|
PR AAA REPAIR,AORTO-AORTIC TUBE PROSTH
|
Professional
|
Both
|
$3,860.00
|
|
|
Service Code
|
HCPCS 34800
|
| Min. Negotiated Rate |
$1,544.00 |
| Max. Negotiated Rate |
$2,702.00 |
| Rate for Payer: BCBS Complete |
$1,544.00
|
| Rate for Payer: Cash Price |
$3,088.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,702.00
|
|
|
PR AAA REPAIR,MODULR BIFURCATED PROSTH
|
Professional
|
Both
|
$2,505.00
|
|
|
Service Code
|
HCPCS 34802
|
| Min. Negotiated Rate |
$1,002.00 |
| Max. Negotiated Rate |
$1,753.50 |
| Rate for Payer: BCBS Complete |
$1,002.00
|
| Rate for Payer: Cash Price |
$2,004.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,753.50
|
|
|
PR AAA REPAIR,MODULR BIFUR PROSTH,2-DOCK
|
Professional
|
Both
|
$2,571.00
|
|
|
Service Code
|
HCPCS 34803
|
| Min. Negotiated Rate |
$1,028.40 |
| Max. Negotiated Rate |
$1,799.70 |
| Rate for Payer: BCBS Complete |
$1,028.40
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.70
|
|
|
PR AAA REPAIR,UNIBODY BIFURCATED PROSTH
|
Professional
|
Both
|
$5,404.00
|
|
|
Service Code
|
HCPCS 34804
|
| Min. Negotiated Rate |
$2,161.60 |
| Max. Negotiated Rate |
$3,782.80 |
| Rate for Payer: BCBS Complete |
$2,161.60
|
| Rate for Payer: Cash Price |
$4,323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,782.80
|
|
|
PR AAA REPR,1ST VESSEL,EXTENSION PROSTH
|
Professional
|
Both
|
$2,645.00
|
|
|
Service Code
|
HCPCS 34825
|
| Min. Negotiated Rate |
$1,058.00 |
| Max. Negotiated Rate |
$1,851.50 |
| Rate for Payer: BCBS Complete |
$1,058.00
|
| Rate for Payer: Cash Price |
$2,116.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,851.50
|
|
|
PR AAA REPR,ADD VESSEL,EXTENSION PROSTH
|
Professional
|
Both
|
$427.00
|
|
|
Service Code
|
HCPCS 34826
|
| Min. Negotiated Rate |
$170.80 |
| Max. Negotiated Rate |
$298.90 |
| Rate for Payer: BCBS Complete |
$170.80
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.90
|
|
|
PR ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 38747
|
| Min. Negotiated Rate |
$168.70 |
| Max. Negotiated Rate |
$784.00 |
| Rate for Payer: Aetna Commercial |
$353.83
|
| Rate for Payer: Aetna Medicare |
$274.61
|
| Rate for Payer: BCBS Complete |
$177.14
|
| Rate for Payer: BCBS MAPPO |
$264.05
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$384.59
|
| Rate for Payer: BCN Medicare Advantage |
$264.05
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$353.83
|
| Rate for Payer: Cofinity Commercial |
$380.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.05
|
| Rate for Payer: Mclaren Medicaid |
$168.70
|
| Rate for Payer: Meridian Medicaid |
$177.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$277.25
|
| Rate for Payer: PACE SWMI |
$264.05
|
| Rate for Payer: PHP Medicare Advantage |
$264.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.05
|
| Rate for Payer: Priority Health Medicare |
$264.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$570.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$264.05
|
| Rate for Payer: UHC Medicare Advantage |
$271.97
|
|
|
PR ABDOMINOPLASTY (2HRS)
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 00364
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,040.00 |
| Max. Negotiated Rate |
$1,820.00 |
| Rate for Payer: BCBS Complete |
$1,040.00
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.00
|
|
|
PR ABDOMINOPLASTY (3HRS)
|
Professional
|
Both
|
$4,200.00
|
|
|
Service Code
|
HCPCS 00365
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,680.00 |
| Max. Negotiated Rate |
$2,940.00 |
| Rate for Payer: BCBS Complete |
$1,680.00
|
| Rate for Payer: Cash Price |
$3,360.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,940.00
|
|
|
PR ABDOMINOPLASTY W/ BREAST AUGMENT
|
Professional
|
Both
|
$7,300.00
|
|
|
Service Code
|
HCPCS 00256
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,920.00 |
| Max. Negotiated Rate |
$5,110.00 |
| Rate for Payer: BCBS Complete |
$2,920.00
|
| Rate for Payer: Cash Price |
$5,840.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,110.00
|
|
|
PR ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL
|
Professional
|
Both
|
$2,576.00
|
|
|
Service Code
|
HCPCS 51845
|
| Min. Negotiated Rate |
$371.69 |
| Max. Negotiated Rate |
$3,525.87 |
| Rate for Payer: Aetna Commercial |
$762.35
|
| Rate for Payer: Aetna Medicare |
$591.68
|
| Rate for Payer: BCBS Complete |
$390.27
|
| Rate for Payer: BCBS MAPPO |
$568.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,525.87
|
| Rate for Payer: BCN Commercial |
$841.50
|
| Rate for Payer: BCN Medicare Advantage |
$568.92
|
| Rate for Payer: Cash Price |
$2,060.80
|
| Rate for Payer: Cash Price |
$2,060.80
|
| Rate for Payer: Cofinity Commercial |
$762.35
|
| Rate for Payer: Cofinity Commercial |
$819.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$568.92
|
| Rate for Payer: Mclaren Medicaid |
$371.69
|
| Rate for Payer: Meridian Medicaid |
$390.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$597.37
|
| Rate for Payer: PACE SWMI |
$568.92
|
| Rate for Payer: PHP Medicare Advantage |
$568.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$930.50
|
| Rate for Payer: Priority Health Medicare |
$568.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$930.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$568.92
|
| Rate for Payer: UHC Medicare Advantage |
$585.99
|
|
|
PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 49083
|
| Min. Negotiated Rate |
$66.46 |
| Max. Negotiated Rate |
$759.70 |
| Rate for Payer: Aetna Commercial |
$138.57
|
| Rate for Payer: Aetna Medicare |
$107.55
|
| Rate for Payer: BCBS Complete |
$69.78
|
| Rate for Payer: BCBS MAPPO |
$103.41
|
| Rate for Payer: BCBS Trust/PPO |
$759.70
|
| Rate for Payer: BCN Commercial |
$432.48
|
| Rate for Payer: BCN Medicare Advantage |
$103.41
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$148.91
|
| Rate for Payer: Cofinity Commercial |
$138.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.41
|
| Rate for Payer: Mclaren Medicaid |
$66.46
|
| Rate for Payer: Meridian Medicaid |
$69.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.58
|
| Rate for Payer: PACE SWMI |
$103.41
|
| Rate for Payer: PHP Medicare Advantage |
$103.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.45
|
| Rate for Payer: Priority Health Medicare |
$103.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.41
|
| Rate for Payer: UHC Medicare Advantage |
$106.51
|
|
|
PR ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 49082
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$721.66 |
| Rate for Payer: Aetna Commercial |
$95.78
|
| Rate for Payer: Aetna Medicare |
$74.34
|
| Rate for Payer: BCBS Complete |
$48.75
|
| Rate for Payer: BCBS MAPPO |
$71.48
|
| Rate for Payer: BCBS Trust/PPO |
$721.66
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$71.48
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$95.78
|
| Rate for Payer: Cofinity Commercial |
$102.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.48
|
| Rate for Payer: Mclaren Medicaid |
$46.43
|
| Rate for Payer: Meridian Medicaid |
$48.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.05
|
| Rate for Payer: PACE SWMI |
$71.48
|
| Rate for Payer: PHP Medicare Advantage |
$71.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.01
|
| Rate for Payer: Priority Health Medicare |
$71.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.48
|
| Rate for Payer: UHC Medicare Advantage |
$73.62
|
|
|
PR ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN
|
Professional
|
Both
|
$859.00
|
|
|
Service Code
|
HCPCS 93657
|
| Min. Negotiated Rate |
$190.85 |
| Max. Negotiated Rate |
$3,654.78 |
| Rate for Payer: Aetna Commercial |
$406.09
|
| Rate for Payer: Aetna Medicare |
$315.17
|
| Rate for Payer: BCBS Complete |
$200.39
|
| Rate for Payer: BCBS MAPPO |
$303.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,654.78
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$303.05
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cofinity Commercial |
$406.09
|
| Rate for Payer: Cofinity Commercial |
$436.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.05
|
| Rate for Payer: Mclaren Medicaid |
$190.85
|
| Rate for Payer: Meridian Medicaid |
$200.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.20
|
| Rate for Payer: PACE SWMI |
$303.05
|
| Rate for Payer: PHP Medicare Advantage |
$303.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.42
|
| Rate for Payer: Priority Health Medicare |
$303.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$428.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.05
|
| Rate for Payer: UHC Medicare Advantage |
$312.14
|
|
|
PR ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS
|
Professional
|
Both
|
$3,692.00
|
|
|
Service Code
|
HCPCS 33256
|
| Min. Negotiated Rate |
$1,203.66 |
| Max. Negotiated Rate |
$3,001.31 |
| Rate for Payer: Aetna Commercial |
$2,533.81
|
| Rate for Payer: Aetna Medicare |
$1,966.54
|
| Rate for Payer: BCBS Complete |
$1,263.84
|
| Rate for Payer: BCBS MAPPO |
$1,890.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.88
|
| Rate for Payer: BCN Commercial |
$2,757.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,890.90
|
| Rate for Payer: Cash Price |
$2,953.60
|
| Rate for Payer: Cash Price |
$2,953.60
|
| Rate for Payer: Cofinity Commercial |
$2,722.90
|
| Rate for Payer: Cofinity Commercial |
$2,533.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,890.90
|
| Rate for Payer: Mclaren Medicaid |
$1,203.66
|
| Rate for Payer: Meridian Medicaid |
$1,263.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,985.44
|
| Rate for Payer: PACE SWMI |
$1,890.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,890.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,203.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,584.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,001.31
|
| Rate for Payer: Priority Health Medicare |
$1,890.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,001.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,890.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,890.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,947.63
|
|
|
PR ABLATION & RECONSTRUCTION ATRIA LIMITED
|
Professional
|
Both
|
$3,293.00
|
|
|
Service Code
|
HCPCS 33254
|
| Min. Negotiated Rate |
$856.47 |
| Max. Negotiated Rate |
$2,305.10 |
| Rate for Payer: Aetna Commercial |
$1,788.87
|
| Rate for Payer: Aetna Medicare |
$1,388.38
|
| Rate for Payer: BCBS Complete |
$899.29
|
| Rate for Payer: BCBS MAPPO |
$1,334.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,663.62
|
| Rate for Payer: BCN Commercial |
$1,950.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,334.98
|
| Rate for Payer: Cash Price |
$2,634.40
|
| Rate for Payer: Cash Price |
$2,634.40
|
| Rate for Payer: Cofinity Commercial |
$1,788.87
|
| Rate for Payer: Cofinity Commercial |
$1,922.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,334.98
|
| Rate for Payer: Mclaren Medicaid |
$856.47
|
| Rate for Payer: Meridian Medicaid |
$899.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,401.73
|
| Rate for Payer: PACE SWMI |
$1,334.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,334.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,305.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,123.58
|
| Rate for Payer: Priority Health Medicare |
$1,334.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,123.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,334.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,334.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,375.03
|
|
|
PR ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 30802
|
| Min. Negotiated Rate |
$130.36 |
| Max. Negotiated Rate |
$724.30 |
| Rate for Payer: Aetna Commercial |
$264.57
|
| Rate for Payer: Aetna Medicare |
$205.34
|
| Rate for Payer: BCBS Complete |
$136.88
|
| Rate for Payer: BCBS MAPPO |
$197.44
|
| Rate for Payer: BCBS Trust/PPO |
$724.30
|
| Rate for Payer: BCN Commercial |
$411.96
|
| Rate for Payer: BCN Medicare Advantage |
$197.44
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$284.31
|
| Rate for Payer: Cofinity Commercial |
$264.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.44
|
| Rate for Payer: Mclaren Medicaid |
$130.36
|
| Rate for Payer: Meridian Medicaid |
$136.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$207.31
|
| Rate for Payer: PACE SWMI |
$197.44
|
| Rate for Payer: PHP Medicare Advantage |
$197.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.31
|
| Rate for Payer: Priority Health Medicare |
$197.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$284.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.44
|
| Rate for Payer: UHC Medicare Advantage |
$203.36
|
|
|
PR ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 30801
|
| Min. Negotiated Rate |
$97.98 |
| Max. Negotiated Rate |
$959.39 |
| Rate for Payer: Aetna Commercial |
$196.99
|
| Rate for Payer: Aetna Medicare |
$152.89
|
| Rate for Payer: BCBS Complete |
$102.88
|
| Rate for Payer: BCBS MAPPO |
$147.01
|
| Rate for Payer: BCBS Trust/PPO |
$959.39
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: BCN Medicare Advantage |
$147.01
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$211.69
|
| Rate for Payer: Cofinity Commercial |
$196.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.01
|
| Rate for Payer: Mclaren Medicaid |
$97.98
|
| Rate for Payer: Meridian Medicaid |
$102.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.36
|
| Rate for Payer: PACE SWMI |
$147.01
|
| Rate for Payer: PHP Medicare Advantage |
$147.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.93
|
| Rate for Payer: Priority Health Medicare |
$147.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.01
|
| Rate for Payer: UHC Medicare Advantage |
$151.42
|
|
|
PR ABRASION 1 LESION
|
Facility
|
OP
|
$433.00
|
|
|
Service Code
|
CPT 15786
|
| Hospital Charge Code |
15786
|
| Min. Negotiated Rate |
$102.84 |
| Max. Negotiated Rate |
$389.70 |
| Rate for Payer: Aetna Commercial |
$368.05
|
| Rate for Payer: Aetna Medicare |
$112.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$135.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$135.31
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$108.25
|
| Rate for Payer: BCBS Trust/PPO |
$336.66
|
| Rate for Payer: BCN Commercial |
$336.66
|
| Rate for Payer: BCN Medicare Advantage |
$108.25
|
| Rate for Payer: Cash Price |
$346.40
|
| Rate for Payer: Cash Price |
$346.40
|
| Rate for Payer: Cofinity Commercial |
$372.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.25
|
| Rate for Payer: Healthscope Commercial |
$389.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.75
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$113.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$368.05
|
| Rate for Payer: PACE Senior Care Partners |
$102.84
|
| Rate for Payer: PACE SWMI |
$108.25
|
| Rate for Payer: PHP Commercial |
$368.05
|
| Rate for Payer: PHP Medicare Advantage |
$108.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$376.71
|
| Rate for Payer: Priority Health Medicare |
$108.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.09
|
| Rate for Payer: Railroad Medicare Medicare |
$108.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$381.04
|
| Rate for Payer: UHC Core |
$361.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.25
|
| Rate for Payer: UHC Medicare Advantage |
$111.50
|
| Rate for Payer: VA VA |
$108.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.75
|
|
|
PR ABRASION 1 LESION
|
Facility
|
IP
|
$433.00
|
|
|
Service Code
|
CPT 15786
|
| Hospital Charge Code |
15786
|
| Min. Negotiated Rate |
$264.09 |
| Max. Negotiated Rate |
$389.70 |
| Rate for Payer: Aetna Commercial |
$368.05
|
| Rate for Payer: BCBS Trust/PPO |
$334.62
|
| Rate for Payer: BCN Commercial |
$334.62
|
| Rate for Payer: Cash Price |
$346.40
|
| Rate for Payer: Cofinity Commercial |
$372.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.40
|
| Rate for Payer: Healthscope Commercial |
$389.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$368.05
|
| Rate for Payer: PHP Commercial |
$368.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$376.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$381.04
|
| Rate for Payer: UHC Core |
$361.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.75
|
|
|
PR ACETABULOPLASTY RESECTION FEMORAL HEAD
|
Professional
|
Both
|
$1,937.00
|
|
|
Service Code
|
HCPCS 27122
|
| Min. Negotiated Rate |
$674.11 |
| Max. Negotiated Rate |
$1,687.70 |
| Rate for Payer: Aetna Commercial |
$1,456.35
|
| Rate for Payer: Aetna Medicare |
$1,130.30
|
| Rate for Payer: BCBS Complete |
$744.98
|
| Rate for Payer: BCBS MAPPO |
$1,086.83
|
| Rate for Payer: BCBS Trust/PPO |
$674.11
|
| Rate for Payer: BCN Commercial |
$1,615.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,086.83
|
| Rate for Payer: Cash Price |
$1,549.60
|
| Rate for Payer: Cash Price |
$1,549.60
|
| Rate for Payer: Cofinity Commercial |
$1,456.35
|
| Rate for Payer: Cofinity Commercial |
$1,565.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.83
|
| Rate for Payer: Mclaren Medicaid |
$709.50
|
| Rate for Payer: Meridian Medicaid |
$744.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,141.17
|
| Rate for Payer: PACE SWMI |
$1,086.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,086.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,687.70
|
| Rate for Payer: Priority Health Medicare |
$1,086.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,687.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,086.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,119.43
|
|
|
PR ACNE SURGERY
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 10040
|
| Min. Negotiated Rate |
$22.20 |
| Max. Negotiated Rate |
$137.04 |
| Rate for Payer: Aetna Commercial |
$68.14
|
| Rate for Payer: Aetna Medicare |
$52.88
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS MAPPO |
$50.85
|
| Rate for Payer: BCBS Trust/PPO |
$22.20
|
| Rate for Payer: BCN Commercial |
$137.04
|
| Rate for Payer: BCN Medicare Advantage |
$50.85
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$73.22
|
| Rate for Payer: Cofinity Commercial |
$68.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.85
|
| Rate for Payer: Mclaren Medicaid |
$33.02
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.39
|
| Rate for Payer: PACE SWMI |
$50.85
|
| Rate for Payer: PHP Medicare Advantage |
$50.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.30
|
| Rate for Payer: Priority Health Medicare |
$50.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.85
|
| Rate for Payer: UHC Medicare Advantage |
$52.38
|
|
|
PR ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 92570
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$1,989.05 |
| Rate for Payer: Aetna Commercial |
$37.95
|
| Rate for Payer: Aetna Medicare |
$29.45
|
| Rate for Payer: BCBS Complete |
$19.24
|
| Rate for Payer: BCBS MAPPO |
$28.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.05
|
| Rate for Payer: BCN Commercial |
$46.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.32
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$37.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.32
|
| Rate for Payer: Mclaren Medicaid |
$18.32
|
| Rate for Payer: Meridian Medicaid |
$19.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.74
|
| Rate for Payer: PACE SWMI |
$28.32
|
| Rate for Payer: PHP Medicare Advantage |
$28.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.62
|
| Rate for Payer: Priority Health Medicare |
$28.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.17
|
|
|
PR ACTIGRAPHY TESTING RECORDING ANALYSIS I&R
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS 95803
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$641.88 |
| Rate for Payer: Aetna Commercial |
$175.54
|
| Rate for Payer: Aetna Commercial |
$175.54
|
| Rate for Payer: Aetna Medicare |
$136.24
|
| Rate for Payer: Aetna Medicare |
$136.24
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCBS Complete |
$236.80
|
| Rate for Payer: BCBS MAPPO |
$131.00
|
| Rate for Payer: BCBS MAPPO |
$131.00
|
| Rate for Payer: BCBS Trust/PPO |
$641.88
|
| Rate for Payer: BCBS Trust/PPO |
$641.88
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Medicare Advantage |
$131.00
|
| Rate for Payer: BCN Medicare Advantage |
$131.00
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$188.64
|
| Rate for Payer: Cofinity Commercial |
$175.54
|
| Rate for Payer: Cofinity Commercial |
$175.54
|
| Rate for Payer: Cofinity Commercial |
$188.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.55
|
| Rate for Payer: PACE SWMI |
$131.00
|
| Rate for Payer: PACE SWMI |
$131.00
|
| Rate for Payer: PHP Medicare Advantage |
$131.00
|
| Rate for Payer: PHP Medicare Advantage |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.39
|
| Rate for Payer: Priority Health Medicare |
$131.00
|
| Rate for Payer: Priority Health Medicare |
$131.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.00
|
| Rate for Payer: UHC Medicare Advantage |
$134.93
|
| Rate for Payer: UHC Medicare Advantage |
$134.93
|
|
|
PR ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 97155
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$1,401.05 |
| Rate for Payer: Aetna Commercial |
$20.80
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,401.05
|
| Rate for Payer: BCN Commercial |
$25.38
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.84
|
|
