PR ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER
|
Professional
|
Both
|
$2,556.00
|
|
Service Code
|
HCPCS 33956
|
Min. Negotiated Rate |
$521.00 |
Max. Negotiated Rate |
$3,231.61 |
Rate for Payer: Aetna Commercial |
$1,102.12
|
Rate for Payer: Aetna Medicare |
$855.38
|
Rate for Payer: BCBS Complete |
$547.05
|
Rate for Payer: BCBS MAPPO |
$822.48
|
Rate for Payer: BCBS Trust/PPO |
$3,231.61
|
Rate for Payer: BCN Commercial |
$1,192.37
|
Rate for Payer: BCN Medicare Advantage |
$822.48
|
Rate for Payer: Cash Price |
$2,044.80
|
Rate for Payer: Cash Price |
$2,044.80
|
Rate for Payer: Cofinity Commercial |
$1,102.12
|
Rate for Payer: Cofinity Commercial |
$1,184.37
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.48
|
Rate for Payer: Mclaren Medicaid |
$521.00
|
Rate for Payer: Meridian Medicaid |
$547.05
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$863.60
|
Rate for Payer: PACE SWMI |
$822.48
|
Rate for Payer: PHP Medicare Advantage |
$822.48
|
Rate for Payer: Priority Health Choice Medicaid |
$521.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,789.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,297.98
|
Rate for Payer: Priority Health Medicare |
$822.48
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,297.98
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$822.48
|
Rate for Payer: UHC Dual Complete DSNP |
$822.48
|
Rate for Payer: UHC Medicare Advantage |
$847.15
|
|
PR ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ
|
Professional
|
Both
|
$881.00
|
|
Service Code
|
HCPCS 33952
|
Min. Negotiated Rate |
$266.25 |
Max. Negotiated Rate |
$3,277.57 |
Rate for Payer: Aetna Commercial |
$562.61
|
Rate for Payer: Aetna Medicare |
$436.65
|
Rate for Payer: BCBS Complete |
$279.56
|
Rate for Payer: BCBS MAPPO |
$419.86
|
Rate for Payer: BCBS Trust/PPO |
$3,277.57
|
Rate for Payer: BCN Commercial |
$609.87
|
Rate for Payer: BCN Medicare Advantage |
$419.86
|
Rate for Payer: Cash Price |
$704.80
|
Rate for Payer: Cash Price |
$704.80
|
Rate for Payer: Cofinity Commercial |
$604.60
|
Rate for Payer: Cofinity Commercial |
$562.61
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.86
|
Rate for Payer: Mclaren Medicaid |
$266.25
|
Rate for Payer: Meridian Medicaid |
$279.56
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$440.85
|
Rate for Payer: PACE SWMI |
$419.86
|
Rate for Payer: PHP Medicare Advantage |
$419.86
|
Rate for Payer: Priority Health Choice Medicaid |
$266.25
|
Rate for Payer: Priority Health Cigna Priority Health |
$616.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.88
|
Rate for Payer: Priority Health Medicare |
$419.86
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$663.88
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$419.86
|
Rate for Payer: UHC Dual Complete DSNP |
$419.86
|
Rate for Payer: UHC Medicare Advantage |
$432.46
|
|
PR ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS OPEN
|
Professional
|
Both
|
$710.00
|
|
Service Code
|
HCPCS 33953
|
Min. Negotiated Rate |
$292.88 |
Max. Negotiated Rate |
$3,959.61 |
Rate for Payer: Aetna Commercial |
$621.80
|
Rate for Payer: Aetna Medicare |
$482.59
|
Rate for Payer: BCBS Complete |
$307.52
|
Rate for Payer: BCBS MAPPO |
$464.03
|
Rate for Payer: BCBS Trust/PPO |
$3,959.61
|
Rate for Payer: BCN Commercial |
$672.91
|
Rate for Payer: BCN Medicare Advantage |
$464.03
|
Rate for Payer: Cash Price |
$568.00
|
Rate for Payer: Cash Price |
$568.00
|
Rate for Payer: Cofinity Commercial |
$621.80
|
Rate for Payer: Cofinity Commercial |
$668.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.03
|
Rate for Payer: Mclaren Medicaid |
$292.88
|
Rate for Payer: Meridian Medicaid |
$307.52
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$487.23
|
Rate for Payer: PACE SWMI |
$464.03
|
Rate for Payer: PHP Medicare Advantage |
$464.03
|
Rate for Payer: Priority Health Choice Medicaid |
$292.88
|
Rate for Payer: Priority Health Cigna Priority Health |
$497.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.51
|
Rate for Payer: Priority Health Medicare |
$464.03
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$732.51
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$464.03
|
Rate for Payer: UHC Dual Complete DSNP |
$464.03
|
Rate for Payer: UHC Medicare Advantage |
$477.95
|
|
PR ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER
|
Professional
|
Both
|
$1,078.00
|
|
Service Code
|
HCPCS 33986
|
Min. Negotiated Rate |
$128.38 |
Max. Negotiated Rate |
$813.37 |
Rate for Payer: Aetna Commercial |
$690.30
|
Rate for Payer: Aetna Medicare |
$535.76
|
Rate for Payer: BCBS Complete |
$342.64
|
Rate for Payer: BCBS MAPPO |
$515.15
|
Rate for Payer: BCBS Trust/PPO |
$128.38
|
Rate for Payer: BCN Commercial |
$747.19
|
Rate for Payer: BCN Medicare Advantage |
$515.15
|
Rate for Payer: Cash Price |
$862.40
|
Rate for Payer: Cash Price |
$862.40
|
Rate for Payer: Cofinity Commercial |
$741.82
|
Rate for Payer: Cofinity Commercial |
$690.30
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.15
|
Rate for Payer: Mclaren Medicaid |
$326.32
|
Rate for Payer: Meridian Medicaid |
$342.64
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$540.91
|
Rate for Payer: PACE SWMI |
$515.15
|
Rate for Payer: PHP Medicare Advantage |
$515.15
|
Rate for Payer: Priority Health Choice Medicaid |
$326.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$754.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.37
|
Rate for Payer: Priority Health Medicare |
$515.15
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$813.37
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$515.15
|
Rate for Payer: UHC Dual Complete DSNP |
$515.15
|
Rate for Payer: UHC Medicare Advantage |
$530.60
|
|
PR ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS
|
Professional
|
Both
|
$225.00
|
|
Service Code
|
HCPCS 95836
|
Min. Negotiated Rate |
$66.67 |
Max. Negotiated Rate |
$658.26 |
Rate for Payer: Aetna Commercial |
$138.42
|
Rate for Payer: Aetna Medicare |
$107.43
|
Rate for Payer: BCBS Complete |
$70.00
|
Rate for Payer: BCBS MAPPO |
$103.30
|
Rate for Payer: BCBS Trust/PPO |
$658.26
|
Rate for Payer: BCN Commercial |
$152.47
|
Rate for Payer: BCN Medicare Advantage |
$103.30
|
Rate for Payer: Cash Price |
$180.00
|
Rate for Payer: Cash Price |
$180.00
|
Rate for Payer: Cofinity Commercial |
$148.75
|
Rate for Payer: Cofinity Commercial |
$138.42
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.30
|
Rate for Payer: Mclaren Medicaid |
$66.67
|
Rate for Payer: Meridian Medicaid |
$70.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.46
|
Rate for Payer: PACE SWMI |
$103.30
|
Rate for Payer: PHP Medicare Advantage |
$103.30
|
Rate for Payer: Priority Health Choice Medicaid |
$66.67
|
Rate for Payer: Priority Health Cigna Priority Health |
$157.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.14
|
Rate for Payer: Priority Health Medicare |
$103.30
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$140.14
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$103.30
|
Rate for Payer: UHC Dual Complete DSNP |
$103.30
|
Rate for Payer: UHC Medicare Advantage |
$106.40
|
|
PR EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM
|
Professional
|
Both
|
$978.00
|
|
Service Code
|
HCPCS 43259
|
Min. Negotiated Rate |
$141.65 |
Max. Negotiated Rate |
$946.19 |
Rate for Payer: Aetna Commercial |
$292.64
|
Rate for Payer: Aetna Medicare |
$227.13
|
Rate for Payer: BCBS Complete |
$148.73
|
Rate for Payer: BCBS MAPPO |
$218.39
|
Rate for Payer: BCBS Trust/PPO |
$946.19
|
Rate for Payer: BCN Commercial |
$322.53
|
Rate for Payer: BCN Medicare Advantage |
$218.39
|
Rate for Payer: Cash Price |
$782.40
|
Rate for Payer: Cash Price |
$782.40
|
Rate for Payer: Cofinity Commercial |
$292.64
|
Rate for Payer: Cofinity Commercial |
$314.48
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.39
|
Rate for Payer: Mclaren Medicaid |
$141.65
|
Rate for Payer: Meridian Medicaid |
$148.73
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$229.31
|
Rate for Payer: PACE SWMI |
$218.39
|
Rate for Payer: PHP Medicare Advantage |
$218.39
|
Rate for Payer: Priority Health Choice Medicaid |
$141.65
|
Rate for Payer: Priority Health Cigna Priority Health |
$684.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$388.07
|
Rate for Payer: Priority Health Medicare |
$218.39
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$388.07
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$218.39
|
Rate for Payer: UHC Dual Complete DSNP |
$218.39
|
Rate for Payer: UHC Medicare Advantage |
$224.94
|
|
PREDNISOLONE 15 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$1,895.04
|
|
Service Code
|
HCPCS J7510
|
Hospital Charge Code |
11117
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1,155.78 |
Max. Negotiated Rate |
$1,705.54 |
Rate for Payer: Aetna Commercial |
$1,610.78
|
Rate for Payer: BCBS Trust/PPO |
$1,464.49
|
Rate for Payer: BCN Commercial |
$1,464.49
|
Rate for Payer: Cash Price |
$1,516.03
|
Rate for Payer: Cofinity Commercial |
$1,629.73
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,516.03
|
Rate for Payer: Healthscope Commercial |
$1,705.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,421.28
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,610.78
|
Rate for Payer: PHP Commercial |
$1,610.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,326.53
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,648.68
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,155.78
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,667.64
|
Rate for Payer: UHC Core |
$1,582.36
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,421.28
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION
|
Facility
|
IP
|
$100.87
|
|
Service Code
|
NDC 61314-637-05
|
Hospital Charge Code |
6487
|
Hospital Revenue Code
|
637
|
Min. Negotiated Rate |
$61.52 |
Max. Negotiated Rate |
$90.78 |
Rate for Payer: Aetna Commercial |
$85.74
|
Rate for Payer: BCBS Trust/PPO |
$77.95
|
Rate for Payer: BCN Commercial |
$77.95
|
Rate for Payer: Cash Price |
$80.70
|
Rate for Payer: Cofinity Commercial |
$86.75
|
Rate for Payer: Encore Health Key Benefits Commercial |
$80.70
|
Rate for Payer: Healthscope Commercial |
$90.78
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.65
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.74
|
Rate for Payer: PHP Commercial |
$85.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$70.61
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.76
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$61.52
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$88.77
|
Rate for Payer: UHC Core |
$84.23
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.65
|
|
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$7.99
|
|
Service Code
|
HCPCS J7510
|
Hospital Charge Code |
29302
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$4.87 |
Max. Negotiated Rate |
$7.19 |
Rate for Payer: Aetna Commercial |
$6.79
|
Rate for Payer: Aetna Commercial |
$658.04
|
Rate for Payer: BCBS Trust/PPO |
$598.28
|
Rate for Payer: BCBS Trust/PPO |
$6.17
|
Rate for Payer: BCN Commercial |
$598.28
|
Rate for Payer: BCN Commercial |
$6.17
|
Rate for Payer: Cash Price |
$619.34
|
Rate for Payer: Cash Price |
$6.39
|
Rate for Payer: Cofinity Commercial |
$665.79
|
Rate for Payer: Cofinity Commercial |
$6.87
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6.39
|
Rate for Payer: Encore Health Key Benefits Commercial |
$619.34
|
Rate for Payer: Healthscope Commercial |
$696.75
|
Rate for Payer: Healthscope Commercial |
$7.19
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$580.63
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.79
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$658.04
|
Rate for Payer: PHP Commercial |
$658.04
|
Rate for Payer: PHP Commercial |
$6.79
|
Rate for Payer: Priority Health Cigna Priority Health |
$5.59
|
Rate for Payer: Priority Health Cigna Priority Health |
$541.92
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.95
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$673.53
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$4.87
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$472.17
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$7.03
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$681.27
|
Rate for Payer: UHC Core |
$646.43
|
Rate for Payer: UHC Core |
$6.67
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$580.63
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.99
|
|
PREDNISONE 10 MG TABLET
|
Facility
|
IP
|
$267.90
|
|
Service Code
|
HCPCS J7512
|
Hospital Charge Code |
6494
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$163.39 |
Max. Negotiated Rate |
$241.11 |
Rate for Payer: Aetna Commercial |
$227.72
|
Rate for Payer: Aetna Commercial |
$39.75
|
Rate for Payer: BCBS Trust/PPO |
$207.03
|
Rate for Payer: BCBS Trust/PPO |
$36.14
|
Rate for Payer: BCN Commercial |
$207.03
|
Rate for Payer: BCN Commercial |
$36.14
|
Rate for Payer: Cash Price |
$37.42
|
Rate for Payer: Cash Price |
$214.32
|
Rate for Payer: Cofinity Commercial |
$230.39
|
Rate for Payer: Cofinity Commercial |
$40.22
|
Rate for Payer: Encore Health Key Benefits Commercial |
$214.32
|
Rate for Payer: Encore Health Key Benefits Commercial |
$37.42
|
Rate for Payer: Healthscope Commercial |
$241.11
|
Rate for Payer: Healthscope Commercial |
$42.09
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.92
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.08
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.75
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$227.72
|
Rate for Payer: PHP Commercial |
$227.72
|
Rate for Payer: PHP Commercial |
$39.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$187.53
|
Rate for Payer: Priority Health Cigna Priority Health |
$32.74
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.69
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.07
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$163.39
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$28.53
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$41.16
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$235.75
|
Rate for Payer: UHC Core |
$223.70
|
Rate for Payer: UHC Core |
$39.05
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.92
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.08
|
|
PREDNISONE 1 MG TABLET
|
Facility
|
IP
|
$196.65
|
|
Service Code
|
HCPCS J7512
|
Hospital Charge Code |
6493
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$119.94 |
Max. Negotiated Rate |
$176.98 |
Rate for Payer: Aetna Commercial |
$167.15
|
Rate for Payer: Aetna Commercial |
$375.53
|
Rate for Payer: BCBS Trust/PPO |
$151.97
|
Rate for Payer: BCBS Trust/PPO |
$341.42
|
Rate for Payer: BCN Commercial |
$151.97
|
Rate for Payer: BCN Commercial |
$341.42
|
Rate for Payer: Cash Price |
$157.32
|
Rate for Payer: Cash Price |
$353.44
|
Rate for Payer: Cofinity Commercial |
$379.95
|
Rate for Payer: Cofinity Commercial |
$169.12
|
Rate for Payer: Encore Health Key Benefits Commercial |
$157.32
|
Rate for Payer: Encore Health Key Benefits Commercial |
$353.44
|
Rate for Payer: Healthscope Commercial |
$397.62
|
Rate for Payer: Healthscope Commercial |
$176.98
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.49
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.35
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$167.15
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$375.53
|
Rate for Payer: PHP Commercial |
$167.15
|
Rate for Payer: PHP Commercial |
$375.53
|
Rate for Payer: Priority Health Cigna Priority Health |
$137.66
|
Rate for Payer: Priority Health Cigna Priority Health |
$309.26
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.37
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.09
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$119.94
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$269.45
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$388.78
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$173.05
|
Rate for Payer: UHC Core |
$164.20
|
Rate for Payer: UHC Core |
$368.90
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.49
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.35
|
|
PREDNISONE 20 MG TABLET
|
Facility
|
IP
|
$293.75
|
|
Service Code
|
HCPCS J7512
|
Hospital Charge Code |
6496
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$179.16 |
Max. Negotiated Rate |
$264.38 |
Rate for Payer: Aetna Commercial |
$249.69
|
Rate for Payer: Aetna Commercial |
$17.12
|
Rate for Payer: BCBS Trust/PPO |
$227.01
|
Rate for Payer: BCBS Trust/PPO |
$15.56
|
Rate for Payer: BCN Commercial |
$15.56
|
Rate for Payer: BCN Commercial |
$227.01
|
Rate for Payer: Cash Price |
$16.11
|
Rate for Payer: Cash Price |
$235.00
|
Rate for Payer: Cofinity Commercial |
$17.32
|
Rate for Payer: Cofinity Commercial |
$252.62
|
Rate for Payer: Encore Health Key Benefits Commercial |
$235.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.11
|
Rate for Payer: Healthscope Commercial |
$264.38
|
Rate for Payer: Healthscope Commercial |
$18.13
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.10
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.31
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.69
|
Rate for Payer: PHP Commercial |
$17.12
|
Rate for Payer: PHP Commercial |
$249.69
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$205.62
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.56
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.52
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$12.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$179.16
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$17.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$258.50
|
Rate for Payer: UHC Core |
$16.82
|
Rate for Payer: UHC Core |
$245.28
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.10
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.31
|
|
PREDNISONE 50 MG TABLET
|
Facility
|
IP
|
$296.40
|
|
Service Code
|
HCPCS J7512
|
Hospital Charge Code |
6498
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$180.77 |
Max. Negotiated Rate |
$266.76 |
Rate for Payer: Aetna Commercial |
$251.94
|
Rate for Payer: BCBS Trust/PPO |
$229.06
|
Rate for Payer: BCN Commercial |
$229.06
|
Rate for Payer: Cash Price |
$237.12
|
Rate for Payer: Cofinity Commercial |
$254.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$237.12
|
Rate for Payer: Healthscope Commercial |
$266.76
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$251.94
|
Rate for Payer: PHP Commercial |
$251.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$207.48
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$257.87
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$180.77
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$260.83
|
Rate for Payer: UHC Core |
$247.49
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.30
|
|
PREDNISONE 5 MG TABLET
|
Facility
|
IP
|
$43.48
|
|
Service Code
|
HCPCS J7512
|
Hospital Charge Code |
6497
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$26.52 |
Max. Negotiated Rate |
$39.13 |
Rate for Payer: Aetna Commercial |
$36.96
|
Rate for Payer: Aetna Commercial |
$311.61
|
Rate for Payer: Aetna Commercial |
$3.12
|
Rate for Payer: BCBS Trust/PPO |
$283.31
|
Rate for Payer: BCBS Trust/PPO |
$33.60
|
Rate for Payer: BCBS Trust/PPO |
$2.84
|
Rate for Payer: BCN Commercial |
$2.84
|
Rate for Payer: BCN Commercial |
$283.31
|
Rate for Payer: BCN Commercial |
$33.60
|
Rate for Payer: Cash Price |
$34.78
|
Rate for Payer: Cash Price |
$2.94
|
Rate for Payer: Cash Price |
$293.28
|
Rate for Payer: Cofinity Commercial |
$37.39
|
Rate for Payer: Cofinity Commercial |
$315.28
|
Rate for Payer: Cofinity Commercial |
$3.16
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
Rate for Payer: Encore Health Key Benefits Commercial |
$293.28
|
Rate for Payer: Encore Health Key Benefits Commercial |
$34.78
|
Rate for Payer: Healthscope Commercial |
$329.94
|
Rate for Payer: Healthscope Commercial |
$39.13
|
Rate for Payer: Healthscope Commercial |
$3.30
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.95
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.61
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.75
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$311.61
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.96
|
Rate for Payer: PHP Commercial |
$311.61
|
Rate for Payer: PHP Commercial |
$36.96
|
Rate for Payer: PHP Commercial |
$3.12
|
Rate for Payer: Priority Health Cigna Priority Health |
$30.44
|
Rate for Payer: Priority Health Cigna Priority Health |
$256.62
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.57
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.83
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.19
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.94
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2.24
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$26.52
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$223.59
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$322.61
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$38.26
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3.23
|
Rate for Payer: UHC Core |
$36.31
|
Rate for Payer: UHC Core |
$306.11
|
Rate for Payer: UHC Core |
$3.06
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.75
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.95
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.61
|
|
PR EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT
|
Professional
|
Both
|
$47.00
|
|
Service Code
|
HCPCS 98960
|
Min. Negotiated Rate |
$18.80 |
Max. Negotiated Rate |
$505.58 |
Rate for Payer: Aetna Commercial |
$28.53
|
Rate for Payer: BCBS Complete |
$18.80
|
Rate for Payer: BCBS Trust/PPO |
$505.58
|
Rate for Payer: BCN Commercial |
$33.79
|
Rate for Payer: Cash Price |
$37.60
|
Rate for Payer: Cash Price |
$37.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.07
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$39.07
|
|
PR EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS
|
Professional
|
Both
|
$23.00
|
|
Service Code
|
HCPCS 98961
|
Min. Negotiated Rate |
$9.20 |
Max. Negotiated Rate |
$656.15 |
Rate for Payer: Aetna Commercial |
$13.91
|
Rate for Payer: BCBS Complete |
$9.20
|
Rate for Payer: BCBS Trust/PPO |
$656.15
|
Rate for Payer: BCN Commercial |
$14.19
|
Rate for Payer: Cash Price |
$18.40
|
Rate for Payer: Cash Price |
$18.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.86
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$18.86
|
|
PR EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS
|
Professional
|
Both
|
$17.00
|
|
Service Code
|
HCPCS 98962
|
Min. Negotiated Rate |
$6.80 |
Max. Negotiated Rate |
$888.07 |
Rate for Payer: Aetna Commercial |
$10.35
|
Rate for Payer: BCBS Complete |
$6.80
|
Rate for Payer: BCBS Trust/PPO |
$888.07
|
Rate for Payer: BCN Commercial |
$10.55
|
Rate for Payer: Cash Price |
$13.60
|
Rate for Payer: Cash Price |
$13.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$11.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.93
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$13.93
|
|
PR EEG,ALL NIGHT RECORD
|
Professional
|
Both
|
$1,319.00
|
|
Service Code
|
HCPCS 95827
|
Min. Negotiated Rate |
$527.60 |
Max. Negotiated Rate |
$923.30 |
Rate for Payer: BCBS Complete |
$527.60
|
Rate for Payer: Cash Price |
$1,055.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$923.30
|
|
PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO
|
Professional
|
Both
|
$420.00
|
|
Service Code
|
HCPCS 95721
|
Min. Negotiated Rate |
$129.93 |
Max. Negotiated Rate |
$405.73 |
Rate for Payer: Aetna Commercial |
$265.98
|
Rate for Payer: Aetna Medicare |
$206.43
|
Rate for Payer: BCBS Complete |
$136.43
|
Rate for Payer: BCBS MAPPO |
$198.49
|
Rate for Payer: BCBS Trust/PPO |
$405.73
|
Rate for Payer: BCN Commercial |
$299.07
|
Rate for Payer: BCN Medicare Advantage |
$198.49
|
Rate for Payer: Cash Price |
$336.00
|
Rate for Payer: Cash Price |
$336.00
|
Rate for Payer: Cofinity Commercial |
$265.98
|
Rate for Payer: Cofinity Commercial |
$285.83
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.49
|
Rate for Payer: Mclaren Medicaid |
$129.93
|
Rate for Payer: Meridian Medicaid |
$136.43
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$208.41
|
Rate for Payer: PACE SWMI |
$198.49
|
Rate for Payer: PHP Medicare Advantage |
$198.49
|
Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
Rate for Payer: Priority Health Cigna Priority Health |
$294.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.48
|
Rate for Payer: Priority Health Medicare |
$198.49
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$269.48
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$198.49
|
Rate for Payer: UHC Dual Complete DSNP |
$198.49
|
Rate for Payer: UHC Medicare Advantage |
$204.44
|
|
PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG
|
Professional
|
Both
|
$510.00
|
|
Service Code
|
HCPCS 95722
|
Min. Negotiated Rate |
$157.62 |
Max. Negotiated Rate |
$364.06 |
Rate for Payer: Aetna Commercial |
$324.16
|
Rate for Payer: Aetna Medicare |
$251.59
|
Rate for Payer: BCBS Complete |
$165.50
|
Rate for Payer: BCBS MAPPO |
$241.91
|
Rate for Payer: BCBS Trust/PPO |
$240.38
|
Rate for Payer: BCN Commercial |
$364.06
|
Rate for Payer: BCN Medicare Advantage |
$241.91
|
Rate for Payer: Cash Price |
$408.00
|
Rate for Payer: Cash Price |
$408.00
|
Rate for Payer: Cofinity Commercial |
$348.35
|
Rate for Payer: Cofinity Commercial |
$324.16
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.91
|
Rate for Payer: Mclaren Medicaid |
$157.62
|
Rate for Payer: Meridian Medicaid |
$165.50
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.01
|
Rate for Payer: PACE SWMI |
$241.91
|
Rate for Payer: PHP Medicare Advantage |
$241.91
|
Rate for Payer: Priority Health Choice Medicaid |
$157.62
|
Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.33
|
Rate for Payer: Priority Health Medicare |
$241.91
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$328.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$241.91
|
Rate for Payer: UHC Dual Complete DSNP |
$241.91
|
Rate for Payer: UHC Medicare Advantage |
$249.17
|
|
PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO
|
Professional
|
Both
|
$521.00
|
|
Service Code
|
HCPCS 95723
|
Min. Negotiated Rate |
$157.62 |
Max. Negotiated Rate |
$365.53 |
Rate for Payer: Aetna Commercial |
$325.46
|
Rate for Payer: Aetna Medicare |
$252.60
|
Rate for Payer: BCBS Complete |
$165.50
|
Rate for Payer: BCBS MAPPO |
$242.88
|
Rate for Payer: BCBS Trust/PPO |
$282.64
|
Rate for Payer: BCN Commercial |
$365.53
|
Rate for Payer: BCN Medicare Advantage |
$242.88
|
Rate for Payer: Cash Price |
$416.80
|
Rate for Payer: Cash Price |
$416.80
|
Rate for Payer: Cofinity Commercial |
$325.46
|
Rate for Payer: Cofinity Commercial |
$349.75
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.88
|
Rate for Payer: Mclaren Medicaid |
$157.62
|
Rate for Payer: Meridian Medicaid |
$165.50
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$255.02
|
Rate for Payer: PACE SWMI |
$242.88
|
Rate for Payer: PHP Medicare Advantage |
$242.88
|
Rate for Payer: Priority Health Choice Medicaid |
$157.62
|
Rate for Payer: Priority Health Cigna Priority Health |
$364.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.67
|
Rate for Payer: Priority Health Medicare |
$242.88
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$329.67
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$242.88
|
Rate for Payer: UHC Dual Complete DSNP |
$242.88
|
Rate for Payer: UHC Medicare Advantage |
$250.17
|
|
PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG
|
Professional
|
Both
|
$651.00
|
|
Service Code
|
HCPCS 95724
|
Min. Negotiated Rate |
$198.30 |
Max. Negotiated Rate |
$460.34 |
Rate for Payer: Aetna Commercial |
$410.60
|
Rate for Payer: Aetna Medicare |
$318.68
|
Rate for Payer: BCBS Complete |
$208.22
|
Rate for Payer: BCBS MAPPO |
$306.42
|
Rate for Payer: BCBS Trust/PPO |
$438.49
|
Rate for Payer: BCN Commercial |
$460.34
|
Rate for Payer: BCN Medicare Advantage |
$306.42
|
Rate for Payer: Cash Price |
$520.80
|
Rate for Payer: Cash Price |
$520.80
|
Rate for Payer: Cofinity Commercial |
$441.24
|
Rate for Payer: Cofinity Commercial |
$410.60
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.42
|
Rate for Payer: Mclaren Medicaid |
$198.30
|
Rate for Payer: Meridian Medicaid |
$208.22
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$321.74
|
Rate for Payer: PACE SWMI |
$306.42
|
Rate for Payer: PHP Medicare Advantage |
$306.42
|
Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
Rate for Payer: Priority Health Cigna Priority Health |
$455.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$415.91
|
Rate for Payer: Priority Health Medicare |
$306.42
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$415.91
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$306.42
|
Rate for Payer: UHC Dual Complete DSNP |
$306.42
|
Rate for Payer: UHC Medicare Advantage |
$315.61
|
|
PR EEG COMPLETE STD PHYS/QHP>84 HR W/O VID
|
Professional
|
Both
|
$595.00
|
|
Service Code
|
HCPCS 95725
|
Min. Negotiated Rate |
$181.90 |
Max. Negotiated Rate |
$476.00 |
Rate for Payer: Aetna Commercial |
$371.56
|
Rate for Payer: Aetna Medicare |
$288.37
|
Rate for Payer: BCBS Complete |
$191.00
|
Rate for Payer: BCBS MAPPO |
$277.28
|
Rate for Payer: BCBS Trust/PPO |
$476.00
|
Rate for Payer: BCN Commercial |
$418.30
|
Rate for Payer: BCN Medicare Advantage |
$277.28
|
Rate for Payer: Cash Price |
$476.00
|
Rate for Payer: Cash Price |
$476.00
|
Rate for Payer: Cofinity Commercial |
$399.28
|
Rate for Payer: Cofinity Commercial |
$371.56
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.28
|
Rate for Payer: Mclaren Medicaid |
$181.90
|
Rate for Payer: Meridian Medicaid |
$191.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$291.14
|
Rate for Payer: PACE SWMI |
$277.28
|
Rate for Payer: PHP Medicare Advantage |
$277.28
|
Rate for Payer: Priority Health Choice Medicaid |
$181.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$416.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$376.38
|
Rate for Payer: Priority Health Medicare |
$277.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$376.38
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$277.28
|
Rate for Payer: UHC Dual Complete DSNP |
$277.28
|
Rate for Payer: UHC Medicare Advantage |
$285.60
|
|
PR EEG COMPLETE STD PHYS/QHP>84 HR W/VEEG
|
Professional
|
Both
|
$823.00
|
|
Service Code
|
HCPCS 95726
|
Min. Negotiated Rate |
$254.11 |
Max. Negotiated Rate |
$585.43 |
Rate for Payer: Aetna Commercial |
$521.46
|
Rate for Payer: Aetna Medicare |
$404.72
|
Rate for Payer: BCBS Complete |
$266.82
|
Rate for Payer: BCBS MAPPO |
$389.15
|
Rate for Payer: BCBS Trust/PPO |
$530.41
|
Rate for Payer: BCN Commercial |
$585.43
|
Rate for Payer: BCN Medicare Advantage |
$389.15
|
Rate for Payer: Cash Price |
$658.40
|
Rate for Payer: Cash Price |
$658.40
|
Rate for Payer: Cofinity Commercial |
$560.38
|
Rate for Payer: Cofinity Commercial |
$521.46
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.15
|
Rate for Payer: Mclaren Medicaid |
$254.11
|
Rate for Payer: Meridian Medicaid |
$266.82
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$408.61
|
Rate for Payer: PACE SWMI |
$389.15
|
Rate for Payer: PHP Medicare Advantage |
$389.15
|
Rate for Payer: Priority Health Choice Medicaid |
$254.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$576.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$528.19
|
Rate for Payer: Priority Health Medicare |
$389.15
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$528.19
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$389.15
|
Rate for Payer: UHC Dual Complete DSNP |
$389.15
|
Rate for Payer: UHC Medicare Advantage |
$400.82
|
|
PR EEG EXTENDED MONITORING 61-119 MINUTES
|
Professional
|
Both
|
$851.00
|
|
Service Code
|
HCPCS 95813
|
Min. Negotiated Rate |
$340.40 |
Max. Negotiated Rate |
$692.07 |
Rate for Payer: Aetna Commercial |
$537.74
|
Rate for Payer: Aetna Medicare |
$417.35
|
Rate for Payer: BCBS Complete |
$340.40
|
Rate for Payer: BCBS MAPPO |
$401.30
|
Rate for Payer: BCBS Trust/PPO |
$692.07
|
Rate for Payer: BCN Commercial |
$626.48
|
Rate for Payer: BCN Medicare Advantage |
$401.30
|
Rate for Payer: Cash Price |
$680.80
|
Rate for Payer: Cash Price |
$680.80
|
Rate for Payer: Cofinity Commercial |
$577.87
|
Rate for Payer: Cofinity Commercial |
$537.74
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.30
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.36
|
Rate for Payer: PACE SWMI |
$401.30
|
Rate for Payer: PHP Medicare Advantage |
$401.30
|
Rate for Payer: Priority Health Cigna Priority Health |
$595.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$575.80
|
Rate for Payer: Priority Health Medicare |
$401.30
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$575.80
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$401.30
|
Rate for Payer: UHC Dual Complete DSNP |
$401.30
|
Rate for Payer: UHC Medicare Advantage |
$413.34
|
|