|
PR EAR PIERCING
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 69090
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$248.83 |
| Rate for Payer: Aetna Commercial |
$35.41
|
| Rate for Payer: BCBS Complete |
$28.00
|
| Rate for Payer: BCBS Trust/PPO |
$248.83
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.85
|
|
|
PR ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 93010
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$2,320.82 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare |
$8.30
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$7.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,320.82
|
| Rate for Payer: BCN Commercial |
$9.43
|
| Rate for Payer: BCN Medicare Advantage |
$7.98
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$10.69
|
| Rate for Payer: Cofinity Commercial |
$11.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.98
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.38
|
| Rate for Payer: PACE SWMI |
$7.98
|
| Rate for Payer: PHP Medicare Advantage |
$7.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.34
|
| Rate for Payer: Priority Health Medicare |
$7.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.98
|
| Rate for Payer: UHC Medicare Advantage |
$8.22
|
|
|
PR ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 93005
|
| Min. Negotiated Rate |
$5.92 |
| Max. Negotiated Rate |
$1,832.67 |
| Rate for Payer: Aetna Commercial |
$7.93
|
| Rate for Payer: Aetna Medicare |
$6.16
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$5.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.67
|
| Rate for Payer: BCN Commercial |
$7.46
|
| Rate for Payer: BCN Medicare Advantage |
$5.92
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$8.52
|
| Rate for Payer: Cofinity Commercial |
$7.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.22
|
| Rate for Payer: PACE SWMI |
$5.92
|
| Rate for Payer: PHP Medicare Advantage |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.99
|
| Rate for Payer: Priority Health Medicare |
$5.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.92
|
| Rate for Payer: UHC Medicare Advantage |
$6.10
|
|
|
PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 93000
|
| Min. Negotiated Rate |
$13.90 |
| Max. Negotiated Rate |
$1,966.86 |
| Rate for Payer: Aetna Commercial |
$18.63
|
| Rate for Payer: Aetna Medicare |
$14.46
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$13.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,966.86
|
| Rate for Payer: BCN Commercial |
$16.88
|
| Rate for Payer: BCN Medicare Advantage |
$13.90
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$20.02
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.60
|
| Rate for Payer: PACE SWMI |
$13.90
|
| Rate for Payer: PHP Medicare Advantage |
$13.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.33
|
| Rate for Payer: Priority Health Medicare |
$13.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.90
|
| Rate for Payer: UHC Medicare Advantage |
$14.32
|
|
|
PR ECHO R-T 2D W/PROBE PLACEMENT ONLY
|
Professional
|
Both
|
$746.00
|
|
|
Service Code
|
HCPCS 93313
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$1,750.26 |
| Rate for Payer: Aetna Commercial |
$14.85
|
| Rate for Payer: Aetna Medicare |
$11.52
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$11.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,750.26
|
| Rate for Payer: BCN Commercial |
$16.12
|
| Rate for Payer: BCN Medicare Advantage |
$11.08
|
| Rate for Payer: Cash Price |
$596.80
|
| Rate for Payer: Cash Price |
$596.80
|
| Rate for Payer: Cofinity Commercial |
$15.96
|
| Rate for Payer: Cofinity Commercial |
$14.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.08
|
| Rate for Payer: Mclaren Medicaid |
$7.03
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.63
|
| Rate for Payer: PACE SWMI |
$11.08
|
| Rate for Payer: PHP Medicare Advantage |
$11.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$11.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$11.41
|
|
|
PR ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
HCPCS 93355
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$1,372.52 |
| Rate for Payer: Aetna Commercial |
$292.94
|
| Rate for Payer: Aetna Medicare |
$227.35
|
| Rate for Payer: BCBS Complete |
$147.16
|
| Rate for Payer: BCBS MAPPO |
$218.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,372.52
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: BCN Medicare Advantage |
$218.61
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cofinity Commercial |
$292.94
|
| Rate for Payer: Cofinity Commercial |
$314.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.61
|
| Rate for Payer: Mclaren Medicaid |
$140.15
|
| Rate for Payer: Meridian Medicaid |
$147.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$229.54
|
| Rate for Payer: PACE SWMI |
$218.61
|
| Rate for Payer: PHP Medicare Advantage |
$218.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$310.68
|
| Rate for Payer: Priority Health Medicare |
$218.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.61
|
| Rate for Payer: UHC Medicare Advantage |
$225.17
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
93315
|
| Min. Negotiated Rate |
$353.74 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna Commercial |
$493.00
|
| Rate for Payer: BCBS Trust/PPO |
$448.22
|
| Rate for Payer: BCN Commercial |
$448.22
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$498.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.00
|
| Rate for Payer: Healthscope Commercial |
$522.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$493.00
|
| Rate for Payer: PHP Commercial |
$493.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.40
|
| Rate for Payer: UHC Core |
$484.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.00
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT 93315
|
| Hospital Charge Code |
93315
|
| Min. Negotiated Rate |
$137.75 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna Commercial |
$493.00
|
| Rate for Payer: Aetna Medicare |
$150.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.25
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$145.00
|
| Rate for Payer: BCBS Trust/PPO |
$450.95
|
| Rate for Payer: BCN Commercial |
$450.95
|
| Rate for Payer: BCN Medicare Advantage |
$145.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$498.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.00
|
| Rate for Payer: Healthscope Commercial |
$522.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.00
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$493.00
|
| Rate for Payer: PACE Senior Care Partners |
$137.75
|
| Rate for Payer: PACE SWMI |
$145.00
|
| Rate for Payer: PHP Commercial |
$493.00
|
| Rate for Payer: PHP Medicare Advantage |
$145.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.60
|
| Rate for Payer: Priority Health Medicare |
$145.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.74
|
| Rate for Payer: Railroad Medicare Medicare |
$145.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.40
|
| Rate for Payer: UHC Core |
$484.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.00
|
| Rate for Payer: UHC Medicare Advantage |
$149.35
|
| Rate for Payer: VA VA |
$145.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.00
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 93315
|
| Min. Negotiated Rate |
$232.00 |
| Max. Negotiated Rate |
$1,889.20 |
| Rate for Payer: Aetna Commercial |
$637.15
|
| Rate for Payer: BCBS Complete |
$232.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,889.20
|
| Rate for Payer: BCN Commercial |
$646.21
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$350.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.39
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 93315
|
| Hospital Charge Code |
93315
|
| Min. Negotiated Rate |
$232.00 |
| Max. Negotiated Rate |
$1,889.20 |
| Rate for Payer: Aetna Commercial |
$637.15
|
| Rate for Payer: BCBS Complete |
$232.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,889.20
|
| Rate for Payer: BCN Commercial |
$646.21
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$350.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.39
|
|
|
PR ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 93316
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$1,443.32 |
| Rate for Payer: Aetna Commercial |
$33.75
|
| Rate for Payer: Aetna Medicare |
$26.20
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$25.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.32
|
| Rate for Payer: BCN Commercial |
$36.65
|
| Rate for Payer: BCN Medicare Advantage |
$25.19
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$36.27
|
| Rate for Payer: Cofinity Commercial |
$33.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.19
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.45
|
| Rate for Payer: PACE SWMI |
$25.19
|
| Rate for Payer: PHP Medicare Advantage |
$25.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.47
|
| Rate for Payer: Priority Health Medicare |
$25.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.19
|
| Rate for Payer: UHC Medicare Advantage |
$25.95
|
|
|
PR ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT
|
Facility
|
OP
|
$114.00
|
|
|
Service Code
|
CPT 93317
|
| Hospital Charge Code |
93317
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$27.08 |
| Max. Negotiated Rate |
$102.60 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Aetna Medicare |
$29.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.62
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCBS MAPPO |
$28.50
|
| Rate for Payer: BCBS Trust/PPO |
$88.64
|
| Rate for Payer: BCN Commercial |
$88.64
|
| Rate for Payer: BCN Medicare Advantage |
$28.50
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$98.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.50
|
| Rate for Payer: Healthscope Commercial |
$102.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.90
|
| Rate for Payer: PACE Senior Care Partners |
$27.08
|
| Rate for Payer: PACE SWMI |
$28.50
|
| Rate for Payer: PHP Commercial |
$96.90
|
| Rate for Payer: PHP Medicare Advantage |
$28.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.18
|
| Rate for Payer: Priority Health Medicare |
$28.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.53
|
| Rate for Payer: Railroad Medicare Medicare |
$28.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.32
|
| Rate for Payer: UHC Core |
$95.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.50
|
| Rate for Payer: UHC Medicare Advantage |
$29.36
|
| Rate for Payer: VA VA |
$28.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.50
|
|
|
PR ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT
|
Facility
|
IP
|
$114.00
|
|
|
Service Code
|
CPT 93317
|
| Hospital Charge Code |
93317
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$69.53 |
| Max. Negotiated Rate |
$102.60 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: BCBS Trust/PPO |
$88.10
|
| Rate for Payer: BCN Commercial |
$88.10
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$98.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.20
|
| Rate for Payer: Healthscope Commercial |
$102.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.90
|
| Rate for Payer: PHP Commercial |
$96.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.32
|
| Rate for Payer: UHC Core |
$95.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.50
|
|
|
PR ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 93318
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$2,220.97 |
| Rate for Payer: Aetna Commercial |
$630.42
|
| Rate for Payer: BCBS Complete |
$181.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,220.97
|
| Rate for Payer: BCN Commercial |
$611.51
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$317.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.78
|
|
|
PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R
|
Professional
|
Both
|
$544.00
|
|
|
Service Code
|
HCPCS 93312
|
| Min. Negotiated Rate |
$217.60 |
| Max. Negotiated Rate |
$1,669.96 |
| Rate for Payer: Aetna Commercial |
$302.10
|
| Rate for Payer: Aetna Medicare |
$234.47
|
| Rate for Payer: BCBS Complete |
$217.60
|
| Rate for Payer: BCBS MAPPO |
$225.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,669.96
|
| Rate for Payer: BCN Commercial |
$345.01
|
| Rate for Payer: BCN Medicare Advantage |
$225.45
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cofinity Commercial |
$324.65
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.72
|
| Rate for Payer: PACE SWMI |
$225.45
|
| Rate for Payer: PHP Medicare Advantage |
$225.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.84
|
| Rate for Payer: Priority Health Medicare |
$225.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.45
|
| Rate for Payer: UHC Medicare Advantage |
$232.21
|
|
|
PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R
|
Facility
|
IP
|
$544.00
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
93312
|
| Min. Negotiated Rate |
$331.79 |
| Max. Negotiated Rate |
$489.60 |
| Rate for Payer: Aetna Commercial |
$462.40
|
| Rate for Payer: BCBS Trust/PPO |
$420.40
|
| Rate for Payer: BCN Commercial |
$420.40
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cofinity Commercial |
$467.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.20
|
| Rate for Payer: Healthscope Commercial |
$489.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$462.40
|
| Rate for Payer: PHP Commercial |
$462.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.72
|
| Rate for Payer: UHC Core |
$454.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.00
|
|
|
PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R
|
Facility
|
OP
|
$544.00
|
|
|
Service Code
|
CPT 93312
|
| Hospital Charge Code |
93312
|
| Min. Negotiated Rate |
$129.20 |
| Max. Negotiated Rate |
$489.60 |
| Rate for Payer: Aetna Commercial |
$462.40
|
| Rate for Payer: Aetna Medicare |
$141.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$170.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$170.00
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$422.96
|
| Rate for Payer: BCN Commercial |
$422.96
|
| Rate for Payer: BCN Medicare Advantage |
$136.00
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cofinity Commercial |
$467.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$435.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.00
|
| Rate for Payer: Healthscope Commercial |
$489.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.00
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$142.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$462.40
|
| Rate for Payer: PACE Senior Care Partners |
$129.20
|
| Rate for Payer: PACE SWMI |
$136.00
|
| Rate for Payer: PHP Commercial |
$462.40
|
| Rate for Payer: PHP Medicare Advantage |
$136.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.28
|
| Rate for Payer: Priority Health Medicare |
$136.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.79
|
| Rate for Payer: Railroad Medicare Medicare |
$136.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.72
|
| Rate for Payer: UHC Core |
$454.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.00
|
| Rate for Payer: UHC Medicare Advantage |
$140.08
|
| Rate for Payer: VA VA |
$136.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.00
|
|
|
PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R
|
Professional
|
Both
|
$544.00
|
|
|
Service Code
|
HCPCS 93312
|
| Hospital Charge Code |
93312
|
| Min. Negotiated Rate |
$217.60 |
| Max. Negotiated Rate |
$1,669.96 |
| Rate for Payer: Aetna Commercial |
$302.10
|
| Rate for Payer: Aetna Medicare |
$234.47
|
| Rate for Payer: BCBS Complete |
$217.60
|
| Rate for Payer: BCBS MAPPO |
$225.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,669.96
|
| Rate for Payer: BCN Commercial |
$345.01
|
| Rate for Payer: BCN Medicare Advantage |
$225.45
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cofinity Commercial |
$324.65
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.72
|
| Rate for Payer: PACE SWMI |
$225.45
|
| Rate for Payer: PHP Medicare Advantage |
$225.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.84
|
| Rate for Payer: Priority Health Medicare |
$225.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.45
|
| Rate for Payer: UHC Medicare Advantage |
$232.21
|
|
|
PR ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 93307
|
| Min. Negotiated Rate |
$129.37 |
| Max. Negotiated Rate |
$1,789.88 |
| Rate for Payer: Aetna Commercial |
$173.36
|
| Rate for Payer: Aetna Commercial |
$173.36
|
| Rate for Payer: Aetna Medicare |
$134.54
|
| Rate for Payer: Aetna Medicare |
$134.54
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: BCBS Complete |
$192.80
|
| Rate for Payer: BCBS MAPPO |
$129.37
|
| Rate for Payer: BCBS MAPPO |
$129.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.88
|
| Rate for Payer: BCN Commercial |
$199.86
|
| Rate for Payer: BCN Commercial |
$199.86
|
| Rate for Payer: BCN Medicare Advantage |
$129.37
|
| Rate for Payer: BCN Medicare Advantage |
$129.37
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$186.29
|
| Rate for Payer: Cofinity Commercial |
$186.29
|
| Rate for Payer: Cofinity Commercial |
$173.36
|
| Rate for Payer: Cofinity Commercial |
$173.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.84
|
| Rate for Payer: PACE SWMI |
$129.37
|
| Rate for Payer: PACE SWMI |
$129.37
|
| Rate for Payer: PHP Medicare Advantage |
$129.37
|
| Rate for Payer: PHP Medicare Advantage |
$129.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.40
|
| Rate for Payer: Priority Health Medicare |
$129.37
|
| Rate for Payer: Priority Health Medicare |
$129.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.37
|
| Rate for Payer: UHC Medicare Advantage |
$133.25
|
| Rate for Payer: UHC Medicare Advantage |
$133.25
|
|
|
PR ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 93308
|
| Min. Negotiated Rate |
$92.58 |
| Max. Negotiated Rate |
$1,789.88 |
| Rate for Payer: Aetna Commercial |
$124.06
|
| Rate for Payer: Aetna Commercial |
$124.06
|
| Rate for Payer: Aetna Medicare |
$96.28
|
| Rate for Payer: Aetna Medicare |
$96.28
|
| Rate for Payer: BCBS Complete |
$113.60
|
| Rate for Payer: BCBS Complete |
$69.60
|
| Rate for Payer: BCBS MAPPO |
$92.58
|
| Rate for Payer: BCBS MAPPO |
$92.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,789.88
|
| Rate for Payer: BCN Commercial |
$143.67
|
| Rate for Payer: BCN Commercial |
$143.67
|
| Rate for Payer: BCN Medicare Advantage |
$92.58
|
| Rate for Payer: BCN Medicare Advantage |
$92.58
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$133.32
|
| Rate for Payer: Cofinity Commercial |
$124.06
|
| Rate for Payer: Cofinity Commercial |
$124.06
|
| Rate for Payer: Cofinity Commercial |
$133.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.21
|
| Rate for Payer: PACE SWMI |
$92.58
|
| Rate for Payer: PACE SWMI |
$92.58
|
| Rate for Payer: PHP Medicare Advantage |
$92.58
|
| Rate for Payer: PHP Medicare Advantage |
$92.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.03
|
| Rate for Payer: Priority Health Medicare |
$92.58
|
| Rate for Payer: Priority Health Medicare |
$92.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.58
|
| Rate for Payer: UHC Medicare Advantage |
$95.36
|
| Rate for Payer: UHC Medicare Advantage |
$95.36
|
|
|
PR ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 93350
|
| Min. Negotiated Rate |
$58.00 |
| Max. Negotiated Rate |
$1,950.48 |
| Rate for Payer: Aetna Commercial |
$235.53
|
| Rate for Payer: Aetna Commercial |
$235.53
|
| Rate for Payer: Aetna Medicare |
$182.80
|
| Rate for Payer: Aetna Medicare |
$182.80
|
| Rate for Payer: BCBS Complete |
$58.00
|
| Rate for Payer: BCBS Complete |
$177.20
|
| Rate for Payer: BCBS MAPPO |
$175.77
|
| Rate for Payer: BCBS MAPPO |
$175.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,950.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,950.48
|
| Rate for Payer: BCN Commercial |
$270.73
|
| Rate for Payer: BCN Commercial |
$270.73
|
| Rate for Payer: BCN Medicare Advantage |
$175.77
|
| Rate for Payer: BCN Medicare Advantage |
$175.77
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cofinity Commercial |
$253.11
|
| Rate for Payer: Cofinity Commercial |
$235.53
|
| Rate for Payer: Cofinity Commercial |
$235.53
|
| Rate for Payer: Cofinity Commercial |
$253.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.56
|
| Rate for Payer: PACE SWMI |
$175.77
|
| Rate for Payer: PACE SWMI |
$175.77
|
| Rate for Payer: PHP Medicare Advantage |
$175.77
|
| Rate for Payer: PHP Medicare Advantage |
$175.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.98
|
| Rate for Payer: Priority Health Medicare |
$175.77
|
| Rate for Payer: Priority Health Medicare |
$175.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.77
|
| Rate for Payer: UHC Medicare Advantage |
$181.04
|
| Rate for Payer: UHC Medicare Advantage |
$181.04
|
|
|
PR ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D
|
Professional
|
Both
|
$980.00
|
|
|
Service Code
|
HCPCS 93306
|
| Min. Negotiated Rate |
$185.76 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna Commercial |
$248.92
|
| Rate for Payer: Aetna Commercial |
$248.92
|
| Rate for Payer: Aetna Medicare |
$193.19
|
| Rate for Payer: Aetna Medicare |
$193.19
|
| Rate for Payer: BCBS Complete |
$106.00
|
| Rate for Payer: BCBS Complete |
$392.00
|
| Rate for Payer: BCBS MAPPO |
$185.76
|
| Rate for Payer: BCBS MAPPO |
$185.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,092.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,092.00
|
| Rate for Payer: BCN Commercial |
$286.36
|
| Rate for Payer: BCN Commercial |
$286.36
|
| Rate for Payer: BCN Medicare Advantage |
$185.76
|
| Rate for Payer: BCN Medicare Advantage |
$185.76
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$784.00
|
| Rate for Payer: Cash Price |
$784.00
|
| Rate for Payer: Cofinity Commercial |
$267.49
|
| Rate for Payer: Cofinity Commercial |
$248.92
|
| Rate for Payer: Cofinity Commercial |
$267.49
|
| Rate for Payer: Cofinity Commercial |
$248.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.05
|
| Rate for Payer: PACE SWMI |
$185.76
|
| Rate for Payer: PACE SWMI |
$185.76
|
| Rate for Payer: PHP Medicare Advantage |
$185.76
|
| Rate for Payer: PHP Medicare Advantage |
$185.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$686.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$277.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$277.10
|
| Rate for Payer: Priority Health Medicare |
$185.76
|
| Rate for Payer: Priority Health Medicare |
$185.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.76
|
| Rate for Payer: UHC Medicare Advantage |
$191.33
|
| Rate for Payer: UHC Medicare Advantage |
$191.33
|
|
|
PR ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 33949
|
| Min. Negotiated Rate |
$145.05 |
| Max. Negotiated Rate |
$1,551.62 |
| Rate for Payer: Aetna Commercial |
$303.44
|
| Rate for Payer: Aetna Medicare |
$235.51
|
| Rate for Payer: BCBS Complete |
$152.30
|
| Rate for Payer: BCBS MAPPO |
$226.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,551.62
|
| Rate for Payer: BCN Commercial |
$329.86
|
| Rate for Payer: BCN Medicare Advantage |
$226.45
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cofinity Commercial |
$326.09
|
| Rate for Payer: Cofinity Commercial |
$303.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.45
|
| Rate for Payer: Mclaren Medicaid |
$145.05
|
| Rate for Payer: Meridian Medicaid |
$152.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$237.77
|
| Rate for Payer: PACE SWMI |
$226.45
|
| Rate for Payer: PHP Medicare Advantage |
$226.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.07
|
| Rate for Payer: Priority Health Medicare |
$226.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$359.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.45
|
| Rate for Payer: UHC Medicare Advantage |
$233.24
|
|
|
PR ECMO/ECLS INITIATION VENO-ARTERIAL
|
Professional
|
Both
|
$1,030.00
|
|
|
Service Code
|
HCPCS 33947
|
| Min. Negotiated Rate |
$213.85 |
| Max. Negotiated Rate |
$1,408.45 |
| Rate for Payer: Aetna Commercial |
$451.30
|
| Rate for Payer: Aetna Medicare |
$350.26
|
| Rate for Payer: BCBS Complete |
$224.54
|
| Rate for Payer: BCBS MAPPO |
$336.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,408.45
|
| Rate for Payer: BCN Commercial |
$489.17
|
| Rate for Payer: BCN Medicare Advantage |
$336.79
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cofinity Commercial |
$484.98
|
| Rate for Payer: Cofinity Commercial |
$451.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.79
|
| Rate for Payer: Mclaren Medicaid |
$213.85
|
| Rate for Payer: Meridian Medicaid |
$224.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$353.63
|
| Rate for Payer: PACE SWMI |
$336.79
|
| Rate for Payer: PHP Medicare Advantage |
$336.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$532.49
|
| Rate for Payer: Priority Health Medicare |
$336.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$532.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.79
|
| Rate for Payer: UHC Medicare Advantage |
$346.89
|
|
|
PR ECMO/ECLS INITIATION VENO-VENOUS
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 33946
|
| Min. Negotiated Rate |
$193.19 |
| Max. Negotiated Rate |
$1,643.01 |
| Rate for Payer: Aetna Commercial |
$407.91
|
| Rate for Payer: Aetna Medicare |
$316.59
|
| Rate for Payer: BCBS Complete |
$202.85
|
| Rate for Payer: BCBS MAPPO |
$304.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.01
|
| Rate for Payer: BCN Commercial |
$442.25
|
| Rate for Payer: BCN Medicare Advantage |
$304.41
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$438.35
|
| Rate for Payer: Cofinity Commercial |
$407.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.41
|
| Rate for Payer: Mclaren Medicaid |
$193.19
|
| Rate for Payer: Meridian Medicaid |
$202.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$319.63
|
| Rate for Payer: PACE SWMI |
$304.41
|
| Rate for Payer: PHP Medicare Advantage |
$304.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.42
|
| Rate for Payer: Priority Health Medicare |
$304.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$304.41
|
| Rate for Payer: UHC Medicare Advantage |
$313.54
|
|
