|
PR LARYNGOSCOPY W/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 31530
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$35,188.00 |
| Rate for Payer: Aetna Commercial |
$254.28
|
| Rate for Payer: Aetna Medicare |
$197.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.25
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$189.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,856.45
|
| Rate for Payer: BCN Commercial |
$288.81
|
| Rate for Payer: BCN Medicare Advantage |
$189.76
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$273.25
|
| Rate for Payer: Cofinity Commercial |
$254.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.76
|
| Rate for Payer: Healthscope Commercial |
$351.06
|
| Rate for Payer: Healthscope Commercial |
$303.62
|
| Rate for Payer: Mclaren Medicaid |
$126.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.25
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,188.00
|
| Rate for Payer: Nomi Health Commercial |
$227.71
|
| Rate for Payer: PACE SWMI |
$189.76
|
| Rate for Payer: PHP Medicare Advantage |
$189.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.83
|
| Rate for Payer: Priority Health Medicare |
$189.76
|
| Rate for Payer: Priority Health Narrow Network |
$274.83
|
| Rate for Payer: Priority Health SBD |
$274.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.76
|
| Rate for Payer: UHC Exchange |
$297.87
|
| Rate for Payer: UHC Medicare Advantage |
$189.76
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 31515
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$19,678.00 |
| Rate for Payer: Aetna Commercial |
$142.29
|
| Rate for Payer: Aetna Medicare |
$110.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.91
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS MAPPO |
$106.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$316.66
|
| Rate for Payer: BCN Medicare Advantage |
$106.19
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$152.91
|
| Rate for Payer: Cofinity Commercial |
$142.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.19
|
| Rate for Payer: Healthscope Commercial |
$196.45
|
| Rate for Payer: Healthscope Commercial |
$169.90
|
| Rate for Payer: Mclaren Medicaid |
$71.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.50
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,678.00
|
| Rate for Payer: Nomi Health Commercial |
$127.43
|
| Rate for Payer: PACE SWMI |
$106.19
|
| Rate for Payer: PHP Medicare Advantage |
$106.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.86
|
| Rate for Payer: Priority Health Medicare |
$106.19
|
| Rate for Payer: Priority Health Narrow Network |
$153.86
|
| Rate for Payer: Priority Health SBD |
$153.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.19
|
| Rate for Payer: UHC Exchange |
$223.62
|
| Rate for Payer: UHC Medicare Advantage |
$106.19
|
| Rate for Payer: UHCCP Medicaid |
$71.36
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 31529
|
| Min. Negotiated Rate |
$102.88 |
| Max. Negotiated Rate |
$28,334.00 |
| Rate for Payer: Aetna Commercial |
$205.49
|
| Rate for Payer: Aetna Medicare |
$159.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.82
|
| Rate for Payer: BCBS Complete |
$108.02
|
| Rate for Payer: BCBS MAPPO |
$153.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,150.11
|
| Rate for Payer: BCN Commercial |
$233.10
|
| Rate for Payer: BCN Medicare Advantage |
$153.35
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$220.82
|
| Rate for Payer: Cofinity Commercial |
$205.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.35
|
| Rate for Payer: Healthscope Commercial |
$283.70
|
| Rate for Payer: Healthscope Commercial |
$245.36
|
| Rate for Payer: Mclaren Medicaid |
$102.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.02
|
| Rate for Payer: Meridian Medicaid |
$108.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,334.00
|
| Rate for Payer: Nomi Health Commercial |
$184.02
|
| Rate for Payer: PACE SWMI |
$153.35
|
| Rate for Payer: PHP Medicare Advantage |
$153.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.92
|
| Rate for Payer: Priority Health Medicare |
$153.35
|
| Rate for Payer: Priority Health Narrow Network |
$222.92
|
| Rate for Payer: Priority Health SBD |
$222.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.35
|
| Rate for Payer: UHC Exchange |
$210.82
|
| Rate for Payer: UHC Medicare Advantage |
$153.35
|
| Rate for Payer: UHCCP Medicaid |
$102.88
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN
|
Professional
|
Both
|
$624.00
|
|
|
Service Code
|
HCPCS 31525
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$28,139.00 |
| Rate for Payer: Aetna Commercial |
$204.51
|
| Rate for Payer: Aetna Medicare |
$158.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.77
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$152.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.05
|
| Rate for Payer: BCN Commercial |
$367.97
|
| Rate for Payer: BCN Medicare Advantage |
$152.62
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cofinity Commercial |
$219.77
|
| Rate for Payer: Cofinity Commercial |
$204.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.62
|
| Rate for Payer: Healthscope Commercial |
$282.35
|
| Rate for Payer: Healthscope Commercial |
$244.19
|
| Rate for Payer: Mclaren Medicaid |
$102.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.25
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,139.00
|
| Rate for Payer: Nomi Health Commercial |
$183.14
|
| Rate for Payer: PACE SWMI |
$152.62
|
| Rate for Payer: PHP Medicare Advantage |
$152.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.00
|
| Rate for Payer: Priority Health Medicare |
$152.62
|
| Rate for Payer: Priority Health Narrow Network |
$222.00
|
| Rate for Payer: Priority Health SBD |
$222.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.62
|
| Rate for Payer: UHC Exchange |
$269.45
|
| Rate for Payer: UHC Medicare Advantage |
$152.62
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 31528
|
| Min. Negotiated Rate |
$92.44 |
| Max. Negotiated Rate |
$25,477.00 |
| Rate for Payer: Aetna Commercial |
$184.49
|
| Rate for Payer: Aetna Medicare |
$143.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.26
|
| Rate for Payer: BCBS Complete |
$97.06
|
| Rate for Payer: BCBS MAPPO |
$137.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| Rate for Payer: BCN Commercial |
$209.64
|
| Rate for Payer: BCN Medicare Advantage |
$137.68
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$198.26
|
| Rate for Payer: Cofinity Commercial |
$184.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.68
|
| Rate for Payer: Healthscope Commercial |
$254.71
|
| Rate for Payer: Healthscope Commercial |
$220.29
|
| Rate for Payer: Mclaren Medicaid |
$92.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.56
|
| Rate for Payer: Meridian Medicaid |
$97.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,477.00
|
| Rate for Payer: Nomi Health Commercial |
$165.22
|
| Rate for Payer: PACE SWMI |
$137.68
|
| Rate for Payer: PHP Medicare Advantage |
$137.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.76
|
| Rate for Payer: Priority Health Medicare |
$137.68
|
| Rate for Payer: Priority Health Narrow Network |
$199.76
|
| Rate for Payer: Priority Health SBD |
$199.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.68
|
| Rate for Payer: UHC Exchange |
$181.53
|
| Rate for Payer: UHC Medicare Advantage |
$137.68
|
| Rate for Payer: UHCCP Medicaid |
$92.44
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 31526
|
| Min. Negotiated Rate |
$100.75 |
| Max. Negotiated Rate |
$27,662.00 |
| Rate for Payer: Aetna Commercial |
$201.12
|
| Rate for Payer: Aetna Medicare |
$156.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.13
|
| Rate for Payer: BCBS Complete |
$105.79
|
| Rate for Payer: BCBS MAPPO |
$150.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.54
|
| Rate for Payer: BCN Commercial |
$227.73
|
| Rate for Payer: BCN Medicare Advantage |
$150.09
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$216.13
|
| Rate for Payer: Cofinity Commercial |
$201.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.09
|
| Rate for Payer: Healthscope Commercial |
$277.67
|
| Rate for Payer: Healthscope Commercial |
$240.14
|
| Rate for Payer: Mclaren Medicaid |
$100.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.59
|
| Rate for Payer: Meridian Medicaid |
$105.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,662.00
|
| Rate for Payer: Nomi Health Commercial |
$180.11
|
| Rate for Payer: PACE SWMI |
$150.09
|
| Rate for Payer: PHP Medicare Advantage |
$150.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.37
|
| Rate for Payer: Priority Health Medicare |
$150.09
|
| Rate for Payer: Priority Health Narrow Network |
$217.37
|
| Rate for Payer: Priority Health SBD |
$217.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.09
|
| Rate for Payer: UHC Exchange |
$205.14
|
| Rate for Payer: UHC Medicare Advantage |
$150.09
|
| Rate for Payer: UHCCP Medicaid |
$100.75
|
|
|
PR LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY
|
Professional
|
Both
|
$2,271.00
|
|
|
Service Code
|
HCPCS 31300
|
| Min. Negotiated Rate |
$800.24 |
| Max. Negotiated Rate |
$220,302.00 |
| Rate for Payer: Aetna Commercial |
$1,571.12
|
| Rate for Payer: Aetna Medicare |
$1,219.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,688.37
|
| Rate for Payer: BCBS Complete |
$840.25
|
| Rate for Payer: BCBS MAPPO |
$1,172.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,537.35
|
| Rate for Payer: BCN Commercial |
$1,841.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,172.48
|
| Rate for Payer: Cash Price |
$1,816.80
|
| Rate for Payer: Cash Price |
$1,816.80
|
| Rate for Payer: Cofinity Commercial |
$1,688.37
|
| Rate for Payer: Cofinity Commercial |
$1,571.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,172.48
|
| Rate for Payer: Healthscope Commercial |
$2,169.09
|
| Rate for Payer: Healthscope Commercial |
$1,875.97
|
| Rate for Payer: Mclaren Medicaid |
$800.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,231.10
|
| Rate for Payer: Meridian Medicaid |
$840.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220,302.00
|
| Rate for Payer: Nomi Health Commercial |
$1,406.98
|
| Rate for Payer: PACE SWMI |
$1,172.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,172.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$800.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,476.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,743.57
|
| Rate for Payer: Priority Health Medicare |
$1,172.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,743.57
|
| Rate for Payer: Priority Health SBD |
$1,743.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,318.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,172.48
|
| Rate for Payer: UHC Exchange |
$1,318.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,172.48
|
| Rate for Payer: UHCCP Medicaid |
$800.24
|
|
|
PR LASER CO2 - FULL FACE
|
Professional
|
Both
|
$2,805.00
|
|
|
Service Code
|
HCPCS 00263
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,122.00 |
| Max. Negotiated Rate |
$1,823.25 |
| Rate for Payer: Aetna Medicare |
$1,402.50
|
| Rate for Payer: BCBS Complete |
$1,122.00
|
| Rate for Payer: Cash Price |
$2,244.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,823.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,823.25
|
|
|
PR LASER CO2 - ONE AREA
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 00181
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$1,160.25 |
| Rate for Payer: Aetna Medicare |
$892.50
|
| Rate for Payer: BCBS Complete |
$714.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,160.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
|
|
PR LASER CO2 - TWO AREAS
|
Professional
|
Both
|
$2,295.00
|
|
|
Service Code
|
HCPCS 00182
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$1,491.75 |
| Rate for Payer: Aetna Medicare |
$1,147.50
|
| Rate for Payer: BCBS Complete |
$918.00
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,491.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.75
|
|
|
PR LASER ENUCLEATION PROSTATE W/MORCELLATION
|
Professional
|
Both
|
$1,709.00
|
|
|
Service Code
|
HCPCS 52649
|
| Min. Negotiated Rate |
$528.03 |
| Max. Negotiated Rate |
$144,954.00 |
| Rate for Payer: Aetna Commercial |
$1,055.14
|
| Rate for Payer: Aetna Medicare |
$818.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.88
|
| Rate for Payer: BCBS Complete |
$554.43
|
| Rate for Payer: BCBS MAPPO |
$787.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.05
|
| Rate for Payer: BCN Commercial |
$1,189.93
|
| Rate for Payer: BCN Medicare Advantage |
$787.42
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cofinity Commercial |
$1,133.88
|
| Rate for Payer: Cofinity Commercial |
$1,055.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.42
|
| Rate for Payer: Healthscope Commercial |
$1,456.73
|
| Rate for Payer: Healthscope Commercial |
$1,259.87
|
| Rate for Payer: Mclaren Medicaid |
$528.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.79
|
| Rate for Payer: Meridian Medicaid |
$554.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144,954.00
|
| Rate for Payer: Nomi Health Commercial |
$944.90
|
| Rate for Payer: PACE SWMI |
$787.42
|
| Rate for Payer: PHP Medicare Advantage |
$787.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,312.32
|
| Rate for Payer: Priority Health Medicare |
$787.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,312.32
|
| Rate for Payer: Priority Health SBD |
$1,312.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.42
|
| Rate for Payer: UHC Medicare Advantage |
$787.42
|
| Rate for Payer: UHCCP Medicaid |
$528.03
|
|
|
PR LASER VAPORIZATION OF PROSTATE FOR URINE FLOW
|
Professional
|
Both
|
$3,308.00
|
|
|
Service Code
|
HCPCS 52648
|
| Min. Negotiated Rate |
$444.32 |
| Max. Negotiated Rate |
$121,637.00 |
| Rate for Payer: Aetna Commercial |
$887.25
|
| Rate for Payer: Aetna Medicare |
$688.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$953.47
|
| Rate for Payer: BCBS Complete |
$466.54
|
| Rate for Payer: BCBS MAPPO |
$662.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,272.67
|
| Rate for Payer: BCN Commercial |
$2,363.74
|
| Rate for Payer: BCN Medicare Advantage |
$662.13
|
| Rate for Payer: Cash Price |
$2,646.40
|
| Rate for Payer: Cash Price |
$2,646.40
|
| Rate for Payer: Cofinity Commercial |
$953.47
|
| Rate for Payer: Cofinity Commercial |
$887.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$662.13
|
| Rate for Payer: Healthscope Commercial |
$1,224.94
|
| Rate for Payer: Healthscope Commercial |
$1,059.41
|
| Rate for Payer: Mclaren Medicaid |
$444.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$695.24
|
| Rate for Payer: Meridian Medicaid |
$466.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121,637.00
|
| Rate for Payer: Nomi Health Commercial |
$794.56
|
| Rate for Payer: PACE SWMI |
$662.13
|
| Rate for Payer: PHP Medicare Advantage |
$662.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,150.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.55
|
| Rate for Payer: Priority Health Medicare |
$662.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,103.55
|
| Rate for Payer: Priority Health SBD |
$1,103.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$662.13
|
| Rate for Payer: UHC Exchange |
$798.46
|
| Rate for Payer: UHC Medicare Advantage |
$662.13
|
| Rate for Payer: UHCCP Medicaid |
$444.32
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Professional
|
Both
|
$1,697.00
|
|
|
Service Code
|
HCPCS 27425
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$80,566.00 |
| Rate for Payer: Aetna Commercial |
$589.65
|
| Rate for Payer: Aetna Medicare |
$457.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.66
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$440.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.75
|
| Rate for Payer: BCN Commercial |
$741.46
|
| Rate for Payer: BCN Medicare Advantage |
$440.04
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cofinity Commercial |
$633.66
|
| Rate for Payer: Cofinity Commercial |
$589.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.04
|
| Rate for Payer: Healthscope Commercial |
$814.07
|
| Rate for Payer: Healthscope Commercial |
$704.06
|
| Rate for Payer: Mclaren Medicaid |
$300.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.04
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,566.00
|
| Rate for Payer: Nomi Health Commercial |
$528.05
|
| Rate for Payer: PACE SWMI |
$440.04
|
| Rate for Payer: PHP Medicare Advantage |
$440.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$710.36
|
| Rate for Payer: Priority Health Medicare |
$440.04
|
| Rate for Payer: Priority Health Narrow Network |
$710.36
|
| Rate for Payer: Priority Health SBD |
$710.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.04
|
| Rate for Payer: UHC Exchange |
$916.08
|
| Rate for Payer: UHC Medicare Advantage |
$440.04
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Facility
|
OP
|
$1,697.00
|
|
|
Service Code
|
CPT 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$485.83 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$1,442.45
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.09
|
| Rate for Payer: BCN Commercial |
$1,271.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cofinity Commercial |
$1,459.42
|
| Rate for Payer: Cofinity Commercial |
$1,187.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,187.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,357.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,527.30
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,442.45
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,442.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$1,069.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.83
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Professional
|
Both
|
$1,697.00
|
|
|
Service Code
|
HCPCS 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$80,566.00 |
| Rate for Payer: Aetna Commercial |
$589.65
|
| Rate for Payer: Aetna Medicare |
$457.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.66
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$440.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.75
|
| Rate for Payer: BCN Commercial |
$741.46
|
| Rate for Payer: BCN Medicare Advantage |
$440.04
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cofinity Commercial |
$633.66
|
| Rate for Payer: Cofinity Commercial |
$589.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.04
|
| Rate for Payer: Healthscope Commercial |
$814.07
|
| Rate for Payer: Healthscope Commercial |
$704.06
|
| Rate for Payer: Mclaren Medicaid |
$300.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.04
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,566.00
|
| Rate for Payer: Nomi Health Commercial |
$528.05
|
| Rate for Payer: PACE SWMI |
$440.04
|
| Rate for Payer: PHP Medicare Advantage |
$440.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$710.36
|
| Rate for Payer: Priority Health Medicare |
$440.04
|
| Rate for Payer: Priority Health Narrow Network |
$710.36
|
| Rate for Payer: Priority Health SBD |
$710.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.04
|
| Rate for Payer: UHC Exchange |
$916.08
|
| Rate for Payer: UHC Medicare Advantage |
$440.04
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Facility
|
IP
|
$1,697.00
|
|
|
Service Code
|
CPT 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$1,069.11 |
| Max. Negotiated Rate |
$1,527.30 |
| Rate for Payer: Aetna Commercial |
$1,442.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.05
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cofinity Commercial |
$1,187.90
|
| Rate for Payer: Cofinity Commercial |
$1,459.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,187.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,357.60
|
| Rate for Payer: Healthscope Commercial |
$1,527.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,442.45
|
| Rate for Payer: PHP Commercial |
$1,442.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.05
|
| Rate for Payer: Priority Health SBD |
$1,069.11
|
|
|
PR LATISSE
|
Professional
|
Both
|
$183.00
|
|
|
Service Code
|
HCPCS 00267
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$73.20 |
| Max. Negotiated Rate |
$118.95 |
| Rate for Payer: Aetna Medicare |
$91.50
|
| Rate for Payer: BCBS Complete |
$73.20
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.95
|
|
|
PR LAVAGE CANNULATION MAXILLARY SINUS
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 31000
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$19,282.00 |
| Rate for Payer: Aetna Commercial |
$139.12
|
| Rate for Payer: Aetna Medicare |
$107.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.50
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$103.82
|
| Rate for Payer: BCBS Trust/PPO |
$694.71
|
| Rate for Payer: BCN Commercial |
$274.15
|
| Rate for Payer: BCN Medicare Advantage |
$103.82
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$149.50
|
| Rate for Payer: Cofinity Commercial |
$139.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.82
|
| Rate for Payer: Healthscope Commercial |
$192.07
|
| Rate for Payer: Healthscope Commercial |
$166.11
|
| Rate for Payer: Mclaren Medicaid |
$71.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.01
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,282.00
|
| Rate for Payer: Nomi Health Commercial |
$124.58
|
| Rate for Payer: PACE SWMI |
$103.82
|
| Rate for Payer: PHP Medicare Advantage |
$103.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.26
|
| Rate for Payer: Priority Health Medicare |
$103.82
|
| Rate for Payer: Priority Health Narrow Network |
$155.26
|
| Rate for Payer: Priority Health SBD |
$155.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.82
|
| Rate for Payer: UHC Exchange |
$164.64
|
| Rate for Payer: UHC Medicare Advantage |
$103.82
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
|
|
PR LAVAGE CANNULATION SPHENOID SINUS
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 31002
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$33,404.00 |
| Rate for Payer: Aetna Commercial |
$231.35
|
| Rate for Payer: Aetna Medicare |
$179.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.62
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$172.65
|
| Rate for Payer: BCBS Trust/PPO |
$689.96
|
| Rate for Payer: BCN Commercial |
$282.46
|
| Rate for Payer: BCN Medicare Advantage |
$172.65
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$248.62
|
| Rate for Payer: Cofinity Commercial |
$231.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.65
|
| Rate for Payer: Healthscope Commercial |
$319.40
|
| Rate for Payer: Healthscope Commercial |
$276.24
|
| Rate for Payer: Mclaren Medicaid |
$119.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.28
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,404.00
|
| Rate for Payer: Nomi Health Commercial |
$207.18
|
| Rate for Payer: PACE SWMI |
$172.65
|
| Rate for Payer: PHP Medicare Advantage |
$172.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.64
|
| Rate for Payer: Priority Health Medicare |
$172.65
|
| Rate for Payer: Priority Health Narrow Network |
$264.64
|
| Rate for Payer: Priority Health SBD |
$264.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.65
|
| Rate for Payer: UHC Exchange |
$212.53
|
| Rate for Payer: UHC Medicare Advantage |
$172.65
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
|
|
PR LEFT HEART CATH BY TRANSEPTAL PUNCTURE
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 93462
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$30,669.00 |
| Rate for Payer: Aetna Commercial |
$263.11
|
| Rate for Payer: Aetna Medicare |
$204.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.74
|
| Rate for Payer: BCBS Complete |
$135.53
|
| Rate for Payer: BCBS MAPPO |
$196.35
|
| Rate for Payer: BCBS Trust/PPO |
$548.90
|
| Rate for Payer: BCN Commercial |
$298.58
|
| Rate for Payer: BCN Medicare Advantage |
$196.35
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cofinity Commercial |
$282.74
|
| Rate for Payer: Cofinity Commercial |
$263.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.35
|
| Rate for Payer: Healthscope Commercial |
$314.16
|
| Rate for Payer: Healthscope Commercial |
$363.25
|
| Rate for Payer: Mclaren Medicaid |
$129.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.17
|
| Rate for Payer: Meridian Medicaid |
$135.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,669.00
|
| Rate for Payer: Nomi Health Commercial |
$235.62
|
| Rate for Payer: PACE SWMI |
$196.35
|
| Rate for Payer: PHP Medicare Advantage |
$196.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$285.32
|
| Rate for Payer: Priority Health Medicare |
$196.35
|
| Rate for Payer: Priority Health Narrow Network |
$285.32
|
| Rate for Payer: Priority Health SBD |
$285.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.35
|
| Rate for Payer: UHC Medicare Advantage |
$196.35
|
| Rate for Payer: UHCCP Medicaid |
$129.08
|
|
|
PR LENGTHENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,348.00
|
|
|
Service Code
|
HCPCS 26476
|
| Min. Negotiated Rate |
$415.14 |
| Max. Negotiated Rate |
$113,128.00 |
| Rate for Payer: Aetna Commercial |
$802.73
|
| Rate for Payer: Aetna Medicare |
$623.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.63
|
| Rate for Payer: BCBS Complete |
$435.90
|
| Rate for Payer: BCBS MAPPO |
$599.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,727.54
|
| Rate for Payer: BCN Commercial |
$959.76
|
| Rate for Payer: BCN Medicare Advantage |
$599.05
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cash Price |
$1,078.40
|
| Rate for Payer: Cofinity Commercial |
$862.63
|
| Rate for Payer: Cofinity Commercial |
$802.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.05
|
| Rate for Payer: Healthscope Commercial |
$958.48
|
| Rate for Payer: Healthscope Commercial |
$1,108.24
|
| Rate for Payer: Mclaren Medicaid |
$415.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.00
|
| Rate for Payer: Meridian Medicaid |
$435.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113,128.00
|
| Rate for Payer: Nomi Health Commercial |
$718.86
|
| Rate for Payer: PACE SWMI |
$599.05
|
| Rate for Payer: PHP Medicare Advantage |
$599.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$415.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$998.89
|
| Rate for Payer: Priority Health Medicare |
$599.05
|
| Rate for Payer: Priority Health Narrow Network |
$998.89
|
| Rate for Payer: Priority Health SBD |
$998.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$744.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.05
|
| Rate for Payer: UHC Exchange |
$744.10
|
| Rate for Payer: UHC Medicare Advantage |
$599.05
|
| Rate for Payer: UHCCP Medicaid |
$415.14
|
|
|
PR LENGTHENING TENDON FLEXOR HAND/FINGER EACH
|
Professional
|
Both
|
$2,040.00
|
|
|
Service Code
|
HCPCS 26478
|
| Min. Negotiated Rate |
$425.79 |
| Max. Negotiated Rate |
$116,838.00 |
| Rate for Payer: Aetna Commercial |
$824.86
|
| Rate for Payer: Aetna Medicare |
$640.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.42
|
| Rate for Payer: BCBS Complete |
$447.08
|
| Rate for Payer: BCBS MAPPO |
$615.57
|
| Rate for Payer: BCBS Trust/PPO |
$878.03
|
| Rate for Payer: BCN Commercial |
$989.08
|
| Rate for Payer: BCN Medicare Advantage |
$615.57
|
| Rate for Payer: Cash Price |
$1,632.00
|
| Rate for Payer: Cash Price |
$1,632.00
|
| Rate for Payer: Cofinity Commercial |
$886.42
|
| Rate for Payer: Cofinity Commercial |
$824.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.57
|
| Rate for Payer: Healthscope Commercial |
$984.91
|
| Rate for Payer: Healthscope Commercial |
$1,138.80
|
| Rate for Payer: Mclaren Medicaid |
$425.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.35
|
| Rate for Payer: Meridian Medicaid |
$447.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116,838.00
|
| Rate for Payer: Nomi Health Commercial |
$738.68
|
| Rate for Payer: PACE SWMI |
$615.57
|
| Rate for Payer: PHP Medicare Advantage |
$615.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$425.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.25
|
| Rate for Payer: Priority Health Medicare |
$615.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.25
|
| Rate for Payer: Priority Health SBD |
$1,019.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.57
|
| Rate for Payer: UHC Exchange |
$808.47
|
| Rate for Payer: UHC Medicare Advantage |
$615.57
|
| Rate for Payer: UHCCP Medicaid |
$425.79
|
|
|
PR LESION <15
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 00074
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
|
|
PR LESION FL FACE/NECK
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00075
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
|
|
PR LESION REMOVAL COLONOSCOPY
|
Professional
|
Both
|
$1,584.00
|
|
|
Service Code
|
HCPCS G6024
|
| Min. Negotiated Rate |
$633.60 |
| Max. Negotiated Rate |
$1,029.60 |
| Rate for Payer: Aetna Medicare |
$792.00
|
| Rate for Payer: BCBS Complete |
$633.60
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.60
|
|
