|
PR OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 28465
|
| Min. Negotiated Rate |
$395.12 |
| Max. Negotiated Rate |
$1,213.50 |
| Rate for Payer: Aetna Commercial |
$804.58
|
| Rate for Payer: Aetna Medicare |
$624.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.62
|
| Rate for Payer: BCBS Complete |
$414.88
|
| Rate for Payer: BCBS MAPPO |
$600.43
|
| Rate for Payer: BCN Commercial |
$980.03
|
| Rate for Payer: BCN Medicare Advantage |
$600.43
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$864.62
|
| Rate for Payer: Cofinity Commercial |
$804.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.43
|
| Rate for Payer: Healthscope Commercial |
$960.69
|
| Rate for Payer: Healthscope Commercial |
$1,110.80
|
| Rate for Payer: Mclaren Medicaid |
$395.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.45
|
| Rate for Payer: Meridian Medicaid |
$414.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$660.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,118.99
|
| Rate for Payer: Nomi Health Commercial |
$720.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,213.50
|
| Rate for Payer: PACE SWMI |
$600.43
|
| Rate for Payer: PHP Medicare Advantage |
$600.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,047.62
|
| Rate for Payer: Priority Health Medicare |
$600.43
|
| Rate for Payer: Priority Health SBD |
$1,047.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.62
|
| Rate for Payer: Railroad Medicare Medicare |
$600.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,098.10
|
| Rate for Payer: UHC Core |
$1,098.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$600.43
|
| Rate for Payer: UHC Exchange |
$1,098.10
|
| Rate for Payer: UHC Medicaid |
$395.12
|
| Rate for Payer: UHCCP Medicaid |
$395.12
|
|
|
PR OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,870.00
|
|
|
Service Code
|
HCPCS 27535
|
| Min. Negotiated Rate |
$519.93 |
| Max. Negotiated Rate |
$2,152.50 |
| Rate for Payer: Aetna Commercial |
$1,074.95
|
| Rate for Payer: Aetna Medicare |
$834.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.17
|
| Rate for Payer: BCBS Complete |
$545.93
|
| Rate for Payer: BCBS MAPPO |
$802.20
|
| Rate for Payer: BCN Commercial |
$1,356.50
|
| Rate for Payer: BCN Medicare Advantage |
$802.20
|
| Rate for Payer: Cash Price |
$2,296.00
|
| Rate for Payer: Cash Price |
$2,296.00
|
| Rate for Payer: Cofinity Commercial |
$1,155.17
|
| Rate for Payer: Cofinity Commercial |
$1,074.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.20
|
| Rate for Payer: Healthscope Commercial |
$1,484.07
|
| Rate for Payer: Healthscope Commercial |
$1,283.52
|
| Rate for Payer: Mclaren Medicaid |
$519.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.31
|
| Rate for Payer: Meridian Medicaid |
$545.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$882.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,592.78
|
| Rate for Payer: Nomi Health Commercial |
$962.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,152.50
|
| Rate for Payer: PACE SWMI |
$802.20
|
| Rate for Payer: PHP Medicare Advantage |
$802.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,450.06
|
| Rate for Payer: Priority Health Medicare |
$802.20
|
| Rate for Payer: Priority Health SBD |
$1,450.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,450.06
|
| Rate for Payer: Railroad Medicare Medicare |
$802.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,577.01
|
| Rate for Payer: UHC Core |
$1,577.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.20
|
| Rate for Payer: UHC Exchange |
$1,577.01
|
| Rate for Payer: UHC Medicaid |
$519.93
|
| Rate for Payer: UHCCP Medicaid |
$519.93
|
|
|
PR OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC
|
Professional
|
Both
|
$2,171.00
|
|
|
Service Code
|
HCPCS 25685
|
| Min. Negotiated Rate |
$440.91 |
| Max. Negotiated Rate |
$1,628.25 |
| Rate for Payer: Aetna Commercial |
$904.39
|
| Rate for Payer: Aetna Medicare |
$701.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$971.88
|
| Rate for Payer: BCBS Complete |
$462.96
|
| Rate for Payer: BCBS MAPPO |
$674.92
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: BCN Medicare Advantage |
$674.92
|
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Cash Price |
$1,736.80
|
| Rate for Payer: Cofinity Commercial |
$971.88
|
| Rate for Payer: Cofinity Commercial |
$904.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.92
|
| Rate for Payer: Healthscope Commercial |
$1,248.60
|
| Rate for Payer: Healthscope Commercial |
$1,079.87
|
| Rate for Payer: Mclaren Medicaid |
$440.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.67
|
| Rate for Payer: Meridian Medicaid |
$462.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$742.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,308.26
|
| Rate for Payer: Nomi Health Commercial |
$809.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,628.25
|
| Rate for Payer: PACE SWMI |
$674.92
|
| Rate for Payer: PHP Medicare Advantage |
$674.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.53
|
| Rate for Payer: Priority Health Medicare |
$674.92
|
| Rate for Payer: Priority Health SBD |
$1,202.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,202.53
|
| Rate for Payer: Railroad Medicare Medicare |
$674.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,283.56
|
| Rate for Payer: UHC Core |
$1,283.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$674.92
|
| Rate for Payer: UHC Exchange |
$1,283.56
|
| Rate for Payer: UHC Medicaid |
$440.91
|
| Rate for Payer: UHCCP Medicaid |
$440.91
|
|
|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP
|
Professional
|
Both
|
$4,293.00
|
|
|
Service Code
|
HCPCS 27823
|
| Min. Negotiated Rate |
$588.73 |
| Max. Negotiated Rate |
$3,219.75 |
| Rate for Payer: Aetna Commercial |
$1,203.88
|
| Rate for Payer: Aetna Medicare |
$934.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,203.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,293.72
|
| Rate for Payer: BCBS Complete |
$618.17
|
| Rate for Payer: BCBS MAPPO |
$898.42
|
| Rate for Payer: BCN Commercial |
$1,488.46
|
| Rate for Payer: BCN Medicare Advantage |
$898.42
|
| Rate for Payer: Cash Price |
$3,434.40
|
| Rate for Payer: Cash Price |
$3,434.40
|
| Rate for Payer: Cofinity Commercial |
$1,293.72
|
| Rate for Payer: Cofinity Commercial |
$1,203.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.42
|
| Rate for Payer: Healthscope Commercial |
$1,662.08
|
| Rate for Payer: Healthscope Commercial |
$1,437.47
|
| Rate for Payer: Mclaren Medicaid |
$588.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$943.34
|
| Rate for Payer: Meridian Medicaid |
$618.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$988.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,742.89
|
| Rate for Payer: Nomi Health Commercial |
$1,078.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,219.75
|
| Rate for Payer: PACE SWMI |
$898.42
|
| Rate for Payer: PHP Medicare Advantage |
$898.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$588.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,591.13
|
| Rate for Payer: Priority Health Medicare |
$898.42
|
| Rate for Payer: Priority Health SBD |
$1,591.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,591.13
|
| Rate for Payer: Railroad Medicare Medicare |
$898.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,707.04
|
| Rate for Payer: UHC Core |
$1,707.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$898.42
|
| Rate for Payer: UHC Exchange |
$1,707.04
|
| Rate for Payer: UHC Medicaid |
$588.73
|
| Rate for Payer: UHCCP Medicaid |
$588.73
|
|
|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP
|
Professional
|
Both
|
$3,643.00
|
|
|
Service Code
|
HCPCS 27822
|
| Min. Negotiated Rate |
$526.96 |
| Max. Negotiated Rate |
$2,732.25 |
| Rate for Payer: Priority Health SBD |
$1,412.80
|
| Rate for Payer: Aetna Commercial |
$1,074.21
|
| Rate for Payer: Aetna Medicare |
$833.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,154.38
|
| Rate for Payer: BCBS Complete |
$553.31
|
| Rate for Payer: BCBS MAPPO |
$801.65
|
| Rate for Payer: BCN Commercial |
$1,321.64
|
| Rate for Payer: BCN Medicare Advantage |
$801.65
|
| Rate for Payer: Cash Price |
$2,914.40
|
| Rate for Payer: Cash Price |
$2,914.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.38
|
| Rate for Payer: Cofinity Commercial |
$1,074.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$801.65
|
| Rate for Payer: Healthscope Commercial |
$1,483.05
|
| Rate for Payer: Healthscope Commercial |
$1,282.64
|
| Rate for Payer: Mclaren Medicaid |
$526.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$841.73
|
| Rate for Payer: Meridian Medicaid |
$553.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$881.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,545.46
|
| Rate for Payer: Nomi Health Commercial |
$961.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,732.25
|
| Rate for Payer: PACE SWMI |
$801.65
|
| Rate for Payer: PHP Medicare Advantage |
$801.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,412.80
|
| Rate for Payer: Priority Health Medicare |
$801.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,412.80
|
| Rate for Payer: Railroad Medicare Medicare |
$801.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,506.11
|
| Rate for Payer: UHC Core |
$1,506.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$801.65
|
| Rate for Payer: UHC Exchange |
$1,506.11
|
| Rate for Payer: UHC Medicaid |
$526.96
|
| Rate for Payer: UHCCP Medicaid |
$526.96
|
|
|
PR OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 92014
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna Medicare |
$63.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.04
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$61.14
|
| Rate for Payer: BCN Commercial |
$81.01
|
| Rate for Payer: BCN Medicare Advantage |
$61.14
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$88.04
|
| Rate for Payer: Cofinity Commercial |
$81.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.14
|
| Rate for Payer: Healthscope Commercial |
$97.82
|
| Rate for Payer: Healthscope Commercial |
$113.11
|
| Rate for Payer: Mclaren Medicaid |
$39.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.20
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.49
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: PACE SWMI |
$61.14
|
| Rate for Payer: PHP Medicare Advantage |
$61.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$95.02
|
| Rate for Payer: Priority Health Medicare |
$61.14
|
| Rate for Payer: Priority Health SBD |
$95.02
|
| Rate for Payer: Priority Health Tiered Network |
$95.02
|
| Rate for Payer: Railroad Medicare Medicare |
$61.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.91
|
| Rate for Payer: UHC Core |
$98.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.14
|
| Rate for Payer: UHC Exchange |
$98.91
|
| Rate for Payer: UHC Medicaid |
$39.62
|
| Rate for Payer: UHCCP Medicaid |
$39.62
|
|
|
PR OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 92004
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Aetna Commercial |
$102.68
|
| Rate for Payer: Aetna Medicare |
$79.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.35
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS MAPPO |
$76.63
|
| Rate for Payer: BCN Commercial |
$100.26
|
| Rate for Payer: BCN Medicare Advantage |
$76.63
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$110.35
|
| Rate for Payer: Cofinity Commercial |
$102.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.63
|
| Rate for Payer: Healthscope Commercial |
$141.77
|
| Rate for Payer: Healthscope Commercial |
$122.61
|
| Rate for Payer: Mclaren Medicaid |
$49.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.46
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.85
|
| Rate for Payer: Nomi Health Commercial |
$91.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.25
|
| Rate for Payer: PACE SWMI |
$76.63
|
| Rate for Payer: PHP Medicare Advantage |
$76.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$117.61
|
| Rate for Payer: Priority Health Medicare |
$76.63
|
| Rate for Payer: Priority Health SBD |
$117.61
|
| Rate for Payer: Priority Health Tiered Network |
$117.61
|
| Rate for Payer: Railroad Medicare Medicare |
$76.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.03
|
| Rate for Payer: UHC Core |
$123.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.63
|
| Rate for Payer: UHC Exchange |
$123.03
|
| Rate for Payer: UHC Medicaid |
$49.63
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
|
|
PR OPH SVCS MEDICAL XM&EVAL INTERMEDIATE EST PT
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 92012
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: Aetna Commercial |
$54.54
|
| Rate for Payer: Aetna Medicare |
$42.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.61
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$40.70
|
| Rate for Payer: BCN Commercial |
$53.76
|
| Rate for Payer: BCN Medicare Advantage |
$40.70
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$58.61
|
| Rate for Payer: Cofinity Commercial |
$54.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.70
|
| Rate for Payer: Healthscope Commercial |
$75.30
|
| Rate for Payer: Healthscope Commercial |
$65.12
|
| Rate for Payer: Mclaren Medicaid |
$26.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.73
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.50
|
| Rate for Payer: Nomi Health Commercial |
$48.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: PACE SWMI |
$40.70
|
| Rate for Payer: PHP Medicare Advantage |
$40.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$63.06
|
| Rate for Payer: Priority Health Medicare |
$40.70
|
| Rate for Payer: Priority Health SBD |
$63.06
|
| Rate for Payer: Priority Health Tiered Network |
$63.06
|
| Rate for Payer: Railroad Medicare Medicare |
$40.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.13
|
| Rate for Payer: UHC Core |
$65.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.70
|
| Rate for Payer: UHC Exchange |
$65.13
|
| Rate for Payer: UHC Medicaid |
$26.41
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
|
|
PR OPH SVCS MEDICAL XM&EVAL INTERMEDIATE NEW PT
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 92002
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Commercial |
$49.79
|
| Rate for Payer: Aetna Medicare |
$38.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.51
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$37.16
|
| Rate for Payer: BCN Commercial |
$48.68
|
| Rate for Payer: BCN Medicare Advantage |
$37.16
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Commercial |
$49.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.16
|
| Rate for Payer: Healthscope Commercial |
$68.75
|
| Rate for Payer: Healthscope Commercial |
$59.46
|
| Rate for Payer: Mclaren Medicaid |
$24.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.02
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.66
|
| Rate for Payer: Nomi Health Commercial |
$44.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: PACE SWMI |
$37.16
|
| Rate for Payer: PHP Medicare Advantage |
$37.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57.09
|
| Rate for Payer: Priority Health Medicare |
$37.16
|
| Rate for Payer: Priority Health SBD |
$57.09
|
| Rate for Payer: Priority Health Tiered Network |
$57.09
|
| Rate for Payer: Railroad Medicare Medicare |
$37.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.50
|
| Rate for Payer: UHC Core |
$59.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.16
|
| Rate for Payer: UHC Exchange |
$59.50
|
| Rate for Payer: UHC Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
|
|
PR OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 34716
|
| Min. Negotiated Rate |
$215.77 |
| Max. Negotiated Rate |
$667.52 |
| Rate for Payer: Aetna Commercial |
$457.97
|
| Rate for Payer: Aetna Medicare |
$355.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.15
|
| Rate for Payer: BCBS Complete |
$226.56
|
| Rate for Payer: BCBS MAPPO |
$341.77
|
| Rate for Payer: BCN Commercial |
$543.80
|
| Rate for Payer: BCN Medicare Advantage |
$341.77
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cofinity Commercial |
$492.15
|
| Rate for Payer: Cofinity Commercial |
$457.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.77
|
| Rate for Payer: Healthscope Commercial |
$632.27
|
| Rate for Payer: Healthscope Commercial |
$546.83
|
| Rate for Payer: Mclaren Medicaid |
$215.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.86
|
| Rate for Payer: Meridian Medicaid |
$226.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$375.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$658.76
|
| Rate for Payer: Nomi Health Commercial |
$410.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$608.25
|
| Rate for Payer: PACE SWMI |
$341.77
|
| Rate for Payer: PHP Medicare Advantage |
$341.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$584.78
|
| Rate for Payer: Priority Health Medicare |
$341.77
|
| Rate for Payer: Priority Health SBD |
$584.78
|
| Rate for Payer: Priority Health Tiered Network |
$584.78
|
| Rate for Payer: Railroad Medicare Medicare |
$341.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.52
|
| Rate for Payer: UHC Core |
$667.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$341.77
|
| Rate for Payer: UHC Exchange |
$667.52
|
| Rate for Payer: UHC Medicaid |
$215.77
|
| Rate for Payer: UHCCP Medicaid |
$215.77
|
|
|
PR OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 34834
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna Commercial |
$158.94
|
| Rate for Payer: Aetna Medicare |
$123.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.80
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$118.61
|
| Rate for Payer: BCN Commercial |
$187.74
|
| Rate for Payer: BCN Medicare Advantage |
$118.61
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$170.80
|
| Rate for Payer: Cofinity Commercial |
$158.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.61
|
| Rate for Payer: Healthscope Commercial |
$219.43
|
| Rate for Payer: Healthscope Commercial |
$189.78
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.54
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.42
|
| Rate for Payer: Nomi Health Commercial |
$142.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$224.25
|
| Rate for Payer: PACE SWMI |
$118.61
|
| Rate for Payer: PHP Medicare Advantage |
$118.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$201.90
|
| Rate for Payer: Priority Health Medicare |
$118.61
|
| Rate for Payer: Priority Health SBD |
$201.90
|
| Rate for Payer: Priority Health Tiered Network |
$201.90
|
| Rate for Payer: Railroad Medicare Medicare |
$118.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.03
|
| Rate for Payer: UHC Core |
$234.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.61
|
| Rate for Payer: UHC Exchange |
$234.03
|
| Rate for Payer: UHC Medicaid |
$74.34
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR OPN FEM ART EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$1,305.00
|
|
|
Service Code
|
HCPCS 34812
|
| Min. Negotiated Rate |
$118.00 |
| Max. Negotiated Rate |
$978.75 |
| Rate for Payer: Priority Health SBD |
$321.84
|
| Rate for Payer: Aetna Commercial |
$252.13
|
| Rate for Payer: Aetna Medicare |
$195.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.95
|
| Rate for Payer: BCBS Complete |
$123.90
|
| Rate for Payer: BCBS MAPPO |
$188.16
|
| Rate for Payer: BCN Commercial |
$299.28
|
| Rate for Payer: BCN Medicare Advantage |
$188.16
|
| Rate for Payer: Cash Price |
$1,044.00
|
| Rate for Payer: Cash Price |
$1,044.00
|
| Rate for Payer: Cofinity Commercial |
$270.95
|
| Rate for Payer: Cofinity Commercial |
$252.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.16
|
| Rate for Payer: Healthscope Commercial |
$348.10
|
| Rate for Payer: Healthscope Commercial |
$301.06
|
| Rate for Payer: Mclaren Medicaid |
$118.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.57
|
| Rate for Payer: Meridian Medicaid |
$123.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$206.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.13
|
| Rate for Payer: Nomi Health Commercial |
$225.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$978.75
|
| Rate for Payer: PACE SWMI |
$188.16
|
| Rate for Payer: PHP Medicare Advantage |
$188.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$321.84
|
| Rate for Payer: Priority Health Medicare |
$188.16
|
| Rate for Payer: Priority Health Tiered Network |
$321.84
|
| Rate for Payer: Railroad Medicare Medicare |
$188.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.43
|
| Rate for Payer: UHC Core |
$372.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.16
|
| Rate for Payer: UHC Exchange |
$372.43
|
| Rate for Payer: UHC Medicaid |
$118.00
|
| Rate for Payer: UHCCP Medicaid |
$118.00
|
|
|
PR OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH
|
Professional
|
Both
|
$585.00
|
|
|
Service Code
|
HCPCS 34714
|
| Min. Negotiated Rate |
$156.34 |
| Max. Negotiated Rate |
$486.61 |
| Rate for Payer: Aetna Commercial |
$332.25
|
| Rate for Payer: Aetna Medicare |
$257.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.05
|
| Rate for Payer: BCBS Complete |
$164.16
|
| Rate for Payer: BCBS MAPPO |
$247.95
|
| Rate for Payer: BCN Commercial |
$392.91
|
| Rate for Payer: BCN Medicare Advantage |
$247.95
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cofinity Commercial |
$357.05
|
| Rate for Payer: Cofinity Commercial |
$332.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.95
|
| Rate for Payer: Healthscope Commercial |
$458.71
|
| Rate for Payer: Healthscope Commercial |
$396.72
|
| Rate for Payer: Mclaren Medicaid |
$156.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.35
|
| Rate for Payer: Meridian Medicaid |
$164.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$272.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.20
|
| Rate for Payer: Nomi Health Commercial |
$297.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.75
|
| Rate for Payer: PACE SWMI |
$247.95
|
| Rate for Payer: PHP Medicare Advantage |
$247.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$422.52
|
| Rate for Payer: Priority Health Medicare |
$247.95
|
| Rate for Payer: Priority Health SBD |
$422.52
|
| Rate for Payer: Priority Health Tiered Network |
$422.52
|
| Rate for Payer: Railroad Medicare Medicare |
$247.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.61
|
| Rate for Payer: UHC Core |
$486.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$247.95
|
| Rate for Payer: UHC Exchange |
$486.61
|
| Rate for Payer: UHC Medicaid |
$156.34
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
|
|
PR OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP
|
Professional
|
Both
|
$2,299.00
|
|
|
Service Code
|
HCPCS 34833
|
| Min. Negotiated Rate |
$226.42 |
| Max. Negotiated Rate |
$1,724.25 |
| Rate for Payer: Aetna Commercial |
$485.09
|
| Rate for Payer: Aetna Medicare |
$376.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.29
|
| Rate for Payer: BCBS Complete |
$237.74
|
| Rate for Payer: BCBS MAPPO |
$362.01
|
| Rate for Payer: BCN Commercial |
$571.68
|
| Rate for Payer: BCN Medicare Advantage |
$362.01
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Cash Price |
$1,839.20
|
| Rate for Payer: Cofinity Commercial |
$521.29
|
| Rate for Payer: Cofinity Commercial |
$485.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.01
|
| Rate for Payer: Healthscope Commercial |
$669.72
|
| Rate for Payer: Healthscope Commercial |
$579.22
|
| Rate for Payer: Mclaren Medicaid |
$226.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.11
|
| Rate for Payer: Meridian Medicaid |
$237.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.17
|
| Rate for Payer: Nomi Health Commercial |
$434.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.25
|
| Rate for Payer: PACE SWMI |
$362.01
|
| Rate for Payer: PHP Medicare Advantage |
$362.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$614.78
|
| Rate for Payer: Priority Health Medicare |
$362.01
|
| Rate for Payer: Priority Health SBD |
$614.78
|
| Rate for Payer: Priority Health Tiered Network |
$614.78
|
| Rate for Payer: Railroad Medicare Medicare |
$362.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.24
|
| Rate for Payer: UHC Core |
$728.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.01
|
| Rate for Payer: UHC Exchange |
$728.24
|
| Rate for Payer: UHC Medicaid |
$226.42
|
| Rate for Payer: UHCCP Medicaid |
$226.42
|
|
|
PR OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH
|
Professional
|
Both
|
$4,956.00
|
|
|
Service Code
|
HCPCS 34830
|
| Min. Negotiated Rate |
$1,021.12 |
| Max. Negotiated Rate |
$3,717.00 |
| Rate for Payer: Aetna Commercial |
$2,177.71
|
| Rate for Payer: Aetna Medicare |
$1,690.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,177.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,340.23
|
| Rate for Payer: BCBS Complete |
$1,072.18
|
| Rate for Payer: BCBS MAPPO |
$1,625.16
|
| Rate for Payer: BCN Commercial |
$2,574.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,625.16
|
| Rate for Payer: Cash Price |
$3,964.80
|
| Rate for Payer: Cash Price |
$3,964.80
|
| Rate for Payer: Cofinity Commercial |
$2,340.23
|
| Rate for Payer: Cofinity Commercial |
$2,177.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,625.16
|
| Rate for Payer: Healthscope Commercial |
$3,006.55
|
| Rate for Payer: Healthscope Commercial |
$2,600.26
|
| Rate for Payer: Mclaren Medicaid |
$1,021.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,706.42
|
| Rate for Payer: Meridian Medicaid |
$1,072.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,787.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,132.40
|
| Rate for Payer: Nomi Health Commercial |
$1,950.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,717.00
|
| Rate for Payer: PACE SWMI |
$1,625.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,625.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,021.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,768.61
|
| Rate for Payer: Priority Health Medicare |
$1,625.16
|
| Rate for Payer: Priority Health SBD |
$2,768.61
|
| Rate for Payer: Priority Health Tiered Network |
$2,768.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,625.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,175.10
|
| Rate for Payer: UHC Core |
$3,175.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,625.16
|
| Rate for Payer: UHC Exchange |
$3,175.10
|
| Rate for Payer: UHC Medicaid |
$1,021.12
|
| Rate for Payer: UHCCP Medicaid |
$1,021.12
|
|
|
PR OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH
|
Professional
|
Both
|
$4,199.00
|
|
|
Service Code
|
HCPCS 34831
|
| Min. Negotiated Rate |
$1,118.68 |
| Max. Negotiated Rate |
$3,470.53 |
| Rate for Payer: Aetna Commercial |
$2,381.39
|
| Rate for Payer: Aetna Medicare |
$1,848.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,381.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,559.11
|
| Rate for Payer: BCBS Complete |
$1,174.61
|
| Rate for Payer: BCBS MAPPO |
$1,777.16
|
| Rate for Payer: BCN Commercial |
$2,825.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,777.16
|
| Rate for Payer: Cash Price |
$3,359.20
|
| Rate for Payer: Cash Price |
$3,359.20
|
| Rate for Payer: Cofinity Commercial |
$2,559.11
|
| Rate for Payer: Cofinity Commercial |
$2,381.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,777.16
|
| Rate for Payer: Healthscope Commercial |
$3,287.75
|
| Rate for Payer: Healthscope Commercial |
$2,843.46
|
| Rate for Payer: Mclaren Medicaid |
$1,118.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,866.02
|
| Rate for Payer: Meridian Medicaid |
$1,174.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,954.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,420.70
|
| Rate for Payer: Nomi Health Commercial |
$2,132.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,149.25
|
| Rate for Payer: PACE SWMI |
$1,777.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,777.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,118.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,037.98
|
| Rate for Payer: Priority Health Medicare |
$1,777.16
|
| Rate for Payer: Priority Health SBD |
$3,037.98
|
| Rate for Payer: Priority Health Tiered Network |
$3,037.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,777.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,470.53
|
| Rate for Payer: UHC Core |
$3,470.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,777.16
|
| Rate for Payer: UHC Exchange |
$3,470.53
|
| Rate for Payer: UHC Medicaid |
$1,118.68
|
| Rate for Payer: UHCCP Medicaid |
$1,118.68
|
|
|
PR OPN SUBCLA CRTD ART TRPOS NCK INC ULAT
|
Professional
|
Both
|
$3,296.00
|
|
|
Service Code
|
HCPCS 33889
|
| Min. Negotiated Rate |
$1,063.36 |
| Max. Negotiated Rate |
$2,472.00 |
| Rate for Payer: Aetna Commercial |
$1,063.36
|
| Rate for Payer: Aetna Medicare |
$1,648.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.36
|
| Rate for Payer: BCBS Complete |
$1,318.40
|
| Rate for Payer: BCN Commercial |
$1,162.29
|
| Rate for Payer: Cash Price |
$2,636.80
|
| Rate for Payer: Cash Price |
$2,636.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,410.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,472.00
|
|
|
PROPOFOL 10 MG/ML 20 ML VIAL (BULK CHARGE)
|
Facility
|
IP
|
$76.22
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.02 |
| Max. Negotiated Rate |
$68.60 |
| Rate for Payer: Aetna Commercial |
$64.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.54
|
| Rate for Payer: Cash Price |
$60.98
|
| Rate for Payer: Cofinity Advantage |
$53.35
|
| Rate for Payer: Cofinity Commercial |
$65.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.98
|
| Rate for Payer: Healthscope Commercial |
$68.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.16
|
| Rate for Payer: PHP Commercial |
$64.79
|
| Rate for Payer: Priority Health SBD |
$48.02
|
|
|
PROPOFOL 10 MG/ML 20 ML VIAL (BULK CHARGE)
|
Facility
|
OP
|
$76.22
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$68.60 |
| Rate for Payer: Aetna Commercial |
$64.79
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.54
|
| Rate for Payer: BCBS Complete |
$30.49
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$60.98
|
| Rate for Payer: Cash Price |
$60.98
|
| Rate for Payer: Cofinity Advantage |
$53.35
|
| Rate for Payer: Cofinity Commercial |
$65.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.98
|
| Rate for Payer: Healthscope Commercial |
$68.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.16
|
| Rate for Payer: PHP Commercial |
$64.79
|
| Rate for Payer: Priority Health SBD |
$48.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
OP
|
$74.97
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$67.47 |
| Rate for Payer: Aetna Commercial |
$63.72
|
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Medicare |
$37.48
|
| Rate for Payer: Aetna Medicare |
$38.56
|
| Rate for Payer: Aetna Medicare |
$43.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.09
|
| Rate for Payer: BCBS Complete |
$34.52
|
| Rate for Payer: BCBS Complete |
$29.99
|
| Rate for Payer: BCBS Complete |
$30.85
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$59.98
|
| Rate for Payer: Cash Price |
$59.98
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cofinity Advantage |
$53.98
|
| Rate for Payer: Cofinity Advantage |
$52.48
|
| Rate for Payer: Cofinity Advantage |
$60.41
|
| Rate for Payer: Cofinity Commercial |
$64.47
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.98
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$67.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.72
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: Priority Health SBD |
$47.23
|
| Rate for Payer: Priority Health SBD |
$54.37
|
| Rate for Payer: Priority Health SBD |
$48.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
IP
|
$77.12
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.59 |
| Max. Negotiated Rate |
$69.41 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$63.72
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.73
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$59.98
|
| Rate for Payer: Cofinity Advantage |
$53.98
|
| Rate for Payer: Cofinity Advantage |
$52.48
|
| Rate for Payer: Cofinity Advantage |
$60.41
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$64.47
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Healthscope Commercial |
$67.47
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: Priority Health SBD |
$54.37
|
| Rate for Payer: Priority Health SBD |
$47.23
|
| Rate for Payer: Priority Health SBD |
$48.59
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
IP
|
$77.12
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.59 |
| Max. Negotiated Rate |
$69.41 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$63.72
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$46.36
|
| Rate for Payer: Aetna Commercial |
$63.21
|
| Rate for Payer: Aetna Commercial |
$57.06
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$71.86
|
| Rate for Payer: Aetna Commercial |
$70.50
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.91
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$59.49
|
| Rate for Payer: Cash Price |
$66.35
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$67.63
|
| Rate for Payer: Cash Price |
$59.98
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cofinity Advantage |
$52.05
|
| Rate for Payer: Cofinity Advantage |
$46.99
|
| Rate for Payer: Cofinity Advantage |
$45.52
|
| Rate for Payer: Cofinity Advantage |
$38.18
|
| Rate for Payer: Cofinity Advantage |
$52.48
|
| Rate for Payer: Cofinity Advantage |
$53.98
|
| Rate for Payer: Cofinity Advantage |
$57.83
|
| Rate for Payer: Cofinity Advantage |
$58.06
|
| Rate for Payer: Cofinity Advantage |
$59.18
|
| Rate for Payer: Cofinity Advantage |
$60.41
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Commercial |
$71.33
|
| Rate for Payer: Cofinity Commercial |
$64.47
|
| Rate for Payer: Cofinity Commercial |
$57.73
|
| Rate for Payer: Cofinity Commercial |
$72.70
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Cofinity Commercial |
$63.95
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.49
|
| Rate for Payer: Healthscope Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$66.92
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$76.09
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Healthscope Commercial |
$74.65
|
| Rate for Payer: Healthscope Commercial |
$67.47
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$49.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.23
|
| Rate for Payer: PHP Commercial |
$46.36
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$63.21
|
| Rate for Payer: PHP Commercial |
$71.86
|
| Rate for Payer: PHP Commercial |
$70.50
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$57.06
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: Priority Health SBD |
$40.97
|
| Rate for Payer: Priority Health SBD |
$34.36
|
| Rate for Payer: Priority Health SBD |
$47.23
|
| Rate for Payer: Priority Health SBD |
$46.85
|
| Rate for Payer: Priority Health SBD |
$52.05
|
| Rate for Payer: Priority Health SBD |
$53.26
|
| Rate for Payer: Priority Health SBD |
$48.59
|
| Rate for Payer: Priority Health SBD |
$54.37
|
| Rate for Payer: Priority Health SBD |
$52.25
|
| Rate for Payer: Priority Health SBD |
$42.29
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
OP
|
$74.97
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$67.47 |
| Rate for Payer: Aetna Commercial |
$63.72
|
| Rate for Payer: Aetna Commercial |
$70.50
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$57.06
|
| Rate for Payer: Aetna Commercial |
$71.86
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$46.36
|
| Rate for Payer: Aetna Commercial |
$63.21
|
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$43.15
|
| Rate for Payer: Aetna Medicare |
$32.52
|
| Rate for Payer: Aetna Medicare |
$27.27
|
| Rate for Payer: Aetna Medicare |
$37.48
|
| Rate for Payer: Aetna Medicare |
$41.47
|
| Rate for Payer: Aetna Medicare |
$38.56
|
| Rate for Payer: Aetna Medicare |
$41.31
|
| Rate for Payer: Aetna Medicare |
$42.27
|
| Rate for Payer: Aetna Medicare |
$33.56
|
| Rate for Payer: Aetna Medicare |
$37.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.27
|
| Rate for Payer: BCBS Complete |
$34.52
|
| Rate for Payer: BCBS Complete |
$33.82
|
| Rate for Payer: BCBS Complete |
$26.01
|
| Rate for Payer: BCBS Complete |
$21.82
|
| Rate for Payer: BCBS Complete |
$26.85
|
| Rate for Payer: BCBS Complete |
$30.85
|
| Rate for Payer: BCBS Complete |
$33.05
|
| Rate for Payer: BCBS Complete |
$29.99
|
| Rate for Payer: BCBS Complete |
$33.18
|
| Rate for Payer: BCBS Complete |
$29.74
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$59.49
|
| Rate for Payer: Cash Price |
$59.98
|
| Rate for Payer: Cash Price |
$59.98
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$67.63
|
| Rate for Payer: Cash Price |
$66.35
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$67.63
|
| Rate for Payer: Cash Price |
$59.49
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$66.35
|
| Rate for Payer: Cofinity Advantage |
$52.48
|
| Rate for Payer: Cofinity Advantage |
$58.06
|
| Rate for Payer: Cofinity Advantage |
$60.41
|
| Rate for Payer: Cofinity Advantage |
$52.05
|
| Rate for Payer: Cofinity Advantage |
$38.18
|
| Rate for Payer: Cofinity Advantage |
$46.99
|
| Rate for Payer: Cofinity Advantage |
$45.52
|
| Rate for Payer: Cofinity Advantage |
$57.83
|
| Rate for Payer: Cofinity Advantage |
$53.98
|
| Rate for Payer: Cofinity Advantage |
$59.18
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Cofinity Commercial |
$64.47
|
| Rate for Payer: Cofinity Commercial |
$57.73
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Cofinity Commercial |
$72.70
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Commercial |
$63.95
|
| Rate for Payer: Cofinity Commercial |
$71.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Healthscope Commercial |
$76.09
|
| Rate for Payer: Healthscope Commercial |
$49.09
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$66.92
|
| Rate for Payer: Healthscope Commercial |
$67.47
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Healthscope Commercial |
$74.65
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.20
|
| Rate for Payer: PHP Commercial |
$71.86
|
| Rate for Payer: PHP Commercial |
$70.50
|
| Rate for Payer: PHP Commercial |
$57.06
|
| Rate for Payer: PHP Commercial |
$46.36
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Commercial |
$63.21
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: Priority Health SBD |
$48.59
|
| Rate for Payer: Priority Health SBD |
$47.23
|
| Rate for Payer: Priority Health SBD |
$52.05
|
| Rate for Payer: Priority Health SBD |
$46.85
|
| Rate for Payer: Priority Health SBD |
$52.25
|
| Rate for Payer: Priority Health SBD |
$42.29
|
| Rate for Payer: Priority Health SBD |
$40.97
|
| Rate for Payer: Priority Health SBD |
$34.36
|
| Rate for Payer: Priority Health SBD |
$53.26
|
| Rate for Payer: Priority Health SBD |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$77.12
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$69.41 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$71.86
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Medicare |
$38.56
|
| Rate for Payer: Aetna Medicare |
$43.15
|
| Rate for Payer: Aetna Medicare |
$42.27
|
| Rate for Payer: Aetna Medicare |
$32.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.13
|
| Rate for Payer: BCBS Complete |
$34.52
|
| Rate for Payer: BCBS Complete |
$30.85
|
| Rate for Payer: BCBS Complete |
$26.01
|
| Rate for Payer: BCBS Complete |
$33.82
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$67.63
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$67.63
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cofinity Advantage |
$60.41
|
| Rate for Payer: Cofinity Advantage |
$45.52
|
| Rate for Payer: Cofinity Advantage |
$59.18
|
| Rate for Payer: Cofinity Advantage |
$53.98
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Cofinity Commercial |
$72.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Healthscope Commercial |
$76.09
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.72
|
| Rate for Payer: PHP Commercial |
$71.86
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: Priority Health SBD |
$40.97
|
| Rate for Payer: Priority Health SBD |
$53.26
|
| Rate for Payer: Priority Health SBD |
$54.37
|
| Rate for Payer: Priority Health SBD |
$48.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Core |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
| Rate for Payer: UHC Exchange |
$0.15
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$86.30
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.37 |
| Max. Negotiated Rate |
$77.67 |
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$71.86
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.09
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$67.63
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cofinity Advantage |
$53.98
|
| Rate for Payer: Cofinity Advantage |
$59.18
|
| Rate for Payer: Cofinity Advantage |
$60.41
|
| Rate for Payer: Cofinity Advantage |
$45.52
|
| Rate for Payer: Cofinity Commercial |
$72.70
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$76.09
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.72
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$71.86
|
| Rate for Payer: Priority Health SBD |
$53.26
|
| Rate for Payer: Priority Health SBD |
$48.59
|
| Rate for Payer: Priority Health SBD |
$54.37
|
| Rate for Payer: Priority Health SBD |
$40.97
|
|
