|
PR ENDOBRONCHIAL U/S ADD-ON
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 31620
|
| Min. Negotiated Rate |
$182.00 |
| Max. Negotiated Rate |
$318.50 |
| Rate for Payer: BCBS Complete |
$182.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 57505
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$232.98 |
| Rate for Payer: Aetna Commercial |
$142.33
|
| Rate for Payer: Aetna Medicare |
$110.47
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$106.22
|
| Rate for Payer: BCBS Trust/PPO |
$232.98
|
| Rate for Payer: BCN Commercial |
$184.16
|
| Rate for Payer: BCN Medicare Advantage |
$106.22
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$142.33
|
| Rate for Payer: Cofinity Commercial |
$152.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.22
|
| Rate for Payer: Mclaren Medicaid |
$70.72
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.53
|
| Rate for Payer: PACE SWMI |
$106.22
|
| Rate for Payer: PHP Medicare Advantage |
$106.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.76
|
| Rate for Payer: Priority Health Medicare |
$106.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.22
|
| Rate for Payer: UHC Medicare Advantage |
$109.41
|
|
|
PR END OF LIFE COUNSELING
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS S0257
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$206.57 |
| Rate for Payer: Aetna Commercial |
$3.85
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: BCN Commercial |
$28.73
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.64
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 92979
|
| Min. Negotiated Rate |
$120.40 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: BCBS Complete |
$120.40
|
| Rate for Payer: BCBS Trust/PPO |
$230.34
|
| Rate for Payer: BCN Commercial |
$233.10
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.03
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL
|
Professional
|
Both
|
$491.00
|
|
|
Service Code
|
HCPCS 92978
|
| Min. Negotiated Rate |
$154.26 |
| Max. Negotiated Rate |
$386.06 |
| Rate for Payer: Aetna Commercial |
$348.91
|
| Rate for Payer: BCBS Complete |
$196.40
|
| Rate for Payer: BCBS Trust/PPO |
$154.26
|
| Rate for Payer: BCN Commercial |
$386.06
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$373.09
|
|
|
PR ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID
|
Professional
|
Both
|
$2,003.00
|
|
|
Service Code
|
HCPCS 58353
|
| Min. Negotiated Rate |
$148.46 |
| Max. Negotiated Rate |
$1,402.10 |
| Rate for Payer: Aetna Commercial |
$306.89
|
| Rate for Payer: Aetna Medicare |
$238.18
|
| Rate for Payer: BCBS Complete |
$155.88
|
| Rate for Payer: BCBS MAPPO |
$229.02
|
| Rate for Payer: BCBS Trust/PPO |
$572.15
|
| Rate for Payer: BCN Commercial |
$1,387.35
|
| Rate for Payer: BCN Medicare Advantage |
$229.02
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cofinity Commercial |
$306.89
|
| Rate for Payer: Cofinity Commercial |
$329.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.02
|
| Rate for Payer: Mclaren Medicaid |
$148.46
|
| Rate for Payer: Meridian Medicaid |
$155.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$240.47
|
| Rate for Payer: PACE SWMI |
$229.02
|
| Rate for Payer: PHP Medicare Advantage |
$229.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,402.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.50
|
| Rate for Payer: Priority Health Medicare |
$229.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.02
|
| Rate for Payer: UHC Medicare Advantage |
$235.89
|
|
|
PR ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 58110
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$1,845.88 |
| Rate for Payer: Aetna Commercial |
$53.24
|
| Rate for Payer: Aetna Medicare |
$41.32
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$39.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.88
|
| Rate for Payer: BCN Commercial |
$72.82
|
| Rate for Payer: BCN Medicare Advantage |
$39.73
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$53.24
|
| Rate for Payer: Cofinity Commercial |
$57.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.73
|
| Rate for Payer: Mclaren Medicaid |
$25.56
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.72
|
| Rate for Payer: PACE SWMI |
$39.73
|
| Rate for Payer: PHP Medicare Advantage |
$39.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.34
|
| Rate for Payer: Priority Health Medicare |
$39.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.73
|
| Rate for Payer: UHC Medicare Advantage |
$40.92
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 58100
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$1,579.09 |
| Rate for Payer: Aetna Commercial |
$84.08
|
| Rate for Payer: Aetna Medicare |
$65.26
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$62.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.09
|
| Rate for Payer: BCN Commercial |
$120.16
|
| Rate for Payer: BCN Medicare Advantage |
$62.75
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$84.08
|
| Rate for Payer: Cofinity Commercial |
$90.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.75
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.89
|
| Rate for Payer: PACE SWMI |
$62.75
|
| Rate for Payer: PHP Medicare Advantage |
$62.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.01
|
| Rate for Payer: Priority Health Medicare |
$62.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.75
|
| Rate for Payer: UHC Medicare Advantage |
$64.63
|
|
|
PR ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR
|
Professional
|
Both
|
$2,758.00
|
|
|
Service Code
|
HCPCS 58356
|
| Min. Negotiated Rate |
$226.42 |
| Max. Negotiated Rate |
$2,491.27 |
| Rate for Payer: Aetna Commercial |
$473.17
|
| Rate for Payer: Aetna Medicare |
$367.23
|
| Rate for Payer: BCBS Complete |
$237.74
|
| Rate for Payer: BCBS MAPPO |
$353.11
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: BCN Commercial |
$2,491.27
|
| Rate for Payer: BCN Medicare Advantage |
$353.11
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cash Price |
$2,206.40
|
| Rate for Payer: Cofinity Commercial |
$508.48
|
| Rate for Payer: Cofinity Commercial |
$473.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.11
|
| Rate for Payer: Mclaren Medicaid |
$226.42
|
| Rate for Payer: Meridian Medicaid |
$237.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.77
|
| Rate for Payer: PACE SWMI |
$353.11
|
| Rate for Payer: PHP Medicare Advantage |
$353.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,930.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$502.77
|
| Rate for Payer: Priority Health Medicare |
$353.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$502.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.11
|
| Rate for Payer: UHC Medicare Advantage |
$363.70
|
|
|
PR ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 43273
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$786.11 |
| Rate for Payer: Aetna Commercial |
$154.48
|
| Rate for Payer: Aetna Medicare |
$119.89
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$115.28
|
| Rate for Payer: BCBS Trust/PPO |
$786.11
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: BCN Medicare Advantage |
$115.28
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$154.48
|
| Rate for Payer: Cofinity Commercial |
$166.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.28
|
| Rate for Payer: Mclaren Medicaid |
$74.55
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$121.04
|
| Rate for Payer: PACE SWMI |
$115.28
|
| Rate for Payer: PHP Medicare Advantage |
$115.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.03
|
| Rate for Payer: Priority Health Medicare |
$115.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.28
|
| Rate for Payer: UHC Medicare Advantage |
$118.74
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE
|
Professional
|
Both
|
$917.00
|
|
|
Service Code
|
HCPCS 44360
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$641.90 |
| Rate for Payer: Aetna Commercial |
$186.39
|
| Rate for Payer: Aetna Medicare |
$144.66
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$139.10
|
| Rate for Payer: BCBS Trust/PPO |
$381.96
|
| Rate for Payer: BCN Commercial |
$205.73
|
| Rate for Payer: BCN Medicare Advantage |
$139.10
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cofinity Commercial |
$200.30
|
| Rate for Payer: Cofinity Commercial |
$186.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.10
|
| Rate for Payer: Mclaren Medicaid |
$90.53
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.06
|
| Rate for Payer: PACE SWMI |
$139.10
|
| Rate for Payer: PHP Medicare Advantage |
$139.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.55
|
| Rate for Payer: Priority Health Medicare |
$139.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.10
|
| Rate for Payer: UHC Medicare Advantage |
$143.27
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 44361
|
| Min. Negotiated Rate |
$99.68 |
| Max. Negotiated Rate |
$678.30 |
| Rate for Payer: Aetna Commercial |
$205.46
|
| Rate for Payer: Aetna Medicare |
$159.46
|
| Rate for Payer: BCBS Complete |
$104.66
|
| Rate for Payer: BCBS MAPPO |
$153.33
|
| Rate for Payer: BCBS Trust/PPO |
$508.22
|
| Rate for Payer: BCN Commercial |
$226.75
|
| Rate for Payer: BCN Medicare Advantage |
$153.33
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$205.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.33
|
| Rate for Payer: Mclaren Medicaid |
$99.68
|
| Rate for Payer: Meridian Medicaid |
$104.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.00
|
| Rate for Payer: PACE SWMI |
$153.33
|
| Rate for Payer: PHP Medicare Advantage |
$153.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$272.83
|
| Rate for Payer: Priority Health Medicare |
$153.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$272.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.33
|
| Rate for Payer: UHC Medicare Advantage |
$157.93
|
|
|
PR ENDOVASC ABDO REPAIR W/PROS
|
Professional
|
Both
|
$5,228.00
|
|
|
Service Code
|
HCPCS 34805
|
| Min. Negotiated Rate |
$2,091.20 |
| Max. Negotiated Rate |
$3,659.60 |
| Rate for Payer: BCBS Complete |
$2,091.20
|
| Rate for Payer: Cash Price |
$4,182.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,659.60
|
|
|
PR ENDOVASCULAR REPAIR ILIAC ARTERY W ILIO-ILIAC PROSTHESIS
|
Professional
|
Both
|
$1,731.00
|
|
|
Service Code
|
HCPCS 34900
|
| Min. Negotiated Rate |
$692.40 |
| Max. Negotiated Rate |
$1,211.70 |
| Rate for Payer: BCBS Complete |
$692.40
|
| Rate for Payer: Cash Price |
$1,384.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.70
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
IP
|
$2,687.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$1,638.80 |
| Max. Negotiated Rate |
$2,418.30 |
| Rate for Payer: Aetna Commercial |
$2,283.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,076.51
|
| Rate for Payer: BCN Commercial |
$2,076.51
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$2,310.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,149.60
|
| Rate for Payer: Healthscope Commercial |
$2,418.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,015.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,283.95
|
| Rate for Payer: PHP Commercial |
$2,283.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,337.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,638.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,364.56
|
| Rate for Payer: UHC Core |
$2,243.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,015.25
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,687.00
|
|
|
Service Code
|
HCPCS 36478
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$1,880.90 |
| Rate for Payer: Aetna Commercial |
$365.27
|
| Rate for Payer: Aetna Medicare |
$283.49
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$272.59
|
| Rate for Payer: BCBS Trust/PPO |
$288.45
|
| Rate for Payer: BCN Commercial |
$1,440.13
|
| Rate for Payer: BCN Medicare Advantage |
$272.59
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$392.53
|
| Rate for Payer: Cofinity Commercial |
$365.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.59
|
| Rate for Payer: Mclaren Medicaid |
$173.60
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.22
|
| Rate for Payer: PACE SWMI |
$272.59
|
| Rate for Payer: PHP Medicare Advantage |
$272.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$431.94
|
| Rate for Payer: Priority Health Medicare |
$272.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$431.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$272.59
|
| Rate for Payer: UHC Medicare Advantage |
$280.77
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
OP
|
$2,687.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$638.16 |
| Max. Negotiated Rate |
$2,418.30 |
| Rate for Payer: Aetna Commercial |
$2,283.95
|
| Rate for Payer: Aetna Medicare |
$698.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$839.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$839.69
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$671.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,089.14
|
| Rate for Payer: BCN Commercial |
$2,089.14
|
| Rate for Payer: BCN Medicare Advantage |
$671.75
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$2,310.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,149.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.75
|
| Rate for Payer: Healthscope Commercial |
$2,418.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,015.25
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$705.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$772.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,283.95
|
| Rate for Payer: PACE Senior Care Partners |
$638.16
|
| Rate for Payer: PACE SWMI |
$671.75
|
| Rate for Payer: PHP Commercial |
$2,283.95
|
| Rate for Payer: PHP Medicare Advantage |
$671.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,337.69
|
| Rate for Payer: Priority Health Medicare |
$671.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,638.80
|
| Rate for Payer: Railroad Medicare Medicare |
$671.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,364.56
|
| Rate for Payer: UHC Core |
$2,243.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$671.75
|
| Rate for Payer: UHC Medicare Advantage |
$691.90
|
| Rate for Payer: VA VA |
$671.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,015.25
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Professional
|
Both
|
$2,687.00
|
|
|
Service Code
|
HCPCS 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$1,880.90 |
| Rate for Payer: Aetna Commercial |
$365.27
|
| Rate for Payer: Aetna Medicare |
$283.49
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$272.59
|
| Rate for Payer: BCBS Trust/PPO |
$288.45
|
| Rate for Payer: BCN Commercial |
$1,440.13
|
| Rate for Payer: BCN Medicare Advantage |
$272.59
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$365.27
|
| Rate for Payer: Cofinity Commercial |
$392.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.59
|
| Rate for Payer: Mclaren Medicaid |
$173.60
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.22
|
| Rate for Payer: PACE SWMI |
$272.59
|
| Rate for Payer: PHP Medicare Advantage |
$272.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$431.94
|
| Rate for Payer: Priority Health Medicare |
$272.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$431.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$272.59
|
| Rate for Payer: UHC Medicare Advantage |
$280.77
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN
|
Professional
|
Both
|
$3,087.00
|
|
|
Service Code
|
HCPCS 36475
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$2,160.90 |
| Rate for Payer: Aetna Commercial |
$366.05
|
| Rate for Payer: Aetna Medicare |
$284.10
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS MAPPO |
$273.17
|
| Rate for Payer: BCBS Trust/PPO |
$621.81
|
| Rate for Payer: BCN Commercial |
$1,586.74
|
| Rate for Payer: BCN Medicare Advantage |
$273.17
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cofinity Commercial |
$366.05
|
| Rate for Payer: Cofinity Commercial |
$393.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.17
|
| Rate for Payer: Mclaren Medicaid |
$173.60
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.83
|
| Rate for Payer: PACE SWMI |
$273.17
|
| Rate for Payer: PHP Medicare Advantage |
$273.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,160.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.48
|
| Rate for Payer: Priority Health Medicare |
$273.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$432.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.17
|
| Rate for Payer: UHC Medicare Advantage |
$281.37
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 36476
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$510.87 |
| Rate for Payer: Aetna Commercial |
$177.07
|
| Rate for Payer: Aetna Medicare |
$137.43
|
| Rate for Payer: BCBS Complete |
$87.22
|
| Rate for Payer: BCBS MAPPO |
$132.14
|
| Rate for Payer: BCBS Trust/PPO |
$510.87
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Medicare Advantage |
$132.14
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$190.28
|
| Rate for Payer: Cofinity Commercial |
$177.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.14
|
| Rate for Payer: Mclaren Medicaid |
$83.07
|
| Rate for Payer: Meridian Medicaid |
$87.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.75
|
| Rate for Payer: PACE SWMI |
$132.14
|
| Rate for Payer: PHP Medicare Advantage |
$132.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.53
|
| Rate for Payer: Priority Health Medicare |
$132.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.14
|
| Rate for Payer: UHC Medicare Advantage |
$136.10
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 44121
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$1,138.20 |
| Rate for Payer: Aetna Commercial |
$320.61
|
| Rate for Payer: Aetna Medicare |
$248.83
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS MAPPO |
$239.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.90
|
| Rate for Payer: BCN Commercial |
$348.43
|
| Rate for Payer: BCN Medicare Advantage |
$239.26
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cofinity Commercial |
$344.53
|
| Rate for Payer: Cofinity Commercial |
$320.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.26
|
| Rate for Payer: Mclaren Medicaid |
$152.30
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.22
|
| Rate for Payer: PACE SWMI |
$239.26
|
| Rate for Payer: PHP Medicare Advantage |
$239.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.23
|
| Rate for Payer: Priority Health Medicare |
$239.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$419.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.26
|
| Rate for Payer: UHC Medicare Advantage |
$246.44
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY
|
Professional
|
Both
|
$3,428.00
|
|
|
Service Code
|
HCPCS 44125
|
| Min. Negotiated Rate |
$749.76 |
| Max. Negotiated Rate |
$2,399.60 |
| Rate for Payer: Aetna Commercial |
$1,560.76
|
| Rate for Payer: Aetna Medicare |
$1,211.34
|
| Rate for Payer: BCBS Complete |
$787.25
|
| Rate for Payer: BCBS MAPPO |
$1,164.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,185.51
|
| Rate for Payer: BCN Commercial |
$1,708.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,164.75
|
| Rate for Payer: Cash Price |
$2,742.40
|
| Rate for Payer: Cash Price |
$2,742.40
|
| Rate for Payer: Cofinity Commercial |
$1,560.76
|
| Rate for Payer: Cofinity Commercial |
$1,677.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,164.75
|
| Rate for Payer: Mclaren Medicaid |
$749.76
|
| Rate for Payer: Meridian Medicaid |
$787.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,222.99
|
| Rate for Payer: PACE SWMI |
$1,164.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,164.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,399.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,056.15
|
| Rate for Payer: Priority Health Medicare |
$1,164.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,056.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,164.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,164.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,199.69
|
|
|
PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS
|
Professional
|
Both
|
$2,821.00
|
|
|
Service Code
|
HCPCS 51960
|
| Min. Negotiated Rate |
$876.50 |
| Max. Negotiated Rate |
$2,198.72 |
| Rate for Payer: Aetna Commercial |
$1,808.52
|
| Rate for Payer: Aetna Medicare |
$1,403.63
|
| Rate for Payer: BCBS Complete |
$920.32
|
| Rate for Payer: BCBS MAPPO |
$1,349.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.99
|
| Rate for Payer: BCN Commercial |
$1,988.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,349.64
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cofinity Commercial |
$1,808.52
|
| Rate for Payer: Cofinity Commercial |
$1,943.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,349.64
|
| Rate for Payer: Mclaren Medicaid |
$876.50
|
| Rate for Payer: Meridian Medicaid |
$920.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,417.12
|
| Rate for Payer: PACE SWMI |
$1,349.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,349.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,198.72
|
| Rate for Payer: Priority Health Medicare |
$1,349.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,349.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,349.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,390.13
|
|
|
PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX
|
Professional
|
Both
|
$3,110.00
|
|
|
Service Code
|
HCPCS 44130
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$2,305.45 |
| Rate for Payer: Aetna Commercial |
$1,749.96
|
| Rate for Payer: Aetna Medicare |
$1,358.18
|
| Rate for Payer: BCBS Complete |
$881.63
|
| Rate for Payer: BCBS MAPPO |
$1,305.94
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,916.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,305.94
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Cofinity Commercial |
$1,749.96
|
| Rate for Payer: Cofinity Commercial |
$1,880.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,305.94
|
| Rate for Payer: Mclaren Medicaid |
$839.65
|
| Rate for Payer: Meridian Medicaid |
$881.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,371.24
|
| Rate for Payer: PACE SWMI |
$1,305.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,305.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,177.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,305.45
|
| Rate for Payer: Priority Health Medicare |
$1,305.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,305.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,305.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,305.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,345.12
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,761.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
44005
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$1,932.70 |
| Rate for Payer: Aetna Commercial |
$1,453.30
|
| Rate for Payer: Aetna Medicare |
$1,127.93
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS MAPPO |
$1,084.55
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$1,590.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,084.55
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$1,561.75
|
| Rate for Payer: Cofinity Commercial |
$1,453.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,084.55
|
| Rate for Payer: Mclaren Medicaid |
$696.72
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,138.78
|
| Rate for Payer: PACE SWMI |
$1,084.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,084.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,913.26
|
| Rate for Payer: Priority Health Medicare |
$1,084.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,913.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,084.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,117.09
|
|
