|
PR I&D BELOW FASCIA FOOT 1 BURSAL SPACE
|
Professional
|
Both
|
$851.00
|
|
|
Service Code
|
HCPCS 28002
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$595.70 |
| Rate for Payer: Aetna Commercial |
$184.83
|
| Rate for Payer: Aetna Medicare |
$143.45
|
| Rate for Payer: BCBS Complete |
$93.71
|
| Rate for Payer: BCBS MAPPO |
$137.93
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$359.18
|
| Rate for Payer: BCN Medicare Advantage |
$137.93
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cofinity Commercial |
$198.62
|
| Rate for Payer: Cofinity Commercial |
$184.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.93
|
| Rate for Payer: Mclaren Medicaid |
$89.25
|
| Rate for Payer: Meridian Medicaid |
$93.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.83
|
| Rate for Payer: PACE SWMI |
$137.93
|
| Rate for Payer: PHP Medicare Advantage |
$137.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.92
|
| Rate for Payer: Priority Health Medicare |
$137.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.93
|
| Rate for Payer: UHC Medicare Advantage |
$142.07
|
|
|
PR I&D BELOW FASCIA FOOT MULTIPLE AREAS
|
Professional
|
Both
|
$1,219.00
|
|
|
Service Code
|
HCPCS 28003
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$3,691.76 |
| Rate for Payer: Aetna Commercial |
$345.20
|
| Rate for Payer: Aetna Medicare |
$267.91
|
| Rate for Payer: BCBS Complete |
$172.43
|
| Rate for Payer: BCBS MAPPO |
$257.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,691.76
|
| Rate for Payer: BCN Commercial |
$554.65
|
| Rate for Payer: BCN Medicare Advantage |
$257.61
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cofinity Commercial |
$370.96
|
| Rate for Payer: Cofinity Commercial |
$345.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.61
|
| Rate for Payer: Mclaren Medicaid |
$164.22
|
| Rate for Payer: Meridian Medicaid |
$172.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.49
|
| Rate for Payer: PACE SWMI |
$257.61
|
| Rate for Payer: PHP Medicare Advantage |
$257.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.22
|
| Rate for Payer: Priority Health Medicare |
$257.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$394.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.61
|
| Rate for Payer: UHC Medicare Advantage |
$265.34
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS 27301
|
| Min. Negotiated Rate |
$329.94 |
| Max. Negotiated Rate |
$3,899.38 |
| Rate for Payer: Aetna Commercial |
$670.74
|
| Rate for Payer: Aetna Medicare |
$520.57
|
| Rate for Payer: BCBS Complete |
$346.44
|
| Rate for Payer: BCBS MAPPO |
$500.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.38
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$500.55
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cofinity Commercial |
$670.74
|
| Rate for Payer: Cofinity Commercial |
$720.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.55
|
| Rate for Payer: Mclaren Medicaid |
$329.94
|
| Rate for Payer: Meridian Medicaid |
$346.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$525.58
|
| Rate for Payer: PACE SWMI |
$500.55
|
| Rate for Payer: PHP Medicare Advantage |
$500.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$781.29
|
| Rate for Payer: Priority Health Medicare |
$500.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$781.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.55
|
| Rate for Payer: UHC Medicare Advantage |
$515.57
|
|
|
PR I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR
|
Professional
|
Both
|
$2,412.00
|
|
|
Service Code
|
HCPCS 22010
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,688.40 |
| Rate for Payer: Aetna Commercial |
$1,285.68
|
| Rate for Payer: Aetna Medicare |
$997.84
|
| Rate for Payer: BCBS Complete |
$660.89
|
| Rate for Payer: BCBS MAPPO |
$959.46
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$1,424.01
|
| Rate for Payer: BCN Medicare Advantage |
$959.46
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cofinity Commercial |
$1,285.68
|
| Rate for Payer: Cofinity Commercial |
$1,381.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.46
|
| Rate for Payer: Mclaren Medicaid |
$629.42
|
| Rate for Payer: Meridian Medicaid |
$660.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,007.43
|
| Rate for Payer: PACE SWMI |
$959.46
|
| Rate for Payer: PHP Medicare Advantage |
$959.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,688.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,488.03
|
| Rate for Payer: Priority Health Medicare |
$959.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,488.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.46
|
| Rate for Payer: UHC Medicare Advantage |
$988.24
|
|
|
PR I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC
|
Professional
|
Both
|
$1,691.00
|
|
|
Service Code
|
HCPCS 22015
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,462.50 |
| Rate for Payer: Aetna Commercial |
$1,262.60
|
| Rate for Payer: Aetna Medicare |
$979.93
|
| Rate for Payer: BCBS Complete |
$644.78
|
| Rate for Payer: BCBS MAPPO |
$942.24
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$1,399.57
|
| Rate for Payer: BCN Medicare Advantage |
$942.24
|
| Rate for Payer: Cash Price |
$1,352.80
|
| Rate for Payer: Cash Price |
$1,352.80
|
| Rate for Payer: Cofinity Commercial |
$1,262.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$942.24
|
| Rate for Payer: Mclaren Medicaid |
$614.08
|
| Rate for Payer: Meridian Medicaid |
$644.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$989.35
|
| Rate for Payer: PACE SWMI |
$942.24
|
| Rate for Payer: PHP Medicare Advantage |
$942.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$614.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,462.50
|
| Rate for Payer: Priority Health Medicare |
$942.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,462.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$942.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$942.24
|
| Rate for Payer: UHC Medicare Advantage |
$970.51
|
|
|
PR I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 21501
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$801.50 |
| Rate for Payer: Aetna Commercial |
$439.40
|
| Rate for Payer: Aetna Medicare |
$341.03
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS MAPPO |
$327.91
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$718.85
|
| Rate for Payer: BCN Medicare Advantage |
$327.91
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$472.19
|
| Rate for Payer: Cofinity Commercial |
$439.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.91
|
| Rate for Payer: Mclaren Medicaid |
$218.33
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.31
|
| Rate for Payer: PACE SWMI |
$327.91
|
| Rate for Payer: PHP Medicare Advantage |
$327.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.24
|
| Rate for Payer: Priority Health Medicare |
$327.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$515.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.91
|
| Rate for Payer: UHC Medicare Advantage |
$337.75
|
|
|
PR I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI
|
Professional
|
Both
|
$938.00
|
|
|
Service Code
|
HCPCS 21502
|
| Min. Negotiated Rate |
$326.10 |
| Max. Negotiated Rate |
$776.19 |
| Rate for Payer: Aetna Commercial |
$672.85
|
| Rate for Payer: Aetna Medicare |
$522.22
|
| Rate for Payer: BCBS Complete |
$342.40
|
| Rate for Payer: BCBS MAPPO |
$502.13
|
| Rate for Payer: BCBS Trust/PPO |
$483.43
|
| Rate for Payer: BCN Commercial |
$742.79
|
| Rate for Payer: BCN Medicare Advantage |
$502.13
|
| Rate for Payer: Cash Price |
$750.40
|
| Rate for Payer: Cash Price |
$750.40
|
| Rate for Payer: Cofinity Commercial |
$672.85
|
| Rate for Payer: Cofinity Commercial |
$723.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.13
|
| Rate for Payer: Mclaren Medicaid |
$326.10
|
| Rate for Payer: Meridian Medicaid |
$342.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$527.24
|
| Rate for Payer: PACE SWMI |
$502.13
|
| Rate for Payer: PHP Medicare Advantage |
$502.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$776.19
|
| Rate for Payer: Priority Health Medicare |
$502.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$776.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.13
|
| Rate for Payer: UHC Medicare Advantage |
$517.19
|
|
|
PR I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC
|
Professional
|
Both
|
$1,605.00
|
|
|
Service Code
|
HCPCS 45020
|
| Min. Negotiated Rate |
$364.87 |
| Max. Negotiated Rate |
$1,123.50 |
| Rate for Payer: Aetna Commercial |
$759.87
|
| Rate for Payer: Aetna Medicare |
$589.75
|
| Rate for Payer: BCBS Complete |
$383.11
|
| Rate for Payer: BCBS MAPPO |
$567.07
|
| Rate for Payer: BCBS Trust/PPO |
$489.21
|
| Rate for Payer: BCN Commercial |
$841.99
|
| Rate for Payer: BCN Medicare Advantage |
$567.07
|
| Rate for Payer: Cash Price |
$1,284.00
|
| Rate for Payer: Cash Price |
$1,284.00
|
| Rate for Payer: Cofinity Commercial |
$759.87
|
| Rate for Payer: Cofinity Commercial |
$816.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$567.07
|
| Rate for Payer: Mclaren Medicaid |
$364.87
|
| Rate for Payer: Meridian Medicaid |
$383.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$595.42
|
| Rate for Payer: PACE SWMI |
$567.07
|
| Rate for Payer: PHP Medicare Advantage |
$567.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,013.08
|
| Rate for Payer: Priority Health Medicare |
$567.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,013.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$567.07
|
| Rate for Payer: UHC Medicare Advantage |
$584.08
|
|
|
PR I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 54700
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$2,037.12 |
| Rate for Payer: Aetna Commercial |
$277.93
|
| Rate for Payer: Aetna Medicare |
$215.71
|
| Rate for Payer: BCBS Complete |
$143.36
|
| Rate for Payer: BCBS MAPPO |
$207.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,037.12
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Medicare Advantage |
$207.41
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cofinity Commercial |
$298.67
|
| Rate for Payer: Cofinity Commercial |
$277.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.41
|
| Rate for Payer: Mclaren Medicaid |
$136.53
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$217.78
|
| Rate for Payer: PACE SWMI |
$207.41
|
| Rate for Payer: PHP Medicare Advantage |
$207.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.43
|
| Rate for Payer: Priority Health Medicare |
$207.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$340.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.41
|
| Rate for Payer: UHC Medicare Advantage |
$213.63
|
|
|
PR I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 25028
|
| Min. Negotiated Rate |
$209.74 |
| Max. Negotiated Rate |
$1,072.36 |
| Rate for Payer: Aetna Commercial |
$898.44
|
| Rate for Payer: Aetna Medicare |
$697.30
|
| Rate for Payer: BCBS Complete |
$469.66
|
| Rate for Payer: BCBS MAPPO |
$670.48
|
| Rate for Payer: BCBS Trust/PPO |
$209.74
|
| Rate for Payer: BCN Commercial |
$1,026.22
|
| Rate for Payer: BCN Medicare Advantage |
$670.48
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$965.49
|
| Rate for Payer: Cofinity Commercial |
$898.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.48
|
| Rate for Payer: Mclaren Medicaid |
$447.30
|
| Rate for Payer: Meridian Medicaid |
$469.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$704.00
|
| Rate for Payer: PACE SWMI |
$670.48
|
| Rate for Payer: PHP Medicare Advantage |
$670.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.36
|
| Rate for Payer: Priority Health Medicare |
$670.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,072.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.48
|
| Rate for Payer: UHC Medicare Advantage |
$690.59
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$199.08 |
| Rate for Payer: Aetna Commercial |
$153.08
|
| Rate for Payer: Aetna Medicare |
$118.81
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$114.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$114.24
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$164.51
|
| Rate for Payer: Cofinity Commercial |
$153.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.24
|
| Rate for Payer: Mclaren Medicaid |
$76.04
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.95
|
| Rate for Payer: PACE SWMI |
$114.24
|
| Rate for Payer: PHP Medicare Advantage |
$114.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.27
|
| Rate for Payer: Priority Health Medicare |
$114.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.24
|
| Rate for Payer: UHC Medicare Advantage |
$117.67
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$161.01 |
| Max. Negotiated Rate |
$237.60 |
| Rate for Payer: Aetna Commercial |
$224.40
|
| Rate for Payer: BCBS Trust/PPO |
$204.02
|
| Rate for Payer: BCN Commercial |
$204.02
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$227.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.20
|
| Rate for Payer: Healthscope Commercial |
$237.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$224.40
|
| Rate for Payer: PHP Commercial |
$224.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$229.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.32
|
| Rate for Payer: UHC Core |
$220.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.00
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$62.70 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$224.40
|
| Rate for Payer: Aetna Medicare |
$68.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.50
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$66.00
|
| Rate for Payer: BCBS Trust/PPO |
$205.26
|
| Rate for Payer: BCN Commercial |
$205.26
|
| Rate for Payer: BCN Medicare Advantage |
$66.00
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$227.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.00
|
| Rate for Payer: Healthscope Commercial |
$237.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.00
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$224.40
|
| Rate for Payer: PACE Senior Care Partners |
$62.70
|
| Rate for Payer: PACE SWMI |
$66.00
|
| Rate for Payer: PHP Commercial |
$224.40
|
| Rate for Payer: PHP Medicare Advantage |
$66.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$229.68
|
| Rate for Payer: Priority Health Medicare |
$66.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.01
|
| Rate for Payer: Railroad Medicare Medicare |
$66.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.32
|
| Rate for Payer: UHC Core |
$220.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.00
|
| Rate for Payer: UHC Medicare Advantage |
$67.98
|
| Rate for Payer: VA VA |
$66.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.00
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$199.08 |
| Rate for Payer: Aetna Commercial |
$153.08
|
| Rate for Payer: Aetna Medicare |
$118.81
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$114.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$114.24
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$164.51
|
| Rate for Payer: Cofinity Commercial |
$153.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.24
|
| Rate for Payer: Mclaren Medicaid |
$76.04
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.95
|
| Rate for Payer: PACE SWMI |
$114.24
|
| Rate for Payer: PHP Medicare Advantage |
$114.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.27
|
| Rate for Payer: Priority Health Medicare |
$114.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.24
|
| Rate for Payer: UHC Medicare Advantage |
$117.67
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$2,294.94 |
| Rate for Payer: Aetna Commercial |
$577.41
|
| Rate for Payer: Aetna Medicare |
$448.14
|
| Rate for Payer: BCBS Complete |
$297.68
|
| Rate for Payer: BCBS MAPPO |
$430.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.94
|
| Rate for Payer: BCN Commercial |
$644.08
|
| Rate for Payer: BCN Medicare Advantage |
$430.90
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$577.41
|
| Rate for Payer: Cofinity Commercial |
$620.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.90
|
| Rate for Payer: Mclaren Medicaid |
$283.50
|
| Rate for Payer: Meridian Medicaid |
$297.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$452.44
|
| Rate for Payer: PACE SWMI |
$430.90
|
| Rate for Payer: PHP Medicare Advantage |
$430.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.94
|
| Rate for Payer: Priority Health Medicare |
$430.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$774.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.90
|
| Rate for Payer: UHC Medicare Advantage |
$443.83
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 46045
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$2,294.94 |
| Rate for Payer: Aetna Commercial |
$577.41
|
| Rate for Payer: Aetna Medicare |
$448.14
|
| Rate for Payer: BCBS Complete |
$297.68
|
| Rate for Payer: BCBS MAPPO |
$430.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.94
|
| Rate for Payer: BCN Commercial |
$644.08
|
| Rate for Payer: BCN Medicare Advantage |
$430.90
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$577.41
|
| Rate for Payer: Cofinity Commercial |
$620.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.90
|
| Rate for Payer: Mclaren Medicaid |
$283.50
|
| Rate for Payer: Meridian Medicaid |
$297.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$452.44
|
| Rate for Payer: PACE SWMI |
$430.90
|
| Rate for Payer: PHP Medicare Advantage |
$430.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.94
|
| Rate for Payer: Priority Health Medicare |
$430.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$774.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.90
|
| Rate for Payer: UHC Medicare Advantage |
$443.83
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
OP
|
$722.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$171.48 |
| Max. Negotiated Rate |
$1,933.98 |
| Rate for Payer: Aetna Commercial |
$613.70
|
| Rate for Payer: Aetna Medicare |
$187.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.62
|
| Rate for Payer: BCBS Complete |
$1,933.98
|
| Rate for Payer: BCBS MAPPO |
$180.50
|
| Rate for Payer: BCBS Trust/PPO |
$561.36
|
| Rate for Payer: BCN Commercial |
$561.36
|
| Rate for Payer: BCN Medicare Advantage |
$180.50
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$620.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.50
|
| Rate for Payer: Healthscope Commercial |
$649.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.50
|
| Rate for Payer: Mclaren Medicaid |
$1,841.89
|
| Rate for Payer: Meridian Medicaid |
$1,933.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$189.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$613.70
|
| Rate for Payer: PACE Senior Care Partners |
$171.48
|
| Rate for Payer: PACE SWMI |
$180.50
|
| Rate for Payer: PHP Commercial |
$613.70
|
| Rate for Payer: PHP Medicare Advantage |
$180.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,841.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.14
|
| Rate for Payer: Priority Health Medicare |
$180.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$440.35
|
| Rate for Payer: Railroad Medicare Medicare |
$180.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.36
|
| Rate for Payer: UHC Core |
$602.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.50
|
| Rate for Payer: UHC Medicare Advantage |
$185.92
|
| Rate for Payer: VA VA |
$180.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.50
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
IP
|
$722.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$440.35 |
| Max. Negotiated Rate |
$649.80 |
| Rate for Payer: Aetna Commercial |
$613.70
|
| Rate for Payer: BCBS Trust/PPO |
$557.96
|
| Rate for Payer: BCN Commercial |
$557.96
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$620.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.60
|
| Rate for Payer: Healthscope Commercial |
$649.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$613.70
|
| Rate for Payer: PHP Commercial |
$613.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$440.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.36
|
| Rate for Payer: UHC Core |
$602.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.50
|
|
|
PR I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 46060
|
| Min. Negotiated Rate |
$313.54 |
| Max. Negotiated Rate |
$1,459.50 |
| Rate for Payer: Aetna Commercial |
$640.13
|
| Rate for Payer: Aetna Medicare |
$496.82
|
| Rate for Payer: BCBS Complete |
$329.22
|
| Rate for Payer: BCBS MAPPO |
$477.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,438.03
|
| Rate for Payer: BCN Commercial |
$715.42
|
| Rate for Payer: BCN Medicare Advantage |
$477.71
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cofinity Commercial |
$687.90
|
| Rate for Payer: Cofinity Commercial |
$640.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.71
|
| Rate for Payer: Mclaren Medicaid |
$313.54
|
| Rate for Payer: Meridian Medicaid |
$329.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$501.60
|
| Rate for Payer: PACE SWMI |
$477.71
|
| Rate for Payer: PHP Medicare Advantage |
$477.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,459.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$860.79
|
| Rate for Payer: Priority Health Medicare |
$477.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$860.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.71
|
| Rate for Payer: UHC Medicare Advantage |
$492.04
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 46040
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,260.52 |
| Rate for Payer: Aetna Commercial |
$558.85
|
| Rate for Payer: Aetna Medicare |
$433.73
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$417.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$816.58
|
| Rate for Payer: BCN Medicare Advantage |
$417.05
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$600.55
|
| Rate for Payer: Cofinity Commercial |
$558.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.05
|
| Rate for Payer: Mclaren Medicaid |
$274.77
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.90
|
| Rate for Payer: PACE SWMI |
$417.05
|
| Rate for Payer: PHP Medicare Advantage |
$417.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.43
|
| Rate for Payer: Priority Health Medicare |
$417.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$417.05
|
| Rate for Payer: UHC Medicare Advantage |
$429.56
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
IP
|
$906.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$552.57 |
| Max. Negotiated Rate |
$815.40 |
| Rate for Payer: Aetna Commercial |
$770.10
|
| Rate for Payer: BCBS Trust/PPO |
$700.16
|
| Rate for Payer: BCN Commercial |
$700.16
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$779.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.80
|
| Rate for Payer: Healthscope Commercial |
$815.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.10
|
| Rate for Payer: PHP Commercial |
$770.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.28
|
| Rate for Payer: UHC Core |
$756.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.50
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
46040
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,260.52 |
| Rate for Payer: Aetna Commercial |
$558.85
|
| Rate for Payer: Aetna Medicare |
$433.73
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$417.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$816.58
|
| Rate for Payer: BCN Medicare Advantage |
$417.05
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$600.55
|
| Rate for Payer: Cofinity Commercial |
$558.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.05
|
| Rate for Payer: Mclaren Medicaid |
$274.77
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.90
|
| Rate for Payer: PACE SWMI |
$417.05
|
| Rate for Payer: PHP Medicare Advantage |
$417.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.43
|
| Rate for Payer: Priority Health Medicare |
$417.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$417.05
|
| Rate for Payer: UHC Medicare Advantage |
$429.56
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
OP
|
$906.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$215.18 |
| Max. Negotiated Rate |
$815.40 |
| Rate for Payer: Aetna Commercial |
$770.10
|
| Rate for Payer: Aetna Medicare |
$235.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.12
|
| Rate for Payer: BCBS Complete |
$812.82
|
| Rate for Payer: BCBS MAPPO |
$226.50
|
| Rate for Payer: BCBS Trust/PPO |
$704.42
|
| Rate for Payer: BCN Commercial |
$704.42
|
| Rate for Payer: BCN Medicare Advantage |
$226.50
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$779.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.50
|
| Rate for Payer: Healthscope Commercial |
$815.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.50
|
| Rate for Payer: Mclaren Medicaid |
$774.12
|
| Rate for Payer: Meridian Medicaid |
$812.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$237.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.10
|
| Rate for Payer: PACE Senior Care Partners |
$215.18
|
| Rate for Payer: PACE SWMI |
$226.50
|
| Rate for Payer: PHP Commercial |
$770.10
|
| Rate for Payer: PHP Medicare Advantage |
$226.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.22
|
| Rate for Payer: Priority Health Medicare |
$226.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.57
|
| Rate for Payer: Railroad Medicare Medicare |
$226.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.28
|
| Rate for Payer: UHC Core |
$756.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.50
|
| Rate for Payer: UHC Medicare Advantage |
$233.30
|
| Rate for Payer: VA VA |
$226.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.50
|
|
|
PR I&D OF BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 56420
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$275.12 |
| Rate for Payer: Aetna Commercial |
$146.27
|
| Rate for Payer: Aetna Medicare |
$113.53
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS MAPPO |
$109.16
|
| Rate for Payer: BCBS Trust/PPO |
$244.07
|
| Rate for Payer: BCN Commercial |
$275.12
|
| Rate for Payer: BCN Medicare Advantage |
$109.16
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$157.19
|
| Rate for Payer: Cofinity Commercial |
$146.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.16
|
| Rate for Payer: Mclaren Medicaid |
$71.36
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$114.62
|
| Rate for Payer: PACE SWMI |
$109.16
|
| Rate for Payer: PHP Medicare Advantage |
$109.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.59
|
| Rate for Payer: Priority Health Medicare |
$109.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.16
|
| Rate for Payer: UHC Medicare Advantage |
$112.43
|
|
|
PR I&D PELVIS/HIP JOINT AREA INFECTED BURSA
|
Professional
|
Both
|
$1,220.00
|
|
|
Service Code
|
HCPCS 26991
|
| Min. Negotiated Rate |
$342.08 |
| Max. Negotiated Rate |
$1,049.19 |
| Rate for Payer: Aetna Commercial |
$698.38
|
| Rate for Payer: Aetna Medicare |
$542.03
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCBS MAPPO |
$521.18
|
| Rate for Payer: BCBS Trust/PPO |
$758.11
|
| Rate for Payer: BCN Commercial |
$1,049.19
|
| Rate for Payer: BCN Medicare Advantage |
$521.18
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cofinity Commercial |
$750.50
|
| Rate for Payer: Cofinity Commercial |
$698.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$521.18
|
| Rate for Payer: Mclaren Medicaid |
$342.08
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$547.24
|
| Rate for Payer: PACE SWMI |
$521.18
|
| Rate for Payer: PHP Medicare Advantage |
$521.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.46
|
| Rate for Payer: Priority Health Medicare |
$521.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$813.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$521.18
|
| Rate for Payer: UHC Medicare Advantage |
$536.82
|
|
