|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
OP
|
$10.34
|
|
|
Service Code
|
NDC 60687057233
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$9.31 |
| Rate for Payer: Aetna Commercial |
$8.79
|
| Rate for Payer: Aetna Medicare |
$2.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.23
|
| Rate for Payer: BCBS Complete |
$4.14
|
| Rate for Payer: BCBS MAPPO |
$2.58
|
| Rate for Payer: BCBS Trust/PPO |
$8.50
|
| Rate for Payer: BCN Commercial |
$8.04
|
| Rate for Payer: BCN Medicare Advantage |
$2.58
|
| Rate for Payer: Cash Price |
$8.27
|
| Rate for Payer: Cofinity Commercial |
$8.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.58
|
| Rate for Payer: Healthscope Commercial |
$9.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.79
|
| Rate for Payer: Nomi Health Commercial |
$8.48
|
| Rate for Payer: PACE Senior Care Partners |
$2.46
|
| Rate for Payer: PACE SWMI |
$2.58
|
| Rate for Payer: PHP Commercial |
$8.79
|
| Rate for Payer: PHP Medicare Advantage |
$2.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.72
|
| Rate for Payer: Priority Health HMO/PPO |
$9.00
|
| Rate for Payer: Priority Health Medicare |
$2.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.10
|
| Rate for Payer: UHC Core |
$8.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.58
|
| Rate for Payer: UHC Exchange |
$2.58
|
| Rate for Payer: UHC Medicare Advantage |
$2.58
|
| Rate for Payer: VA VA |
$2.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.76
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
OP
|
$584.64
|
|
|
Service Code
|
NDC 00378320501
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$138.85 |
| Max. Negotiated Rate |
$526.18 |
| Rate for Payer: Aetna Commercial |
$496.94
|
| Rate for Payer: Aetna Medicare |
$152.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.70
|
| Rate for Payer: BCBS Complete |
$233.86
|
| Rate for Payer: BCBS MAPPO |
$146.16
|
| Rate for Payer: BCBS Trust/PPO |
$480.63
|
| Rate for Payer: BCN Commercial |
$454.56
|
| Rate for Payer: BCN Medicare Advantage |
$146.16
|
| Rate for Payer: Cash Price |
$467.71
|
| Rate for Payer: Cofinity Commercial |
$502.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.16
|
| Rate for Payer: Healthscope Commercial |
$526.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.94
|
| Rate for Payer: Nomi Health Commercial |
$479.40
|
| Rate for Payer: PACE Senior Care Partners |
$138.85
|
| Rate for Payer: PACE SWMI |
$146.16
|
| Rate for Payer: PHP Commercial |
$496.94
|
| Rate for Payer: PHP Medicare Advantage |
$146.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.02
|
| Rate for Payer: Priority Health HMO/PPO |
$508.64
|
| Rate for Payer: Priority Health Medicare |
$147.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.71
|
| Rate for Payer: Railroad Medicare Medicare |
$146.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.48
|
| Rate for Payer: UHC Core |
$488.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.16
|
| Rate for Payer: UHC Exchange |
$146.16
|
| Rate for Payer: UHC Medicare Advantage |
$146.16
|
| Rate for Payer: VA VA |
$146.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.48
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
IP
|
$206.61
|
|
|
Service Code
|
NDC 60687057232
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.30 |
| Max. Negotiated Rate |
$185.95 |
| Rate for Payer: Aetna Commercial |
$175.62
|
| Rate for Payer: BCBS Trust/PPO |
$168.66
|
| Rate for Payer: BCN Commercial |
$159.67
|
| Rate for Payer: Cash Price |
$165.29
|
| Rate for Payer: Cofinity Commercial |
$177.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.29
|
| Rate for Payer: Healthscope Commercial |
$185.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.62
|
| Rate for Payer: Nomi Health Commercial |
$169.42
|
| Rate for Payer: PHP Commercial |
$175.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.30
|
| Rate for Payer: Priority Health HMO/PPO |
$179.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.82
|
| Rate for Payer: UHC Core |
$172.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.96
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
IP
|
$10.34
|
|
|
Service Code
|
NDC 60687057233
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$9.31 |
| Rate for Payer: Aetna Commercial |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$8.44
|
| Rate for Payer: BCN Commercial |
$7.99
|
| Rate for Payer: Cash Price |
$8.27
|
| Rate for Payer: Cofinity Commercial |
$8.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.27
|
| Rate for Payer: Healthscope Commercial |
$9.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.79
|
| Rate for Payer: Nomi Health Commercial |
$8.48
|
| Rate for Payer: PHP Commercial |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.72
|
| Rate for Payer: Priority Health HMO/PPO |
$9.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.10
|
| Rate for Payer: UHC Core |
$8.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.76
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
OP
|
$206.61
|
|
|
Service Code
|
NDC 60687057232
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.07 |
| Max. Negotiated Rate |
$185.95 |
| Rate for Payer: Aetna Commercial |
$175.62
|
| Rate for Payer: Aetna Medicare |
$53.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.57
|
| Rate for Payer: BCBS Complete |
$82.64
|
| Rate for Payer: BCBS MAPPO |
$51.65
|
| Rate for Payer: BCBS Trust/PPO |
$169.85
|
| Rate for Payer: BCN Commercial |
$160.64
|
| Rate for Payer: BCN Medicare Advantage |
$51.65
|
| Rate for Payer: Cash Price |
$165.29
|
| Rate for Payer: Cofinity Commercial |
$177.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.65
|
| Rate for Payer: Healthscope Commercial |
$185.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.62
|
| Rate for Payer: Nomi Health Commercial |
$169.42
|
| Rate for Payer: PACE Senior Care Partners |
$49.07
|
| Rate for Payer: PACE SWMI |
$51.65
|
| Rate for Payer: PHP Commercial |
$175.62
|
| Rate for Payer: PHP Medicare Advantage |
$51.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.30
|
| Rate for Payer: Priority Health HMO/PPO |
$179.75
|
| Rate for Payer: Priority Health Medicare |
$52.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.43
|
| Rate for Payer: Railroad Medicare Medicare |
$51.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.82
|
| Rate for Payer: UHC Core |
$172.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.65
|
| Rate for Payer: UHC Exchange |
$51.65
|
| Rate for Payer: UHC Medicare Advantage |
$51.65
|
| Rate for Payer: VA VA |
$51.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.96
|
|
|
PR B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA
|
Professional
|
Both
|
$2,174.00
|
|
|
Service Code
|
HCPCS 27170
|
| Min. Negotiated Rate |
$757.22 |
| Max. Negotiated Rate |
$1,814.18 |
| Rate for Payer: Aetna Commercial |
$1,512.57
|
| Rate for Payer: Aetna Medicare |
$1,173.93
|
| Rate for Payer: BCBS Complete |
$795.08
|
| Rate for Payer: BCBS MAPPO |
$1,128.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,814.18
|
| Rate for Payer: BCN Commercial |
$1,713.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.78
|
| Rate for Payer: Cash Price |
$1,739.20
|
| Rate for Payer: Cash Price |
$1,739.20
|
| Rate for Payer: Cofinity Commercial |
$1,625.44
|
| Rate for Payer: Cofinity Commercial |
$1,512.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.78
|
| Rate for Payer: Mclaren Medicaid |
$757.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,185.22
|
| Rate for Payer: Meridian Medicaid |
$795.08
|
| Rate for Payer: Nomi Health Commercial |
$1,354.54
|
| Rate for Payer: PACE SWMI |
$1,128.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$757.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,413.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,792.72
|
| Rate for Payer: Priority Health Medicare |
$1,140.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,792.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,128.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.78
|
| Rate for Payer: UHC Exchange |
$1,128.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.78
|
| Rate for Payer: UHCCP Medicaid |
$757.22
|
|
|
PR BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 90586
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$224.87 |
| Rate for Payer: Aetna Commercial |
$209.26
|
| Rate for Payer: Aetna Medicare |
$162.41
|
| Rate for Payer: BCBS Complete |
$109.20
|
| Rate for Payer: BCBS MAPPO |
$156.16
|
| Rate for Payer: BCBS Trust/PPO |
$147.22
|
| Rate for Payer: BCN Commercial |
$146.43
|
| Rate for Payer: BCN Medicare Advantage |
$156.16
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$224.87
|
| Rate for Payer: Cofinity Commercial |
$209.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.97
|
| Rate for Payer: Nomi Health Commercial |
$187.39
|
| Rate for Payer: PACE SWMI |
$156.16
|
| Rate for Payer: PHP Medicare Advantage |
$156.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.45
|
| Rate for Payer: Priority Health Medicare |
$157.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.16
|
| Rate for Payer: UHC Exchange |
$156.16
|
| Rate for Payer: UHC Medicare Advantage |
$156.16
|
|
|
PR BALLN ANGIOPLASTY OPEN,BRACHCEPH
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 35458
|
| Min. Negotiated Rate |
$383.20 |
| Max. Negotiated Rate |
$622.70 |
| Rate for Payer: Aetna Medicare |
$479.00
|
| Rate for Payer: BCBS Complete |
$383.20
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.70
|
|
|
PR BALLN ANGIOPLASTY PERC,AORTIC
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 35472
|
| Min. Negotiated Rate |
$275.60 |
| Max. Negotiated Rate |
$447.85 |
| Rate for Payer: Aetna Medicare |
$344.50
|
| Rate for Payer: BCBS Complete |
$275.60
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.85
|
|
|
PR BALLN ANGIOPLASTY PERC,BRACHIOCEPH
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 35475
|
| Min. Negotiated Rate |
$815.60 |
| Max. Negotiated Rate |
$1,325.35 |
| Rate for Payer: Aetna Medicare |
$1,019.50
|
| Rate for Payer: BCBS Complete |
$815.60
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
|
|
PR BALLN ANGIOPLASTY,PERC VENOUS
|
Professional
|
Both
|
$3,441.00
|
|
|
Service Code
|
HCPCS 35476
|
| Min. Negotiated Rate |
$1,376.40 |
| Max. Negotiated Rate |
$2,236.65 |
| Rate for Payer: Aetna Medicare |
$1,720.50
|
| Rate for Payer: BCBS Complete |
$1,376.40
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.65
|
|
|
PR BALLN ANGIOPLASTY PERC,VISCERAL
|
Professional
|
Both
|
$2,857.00
|
|
|
Service Code
|
HCPCS 35471
|
| Min. Negotiated Rate |
$1,142.80 |
| Max. Negotiated Rate |
$1,857.05 |
| Rate for Payer: Aetna Medicare |
$1,428.50
|
| Rate for Payer: BCBS Complete |
$1,142.80
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,857.05
|
|
|
PR BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS
|
Professional
|
Both
|
$4,922.00
|
|
|
Service Code
|
HCPCS 61630
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$3,199.30 |
| Rate for Payer: Aetna Commercial |
$1,784.40
|
| Rate for Payer: Aetna Medicare |
$1,384.91
|
| Rate for Payer: BCBS Complete |
$1,968.80
|
| Rate for Payer: BCBS MAPPO |
$1,331.64
|
| Rate for Payer: BCBS Trust/PPO |
$18.49
|
| Rate for Payer: BCN Commercial |
$1,995.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,331.64
|
| Rate for Payer: Cash Price |
$3,937.60
|
| Rate for Payer: Cash Price |
$3,937.60
|
| Rate for Payer: Cofinity Commercial |
$1,917.56
|
| Rate for Payer: Cofinity Commercial |
$1,784.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,331.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,398.22
|
| Rate for Payer: Nomi Health Commercial |
$1,597.97
|
| Rate for Payer: PACE SWMI |
$1,331.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,331.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.30
|
| Rate for Payer: Priority Health HMO/PPO |
$2,327.76
|
| Rate for Payer: Priority Health Medicare |
$1,344.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,327.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,331.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,331.64
|
| Rate for Payer: UHC Exchange |
$1,331.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,331.64
|
|
|
PR BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 47542
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$763.75 |
| Rate for Payer: Aetna Commercial |
$170.65
|
| Rate for Payer: Aetna Medicare |
$132.44
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$127.35
|
| Rate for Payer: BCN Commercial |
$736.44
|
| Rate for Payer: BCN Medicare Advantage |
$127.35
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$170.65
|
| Rate for Payer: Cofinity Commercial |
$183.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.35
|
| Rate for Payer: Mclaren Medicaid |
$84.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.72
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Nomi Health Commercial |
$152.82
|
| Rate for Payer: PACE SWMI |
$127.35
|
| Rate for Payer: PHP Medicare Advantage |
$127.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO |
$234.46
|
| Rate for Payer: Priority Health Medicare |
$128.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.35
|
| Rate for Payer: UHC Exchange |
$127.35
|
| Rate for Payer: UHC Medicare Advantage |
$127.35
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
|
|
PR BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 61640
|
| Min. Negotiated Rate |
$73.96 |
| Max. Negotiated Rate |
$796.77 |
| Rate for Payer: Aetna Commercial |
$633.90
|
| Rate for Payer: Aetna Medicare |
$493.00
|
| Rate for Payer: BCBS Complete |
$394.40
|
| Rate for Payer: BCBS Trust/PPO |
$73.96
|
| Rate for Payer: BCN Commercial |
$684.64
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO |
$796.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$796.77
|
|
|
PR BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I
|
Professional
|
Both
|
$1,921.00
|
|
|
Service Code
|
HCPCS 50706
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$4,073.19 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$176.94
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$170.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,073.19
|
| Rate for Payer: BCN Commercial |
$1,238.31
|
| Rate for Payer: BCN Medicare Advantage |
$170.13
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cofinity Commercial |
$244.99
|
| Rate for Payer: Cofinity Commercial |
$227.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.13
|
| Rate for Payer: Mclaren Medicaid |
$112.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.64
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Nomi Health Commercial |
$204.16
|
| Rate for Payer: PACE SWMI |
$170.13
|
| Rate for Payer: PHP Medicare Advantage |
$170.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,248.65
|
| Rate for Payer: Priority Health HMO/PPO |
$279.62
|
| Rate for Payer: Priority Health Medicare |
$171.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$279.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.13
|
| Rate for Payer: UHC Exchange |
$170.13
|
| Rate for Payer: UHC Medicare Advantage |
$170.13
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
|
|
PR BCG LIVE INTRAVESICAL VAC
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS J9031
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Medicare |
$90.00
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
|
|
PR BCN APNEALINK PLUS
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 00119
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$301.20 |
| Max. Negotiated Rate |
$489.45 |
| Rate for Payer: Aetna Medicare |
$376.50
|
| Rate for Payer: BCBS Complete |
$301.20
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.45
|
|
|
PR BCN WATCHPAT
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 00120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$223.60 |
| Max. Negotiated Rate |
$363.35 |
| Rate for Payer: Aetna Medicare |
$279.50
|
| Rate for Payer: BCBS Complete |
$223.60
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
|
|
PR BEDSIDE DRAINAGE BAG
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS A4357
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$10.69 |
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCN Commercial |
$10.69
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
|
|
PR BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 96127
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$986.86 |
| Rate for Payer: Aetna Commercial |
$5.64
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.21
|
| Rate for Payer: BCBS Trust/PPO |
$986.86
|
| Rate for Payer: BCN Commercial |
$6.85
|
| Rate for Payer: BCN Medicare Advantage |
$4.21
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$5.64
|
| Rate for Payer: Cofinity Commercial |
$6.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$5.05
|
| Rate for Payer: PACE SWMI |
$4.21
|
| Rate for Payer: PHP Medicare Advantage |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health HMO/PPO |
$8.89
|
| Rate for Payer: Priority Health Medicare |
$4.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.21
|
| Rate for Payer: UHC Exchange |
$4.21
|
| Rate for Payer: UHC Medicare Advantage |
$4.21
|
|
|
PR BEHAV HLTH DAY TREAT, PER HR
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS H2012
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$357.50 |
| Rate for Payer: Aetna Commercial |
$39.28
|
| Rate for Payer: Aetna Medicare |
$275.00
|
| Rate for Payer: BCBS Complete |
$220.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
|
|
PR BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 92524
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$1,450.71 |
| Rate for Payer: Aetna Commercial |
$138.27
|
| Rate for Payer: Aetna Medicare |
$107.32
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS MAPPO |
$103.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,450.71
|
| Rate for Payer: BCN Commercial |
$159.79
|
| Rate for Payer: BCN Medicare Advantage |
$103.19
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$148.59
|
| Rate for Payer: Cofinity Commercial |
$138.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.35
|
| Rate for Payer: Nomi Health Commercial |
$123.83
|
| Rate for Payer: PACE SWMI |
$103.19
|
| Rate for Payer: PHP Medicare Advantage |
$103.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO |
$148.82
|
| Rate for Payer: Priority Health Medicare |
$104.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.19
|
| Rate for Payer: UHC Exchange |
$103.19
|
| Rate for Payer: UHC Medicare Advantage |
$103.19
|
|
|
PR BEHAVIOR COUNSEL OBESITY 15M
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS G0447
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$1,436.98 |
| Rate for Payer: Aetna Commercial |
$38.31
|
| Rate for Payer: Aetna Medicare |
$29.73
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$28.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.98
|
| Rate for Payer: BCN Commercial |
$37.14
|
| Rate for Payer: BCN Medicare Advantage |
$28.59
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$38.31
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.02
|
| Rate for Payer: Nomi Health Commercial |
$34.31
|
| Rate for Payer: PACE SWMI |
$28.59
|
| Rate for Payer: PHP Medicare Advantage |
$28.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO |
$27.23
|
| Rate for Payer: Priority Health Medicare |
$28.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.59
|
| Rate for Payer: UHC Exchange |
$28.59
|
| Rate for Payer: UHC Medicare Advantage |
$28.59
|
|
|
PR BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 97151
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$1,118.41 |
| Rate for Payer: Aetna Commercial |
$20.79
|
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.41
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO |
$65.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.59
|
|
