for Payer: Aetna Commercial |
$100.69
|
| Rate for Payer: Aetna Medicare |
$78.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.21
|
| Rate for Payer: BCBS Complete |
$41.20
|
| Rate for Payer: BCBS MAPPO |
$75.14
|
| Rate for Payer: BCBS Trust/PPO |
$76.66
|
| Rate for Payer: BCN Commercial |
$65.05
|
| Rate for Payer: BCN Medicare Advantage |
$75.14
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$100.69
|
| Rate for Payer: Cofinity Commercial |
$108.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.14
|
| Rate for Payer: Healthscope Commercial |
$139.02
|
| Rate for Payer: Healthscope Commercial |
$120.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,803.00
|
| Rate for Payer: Nomi Health Commercial |
$90.17
|
| Rate for Payer: PACE SWMI |
$75.14
|
| Rate for Payer: PHP Medicare Advantage |
$75.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health Medicare |
$75.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.14
|
| Rate for Payer: UHC Exchange |
$82.01
|
| Rate for Payer: UHC Medicare Advantage |
$75.14
|
|
|
PR HEPB VACCINE ADULT 2/4 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 90739
|
| Min. Negotiated Rate |
$130.40 |
| Max. Negotiated Rate |
$14,341.00 |
| Rate for Payer: Aetna Commercial |
$237.92
|
| Rate for Payer: Aetna Medicare |
$184.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.68
|
| Rate for Payer: BCBS Complete |
$130.40
|
| Rate for Payer: BCBS MAPPO |
$177.56
|
| Rate for Payer: BCBS Trust/PPO |
$166.39
|
| Rate for Payer: BCN Commercial |
$132.46
|
| Rate for Payer: BCN Medicare Advantage |
$177.56
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cofinity Commercial |
$255.68
|
| Rate for Payer: Cofinity Commercial |
$237.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.56
|
| Rate for Payer: Healthscope Commercial |
$284.09
|
| Rate for Payer: Healthscope Commercial |
$328.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,341.00
|
| Rate for Payer: Nomi Health Commercial |
$213.07
|
| Rate for Payer: PACE SWMI |
$177.56
|
| Rate for Payer: PHP Medicare Advantage |
$177.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.90
|
| Rate for Payer: Priority Health Medicare |
$177.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.56
|
| Rate for Payer: UHC Exchange |
$178.40
|
| Rate for Payer: UHC Medicare Advantage |
$177.56
|
|
|
PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS 90746
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$6,803.00 |
| Rate for Payer: Aetna Commercial |
$94.30
|
| Rate for Payer: Aetna Medicare |
$73.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCBS MAPPO |
$70.38
|
| Rate for Payer: BCBS Trust/PPO |
$73.05
|
| Rate for Payer: BCN Commercial |
$65.05
|
| Rate for Payer: BCN Medicare Advantage |
$70.38
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$101.34
|
| Rate for Payer: Cofinity Commercial |
$94.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.38
|
| Rate for Payer: Healthscope Commercial |
$130.20
|
| Rate for Payer: Healthscope Commercial |
$112.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,803.00
|
| Rate for Payer: Nomi Health Commercial |
$84.45
|
| Rate for Payer: PACE SWMI |
$70.38
|
| Rate for Payer: PHP Medicare Advantage |
$70.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.95
|
| Rate for Payer: Priority Health Medicare |
$70.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.38
|
| Rate for Payer: UHC Exchange |
$76.81
|
| Rate for Payer: UHC Medicare Advantage |
$70.38
|
|
