|
PR INCISION FLEXOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 25001
|
| Min. Negotiated Rate |
$228.55 |
| Max. Negotiated Rate |
$1,124.75 |
| Rate for Payer: Aetna Commercial |
$456.50
|
| Rate for Payer: Aetna Medicare |
$354.30
|
| Rate for Payer: BCBS Complete |
$239.98
|
| Rate for Payer: BCBS MAPPO |
$340.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.75
|
| Rate for Payer: BCN Commercial |
$515.07
|
| Rate for Payer: BCN Medicare Advantage |
$340.67
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$456.50
|
| Rate for Payer: Cofinity Commercial |
$490.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.67
|
| Rate for Payer: Mclaren Medicaid |
$228.55
|
| Rate for Payer: Meridian Medicaid |
$239.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$357.70
|
| Rate for Payer: PACE SWMI |
$340.67
|
| Rate for Payer: PHP Medicare Advantage |
$340.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$538.22
|
| Rate for Payer: Priority Health Medicare |
$340.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$538.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.67
|
| Rate for Payer: UHC Medicare Advantage |
$350.89
|
|
|
PR INCISION LABIAL FRENUM FRENOTOMY
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 40806
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$393.58 |
| Rate for Payer: Aetna Commercial |
$37.13
|
| Rate for Payer: Aetna Medicare |
$28.82
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS MAPPO |
$27.71
|
| Rate for Payer: BCBS Trust/PPO |
$393.58
|
| Rate for Payer: BCN Commercial |
$146.11
|
| Rate for Payer: BCN Medicare Advantage |
$27.71
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.71
|
| Rate for Payer: Mclaren Medicaid |
$18.96
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.10
|
| Rate for Payer: PACE SWMI |
$27.71
|
| Rate for Payer: PHP Medicare Advantage |
$27.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.56
|
| Rate for Payer: Priority Health Medicare |
$27.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.71
|
| Rate for Payer: UHC Medicare Advantage |
$28.54
|
|
|
PR INCISION LEG/ANKLE
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 27607
|
| Min. Negotiated Rate |
$386.81 |
| Max. Negotiated Rate |
$1,190.00 |
| Rate for Payer: Aetna Commercial |
$787.46
|
| Rate for Payer: Aetna Medicare |
$611.17
|
| Rate for Payer: BCBS Complete |
$406.15
|
| Rate for Payer: BCBS MAPPO |
$587.66
|
| Rate for Payer: BCBS Trust/PPO |
$864.83
|
| Rate for Payer: BCN Commercial |
$876.69
|
| Rate for Payer: BCN Medicare Advantage |
$587.66
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$787.46
|
| Rate for Payer: Cofinity Commercial |
$846.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.66
|
| Rate for Payer: Mclaren Medicaid |
$386.81
|
| Rate for Payer: Meridian Medicaid |
$406.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$617.04
|
| Rate for Payer: PACE SWMI |
$587.66
|
| Rate for Payer: PHP Medicare Advantage |
$587.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$916.11
|
| Rate for Payer: Priority Health Medicare |
$587.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$916.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.66
|
| Rate for Payer: UHC Medicare Advantage |
$605.29
|
|
|
PR INCISION LINGUAL FRENUM FRENOTOMY
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 41010
|
| Min. Negotiated Rate |
$70.93 |
| Max. Negotiated Rate |
$971.54 |
| Rate for Payer: Aetna Commercial |
$143.10
|
| Rate for Payer: Aetna Medicare |
$111.06
|
| Rate for Payer: BCBS Complete |
$74.48
|
| Rate for Payer: BCBS MAPPO |
$106.79
|
| Rate for Payer: BCBS Trust/PPO |
$971.54
|
| Rate for Payer: BCN Commercial |
$322.04
|
| Rate for Payer: BCN Medicare Advantage |
$106.79
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$153.78
|
| Rate for Payer: Cofinity Commercial |
$143.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.79
|
| Rate for Payer: Mclaren Medicaid |
$70.93
|
| Rate for Payer: Meridian Medicaid |
$74.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.13
|
| Rate for Payer: PACE SWMI |
$106.79
|
| Rate for Payer: PHP Medicare Advantage |
$106.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.21
|
| Rate for Payer: Priority Health Medicare |
$106.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.79
|
| Rate for Payer: UHC Medicare Advantage |
$109.99
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 10121
|
| Min. Negotiated Rate |
$117.58 |
| Max. Negotiated Rate |
$387.52 |
| Rate for Payer: Aetna Commercial |
$240.20
|
| Rate for Payer: Aetna Medicare |
$186.42
|
| Rate for Payer: BCBS Complete |
$123.46
|
| Rate for Payer: BCBS MAPPO |
$179.25
|
| Rate for Payer: BCBS Trust/PPO |
$234.52
|
| Rate for Payer: BCN Commercial |
$387.52
|
| Rate for Payer: BCN Medicare Advantage |
$179.25
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$258.12
|
| Rate for Payer: Cofinity Commercial |
$240.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.25
|
| Rate for Payer: Mclaren Medicaid |
$117.58
|
| Rate for Payer: Meridian Medicaid |
$123.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$188.21
|
| Rate for Payer: PACE SWMI |
$179.25
|
| Rate for Payer: PHP Medicare Advantage |
$179.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.83
|
| Rate for Payer: Priority Health Medicare |
$179.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.25
|
| Rate for Payer: UHC Medicare Advantage |
$184.63
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Facility
|
IP
|
$246.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
10120
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$150.04 |
| Max. Negotiated Rate |
$221.40 |
| Rate for Payer: Aetna Commercial |
$209.10
|
| Rate for Payer: BCBS Trust/PPO |
$190.11
|
| Rate for Payer: BCN Commercial |
$190.11
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$211.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.80
|
| Rate for Payer: Healthscope Commercial |
$221.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$209.10
|
| Rate for Payer: PHP Commercial |
$209.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.48
|
| Rate for Payer: UHC Core |
$205.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.50
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 10120
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna Medicare |
$105.63
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$101.57
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: BCN Medicare Advantage |
$101.57
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$146.26
|
| Rate for Payer: Cofinity Commercial |
$136.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.57
|
| Rate for Payer: Mclaren Medicaid |
$67.95
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.65
|
| Rate for Payer: PACE SWMI |
$101.57
|
| Rate for Payer: PHP Medicare Advantage |
$101.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.07
|
| Rate for Payer: Priority Health Medicare |
$101.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.57
|
| Rate for Payer: UHC Medicare Advantage |
$104.62
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 10120
|
| Hospital Charge Code |
10120
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna Medicare |
$105.63
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$101.57
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: BCN Medicare Advantage |
$101.57
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$136.10
|
| Rate for Payer: Cofinity Commercial |
$146.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.57
|
| Rate for Payer: Mclaren Medicaid |
$67.95
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.65
|
| Rate for Payer: PACE SWMI |
$101.57
|
| Rate for Payer: PHP Medicare Advantage |
$101.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.07
|
| Rate for Payer: Priority Health Medicare |
$101.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.57
|
| Rate for Payer: UHC Medicare Advantage |
$104.62
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Facility
|
OP
|
$246.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
10120
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$209.10
|
| Rate for Payer: Aetna Medicare |
$63.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.88
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$61.50
|
| Rate for Payer: BCBS Trust/PPO |
$191.26
|
| Rate for Payer: BCN Commercial |
$191.26
|
| Rate for Payer: BCN Medicare Advantage |
$61.50
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$211.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.50
|
| Rate for Payer: Healthscope Commercial |
$221.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.50
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$209.10
|
| Rate for Payer: PACE Senior Care Partners |
$58.42
|
| Rate for Payer: PACE SWMI |
$61.50
|
| Rate for Payer: PHP Commercial |
$209.10
|
| Rate for Payer: PHP Medicare Advantage |
$61.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.02
|
| Rate for Payer: Priority Health Medicare |
$61.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.04
|
| Rate for Payer: Railroad Medicare Medicare |
$61.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.48
|
| Rate for Payer: UHC Core |
$205.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.50
|
| Rate for Payer: UHC Medicare Advantage |
$63.34
|
| Rate for Payer: VA VA |
$61.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.50
|
|
|
PR INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF
|
Professional
|
Both
|
$1,562.00
|
|
|
Service Code
|
HCPCS 61316
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$1,093.40 |
| Rate for Payer: Aetna Commercial |
$118.20
|
| Rate for Payer: Aetna Medicare |
$91.74
|
| Rate for Payer: BCBS Complete |
$58.82
|
| Rate for Payer: BCBS MAPPO |
$88.21
|
| Rate for Payer: BCBS Trust/PPO |
$305.36
|
| Rate for Payer: BCN Commercial |
$177.62
|
| Rate for Payer: BCN Medicare Advantage |
$88.21
|
| Rate for Payer: Cash Price |
$1,249.60
|
| Rate for Payer: Cash Price |
$1,249.60
|
| Rate for Payer: Cofinity Commercial |
$118.20
|
| Rate for Payer: Cofinity Commercial |
$127.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.21
|
| Rate for Payer: Mclaren Medicaid |
$56.02
|
| Rate for Payer: Meridian Medicaid |
$58.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$92.62
|
| Rate for Payer: PACE SWMI |
$88.21
|
| Rate for Payer: PHP Medicare Advantage |
$88.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,093.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.34
|
| Rate for Payer: Priority Health Medicare |
$88.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.21
|
| Rate for Payer: UHC Medicare Advantage |
$90.86
|
|
|
PR INCISION THROMBOSED HEMORRHOID EXTERNAL
|
Professional
|
Both
|
$352.00
|
|
|
Service Code
|
HCPCS 46083
|
| Min. Negotiated Rate |
$70.93 |
| Max. Negotiated Rate |
$2,366.78 |
| Rate for Payer: Aetna Commercial |
$143.98
|
| Rate for Payer: Aetna Medicare |
$111.75
|
| Rate for Payer: BCBS Complete |
$74.48
|
| Rate for Payer: BCBS MAPPO |
$107.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,366.78
|
| Rate for Payer: BCN Commercial |
$306.40
|
| Rate for Payer: BCN Medicare Advantage |
$107.45
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$154.73
|
| Rate for Payer: Cofinity Commercial |
$143.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.45
|
| Rate for Payer: Mclaren Medicaid |
$70.93
|
| Rate for Payer: Meridian Medicaid |
$74.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.82
|
| Rate for Payer: PACE SWMI |
$107.45
|
| Rate for Payer: PHP Medicare Advantage |
$107.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.45
|
| Rate for Payer: Priority Health Medicare |
$107.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.45
|
| Rate for Payer: UHC Medicare Advantage |
$110.67
|
|
|
PR INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 99340
|
| Min. Negotiated Rate |
$85.60 |
| Max. Negotiated Rate |
$149.80 |
| Rate for Payer: BCBS Complete |
$85.60
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.80
|
|
|
PR INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC
|
Professional
|
Both
|
$900.00
|
|
|
Service Code
|
HCPCS 59856
|
| Min. Negotiated Rate |
$321.63 |
| Max. Negotiated Rate |
$1,248.90 |
| Rate for Payer: Aetna Commercial |
$669.87
|
| Rate for Payer: Aetna Medicare |
$519.90
|
| Rate for Payer: BCBS Complete |
$337.71
|
| Rate for Payer: BCBS MAPPO |
$499.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.90
|
| Rate for Payer: BCN Commercial |
$733.51
|
| Rate for Payer: BCN Medicare Advantage |
$499.90
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$719.86
|
| Rate for Payer: Cofinity Commercial |
$669.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.90
|
| Rate for Payer: Mclaren Medicaid |
$321.63
|
| Rate for Payer: Meridian Medicaid |
$337.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$524.90
|
| Rate for Payer: PACE SWMI |
$499.90
|
| Rate for Payer: PHP Medicare Advantage |
$499.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$708.74
|
| Rate for Payer: Priority Health Medicare |
$499.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$708.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$499.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$499.90
|
| Rate for Payer: UHC Medicare Advantage |
$514.90
|
|
|
PR INDUCED ABORT 1/> VAG SUPPOS DLVR FETUS HYSTOT
|
Professional
|
Both
|
$1,793.00
|
|
|
Service Code
|
HCPCS 59857
|
| Min. Negotiated Rate |
$374.24 |
| Max. Negotiated Rate |
$1,255.10 |
| Rate for Payer: Aetna Commercial |
$782.13
|
| Rate for Payer: Aetna Medicare |
$607.03
|
| Rate for Payer: BCBS Complete |
$392.95
|
| Rate for Payer: BCBS MAPPO |
$583.68
|
| Rate for Payer: BCBS Trust/PPO |
$756.53
|
| Rate for Payer: BCN Commercial |
$854.70
|
| Rate for Payer: BCN Medicare Advantage |
$583.68
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Cofinity Commercial |
$840.50
|
| Rate for Payer: Cofinity Commercial |
$782.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.68
|
| Rate for Payer: Mclaren Medicaid |
$374.24
|
| Rate for Payer: Meridian Medicaid |
$392.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$612.86
|
| Rate for Payer: PACE SWMI |
$583.68
|
| Rate for Payer: PHP Medicare Advantage |
$583.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,255.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.84
|
| Rate for Payer: Priority Health Medicare |
$583.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$825.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$583.68
|
| Rate for Payer: UHC Medicare Advantage |
$601.19
|
|
|
PR INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 59855
|
| Min. Negotiated Rate |
$275.20 |
| Max. Negotiated Rate |
$1,169.13 |
| Rate for Payer: Aetna Commercial |
$571.60
|
| Rate for Payer: Aetna Medicare |
$443.63
|
| Rate for Payer: BCBS Complete |
$288.96
|
| Rate for Payer: BCBS MAPPO |
$426.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,169.13
|
| Rate for Payer: BCN Commercial |
$627.46
|
| Rate for Payer: BCN Medicare Advantage |
$426.57
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$571.60
|
| Rate for Payer: Cofinity Commercial |
$614.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.57
|
| Rate for Payer: Mclaren Medicaid |
$275.20
|
| Rate for Payer: Meridian Medicaid |
$288.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$447.90
|
| Rate for Payer: PACE SWMI |
$426.57
|
| Rate for Payer: PHP Medicare Advantage |
$426.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.27
|
| Rate for Payer: Priority Health Medicare |
$426.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$606.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$426.57
|
| Rate for Payer: UHC Medicare Advantage |
$439.37
|
|
|
PR INDUCED ABORTION DILATION AND CURETTAGE
|
Professional
|
Both
|
$790.00
|
|
|
Service Code
|
HCPCS 59840
|
| Min. Negotiated Rate |
$143.99 |
| Max. Negotiated Rate |
$1,030.71 |
| Rate for Payer: Aetna Commercial |
$296.49
|
| Rate for Payer: Aetna Medicare |
$230.11
|
| Rate for Payer: BCBS Complete |
$151.19
|
| Rate for Payer: BCBS MAPPO |
$221.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.71
|
| Rate for Payer: BCN Commercial |
$369.44
|
| Rate for Payer: BCN Medicare Advantage |
$221.26
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Cofinity Commercial |
$318.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.26
|
| Rate for Payer: Mclaren Medicaid |
$143.99
|
| Rate for Payer: Meridian Medicaid |
$151.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.32
|
| Rate for Payer: PACE SWMI |
$221.26
|
| Rate for Payer: PHP Medicare Advantage |
$221.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.82
|
| Rate for Payer: Priority Health Medicare |
$221.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$316.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.26
|
| Rate for Payer: UHC Medicare Advantage |
$227.90
|
|
|
PR INDUCED ABORTION DILATION & EVACUATION
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 59841
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$953.58 |
| Rate for Payer: Aetna Commercial |
$499.90
|
| Rate for Payer: Aetna Medicare |
$387.98
|
| Rate for Payer: BCBS Complete |
$252.94
|
| Rate for Payer: BCBS MAPPO |
$373.06
|
| Rate for Payer: BCBS Trust/PPO |
$953.58
|
| Rate for Payer: BCN Commercial |
$630.40
|
| Rate for Payer: BCN Medicare Advantage |
$373.06
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$499.90
|
| Rate for Payer: Cofinity Commercial |
$537.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.06
|
| Rate for Payer: Mclaren Medicaid |
$240.90
|
| Rate for Payer: Meridian Medicaid |
$252.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$391.71
|
| Rate for Payer: PACE SWMI |
$373.06
|
| Rate for Payer: PHP Medicare Advantage |
$373.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$581.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$530.25
|
| Rate for Payer: Priority Health Medicare |
$373.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.06
|
| Rate for Payer: UHC Medicare Advantage |
$384.25
|
|
|
PR INDWELLING CATHETER SPECIAL
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS A4340
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Aetna Commercial |
$25.14
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCN Commercial |
$29.71
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
|
|
PR INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI
|
Professional
|
Both
|
$10,750.00
|
|
|
Service Code
|
HCPCS 61591
|
| Min. Negotiated Rate |
$366.64 |
| Max. Negotiated Rate |
$7,525.00 |
| Rate for Payer: Aetna Commercial |
$4,084.74
|
| Rate for Payer: Aetna Medicare |
$3,170.24
|
| Rate for Payer: BCBS Complete |
$2,065.85
|
| Rate for Payer: BCBS MAPPO |
$3,048.31
|
| Rate for Payer: BCBS Trust/PPO |
$366.64
|
| Rate for Payer: BCN Commercial |
$4,510.49
|
| Rate for Payer: BCN Medicare Advantage |
$3,048.31
|
| Rate for Payer: Cash Price |
$8,600.00
|
| Rate for Payer: Cash Price |
$8,600.00
|
| Rate for Payer: Cofinity Commercial |
$4,084.74
|
| Rate for Payer: Cofinity Commercial |
$4,389.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,048.31
|
| Rate for Payer: Mclaren Medicaid |
$1,967.48
|
| Rate for Payer: Meridian Medicaid |
$2,065.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,200.73
|
| Rate for Payer: PACE SWMI |
$3,048.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,048.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,967.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,525.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,226.25
|
| Rate for Payer: Priority Health Medicare |
$3,048.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,226.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,048.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,048.31
|
| Rate for Payer: UHC Medicare Advantage |
$3,139.76
|
|
|
PR INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN
|
Professional
|
Both
|
$6,443.00
|
|
|
Service Code
|
HCPCS 61590
|
| Min. Negotiated Rate |
$514.56 |
| Max. Negotiated Rate |
$5,139.04 |
| Rate for Payer: Aetna Commercial |
$4,012.12
|
| Rate for Payer: Aetna Medicare |
$3,113.88
|
| Rate for Payer: BCBS Complete |
$2,029.18
|
| Rate for Payer: BCBS MAPPO |
$2,994.12
|
| Rate for Payer: BCBS Trust/PPO |
$514.56
|
| Rate for Payer: BCN Commercial |
$4,435.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,994.12
|
| Rate for Payer: Cash Price |
$5,154.40
|
| Rate for Payer: Cash Price |
$5,154.40
|
| Rate for Payer: Cofinity Commercial |
$4,012.12
|
| Rate for Payer: Cofinity Commercial |
$4,311.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,994.12
|
| Rate for Payer: Mclaren Medicaid |
$1,932.55
|
| Rate for Payer: Meridian Medicaid |
$2,029.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,143.83
|
| Rate for Payer: PACE SWMI |
$2,994.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,994.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,932.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,510.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,139.04
|
| Rate for Payer: Priority Health Medicare |
$2,994.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,139.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,994.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,994.12
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.94
|
|
|
PR INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 95079
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$376.15 |
| Rate for Payer: Aetna Commercial |
$88.76
|
| Rate for Payer: Aetna Medicare |
$68.89
|
| Rate for Payer: BCBS Complete |
$44.95
|
| Rate for Payer: BCBS MAPPO |
$66.24
|
| Rate for Payer: BCBS Trust/PPO |
$376.15
|
| Rate for Payer: BCN Commercial |
$122.66
|
| Rate for Payer: BCN Medicare Advantage |
$66.24
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$95.39
|
| Rate for Payer: Cofinity Commercial |
$88.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.24
|
| Rate for Payer: Mclaren Medicaid |
$42.81
|
| Rate for Payer: Meridian Medicaid |
$44.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.55
|
| Rate for Payer: PACE SWMI |
$66.24
|
| Rate for Payer: PHP Medicare Advantage |
$66.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.60
|
| Rate for Payer: Priority Health Medicare |
$66.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.24
|
| Rate for Payer: UHC Medicare Advantage |
$68.23
|
|
|
PR INGESTION CHALLENGE TEST INITIAL 120 MINUTES
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 95076
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$262.04 |
| Rate for Payer: Aetna Commercial |
$96.28
|
| Rate for Payer: Aetna Medicare |
$74.72
|
| Rate for Payer: BCBS Complete |
$48.75
|
| Rate for Payer: BCBS MAPPO |
$71.85
|
| Rate for Payer: BCBS Trust/PPO |
$262.04
|
| Rate for Payer: BCN Commercial |
$175.93
|
| Rate for Payer: BCN Medicare Advantage |
$71.85
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Cofinity Commercial |
$103.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.85
|
| Rate for Payer: Mclaren Medicaid |
$46.43
|
| Rate for Payer: Meridian Medicaid |
$48.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.44
|
| Rate for Payer: PACE SWMI |
$71.85
|
| Rate for Payer: PHP Medicare Advantage |
$71.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.72
|
| Rate for Payer: Priority Health Medicare |
$71.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.85
|
| Rate for Payer: UHC Medicare Advantage |
$74.01
|
|
|
PR INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX
|
Professional
|
Both
|
$2,577.00
|
|
|
Service Code
|
HCPCS 38760
|
| Min. Negotiated Rate |
$536.12 |
| Max. Negotiated Rate |
$1,810.85 |
| Rate for Payer: Aetna Commercial |
$1,110.43
|
| Rate for Payer: Aetna Medicare |
$861.83
|
| Rate for Payer: BCBS Complete |
$562.93
|
| Rate for Payer: BCBS MAPPO |
$828.68
|
| Rate for Payer: BCBS Trust/PPO |
$689.96
|
| Rate for Payer: BCN Commercial |
$1,221.69
|
| Rate for Payer: BCN Medicare Advantage |
$828.68
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cash Price |
$2,061.60
|
| Rate for Payer: Cofinity Commercial |
$1,193.30
|
| Rate for Payer: Cofinity Commercial |
$1,110.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$828.68
|
| Rate for Payer: Mclaren Medicaid |
$536.12
|
| Rate for Payer: Meridian Medicaid |
$562.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$870.11
|
| Rate for Payer: PACE SWMI |
$828.68
|
| Rate for Payer: PHP Medicare Advantage |
$828.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$536.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.85
|
| Rate for Payer: Priority Health Medicare |
$828.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,810.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$828.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$828.68
|
| Rate for Payer: UHC Medicare Advantage |
$853.54
|
|
|
PR INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC
|
Professional
|
Both
|
$2,653.64
|
|
|
Service Code
|
HCPCS 38765
|
| Min. Negotiated Rate |
$524.60 |
| Max. Negotiated Rate |
$2,830.72 |
| Rate for Payer: Aetna Commercial |
$1,739.43
|
| Rate for Payer: Aetna Medicare |
$1,350.00
|
| Rate for Payer: BCBS Complete |
$877.83
|
| Rate for Payer: BCBS MAPPO |
$1,298.08
|
| Rate for Payer: BCBS Trust/PPO |
$524.60
|
| Rate for Payer: BCN Commercial |
$1,909.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,298.08
|
| Rate for Payer: Cash Price |
$2,122.91
|
| Rate for Payer: Cash Price |
$2,122.91
|
| Rate for Payer: Cofinity Commercial |
$1,739.43
|
| Rate for Payer: Cofinity Commercial |
$1,869.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,298.08
|
| Rate for Payer: Mclaren Medicaid |
$836.03
|
| Rate for Payer: Meridian Medicaid |
$877.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,362.98
|
| Rate for Payer: PACE SWMI |
$1,298.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,298.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,857.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,830.72
|
| Rate for Payer: Priority Health Medicare |
$1,298.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,830.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,298.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,337.02
|
|
|
PR INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 95070
|
| Min. Negotiated Rate |
$31.91 |
| Max. Negotiated Rate |
$302.19 |
| Rate for Payer: Aetna Commercial |
$42.76
|
| Rate for Payer: Aetna Medicare |
$33.19
|
| Rate for Payer: BCBS Complete |
$97.60
|
| Rate for Payer: BCBS MAPPO |
$31.91
|
| Rate for Payer: BCBS Trust/PPO |
$302.19
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Medicare Advantage |
$31.91
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$45.95
|
| Rate for Payer: Cofinity Commercial |
$42.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.51
|
| Rate for Payer: PACE SWMI |
$31.91
|
| Rate for Payer: PHP Medicare Advantage |
$31.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.05
|
| Rate for Payer: Priority Health Medicare |
$31.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.91
|
| Rate for Payer: UHC Medicare Advantage |
$32.87
|
|
