PR EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Professional
|
Both
|
$350.00
|
|
Service Code
|
HCPCS 92523
|
Min. Negotiated Rate |
$140.00 |
Max. Negotiated Rate |
$1,440.15 |
Rate for Payer: Aetna Commercial |
$297.16
|
Rate for Payer: Aetna Medicare |
$230.63
|
Rate for Payer: BCBS Complete |
$140.00
|
Rate for Payer: BCBS MAPPO |
$221.76
|
Rate for Payer: BCBS Trust/PPO |
$1,440.15
|
Rate for Payer: BCN Commercial |
$331.82
|
Rate for Payer: BCN Medicare Advantage |
$221.76
|
Rate for Payer: Cash Price |
$280.00
|
Rate for Payer: Cash Price |
$280.00
|
Rate for Payer: Cofinity Commercial |
$319.33
|
Rate for Payer: Cofinity Commercial |
$297.16
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.76
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.85
|
Rate for Payer: PACE SWMI |
$221.76
|
Rate for Payer: PHP Medicare Advantage |
$221.76
|
Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.96
|
Rate for Payer: Priority Health Medicare |
$221.76
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$304.96
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$221.76
|
Rate for Payer: UHC Dual Complete DSNP |
$221.76
|
Rate for Payer: UHC Medicare Advantage |
$228.41
|
|
PR EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Professional
|
Both
|
$207.00
|
|
Service Code
|
HCPCS 92521
|
Min. Negotiated Rate |
$82.80 |
Max. Negotiated Rate |
$1,170.71 |
Rate for Payer: Aetna Commercial |
$173.32
|
Rate for Payer: Aetna Medicare |
$134.51
|
Rate for Payer: BCBS Complete |
$82.80
|
Rate for Payer: BCBS MAPPO |
$129.34
|
Rate for Payer: BCBS Trust/PPO |
$1,170.71
|
Rate for Payer: BCN Commercial |
$193.52
|
Rate for Payer: BCN Medicare Advantage |
$129.34
|
Rate for Payer: Cash Price |
$165.60
|
Rate for Payer: Cash Price |
$165.60
|
Rate for Payer: Cofinity Commercial |
$173.32
|
Rate for Payer: Cofinity Commercial |
$186.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.34
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.81
|
Rate for Payer: PACE SWMI |
$129.34
|
Rate for Payer: PHP Medicare Advantage |
$129.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$144.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.86
|
Rate for Payer: Priority Health Medicare |
$129.34
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$177.86
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$129.34
|
Rate for Payer: UHC Dual Complete DSNP |
$129.34
|
Rate for Payer: UHC Medicare Advantage |
$133.22
|
|
PR EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Professional
|
Both
|
$168.00
|
|
Service Code
|
HCPCS 92522
|
Min. Negotiated Rate |
$67.20 |
Max. Negotiated Rate |
$1,580.15 |
Rate for Payer: Aetna Commercial |
$145.22
|
Rate for Payer: Aetna Medicare |
$112.70
|
Rate for Payer: BCBS Complete |
$67.20
|
Rate for Payer: BCBS MAPPO |
$108.37
|
Rate for Payer: BCBS Trust/PPO |
$1,580.15
|
Rate for Payer: BCN Commercial |
$161.75
|
Rate for Payer: BCN Medicare Advantage |
$108.37
|
Rate for Payer: Cash Price |
$134.40
|
Rate for Payer: Cash Price |
$134.40
|
Rate for Payer: Cofinity Commercial |
$145.22
|
Rate for Payer: Cofinity Commercial |
$156.05
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.37
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$113.79
|
Rate for Payer: PACE SWMI |
$108.37
|
Rate for Payer: PHP Medicare Advantage |
$108.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.67
|
Rate for Payer: Priority Health Medicare |
$108.37
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$148.67
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$108.37
|
Rate for Payer: UHC Dual Complete DSNP |
$108.37
|
Rate for Payer: UHC Medicare Advantage |
$111.62
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST
|
Professional
|
Both
|
$1,083.00
|
|
Service Code
|
HCPCS 61650
|
Min. Negotiated Rate |
$318.04 |
Max. Negotiated Rate |
$964.28 |
Rate for Payer: Aetna Commercial |
$766.86
|
Rate for Payer: Aetna Medicare |
$595.17
|
Rate for Payer: BCBS Complete |
$389.60
|
Rate for Payer: BCBS MAPPO |
$572.28
|
Rate for Payer: BCBS Trust/PPO |
$318.04
|
Rate for Payer: BCN Commercial |
$832.21
|
Rate for Payer: BCN Medicare Advantage |
$572.28
|
Rate for Payer: Cash Price |
$866.40
|
Rate for Payer: Cash Price |
$866.40
|
Rate for Payer: Cofinity Commercial |
$766.86
|
Rate for Payer: Cofinity Commercial |
$824.08
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.28
|
Rate for Payer: Mclaren Medicaid |
$371.05
|
Rate for Payer: Meridian Medicaid |
$389.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$600.89
|
Rate for Payer: PACE SWMI |
$572.28
|
Rate for Payer: PHP Medicare Advantage |
$572.28
|
Rate for Payer: Priority Health Choice Medicaid |
$371.05
|
Rate for Payer: Priority Health Cigna Priority Health |
$758.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$964.28
|
Rate for Payer: Priority Health Medicare |
$572.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$964.28
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$572.28
|
Rate for Payer: UHC Dual Complete DSNP |
$572.28
|
Rate for Payer: UHC Medicare Advantage |
$589.45
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL
|
Professional
|
Both
|
$461.00
|
|
Service Code
|
HCPCS 61651
|
Min. Negotiated Rate |
$158.47 |
Max. Negotiated Rate |
$415.04 |
Rate for Payer: Aetna Commercial |
$330.28
|
Rate for Payer: Aetna Medicare |
$256.34
|
Rate for Payer: BCBS Complete |
$166.39
|
Rate for Payer: BCBS MAPPO |
$246.48
|
Rate for Payer: BCBS Trust/PPO |
$301.13
|
Rate for Payer: BCN Commercial |
$358.20
|
Rate for Payer: BCN Medicare Advantage |
$246.48
|
Rate for Payer: Cash Price |
$368.80
|
Rate for Payer: Cash Price |
$368.80
|
Rate for Payer: Cofinity Commercial |
$354.93
|
Rate for Payer: Cofinity Commercial |
$330.28
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.48
|
Rate for Payer: Mclaren Medicaid |
$158.47
|
Rate for Payer: Meridian Medicaid |
$166.39
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$258.80
|
Rate for Payer: PACE SWMI |
$246.48
|
Rate for Payer: PHP Medicare Advantage |
$246.48
|
Rate for Payer: Priority Health Choice Medicaid |
$158.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$322.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$415.04
|
Rate for Payer: Priority Health Medicare |
$246.48
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$415.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$246.48
|
Rate for Payer: UHC Dual Complete DSNP |
$246.48
|
Rate for Payer: UHC Medicare Advantage |
$253.87
|
|
PR EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE
|
Professional
|
Both
|
$436.00
|
|
Service Code
|
HCPCS 34808
|
Min. Negotiated Rate |
$125.88 |
Max. Negotiated Rate |
$313.33 |
Rate for Payer: Aetna Commercial |
$267.65
|
Rate for Payer: Aetna Medicare |
$207.73
|
Rate for Payer: BCBS Complete |
$132.17
|
Rate for Payer: BCBS MAPPO |
$199.74
|
Rate for Payer: BCBS Trust/PPO |
$212.38
|
Rate for Payer: BCN Commercial |
$287.83
|
Rate for Payer: BCN Medicare Advantage |
$199.74
|
Rate for Payer: Cash Price |
$348.80
|
Rate for Payer: Cash Price |
$348.80
|
Rate for Payer: Cofinity Commercial |
$287.63
|
Rate for Payer: Cofinity Commercial |
$267.65
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.74
|
Rate for Payer: Mclaren Medicaid |
$125.88
|
Rate for Payer: Meridian Medicaid |
$132.17
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$209.73
|
Rate for Payer: PACE SWMI |
$199.74
|
Rate for Payer: PHP Medicare Advantage |
$199.74
|
Rate for Payer: Priority Health Choice Medicaid |
$125.88
|
Rate for Payer: Priority Health Cigna Priority Health |
$305.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.33
|
Rate for Payer: Priority Health Medicare |
$199.74
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$313.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$199.74
|
Rate for Payer: UHC Dual Complete DSNP |
$199.74
|
Rate for Payer: UHC Medicare Advantage |
$205.73
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT
|
Professional
|
Both
|
$2,537.00
|
|
Service Code
|
HCPCS 34701
|
Min. Negotiated Rate |
$769.14 |
Max. Negotiated Rate |
$1,919.30 |
Rate for Payer: Aetna Commercial |
$1,629.72
|
Rate for Payer: Aetna Medicare |
$1,264.86
|
Rate for Payer: BCBS Complete |
$807.60
|
Rate for Payer: BCBS MAPPO |
$1,216.21
|
Rate for Payer: BCBS Trust/PPO |
$1,422.71
|
Rate for Payer: BCN Commercial |
$1,763.15
|
Rate for Payer: BCN Medicare Advantage |
$1,216.21
|
Rate for Payer: Cash Price |
$2,029.60
|
Rate for Payer: Cash Price |
$2,029.60
|
Rate for Payer: Cofinity Commercial |
$1,751.34
|
Rate for Payer: Cofinity Commercial |
$1,629.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,216.21
|
Rate for Payer: Mclaren Medicaid |
$769.14
|
Rate for Payer: Meridian Medicaid |
$807.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,277.02
|
Rate for Payer: PACE SWMI |
$1,216.21
|
Rate for Payer: PHP Medicare Advantage |
$1,216.21
|
Rate for Payer: Priority Health Choice Medicaid |
$769.14
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,775.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,919.30
|
Rate for Payer: Priority Health Medicare |
$1,216.21
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,919.30
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,216.21
|
Rate for Payer: UHC Dual Complete DSNP |
$1,216.21
|
Rate for Payer: UHC Medicare Advantage |
$1,252.70
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT
|
Professional
|
Both
|
$3,836.00
|
|
Service Code
|
HCPCS 34702
|
Min. Negotiated Rate |
$1,148.71 |
Max. Negotiated Rate |
$2,863.53 |
Rate for Payer: Aetna Commercial |
$2,436.07
|
Rate for Payer: Aetna Medicare |
$1,890.68
|
Rate for Payer: BCBS Complete |
$1,206.15
|
Rate for Payer: BCBS MAPPO |
$1,817.96
|
Rate for Payer: BCBS Trust/PPO |
$2,005.96
|
Rate for Payer: BCN Commercial |
$2,630.55
|
Rate for Payer: BCN Medicare Advantage |
$1,817.96
|
Rate for Payer: Cash Price |
$3,068.80
|
Rate for Payer: Cash Price |
$3,068.80
|
Rate for Payer: Cofinity Commercial |
$2,617.86
|
Rate for Payer: Cofinity Commercial |
$2,436.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,817.96
|
Rate for Payer: Mclaren Medicaid |
$1,148.71
|
Rate for Payer: Meridian Medicaid |
$1,206.15
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,908.86
|
Rate for Payer: PACE SWMI |
$1,817.96
|
Rate for Payer: PHP Medicare Advantage |
$1,817.96
|
Rate for Payer: Priority Health Choice Medicaid |
$1,148.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,685.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,863.53
|
Rate for Payer: Priority Health Medicare |
$1,817.96
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,863.53
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,817.96
|
Rate for Payer: UHC Dual Complete DSNP |
$1,817.96
|
Rate for Payer: UHC Medicare Advantage |
$1,872.50
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT
|
Professional
|
Both
|
$3,104.00
|
|
Service Code
|
HCPCS 34705
|
Min. Negotiated Rate |
$949.98 |
Max. Negotiated Rate |
$2,747.37 |
Rate for Payer: Aetna Commercial |
$2,012.47
|
Rate for Payer: Aetna Medicare |
$1,561.91
|
Rate for Payer: BCBS Complete |
$997.48
|
Rate for Payer: BCBS MAPPO |
$1,501.84
|
Rate for Payer: BCBS Trust/PPO |
$2,747.37
|
Rate for Payer: BCN Commercial |
$2,174.62
|
Rate for Payer: BCN Medicare Advantage |
$1,501.84
|
Rate for Payer: Cash Price |
$2,483.20
|
Rate for Payer: Cash Price |
$2,483.20
|
Rate for Payer: Cofinity Commercial |
$2,162.65
|
Rate for Payer: Cofinity Commercial |
$2,012.47
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,501.84
|
Rate for Payer: Mclaren Medicaid |
$949.98
|
Rate for Payer: Meridian Medicaid |
$997.48
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,576.93
|
Rate for Payer: PACE SWMI |
$1,501.84
|
Rate for Payer: PHP Medicare Advantage |
$1,501.84
|
Rate for Payer: Priority Health Choice Medicaid |
$949.98
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,172.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,367.21
|
Rate for Payer: Priority Health Medicare |
$1,501.84
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,367.21
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,501.84
|
Rate for Payer: UHC Dual Complete DSNP |
$1,501.84
|
Rate for Payer: UHC Medicare Advantage |
$1,546.90
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT
|
Professional
|
Both
|
$4,745.00
|
|
Service Code
|
HCPCS 34706
|
Min. Negotiated Rate |
$1,415.81 |
Max. Negotiated Rate |
$3,526.88 |
Rate for Payer: Aetna Commercial |
$3,004.70
|
Rate for Payer: Aetna Medicare |
$2,332.00
|
Rate for Payer: BCBS Complete |
$1,486.60
|
Rate for Payer: BCBS MAPPO |
$2,242.31
|
Rate for Payer: BCBS Trust/PPO |
$2,686.93
|
Rate for Payer: BCN Commercial |
$3,239.93
|
Rate for Payer: BCN Medicare Advantage |
$2,242.31
|
Rate for Payer: Cash Price |
$3,796.00
|
Rate for Payer: Cash Price |
$3,796.00
|
Rate for Payer: Cofinity Commercial |
$3,228.93
|
Rate for Payer: Cofinity Commercial |
$3,004.70
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,242.31
|
Rate for Payer: Mclaren Medicaid |
$1,415.81
|
Rate for Payer: Meridian Medicaid |
$1,486.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,354.43
|
Rate for Payer: PACE SWMI |
$2,242.31
|
Rate for Payer: PHP Medicare Advantage |
$2,242.31
|
Rate for Payer: Priority Health Choice Medicaid |
$1,415.81
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,321.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,526.88
|
Rate for Payer: Priority Health Medicare |
$2,242.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3,526.88
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,242.31
|
Rate for Payer: UHC Dual Complete DSNP |
$2,242.31
|
Rate for Payer: UHC Medicare Advantage |
$2,309.58
|
|
PR EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT
|
Professional
|
Both
|
$2,860.00
|
|
Service Code
|
HCPCS 34703
|
Min. Negotiated Rate |
$854.34 |
Max. Negotiated Rate |
$2,308.14 |
Rate for Payer: Aetna Commercial |
$1,814.04
|
Rate for Payer: Aetna Medicare |
$1,407.91
|
Rate for Payer: BCBS Complete |
$897.06
|
Rate for Payer: BCBS MAPPO |
$1,353.76
|
Rate for Payer: BCBS Trust/PPO |
$2,308.14
|
Rate for Payer: BCN Commercial |
$1,960.57
|
Rate for Payer: BCN Medicare Advantage |
$1,353.76
|
Rate for Payer: Cash Price |
$2,288.00
|
Rate for Payer: Cash Price |
$2,288.00
|
Rate for Payer: Cofinity Commercial |
$1,814.04
|
Rate for Payer: Cofinity Commercial |
$1,949.41
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.76
|
Rate for Payer: Mclaren Medicaid |
$854.34
|
Rate for Payer: Meridian Medicaid |
$897.06
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,421.45
|
Rate for Payer: PACE SWMI |
$1,353.76
|
Rate for Payer: PHP Medicare Advantage |
$1,353.76
|
Rate for Payer: Priority Health Choice Medicaid |
$854.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,002.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,134.21
|
Rate for Payer: Priority Health Medicare |
$1,353.76
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,134.21
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.76
|
Rate for Payer: UHC Dual Complete DSNP |
$1,353.76
|
Rate for Payer: UHC Medicare Advantage |
$1,394.37
|
|
PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT
|
Professional
|
Both
|
$2,367.00
|
|
Service Code
|
HCPCS 34707
|
Min. Negotiated Rate |
$722.50 |
Max. Negotiated Rate |
$2,209.35 |
Rate for Payer: Aetna Commercial |
$1,536.40
|
Rate for Payer: Aetna Medicare |
$1,192.43
|
Rate for Payer: BCBS Complete |
$758.62
|
Rate for Payer: BCBS MAPPO |
$1,146.57
|
Rate for Payer: BCBS Trust/PPO |
$2,209.35
|
Rate for Payer: BCN Commercial |
$1,662.48
|
Rate for Payer: BCN Medicare Advantage |
$1,146.57
|
Rate for Payer: Cash Price |
$1,893.60
|
Rate for Payer: Cash Price |
$1,893.60
|
Rate for Payer: Cofinity Commercial |
$1,651.06
|
Rate for Payer: Cofinity Commercial |
$1,536.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,146.57
|
Rate for Payer: Mclaren Medicaid |
$722.50
|
Rate for Payer: Meridian Medicaid |
$758.62
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,203.90
|
Rate for Payer: PACE SWMI |
$1,146.57
|
Rate for Payer: PHP Medicare Advantage |
$1,146.57
|
Rate for Payer: Priority Health Choice Medicaid |
$722.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,656.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,809.72
|
Rate for Payer: Priority Health Medicare |
$1,146.57
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,809.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,146.57
|
Rate for Payer: UHC Dual Complete DSNP |
$1,146.57
|
Rate for Payer: UHC Medicare Advantage |
$1,180.97
|
|
PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT
|
Professional
|
Both
|
$3,823.00
|
|
Service Code
|
HCPCS 34708
|
Min. Negotiated Rate |
$1,132.52 |
Max. Negotiated Rate |
$2,816.72 |
Rate for Payer: Aetna Commercial |
$2,404.30
|
Rate for Payer: Aetna Medicare |
$1,866.02
|
Rate for Payer: BCBS Complete |
$1,189.15
|
Rate for Payer: BCBS MAPPO |
$1,794.25
|
Rate for Payer: BCBS Trust/PPO |
$1,929.88
|
Rate for Payer: BCN Commercial |
$2,587.55
|
Rate for Payer: BCN Medicare Advantage |
$1,794.25
|
Rate for Payer: Cash Price |
$3,058.40
|
Rate for Payer: Cash Price |
$3,058.40
|
Rate for Payer: Cofinity Commercial |
$2,583.72
|
Rate for Payer: Cofinity Commercial |
$2,404.30
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,794.25
|
Rate for Payer: Mclaren Medicaid |
$1,132.52
|
Rate for Payer: Meridian Medicaid |
$1,189.15
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,883.96
|
Rate for Payer: PACE SWMI |
$1,794.25
|
Rate for Payer: PHP Medicare Advantage |
$1,794.25
|
Rate for Payer: Priority Health Choice Medicaid |
$1,132.52
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,676.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,816.72
|
Rate for Payer: Priority Health Medicare |
$1,794.25
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,816.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,794.25
|
Rate for Payer: UHC Dual Complete DSNP |
$1,794.25
|
Rate for Payer: UHC Medicare Advantage |
$1,848.08
|
|
PR EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH
|
Professional
|
Both
|
$8,083.00
|
|
Service Code
|
HCPCS 33880
|
Min. Negotiated Rate |
$649.81 |
Max. Negotiated Rate |
$5,658.10 |
Rate for Payer: Aetna Commercial |
$2,361.63
|
Rate for Payer: Aetna Medicare |
$1,832.91
|
Rate for Payer: BCBS Complete |
$1,168.80
|
Rate for Payer: BCBS MAPPO |
$1,762.41
|
Rate for Payer: BCBS Trust/PPO |
$649.81
|
Rate for Payer: BCN Commercial |
$2,552.85
|
Rate for Payer: BCN Medicare Advantage |
$1,762.41
|
Rate for Payer: Cash Price |
$6,466.40
|
Rate for Payer: Cash Price |
$6,466.40
|
Rate for Payer: Cofinity Commercial |
$2,361.63
|
Rate for Payer: Cofinity Commercial |
$2,537.87
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,762.41
|
Rate for Payer: Mclaren Medicaid |
$1,113.14
|
Rate for Payer: Meridian Medicaid |
$1,168.80
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,850.53
|
Rate for Payer: PACE SWMI |
$1,762.41
|
Rate for Payer: PHP Medicare Advantage |
$1,762.41
|
Rate for Payer: Priority Health Choice Medicaid |
$1,113.14
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,658.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,778.95
|
Rate for Payer: Priority Health Medicare |
$1,762.41
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,778.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,762.41
|
Rate for Payer: UHC Dual Complete DSNP |
$1,762.41
|
Rate for Payer: UHC Medicare Advantage |
$1,815.28
|
|
PR EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN
|
Professional
|
Both
|
$5,396.00
|
|
Service Code
|
HCPCS 33881
|
Min. Negotiated Rate |
$924.53 |
Max. Negotiated Rate |
$3,777.20 |
Rate for Payer: Aetna Commercial |
$2,022.93
|
Rate for Payer: Aetna Medicare |
$1,570.04
|
Rate for Payer: BCBS Complete |
$1,003.97
|
Rate for Payer: BCBS MAPPO |
$1,509.65
|
Rate for Payer: BCBS Trust/PPO |
$924.53
|
Rate for Payer: BCN Commercial |
$2,187.32
|
Rate for Payer: BCN Medicare Advantage |
$1,509.65
|
Rate for Payer: Cash Price |
$4,316.80
|
Rate for Payer: Cash Price |
$4,316.80
|
Rate for Payer: Cofinity Commercial |
$2,022.93
|
Rate for Payer: Cofinity Commercial |
$2,173.90
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,509.65
|
Rate for Payer: Mclaren Medicaid |
$956.16
|
Rate for Payer: Meridian Medicaid |
$1,003.97
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,585.13
|
Rate for Payer: PACE SWMI |
$1,509.65
|
Rate for Payer: PHP Medicare Advantage |
$1,509.65
|
Rate for Payer: Priority Health Choice Medicaid |
$956.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,777.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,381.04
|
Rate for Payer: Priority Health Medicare |
$1,509.65
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,381.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,509.65
|
Rate for Payer: UHC Dual Complete DSNP |
$1,509.65
|
Rate for Payer: UHC Medicare Advantage |
$1,554.94
|
|
PR EVASC RPR ILAC ART BIFUR ENDGRFT CATHJ RS&I UNI
|
Professional
|
Both
|
$940.00
|
|
Service Code
|
HCPCS 0254T
|
Min. Negotiated Rate |
$376.00 |
Max. Negotiated Rate |
$658.00 |
Rate for Payer: BCBS Complete |
$376.00
|
Rate for Payer: Cash Price |
$752.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$658.00
|
|
PR EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI
|
Professional
|
Both
|
$2,120.00
|
|
Service Code
|
HCPCS 34718
|
Min. Negotiated Rate |
$770.63 |
Max. Negotiated Rate |
$1,914.51 |
Rate for Payer: Aetna Commercial |
$1,627.99
|
Rate for Payer: Aetna Medicare |
$1,263.52
|
Rate for Payer: BCBS Complete |
$809.16
|
Rate for Payer: BCBS MAPPO |
$1,214.92
|
Rate for Payer: BCBS Trust/PPO |
$1,579.62
|
Rate for Payer: BCN Commercial |
$1,758.75
|
Rate for Payer: BCN Medicare Advantage |
$1,214.92
|
Rate for Payer: Cash Price |
$1,696.00
|
Rate for Payer: Cash Price |
$1,696.00
|
Rate for Payer: Cofinity Commercial |
$1,749.48
|
Rate for Payer: Cofinity Commercial |
$1,627.99
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,214.92
|
Rate for Payer: Mclaren Medicaid |
$770.63
|
Rate for Payer: Meridian Medicaid |
$809.16
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,275.67
|
Rate for Payer: PACE SWMI |
$1,214.92
|
Rate for Payer: PHP Medicare Advantage |
$1,214.92
|
Rate for Payer: Priority Health Choice Medicaid |
$770.63
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,484.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,914.51
|
Rate for Payer: Priority Health Medicare |
$1,214.92
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,914.51
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,214.92
|
Rate for Payer: UHC Dual Complete DSNP |
$1,214.92
|
Rate for Payer: UHC Medicare Advantage |
$1,251.37
|
|
PR EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI
|
Professional
|
Both
|
$793.00
|
|
Service Code
|
HCPCS 34717
|
Min. Negotiated Rate |
$274.98 |
Max. Negotiated Rate |
$1,145.35 |
Rate for Payer: Aetna Commercial |
$584.92
|
Rate for Payer: Aetna Medicare |
$453.97
|
Rate for Payer: BCBS Complete |
$288.73
|
Rate for Payer: BCBS MAPPO |
$436.51
|
Rate for Payer: BCBS Trust/PPO |
$1,145.35
|
Rate for Payer: BCN Commercial |
$629.42
|
Rate for Payer: BCN Medicare Advantage |
$436.51
|
Rate for Payer: Cash Price |
$634.40
|
Rate for Payer: Cash Price |
$634.40
|
Rate for Payer: Cofinity Commercial |
$628.57
|
Rate for Payer: Cofinity Commercial |
$584.92
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.51
|
Rate for Payer: Mclaren Medicaid |
$274.98
|
Rate for Payer: Meridian Medicaid |
$288.73
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$458.34
|
Rate for Payer: PACE SWMI |
$436.51
|
Rate for Payer: PHP Medicare Advantage |
$436.51
|
Rate for Payer: Priority Health Choice Medicaid |
$274.98
|
Rate for Payer: Priority Health Cigna Priority Health |
$555.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.17
|
Rate for Payer: Priority Health Medicare |
$436.51
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$685.17
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$436.51
|
Rate for Payer: UHC Dual Complete DSNP |
$436.51
|
Rate for Payer: UHC Medicare Advantage |
$449.61
|
|
PR EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK
|
Professional
|
Both
|
$3,271.00
|
|
Service Code
|
HCPCS 61623
|
Min. Negotiated Rate |
$124.15 |
Max. Negotiated Rate |
$2,289.70 |
Rate for Payer: Aetna Commercial |
$772.03
|
Rate for Payer: Aetna Medicare |
$599.19
|
Rate for Payer: BCBS Complete |
$385.57
|
Rate for Payer: BCBS MAPPO |
$576.14
|
Rate for Payer: BCBS Trust/PPO |
$124.15
|
Rate for Payer: BCN Commercial |
$838.57
|
Rate for Payer: BCN Medicare Advantage |
$576.14
|
Rate for Payer: Cash Price |
$2,616.80
|
Rate for Payer: Cash Price |
$2,616.80
|
Rate for Payer: Cofinity Commercial |
$829.64
|
Rate for Payer: Cofinity Commercial |
$772.03
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$576.14
|
Rate for Payer: Mclaren Medicaid |
$367.21
|
Rate for Payer: Meridian Medicaid |
$385.57
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$604.95
|
Rate for Payer: PACE SWMI |
$576.14
|
Rate for Payer: PHP Medicare Advantage |
$576.14
|
Rate for Payer: Priority Health Choice Medicaid |
$367.21
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,289.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$971.63
|
Rate for Payer: Priority Health Medicare |
$576.14
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$971.63
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$576.14
|
Rate for Payer: UHC Dual Complete DSNP |
$576.14
|
Rate for Payer: UHC Medicare Advantage |
$593.42
|
|
PR EWHO RIGID W/O JNTS CF
|
Professional
|
Both
|
$685.00
|
|
Service Code
|
HCPCS L3763
|
Min. Negotiated Rate |
$274.00 |
Max. Negotiated Rate |
$646.68 |
Rate for Payer: Aetna Commercial |
$410.20
|
Rate for Payer: BCBS Complete |
$274.00
|
Rate for Payer: BCN Commercial |
$646.68
|
Rate for Payer: Cash Price |
$548.00
|
Rate for Payer: Cash Price |
$548.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$479.50
|
|
PR EWHO W/JOINT(S) CF
|
Professional
|
Both
|
$717.00
|
|
Service Code
|
HCPCS L3764
|
Min. Negotiated Rate |
$286.80 |
Max. Negotiated Rate |
$676.76 |
Rate for Payer: Aetna Commercial |
$429.28
|
Rate for Payer: BCBS Complete |
$286.80
|
Rate for Payer: BCN Commercial |
$676.76
|
Rate for Payer: Cash Price |
$573.60
|
Rate for Payer: Cash Price |
$573.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$501.90
|
|
PR EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM
|
Professional
|
Both
|
$2,332.00
|
|
Service Code
|
HCPCS 44110
|
Min. Negotiated Rate |
$543.79 |
Max. Negotiated Rate |
$1,643.01 |
Rate for Payer: Aetna Commercial |
$1,123.90
|
Rate for Payer: Aetna Medicare |
$872.28
|
Rate for Payer: BCBS Complete |
$570.98
|
Rate for Payer: BCBS MAPPO |
$838.73
|
Rate for Payer: BCBS Trust/PPO |
$1,643.01
|
Rate for Payer: BCN Commercial |
$1,234.88
|
Rate for Payer: BCN Medicare Advantage |
$838.73
|
Rate for Payer: Cash Price |
$1,865.60
|
Rate for Payer: Cash Price |
$1,865.60
|
Rate for Payer: Cofinity Commercial |
$1,123.90
|
Rate for Payer: Cofinity Commercial |
$1,207.77
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$838.73
|
Rate for Payer: Mclaren Medicaid |
$543.79
|
Rate for Payer: Meridian Medicaid |
$570.98
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$880.67
|
Rate for Payer: PACE SWMI |
$838.73
|
Rate for Payer: PHP Medicare Advantage |
$838.73
|
Rate for Payer: Priority Health Choice Medicaid |
$543.79
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,632.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,485.81
|
Rate for Payer: Priority Health Medicare |
$838.73
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,485.81
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$838.73
|
Rate for Payer: UHC Dual Complete DSNP |
$838.73
|
Rate for Payer: UHC Medicare Advantage |
$863.89
|
|
PR EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE
|
Professional
|
Both
|
$3,534.00
|
|
Service Code
|
HCPCS 44111
|
Min. Negotiated Rate |
$266.79 |
Max. Negotiated Rate |
$2,473.80 |
Rate for Payer: Aetna Commercial |
$1,308.18
|
Rate for Payer: Aetna Medicare |
$1,015.30
|
Rate for Payer: BCBS Complete |
$655.52
|
Rate for Payer: BCBS MAPPO |
$976.25
|
Rate for Payer: BCBS Trust/PPO |
$266.79
|
Rate for Payer: BCN Commercial |
$1,435.25
|
Rate for Payer: BCN Medicare Advantage |
$976.25
|
Rate for Payer: Cash Price |
$2,827.20
|
Rate for Payer: Cash Price |
$2,827.20
|
Rate for Payer: Cofinity Commercial |
$1,405.80
|
Rate for Payer: Cofinity Commercial |
$1,308.18
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$976.25
|
Rate for Payer: Mclaren Medicaid |
$624.30
|
Rate for Payer: Meridian Medicaid |
$655.52
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,025.06
|
Rate for Payer: PACE SWMI |
$976.25
|
Rate for Payer: PHP Medicare Advantage |
$976.25
|
Rate for Payer: Priority Health Choice Medicaid |
$624.30
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,473.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,726.88
|
Rate for Payer: Priority Health Medicare |
$976.25
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,726.88
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$976.25
|
Rate for Payer: UHC Dual Complete DSNP |
$976.25
|
Rate for Payer: UHC Medicare Advantage |
$1,005.54
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Facility
|
OP
|
$220.00
|
|
Service Code
|
CPT 11440
|
Hospital Charge Code |
11440
|
Hospital Revenue Code
|
521
|
Min. Negotiated Rate |
$52.25 |
Max. Negotiated Rate |
$484.61 |
Rate for Payer: Aetna Commercial |
$187.00
|
Rate for Payer: Aetna Medicare |
$57.20
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.75
|
Rate for Payer: Amish Plain Church Group Commercial |
$68.75
|
Rate for Payer: BCBS Complete |
$484.61
|
Rate for Payer: BCBS MAPPO |
$55.00
|
Rate for Payer: BCBS Trust/PPO |
$171.05
|
Rate for Payer: BCN Commercial |
$171.05
|
Rate for Payer: BCN Medicare Advantage |
$55.00
|
Rate for Payer: Cash Price |
$176.00
|
Rate for Payer: Cash Price |
$176.00
|
Rate for Payer: Cofinity Commercial |
$189.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$176.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.00
|
Rate for Payer: Healthscope Commercial |
$198.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.00
|
Rate for Payer: Mclaren Medicaid |
$461.54
|
Rate for Payer: Meridian Medicaid |
$484.61
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.75
|
Rate for Payer: MI Amish Medical Board Commercial |
$63.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$187.00
|
Rate for Payer: PACE Senior Care Partners |
$52.25
|
Rate for Payer: PACE SWMI |
$55.00
|
Rate for Payer: PHP Commercial |
$187.00
|
Rate for Payer: PHP Medicare Advantage |
$55.00
|
Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.40
|
Rate for Payer: Priority Health Medicare |
$55.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$134.18
|
Rate for Payer: Railroad Medicare Medicare |
$55.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$193.60
|
Rate for Payer: UHC Core |
$183.70
|
Rate for Payer: UHC Dual Complete DSNP |
$55.00
|
Rate for Payer: UHC Medicare Advantage |
$56.65
|
Rate for Payer: VA VA |
$55.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.00
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Professional
|
Both
|
$220.00
|
|
Service Code
|
HCPCS 11440
|
Min. Negotiated Rate |
$28.95 |
Max. Negotiated Rate |
$169.24 |
Rate for Payer: Aetna Commercial |
$136.20
|
Rate for Payer: Aetna Medicare |
$105.71
|
Rate for Payer: BCBS Complete |
$72.46
|
Rate for Payer: BCBS MAPPO |
$101.64
|
Rate for Payer: BCBS Trust/PPO |
$28.95
|
Rate for Payer: BCN Commercial |
$169.24
|
Rate for Payer: BCN Medicare Advantage |
$101.64
|
Rate for Payer: Cash Price |
$176.00
|
Rate for Payer: Cash Price |
$176.00
|
Rate for Payer: Cofinity Commercial |
$146.36
|
Rate for Payer: Cofinity Commercial |
$136.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.64
|
Rate for Payer: Mclaren Medicaid |
$69.01
|
Rate for Payer: Meridian Medicaid |
$72.46
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.72
|
Rate for Payer: PACE SWMI |
$101.64
|
Rate for Payer: PHP Medicare Advantage |
$101.64
|
Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.30
|
Rate for Payer: Priority Health Medicare |
$101.64
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$130.30
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$101.64
|
Rate for Payer: UHC Dual Complete DSNP |
$101.64
|
Rate for Payer: UHC Medicare Advantage |
$104.69
|
|