|
PR ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 36640
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$802.49 |
| Rate for Payer: Aetna Commercial |
$152.06
|
| Rate for Payer: Aetna Medicare |
$118.02
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$113.48
|
| Rate for Payer: BCBS Trust/PPO |
$802.49
|
| Rate for Payer: BCN Commercial |
$168.11
|
| Rate for Payer: BCN Medicare Advantage |
$113.48
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cofinity Commercial |
$163.41
|
| Rate for Payer: Cofinity Commercial |
$152.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.48
|
| Rate for Payer: Mclaren Medicaid |
$74.55
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.15
|
| Rate for Payer: PACE SWMI |
$113.48
|
| Rate for Payer: PHP Medicare Advantage |
$113.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.99
|
| Rate for Payer: Priority Health Medicare |
$113.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.48
|
| Rate for Payer: UHC Medicare Advantage |
$116.88
|
|
|
PR ARVEN ANAST OPN F/ARM VEIN TRPOS
|
Professional
|
Both
|
$1,494.00
|
|
|
Service Code
|
HCPCS 36820
|
| Min. Negotiated Rate |
$454.54 |
| Max. Negotiated Rate |
$1,126.68 |
| Rate for Payer: Aetna Commercial |
$952.28
|
| Rate for Payer: Aetna Medicare |
$739.09
|
| Rate for Payer: BCBS Complete |
$477.27
|
| Rate for Payer: BCBS MAPPO |
$710.66
|
| Rate for Payer: BCBS Trust/PPO |
$769.73
|
| Rate for Payer: BCN Commercial |
$1,035.02
|
| Rate for Payer: BCN Medicare Advantage |
$710.66
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Cofinity Commercial |
$1,023.35
|
| Rate for Payer: Cofinity Commercial |
$952.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.66
|
| Rate for Payer: Mclaren Medicaid |
$454.54
|
| Rate for Payer: Meridian Medicaid |
$477.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$746.19
|
| Rate for Payer: PACE SWMI |
$710.66
|
| Rate for Payer: PHP Medicare Advantage |
$710.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,126.68
|
| Rate for Payer: Priority Health Medicare |
$710.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,126.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$710.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$710.66
|
| Rate for Payer: UHC Medicare Advantage |
$731.98
|
|
|
PR ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS
|
Professional
|
Both
|
$2,387.00
|
|
|
Service Code
|
HCPCS 36819
|
| Min. Negotiated Rate |
$156.91 |
| Max. Negotiated Rate |
$1,670.90 |
| Rate for Payer: Aetna Commercial |
$961.85
|
| Rate for Payer: Aetna Medicare |
$746.51
|
| Rate for Payer: BCBS Complete |
$479.73
|
| Rate for Payer: BCBS MAPPO |
$717.80
|
| Rate for Payer: BCBS Trust/PPO |
$156.91
|
| Rate for Payer: BCN Commercial |
$1,044.31
|
| Rate for Payer: BCN Medicare Advantage |
$717.80
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cash Price |
$1,909.60
|
| Rate for Payer: Cofinity Commercial |
$1,033.63
|
| Rate for Payer: Cofinity Commercial |
$961.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.80
|
| Rate for Payer: Mclaren Medicaid |
$456.89
|
| Rate for Payer: Meridian Medicaid |
$479.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$753.69
|
| Rate for Payer: PACE SWMI |
$717.80
|
| Rate for Payer: PHP Medicare Advantage |
$717.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,670.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,136.79
|
| Rate for Payer: Priority Health Medicare |
$717.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,136.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$717.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.80
|
| Rate for Payer: UHC Medicare Advantage |
$739.33
|
|
|
PR ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS
|
Professional
|
Both
|
$1,970.00
|
|
|
Service Code
|
HCPCS 36818
|
| Min. Negotiated Rate |
$431.54 |
| Max. Negotiated Rate |
$1,379.00 |
| Rate for Payer: Aetna Commercial |
$907.69
|
| Rate for Payer: Aetna Medicare |
$704.48
|
| Rate for Payer: BCBS Complete |
$453.12
|
| Rate for Payer: BCBS MAPPO |
$677.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$986.64
|
| Rate for Payer: BCN Medicare Advantage |
$677.38
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cash Price |
$1,576.00
|
| Rate for Payer: Cofinity Commercial |
$975.43
|
| Rate for Payer: Cofinity Commercial |
$907.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.38
|
| Rate for Payer: Mclaren Medicaid |
$431.54
|
| Rate for Payer: Meridian Medicaid |
$453.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$711.25
|
| Rate for Payer: PACE SWMI |
$677.38
|
| Rate for Payer: PHP Medicare Advantage |
$677.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.02
|
| Rate for Payer: Priority Health Medicare |
$677.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,074.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$677.38
|
| Rate for Payer: UHC Medicare Advantage |
$697.70
|
|
|
PR ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART
|
Professional
|
Both
|
$8,262.00
|
|
|
Service Code
|
HCPCS 61705
|
| Min. Negotiated Rate |
$404.15 |
| Max. Negotiated Rate |
$5,783.40 |
| Rate for Payer: Aetna Commercial |
$3,513.55
|
| Rate for Payer: Aetna Medicare |
$2,726.93
|
| Rate for Payer: BCBS Complete |
$1,767.73
|
| Rate for Payer: BCBS MAPPO |
$2,622.05
|
| Rate for Payer: BCBS Trust/PPO |
$404.15
|
| Rate for Payer: BCN Commercial |
$3,832.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,622.05
|
| Rate for Payer: Cash Price |
$6,609.60
|
| Rate for Payer: Cash Price |
$6,609.60
|
| Rate for Payer: Cofinity Commercial |
$3,513.55
|
| Rate for Payer: Cofinity Commercial |
$3,775.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,622.05
|
| Rate for Payer: Mclaren Medicaid |
$1,683.55
|
| Rate for Payer: Meridian Medicaid |
$1,767.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,753.15
|
| Rate for Payer: PACE SWMI |
$2,622.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,622.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,683.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,783.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,440.32
|
| Rate for Payer: Priority Health Medicare |
$2,622.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,440.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,622.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,622.05
|
| Rate for Payer: UHC Medicare Advantage |
$2,700.71
|
|
|
PR ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH
|
Professional
|
Both
|
$2,046.00
|
|
|
Service Code
|
HCPCS 31400
|
| Min. Negotiated Rate |
$649.44 |
| Max. Negotiated Rate |
$1,845.88 |
| Rate for Payer: Aetna Commercial |
$1,322.27
|
| Rate for Payer: Aetna Medicare |
$1,026.24
|
| Rate for Payer: BCBS Complete |
$681.91
|
| Rate for Payer: BCBS MAPPO |
$986.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.88
|
| Rate for Payer: BCN Commercial |
$1,491.93
|
| Rate for Payer: BCN Medicare Advantage |
$986.77
|
| Rate for Payer: Cash Price |
$1,636.80
|
| Rate for Payer: Cash Price |
$1,636.80
|
| Rate for Payer: Cofinity Commercial |
$1,420.95
|
| Rate for Payer: Cofinity Commercial |
$1,322.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$986.77
|
| Rate for Payer: Mclaren Medicaid |
$649.44
|
| Rate for Payer: Meridian Medicaid |
$681.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,036.11
|
| Rate for Payer: PACE SWMI |
$986.77
|
| Rate for Payer: PHP Medicare Advantage |
$986.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,413.68
|
| Rate for Payer: Priority Health Medicare |
$986.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,413.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$986.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$986.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,016.37
|
|
|
PR AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT
|
Professional
|
Both
|
$6,492.28
|
|
|
Service Code
|
HCPCS 33863
|
| Min. Negotiated Rate |
$745.43 |
| Max. Negotiated Rate |
$4,892.42 |
| Rate for Payer: Aetna Commercial |
$4,144.66
|
| Rate for Payer: Aetna Medicare |
$3,216.75
|
| Rate for Payer: BCBS Complete |
$2,061.60
|
| Rate for Payer: BCBS MAPPO |
$3,093.03
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$4,494.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,093.03
|
| Rate for Payer: Cash Price |
$5,193.82
|
| Rate for Payer: Cash Price |
$5,193.82
|
| Rate for Payer: Cofinity Commercial |
$4,453.96
|
| Rate for Payer: Cofinity Commercial |
$4,144.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,093.03
|
| Rate for Payer: Mclaren Medicaid |
$1,963.43
|
| Rate for Payer: Meridian Medicaid |
$2,061.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,247.68
|
| Rate for Payer: PACE SWMI |
$3,093.03
|
| Rate for Payer: PHP Medicare Advantage |
$3,093.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,963.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,544.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,892.42
|
| Rate for Payer: Priority Health Medicare |
$3,093.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,892.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,093.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,093.03
|
| Rate for Payer: UHC Medicare Advantage |
$3,185.82
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION
|
Professional
|
Both
|
$6,985.00
|
|
|
Service Code
|
HCPCS 33858
|
| Min. Negotiated Rate |
$313.81 |
| Max. Negotiated Rate |
$5,281.27 |
| Rate for Payer: Aetna Commercial |
$4,473.84
|
| Rate for Payer: Aetna Medicare |
$3,472.24
|
| Rate for Payer: BCBS Complete |
$2,224.20
|
| Rate for Payer: BCBS MAPPO |
$3,338.69
|
| Rate for Payer: BCBS Trust/PPO |
$313.81
|
| Rate for Payer: BCN Commercial |
$4,851.59
|
| Rate for Payer: BCN Medicare Advantage |
$3,338.69
|
| Rate for Payer: Cash Price |
$5,588.00
|
| Rate for Payer: Cash Price |
$5,588.00
|
| Rate for Payer: Cofinity Commercial |
$4,473.84
|
| Rate for Payer: Cofinity Commercial |
$4,807.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,338.69
|
| Rate for Payer: Mclaren Medicaid |
$2,118.29
|
| Rate for Payer: Meridian Medicaid |
$2,224.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,505.62
|
| Rate for Payer: PACE SWMI |
$3,338.69
|
| Rate for Payer: PHP Medicare Advantage |
$3,338.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,118.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,889.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,281.27
|
| Rate for Payer: Priority Health Medicare |
$3,338.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,281.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,338.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,338.69
|
| Rate for Payer: UHC Medicare Advantage |
$3,438.85
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ
|
Professional
|
Both
|
$5,011.00
|
|
|
Service Code
|
HCPCS 33859
|
| Min. Negotiated Rate |
$1,128.45 |
| Max. Negotiated Rate |
$3,793.40 |
| Rate for Payer: Aetna Commercial |
$3,210.75
|
| Rate for Payer: Aetna Medicare |
$2,491.92
|
| Rate for Payer: BCBS Complete |
$1,598.88
|
| Rate for Payer: BCBS MAPPO |
$2,396.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.45
|
| Rate for Payer: BCN Commercial |
$3,484.76
|
| Rate for Payer: BCN Medicare Advantage |
$2,396.08
|
| Rate for Payer: Cash Price |
$4,008.80
|
| Rate for Payer: Cash Price |
$4,008.80
|
| Rate for Payer: Cofinity Commercial |
$3,450.36
|
| Rate for Payer: Cofinity Commercial |
$3,210.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,396.08
|
| Rate for Payer: Mclaren Medicaid |
$1,522.74
|
| Rate for Payer: Meridian Medicaid |
$1,598.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,515.88
|
| Rate for Payer: PACE SWMI |
$2,396.08
|
| Rate for Payer: PHP Medicare Advantage |
$2,396.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,522.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,507.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,793.40
|
| Rate for Payer: Priority Health Medicare |
$2,396.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,793.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,396.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,396.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,467.96
|
|
|
PR ASCEND AORTA GRAFT INCL VAVLE SUSPENSION
|
Professional
|
Both
|
$9,858.00
|
|
|
Service Code
|
HCPCS 33860
|
| Min. Negotiated Rate |
$3,943.20 |
| Max. Negotiated Rate |
$6,900.60 |
| Rate for Payer: BCBS Complete |
$3,943.20
|
| Rate for Payer: Cash Price |
$7,886.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,900.60
|
|
|
PR ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL
|
Professional
|
Both
|
$5,125.00
|
|
|
Service Code
|
HCPCS 33864
|
| Min. Negotiated Rate |
$1,166.49 |
| Max. Negotiated Rate |
$5,000.94 |
| Rate for Payer: Aetna Commercial |
$4,236.96
|
| Rate for Payer: Aetna Medicare |
$3,288.39
|
| Rate for Payer: BCBS Complete |
$2,105.44
|
| Rate for Payer: BCBS MAPPO |
$3,161.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,166.49
|
| Rate for Payer: BCN Commercial |
$4,594.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,161.91
|
| Rate for Payer: Cash Price |
$4,100.00
|
| Rate for Payer: Cash Price |
$4,100.00
|
| Rate for Payer: Cofinity Commercial |
$4,236.96
|
| Rate for Payer: Cofinity Commercial |
$4,553.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,161.91
|
| Rate for Payer: Mclaren Medicaid |
$2,005.18
|
| Rate for Payer: Meridian Medicaid |
$2,105.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,320.01
|
| Rate for Payer: PACE SWMI |
$3,161.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,161.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,005.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,587.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,000.94
|
| Rate for Payer: Priority Health Medicare |
$3,161.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,000.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,161.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,161.91
|
| Rate for Payer: UHC Medicare Advantage |
$3,256.77
|
|
|
PR ASPIRATION AND/OR INJECTION THYROID CYST
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS 60300
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$3,338.86 |
| Rate for Payer: Aetna Commercial |
$63.82
|
| Rate for Payer: Aetna Medicare |
$49.54
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS MAPPO |
$47.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,338.86
|
| Rate for Payer: BCN Commercial |
$157.35
|
| Rate for Payer: BCN Medicare Advantage |
$47.63
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cofinity Commercial |
$68.59
|
| Rate for Payer: Cofinity Commercial |
$63.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.63
|
| Rate for Payer: Mclaren Medicaid |
$30.46
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.01
|
| Rate for Payer: PACE SWMI |
$47.63
|
| Rate for Payer: PHP Medicare Advantage |
$47.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.66
|
| Rate for Payer: Priority Health Medicare |
$47.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.63
|
| Rate for Payer: UHC Medicare Advantage |
$49.06
|
|
|
PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 51102
|
| Min. Negotiated Rate |
$89.89 |
| Max. Negotiated Rate |
$1,872.30 |
| Rate for Payer: Aetna Commercial |
$187.73
|
| Rate for Payer: Aetna Medicare |
$145.70
|
| Rate for Payer: BCBS Complete |
$94.38
|
| Rate for Payer: BCBS MAPPO |
$140.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,872.30
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$140.10
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$187.73
|
| Rate for Payer: Cofinity Commercial |
$201.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.10
|
| Rate for Payer: Mclaren Medicaid |
$89.89
|
| Rate for Payer: Meridian Medicaid |
$94.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.10
|
| Rate for Payer: PACE SWMI |
$140.10
|
| Rate for Payer: PHP Medicare Advantage |
$140.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.02
|
| Rate for Payer: Priority Health Medicare |
$140.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.10
|
| Rate for Payer: UHC Medicare Advantage |
$144.30
|
|
|
PR ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 51100
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$2,925.20 |
| Rate for Payer: Aetna Commercial |
$51.47
|
| Rate for Payer: Aetna Medicare |
$39.95
|
| Rate for Payer: BCBS Complete |
$25.95
|
| Rate for Payer: BCBS MAPPO |
$38.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,925.20
|
| Rate for Payer: BCN Commercial |
$107.02
|
| Rate for Payer: BCN Medicare Advantage |
$38.41
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$55.31
|
| Rate for Payer: Cofinity Commercial |
$51.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.41
|
| Rate for Payer: Mclaren Medicaid |
$24.71
|
| Rate for Payer: Meridian Medicaid |
$25.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.33
|
| Rate for Payer: PACE SWMI |
$38.41
|
| Rate for Payer: PHP Medicare Advantage |
$38.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$38.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.41
|
| Rate for Payer: UHC Medicare Advantage |
$39.56
|
|
|
PR ASPIRATION BLADDER TROCAR/INTRACATHETER
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 51101
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$2,914.10 |
| Rate for Payer: Aetna Commercial |
$66.66
|
| Rate for Payer: Aetna Medicare |
$51.74
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS MAPPO |
$49.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,914.10
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$49.75
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cofinity Commercial |
$71.64
|
| Rate for Payer: Cofinity Commercial |
$66.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.75
|
| Rate for Payer: Mclaren Medicaid |
$32.16
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.24
|
| Rate for Payer: PACE SWMI |
$49.75
|
| Rate for Payer: PHP Medicare Advantage |
$49.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.51
|
| Rate for Payer: Priority Health Medicare |
$49.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.75
|
| Rate for Payer: UHC Medicare Advantage |
$51.24
|
|
|
PR ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 20612
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$2,114.22 |
| Rate for Payer: Aetna Commercial |
$54.04
|
| Rate for Payer: Aetna Medicare |
$41.94
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS MAPPO |
$40.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,114.22
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$40.33
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$58.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.33
|
| Rate for Payer: Mclaren Medicaid |
$26.20
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.35
|
| Rate for Payer: PACE SWMI |
$40.33
|
| Rate for Payer: PHP Medicare Advantage |
$40.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.30
|
| Rate for Payer: Priority Health Medicare |
$40.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.33
|
| Rate for Payer: UHC Medicare Advantage |
$41.54
|
|
|
PR ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR
|
Professional
|
Both
|
$199.00
|
|
|
Service Code
|
HCPCS 96105
|
| Min. Negotiated Rate |
$79.60 |
| Max. Negotiated Rate |
$332.30 |
| Rate for Payer: Aetna Commercial |
$127.78
|
| Rate for Payer: Aetna Medicare |
$99.17
|
| Rate for Payer: BCBS Complete |
$79.60
|
| Rate for Payer: BCBS MAPPO |
$95.36
|
| Rate for Payer: BCBS Trust/PPO |
$332.30
|
| Rate for Payer: BCN Commercial |
$141.72
|
| Rate for Payer: BCN Medicare Advantage |
$95.36
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cofinity Commercial |
$137.32
|
| Rate for Payer: Cofinity Commercial |
$127.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.13
|
| Rate for Payer: PACE SWMI |
$95.36
|
| Rate for Payer: PHP Medicare Advantage |
$95.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.25
|
| Rate for Payer: Priority Health Medicare |
$95.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.36
|
| Rate for Payer: UHC Medicare Advantage |
$98.22
|
|
|
PR ASSESSMENT FOR HEARING AID
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS V5010
|
| Min. Negotiated Rate |
$47.05 |
| Max. Negotiated Rate |
$98.00 |
| Rate for Payer: Aetna Commercial |
$47.05
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
|
|
PR ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 99483
|
| Min. Negotiated Rate |
$122.26 |
| Max. Negotiated Rate |
$405.21 |
| Rate for Payer: Aetna Commercial |
$254.51
|
| Rate for Payer: Aetna Medicare |
$197.53
|
| Rate for Payer: BCBS Complete |
$128.37
|
| Rate for Payer: BCBS MAPPO |
$189.93
|
| Rate for Payer: BCBS Trust/PPO |
$405.21
|
| Rate for Payer: BCN Commercial |
$288.40
|
| Rate for Payer: BCN Medicare Advantage |
$189.93
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$254.51
|
| Rate for Payer: Cofinity Commercial |
$273.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.93
|
| Rate for Payer: Mclaren Medicaid |
$122.26
|
| Rate for Payer: Meridian Medicaid |
$128.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.43
|
| Rate for Payer: PACE SWMI |
$189.93
|
| Rate for Payer: PHP Medicare Advantage |
$189.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.42
|
| Rate for Payer: Priority Health Medicare |
$189.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.93
|
| Rate for Payer: UHC Medicare Advantage |
$195.63
|
|
|
PRASUGREL 10 MG TABLET
|
Facility
|
IP
|
$94.34
|
|
|
Service Code
|
NDC 60505-4643-3
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.54 |
| Max. Negotiated Rate |
$84.91 |
| Rate for Payer: Aetna Commercial |
$80.19
|
| Rate for Payer: BCBS Trust/PPO |
$72.91
|
| Rate for Payer: BCN Commercial |
$72.91
|
| Rate for Payer: Cash Price |
$75.47
|
| Rate for Payer: Cofinity Commercial |
$81.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.47
|
| Rate for Payer: Healthscope Commercial |
$84.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.19
|
| Rate for Payer: PHP Commercial |
$80.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.02
|
| Rate for Payer: UHC Core |
$78.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.76
|
|
|
PRASUGREL 10 MG TABLET
|
Facility
|
IP
|
$1,577.54
|
|
|
Service Code
|
NDC 0002-5123-30
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$962.14 |
| Max. Negotiated Rate |
$1,419.79 |
| Rate for Payer: Aetna Commercial |
$1,340.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,219.12
|
| Rate for Payer: BCN Commercial |
$1,219.12
|
| Rate for Payer: Cash Price |
$1,262.03
|
| Rate for Payer: Cofinity Commercial |
$1,356.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,262.03
|
| Rate for Payer: Healthscope Commercial |
$1,419.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,183.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,340.91
|
| Rate for Payer: PHP Commercial |
$1,340.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,104.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,372.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$962.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,388.24
|
| Rate for Payer: UHC Core |
$1,317.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,183.16
|
|
|
PR ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE
|
Professional
|
Both
|
$1,495.00
|
|
|
Service Code
|
HCPCS 33257
|
| Min. Negotiated Rate |
$367.43 |
| Max. Negotiated Rate |
$2,631.46 |
| Rate for Payer: Aetna Commercial |
$765.72
|
| Rate for Payer: Aetna Medicare |
$594.29
|
| Rate for Payer: BCBS Complete |
$385.80
|
| Rate for Payer: BCBS MAPPO |
$571.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,631.46
|
| Rate for Payer: BCN Commercial |
$838.57
|
| Rate for Payer: BCN Medicare Advantage |
$571.43
|
| Rate for Payer: Cash Price |
$1,196.00
|
| Rate for Payer: Cash Price |
$1,196.00
|
| Rate for Payer: Cofinity Commercial |
$822.86
|
| Rate for Payer: Cofinity Commercial |
$765.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.43
|
| Rate for Payer: Mclaren Medicaid |
$367.43
|
| Rate for Payer: Meridian Medicaid |
$385.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$600.00
|
| Rate for Payer: PACE SWMI |
$571.43
|
| Rate for Payer: PHP Medicare Advantage |
$571.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,046.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$912.83
|
| Rate for Payer: Priority Health Medicare |
$571.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$912.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.43
|
| Rate for Payer: UHC Medicare Advantage |
$588.57
|
|
|
PR ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS
|
Professional
|
Both
|
$2,258.00
|
|
|
Service Code
|
HCPCS 33259
|
| Min. Negotiated Rate |
$533.78 |
| Max. Negotiated Rate |
$5,209.57 |
| Rate for Payer: Aetna Commercial |
$1,111.13
|
| Rate for Payer: Aetna Medicare |
$862.37
|
| Rate for Payer: BCBS Complete |
$560.47
|
| Rate for Payer: BCBS MAPPO |
$829.20
|
| Rate for Payer: BCBS Trust/PPO |
$5,209.57
|
| Rate for Payer: BCN Commercial |
$1,216.32
|
| Rate for Payer: BCN Medicare Advantage |
$829.20
|
| Rate for Payer: Cash Price |
$1,806.40
|
| Rate for Payer: Cash Price |
$1,806.40
|
| Rate for Payer: Cofinity Commercial |
$1,111.13
|
| Rate for Payer: Cofinity Commercial |
$1,194.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.20
|
| Rate for Payer: Mclaren Medicaid |
$533.78
|
| Rate for Payer: Meridian Medicaid |
$560.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$870.66
|
| Rate for Payer: PACE SWMI |
$829.20
|
| Rate for Payer: PHP Medicare Advantage |
$829.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$533.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,580.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,324.04
|
| Rate for Payer: Priority Health Medicare |
$829.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,324.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$829.20
|
| Rate for Payer: UHC Medicare Advantage |
$854.08
|
|
|
PR ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 99464
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$1,378.86 |
| Rate for Payer: Aetna Commercial |
$95.76
|
| Rate for Payer: Aetna Medicare |
$74.32
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,378.86
|
| Rate for Payer: BCN Commercial |
$105.06
|
| Rate for Payer: BCN Medicare Advantage |
$71.46
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Cofinity Commercial |
$95.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.46
|
| Rate for Payer: Mclaren Medicaid |
$45.80
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.03
|
| Rate for Payer: PACE SWMI |
$71.46
|
| Rate for Payer: PHP Medicare Advantage |
$71.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$281.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.09
|
| Rate for Payer: Priority Health Medicare |
$71.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.46
|
| Rate for Payer: UHC Medicare Advantage |
$73.60
|
|
|
PR AUDIOMETRY FOR HEARING AID
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS S0618
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$53.90 |
| Rate for Payer: Aetna Commercial |
$43.02
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.90
|
|
