|
PR COUNSEL IMMUNE <21 16-30 M
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS G0314
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
|
|
PR COUNSEL IMMUNE <21 5-15 M
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS G0315
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
|
|
PR COUNSEL LUNG SCRN LDCT
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS G0296
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$735.92 |
| Rate for Payer: Aetna Commercial |
$33.84
|
| Rate for Payer: Aetna Medicare |
$26.26
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$735.92
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Medicare Advantage |
$25.25
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$36.36
|
| Rate for Payer: Cofinity Commercial |
$33.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.51
|
| Rate for Payer: PACE SWMI |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$25.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.13
|
| Rate for Payer: Priority Health Medicare |
$25.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.25
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
|
|
PR CPAP VENTILATION CPAP INITIATION&MGMT
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 94660
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$313.28 |
| Rate for Payer: Aetna Commercial |
$48.62
|
| Rate for Payer: Aetna Medicare |
$37.73
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS MAPPO |
$36.28
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$91.87
|
| Rate for Payer: BCN Medicare Advantage |
$36.28
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$48.62
|
| Rate for Payer: Cofinity Commercial |
$52.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.28
|
| Rate for Payer: Mclaren Medicaid |
$23.43
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.09
|
| Rate for Payer: PACE SWMI |
$36.28
|
| Rate for Payer: PHP Medicare Advantage |
$36.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.96
|
| Rate for Payer: Priority Health Medicare |
$36.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.28
|
| Rate for Payer: UHC Medicare Advantage |
$37.37
|
|
|
PR CPLX CHRONIC CARE MGMT SVC EA ADDL 30 MIN CAL MO
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 99489
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$1,256.83 |
| Rate for Payer: Aetna Commercial |
$65.79
|
| Rate for Payer: Aetna Medicare |
$51.06
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS MAPPO |
$49.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,256.83
|
| Rate for Payer: BCN Commercial |
$74.52
|
| Rate for Payer: BCN Medicare Advantage |
$49.10
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$70.70
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.10
|
| Rate for Payer: Mclaren Medicaid |
$31.74
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.56
|
| Rate for Payer: PACE SWMI |
$49.10
|
| Rate for Payer: PHP Medicare Advantage |
$49.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.39
|
| Rate for Payer: Priority Health Medicare |
$49.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.10
|
| Rate for Payer: UHC Medicare Advantage |
$50.57
|
|
|
PR CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ
|
Professional
|
Both
|
$10,100.00
|
|
|
Service Code
|
HCPCS 61698
|
| Min. Negotiated Rate |
$905.51 |
| Max. Negotiated Rate |
$9,419.88 |
| Rate for Payer: Aetna Commercial |
$6,240.85
|
| Rate for Payer: Aetna Medicare |
$4,843.64
|
| Rate for Payer: BCBS Complete |
$3,129.08
|
| Rate for Payer: BCBS MAPPO |
$4,657.35
|
| Rate for Payer: BCBS Trust/PPO |
$905.51
|
| Rate for Payer: BCN Commercial |
$9,419.88
|
| Rate for Payer: BCN Medicare Advantage |
$4,657.35
|
| Rate for Payer: Cash Price |
$8,080.00
|
| Rate for Payer: Cash Price |
$8,080.00
|
| Rate for Payer: Cofinity Commercial |
$6,706.58
|
| Rate for Payer: Cofinity Commercial |
$6,240.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,657.35
|
| Rate for Payer: Mclaren Medicaid |
$2,980.08
|
| Rate for Payer: Meridian Medicaid |
$3,129.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,890.22
|
| Rate for Payer: PACE SWMI |
$4,657.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,657.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,070.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,867.68
|
| Rate for Payer: Priority Health Medicare |
$4,657.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,867.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,657.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,657.35
|
| Rate for Payer: UHC Medicare Advantage |
$4,797.07
|
|
|
PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 0055T
|
| Min. Negotiated Rate |
$146.69 |
| Max. Negotiated Rate |
$448.43 |
| Rate for Payer: Aetna Commercial |
$210.14
|
| Rate for Payer: BCBS Complete |
$154.02
|
| Rate for Payer: BCBS Trust/PPO |
$448.43
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Mclaren Medicaid |
$146.69
|
| Rate for Payer: Meridian Medicaid |
$154.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
|
|
PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES
|
Professional
|
Both
|
$261.87
|
|
|
Service Code
|
HCPCS 0054T
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$183.31 |
| Rate for Payer: Aetna Commercial |
$179.20
|
| Rate for Payer: BCBS Complete |
$96.34
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: Cash Price |
$209.50
|
| Rate for Payer: Cash Price |
$209.50
|
| Rate for Payer: Mclaren Medicaid |
$91.75
|
| Rate for Payer: Meridian Medicaid |
$96.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.31
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 20985
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$219.57 |
| Rate for Payer: Aetna Commercial |
$191.81
|
| Rate for Payer: Aetna Medicare |
$148.87
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$143.14
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: BCN Commercial |
$210.13
|
| Rate for Payer: BCN Medicare Advantage |
$143.14
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$191.81
|
| Rate for Payer: Cofinity Commercial |
$206.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.14
|
| Rate for Payer: Mclaren Medicaid |
$91.59
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.30
|
| Rate for Payer: PACE SWMI |
$143.14
|
| Rate for Payer: PHP Medicare Advantage |
$143.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$219.57
|
| Rate for Payer: Priority Health Medicare |
$143.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.14
|
| Rate for Payer: UHC Medicare Advantage |
$147.43
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Facility
|
IP
|
$277.00
|
|
|
Service Code
|
CPT 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$168.94 |
| Max. Negotiated Rate |
$249.30 |
| Rate for Payer: Aetna Commercial |
$235.45
|
| Rate for Payer: BCBS Trust/PPO |
$214.07
|
| Rate for Payer: BCN Commercial |
$214.07
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$238.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.60
|
| Rate for Payer: Healthscope Commercial |
$249.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.45
|
| Rate for Payer: PHP Commercial |
$235.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.76
|
| Rate for Payer: UHC Core |
$231.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.75
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$219.57 |
| Rate for Payer: Aetna Commercial |
$191.81
|
| Rate for Payer: Aetna Medicare |
$148.87
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$143.14
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: BCN Commercial |
$210.13
|
| Rate for Payer: BCN Medicare Advantage |
$143.14
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$191.81
|
| Rate for Payer: Cofinity Commercial |
$206.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.14
|
| Rate for Payer: Mclaren Medicaid |
$91.59
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.30
|
| Rate for Payer: PACE SWMI |
$143.14
|
| Rate for Payer: PHP Medicare Advantage |
$143.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$219.57
|
| Rate for Payer: Priority Health Medicare |
$143.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.14
|
| Rate for Payer: UHC Medicare Advantage |
$147.43
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Facility
|
OP
|
$277.00
|
|
|
Service Code
|
CPT 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$65.79 |
| Max. Negotiated Rate |
$249.30 |
| Rate for Payer: Aetna Commercial |
$235.45
|
| Rate for Payer: Aetna Medicare |
$72.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.56
|
| Rate for Payer: BCBS Complete |
$110.80
|
| Rate for Payer: BCBS MAPPO |
$69.25
|
| Rate for Payer: BCBS Trust/PPO |
$215.37
|
| Rate for Payer: BCN Commercial |
$215.37
|
| Rate for Payer: BCN Medicare Advantage |
$69.25
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$238.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.25
|
| Rate for Payer: Healthscope Commercial |
$249.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.45
|
| Rate for Payer: PACE Senior Care Partners |
$65.79
|
| Rate for Payer: PACE SWMI |
$69.25
|
| Rate for Payer: PHP Commercial |
$235.45
|
| Rate for Payer: PHP Medicare Advantage |
$69.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.99
|
| Rate for Payer: Priority Health Medicare |
$69.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.94
|
| Rate for Payer: Railroad Medicare Medicare |
$69.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.76
|
| Rate for Payer: UHC Core |
$231.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.25
|
| Rate for Payer: UHC Medicare Advantage |
$71.33
|
| Rate for Payer: VA VA |
$69.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.75
|
|
|
PR CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT
|
Professional
|
Both
|
$7,151.00
|
|
|
Service Code
|
HCPCS 61582
|
| Min. Negotiated Rate |
$893.36 |
| Max. Negotiated Rate |
$6,455.95 |
| Rate for Payer: Aetna Commercial |
$4,188.05
|
| Rate for Payer: Aetna Medicare |
$3,250.43
|
| Rate for Payer: BCBS Complete |
$2,033.65
|
| Rate for Payer: BCBS MAPPO |
$3,125.41
|
| Rate for Payer: BCBS Trust/PPO |
$893.36
|
| Rate for Payer: BCN Commercial |
$6,455.95
|
| Rate for Payer: BCN Medicare Advantage |
$3,125.41
|
| Rate for Payer: Cash Price |
$5,720.80
|
| Rate for Payer: Cash Price |
$5,720.80
|
| Rate for Payer: Cofinity Commercial |
$4,500.59
|
| Rate for Payer: Cofinity Commercial |
$4,188.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,125.41
|
| Rate for Payer: Mclaren Medicaid |
$1,936.81
|
| Rate for Payer: Meridian Medicaid |
$2,033.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,281.68
|
| Rate for Payer: PACE SWMI |
$3,125.41
|
| Rate for Payer: PHP Medicare Advantage |
$3,125.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,005.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,392.15
|
| Rate for Payer: Priority Health Medicare |
$3,125.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,392.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,125.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,125.41
|
| Rate for Payer: UHC Medicare Advantage |
$3,219.17
|
|
|
PR CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE
|
Professional
|
Both
|
$7,812.00
|
|
|
Service Code
|
HCPCS 61583
|
| Min. Negotiated Rate |
$841.58 |
| Max. Negotiated Rate |
$6,001.73 |
| Rate for Payer: Aetna Commercial |
$3,928.00
|
| Rate for Payer: Aetna Medicare |
$3,048.59
|
| Rate for Payer: BCBS Complete |
$1,978.63
|
| Rate for Payer: BCBS MAPPO |
$2,931.34
|
| Rate for Payer: BCBS Trust/PPO |
$841.58
|
| Rate for Payer: BCN Commercial |
$6,001.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,931.34
|
| Rate for Payer: Cash Price |
$6,249.60
|
| Rate for Payer: Cash Price |
$6,249.60
|
| Rate for Payer: Cofinity Commercial |
$4,221.13
|
| Rate for Payer: Cofinity Commercial |
$3,928.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,931.34
|
| Rate for Payer: Mclaren Medicaid |
$1,884.41
|
| Rate for Payer: Meridian Medicaid |
$1,978.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,077.91
|
| Rate for Payer: PACE SWMI |
$2,931.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,931.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,884.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,468.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,012.77
|
| Rate for Payer: Priority Health Medicare |
$2,931.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,012.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,931.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,931.34
|
| Rate for Payer: UHC Medicare Advantage |
$3,019.28
|
|
|
PR CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY
|
Professional
|
Both
|
$8,634.00
|
|
|
Service Code
|
HCPCS 61323
|
| Min. Negotiated Rate |
$679.39 |
| Max. Negotiated Rate |
$6,043.80 |
| Rate for Payer: Aetna Commercial |
$3,229.82
|
| Rate for Payer: Aetna Medicare |
$2,506.72
|
| Rate for Payer: BCBS Complete |
$1,625.94
|
| Rate for Payer: BCBS MAPPO |
$2,410.31
|
| Rate for Payer: BCBS Trust/PPO |
$679.39
|
| Rate for Payer: BCN Commercial |
$4,887.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,410.31
|
| Rate for Payer: Cash Price |
$6,907.20
|
| Rate for Payer: Cash Price |
$6,907.20
|
| Rate for Payer: Cofinity Commercial |
$3,470.85
|
| Rate for Payer: Cofinity Commercial |
$3,229.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,410.31
|
| Rate for Payer: Mclaren Medicaid |
$1,548.51
|
| Rate for Payer: Meridian Medicaid |
$1,625.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,530.83
|
| Rate for Payer: PACE SWMI |
$2,410.31
|
| Rate for Payer: PHP Medicare Advantage |
$2,410.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,548.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,043.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,081.91
|
| Rate for Payer: Priority Health Medicare |
$2,410.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,081.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,410.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,410.31
|
| Rate for Payer: UHC Medicare Advantage |
$2,482.62
|
|
|
PR CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY
|
Professional
|
Both
|
$4,919.58
|
|
|
Service Code
|
HCPCS 61322
|
| Min. Negotiated Rate |
$569.51 |
| Max. Negotiated Rate |
$4,067.19 |
| Rate for Payer: Aetna Commercial |
$3,213.28
|
| Rate for Payer: Aetna Medicare |
$2,493.89
|
| Rate for Payer: BCBS Complete |
$1,622.13
|
| Rate for Payer: BCBS MAPPO |
$2,397.97
|
| Rate for Payer: BCBS Trust/PPO |
$569.51
|
| Rate for Payer: BCN Commercial |
$3,510.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,397.97
|
| Rate for Payer: Cash Price |
$3,935.66
|
| Rate for Payer: Cash Price |
$3,935.66
|
| Rate for Payer: Cofinity Commercial |
$3,453.08
|
| Rate for Payer: Cofinity Commercial |
$3,213.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,397.97
|
| Rate for Payer: Mclaren Medicaid |
$1,544.89
|
| Rate for Payer: Meridian Medicaid |
$1,622.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,517.87
|
| Rate for Payer: PACE SWMI |
$2,397.97
|
| Rate for Payer: PHP Medicare Advantage |
$2,397.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,544.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,443.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,067.19
|
| Rate for Payer: Priority Health Medicare |
$2,397.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,067.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,397.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,397.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,469.91
|
|
|
PR CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP
|
Professional
|
Both
|
$3,321.00
|
|
|
Service Code
|
HCPCS 61557
|
| Min. Negotiated Rate |
$1,097.80 |
| Max. Negotiated Rate |
$3,460.84 |
| Rate for Payer: Aetna Commercial |
$2,276.82
|
| Rate for Payer: Aetna Medicare |
$1,767.08
|
| Rate for Payer: BCBS Complete |
$1,152.69
|
| Rate for Payer: BCBS MAPPO |
$1,699.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.29
|
| Rate for Payer: BCN Commercial |
$3,460.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,699.12
|
| Rate for Payer: Cash Price |
$2,656.80
|
| Rate for Payer: Cash Price |
$2,656.80
|
| Rate for Payer: Cofinity Commercial |
$2,446.73
|
| Rate for Payer: Cofinity Commercial |
$2,276.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,699.12
|
| Rate for Payer: Mclaren Medicaid |
$1,097.80
|
| Rate for Payer: Meridian Medicaid |
$1,152.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,784.08
|
| Rate for Payer: PACE SWMI |
$1,699.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,699.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,097.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,324.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,890.57
|
| Rate for Payer: Priority Health Medicare |
$1,699.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,890.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,699.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,699.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,750.09
|
|
|
PR CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL
|
Professional
|
Both
|
$4,272.00
|
|
|
Service Code
|
HCPCS 61321
|
| Min. Negotiated Rate |
$431.09 |
| Max. Negotiated Rate |
$3,631.20 |
| Rate for Payer: Aetna Commercial |
$2,868.89
|
| Rate for Payer: Aetna Medicare |
$2,226.60
|
| Rate for Payer: BCBS Complete |
$1,446.56
|
| Rate for Payer: BCBS MAPPO |
$2,140.96
|
| Rate for Payer: BCBS Trust/PPO |
$431.09
|
| Rate for Payer: BCN Commercial |
$3,133.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,140.96
|
| Rate for Payer: Cash Price |
$3,417.60
|
| Rate for Payer: Cash Price |
$3,417.60
|
| Rate for Payer: Cofinity Commercial |
$3,082.98
|
| Rate for Payer: Cofinity Commercial |
$2,868.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,140.96
|
| Rate for Payer: Mclaren Medicaid |
$1,377.68
|
| Rate for Payer: Meridian Medicaid |
$1,446.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,248.01
|
| Rate for Payer: PACE SWMI |
$2,140.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,140.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,377.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,990.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,631.20
|
| Rate for Payer: Priority Health Medicare |
$2,140.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,631.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,140.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,140.96
|
| Rate for Payer: UHC Medicare Advantage |
$2,205.19
|
|
|
PR CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL
|
Professional
|
Both
|
$6,708.00
|
|
|
Service Code
|
HCPCS 61320
|
| Min. Negotiated Rate |
$495.02 |
| Max. Negotiated Rate |
$4,695.60 |
| Rate for Payer: Aetna Commercial |
$2,554.79
|
| Rate for Payer: Aetna Medicare |
$1,982.82
|
| Rate for Payer: BCBS Complete |
$1,289.12
|
| Rate for Payer: BCBS MAPPO |
$1,906.56
|
| Rate for Payer: BCBS Trust/PPO |
$495.02
|
| Rate for Payer: BCN Commercial |
$3,871.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,906.56
|
| Rate for Payer: Cash Price |
$5,366.40
|
| Rate for Payer: Cash Price |
$5,366.40
|
| Rate for Payer: Cofinity Commercial |
$2,745.45
|
| Rate for Payer: Cofinity Commercial |
$2,554.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,906.56
|
| Rate for Payer: Mclaren Medicaid |
$1,227.73
|
| Rate for Payer: Meridian Medicaid |
$1,289.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,001.89
|
| Rate for Payer: PACE SWMI |
$1,906.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,906.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,227.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,695.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,233.14
|
| Rate for Payer: Priority Health Medicare |
$1,906.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,233.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,906.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,906.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,963.76
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN
|
Professional
|
Both
|
$9,210.00
|
|
|
Service Code
|
HCPCS 61570
|
| Min. Negotiated Rate |
$610.19 |
| Max. Negotiated Rate |
$6,447.00 |
| Rate for Payer: Aetna Commercial |
$2,527.84
|
| Rate for Payer: Aetna Medicare |
$1,961.91
|
| Rate for Payer: BCBS Complete |
$1,276.59
|
| Rate for Payer: BCBS MAPPO |
$1,886.45
|
| Rate for Payer: BCBS Trust/PPO |
$610.19
|
| Rate for Payer: BCN Commercial |
$3,835.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,886.45
|
| Rate for Payer: Cash Price |
$7,368.00
|
| Rate for Payer: Cash Price |
$7,368.00
|
| Rate for Payer: Cofinity Commercial |
$2,716.49
|
| Rate for Payer: Cofinity Commercial |
$2,527.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,886.45
|
| Rate for Payer: Mclaren Medicaid |
$1,215.80
|
| Rate for Payer: Meridian Medicaid |
$1,276.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,980.77
|
| Rate for Payer: PACE SWMI |
$1,886.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,886.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,215.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,447.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,203.13
|
| Rate for Payer: Priority Health Medicare |
$1,886.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,203.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,886.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,886.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,943.04
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL
|
Professional
|
Both
|
$4,106.00
|
|
|
Service Code
|
HCPCS 61305
|
| Min. Negotiated Rate |
$1,101.51 |
| Max. Negotiated Rate |
$3,429.05 |
| Rate for Payer: Aetna Commercial |
$2,707.87
|
| Rate for Payer: Aetna Medicare |
$2,101.63
|
| Rate for Payer: BCBS Complete |
$1,366.28
|
| Rate for Payer: BCBS MAPPO |
$2,020.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.51
|
| Rate for Payer: BCN Commercial |
$2,959.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,020.80
|
| Rate for Payer: Cash Price |
$3,284.80
|
| Rate for Payer: Cash Price |
$3,284.80
|
| Rate for Payer: Cofinity Commercial |
$2,707.87
|
| Rate for Payer: Cofinity Commercial |
$2,909.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,020.80
|
| Rate for Payer: Mclaren Medicaid |
$1,301.22
|
| Rate for Payer: Meridian Medicaid |
$1,366.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,121.84
|
| Rate for Payer: PACE SWMI |
$2,020.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,020.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,301.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,874.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,429.05
|
| Rate for Payer: Priority Health Medicare |
$2,020.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,429.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,020.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,020.80
|
| Rate for Payer: UHC Medicare Advantage |
$2,081.42
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL
|
Professional
|
Both
|
$5,356.00
|
|
|
Service Code
|
HCPCS 61304
|
| Min. Negotiated Rate |
$797.20 |
| Max. Negotiated Rate |
$3,749.20 |
| Rate for Payer: Aetna Commercial |
$2,208.07
|
| Rate for Payer: Aetna Medicare |
$1,713.72
|
| Rate for Payer: BCBS Complete |
$1,118.03
|
| Rate for Payer: BCBS MAPPO |
$1,647.81
|
| Rate for Payer: BCBS Trust/PPO |
$797.20
|
| Rate for Payer: BCN Commercial |
$3,350.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,647.81
|
| Rate for Payer: Cash Price |
$4,284.80
|
| Rate for Payer: Cash Price |
$4,284.80
|
| Rate for Payer: Cofinity Commercial |
$2,372.85
|
| Rate for Payer: Cofinity Commercial |
$2,208.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,647.81
|
| Rate for Payer: Mclaren Medicaid |
$1,064.79
|
| Rate for Payer: Meridian Medicaid |
$1,118.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,730.20
|
| Rate for Payer: PACE SWMI |
$1,647.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,647.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,064.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,749.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,798.28
|
| Rate for Payer: Priority Health Medicare |
$1,647.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,798.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,647.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,647.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,697.24
|
|
|
PR CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN
|
Professional
|
Both
|
$8,807.00
|
|
|
Service Code
|
HCPCS 61571
|
| Min. Negotiated Rate |
$723.24 |
| Max. Negotiated Rate |
$6,164.90 |
| Rate for Payer: Aetna Commercial |
$2,689.27
|
| Rate for Payer: Aetna Medicare |
$2,087.20
|
| Rate for Payer: BCBS Complete |
$1,357.34
|
| Rate for Payer: BCBS MAPPO |
$2,006.92
|
| Rate for Payer: BCBS Trust/PPO |
$723.24
|
| Rate for Payer: BCN Commercial |
$2,939.39
|
| Rate for Payer: BCN Medicare Advantage |
$2,006.92
|
| Rate for Payer: Cash Price |
$7,045.60
|
| Rate for Payer: Cash Price |
$7,045.60
|
| Rate for Payer: Cofinity Commercial |
$2,889.96
|
| Rate for Payer: Cofinity Commercial |
$2,689.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,006.92
|
| Rate for Payer: Mclaren Medicaid |
$1,292.70
|
| Rate for Payer: Meridian Medicaid |
$1,357.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,107.27
|
| Rate for Payer: PACE SWMI |
$2,006.92
|
| Rate for Payer: PHP Medicare Advantage |
$2,006.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,292.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,164.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,405.84
|
| Rate for Payer: Priority Health Medicare |
$2,006.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,405.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,006.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,006.92
|
| Rate for Payer: UHC Medicare Advantage |
$2,067.13
|
|
|
PR CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL
|
Professional
|
Both
|
$5,502.00
|
|
|
Service Code
|
HCPCS 61314
|
| Min. Negotiated Rate |
$1,064.00 |
| Max. Negotiated Rate |
$3,851.40 |
| Rate for Payer: Aetna Commercial |
$2,458.22
|
| Rate for Payer: Aetna Medicare |
$1,907.87
|
| Rate for Payer: BCBS Complete |
$1,244.17
|
| Rate for Payer: BCBS MAPPO |
$1,834.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,064.00
|
| Rate for Payer: BCN Commercial |
$3,730.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,834.49
|
| Rate for Payer: Cash Price |
$4,401.60
|
| Rate for Payer: Cash Price |
$4,401.60
|
| Rate for Payer: Cofinity Commercial |
$2,641.67
|
| Rate for Payer: Cofinity Commercial |
$2,458.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,834.49
|
| Rate for Payer: Mclaren Medicaid |
$1,184.92
|
| Rate for Payer: Meridian Medicaid |
$1,244.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,926.21
|
| Rate for Payer: PACE SWMI |
$1,834.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,834.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,184.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,851.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,115.92
|
| Rate for Payer: Priority Health Medicare |
$1,834.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,115.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,834.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,834.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,889.52
|
|
|
PR CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL
|
Professional
|
Both
|
$6,989.00
|
|
|
Service Code
|
HCPCS 61312
|
| Min. Negotiated Rate |
$831.54 |
| Max. Negotiated Rate |
$4,892.30 |
| Rate for Payer: Aetna Commercial |
$2,796.29
|
| Rate for Payer: Aetna Medicare |
$2,170.25
|
| Rate for Payer: BCBS Complete |
$1,408.77
|
| Rate for Payer: BCBS MAPPO |
$2,086.78
|
| Rate for Payer: BCBS Trust/PPO |
$831.54
|
| Rate for Payer: BCN Commercial |
$4,233.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,086.78
|
| Rate for Payer: Cash Price |
$5,591.20
|
| Rate for Payer: Cash Price |
$5,591.20
|
| Rate for Payer: Cofinity Commercial |
$3,004.96
|
| Rate for Payer: Cofinity Commercial |
$2,796.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,086.78
|
| Rate for Payer: Mclaren Medicaid |
$1,341.69
|
| Rate for Payer: Meridian Medicaid |
$1,408.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,191.12
|
| Rate for Payer: PACE SWMI |
$2,086.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,086.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,341.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,892.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,536.07
|
| Rate for Payer: Priority Health Medicare |
$2,086.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,536.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,086.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,086.78
|
| Rate for Payer: UHC Medicare Advantage |
$2,149.38
|
|
