|
PR LYSIS OF ADHESIONS SALPINX/OVARY
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 58740
|
| Min. Negotiated Rate |
$207.09 |
| Max. Negotiated Rate |
$161,255.00 |
| Rate for Payer: Aetna Commercial |
$1,167.03
|
| Rate for Payer: Aetna Medicare |
$905.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,254.12
|
| Rate for Payer: BCBS Complete |
$610.56
|
| Rate for Payer: BCBS MAPPO |
$870.92
|
| Rate for Payer: BCBS Trust/PPO |
$207.09
|
| Rate for Payer: BCN Commercial |
$1,323.34
|
| Rate for Payer: BCN Medicare Advantage |
$870.92
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$1,254.12
|
| Rate for Payer: Cofinity Commercial |
$1,167.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.92
|
| Rate for Payer: Healthscope Commercial |
$1,611.20
|
| Rate for Payer: Healthscope Commercial |
$1,393.47
|
| Rate for Payer: Mclaren Medicaid |
$581.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.47
|
| Rate for Payer: Meridian Medicaid |
$610.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161,255.00
|
| Rate for Payer: Nomi Health Commercial |
$1,045.10
|
| Rate for Payer: PACE SWMI |
$870.92
|
| Rate for Payer: PHP Medicare Advantage |
$870.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,349.25
|
| Rate for Payer: Priority Health Medicare |
$870.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,349.25
|
| Rate for Payer: Priority Health SBD |
$1,349.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,064.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$870.92
|
| Rate for Payer: UHC Exchange |
$1,064.80
|
| Rate for Payer: UHC Medicare Advantage |
$870.92
|
| Rate for Payer: UHCCP Medicaid |
$581.49
|
|
|
PR MA/EC CONTRACEPTIVEINJECTION
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS J1056
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
|
|
PR MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC
|
Professional
|
Both
|
$3,348.00
|
|
|
Service Code
|
HCPCS 32820
|
| Min. Negotiated Rate |
$878.56 |
| Max. Negotiated Rate |
$235,957.00 |
| Rate for Payer: Aetna Commercial |
$1,792.56
|
| Rate for Payer: Aetna Medicare |
$1,391.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,792.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,926.33
|
| Rate for Payer: BCBS Complete |
$931.51
|
| Rate for Payer: BCBS MAPPO |
$1,337.73
|
| Rate for Payer: BCBS Trust/PPO |
$878.56
|
| Rate for Payer: BCN Commercial |
$1,919.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,337.73
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Cofinity Commercial |
$1,926.33
|
| Rate for Payer: Cofinity Commercial |
$1,792.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,337.73
|
| Rate for Payer: Healthscope Commercial |
$2,474.80
|
| Rate for Payer: Healthscope Commercial |
$2,140.37
|
| Rate for Payer: Mclaren Medicaid |
$887.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,404.62
|
| Rate for Payer: Meridian Medicaid |
$931.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235,957.00
|
| Rate for Payer: Nomi Health Commercial |
$1,605.28
|
| Rate for Payer: PACE SWMI |
$1,337.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,337.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$887.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,831.62
|
| Rate for Payer: Priority Health Medicare |
$1,337.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,831.62
|
| Rate for Payer: Priority Health SBD |
$1,831.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,337.73
|
| Rate for Payer: UHC Exchange |
$1,824.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,337.73
|
| Rate for Payer: UHCCP Medicaid |
$887.15
|
|
|
PR MAKENA, 10 MG
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS J1726
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2,062.00 |
| Rate for Payer: Aetna Commercial |
$19.41
|
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.41
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: BCBS Trust/PPO |
$6.80
|
| Rate for Payer: BCN Commercial |
$6.80
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,062.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.45
|
| Rate for Payer: UHC Exchange |
$21.45
|
|
|
PR MAMMAPLASTY AUGMENTATION - GEL
|
Professional
|
Both
|
$4,937.00
|
|
|
Service Code
|
HCPCS 00261
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,974.80 |
| Max. Negotiated Rate |
$3,209.05 |
| Rate for Payer: Aetna Medicare |
$2,468.50
|
| Rate for Payer: BCBS Complete |
$1,974.80
|
| Rate for Payer: Cash Price |
$3,949.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,209.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,209.05
|
|
|
PR MAMMAPLASTY AUGMENTATION - SALINE
|
Professional
|
Both
|
$3,774.00
|
|
|
Service Code
|
HCPCS 00262
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,509.60 |
| Max. Negotiated Rate |
$2,453.10 |
| Rate for Payer: Aetna Medicare |
$1,887.00
|
| Rate for Payer: BCBS Complete |
$1,509.60
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,453.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,453.10
|
|
|
PR MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 26341
|
| Min. Negotiated Rate |
$50.91 |
| Max. Negotiated Rate |
$13,790.00 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$77.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.70
|
| Rate for Payer: BCBS Complete |
$53.46
|
| Rate for Payer: BCBS MAPPO |
$74.40
|
| Rate for Payer: BCBS Trust/PPO |
$354.49
|
| Rate for Payer: BCN Commercial |
$173.48
|
| Rate for Payer: BCN Medicare Advantage |
$74.40
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$99.70
|
| Rate for Payer: Cofinity Commercial |
$107.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.40
|
| Rate for Payer: Healthscope Commercial |
$137.64
|
| Rate for Payer: Healthscope Commercial |
$119.04
|
| Rate for Payer: Mclaren Medicaid |
$50.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.12
|
| Rate for Payer: Meridian Medicaid |
$53.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,790.00
|
| Rate for Payer: Nomi Health Commercial |
$89.28
|
| Rate for Payer: PACE SWMI |
$74.40
|
| Rate for Payer: PHP Medicare Advantage |
$74.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.10
|
| Rate for Payer: Priority Health Medicare |
$74.40
|
| Rate for Payer: Priority Health Narrow Network |
$121.10
|
| Rate for Payer: Priority Health SBD |
$121.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.40
|
| Rate for Payer: UHC Medicare Advantage |
$74.40
|
| Rate for Payer: UHCCP Medicaid |
$50.91
|
|
|
PR MANIPULATION ANKLE UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$630.00
|
|
|
Service Code
|
HCPCS 27860
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$29,034.00 |
| Rate for Payer: Aetna Commercial |
$210.90
|
| Rate for Payer: Aetna Medicare |
$163.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.64
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS MAPPO |
$157.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,252.07
|
| Rate for Payer: BCN Commercial |
$240.92
|
| Rate for Payer: BCN Medicare Advantage |
$157.39
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$226.64
|
| Rate for Payer: Cofinity Commercial |
$210.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.39
|
| Rate for Payer: Healthscope Commercial |
$291.17
|
| Rate for Payer: Healthscope Commercial |
$251.82
|
| Rate for Payer: Mclaren Medicaid |
$106.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.26
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,034.00
|
| Rate for Payer: Nomi Health Commercial |
$188.87
|
| Rate for Payer: PACE SWMI |
$157.39
|
| Rate for Payer: PHP Medicare Advantage |
$157.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.88
|
| Rate for Payer: Priority Health Medicare |
$157.39
|
| Rate for Payer: Priority Health Narrow Network |
$251.88
|
| Rate for Payer: Priority Health SBD |
$251.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.39
|
| Rate for Payer: UHC Exchange |
$247.48
|
| Rate for Payer: UHC Medicare Advantage |
$157.39
|
| Rate for Payer: UHCCP Medicaid |
$106.71
|
|
|
PR MANIPULATION ELBOW UNDER ANESTHESIA
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 24300
|
| Min. Negotiated Rate |
$92.45 |
| Max. Negotiated Rate |
$76,732.00 |
| Rate for Payer: Aetna Commercial |
$567.33
|
| Rate for Payer: Aetna Medicare |
$440.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.67
|
| Rate for Payer: BCBS Complete |
$307.74
|
| Rate for Payer: BCBS MAPPO |
$423.38
|
| Rate for Payer: BCBS Trust/PPO |
$92.45
|
| Rate for Payer: BCN Commercial |
$648.96
|
| Rate for Payer: BCN Medicare Advantage |
$423.38
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$609.67
|
| Rate for Payer: Cofinity Commercial |
$567.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.38
|
| Rate for Payer: Healthscope Commercial |
$783.25
|
| Rate for Payer: Healthscope Commercial |
$677.41
|
| Rate for Payer: Mclaren Medicaid |
$293.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.55
|
| Rate for Payer: Meridian Medicaid |
$307.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,732.00
|
| Rate for Payer: Nomi Health Commercial |
$508.06
|
| Rate for Payer: PACE SWMI |
$423.38
|
| Rate for Payer: PHP Medicare Advantage |
$423.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.55
|
| Rate for Payer: Priority Health Medicare |
$423.38
|
| Rate for Payer: Priority Health Narrow Network |
$691.55
|
| Rate for Payer: Priority Health SBD |
$691.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$423.38
|
| Rate for Payer: UHC Exchange |
$402.86
|
| Rate for Payer: UHC Medicare Advantage |
$423.38
|
| Rate for Payer: UHCCP Medicaid |
$293.09
|
|
|
PR MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 26340
|
| Min. Negotiated Rate |
$108.30 |
| Max. Negotiated Rate |
$62,102.00 |
| Rate for Payer: Aetna Commercial |
$460.14
|
| Rate for Payer: Aetna Medicare |
$357.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.48
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$343.39
|
| Rate for Payer: BCBS Trust/PPO |
$108.30
|
| Rate for Payer: BCN Commercial |
$528.26
|
| Rate for Payer: BCN Medicare Advantage |
$343.39
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$494.48
|
| Rate for Payer: Cofinity Commercial |
$460.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.39
|
| Rate for Payer: Healthscope Commercial |
$635.27
|
| Rate for Payer: Healthscope Commercial |
$549.42
|
| Rate for Payer: Mclaren Medicaid |
$239.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.56
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,102.00
|
| Rate for Payer: Nomi Health Commercial |
$412.07
|
| Rate for Payer: PACE SWMI |
$343.39
|
| Rate for Payer: PHP Medicare Advantage |
$343.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$562.30
|
| Rate for Payer: Priority Health Medicare |
$343.39
|
| Rate for Payer: Priority Health Narrow Network |
$562.30
|
| Rate for Payer: Priority Health SBD |
$562.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.39
|
| Rate for Payer: UHC Exchange |
$301.58
|
| Rate for Payer: UHC Medicare Advantage |
$343.39
|
| Rate for Payer: UHCCP Medicaid |
$239.20
|
|
|
PR MANIPULATION HIP JOINT GENERAL ANESTHESIA
|
Professional
|
Both
|
$1,008.00
|
|
|
Service Code
|
HCPCS 27275
|
| Min. Negotiated Rate |
$120.98 |
| Max. Negotiated Rate |
$32,486.00 |
| Rate for Payer: Aetna Commercial |
$238.57
|
| Rate for Payer: Aetna Medicare |
$185.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.38
|
| Rate for Payer: BCBS Complete |
$127.03
|
| Rate for Payer: BCBS MAPPO |
$178.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,431.91
|
| Rate for Payer: BCN Commercial |
$270.73
|
| Rate for Payer: BCN Medicare Advantage |
$178.04
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cofinity Commercial |
$256.38
|
| Rate for Payer: Cofinity Commercial |
$238.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.04
|
| Rate for Payer: Healthscope Commercial |
$329.37
|
| Rate for Payer: Healthscope Commercial |
$284.86
|
| Rate for Payer: Mclaren Medicaid |
$120.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.94
|
| Rate for Payer: Meridian Medicaid |
$127.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,486.00
|
| Rate for Payer: Nomi Health Commercial |
$213.65
|
| Rate for Payer: PACE SWMI |
$178.04
|
| Rate for Payer: PHP Medicare Advantage |
$178.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$655.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$285.47
|
| Rate for Payer: Priority Health Medicare |
$178.04
|
| Rate for Payer: Priority Health Narrow Network |
$285.47
|
| Rate for Payer: Priority Health SBD |
$285.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.04
|
| Rate for Payer: UHC Exchange |
$258.23
|
| Rate for Payer: UHC Medicare Advantage |
$178.04
|
| Rate for Payer: UHCCP Medicaid |
$120.98
|
|
|
PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 27570
|
| Hospital Charge Code |
27570
|
| Min. Negotiated Rate |
$101.60 |
| Max. Negotiated Rate |
$27,063.00 |
| Rate for Payer: Aetna Commercial |
$199.57
|
| Rate for Payer: Aetna Medicare |
$154.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.46
|
| Rate for Payer: BCBS Complete |
$106.68
|
| Rate for Payer: BCBS MAPPO |
$148.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,799.92
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$148.93
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cofinity Commercial |
$214.46
|
| Rate for Payer: Cofinity Commercial |
$199.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.93
|
| Rate for Payer: Healthscope Commercial |
$275.52
|
| Rate for Payer: Healthscope Commercial |
$238.29
|
| Rate for Payer: Mclaren Medicaid |
$101.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.38
|
| Rate for Payer: Meridian Medicaid |
$106.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,063.00
|
| Rate for Payer: Nomi Health Commercial |
$178.72
|
| Rate for Payer: PACE SWMI |
$148.93
|
| Rate for Payer: PHP Medicare Advantage |
$148.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.16
|
| Rate for Payer: Priority Health Medicare |
$148.93
|
| Rate for Payer: Priority Health Narrow Network |
$239.16
|
| Rate for Payer: Priority Health SBD |
$239.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.93
|
| Rate for Payer: UHC Exchange |
$247.69
|
| Rate for Payer: UHC Medicare Advantage |
$148.93
|
| Rate for Payer: UHCCP Medicaid |
$101.60
|
|
|
PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA
|
Facility
|
IP
|
$669.00
|
|
|
Service Code
|
CPT 27570
|
| Hospital Charge Code |
27570
|
| Min. Negotiated Rate |
$421.47 |
| Max. Negotiated Rate |
$602.10 |
| Rate for Payer: Aetna Commercial |
$568.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.85
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cofinity Commercial |
$468.30
|
| Rate for Payer: Cofinity Commercial |
$575.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$468.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$535.20
|
| Rate for Payer: Healthscope Commercial |
$602.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$568.65
|
| Rate for Payer: PHP Commercial |
$568.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health SBD |
$421.47
|
|
|
PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA
|
Facility
|
OP
|
$669.00
|
|
|
Service Code
|
CPT 27570
|
| Hospital Charge Code |
27570
|
| Min. Negotiated Rate |
$163.45 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna Commercial |
$568.65
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,025.82
|
| Rate for Payer: BCN Commercial |
$1,025.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cofinity Commercial |
$575.34
|
| Rate for Payer: Cofinity Commercial |
$468.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$468.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$535.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$602.10
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$568.65
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$568.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$421.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.45
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$882.81
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 27570
|
| Min. Negotiated Rate |
$101.60 |
| Max. Negotiated Rate |
$27,063.00 |
| Rate for Payer: Aetna Commercial |
$199.57
|
| Rate for Payer: Aetna Medicare |
$154.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.46
|
| Rate for Payer: BCBS Complete |
$106.68
|
| Rate for Payer: BCBS MAPPO |
$148.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,799.92
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$148.93
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cofinity Commercial |
$214.46
|
| Rate for Payer: Cofinity Commercial |
$199.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.93
|
| Rate for Payer: Healthscope Commercial |
$275.52
|
| Rate for Payer: Healthscope Commercial |
$238.29
|
| Rate for Payer: Mclaren Medicaid |
$101.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.38
|
| Rate for Payer: Meridian Medicaid |
$106.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,063.00
|
| Rate for Payer: Nomi Health Commercial |
$178.72
|
| Rate for Payer: PACE SWMI |
$148.93
|
| Rate for Payer: PHP Medicare Advantage |
$148.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.16
|
| Rate for Payer: Priority Health Medicare |
$148.93
|
| Rate for Payer: Priority Health Narrow Network |
$239.16
|
| Rate for Payer: Priority Health SBD |
$239.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.93
|
| Rate for Payer: UHC Exchange |
$247.69
|
| Rate for Payer: UHC Medicare Advantage |
$148.93
|
| Rate for Payer: UHCCP Medicaid |
$101.60
|
|
|
PR MANIPULATION SPINE REQUIRING ANESTHESIA
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS 22505
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$23,004.00 |
| Rate for Payer: Aetna Commercial |
$196.81
|
| Rate for Payer: Aetna Medicare |
$152.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.49
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$146.87
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$209.31
|
| Rate for Payer: BCN Medicare Advantage |
$146.87
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cofinity Commercial |
$211.49
|
| Rate for Payer: Cofinity Commercial |
$196.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.87
|
| Rate for Payer: Healthscope Commercial |
$271.71
|
| Rate for Payer: Healthscope Commercial |
$234.99
|
| Rate for Payer: Mclaren Medicaid |
$97.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.21
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,004.00
|
| Rate for Payer: Nomi Health Commercial |
$176.24
|
| Rate for Payer: PACE SWMI |
$146.87
|
| Rate for Payer: PHP Medicare Advantage |
$146.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.98
|
| Rate for Payer: Priority Health Medicare |
$146.87
|
| Rate for Payer: Priority Health Narrow Network |
$199.98
|
| Rate for Payer: Priority Health SBD |
$199.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.87
|
| Rate for Payer: UHC Exchange |
$257.93
|
| Rate for Payer: UHC Medicare Advantage |
$146.87
|
| Rate for Payer: UHCCP Medicaid |
$97.55
|
|
|
PR MANIPULATION WRIST UNDER ANESTHESIA
|
Professional
|
Both
|
$686.00
|
|
|
Service Code
|
HCPCS 25259
|
| Min. Negotiated Rate |
$278.60 |
| Max. Negotiated Rate |
$76,075.00 |
| Rate for Payer: Aetna Commercial |
$539.68
|
| Rate for Payer: Aetna Medicare |
$418.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.96
|
| Rate for Payer: BCBS Complete |
$292.53
|
| Rate for Payer: BCBS MAPPO |
$402.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.45
|
| Rate for Payer: BCN Commercial |
$643.10
|
| Rate for Payer: BCN Medicare Advantage |
$402.75
|
| Rate for Payer: Cash Price |
$548.80
|
| Rate for Payer: Cash Price |
$548.80
|
| Rate for Payer: Cofinity Commercial |
$579.96
|
| Rate for Payer: Cofinity Commercial |
$539.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.75
|
| Rate for Payer: Healthscope Commercial |
$745.09
|
| Rate for Payer: Healthscope Commercial |
$644.40
|
| Rate for Payer: Mclaren Medicaid |
$278.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.89
|
| Rate for Payer: Meridian Medicaid |
$292.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,075.00
|
| Rate for Payer: Nomi Health Commercial |
$483.30
|
| Rate for Payer: PACE SWMI |
$402.75
|
| Rate for Payer: PHP Medicare Advantage |
$402.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.84
|
| Rate for Payer: Priority Health Medicare |
$402.75
|
| Rate for Payer: Priority Health Narrow Network |
$679.84
|
| Rate for Payer: Priority Health SBD |
$679.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.75
|
| Rate for Payer: UHC Exchange |
$398.56
|
| Rate for Payer: UHC Medicare Advantage |
$402.75
|
| Rate for Payer: UHCCP Medicaid |
$278.60
|
|
|
PR MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 20700
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$15,034.00 |
| Rate for Payer: Aetna Commercial |
$108.08
|
| Rate for Payer: Aetna Medicare |
$83.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$80.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.86
|
| Rate for Payer: BCN Commercial |
$122.66
|
| Rate for Payer: BCN Medicare Advantage |
$80.66
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$116.15
|
| Rate for Payer: Cofinity Commercial |
$108.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$129.06
|
| Rate for Payer: Healthscope Commercial |
$149.22
|
| Rate for Payer: Mclaren Medicaid |
$53.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.69
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,034.00
|
| Rate for Payer: Nomi Health Commercial |
$96.79
|
| Rate for Payer: PACE SWMI |
$80.66
|
| Rate for Payer: PHP Medicare Advantage |
$80.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.23
|
| Rate for Payer: Priority Health Medicare |
$80.66
|
| Rate for Payer: Priority Health Narrow Network |
$128.23
|
| Rate for Payer: Priority Health SBD |
$128.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.66
|
| Rate for Payer: UHC Medicare Advantage |
$80.66
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
PR MANUAL PREP&INSJ INTRAMEDULLARY DRUG DLVR DEVICE
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 20702
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$25,357.00 |
| Rate for Payer: Aetna Commercial |
$184.33
|
| Rate for Payer: Aetna Medicare |
$143.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.09
|
| Rate for Payer: BCBS Complete |
$95.72
|
| Rate for Payer: BCBS MAPPO |
$137.56
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$206.71
|
| Rate for Payer: BCN Medicare Advantage |
$137.56
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$198.09
|
| Rate for Payer: Cofinity Commercial |
$184.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.56
|
| Rate for Payer: Healthscope Commercial |
$220.10
|
| Rate for Payer: Healthscope Commercial |
$254.49
|
| Rate for Payer: Mclaren Medicaid |
$91.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.44
|
| Rate for Payer: Meridian Medicaid |
$95.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,357.00
|
| Rate for Payer: Nomi Health Commercial |
$165.07
|
| Rate for Payer: PACE SWMI |
$137.56
|
| Rate for Payer: PHP Medicare Advantage |
$137.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.76
|
| Rate for Payer: Priority Health Medicare |
$137.56
|
| Rate for Payer: Priority Health Narrow Network |
$215.76
|
| Rate for Payer: Priority Health SBD |
$215.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.56
|
| Rate for Payer: UHC Medicare Advantage |
$137.56
|
| Rate for Payer: UHCCP Medicaid |
$91.16
|
|
|
PR MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 97140
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$3,954.00 |
| Rate for Payer: Aetna Commercial |
$34.95
|
| Rate for Payer: Aetna Medicare |
$27.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.56
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$26.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,604.98
|
| Rate for Payer: BCN Commercial |
$26.43
|
| Rate for Payer: BCN Medicare Advantage |
$26.08
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$37.56
|
| Rate for Payer: Cofinity Commercial |
$34.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.08
|
| Rate for Payer: Healthscope Commercial |
$41.73
|
| Rate for Payer: Healthscope Commercial |
$48.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,954.00
|
| Rate for Payer: Nomi Health Commercial |
$31.30
|
| Rate for Payer: PACE SWMI |
$26.08
|
| Rate for Payer: PHP Medicare Advantage |
$26.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$26.08
|
| Rate for Payer: Priority Health Narrow Network |
$77.25
|
| Rate for Payer: Priority Health SBD |
$77.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.08
|
| Rate for Payer: UHC Exchange |
$28.10
|
| Rate for Payer: UHC Medicare Advantage |
$26.08
|
|
|
PR MARSUPIALIZATION BARTHOLINS GLAND CYST
|
Professional
|
Both
|
$785.00
|
|
|
Service Code
|
HCPCS 56440
|
| Min. Negotiated Rate |
$117.15 |
| Max. Negotiated Rate |
$32,215.00 |
| Rate for Payer: Aetna Commercial |
$234.00
|
| Rate for Payer: Aetna Medicare |
$181.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.47
|
| Rate for Payer: BCBS Complete |
$123.01
|
| Rate for Payer: BCBS MAPPO |
$174.63
|
| Rate for Payer: BCBS Trust/PPO |
$226.64
|
| Rate for Payer: BCN Commercial |
$265.35
|
| Rate for Payer: BCN Medicare Advantage |
$174.63
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Cofinity Commercial |
$251.47
|
| Rate for Payer: Cofinity Commercial |
$234.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.63
|
| Rate for Payer: Healthscope Commercial |
$323.07
|
| Rate for Payer: Healthscope Commercial |
$279.41
|
| Rate for Payer: Mclaren Medicaid |
$117.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.36
|
| Rate for Payer: Meridian Medicaid |
$123.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,215.00
|
| Rate for Payer: Nomi Health Commercial |
$209.56
|
| Rate for Payer: PACE SWMI |
$174.63
|
| Rate for Payer: PHP Medicare Advantage |
$174.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$272.33
|
| Rate for Payer: Priority Health Medicare |
$174.63
|
| Rate for Payer: Priority Health Narrow Network |
$272.33
|
| Rate for Payer: Priority Health SBD |
$272.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.63
|
| Rate for Payer: UHC Exchange |
$311.19
|
| Rate for Payer: UHC Medicare Advantage |
$174.63
|
| Rate for Payer: UHCCP Medicaid |
$117.15
|
|
|
PR MARSUPIALIZATION CST/ABSC LVR
|
Professional
|
Both
|
$2,342.00
|
|
|
Service Code
|
HCPCS 47300
|
| Min. Negotiated Rate |
$729.31 |
| Max. Negotiated Rate |
$203,162.00 |
| Rate for Payer: Aetna Commercial |
$1,473.10
|
| Rate for Payer: Aetna Medicare |
$1,143.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,583.04
|
| Rate for Payer: BCBS Complete |
$765.78
|
| Rate for Payer: BCBS MAPPO |
$1,099.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,350.41
|
| Rate for Payer: BCN Commercial |
$1,661.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.33
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cofinity Commercial |
$1,583.04
|
| Rate for Payer: Cofinity Commercial |
$1,473.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.33
|
| Rate for Payer: Healthscope Commercial |
$2,033.76
|
| Rate for Payer: Healthscope Commercial |
$1,758.93
|
| Rate for Payer: Mclaren Medicaid |
$729.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,154.30
|
| Rate for Payer: Meridian Medicaid |
$765.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203,162.00
|
| Rate for Payer: Nomi Health Commercial |
$1,319.20
|
| Rate for Payer: PACE SWMI |
$1,099.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$729.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,037.37
|
| Rate for Payer: Priority Health Medicare |
$1,099.33
|
| Rate for Payer: Priority Health Narrow Network |
$2,037.37
|
| Rate for Payer: Priority Health SBD |
$2,037.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$930.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,099.33
|
| Rate for Payer: UHC Exchange |
$930.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,099.33
|
| Rate for Payer: UHCCP Medicaid |
$729.31
|
|
|
PR MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA
|
Professional
|
Both
|
$696.00
|
|
|
Service Code
|
HCPCS 42409
|
| Min. Negotiated Rate |
$151.66 |
| Max. Negotiated Rate |
$40,790.00 |
| Rate for Payer: Aetna Commercial |
$297.25
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.44
|
| Rate for Payer: BCBS Complete |
$159.24
|
| Rate for Payer: BCBS MAPPO |
$221.83
|
| Rate for Payer: BCBS Trust/PPO |
$641.36
|
| Rate for Payer: BCN Commercial |
$586.41
|
| Rate for Payer: BCN Medicare Advantage |
$221.83
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cofinity Commercial |
$319.44
|
| Rate for Payer: Cofinity Commercial |
$297.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.83
|
| Rate for Payer: Healthscope Commercial |
$410.39
|
| Rate for Payer: Healthscope Commercial |
$354.93
|
| Rate for Payer: Mclaren Medicaid |
$151.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.92
|
| Rate for Payer: Meridian Medicaid |
$159.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,790.00
|
| Rate for Payer: Nomi Health Commercial |
$266.20
|
| Rate for Payer: PACE SWMI |
$221.83
|
| Rate for Payer: PHP Medicare Advantage |
$221.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.20
|
| Rate for Payer: Priority Health Medicare |
$221.83
|
| Rate for Payer: Priority Health Narrow Network |
$421.20
|
| Rate for Payer: Priority Health SBD |
$421.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.83
|
| Rate for Payer: UHC Exchange |
$277.15
|
| Rate for Payer: UHC Medicare Advantage |
$221.83
|
| Rate for Payer: UHCCP Medicaid |
$151.66
|
|
|
PR MASTECTOMY FOR GYNECOMASTIA
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS 19300
|
| Min. Negotiated Rate |
$281.59 |
| Max. Negotiated Rate |
$76,592.00 |
| Rate for Payer: Aetna Commercial |
$556.46
|
| Rate for Payer: Aetna Medicare |
$431.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.99
|
| Rate for Payer: BCBS Complete |
$295.67
|
| Rate for Payer: BCBS MAPPO |
$415.27
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$858.11
|
| Rate for Payer: BCN Medicare Advantage |
$415.27
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cofinity Commercial |
$597.99
|
| Rate for Payer: Cofinity Commercial |
$556.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.27
|
| Rate for Payer: Healthscope Commercial |
$768.25
|
| Rate for Payer: Healthscope Commercial |
$664.43
|
| Rate for Payer: Mclaren Medicaid |
$281.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.03
|
| Rate for Payer: Meridian Medicaid |
$295.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,592.00
|
| Rate for Payer: Nomi Health Commercial |
$498.32
|
| Rate for Payer: PACE SWMI |
$415.27
|
| Rate for Payer: PHP Medicare Advantage |
$415.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,060.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$590.14
|
| Rate for Payer: Priority Health Medicare |
$415.27
|
| Rate for Payer: Priority Health Narrow Network |
$590.14
|
| Rate for Payer: Priority Health SBD |
$590.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$415.27
|
| Rate for Payer: UHC Exchange |
$553.29
|
| Rate for Payer: UHC Medicare Advantage |
$415.27
|
| Rate for Payer: UHCCP Medicaid |
$281.59
|
|
|
PR MASTECTOMY FOR GYNECOMASTIA
|
Facility
|
IP
|
$1,632.00
|
|
|
Service Code
|
CPT 19300
|
| Hospital Charge Code |
19300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,028.16 |
| Max. Negotiated Rate |
$1,468.80 |
| Rate for Payer: Aetna Commercial |
$1,387.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cofinity Commercial |
$1,142.40
|
| Rate for Payer: Cofinity Commercial |
$1,403.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,142.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,305.60
|
| Rate for Payer: Healthscope Commercial |
$1,468.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,387.20
|
| Rate for Payer: PHP Commercial |
$1,387.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,060.80
|
| Rate for Payer: Priority Health SBD |
$1,028.16
|
|
