|
PR LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE
|
Professional
|
Both
|
$979.00
|
|
|
Service Code
|
HCPCS 31536
|
| Min. Negotiated Rate |
$114.17 |
| Max. Negotiated Rate |
$734.25 |
| Rate for Payer: Aetna Commercial |
$237.23
|
| Rate for Payer: Aetna Medicare |
$184.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.94
|
| Rate for Payer: BCBS Complete |
$119.88
|
| Rate for Payer: BCBS MAPPO |
$177.04
|
| Rate for Payer: BCN Commercial |
$313.23
|
| Rate for Payer: BCN Medicare Advantage |
$177.04
|
| Rate for Payer: Cash Price |
$783.20
|
| Rate for Payer: Cash Price |
$783.20
|
| Rate for Payer: Cofinity Commercial |
$254.94
|
| Rate for Payer: Cofinity Commercial |
$237.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.04
|
| Rate for Payer: Healthscope Commercial |
$327.52
|
| Rate for Payer: Healthscope Commercial |
$283.26
|
| Rate for Payer: Mclaren Medicaid |
$114.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.89
|
| Rate for Payer: Meridian Medicaid |
$119.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.70
|
| Rate for Payer: Nomi Health Commercial |
$212.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$734.25
|
| Rate for Payer: PACE SWMI |
$177.04
|
| Rate for Payer: PHP Medicare Advantage |
$177.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$294.97
|
| Rate for Payer: Priority Health Medicare |
$177.04
|
| Rate for Payer: Priority Health SBD |
$294.97
|
| Rate for Payer: Priority Health Tiered Network |
$294.97
|
| Rate for Payer: Railroad Medicare Medicare |
$177.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.29
|
| Rate for Payer: UHC Core |
$366.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.04
|
| Rate for Payer: UHC Exchange |
$366.29
|
| Rate for Payer: UHC Medicaid |
$114.17
|
| Rate for Payer: UHCCP Medicaid |
$114.17
|
|
|
PR LARYNGOSCOPY W/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 31530
|
| Min. Negotiated Rate |
$110.33 |
| Max. Negotiated Rate |
$351.88 |
| Rate for Payer: Aetna Commercial |
$229.45
|
| Rate for Payer: Aetna Medicare |
$178.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.57
|
| Rate for Payer: BCBS Complete |
$115.85
|
| Rate for Payer: BCBS MAPPO |
$171.23
|
| Rate for Payer: BCN Commercial |
$296.80
|
| Rate for Payer: BCN Medicare Advantage |
$171.23
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$246.57
|
| Rate for Payer: Cofinity Commercial |
$229.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.23
|
| Rate for Payer: Healthscope Commercial |
$316.78
|
| Rate for Payer: Healthscope Commercial |
$273.97
|
| Rate for Payer: Mclaren Medicaid |
$110.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.79
|
| Rate for Payer: Meridian Medicaid |
$115.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.88
|
| Rate for Payer: Nomi Health Commercial |
$205.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PACE SWMI |
$171.23
|
| Rate for Payer: PHP Medicare Advantage |
$171.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$279.50
|
| Rate for Payer: Priority Health Medicare |
$171.23
|
| Rate for Payer: Priority Health SBD |
$279.50
|
| Rate for Payer: Priority Health Tiered Network |
$279.50
|
| Rate for Payer: Railroad Medicare Medicare |
$171.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.09
|
| Rate for Payer: UHC Core |
$348.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$171.23
|
| Rate for Payer: UHC Exchange |
$348.09
|
| Rate for Payer: UHC Medicaid |
$110.33
|
| Rate for Payer: UHCCP Medicaid |
$110.33
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 31515
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$287.25 |
| Rate for Payer: Aetna Commercial |
$133.60
|
| Rate for Payer: Aetna Medicare |
$103.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.57
|
| Rate for Payer: BCBS Complete |
$67.99
|
| Rate for Payer: BCBS MAPPO |
$99.70
|
| Rate for Payer: BCN Commercial |
$166.82
|
| Rate for Payer: BCN Medicare Advantage |
$99.70
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$143.57
|
| Rate for Payer: Cofinity Commercial |
$133.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.70
|
| Rate for Payer: Healthscope Commercial |
$184.44
|
| Rate for Payer: Healthscope Commercial |
$159.52
|
| Rate for Payer: Mclaren Medicaid |
$64.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.69
|
| Rate for Payer: Meridian Medicaid |
$67.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.78
|
| Rate for Payer: Nomi Health Commercial |
$119.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.25
|
| Rate for Payer: PACE SWMI |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$99.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.10
|
| Rate for Payer: Priority Health Medicare |
$99.70
|
| Rate for Payer: Priority Health SBD |
$157.10
|
| Rate for Payer: Priority Health Tiered Network |
$157.10
|
| Rate for Payer: Railroad Medicare Medicare |
$99.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.30
|
| Rate for Payer: UHC Core |
$191.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.70
|
| Rate for Payer: UHC Exchange |
$191.30
|
| Rate for Payer: UHC Medicaid |
$64.75
|
| Rate for Payer: UHCCP Medicaid |
$64.75
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 31529
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$283.34 |
| Rate for Payer: Aetna Commercial |
$182.60
|
| Rate for Payer: Aetna Medicare |
$141.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.23
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS MAPPO |
$136.27
|
| Rate for Payer: BCN Commercial |
$240.53
|
| Rate for Payer: BCN Medicare Advantage |
$136.27
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$196.23
|
| Rate for Payer: Cofinity Commercial |
$182.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.27
|
| Rate for Payer: Healthscope Commercial |
$252.10
|
| Rate for Payer: Healthscope Commercial |
$218.03
|
| Rate for Payer: Mclaren Medicaid |
$87.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.08
|
| Rate for Payer: Meridian Medicaid |
$92.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.34
|
| Rate for Payer: Nomi Health Commercial |
$163.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$136.27
|
| Rate for Payer: PHP Medicare Advantage |
$136.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$226.50
|
| Rate for Payer: Priority Health Medicare |
$136.27
|
| Rate for Payer: Priority Health SBD |
$226.50
|
| Rate for Payer: Priority Health Tiered Network |
$226.50
|
| Rate for Payer: Railroad Medicare Medicare |
$136.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.98
|
| Rate for Payer: UHC Core |
$279.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.27
|
| Rate for Payer: UHC Exchange |
$279.98
|
| Rate for Payer: UHC Medicaid |
$87.97
|
| Rate for Payer: UHCCP Medicaid |
$87.97
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 31525
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$482.25 |
| Rate for Payer: Aetna Commercial |
$182.00
|
| Rate for Payer: Aetna Medicare |
$141.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.58
|
| Rate for Payer: BCBS Complete |
$92.15
|
| Rate for Payer: BCBS MAPPO |
$135.82
|
| Rate for Payer: BCN Commercial |
$239.53
|
| Rate for Payer: BCN Medicare Advantage |
$135.82
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cofinity Commercial |
$195.58
|
| Rate for Payer: Cofinity Commercial |
$182.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.82
|
| Rate for Payer: Healthscope Commercial |
$251.27
|
| Rate for Payer: Healthscope Commercial |
$217.31
|
| Rate for Payer: Mclaren Medicaid |
$87.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.61
|
| Rate for Payer: Meridian Medicaid |
$92.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.39
|
| Rate for Payer: Nomi Health Commercial |
$162.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$482.25
|
| Rate for Payer: PACE SWMI |
$135.82
|
| Rate for Payer: PHP Medicare Advantage |
$135.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$225.57
|
| Rate for Payer: Priority Health Medicare |
$135.82
|
| Rate for Payer: Priority Health SBD |
$225.57
|
| Rate for Payer: Priority Health Tiered Network |
$225.57
|
| Rate for Payer: Railroad Medicare Medicare |
$135.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.00
|
| Rate for Payer: UHC Core |
$278.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.82
|
| Rate for Payer: UHC Exchange |
$278.00
|
| Rate for Payer: UHC Medicaid |
$87.76
|
| Rate for Payer: UHCCP Medicaid |
$87.76
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN
|
Professional
|
Both
|
$816.00
|
|
|
Service Code
|
HCPCS 31528
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$612.00 |
| Rate for Payer: Aetna Commercial |
$165.21
|
| Rate for Payer: Aetna Medicare |
$128.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.54
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$123.29
|
| Rate for Payer: BCN Commercial |
$216.13
|
| Rate for Payer: BCN Medicare Advantage |
$123.29
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Cofinity Commercial |
$177.54
|
| Rate for Payer: Cofinity Commercial |
$165.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.29
|
| Rate for Payer: Healthscope Commercial |
$228.09
|
| Rate for Payer: Healthscope Commercial |
$197.26
|
| Rate for Payer: Mclaren Medicaid |
$79.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.45
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.77
|
| Rate for Payer: Nomi Health Commercial |
$147.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.00
|
| Rate for Payer: PACE SWMI |
$123.29
|
| Rate for Payer: PHP Medicare Advantage |
$123.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.52
|
| Rate for Payer: Priority Health Medicare |
$123.29
|
| Rate for Payer: Priority Health SBD |
$203.52
|
| Rate for Payer: Priority Health Tiered Network |
$203.52
|
| Rate for Payer: Railroad Medicare Medicare |
$123.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.34
|
| Rate for Payer: UHC Core |
$249.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.29
|
| Rate for Payer: UHC Exchange |
$249.34
|
| Rate for Payer: UHC Medicaid |
$79.66
|
| Rate for Payer: UHCCP Medicaid |
$79.66
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 31526
|
| Min. Negotiated Rate |
$86.27 |
| Max. Negotiated Rate |
$276.62 |
| Rate for Payer: Aetna Commercial |
$178.85
|
| Rate for Payer: Aetna Medicare |
$138.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.20
|
| Rate for Payer: BCBS Complete |
$90.58
|
| Rate for Payer: BCBS MAPPO |
$133.47
|
| Rate for Payer: BCN Commercial |
$235.55
|
| Rate for Payer: BCN Medicare Advantage |
$133.47
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$192.20
|
| Rate for Payer: Cofinity Commercial |
$178.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.47
|
| Rate for Payer: Healthscope Commercial |
$246.92
|
| Rate for Payer: Healthscope Commercial |
$213.55
|
| Rate for Payer: Mclaren Medicaid |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.14
|
| Rate for Payer: Meridian Medicaid |
$90.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.62
|
| Rate for Payer: Nomi Health Commercial |
$160.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: PACE SWMI |
$133.47
|
| Rate for Payer: PHP Medicare Advantage |
$133.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$221.82
|
| Rate for Payer: Priority Health Medicare |
$133.47
|
| Rate for Payer: Priority Health SBD |
$221.82
|
| Rate for Payer: Priority Health Tiered Network |
$221.82
|
| Rate for Payer: Railroad Medicare Medicare |
$133.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.82
|
| Rate for Payer: UHC Core |
$271.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.47
|
| Rate for Payer: UHC Exchange |
$271.82
|
| Rate for Payer: UHC Medicaid |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$86.27
|
|
|
PR LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY
|
Professional
|
Both
|
$2,339.00
|
|
|
Service Code
|
HCPCS 31300
|
| Min. Negotiated Rate |
$715.25 |
| Max. Negotiated Rate |
$2,203.02 |
| Rate for Payer: Aetna Commercial |
$1,454.44
|
| Rate for Payer: Aetna Medicare |
$1,128.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,454.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,562.98
|
| Rate for Payer: BCBS Complete |
$751.01
|
| Rate for Payer: BCBS MAPPO |
$1,085.40
|
| Rate for Payer: BCN Commercial |
$1,870.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,085.40
|
| Rate for Payer: Cash Price |
$1,871.20
|
| Rate for Payer: Cash Price |
$1,871.20
|
| Rate for Payer: Cofinity Commercial |
$1,562.98
|
| Rate for Payer: Cofinity Commercial |
$1,454.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,085.40
|
| Rate for Payer: Healthscope Commercial |
$2,007.99
|
| Rate for Payer: Healthscope Commercial |
$1,736.64
|
| Rate for Payer: Mclaren Medicaid |
$715.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,139.67
|
| Rate for Payer: Meridian Medicaid |
$751.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,193.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,203.02
|
| Rate for Payer: Nomi Health Commercial |
$1,302.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,754.25
|
| Rate for Payer: PACE SWMI |
$1,085.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,085.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,761.85
|
| Rate for Payer: Priority Health Medicare |
$1,085.40
|
| Rate for Payer: Priority Health SBD |
$1,761.85
|
| Rate for Payer: Priority Health Tiered Network |
$1,761.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,085.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,172.34
|
| Rate for Payer: UHC Core |
$2,172.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,085.40
|
| Rate for Payer: UHC Exchange |
$2,172.34
|
| Rate for Payer: UHC Medicaid |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$715.25
|
|
|
PR LASER CO2 - FULL FACE
|
Professional
|
Both
|
$2,889.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,155.60 |
| Max. Negotiated Rate |
$2,166.75 |
| Rate for Payer: Aetna Medicare |
$1,444.50
|
| Rate for Payer: BCBS Complete |
$1,155.60
|
| Rate for Payer: Cash Price |
$2,311.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,877.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,166.75
|
|
|
PR LASER CO2 - ONE AREA
|
Professional
|
Both
|
$1,839.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$735.60 |
| Max. Negotiated Rate |
$1,379.25 |
| Rate for Payer: Aetna Medicare |
$919.50
|
| Rate for Payer: BCBS Complete |
$735.60
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,379.25
|
|
|
PR LASER CO2 - TWO AREAS
|
Professional
|
Both
|
$2,364.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$945.60 |
| Max. Negotiated Rate |
$1,773.00 |
| Rate for Payer: Aetna Medicare |
$1,182.00
|
| Rate for Payer: BCBS Complete |
$945.60
|
| Rate for Payer: Cash Price |
$1,891.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,536.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,773.00
|
|
|
PR LASER ENUCLEATION PROSTATE W/MORCELLATION
|
Professional
|
Both
|
$1,760.00
|
|
|
Service Code
|
HCPCS 52649
|
| Min. Negotiated Rate |
$418.97 |
| Max. Negotiated Rate |
$1,455.81 |
| Rate for Payer: Aetna Commercial |
$868.91
|
| Rate for Payer: Aetna Medicare |
$674.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$868.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.75
|
| Rate for Payer: BCBS Complete |
$439.92
|
| Rate for Payer: BCBS MAPPO |
$648.44
|
| Rate for Payer: BCN Commercial |
$1,234.50
|
| Rate for Payer: BCN Medicare Advantage |
$648.44
|
| Rate for Payer: Cash Price |
$1,408.00
|
| Rate for Payer: Cash Price |
$1,408.00
|
| Rate for Payer: Cofinity Commercial |
$933.75
|
| Rate for Payer: Cofinity Commercial |
$868.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.44
|
| Rate for Payer: Healthscope Commercial |
$1,199.61
|
| Rate for Payer: Healthscope Commercial |
$1,037.50
|
| Rate for Payer: Mclaren Medicaid |
$418.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.86
|
| Rate for Payer: Meridian Medicaid |
$439.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$713.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,449.54
|
| Rate for Payer: Nomi Health Commercial |
$778.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,320.00
|
| Rate for Payer: PACE SWMI |
$648.44
|
| Rate for Payer: PHP Medicare Advantage |
$648.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,344.77
|
| Rate for Payer: Priority Health Medicare |
$648.44
|
| Rate for Payer: Priority Health SBD |
$1,344.77
|
| Rate for Payer: Priority Health Tiered Network |
$1,344.77
|
| Rate for Payer: Railroad Medicare Medicare |
$648.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,455.81
|
| Rate for Payer: UHC Core |
$1,455.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$648.44
|
| Rate for Payer: UHC Exchange |
$1,455.81
|
| Rate for Payer: UHC Medicaid |
$418.97
|
| Rate for Payer: UHCCP Medicaid |
$418.97
|
|
|
PR LASER VAPORIZATION OF PROSTATE FOR URINE FLOW
|
Professional
|
Both
|
$3,407.00
|
|
|
Service Code
|
HCPCS 52648
|
| Min. Negotiated Rate |
$336.97 |
| Max. Negotiated Rate |
$2,555.25 |
| Rate for Payer: Aetna Commercial |
$696.89
|
| Rate for Payer: Aetna Medicare |
$540.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.90
|
| Rate for Payer: BCBS Complete |
$353.82
|
| Rate for Payer: BCBS MAPPO |
$520.07
|
| Rate for Payer: BCN Commercial |
$1,038.79
|
| Rate for Payer: BCN Medicare Advantage |
$520.07
|
| Rate for Payer: Cash Price |
$2,725.60
|
| Rate for Payer: Cash Price |
$2,725.60
|
| Rate for Payer: Cofinity Commercial |
$748.90
|
| Rate for Payer: Cofinity Commercial |
$696.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.07
|
| Rate for Payer: Healthscope Commercial |
$962.13
|
| Rate for Payer: Healthscope Commercial |
$832.11
|
| Rate for Payer: Mclaren Medicaid |
$336.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$546.07
|
| Rate for Payer: Meridian Medicaid |
$353.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$572.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,216.37
|
| Rate for Payer: Nomi Health Commercial |
$624.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,555.25
|
| Rate for Payer: PACE SWMI |
$520.07
|
| Rate for Payer: PHP Medicare Advantage |
$520.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,131.58
|
| Rate for Payer: Priority Health Medicare |
$520.07
|
| Rate for Payer: Priority Health SBD |
$1,131.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,131.58
|
| Rate for Payer: Railroad Medicare Medicare |
$520.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,217.90
|
| Rate for Payer: UHC Core |
$1,217.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$520.07
|
| Rate for Payer: UHC Exchange |
$1,217.90
|
| Rate for Payer: UHC Medicaid |
$336.97
|
| Rate for Payer: UHCCP Medicaid |
$336.97
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Professional
|
Both
|
$1,748.00
|
|
|
Service Code
|
HCPCS 27425
|
| Min. Negotiated Rate |
$282.44 |
| Max. Negotiated Rate |
$1,311.00 |
| Rate for Payer: Aetna Commercial |
$573.06
|
| Rate for Payer: Aetna Medicare |
$444.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.83
|
| Rate for Payer: BCBS Complete |
$296.56
|
| Rate for Payer: BCBS MAPPO |
$427.66
|
| Rate for Payer: BCN Commercial |
$770.82
|
| Rate for Payer: BCN Medicare Advantage |
$427.66
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cofinity Commercial |
$615.83
|
| Rate for Payer: Cofinity Commercial |
$573.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.66
|
| Rate for Payer: Healthscope Commercial |
$791.17
|
| Rate for Payer: Healthscope Commercial |
$684.26
|
| Rate for Payer: Mclaren Medicaid |
$282.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.04
|
| Rate for Payer: Meridian Medicaid |
$296.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$470.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$805.66
|
| Rate for Payer: Nomi Health Commercial |
$513.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,311.00
|
| Rate for Payer: PACE SWMI |
$427.66
|
| Rate for Payer: PHP Medicare Advantage |
$427.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$750.05
|
| Rate for Payer: Priority Health Medicare |
$427.66
|
| Rate for Payer: Priority Health SBD |
$750.05
|
| Rate for Payer: Priority Health Tiered Network |
$750.05
|
| Rate for Payer: Railroad Medicare Medicare |
$427.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.96
|
| Rate for Payer: UHC Core |
$778.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$427.66
|
| Rate for Payer: UHC Exchange |
$778.96
|
| Rate for Payer: UHC Medicaid |
$282.44
|
| Rate for Payer: UHCCP Medicaid |
$282.44
|
|
|
PR LATISSE
|
Professional
|
Both
|
$188.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$141.00 |
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.00
|
|
|
PR LAVAGE CANNULATION MAXILLARY SINUS
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 31000
|
| Min. Negotiated Rate |
$65.18 |
| Max. Negotiated Rate |
$225.75 |
| Rate for Payer: Aetna Commercial |
$131.15
|
| Rate for Payer: Aetna Medicare |
$101.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.93
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$97.87
|
| Rate for Payer: BCN Commercial |
$167.32
|
| Rate for Payer: BCN Medicare Advantage |
$97.87
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$140.93
|
| Rate for Payer: Cofinity Commercial |
$131.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.87
|
| Rate for Payer: Healthscope Commercial |
$156.59
|
| Rate for Payer: Healthscope Commercial |
$181.06
|
| Rate for Payer: Mclaren Medicaid |
$65.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.76
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.82
|
| Rate for Payer: Nomi Health Commercial |
$117.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.75
|
| Rate for Payer: PACE SWMI |
$97.87
|
| Rate for Payer: PHP Medicare Advantage |
$97.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.56
|
| Rate for Payer: Priority Health Medicare |
$97.87
|
| Rate for Payer: Priority Health SBD |
$157.56
|
| Rate for Payer: Priority Health Tiered Network |
$157.56
|
| Rate for Payer: Railroad Medicare Medicare |
$97.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.77
|
| Rate for Payer: UHC Core |
$180.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.87
|
| Rate for Payer: UHC Exchange |
$180.77
|
| Rate for Payer: UHC Medicaid |
$65.18
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR LAVAGE CANNULATION SPHENOID SINUS
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 31002
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$334.04 |
| Rate for Payer: Aetna Commercial |
$214.00
|
| Rate for Payer: Aetna Medicare |
$166.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.97
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS MAPPO |
$159.70
|
| Rate for Payer: BCN Commercial |
$279.37
|
| Rate for Payer: BCN Medicare Advantage |
$159.70
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cofinity Commercial |
$229.97
|
| Rate for Payer: Cofinity Commercial |
$214.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.70
|
| Rate for Payer: Healthscope Commercial |
$295.44
|
| Rate for Payer: Healthscope Commercial |
$255.52
|
| Rate for Payer: Mclaren Medicaid |
$106.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.69
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.04
|
| Rate for Payer: Nomi Health Commercial |
$191.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.25
|
| Rate for Payer: PACE SWMI |
$159.70
|
| Rate for Payer: PHP Medicare Advantage |
$159.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$263.08
|
| Rate for Payer: Priority Health Medicare |
$159.70
|
| Rate for Payer: Priority Health SBD |
$263.08
|
| Rate for Payer: Priority Health Tiered Network |
$263.08
|
| Rate for Payer: Railroad Medicare Medicare |
$159.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.17
|
| Rate for Payer: UHC Core |
$321.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$159.70
|
| Rate for Payer: UHC Exchange |
$321.17
|
| Rate for Payer: UHC Medicaid |
$106.71
|
| Rate for Payer: UHCCP Medicaid |
$106.71
|
|
|
PR LEFT HEART CATH BY TRANSEPTAL PUNCTURE
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 93462
|
| Min. Negotiated Rate |
$112.89 |
| Max. Negotiated Rate |
$346.68 |
| Rate for Payer: Aetna Commercial |
$239.07
|
| Rate for Payer: Aetna Medicare |
$185.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.91
|
| Rate for Payer: BCBS Complete |
$118.53
|
| Rate for Payer: BCBS MAPPO |
$178.41
|
| Rate for Payer: BCN Commercial |
$301.78
|
| Rate for Payer: BCN Medicare Advantage |
$178.41
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cofinity Commercial |
$256.91
|
| Rate for Payer: Cofinity Commercial |
$239.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.41
|
| Rate for Payer: Healthscope Commercial |
$330.06
|
| Rate for Payer: Healthscope Commercial |
$285.46
|
| Rate for Payer: Mclaren Medicaid |
$112.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.33
|
| Rate for Payer: Meridian Medicaid |
$118.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$196.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.69
|
| Rate for Payer: Nomi Health Commercial |
$214.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$341.25
|
| Rate for Payer: PACE SWMI |
$178.41
|
| Rate for Payer: PHP Medicare Advantage |
$178.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$286.82
|
| Rate for Payer: Priority Health Medicare |
$178.41
|
| Rate for Payer: Priority Health SBD |
$286.82
|
| Rate for Payer: Priority Health Tiered Network |
$286.82
|
| Rate for Payer: Railroad Medicare Medicare |
$178.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.68
|
| Rate for Payer: UHC Core |
$346.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$178.41
|
| Rate for Payer: UHC Exchange |
$346.68
|
| Rate for Payer: UHC Medicaid |
$112.89
|
| Rate for Payer: UHCCP Medicaid |
$112.89
|
|
|
PR LENGTHENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 26476
|
| Min. Negotiated Rate |
$413.43 |
| Max. Negotiated Rate |
$1,138.05 |
| Rate for Payer: Aetna Commercial |
$824.31
|
| Rate for Payer: Aetna Medicare |
$639.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$885.83
|
| Rate for Payer: BCBS Complete |
$434.10
|
| Rate for Payer: BCBS MAPPO |
$615.16
|
| Rate for Payer: BCN Commercial |
$970.57
|
| Rate for Payer: BCN Medicare Advantage |
$615.16
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$885.83
|
| Rate for Payer: Cofinity Commercial |
$824.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.16
|
| Rate for Payer: Healthscope Commercial |
$984.26
|
| Rate for Payer: Healthscope Commercial |
$1,138.05
|
| Rate for Payer: Mclaren Medicaid |
$413.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.92
|
| Rate for Payer: Meridian Medicaid |
$434.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$676.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,131.28
|
| Rate for Payer: Nomi Health Commercial |
$738.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.00
|
| Rate for Payer: PACE SWMI |
$615.16
|
| Rate for Payer: PHP Medicare Advantage |
$615.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,037.50
|
| Rate for Payer: Priority Health Medicare |
$615.16
|
| Rate for Payer: Priority Health SBD |
$1,037.50
|
| Rate for Payer: Priority Health Tiered Network |
$1,037.50
|
| Rate for Payer: Railroad Medicare Medicare |
$615.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,041.34
|
| Rate for Payer: UHC Core |
$1,041.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.16
|
| Rate for Payer: UHC Exchange |
$1,041.34
|
| Rate for Payer: UHC Medicaid |
$413.43
|
| Rate for Payer: UHCCP Medicaid |
$413.43
|
|
|
PR LENGTHENING TENDON FLEXOR HAND/FINGER EACH
|
Professional
|
Both
|
$2,101.00
|
|
|
Service Code
|
HCPCS 26478
|
| Min. Negotiated Rate |
$415.14 |
| Max. Negotiated Rate |
$1,575.75 |
| Rate for Payer: Aetna Commercial |
$830.01
|
| Rate for Payer: Aetna Medicare |
$644.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$830.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.95
|
| Rate for Payer: BCBS Complete |
$435.90
|
| Rate for Payer: BCBS MAPPO |
$619.41
|
| Rate for Payer: BCN Commercial |
$995.47
|
| Rate for Payer: BCN Medicare Advantage |
$619.41
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cofinity Commercial |
$891.95
|
| Rate for Payer: Cofinity Commercial |
$830.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.41
|
| Rate for Payer: Healthscope Commercial |
$991.06
|
| Rate for Payer: Healthscope Commercial |
$1,145.91
|
| Rate for Payer: Mclaren Medicaid |
$415.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.38
|
| Rate for Payer: Meridian Medicaid |
$435.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$681.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,168.38
|
| Rate for Payer: Nomi Health Commercial |
$743.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,575.75
|
| Rate for Payer: PACE SWMI |
$619.41
|
| Rate for Payer: PHP Medicare Advantage |
$619.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$415.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,064.13
|
| Rate for Payer: Priority Health Medicare |
$619.41
|
| Rate for Payer: Priority Health SBD |
$1,064.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,064.13
|
| Rate for Payer: Railroad Medicare Medicare |
$619.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.02
|
| Rate for Payer: UHC Core |
$1,086.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$619.41
|
| Rate for Payer: UHC Exchange |
$1,086.02
|
| Rate for Payer: UHC Medicaid |
$415.14
|
| Rate for Payer: UHCCP Medicaid |
$415.14
|
|
|
PR LESION <15
|
Professional
|
Both
|
$132.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
|
|
PR LESION FL FACE/NECK
|
Professional
|
Both
|
$263.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
PR LESION REMOVAL COLONOSCOPY
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS G6024
|
| Min. Negotiated Rate |
$652.80 |
| Max. Negotiated Rate |
$1,224.00 |
| Rate for Payer: Aetna Medicare |
$816.00
|
| Rate for Payer: BCBS Complete |
$652.80
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,224.00
|
|
|
PR LESION SINGLE
|
Professional
|
Both
|
$37.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
|
|
PR LEUPROLIDE ACETATE /3.75 MG
|
Professional
|
Both
|
$1,136.00
|
|
|
Service Code
|
HCPCS J1950
|
| Min. Negotiated Rate |
$852.00 |
| Max. Negotiated Rate |
$3,266.30 |
| Rate for Payer: Aetna Commercial |
$2,365.86
|
| Rate for Payer: Aetna Medicare |
$1,836.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,365.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,542.42
|
| Rate for Payer: BCBS MAPPO |
$1,765.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.42
|
| Rate for Payer: BCN Commercial |
$1,186.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,765.57
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cofinity Commercial |
$2,542.42
|
| Rate for Payer: Cofinity Commercial |
$2,365.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,765.57
|
| Rate for Payer: Healthscope Commercial |
$3,266.30
|
| Rate for Payer: Healthscope Commercial |
$2,824.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,853.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,942.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,524.34
|
| Rate for Payer: Nomi Health Commercial |
$2,118.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.00
|
| Rate for Payer: PACE SWMI |
$1,765.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,765.57
|
| Rate for Payer: Priority Health Medicare |
$1,765.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,765.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,763.87
|
| Rate for Payer: UHC Core |
$1,763.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,765.57
|
| Rate for Payer: UHC Exchange |
$1,763.87
|
|
