|
PR HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 58555
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$26,942.00 |
| Rate for Payer: Aetna Commercial |
$196.02
|
| Rate for Payer: Aetna Medicare |
$152.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.64
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$146.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.58
|
| Rate for Payer: BCN Commercial |
$536.08
|
| Rate for Payer: BCN Medicare Advantage |
$146.28
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$210.64
|
| Rate for Payer: Cofinity Commercial |
$196.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.28
|
| Rate for Payer: Healthscope Commercial |
$270.62
|
| Rate for Payer: Healthscope Commercial |
$234.05
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.59
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,942.00
|
| Rate for Payer: Nomi Health Commercial |
$175.54
|
| Rate for Payer: PACE SWMI |
$146.28
|
| Rate for Payer: PHP Medicare Advantage |
$146.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.71
|
| Rate for Payer: Priority Health Medicare |
$146.28
|
| Rate for Payer: Priority Health Narrow Network |
$224.71
|
| Rate for Payer: Priority Health SBD |
$224.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.28
|
| Rate for Payer: UHC Exchange |
$246.38
|
| Rate for Payer: UHC Medicare Advantage |
$146.28
|
| Rate for Payer: UHCCP Medicaid |
$97.34
|
|
|
PR HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE
|
Facility
|
OP
|
$813.00
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
58555
|
| Min. Negotiated Rate |
$161.29 |
| Max. Negotiated Rate |
$9,791.14 |
| Rate for Payer: Aetna Commercial |
$691.05
|
| Rate for Payer: Aetna Medicare |
$3,239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$967.09
|
| Rate for Payer: BCN Commercial |
$967.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$699.18
|
| Rate for Payer: Cofinity Commercial |
$569.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$569.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$731.70
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.05
|
| Rate for Payer: Nomi Health Commercial |
$6,542.00
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$691.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,791.14
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,832.91
|
| Rate for Payer: Priority Health SBD |
$512.19
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.29
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,753.88
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
PR HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE
|
Facility
|
IP
|
$813.00
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
58555
|
| Min. Negotiated Rate |
$512.19 |
| Max. Negotiated Rate |
$731.70 |
| Rate for Payer: Aetna Commercial |
$691.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.45
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$569.10
|
| Rate for Payer: Cofinity Commercial |
$699.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$569.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.40
|
| Rate for Payer: Healthscope Commercial |
$731.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.05
|
| Rate for Payer: PHP Commercial |
$691.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health SBD |
$512.19
|
|
|
PR HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 58555
|
| Hospital Charge Code |
58555
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$26,942.00 |
| Rate for Payer: Aetna Commercial |
$196.02
|
| Rate for Payer: Aetna Medicare |
$152.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.64
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$146.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.58
|
| Rate for Payer: BCN Commercial |
$536.08
|
| Rate for Payer: BCN Medicare Advantage |
$146.28
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$210.64
|
| Rate for Payer: Cofinity Commercial |
$196.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.28
|
| Rate for Payer: Healthscope Commercial |
$270.62
|
| Rate for Payer: Healthscope Commercial |
$234.05
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.59
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,942.00
|
| Rate for Payer: Nomi Health Commercial |
$175.54
|
| Rate for Payer: PACE SWMI |
$146.28
|
| Rate for Payer: PHP Medicare Advantage |
$146.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.71
|
| Rate for Payer: Priority Health Medicare |
$146.28
|
| Rate for Payer: Priority Health Narrow Network |
$224.71
|
| Rate for Payer: Priority Health SBD |
$224.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.28
|
| Rate for Payer: UHC Exchange |
$246.38
|
| Rate for Payer: UHC Medicare Advantage |
$146.28
|
| Rate for Payer: UHCCP Medicaid |
$97.34
|
|
|
PR HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM
|
Professional
|
Both
|
$1,673.00
|
|
|
Service Code
|
HCPCS 58560
|
| Min. Negotiated Rate |
$29.58 |
| Max. Negotiated Rate |
$55,746.00 |
| Rate for Payer: Aetna Commercial |
$402.40
|
| Rate for Payer: Aetna Medicare |
$312.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.43
|
| Rate for Payer: BCBS Complete |
$209.12
|
| Rate for Payer: BCBS MAPPO |
$300.30
|
| Rate for Payer: BCBS Trust/PPO |
$29.58
|
| Rate for Payer: BCN Commercial |
$454.47
|
| Rate for Payer: BCN Medicare Advantage |
$300.30
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cofinity Commercial |
$432.43
|
| Rate for Payer: Cofinity Commercial |
$402.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.30
|
| Rate for Payer: Healthscope Commercial |
$555.56
|
| Rate for Payer: Healthscope Commercial |
$480.48
|
| Rate for Payer: Mclaren Medicaid |
$199.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.32
|
| Rate for Payer: Meridian Medicaid |
$209.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,746.00
|
| Rate for Payer: Nomi Health Commercial |
$360.36
|
| Rate for Payer: PACE SWMI |
$300.30
|
| Rate for Payer: PHP Medicare Advantage |
$300.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.81
|
| Rate for Payer: Priority Health Medicare |
$300.30
|
| Rate for Payer: Priority Health Narrow Network |
$463.81
|
| Rate for Payer: Priority Health SBD |
$463.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.30
|
| Rate for Payer: UHC Exchange |
$463.45
|
| Rate for Payer: UHC Medicare Advantage |
$300.30
|
| Rate for Payer: UHCCP Medicaid |
$199.16
|
|
|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 58563
|
| Min. Negotiated Rate |
$14.26 |
| Max. Negotiated Rate |
$43,904.00 |
| Rate for Payer: Aetna Commercial |
$316.27
|
| Rate for Payer: Aetna Medicare |
$245.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.87
|
| Rate for Payer: BCBS Complete |
$164.61
|
| Rate for Payer: BCBS MAPPO |
$236.02
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCN Commercial |
$3,149.52
|
| Rate for Payer: BCN Medicare Advantage |
$236.02
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$339.87
|
| Rate for Payer: Cofinity Commercial |
$316.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.02
|
| Rate for Payer: Healthscope Commercial |
$436.64
|
| Rate for Payer: Healthscope Commercial |
$377.63
|
| Rate for Payer: Mclaren Medicaid |
$156.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.82
|
| Rate for Payer: Meridian Medicaid |
$164.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,904.00
|
| Rate for Payer: Nomi Health Commercial |
$283.22
|
| Rate for Payer: PACE SWMI |
$236.02
|
| Rate for Payer: PHP Medicare Advantage |
$236.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.59
|
| Rate for Payer: Priority Health Medicare |
$236.02
|
| Rate for Payer: Priority Health Narrow Network |
$364.59
|
| Rate for Payer: Priority Health SBD |
$364.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.02
|
| Rate for Payer: UHC Exchange |
$417.85
|
| Rate for Payer: UHC Medicare Advantage |
$236.02
|
| Rate for Payer: UHCCP Medicaid |
$156.77
|
|
|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 58563
|
| Hospital Charge Code |
58563
|
| Min. Negotiated Rate |
$14.26 |
| Max. Negotiated Rate |
$43,904.00 |
| Rate for Payer: Aetna Commercial |
$316.27
|
| Rate for Payer: Aetna Medicare |
$245.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.87
|
| Rate for Payer: BCBS Complete |
$164.61
|
| Rate for Payer: BCBS MAPPO |
$236.02
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCN Commercial |
$3,149.52
|
| Rate for Payer: BCN Medicare Advantage |
$236.02
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$339.87
|
| Rate for Payer: Cofinity Commercial |
$316.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.02
|
| Rate for Payer: Healthscope Commercial |
$436.64
|
| Rate for Payer: Healthscope Commercial |
$377.63
|
| Rate for Payer: Mclaren Medicaid |
$156.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.82
|
| Rate for Payer: Meridian Medicaid |
$164.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,904.00
|
| Rate for Payer: Nomi Health Commercial |
$283.22
|
| Rate for Payer: PACE SWMI |
$236.02
|
| Rate for Payer: PHP Medicare Advantage |
$236.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.59
|
| Rate for Payer: Priority Health Medicare |
$236.02
|
| Rate for Payer: Priority Health Narrow Network |
$364.59
|
| Rate for Payer: Priority Health SBD |
$364.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.02
|
| Rate for Payer: UHC Exchange |
$417.85
|
| Rate for Payer: UHC Medicare Advantage |
$236.02
|
| Rate for Payer: UHCCP Medicaid |
$156.77
|
|
|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Facility
|
IP
|
$1,564.00
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
58563
|
| Min. Negotiated Rate |
$985.32 |
| Max. Negotiated Rate |
$1,407.60 |
| Rate for Payer: Aetna Commercial |
$1,329.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,016.60
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,094.80
|
| Rate for Payer: Cofinity Commercial |
$1,345.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,094.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.20
|
| Rate for Payer: Healthscope Commercial |
$1,407.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,329.40
|
| Rate for Payer: PHP Commercial |
$1,329.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health SBD |
$985.32
|
|
|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Facility
|
OP
|
$1,564.00
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
58563
|
| Min. Negotiated Rate |
$262.58 |
| Max. Negotiated Rate |
$15,201.47 |
| Rate for Payer: Aetna Commercial |
$1,329.40
|
| Rate for Payer: Aetna Medicare |
$5,030.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,016.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,045.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,045.79
|
| Rate for Payer: BCBS Complete |
$2,722.06
|
| Rate for Payer: BCBS MAPPO |
$4,836.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,042.88
|
| Rate for Payer: BCN Commercial |
$2,042.88
|
| Rate for Payer: BCN Medicare Advantage |
$4,836.63
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,345.04
|
| Rate for Payer: Cofinity Commercial |
$1,094.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,094.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,836.63
|
| Rate for Payer: Healthscope Commercial |
$1,407.60
|
| Rate for Payer: Mclaren Medicaid |
$2,592.43
|
| Rate for Payer: Mclaren Medicare |
$4,836.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,078.46
|
| Rate for Payer: Meridian Medicaid |
$2,722.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,562.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,329.40
|
| Rate for Payer: Nomi Health Commercial |
$10,156.92
|
| Rate for Payer: PACE Medicare |
$4,594.80
|
| Rate for Payer: PACE SWMI |
$4,836.63
|
| Rate for Payer: PHP Commercial |
$1,329.40
|
| Rate for Payer: PHP Medicare Advantage |
$4,836.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,592.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,201.47
|
| Rate for Payer: Priority Health Medicare |
$4,836.63
|
| Rate for Payer: Priority Health Narrow Network |
$12,161.18
|
| Rate for Payer: Priority Health SBD |
$985.32
|
| Rate for Payer: Railroad Medicare Medicare |
$4,836.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.58
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,836.63
|
| Rate for Payer: UHC Medicare Advantage |
$4,836.63
|
| Rate for Payer: UHCCP Medicaid |
$2,723.02
|
| Rate for Payer: VA VA |
$4,836.63
|
|
|
PR HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
HCPCS 58559
|
| Min. Negotiated Rate |
$180.84 |
| Max. Negotiated Rate |
$50,623.00 |
| Rate for Payer: Aetna Commercial |
$365.18
|
| Rate for Payer: Aetna Medicare |
$283.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.43
|
| Rate for Payer: BCBS Complete |
$189.88
|
| Rate for Payer: BCBS MAPPO |
$272.52
|
| Rate for Payer: BCBS Trust/PPO |
$498.19
|
| Rate for Payer: BCN Commercial |
$412.93
|
| Rate for Payer: BCN Medicare Advantage |
$272.52
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cofinity Commercial |
$392.43
|
| Rate for Payer: Cofinity Commercial |
$365.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.52
|
| Rate for Payer: Healthscope Commercial |
$504.16
|
| Rate for Payer: Healthscope Commercial |
$436.03
|
| Rate for Payer: Mclaren Medicaid |
$180.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.15
|
| Rate for Payer: Meridian Medicaid |
$189.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50,623.00
|
| Rate for Payer: Nomi Health Commercial |
$327.02
|
| Rate for Payer: PACE SWMI |
$272.52
|
| Rate for Payer: PHP Medicare Advantage |
$272.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.14
|
| Rate for Payer: Priority Health Medicare |
$272.52
|
| Rate for Payer: Priority Health Narrow Network |
$421.14
|
| Rate for Payer: Priority Health SBD |
$421.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$272.52
|
| Rate for Payer: UHC Exchange |
$405.76
|
| Rate for Payer: UHC Medicare Advantage |
$272.52
|
| Rate for Payer: UHCCP Medicaid |
$180.84
|
|
|
PR HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY
|
Professional
|
Both
|
$1,177.00
|
|
|
Service Code
|
HCPCS 58562
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$39,510.00 |
| Rate for Payer: Aetna Commercial |
$284.72
|
| Rate for Payer: Aetna Medicare |
$220.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.97
|
| Rate for Payer: BCBS Complete |
$148.28
|
| Rate for Payer: BCBS MAPPO |
$212.48
|
| Rate for Payer: BCBS Trust/PPO |
$13.74
|
| Rate for Payer: BCN Commercial |
$639.19
|
| Rate for Payer: BCN Medicare Advantage |
$212.48
|
| Rate for Payer: Cash Price |
$941.60
|
| Rate for Payer: Cash Price |
$941.60
|
| Rate for Payer: Cofinity Commercial |
$305.97
|
| Rate for Payer: Cofinity Commercial |
$284.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.48
|
| Rate for Payer: Healthscope Commercial |
$393.09
|
| Rate for Payer: Healthscope Commercial |
$339.97
|
| Rate for Payer: Mclaren Medicaid |
$141.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.10
|
| Rate for Payer: Meridian Medicaid |
$148.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,510.00
|
| Rate for Payer: Nomi Health Commercial |
$254.98
|
| Rate for Payer: PACE SWMI |
$212.48
|
| Rate for Payer: PHP Medicare Advantage |
$212.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$765.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.88
|
| Rate for Payer: Priority Health Medicare |
$212.48
|
| Rate for Payer: Priority Health Narrow Network |
$328.88
|
| Rate for Payer: Priority Health SBD |
$328.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.48
|
| Rate for Payer: UHC Exchange |
$344.38
|
| Rate for Payer: UHC Medicare Advantage |
$212.48
|
| Rate for Payer: UHCCP Medicaid |
$141.22
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 58561
|
| Hospital Charge Code |
58561
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$63,869.00 |
| Rate for Payer: Aetna Commercial |
$460.57
|
| Rate for Payer: Aetna Medicare |
$357.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.94
|
| Rate for Payer: BCBS Complete |
$239.31
|
| Rate for Payer: BCBS MAPPO |
$343.71
|
| Rate for Payer: BCBS Trust/PPO |
$23.25
|
| Rate for Payer: BCN Commercial |
$520.44
|
| Rate for Payer: BCN Medicare Advantage |
$343.71
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$494.94
|
| Rate for Payer: Cofinity Commercial |
$460.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.71
|
| Rate for Payer: Healthscope Commercial |
$635.86
|
| Rate for Payer: Healthscope Commercial |
$549.94
|
| Rate for Payer: Mclaren Medicaid |
$227.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.90
|
| Rate for Payer: Meridian Medicaid |
$239.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,869.00
|
| Rate for Payer: Nomi Health Commercial |
$412.45
|
| Rate for Payer: PACE SWMI |
$343.71
|
| Rate for Payer: PHP Medicare Advantage |
$343.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$530.78
|
| Rate for Payer: Priority Health Medicare |
$343.71
|
| Rate for Payer: Priority Health Narrow Network |
$530.78
|
| Rate for Payer: Priority Health SBD |
$530.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$659.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.71
|
| Rate for Payer: UHC Exchange |
$659.39
|
| Rate for Payer: UHC Medicare Advantage |
$343.71
|
| Rate for Payer: UHCCP Medicaid |
$227.91
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 58561
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$63,869.00 |
| Rate for Payer: Aetna Commercial |
$460.57
|
| Rate for Payer: Aetna Medicare |
$357.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.94
|
| Rate for Payer: BCBS Complete |
$239.31
|
| Rate for Payer: BCBS MAPPO |
$343.71
|
| Rate for Payer: BCBS Trust/PPO |
$23.25
|
| Rate for Payer: BCN Commercial |
$520.44
|
| Rate for Payer: BCN Medicare Advantage |
$343.71
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$494.94
|
| Rate for Payer: Cofinity Commercial |
$460.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.71
|
| Rate for Payer: Healthscope Commercial |
$635.86
|
| Rate for Payer: Healthscope Commercial |
$549.94
|
| Rate for Payer: Mclaren Medicaid |
$227.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.90
|
| Rate for Payer: Meridian Medicaid |
$239.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,869.00
|
| Rate for Payer: Nomi Health Commercial |
$412.45
|
| Rate for Payer: PACE SWMI |
$343.71
|
| Rate for Payer: PHP Medicare Advantage |
$343.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$530.78
|
| Rate for Payer: Priority Health Medicare |
$343.71
|
| Rate for Payer: Priority Health Narrow Network |
$530.78
|
| Rate for Payer: Priority Health SBD |
$530.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$659.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.71
|
| Rate for Payer: UHC Exchange |
$659.39
|
| Rate for Payer: UHC Medicare Advantage |
$343.71
|
| Rate for Payer: UHCCP Medicaid |
$227.91
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Facility
|
OP
|
$941.00
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
58561
|
| Min. Negotiated Rate |
$382.92 |
| Max. Negotiated Rate |
$15,201.47 |
| Rate for Payer: Aetna Commercial |
$799.85
|
| Rate for Payer: Aetna Medicare |
$5,030.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,045.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,045.79
|
| Rate for Payer: BCBS Complete |
$2,722.06
|
| Rate for Payer: BCBS MAPPO |
$4,836.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,466.77
|
| Rate for Payer: BCN Commercial |
$2,466.77
|
| Rate for Payer: BCN Medicare Advantage |
$4,836.63
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$809.26
|
| Rate for Payer: Cofinity Commercial |
$658.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$658.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,836.63
|
| Rate for Payer: Healthscope Commercial |
$846.90
|
| Rate for Payer: Mclaren Medicaid |
$2,592.43
|
| Rate for Payer: Mclaren Medicare |
$4,836.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,078.46
|
| Rate for Payer: Meridian Medicaid |
$2,722.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,562.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.85
|
| Rate for Payer: Nomi Health Commercial |
$10,156.92
|
| Rate for Payer: PACE Medicare |
$4,594.80
|
| Rate for Payer: PACE SWMI |
$4,836.63
|
| Rate for Payer: PHP Commercial |
$799.85
|
| Rate for Payer: PHP Medicare Advantage |
$4,836.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,592.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,201.47
|
| Rate for Payer: Priority Health Medicare |
$4,836.63
|
| Rate for Payer: Priority Health Narrow Network |
$12,161.18
|
| Rate for Payer: Priority Health SBD |
$592.83
|
| Rate for Payer: Railroad Medicare Medicare |
$4,836.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.92
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,836.63
|
| Rate for Payer: UHC Medicare Advantage |
$4,836.63
|
| Rate for Payer: UHCCP Medicaid |
$2,723.02
|
| Rate for Payer: VA VA |
$4,836.63
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Facility
|
IP
|
$941.00
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
58561
|
| Min. Negotiated Rate |
$592.83 |
| Max. Negotiated Rate |
$846.90 |
| Rate for Payer: Aetna Commercial |
$799.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.65
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$658.70
|
| Rate for Payer: Cofinity Commercial |
$809.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$658.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.80
|
| Rate for Payer: Healthscope Commercial |
$846.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.85
|
| Rate for Payer: PHP Commercial |
$799.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health SBD |
$592.83
|
|
|
PR HYSTEROTOMY ABDOMINAL
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 59100
|
| Min. Negotiated Rate |
$130.49 |
| Max. Negotiated Rate |
$154,575.00 |
| Rate for Payer: Aetna Commercial |
$1,119.72
|
| Rate for Payer: Aetna Medicare |
$869.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,203.28
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS MAPPO |
$835.61
|
| Rate for Payer: BCBS Trust/PPO |
$130.49
|
| Rate for Payer: BCN Commercial |
$1,260.30
|
| Rate for Payer: BCN Medicare Advantage |
$835.61
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,203.28
|
| Rate for Payer: Cofinity Commercial |
$1,119.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.61
|
| Rate for Payer: Healthscope Commercial |
$1,545.88
|
| Rate for Payer: Healthscope Commercial |
$1,336.98
|
| Rate for Payer: Mclaren Medicaid |
$551.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.39
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154,575.00
|
| Rate for Payer: Nomi Health Commercial |
$1,002.73
|
| Rate for Payer: PACE SWMI |
$835.61
|
| Rate for Payer: PHP Medicare Advantage |
$835.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,208.65
|
| Rate for Payer: Priority Health Medicare |
$835.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,208.65
|
| Rate for Payer: Priority Health SBD |
$1,208.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$941.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.61
|
| Rate for Payer: UHC Exchange |
$941.00
|
| Rate for Payer: UHC Medicare Advantage |
$835.61
|
| Rate for Payer: UHCCP Medicaid |
$551.24
|
|
|
PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM USE
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 90750
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$18,708.00 |
| Rate for Payer: Aetna Commercial |
$187.08
|
| Rate for Payer: Aetna Medicare |
$85.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.08
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: BCBS Trust/PPO |
$175.26
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,708.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.07
|
| Rate for Payer: UHC Exchange |
$216.07
|
|
|
PR I131 IODIDE CAP, RX
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS A9517
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$10,326.00 |
| Rate for Payer: Aetna Commercial |
$40.43
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.43
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.29
|
| Rate for Payer: BCN Commercial |
$23.73
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,326.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.41
|
| Rate for Payer: UHC Exchange |
$45.41
|
|
|
PR ICAR CATH ABLATION DISCRETE MECHANISM ARRHYTHMIA
|
Professional
|
Both
|
$1,492.00
|
|
|
Service Code
|
HCPCS 93655
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$45,458.00 |
| Rate for Payer: Aetna Commercial |
$390.01
|
| Rate for Payer: Aetna Medicare |
$302.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.11
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS MAPPO |
$291.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,991.76
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$291.05
|
| Rate for Payer: Cash Price |
$1,193.60
|
| Rate for Payer: Cash Price |
$1,193.60
|
| Rate for Payer: Cofinity Commercial |
$419.11
|
| Rate for Payer: Cofinity Commercial |
$390.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.05
|
| Rate for Payer: Healthscope Commercial |
$465.68
|
| Rate for Payer: Healthscope Commercial |
$538.44
|
| Rate for Payer: Mclaren Medicaid |
$191.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.60
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,458.00
|
| Rate for Payer: Nomi Health Commercial |
$349.26
|
| Rate for Payer: PACE SWMI |
$291.05
|
| Rate for Payer: PHP Medicare Advantage |
$291.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.39
|
| Rate for Payer: Priority Health Medicare |
$291.05
|
| Rate for Payer: Priority Health Narrow Network |
$421.39
|
| Rate for Payer: Priority Health SBD |
$421.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.05
|
| Rate for Payer: UHC Medicare Advantage |
$291.05
|
| Rate for Payer: UHCCP Medicaid |
$191.27
|
|
|
PR ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 93650
|
| Min. Negotiated Rate |
$363.17 |
| Max. Negotiated Rate |
$86,193.00 |
| Rate for Payer: Aetna Commercial |
$738.98
|
| Rate for Payer: Aetna Medicare |
$573.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$794.13
|
| Rate for Payer: BCBS Complete |
$381.33
|
| Rate for Payer: BCBS MAPPO |
$551.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,821.65
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$551.48
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cofinity Commercial |
$794.13
|
| Rate for Payer: Cofinity Commercial |
$738.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.48
|
| Rate for Payer: Healthscope Commercial |
$882.37
|
| Rate for Payer: Healthscope Commercial |
$1,020.24
|
| Rate for Payer: Mclaren Medicaid |
$363.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.05
|
| Rate for Payer: Meridian Medicaid |
$381.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86,193.00
|
| Rate for Payer: Nomi Health Commercial |
$661.78
|
| Rate for Payer: PACE SWMI |
$551.48
|
| Rate for Payer: PHP Medicare Advantage |
$551.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,196.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$800.43
|
| Rate for Payer: Priority Health Medicare |
$551.48
|
| Rate for Payer: Priority Health Narrow Network |
$800.43
|
| Rate for Payer: Priority Health SBD |
$800.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,083.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.48
|
| Rate for Payer: UHC Exchange |
$1,083.88
|
| Rate for Payer: UHC Medicare Advantage |
$551.48
|
| Rate for Payer: UHCCP Medicaid |
$363.17
|
|
|
PR I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 42700
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$23,886.00 |
| Rate for Payer: Aetna Commercial |
$173.38
|
| Rate for Payer: Aetna Medicare |
$134.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.32
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$129.39
|
| Rate for Payer: BCBS Trust/PPO |
$492.38
|
| Rate for Payer: BCN Commercial |
$284.90
|
| Rate for Payer: BCN Medicare Advantage |
$129.39
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$186.32
|
| Rate for Payer: Cofinity Commercial |
$173.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.39
|
| Rate for Payer: Healthscope Commercial |
$239.37
|
| Rate for Payer: Healthscope Commercial |
$207.02
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.86
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,886.00
|
| Rate for Payer: Nomi Health Commercial |
$155.27
|
| Rate for Payer: PACE SWMI |
$129.39
|
| Rate for Payer: PHP Medicare Advantage |
$129.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.79
|
| Rate for Payer: Priority Health Medicare |
$129.39
|
| Rate for Payer: Priority Health Narrow Network |
$245.79
|
| Rate for Payer: Priority Health SBD |
$245.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.39
|
| Rate for Payer: UHC Exchange |
$206.06
|
| Rate for Payer: UHC Medicare Advantage |
$129.39
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 42720
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$68,416.00 |
| Rate for Payer: Aetna Commercial |
$494.58
|
| Rate for Payer: Aetna Medicare |
$383.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.49
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS MAPPO |
$369.09
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: BCN Commercial |
$657.27
|
| Rate for Payer: BCN Medicare Advantage |
$369.09
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$531.49
|
| Rate for Payer: Cofinity Commercial |
$494.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.09
|
| Rate for Payer: Healthscope Commercial |
$682.82
|
| Rate for Payer: Healthscope Commercial |
$590.54
|
| Rate for Payer: Mclaren Medicaid |
$248.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.54
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,416.00
|
| Rate for Payer: Nomi Health Commercial |
$442.91
|
| Rate for Payer: PACE SWMI |
$369.09
|
| Rate for Payer: PHP Medicare Advantage |
$369.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$692.06
|
| Rate for Payer: Priority Health Medicare |
$369.09
|
| Rate for Payer: Priority Health Narrow Network |
$692.06
|
| Rate for Payer: Priority Health SBD |
$692.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$369.09
|
| Rate for Payer: UHC Exchange |
$448.16
|
| Rate for Payer: UHC Medicare Advantage |
$369.09
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 42725
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$141,124.00 |
| Rate for Payer: Aetna Commercial |
$1,025.14
|
| Rate for Payer: Aetna Medicare |
$795.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,101.64
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS MAPPO |
$765.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.83
|
| Rate for Payer: BCN Commercial |
$1,165.98
|
| Rate for Payer: BCN Medicare Advantage |
$765.03
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cofinity Commercial |
$1,101.64
|
| Rate for Payer: Cofinity Commercial |
$1,025.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.03
|
| Rate for Payer: Healthscope Commercial |
$1,415.31
|
| Rate for Payer: Healthscope Commercial |
$1,224.05
|
| Rate for Payer: Mclaren Medicaid |
$515.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.28
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141,124.00
|
| Rate for Payer: Nomi Health Commercial |
$918.04
|
| Rate for Payer: PACE SWMI |
$765.03
|
| Rate for Payer: PHP Medicare Advantage |
$765.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$960.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,436.59
|
| Rate for Payer: Priority Health Medicare |
$765.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,436.59
|
| Rate for Payer: Priority Health SBD |
$1,436.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$843.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.03
|
| Rate for Payer: UHC Exchange |
$843.38
|
| Rate for Payer: UHC Medicare Advantage |
$765.03
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
|
|
PR I&D BELOW FASCIA FOOT 1 BURSAL SPACE
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 28002
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$24,827.00 |
| Rate for Payer: Aetna Commercial |
$179.72
|
| Rate for Payer: Aetna Medicare |
$139.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.13
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$134.12
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$359.18
|
| Rate for Payer: BCN Medicare Advantage |
$134.12
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cofinity Commercial |
$193.13
|
| Rate for Payer: Cofinity Commercial |
$179.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.12
|
| Rate for Payer: Healthscope Commercial |
$248.12
|
| Rate for Payer: Healthscope Commercial |
$214.59
|
| Rate for Payer: Mclaren Medicaid |
$89.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.83
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,827.00
|
| Rate for Payer: Nomi Health Commercial |
$160.94
|
| Rate for Payer: PACE SWMI |
$134.12
|
| Rate for Payer: PHP Medicare Advantage |
$134.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.21
|
| Rate for Payer: Priority Health Medicare |
$134.12
|
| Rate for Payer: Priority Health Narrow Network |
$213.21
|
| Rate for Payer: Priority Health SBD |
$213.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.12
|
| Rate for Payer: UHC Exchange |
$495.12
|
| Rate for Payer: UHC Medicare Advantage |
$134.12
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
|
|
PR I&D BELOW FASCIA FOOT MULTIPLE AREAS
|
Professional
|
Both
|
$1,243.00
|
|
|
Service Code
|
HCPCS 28003
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$46,370.00 |
| Rate for Payer: Aetna Commercial |
$330.94
|
| Rate for Payer: Aetna Medicare |
$256.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.64
|
| Rate for Payer: BCBS Complete |
$172.43
|
| Rate for Payer: BCBS MAPPO |
$246.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,691.76
|
| Rate for Payer: BCN Commercial |
$554.65
|
| Rate for Payer: BCN Medicare Advantage |
$246.97
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cofinity Commercial |
$355.64
|
| Rate for Payer: Cofinity Commercial |
$330.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.97
|
| Rate for Payer: Healthscope Commercial |
$456.89
|
| Rate for Payer: Healthscope Commercial |
$395.15
|
| Rate for Payer: Mclaren Medicaid |
$164.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.32
|
| Rate for Payer: Meridian Medicaid |
$172.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,370.00
|
| Rate for Payer: Nomi Health Commercial |
$296.36
|
| Rate for Payer: PACE SWMI |
$246.97
|
| Rate for Payer: PHP Medicare Advantage |
$246.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.34
|
| Rate for Payer: Priority Health Medicare |
$246.97
|
| Rate for Payer: Priority Health Narrow Network |
$392.34
|
| Rate for Payer: Priority Health SBD |
$392.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$802.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.97
|
| Rate for Payer: UHC Exchange |
$802.97
|
| Rate for Payer: UHC Medicare Advantage |
$246.97
|
| Rate for Payer: UHCCP Medicaid |
$164.22
|
|
