|
PR CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 50688
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$2,900.37 |
| Rate for Payer: Aetna Commercial |
$97.34
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.37
|
| Rate for Payer: BCN Commercial |
$111.42
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Mclaren Medicaid |
$49.20
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.20
|
|
|
PR CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,078.00
|
|
|
Service Code
|
HCPCS 47620
|
| Min. Negotiated Rate |
$521.43 |
| Max. Negotiated Rate |
$2,414.81 |
| Rate for Payer: Aetna Commercial |
$1,835.51
|
| Rate for Payer: Aetna Medicare |
$1,424.57
|
| Rate for Payer: BCBS Complete |
$922.11
|
| Rate for Payer: BCBS MAPPO |
$1,369.78
|
| Rate for Payer: BCBS Trust/PPO |
$521.43
|
| Rate for Payer: BCN Commercial |
$2,007.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,369.78
|
| Rate for Payer: Cash Price |
$1,662.40
|
| Rate for Payer: Cash Price |
$1,662.40
|
| Rate for Payer: Cofinity Commercial |
$1,835.51
|
| Rate for Payer: Cofinity Commercial |
$1,972.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,369.78
|
| Rate for Payer: Mclaren Medicaid |
$878.20
|
| Rate for Payer: Meridian Medicaid |
$922.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,438.27
|
| Rate for Payer: PACE SWMI |
$1,369.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,369.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,414.81
|
| Rate for Payer: Priority Health Medicare |
$1,369.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,414.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,369.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,369.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,410.87
|
|
|
PR CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM
|
Professional
|
Both
|
$2,592.00
|
|
|
Service Code
|
HCPCS 47741
|
| Min. Negotiated Rate |
$446.41 |
| Max. Negotiated Rate |
$2,592.97 |
| Rate for Payer: Aetna Commercial |
$1,967.55
|
| Rate for Payer: Aetna Medicare |
$1,527.05
|
| Rate for Payer: BCBS Complete |
$990.32
|
| Rate for Payer: BCBS MAPPO |
$1,468.32
|
| Rate for Payer: BCBS Trust/PPO |
$446.41
|
| Rate for Payer: BCN Commercial |
$2,155.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,468.32
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cofinity Commercial |
$2,114.38
|
| Rate for Payer: Cofinity Commercial |
$1,967.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,468.32
|
| Rate for Payer: Mclaren Medicaid |
$943.16
|
| Rate for Payer: Meridian Medicaid |
$990.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,541.74
|
| Rate for Payer: PACE SWMI |
$1,468.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,468.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$943.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,592.97
|
| Rate for Payer: Priority Health Medicare |
$1,468.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,592.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,468.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,468.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,512.37
|
|
|
PR CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX
|
Professional
|
Both
|
$2,572.00
|
|
|
Service Code
|
HCPCS 47480
|
| Min. Negotiated Rate |
$561.47 |
| Max. Negotiated Rate |
$1,800.40 |
| Rate for Payer: Aetna Commercial |
$1,163.87
|
| Rate for Payer: Aetna Medicare |
$903.30
|
| Rate for Payer: BCBS Complete |
$589.54
|
| Rate for Payer: BCBS MAPPO |
$868.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.28
|
| Rate for Payer: BCN Commercial |
$1,283.75
|
| Rate for Payer: BCN Medicare Advantage |
$868.56
|
| Rate for Payer: Cash Price |
$2,057.60
|
| Rate for Payer: Cash Price |
$2,057.60
|
| Rate for Payer: Cofinity Commercial |
$1,250.73
|
| Rate for Payer: Cofinity Commercial |
$1,163.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.56
|
| Rate for Payer: Mclaren Medicaid |
$561.47
|
| Rate for Payer: Meridian Medicaid |
$589.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$911.99
|
| Rate for Payer: PACE SWMI |
$868.56
|
| Rate for Payer: PHP Medicare Advantage |
$868.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$561.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,800.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.61
|
| Rate for Payer: Priority Health Medicare |
$868.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,544.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.56
|
| Rate for Payer: UHC Medicare Advantage |
$894.62
|
|
|
PR CHOLECYSTECTOMY
|
Facility
|
IP
|
$2,566.00
|
|
|
Service Code
|
CPT 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$1,565.00 |
| Max. Negotiated Rate |
$2,309.40 |
| Rate for Payer: Aetna Commercial |
$2,181.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,983.00
|
| Rate for Payer: BCN Commercial |
$1,983.00
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$2,206.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,052.80
|
| Rate for Payer: Healthscope Commercial |
$2,309.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,924.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,181.10
|
| Rate for Payer: PHP Commercial |
$2,181.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,232.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,258.08
|
| Rate for Payer: UHC Core |
$2,142.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,924.50
|
|
|
PR CHOLECYSTECTOMY
|
Professional
|
Both
|
$2,566.00
|
|
|
Service Code
|
HCPCS 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$685.22 |
| Max. Negotiated Rate |
$2,558.03 |
| Rate for Payer: Aetna Commercial |
$1,425.20
|
| Rate for Payer: Aetna Medicare |
$1,106.12
|
| Rate for Payer: BCBS Complete |
$719.48
|
| Rate for Payer: BCBS MAPPO |
$1,063.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,558.03
|
| Rate for Payer: BCN Commercial |
$1,562.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.58
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,425.20
|
| Rate for Payer: Cofinity Commercial |
$1,531.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.58
|
| Rate for Payer: Mclaren Medicaid |
$685.22
|
| Rate for Payer: Meridian Medicaid |
$719.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,116.76
|
| Rate for Payer: PACE SWMI |
$1,063.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,880.33
|
| Rate for Payer: Priority Health Medicare |
$1,063.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,880.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,063.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.49
|
|
|
PR CHOLECYSTECTOMY
|
Facility
|
OP
|
$2,566.00
|
|
|
Service Code
|
CPT 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$609.42 |
| Max. Negotiated Rate |
$2,309.40 |
| Rate for Payer: Aetna Commercial |
$2,181.10
|
| Rate for Payer: Aetna Medicare |
$667.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$801.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$801.88
|
| Rate for Payer: BCBS Complete |
$1,026.40
|
| Rate for Payer: BCBS MAPPO |
$641.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,995.06
|
| Rate for Payer: BCN Commercial |
$1,995.06
|
| Rate for Payer: BCN Medicare Advantage |
$641.50
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$2,206.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,052.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.50
|
| Rate for Payer: Healthscope Commercial |
$2,309.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,924.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$673.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$737.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,181.10
|
| Rate for Payer: PACE Senior Care Partners |
$609.42
|
| Rate for Payer: PACE SWMI |
$641.50
|
| Rate for Payer: PHP Commercial |
$2,181.10
|
| Rate for Payer: PHP Medicare Advantage |
$641.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,232.42
|
| Rate for Payer: Priority Health Medicare |
$641.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.00
|
| Rate for Payer: Railroad Medicare Medicare |
$641.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,258.08
|
| Rate for Payer: UHC Core |
$2,142.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.50
|
| Rate for Payer: UHC Medicare Advantage |
$660.74
|
| Rate for Payer: VA VA |
$641.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,924.50
|
|
|
PR CHOLECYSTECTOMY
|
Professional
|
Both
|
$2,566.00
|
|
|
Service Code
|
HCPCS 47600
|
| Min. Negotiated Rate |
$685.22 |
| Max. Negotiated Rate |
$2,558.03 |
| Rate for Payer: Aetna Commercial |
$1,425.20
|
| Rate for Payer: Aetna Medicare |
$1,106.12
|
| Rate for Payer: BCBS Complete |
$719.48
|
| Rate for Payer: BCBS MAPPO |
$1,063.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,558.03
|
| Rate for Payer: BCN Commercial |
$1,562.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.58
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,425.20
|
| Rate for Payer: Cofinity Commercial |
$1,531.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.58
|
| Rate for Payer: Mclaren Medicaid |
$685.22
|
| Rate for Payer: Meridian Medicaid |
$719.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,116.76
|
| Rate for Payer: PACE SWMI |
$1,063.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,880.33
|
| Rate for Payer: Priority Health Medicare |
$1,063.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,880.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,063.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.49
|
|
|
PR CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY
|
Professional
|
Both
|
$4,618.00
|
|
|
Service Code
|
HCPCS 47612
|
| Min. Negotiated Rate |
$676.22 |
| Max. Negotiated Rate |
$3,232.60 |
| Rate for Payer: Aetna Commercial |
$1,699.12
|
| Rate for Payer: Aetna Medicare |
$1,318.72
|
| Rate for Payer: BCBS Complete |
$854.34
|
| Rate for Payer: BCBS MAPPO |
$1,268.00
|
| Rate for Payer: BCBS Trust/PPO |
$676.22
|
| Rate for Payer: BCN Commercial |
$1,858.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,268.00
|
| Rate for Payer: Cash Price |
$3,694.40
|
| Rate for Payer: Cash Price |
$3,694.40
|
| Rate for Payer: Cofinity Commercial |
$1,825.92
|
| Rate for Payer: Cofinity Commercial |
$1,699.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,268.00
|
| Rate for Payer: Mclaren Medicaid |
$813.66
|
| Rate for Payer: Meridian Medicaid |
$854.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,331.40
|
| Rate for Payer: PACE SWMI |
$1,268.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,268.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$813.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,232.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,236.65
|
| Rate for Payer: Priority Health Medicare |
$1,268.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,236.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,268.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,306.04
|
|
|
PR CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$2,950.00
|
|
|
Service Code
|
HCPCS 47605
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$2,065.00 |
| Rate for Payer: Aetna Commercial |
$1,504.03
|
| Rate for Payer: Aetna Medicare |
$1,167.31
|
| Rate for Payer: BCBS Complete |
$757.50
|
| Rate for Payer: BCBS MAPPO |
$1,122.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.79
|
| Rate for Payer: BCN Commercial |
$1,648.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,122.41
|
| Rate for Payer: Cash Price |
$2,360.00
|
| Rate for Payer: Cash Price |
$2,360.00
|
| Rate for Payer: Cofinity Commercial |
$1,616.27
|
| Rate for Payer: Cofinity Commercial |
$1,504.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,122.41
|
| Rate for Payer: Mclaren Medicaid |
$721.43
|
| Rate for Payer: Meridian Medicaid |
$757.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,178.53
|
| Rate for Payer: PACE SWMI |
$1,122.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,122.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,065.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,983.24
|
| Rate for Payer: Priority Health Medicare |
$1,122.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,983.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,122.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,156.08
|
|
|
PR CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT
|
Professional
|
Both
|
$3,245.00
|
|
|
Service Code
|
HCPCS 47610
|
| Min. Negotiated Rate |
$141.58 |
| Max. Negotiated Rate |
$2,271.50 |
| Rate for Payer: Aetna Commercial |
$1,671.44
|
| Rate for Payer: Aetna Medicare |
$1,297.23
|
| Rate for Payer: BCBS Complete |
$838.02
|
| Rate for Payer: BCBS MAPPO |
$1,247.34
|
| Rate for Payer: BCBS Trust/PPO |
$141.58
|
| Rate for Payer: BCN Commercial |
$1,829.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,247.34
|
| Rate for Payer: Cash Price |
$2,596.00
|
| Rate for Payer: Cash Price |
$2,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,671.44
|
| Rate for Payer: Cofinity Commercial |
$1,796.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,247.34
|
| Rate for Payer: Mclaren Medicaid |
$798.11
|
| Rate for Payer: Meridian Medicaid |
$838.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,309.71
|
| Rate for Payer: PACE SWMI |
$1,247.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,247.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$798.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,271.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,200.79
|
| Rate for Payer: Priority Health Medicare |
$1,247.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,200.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,247.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,247.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,284.76
|
|
|
PR CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 47490
|
| Min. Negotiated Rate |
$208.53 |
| Max. Negotiated Rate |
$4,357.95 |
| Rate for Payer: Aetna Commercial |
$429.32
|
| Rate for Payer: Aetna Medicare |
$333.21
|
| Rate for Payer: BCBS Complete |
$218.96
|
| Rate for Payer: BCBS MAPPO |
$320.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,357.95
|
| Rate for Payer: BCN Commercial |
$480.37
|
| Rate for Payer: BCN Medicare Advantage |
$320.39
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cofinity Commercial |
$429.32
|
| Rate for Payer: Cofinity Commercial |
$461.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.39
|
| Rate for Payer: Mclaren Medicaid |
$208.53
|
| Rate for Payer: Meridian Medicaid |
$218.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$336.41
|
| Rate for Payer: PACE SWMI |
$320.39
|
| Rate for Payer: PHP Medicare Advantage |
$320.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$577.98
|
| Rate for Payer: Priority Health Medicare |
$320.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$577.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.39
|
| Rate for Payer: UHC Medicare Advantage |
$330.00
|
|
|
PR CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,358.00
|
|
|
Service Code
|
HCPCS 47420
|
| Min. Negotiated Rate |
$855.62 |
| Max. Negotiated Rate |
$2,338.95 |
| Rate for Payer: Aetna Commercial |
$1,774.33
|
| Rate for Payer: Aetna Medicare |
$1,377.10
|
| Rate for Payer: BCBS Complete |
$898.40
|
| Rate for Payer: BCBS MAPPO |
$1,324.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.71
|
| Rate for Payer: BCN Commercial |
$1,943.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,324.13
|
| Rate for Payer: Cash Price |
$1,886.40
|
| Rate for Payer: Cash Price |
$1,886.40
|
| Rate for Payer: Cofinity Commercial |
$1,906.75
|
| Rate for Payer: Cofinity Commercial |
$1,774.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,324.13
|
| Rate for Payer: Mclaren Medicaid |
$855.62
|
| Rate for Payer: Meridian Medicaid |
$898.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,390.34
|
| Rate for Payer: PACE SWMI |
$1,324.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,324.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,650.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,338.95
|
| Rate for Payer: Priority Health Medicare |
$1,324.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,338.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,324.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,324.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,363.85
|
|
|
PR CHOLERA IMMUNIZATION,INJECTABLE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 90725
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.40
|
|
|
PR CHOLINESTERASE INHIBITOR CHALLENGE TEST
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 95857
|
| Min. Negotiated Rate |
$17.89 |
| Max. Negotiated Rate |
$220.30 |
| Rate for Payer: Aetna Commercial |
$37.18
|
| Rate for Payer: Aetna Medicare |
$28.86
|
| Rate for Payer: BCBS Complete |
$18.78
|
| Rate for Payer: BCBS MAPPO |
$27.75
|
| Rate for Payer: BCBS Trust/PPO |
$220.30
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$27.75
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$39.96
|
| Rate for Payer: Cofinity Commercial |
$37.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.75
|
| Rate for Payer: Mclaren Medicaid |
$17.89
|
| Rate for Payer: Meridian Medicaid |
$18.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.14
|
| Rate for Payer: PACE SWMI |
$27.75
|
| Rate for Payer: PHP Medicare Advantage |
$27.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.73
|
| Rate for Payer: Priority Health Medicare |
$27.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.75
|
| Rate for Payer: UHC Medicare Advantage |
$28.58
|
|
|
PR CHORIONIC VILLUS SAMPLING
|
Professional
|
Both
|
$390.00
|
|
|
Service Code
|
HCPCS 59015
|
| Min. Negotiated Rate |
$84.14 |
| Max. Negotiated Rate |
$273.00 |
| Rate for Payer: Aetna Commercial |
$175.58
|
| Rate for Payer: Aetna Medicare |
$136.27
|
| Rate for Payer: BCBS Complete |
$88.35
|
| Rate for Payer: BCBS MAPPO |
$131.03
|
| Rate for Payer: BCBS Trust/PPO |
$143.17
|
| Rate for Payer: BCN Commercial |
$231.15
|
| Rate for Payer: BCN Medicare Advantage |
$131.03
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$175.58
|
| Rate for Payer: Cofinity Commercial |
$188.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.03
|
| Rate for Payer: Mclaren Medicaid |
$84.14
|
| Rate for Payer: Meridian Medicaid |
$88.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.58
|
| Rate for Payer: PACE SWMI |
$131.03
|
| Rate for Payer: PHP Medicare Advantage |
$131.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.62
|
| Rate for Payer: Priority Health Medicare |
$131.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.03
|
| Rate for Payer: UHC Medicare Advantage |
$134.96
|
|
|
PR CHROMOTUBATION OVIDUCT W/MATERIALS
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 58350
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$508.22 |
| Rate for Payer: Aetna Commercial |
$124.77
|
| Rate for Payer: Aetna Medicare |
$96.83
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$93.11
|
| Rate for Payer: BCBS Trust/PPO |
$508.22
|
| Rate for Payer: BCN Commercial |
$228.22
|
| Rate for Payer: BCN Medicare Advantage |
$93.11
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Commercial |
$134.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.11
|
| Rate for Payer: Mclaren Medicaid |
$61.34
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.77
|
| Rate for Payer: PACE SWMI |
$93.11
|
| Rate for Payer: PHP Medicare Advantage |
$93.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.35
|
| Rate for Payer: Priority Health Medicare |
$93.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.11
|
| Rate for Payer: UHC Medicare Advantage |
$95.90
|
|
|
PR CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE
|
Professional
|
Both
|
$3,466.00
|
|
|
Service Code
|
HCPCS 24940
|
| Min. Negotiated Rate |
$602.42 |
| Max. Negotiated Rate |
$11,675.93 |
| Rate for Payer: Aetna Commercial |
$1,439.82
|
| Rate for Payer: BCBS Complete |
$632.54
|
| Rate for Payer: BCBS Trust/PPO |
$730.11
|
| Rate for Payer: BCN Commercial |
$11,675.93
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Mclaren Medicaid |
$602.42
|
| Rate for Payer: Meridian Medicaid |
$632.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,426.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,668.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,668.80
|
|
|
PR CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT
|
Professional
|
Both
|
$633.00
|
|
|
Service Code
|
HCPCS 94772
|
| Min. Negotiated Rate |
$253.20 |
| Max. Negotiated Rate |
$544.82 |
| Rate for Payer: Aetna Commercial |
$318.52
|
| Rate for Payer: BCBS Complete |
$253.20
|
| Rate for Payer: BCBS Trust/PPO |
$518.79
|
| Rate for Payer: BCN Commercial |
$544.82
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$417.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$417.25
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$922.78 |
| Max. Negotiated Rate |
$1,361.70 |
| Rate for Payer: Aetna Commercial |
$1,286.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,169.25
|
| Rate for Payer: BCN Commercial |
$1,169.25
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,301.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,210.40
|
| Rate for Payer: Healthscope Commercial |
$1,361.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,134.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,286.05
|
| Rate for Payer: PHP Commercial |
$1,286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,059.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,316.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,331.44
|
| Rate for Payer: UHC Core |
$1,263.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,134.75
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 54161
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$1,059.10 |
| Rate for Payer: Aetna Commercial |
$258.00
|
| Rate for Payer: Aetna Medicare |
$200.24
|
| Rate for Payer: BCBS Complete |
$132.40
|
| Rate for Payer: BCBS MAPPO |
$192.54
|
| Rate for Payer: BCBS Trust/PPO |
$496.07
|
| Rate for Payer: BCN Commercial |
$285.39
|
| Rate for Payer: BCN Medicare Advantage |
$192.54
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Cofinity Commercial |
$277.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.54
|
| Rate for Payer: Mclaren Medicaid |
$126.10
|
| Rate for Payer: Meridian Medicaid |
$132.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.17
|
| Rate for Payer: PACE SWMI |
$192.54
|
| Rate for Payer: PHP Medicare Advantage |
$192.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,059.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.57
|
| Rate for Payer: Priority Health Medicare |
$192.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$315.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.54
|
| Rate for Payer: UHC Medicare Advantage |
$198.32
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$359.34 |
| Max. Negotiated Rate |
$1,402.94 |
| Rate for Payer: Aetna Commercial |
$1,286.05
|
| Rate for Payer: Aetna Medicare |
$393.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$472.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$472.81
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$378.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,176.36
|
| Rate for Payer: BCN Commercial |
$1,176.36
|
| Rate for Payer: BCN Medicare Advantage |
$378.25
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,301.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,210.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.25
|
| Rate for Payer: Healthscope Commercial |
$1,361.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,134.75
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$397.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$434.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,286.05
|
| Rate for Payer: PACE Senior Care Partners |
$359.34
|
| Rate for Payer: PACE SWMI |
$378.25
|
| Rate for Payer: PHP Commercial |
$1,286.05
|
| Rate for Payer: PHP Medicare Advantage |
$378.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,059.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,316.31
|
| Rate for Payer: Priority Health Medicare |
$378.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.78
|
| Rate for Payer: Railroad Medicare Medicare |
$378.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,331.44
|
| Rate for Payer: UHC Core |
$1,263.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$378.25
|
| Rate for Payer: UHC Medicare Advantage |
$389.60
|
| Rate for Payer: VA VA |
$378.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,134.75
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 54161
|
| Hospital Charge Code |
54161
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$1,059.10 |
| Rate for Payer: Aetna Commercial |
$258.00
|
| Rate for Payer: Aetna Medicare |
$200.24
|
| Rate for Payer: BCBS Complete |
$132.40
|
| Rate for Payer: BCBS MAPPO |
$192.54
|
| Rate for Payer: BCBS Trust/PPO |
$496.07
|
| Rate for Payer: BCN Commercial |
$285.39
|
| Rate for Payer: BCN Medicare Advantage |
$192.54
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$277.26
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.54
|
| Rate for Payer: Mclaren Medicaid |
$126.10
|
| Rate for Payer: Meridian Medicaid |
$132.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.17
|
| Rate for Payer: PACE SWMI |
$192.54
|
| Rate for Payer: PHP Medicare Advantage |
$192.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,059.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.57
|
| Rate for Payer: Priority Health Medicare |
$192.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$315.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.54
|
| Rate for Payer: UHC Medicare Advantage |
$198.32
|
|
|
PR CIRCUMCISION NEONATE
|
Professional
|
Both
|
$594.00
|
|
|
Service Code
|
HCPCS 54160
|
| Min. Negotiated Rate |
$92.87 |
| Max. Negotiated Rate |
$2,797.35 |
| Rate for Payer: Aetna Commercial |
$190.35
|
| Rate for Payer: Aetna Medicare |
$147.73
|
| Rate for Payer: BCBS Complete |
$97.51
|
| Rate for Payer: BCBS MAPPO |
$142.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,797.35
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: BCN Medicare Advantage |
$142.05
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cofinity Commercial |
$190.35
|
| Rate for Payer: Cofinity Commercial |
$204.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.05
|
| Rate for Payer: Mclaren Medicaid |
$92.87
|
| Rate for Payer: Meridian Medicaid |
$97.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.15
|
| Rate for Payer: PACE SWMI |
$142.05
|
| Rate for Payer: PHP Medicare Advantage |
$142.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$415.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.35
|
| Rate for Payer: Priority Health Medicare |
$142.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.05
|
| Rate for Payer: UHC Medicare Advantage |
$146.31
|
|
|
PR CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK
|
Professional
|
Both
|
$511.00
|
|
|
Service Code
|
HCPCS 54150
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$1,797.28 |
| Rate for Payer: Aetna Commercial |
$127.45
|
| Rate for Payer: Aetna Medicare |
$98.91
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS MAPPO |
$95.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.28
|
| Rate for Payer: BCN Commercial |
$216.98
|
| Rate for Payer: BCN Medicare Advantage |
$95.11
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cofinity Commercial |
$136.96
|
| Rate for Payer: Cofinity Commercial |
$127.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.11
|
| Rate for Payer: Mclaren Medicaid |
$60.71
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.87
|
| Rate for Payer: PACE SWMI |
$95.11
|
| Rate for Payer: PHP Medicare Advantage |
$95.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.00
|
| Rate for Payer: Priority Health Medicare |
$95.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.11
|
| Rate for Payer: UHC Medicare Advantage |
$97.96
|
|
