|
PR EXTERNAL ECG REC>48HR<7D SCAN ALYS REPORT R&I
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 93241
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$485.51 |
| Rate for Payer: Aetna Commercial |
$328.72
|
| Rate for Payer: Aetna Medicare |
$255.12
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS MAPPO |
$245.31
|
| Rate for Payer: BCBS Trust/PPO |
$485.51
|
| Rate for Payer: BCN Commercial |
$309.81
|
| Rate for Payer: BCN Medicare Advantage |
$245.31
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$328.72
|
| Rate for Payer: Cofinity Commercial |
$353.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$257.58
|
| Rate for Payer: PACE SWMI |
$245.31
|
| Rate for Payer: PHP Medicare Advantage |
$245.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.09
|
| Rate for Payer: Priority Health Medicare |
$245.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$373.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$245.31
|
| Rate for Payer: UHC Medicare Advantage |
$252.67
|
|
|
PR EXTERNAL ECG REC>7D<15D RECORDING
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 93246
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$607.55 |
| Rate for Payer: Aetna Commercial |
$14.97
|
| Rate for Payer: Aetna Medicare |
$11.62
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$11.17
|
| Rate for Payer: BCBS Trust/PPO |
$607.55
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$11.17
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$16.08
|
| Rate for Payer: Cofinity Commercial |
$14.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.73
|
| Rate for Payer: PACE SWMI |
$11.17
|
| Rate for Payer: PHP Medicare Advantage |
$11.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.02
|
| Rate for Payer: Priority Health Medicare |
$11.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.17
|
| Rate for Payer: UHC Medicare Advantage |
$11.51
|
|
|
PR EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 93248
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$892.83 |
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna Medicare |
$26.24
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$892.83
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: BCN Medicare Advantage |
$25.23
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Cofinity Commercial |
$36.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.23
|
| Rate for Payer: Mclaren Medicaid |
$15.98
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.49
|
| Rate for Payer: PACE SWMI |
$25.23
|
| Rate for Payer: PHP Medicare Advantage |
$25.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.93
|
| Rate for Payer: Priority Health Medicare |
$25.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.23
|
| Rate for Payer: UHC Medicare Advantage |
$25.99
|
|
|
PR EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY
|
Professional
|
Both
|
$3,153.00
|
|
|
Service Code
|
HCPCS 32540
|
| Min. Negotiated Rate |
$1,088.00 |
| Max. Negotiated Rate |
$2,481.51 |
| Rate for Payer: Aetna Commercial |
$2,276.27
|
| Rate for Payer: Aetna Medicare |
$1,766.66
|
| Rate for Payer: BCBS Complete |
$1,142.40
|
| Rate for Payer: BCBS MAPPO |
$1,698.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,336.07
|
| Rate for Payer: BCN Commercial |
$2,481.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,698.71
|
| Rate for Payer: Cash Price |
$2,522.40
|
| Rate for Payer: Cash Price |
$2,522.40
|
| Rate for Payer: Cofinity Commercial |
$2,276.27
|
| Rate for Payer: Cofinity Commercial |
$2,446.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,698.71
|
| Rate for Payer: Mclaren Medicaid |
$1,088.00
|
| Rate for Payer: Meridian Medicaid |
$1,142.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,783.65
|
| Rate for Payer: PACE SWMI |
$1,698.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,698.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,088.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,207.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.34
|
| Rate for Payer: Priority Health Medicare |
$1,698.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,351.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,698.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,698.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,749.67
|
|
|
PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26111
|
| Min. Negotiated Rate |
$210.98 |
| Max. Negotiated Rate |
$826.00 |
| Rate for Payer: Aetna Commercial |
$549.12
|
| Rate for Payer: Aetna Medicare |
$426.18
|
| Rate for Payer: BCBS Complete |
$284.26
|
| Rate for Payer: BCBS MAPPO |
$409.79
|
| Rate for Payer: BCBS Trust/PPO |
$210.98
|
| Rate for Payer: BCN Commercial |
$613.77
|
| Rate for Payer: BCN Medicare Advantage |
$409.79
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$590.10
|
| Rate for Payer: Cofinity Commercial |
$549.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.79
|
| Rate for Payer: Mclaren Medicaid |
$270.72
|
| Rate for Payer: Meridian Medicaid |
$284.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$430.28
|
| Rate for Payer: PACE SWMI |
$409.79
|
| Rate for Payer: PHP Medicare Advantage |
$409.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.37
|
| Rate for Payer: Priority Health Medicare |
$409.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$641.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$409.79
|
| Rate for Payer: UHC Medicare Advantage |
$422.08
|
|
|
PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>
|
Professional
|
Both
|
$1,803.00
|
|
|
Service Code
|
HCPCS 26113
|
| Min. Negotiated Rate |
$254.28 |
| Max. Negotiated Rate |
$1,262.10 |
| Rate for Payer: Aetna Commercial |
$722.43
|
| Rate for Payer: Aetna Medicare |
$560.70
|
| Rate for Payer: BCBS Complete |
$373.72
|
| Rate for Payer: BCBS MAPPO |
$539.13
|
| Rate for Payer: BCBS Trust/PPO |
$254.28
|
| Rate for Payer: BCN Commercial |
$807.78
|
| Rate for Payer: BCN Medicare Advantage |
$539.13
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Cofinity Commercial |
$776.35
|
| Rate for Payer: Cofinity Commercial |
$722.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.13
|
| Rate for Payer: Mclaren Medicaid |
$355.92
|
| Rate for Payer: Meridian Medicaid |
$373.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$566.09
|
| Rate for Payer: PACE SWMI |
$539.13
|
| Rate for Payer: PHP Medicare Advantage |
$539.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$844.11
|
| Rate for Payer: Priority Health Medicare |
$539.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$844.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$539.13
|
| Rate for Payer: UHC Medicare Advantage |
$555.30
|
|
|
PR FAA PHYSICAL
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 00180
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
|
|
PR FACIAL NERVE FUNCTION STUDIES
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 92516
|
| Min. Negotiated Rate |
$22.51 |
| Max. Negotiated Rate |
$2,145.40 |
| Rate for Payer: Aetna Commercial |
$30.16
|
| Rate for Payer: Aetna Medicare |
$23.41
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$22.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,145.40
|
| Rate for Payer: BCN Commercial |
$103.60
|
| Rate for Payer: BCN Medicare Advantage |
$22.51
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$30.16
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.64
|
| Rate for Payer: PACE SWMI |
$22.51
|
| Rate for Payer: PHP Medicare Advantage |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.54
|
| Rate for Payer: Priority Health Medicare |
$22.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.19
|
|
|
PR FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 97156
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$1,096.22 |
| Rate for Payer: Aetna Commercial |
$20.79
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.22
|
| Rate for Payer: BCN Commercial |
$37.50
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.73
|
|
|
PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 90846
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$346.04 |
| Rate for Payer: Aetna Commercial |
$126.47
|
| Rate for Payer: Aetna Medicare |
$98.16
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCBS MAPPO |
$94.38
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$137.81
|
| Rate for Payer: BCN Medicare Advantage |
$94.38
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$135.91
|
| Rate for Payer: Cofinity Commercial |
$126.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.10
|
| Rate for Payer: PACE SWMI |
$94.38
|
| Rate for Payer: PHP Medicare Advantage |
$94.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.43
|
| Rate for Payer: Priority Health Medicare |
$94.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.38
|
| Rate for Payer: UHC Medicare Advantage |
$97.21
|
|
|
PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 90847
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$141.67 |
| Rate for Payer: Aetna Commercial |
$131.83
|
| Rate for Payer: Aetna Medicare |
$102.32
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$98.38
|
| Rate for Payer: BCBS Trust/PPO |
$109.89
|
| Rate for Payer: BCN Commercial |
$115.44
|
| Rate for Payer: BCN Medicare Advantage |
$98.38
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$141.67
|
| Rate for Payer: Cofinity Commercial |
$131.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.38
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.30
|
| Rate for Payer: PACE SWMI |
$98.38
|
| Rate for Payer: PHP Medicare Advantage |
$98.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.88
|
| Rate for Payer: Priority Health Medicare |
$98.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.38
|
| Rate for Payer: UHC Medicare Advantage |
$101.33
|
|
|
PR FASCIA LATA GRAFT INCISION & AREA EXPOSURE
|
Professional
|
Both
|
$1,056.00
|
|
|
Service Code
|
HCPCS 20922
|
| Min. Negotiated Rate |
$321.84 |
| Max. Negotiated Rate |
$55,000.50 |
| Rate for Payer: Aetna Commercial |
$651.00
|
| Rate for Payer: Aetna Medicare |
$505.25
|
| Rate for Payer: BCBS Complete |
$337.93
|
| Rate for Payer: BCBS MAPPO |
$485.82
|
| Rate for Payer: BCBS Trust/PPO |
$55,000.50
|
| Rate for Payer: BCN Commercial |
$892.81
|
| Rate for Payer: BCN Medicare Advantage |
$485.82
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cofinity Commercial |
$699.58
|
| Rate for Payer: Cofinity Commercial |
$651.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.82
|
| Rate for Payer: Mclaren Medicaid |
$321.84
|
| Rate for Payer: Meridian Medicaid |
$337.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$510.11
|
| Rate for Payer: PACE SWMI |
$485.82
|
| Rate for Payer: PHP Medicare Advantage |
$485.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$755.25
|
| Rate for Payer: Priority Health Medicare |
$485.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$755.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.82
|
| Rate for Payer: UHC Medicare Advantage |
$500.39
|
|
|
PR FASCIECTOMY PLANTAR FASCIA PARTIAL SPX
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 28060
|
| Min. Negotiated Rate |
$232.60 |
| Max. Negotiated Rate |
$2,093.12 |
| Rate for Payer: Aetna Commercial |
$469.07
|
| Rate for Payer: Aetna Medicare |
$364.05
|
| Rate for Payer: BCBS Complete |
$244.23
|
| Rate for Payer: BCBS MAPPO |
$350.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.12
|
| Rate for Payer: BCN Commercial |
$752.07
|
| Rate for Payer: BCN Medicare Advantage |
$350.05
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cofinity Commercial |
$469.07
|
| Rate for Payer: Cofinity Commercial |
$504.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.05
|
| Rate for Payer: Mclaren Medicaid |
$232.60
|
| Rate for Payer: Meridian Medicaid |
$244.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$367.55
|
| Rate for Payer: PACE SWMI |
$350.05
|
| Rate for Payer: PHP Medicare Advantage |
$350.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.90
|
| Rate for Payer: Priority Health Medicare |
$350.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$546.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.05
|
| Rate for Payer: UHC Medicare Advantage |
$360.55
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$3,296.59 |
| Rate for Payer: Aetna Commercial |
$384.83
|
| Rate for Payer: Aetna Medicare |
$298.68
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCBS MAPPO |
$287.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,296.59
|
| Rate for Payer: BCN Commercial |
$623.06
|
| Rate for Payer: BCN Medicare Advantage |
$287.19
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$413.55
|
| Rate for Payer: Cofinity Commercial |
$384.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.19
|
| Rate for Payer: Mclaren Medicaid |
$189.78
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$301.55
|
| Rate for Payer: PACE SWMI |
$287.19
|
| Rate for Payer: PHP Medicare Advantage |
$287.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$448.35
|
| Rate for Payer: Priority Health Medicare |
$287.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$448.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.19
|
| Rate for Payer: UHC Medicare Advantage |
$295.81
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Facility
|
IP
|
$705.00
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$429.98 |
| Max. Negotiated Rate |
$634.50 |
| Rate for Payer: Aetna Commercial |
$599.25
|
| Rate for Payer: BCBS Trust/PPO |
$544.82
|
| Rate for Payer: BCN Commercial |
$544.82
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$606.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.00
|
| Rate for Payer: Healthscope Commercial |
$634.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$599.25
|
| Rate for Payer: PHP Commercial |
$599.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$429.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.40
|
| Rate for Payer: UHC Core |
$588.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.75
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Facility
|
OP
|
$705.00
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
28008
|
| Min. Negotiated Rate |
$167.44 |
| Max. Negotiated Rate |
$2,229.50 |
| Rate for Payer: Aetna Commercial |
$599.25
|
| Rate for Payer: Aetna Medicare |
$183.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.31
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$176.25
|
| Rate for Payer: BCBS Trust/PPO |
$548.14
|
| Rate for Payer: BCN Commercial |
$548.14
|
| Rate for Payer: BCN Medicare Advantage |
$176.25
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$606.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.25
|
| Rate for Payer: Healthscope Commercial |
$634.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.75
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$599.25
|
| Rate for Payer: PACE Senior Care Partners |
$167.44
|
| Rate for Payer: PACE SWMI |
$176.25
|
| Rate for Payer: PHP Commercial |
$599.25
|
| Rate for Payer: PHP Medicare Advantage |
$176.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.35
|
| Rate for Payer: Priority Health Medicare |
$176.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$429.98
|
| Rate for Payer: Railroad Medicare Medicare |
$176.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.40
|
| Rate for Payer: UHC Core |
$588.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.25
|
| Rate for Payer: UHC Medicare Advantage |
$181.54
|
| Rate for Payer: VA VA |
$176.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.75
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 28008
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$3,296.59 |
| Rate for Payer: Aetna Commercial |
$384.83
|
| Rate for Payer: Aetna Medicare |
$298.68
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCBS MAPPO |
$287.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,296.59
|
| Rate for Payer: BCN Commercial |
$623.06
|
| Rate for Payer: BCN Medicare Advantage |
$287.19
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$413.55
|
| Rate for Payer: Cofinity Commercial |
$384.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.19
|
| Rate for Payer: Mclaren Medicaid |
$189.78
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$301.55
|
| Rate for Payer: PACE SWMI |
$287.19
|
| Rate for Payer: PHP Medicare Advantage |
$287.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$448.35
|
| Rate for Payer: Priority Health Medicare |
$287.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$448.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.19
|
| Rate for Payer: UHC Medicare Advantage |
$295.81
|
|
|
PR FASCIOTOMY HIP/THIGH ANY TYPE
|
Professional
|
Both
|
$3,417.00
|
|
|
Service Code
|
HCPCS 27025
|
| Min. Negotiated Rate |
$191.38 |
| Max. Negotiated Rate |
$2,391.90 |
| Rate for Payer: Aetna Commercial |
$1,216.33
|
| Rate for Payer: Aetna Medicare |
$944.02
|
| Rate for Payer: BCBS Complete |
$628.91
|
| Rate for Payer: BCBS MAPPO |
$907.71
|
| Rate for Payer: BCBS Trust/PPO |
$191.38
|
| Rate for Payer: BCN Commercial |
$1,352.66
|
| Rate for Payer: BCN Medicare Advantage |
$907.71
|
| Rate for Payer: Cash Price |
$2,733.60
|
| Rate for Payer: Cash Price |
$2,733.60
|
| Rate for Payer: Cofinity Commercial |
$1,307.10
|
| Rate for Payer: Cofinity Commercial |
$1,216.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$907.71
|
| Rate for Payer: Mclaren Medicaid |
$598.96
|
| Rate for Payer: Meridian Medicaid |
$628.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$953.10
|
| Rate for Payer: PACE SWMI |
$907.71
|
| Rate for Payer: PHP Medicare Advantage |
$907.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,413.48
|
| Rate for Payer: Priority Health Medicare |
$907.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,413.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$907.71
|
| Rate for Payer: UHC Medicare Advantage |
$934.94
|
|
|
PR FASCIOTOMY ILIOTIBIAL OPEN
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 27305
|
| Min. Negotiated Rate |
$314.81 |
| Max. Negotiated Rate |
$1,940.97 |
| Rate for Payer: Aetna Commercial |
$640.08
|
| Rate for Payer: Aetna Medicare |
$496.78
|
| Rate for Payer: BCBS Complete |
$330.55
|
| Rate for Payer: BCBS MAPPO |
$477.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.97
|
| Rate for Payer: BCN Commercial |
$715.91
|
| Rate for Payer: BCN Medicare Advantage |
$477.67
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$640.08
|
| Rate for Payer: Cofinity Commercial |
$687.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.67
|
| Rate for Payer: Mclaren Medicaid |
$314.81
|
| Rate for Payer: Meridian Medicaid |
$330.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$501.55
|
| Rate for Payer: PACE SWMI |
$477.67
|
| Rate for Payer: PHP Medicare Advantage |
$477.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$907.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.11
|
| Rate for Payer: Priority Health Medicare |
$477.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$748.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.67
|
| Rate for Payer: UHC Medicare Advantage |
$492.00
|
|
|
PR FASCIOTOMY PALMAR OPEN PARTIAL
|
Professional
|
Both
|
$1,341.00
|
|
|
Service Code
|
HCPCS 26045
|
| Min. Negotiated Rate |
$153.67 |
| Max. Negotiated Rate |
$938.70 |
| Rate for Payer: Aetna Commercial |
$625.10
|
| Rate for Payer: Aetna Medicare |
$485.15
|
| Rate for Payer: BCBS Complete |
$324.51
|
| Rate for Payer: BCBS MAPPO |
$466.49
|
| Rate for Payer: BCBS Trust/PPO |
$153.67
|
| Rate for Payer: BCN Commercial |
$701.25
|
| Rate for Payer: BCN Medicare Advantage |
$466.49
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cofinity Commercial |
$671.75
|
| Rate for Payer: Cofinity Commercial |
$625.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.49
|
| Rate for Payer: Mclaren Medicaid |
$309.06
|
| Rate for Payer: Meridian Medicaid |
$324.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$489.81
|
| Rate for Payer: PACE SWMI |
$466.49
|
| Rate for Payer: PHP Medicare Advantage |
$466.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.78
|
| Rate for Payer: Priority Health Medicare |
$466.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.49
|
| Rate for Payer: UHC Medicare Advantage |
$480.48
|
|
|
PR FASCIOTOMY PALMAR PERCUTANEOUS
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 26040
|
| Min. Negotiated Rate |
$139.24 |
| Max. Negotiated Rate |
$638.40 |
| Rate for Payer: Aetna Commercial |
$417.56
|
| Rate for Payer: Aetna Medicare |
$324.07
|
| Rate for Payer: BCBS Complete |
$218.28
|
| Rate for Payer: BCBS MAPPO |
$311.61
|
| Rate for Payer: BCBS Trust/PPO |
$139.24
|
| Rate for Payer: BCN Commercial |
$471.08
|
| Rate for Payer: BCN Medicare Advantage |
$311.61
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$417.56
|
| Rate for Payer: Cofinity Commercial |
$448.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.61
|
| Rate for Payer: Mclaren Medicaid |
$207.89
|
| Rate for Payer: Meridian Medicaid |
$218.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$327.19
|
| Rate for Payer: PACE SWMI |
$311.61
|
| Rate for Payer: PHP Medicare Advantage |
$311.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$492.26
|
| Rate for Payer: Priority Health Medicare |
$311.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$492.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.61
|
| Rate for Payer: UHC Medicare Advantage |
$320.96
|
|
|
PR FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT
|
Professional
|
Both
|
$2,315.00
|
|
|
Service Code
|
HCPCS 26121
|
| Min. Negotiated Rate |
$250.03 |
| Max. Negotiated Rate |
$1,620.50 |
| Rate for Payer: Aetna Commercial |
$793.33
|
| Rate for Payer: Aetna Medicare |
$615.72
|
| Rate for Payer: BCBS Complete |
$409.95
|
| Rate for Payer: BCBS MAPPO |
$592.04
|
| Rate for Payer: BCBS Trust/PPO |
$250.03
|
| Rate for Payer: BCN Commercial |
$887.44
|
| Rate for Payer: BCN Medicare Advantage |
$592.04
|
| Rate for Payer: Cash Price |
$1,852.00
|
| Rate for Payer: Cash Price |
$1,852.00
|
| Rate for Payer: Cofinity Commercial |
$852.54
|
| Rate for Payer: Cofinity Commercial |
$793.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.04
|
| Rate for Payer: Mclaren Medicaid |
$390.43
|
| Rate for Payer: Meridian Medicaid |
$409.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$621.64
|
| Rate for Payer: PACE SWMI |
$592.04
|
| Rate for Payer: PHP Medicare Advantage |
$592.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,620.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.34
|
| Rate for Payer: Priority Health Medicare |
$592.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$927.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$592.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$592.04
|
| Rate for Payer: UHC Medicare Advantage |
$609.80
|
|
|
PR FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$2,894.00
|
|
|
Service Code
|
HCPCS 26123
|
| Min. Negotiated Rate |
$337.48 |
| Max. Negotiated Rate |
$2,025.80 |
| Rate for Payer: Aetna Commercial |
$1,105.22
|
| Rate for Payer: Aetna Medicare |
$857.78
|
| Rate for Payer: BCBS Complete |
$571.20
|
| Rate for Payer: BCBS MAPPO |
$824.79
|
| Rate for Payer: BCBS Trust/PPO |
$337.48
|
| Rate for Payer: BCN Commercial |
$1,235.86
|
| Rate for Payer: BCN Medicare Advantage |
$824.79
|
| Rate for Payer: Cash Price |
$2,315.20
|
| Rate for Payer: Cash Price |
$2,315.20
|
| Rate for Payer: Cofinity Commercial |
$1,187.70
|
| Rate for Payer: Cofinity Commercial |
$1,105.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$824.79
|
| Rate for Payer: Mclaren Medicaid |
$544.00
|
| Rate for Payer: Meridian Medicaid |
$571.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$866.03
|
| Rate for Payer: PACE SWMI |
$824.79
|
| Rate for Payer: PHP Medicare Advantage |
$824.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,025.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,291.44
|
| Rate for Payer: Priority Health Medicare |
$824.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,291.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$824.79
|
| Rate for Payer: UHC Medicare Advantage |
$849.53
|
|
|
PR FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 26125
|
| Min. Negotiated Rate |
$170.40 |
| Max. Negotiated Rate |
$607.60 |
| Rate for Payer: Aetna Commercial |
$354.99
|
| Rate for Payer: Aetna Medicare |
$275.52
|
| Rate for Payer: BCBS Complete |
$178.92
|
| Rate for Payer: BCBS MAPPO |
$264.92
|
| Rate for Payer: BCBS Trust/PPO |
$555.24
|
| Rate for Payer: BCN Commercial |
$389.96
|
| Rate for Payer: BCN Medicare Advantage |
$264.92
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cofinity Commercial |
$354.99
|
| Rate for Payer: Cofinity Commercial |
$381.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.92
|
| Rate for Payer: Mclaren Medicaid |
$170.40
|
| Rate for Payer: Meridian Medicaid |
$178.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$278.17
|
| Rate for Payer: PACE SWMI |
$264.92
|
| Rate for Payer: PHP Medicare Advantage |
$264.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$407.50
|
| Rate for Payer: Priority Health Medicare |
$264.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$407.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$264.92
|
| Rate for Payer: UHC Medicare Advantage |
$272.87
|
|
|
PR FECAL BLOOD SCRN IMMUNOASSAY
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0328
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$1,270.03 |
| Rate for Payer: Aetna Commercial |
$24.19
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,270.03
|
| Rate for Payer: BCN Commercial |
$18.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$24.19
|
| Rate for Payer: Cofinity Commercial |
$25.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.63
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Medicare Advantage |
$18.59
|
|
