|
PR BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP
|
Professional
|
Both
|
$3,032.00
|
|
|
Service Code
|
HCPCS 19367
|
| Min. Negotiated Rate |
$1,139.12 |
| Max. Negotiated Rate |
$2,583.15 |
| Rate for Payer: Aetna Commercial |
$2,270.88
|
| Rate for Payer: Aetna Medicare |
$1,762.48
|
| Rate for Payer: BCBS Complete |
$1,196.08
|
| Rate for Payer: BCBS MAPPO |
$1,694.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,327.27
|
| Rate for Payer: BCN Commercial |
$2,583.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,694.69
|
| Rate for Payer: Cash Price |
$2,425.60
|
| Rate for Payer: Cash Price |
$2,425.60
|
| Rate for Payer: Cofinity Commercial |
$2,440.35
|
| Rate for Payer: Cofinity Commercial |
$2,270.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,694.69
|
| Rate for Payer: Mclaren Medicaid |
$1,139.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,779.42
|
| Rate for Payer: Meridian Medicaid |
$1,196.08
|
| Rate for Payer: Nomi Health Commercial |
$2,033.63
|
| Rate for Payer: PACE SWMI |
$1,694.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,694.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,139.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,970.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,392.58
|
| Rate for Payer: Priority Health Medicare |
$1,711.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,392.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,694.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,694.69
|
| Rate for Payer: UHC Exchange |
$1,694.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,694.69
|
| Rate for Payer: UHCCP Medicaid |
$1,139.12
|
|
|
PR BREAST RECONSTRUCTION W/LATISSIMUS DORSI FLAP
|
Professional
|
Both
|
$2,920.00
|
|
|
Service Code
|
HCPCS 19361
|
| Min. Negotiated Rate |
$312.59 |
| Max. Negotiated Rate |
$2,274.31 |
| Rate for Payer: Aetna Commercial |
$1,999.74
|
| Rate for Payer: Aetna Medicare |
$1,552.03
|
| Rate for Payer: BCBS Complete |
$1,053.61
|
| Rate for Payer: BCBS MAPPO |
$1,492.34
|
| Rate for Payer: BCBS Trust/PPO |
$312.59
|
| Rate for Payer: BCN Commercial |
$2,274.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,492.34
|
| Rate for Payer: Cash Price |
$2,336.00
|
| Rate for Payer: Cash Price |
$2,336.00
|
| Rate for Payer: Cofinity Commercial |
$2,148.97
|
| Rate for Payer: Cofinity Commercial |
$1,999.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,492.34
|
| Rate for Payer: Mclaren Medicaid |
$1,003.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,566.96
|
| Rate for Payer: Meridian Medicaid |
$1,053.61
|
| Rate for Payer: Nomi Health Commercial |
$1,790.81
|
| Rate for Payer: PACE SWMI |
$1,492.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,492.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,003.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,898.00
|
| Rate for Payer: Priority Health HMO/PPO |
$2,107.68
|
| Rate for Payer: Priority Health Medicare |
$1,507.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,107.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,492.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,492.34
|
| Rate for Payer: UHC Exchange |
$1,492.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,492.34
|
| Rate for Payer: UHCCP Medicaid |
$1,003.44
|
|
|
PR BREAST RECONSTRUC W OTHR TECHNIQ
|
Professional
|
Both
|
$2,903.00
|
|
|
Service Code
|
HCPCS 19366
|
| Min. Negotiated Rate |
$1,161.20 |
| Max. Negotiated Rate |
$1,886.95 |
| Rate for Payer: Aetna Medicare |
$1,451.50
|
| Rate for Payer: BCBS Complete |
$1,161.20
|
| Rate for Payer: Cash Price |
$2,322.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,886.95
|
|
|
PR BREAST REDUCTION
|
Facility
|
OP
|
$1,938.00
|
|
|
Service Code
|
CPT 19318
|
| Hospital Charge Code |
19318
|
| Min. Negotiated Rate |
$460.28 |
| Max. Negotiated Rate |
$4,850.98 |
| Rate for Payer: Aetna Commercial |
$1,647.30
|
| Rate for Payer: Aetna Medicare |
$503.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$605.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$605.62
|
| Rate for Payer: BCBS Complete |
$4,850.98
|
| Rate for Payer: BCBS MAPPO |
$484.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,593.23
|
| Rate for Payer: BCN Commercial |
$1,506.80
|
| Rate for Payer: BCN Medicare Advantage |
$484.50
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,666.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.50
|
| Rate for Payer: Healthscope Commercial |
$1,744.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.50
|
| Rate for Payer: Mclaren Medicaid |
$4,619.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.72
|
| Rate for Payer: Meridian Medicaid |
$4,850.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$557.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.30
|
| Rate for Payer: Nomi Health Commercial |
$1,589.16
|
| Rate for Payer: PACE Senior Care Partners |
$460.28
|
| Rate for Payer: PACE SWMI |
$484.50
|
| Rate for Payer: PHP Commercial |
$1,647.30
|
| Rate for Payer: PHP Medicare Advantage |
$484.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,619.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,686.06
|
| Rate for Payer: Priority Health Medicare |
$489.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,298.46
|
| Rate for Payer: Railroad Medicare Medicare |
$484.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,705.44
|
| Rate for Payer: UHC Core |
$1,618.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.50
|
| Rate for Payer: UHC Exchange |
$484.50
|
| Rate for Payer: UHC Medicare Advantage |
$484.50
|
| Rate for Payer: UHCCP Medicaid |
$4,619.68
|
| Rate for Payer: VA VA |
$484.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.50
|
|
|
PR BREAST REDUCTION
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 19318
|
| Hospital Charge Code |
19318
|
| Min. Negotiated Rate |
$293.06 |
| Max. Negotiated Rate |
$1,597.97 |
| Rate for Payer: Aetna Commercial |
$1,404.78
|
| Rate for Payer: Aetna Medicare |
$1,090.27
|
| Rate for Payer: BCBS Complete |
$741.40
|
| Rate for Payer: BCBS MAPPO |
$1,048.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$1,597.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.34
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,509.61
|
| Rate for Payer: Cofinity Commercial |
$1,404.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.34
|
| Rate for Payer: Mclaren Medicaid |
$706.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.76
|
| Rate for Payer: Meridian Medicaid |
$741.40
|
| Rate for Payer: Nomi Health Commercial |
$1,258.01
|
| Rate for Payer: PACE SWMI |
$1,048.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,482.33
|
| Rate for Payer: Priority Health Medicare |
$1,058.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,482.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,048.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.34
|
| Rate for Payer: UHC Exchange |
$1,048.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.34
|
| Rate for Payer: UHCCP Medicaid |
$706.10
|
|
|
PR BREAST REDUCTION
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 19318
|
| Min. Negotiated Rate |
$293.06 |
| Max. Negotiated Rate |
$1,597.97 |
| Rate for Payer: Aetna Commercial |
$1,404.78
|
| Rate for Payer: Aetna Medicare |
$1,090.27
|
| Rate for Payer: BCBS Complete |
$741.40
|
| Rate for Payer: BCBS MAPPO |
$1,048.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$1,597.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.34
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,509.61
|
| Rate for Payer: Cofinity Commercial |
$1,404.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.34
|
| Rate for Payer: Mclaren Medicaid |
$706.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.76
|
| Rate for Payer: Meridian Medicaid |
$741.40
|
| Rate for Payer: Nomi Health Commercial |
$1,258.01
|
| Rate for Payer: PACE SWMI |
$1,048.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,482.33
|
| Rate for Payer: Priority Health Medicare |
$1,058.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,482.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,048.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.34
|
| Rate for Payer: UHC Exchange |
$1,048.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.34
|
| Rate for Payer: UHCCP Medicaid |
$706.10
|
|
|
PR BREAST REDUCTION
|
Facility
|
IP
|
$1,938.00
|
|
|
Service Code
|
CPT 19318
|
| Hospital Charge Code |
19318
|
| Min. Negotiated Rate |
$1,259.70 |
| Max. Negotiated Rate |
$1,744.20 |
| Rate for Payer: Aetna Commercial |
$1,647.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,581.99
|
| Rate for Payer: BCN Commercial |
$1,497.69
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,666.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.40
|
| Rate for Payer: Healthscope Commercial |
$1,744.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.30
|
| Rate for Payer: Nomi Health Commercial |
$1,589.16
|
| Rate for Payer: PHP Commercial |
$1,647.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,686.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,298.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,705.44
|
| Rate for Payer: UHC Core |
$1,618.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.50
|
|
|
PR BREATH HYDROGEN/METHANE TEST
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 91065
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$1,135.85 |
| Rate for Payer: Aetna Commercial |
$78.39
|
| Rate for Payer: Aetna Medicare |
$60.84
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$58.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.85
|
| Rate for Payer: BCN Commercial |
$123.15
|
| Rate for Payer: BCN Medicare Advantage |
$58.50
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$84.24
|
| Rate for Payer: Cofinity Commercial |
$78.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.50
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.42
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Nomi Health Commercial |
$70.20
|
| Rate for Payer: PACE SWMI |
$58.50
|
| Rate for Payer: PHP Medicare Advantage |
$58.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.55
|
| Rate for Payer: Priority Health HMO/PPO |
$13.11
|
| Rate for Payer: Priority Health Medicare |
$59.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.50
|
| Rate for Payer: UHC Exchange |
$58.50
|
| Rate for Payer: UHC Medicare Advantage |
$58.50
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
|
|
PR BREATHING RESPONSE TO HYPOXIA
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 94450
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Aetna Commercial |
$105.85
|
| Rate for Payer: Aetna Medicare |
$82.15
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$78.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.66
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$78.99
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$105.85
|
| Rate for Payer: Cofinity Commercial |
$113.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.99
|
| Rate for Payer: Mclaren Medicaid |
$12.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.94
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Nomi Health Commercial |
$94.79
|
| Rate for Payer: PACE SWMI |
$78.99
|
| Rate for Payer: PHP Medicare Advantage |
$78.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO |
$25.78
|
| Rate for Payer: Priority Health Medicare |
$79.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.99
|
| Rate for Payer: UHC Exchange |
$78.99
|
| Rate for Payer: UHC Medicare Advantage |
$78.99
|
| Rate for Payer: UHCCP Medicaid |
$12.57
|
|
|
PR BRIEF CHECK IN BY MD/QHP
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS G2012
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$403.09 |
| Rate for Payer: Aetna Commercial |
$13.03
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$403.09
|
| Rate for Payer: BCN Commercial |
$20.53
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO |
$17.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.05
|
|
|
PR BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 98016
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$19.15
|
| Rate for Payer: Aetna Medicare |
$14.86
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$14.29
|
| Rate for Payer: BCN Medicare Advantage |
$14.29
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.29
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.00
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: Nomi Health Commercial |
$17.15
|
| Rate for Payer: PACE SWMI |
$14.29
|
| Rate for Payer: PHP Medicare Advantage |
$14.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$14.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.29
|
| Rate for Payer: UHC Exchange |
$14.29
|
| Rate for Payer: UHC Medicare Advantage |
$14.29
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
|
|
PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 94060
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$1,399.47 |
| Rate for Payer: Aetna Commercial |
$47.28
|
| Rate for Payer: Aetna Commercial |
$47.28
|
| Rate for Payer: Aetna Medicare |
$36.69
|
| Rate for Payer: Aetna Medicare |
$36.69
|
| Rate for Payer: BCBS Complete |
$6.71
|
| Rate for Payer: BCBS Complete |
$6.71
|
| Rate for Payer: BCBS MAPPO |
$35.28
|
| Rate for Payer: BCBS MAPPO |
$35.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,399.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,399.47
|
| Rate for Payer: BCN Commercial |
$56.19
|
| Rate for Payer: BCN Commercial |
$56.19
|
| Rate for Payer: BCN Medicare Advantage |
$35.28
|
| Rate for Payer: BCN Medicare Advantage |
$35.28
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$50.80
|
| Rate for Payer: Cofinity Commercial |
$47.28
|
| Rate for Payer: Cofinity Commercial |
$50.80
|
| Rate for Payer: Cofinity Commercial |
$47.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.28
|
| Rate for Payer: Mclaren Medicaid |
$6.39
|
| Rate for Payer: Mclaren Medicaid |
$6.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.04
|
| Rate for Payer: Meridian Medicaid |
$6.71
|
| Rate for Payer: Meridian Medicaid |
$6.71
|
| Rate for Payer: Nomi Health Commercial |
$42.34
|
| Rate for Payer: Nomi Health Commercial |
$42.34
|
| Rate for Payer: PACE SWMI |
$35.28
|
| Rate for Payer: PACE SWMI |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$35.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO |
$18.98
|
| Rate for Payer: Priority Health HMO/PPO |
$18.98
|
| Rate for Payer: Priority Health Medicare |
$35.63
|
| Rate for Payer: Priority Health Medicare |
$35.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.28
|
| Rate for Payer: UHC Exchange |
$35.28
|
| Rate for Payer: UHC Exchange |
$35.28
|
| Rate for Payer: UHC Medicare Advantage |
$35.28
|
| Rate for Payer: UHC Medicare Advantage |
$35.28
|
| Rate for Payer: UHCCP Medicaid |
$6.39
|
| Rate for Payer: UHCCP Medicaid |
$6.39
|
|
|
PR BRNCHSC BRUSHING/PROTECTED BRUSHINGS
|
Professional
|
Both
|
$649.00
|
|
|
Service Code
|
HCPCS 31623
|
| Min. Negotiated Rate |
$82.64 |
| Max. Negotiated Rate |
$720.60 |
| Rate for Payer: Aetna Commercial |
$165.97
|
| Rate for Payer: Aetna Medicare |
$128.81
|
| Rate for Payer: BCBS Complete |
$86.77
|
| Rate for Payer: BCBS MAPPO |
$123.86
|
| Rate for Payer: BCBS Trust/PPO |
$720.60
|
| Rate for Payer: BCN Commercial |
$399.74
|
| Rate for Payer: BCN Medicare Advantage |
$123.86
|
| Rate for Payer: Cash Price |
$519.20
|
| Rate for Payer: Cash Price |
$519.20
|
| Rate for Payer: Cofinity Commercial |
$178.36
|
| Rate for Payer: Cofinity Commercial |
$165.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.86
|
| Rate for Payer: Mclaren Medicaid |
$82.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.05
|
| Rate for Payer: Meridian Medicaid |
$86.77
|
| Rate for Payer: Nomi Health Commercial |
$148.63
|
| Rate for Payer: PACE SWMI |
$123.86
|
| Rate for Payer: PHP Medicare Advantage |
$123.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.85
|
| Rate for Payer: Priority Health HMO/PPO |
$179.36
|
| Rate for Payer: Priority Health Medicare |
$125.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.86
|
| Rate for Payer: UHC Exchange |
$123.86
|
| Rate for Payer: UHC Medicare Advantage |
$123.86
|
| Rate for Payer: UHCCP Medicaid |
$82.64
|
|
|
PR BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 31652
|
| Min. Negotiated Rate |
$138.02 |
| Max. Negotiated Rate |
$1,843.29 |
| Rate for Payer: Aetna Commercial |
$277.96
|
| Rate for Payer: Aetna Medicare |
$215.73
|
| Rate for Payer: BCBS Complete |
$144.92
|
| Rate for Payer: BCBS MAPPO |
$207.43
|
| Rate for Payer: BCBS Trust/PPO |
$853.73
|
| Rate for Payer: BCN Commercial |
$1,843.29
|
| Rate for Payer: BCN Medicare Advantage |
$207.43
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$298.70
|
| Rate for Payer: Cofinity Commercial |
$277.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.43
|
| Rate for Payer: Mclaren Medicaid |
$138.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.80
|
| Rate for Payer: Meridian Medicaid |
$144.92
|
| Rate for Payer: Nomi Health Commercial |
$248.92
|
| Rate for Payer: PACE SWMI |
$207.43
|
| Rate for Payer: PHP Medicare Advantage |
$207.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.30
|
| Rate for Payer: Priority Health HMO/PPO |
$298.93
|
| Rate for Payer: Priority Health Medicare |
$209.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.43
|
| Rate for Payer: UHC Exchange |
$207.43
|
| Rate for Payer: UHC Medicare Advantage |
$207.43
|
| Rate for Payer: UHCCP Medicaid |
$138.02
|
|
|
PR BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX
|
Professional
|
Both
|
$532.00
|
|
|
Service Code
|
HCPCS 31653
|
| Min. Negotiated Rate |
$152.93 |
| Max. Negotiated Rate |
$1,916.10 |
| Rate for Payer: Aetna Commercial |
$308.21
|
| Rate for Payer: Aetna Medicare |
$239.21
|
| Rate for Payer: BCBS Complete |
$160.58
|
| Rate for Payer: BCBS MAPPO |
$230.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,172.30
|
| Rate for Payer: BCN Commercial |
$1,916.10
|
| Rate for Payer: BCN Medicare Advantage |
$230.01
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$331.21
|
| Rate for Payer: Cofinity Commercial |
$308.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.01
|
| Rate for Payer: Mclaren Medicaid |
$152.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.51
|
| Rate for Payer: Meridian Medicaid |
$160.58
|
| Rate for Payer: Nomi Health Commercial |
$276.01
|
| Rate for Payer: PACE SWMI |
$230.01
|
| Rate for Payer: PHP Medicare Advantage |
$230.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.80
|
| Rate for Payer: Priority Health HMO/PPO |
$331.38
|
| Rate for Payer: Priority Health Medicare |
$232.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.01
|
| Rate for Payer: UHC Exchange |
$230.01
|
| Rate for Payer: UHC Medicare Advantage |
$230.01
|
| Rate for Payer: UHCCP Medicaid |
$152.93
|
|
|
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 31622
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$397.64 |
| Rate for Payer: Aetna Commercial |
$167.06
|
| Rate for Payer: Aetna Medicare |
$129.66
|
| Rate for Payer: BCBS Complete |
$87.22
|
| Rate for Payer: BCBS MAPPO |
$124.67
|
| Rate for Payer: BCBS Trust/PPO |
$372.29
|
| Rate for Payer: BCN Commercial |
$397.64
|
| Rate for Payer: BCN Medicare Advantage |
$124.67
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$179.52
|
| Rate for Payer: Cofinity Commercial |
$167.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.67
|
| Rate for Payer: Mclaren Medicaid |
$83.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.90
|
| Rate for Payer: Meridian Medicaid |
$87.22
|
| Rate for Payer: Nomi Health Commercial |
$149.60
|
| Rate for Payer: PACE SWMI |
$124.67
|
| Rate for Payer: PHP Medicare Advantage |
$124.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO |
$180.75
|
| Rate for Payer: Priority Health Medicare |
$125.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.67
|
| Rate for Payer: UHC Exchange |
$124.67
|
| Rate for Payer: UHC Medicare Advantage |
$124.67
|
| Rate for Payer: UHCCP Medicaid |
$83.07
|
|
|
PR BRNCHSC W/BRNCL ALVEOLAR LAVAGE
|
Professional
|
Both
|
$605.00
|
|
|
Service Code
|
HCPCS 31624
|
| Min. Negotiated Rate |
$83.92 |
| Max. Negotiated Rate |
$1,147.47 |
| Rate for Payer: Aetna Commercial |
$168.45
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: BCBS Complete |
$88.12
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.47
|
| Rate for Payer: BCN Commercial |
$371.40
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cofinity Commercial |
$181.02
|
| Rate for Payer: Cofinity Commercial |
$168.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Mclaren Medicaid |
$83.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$88.12
|
| Rate for Payer: Nomi Health Commercial |
$150.85
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.25
|
| Rate for Payer: Priority Health HMO/PPO |
$181.68
|
| Rate for Payer: Priority Health Medicare |
$126.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$125.71
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$83.92
|
|
|
PR BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 31630
|
| Min. Negotiated Rate |
$124.61 |
| Max. Negotiated Rate |
$786.64 |
| Rate for Payer: Aetna Commercial |
$251.04
|
| Rate for Payer: Aetna Medicare |
$194.83
|
| Rate for Payer: BCBS Complete |
$130.84
|
| Rate for Payer: BCBS MAPPO |
$187.34
|
| Rate for Payer: BCBS Trust/PPO |
$786.64
|
| Rate for Payer: BCN Commercial |
$283.43
|
| Rate for Payer: BCN Medicare Advantage |
$187.34
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$269.77
|
| Rate for Payer: Cofinity Commercial |
$251.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.34
|
| Rate for Payer: Mclaren Medicaid |
$124.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.71
|
| Rate for Payer: Meridian Medicaid |
$130.84
|
| Rate for Payer: Nomi Health Commercial |
$224.81
|
| Rate for Payer: PACE SWMI |
$187.34
|
| Rate for Payer: PHP Medicare Advantage |
$187.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO |
$269.73
|
| Rate for Payer: Priority Health Medicare |
$189.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.34
|
| Rate for Payer: UHC Exchange |
$187.34
|
| Rate for Payer: UHC Medicare Advantage |
$187.34
|
| Rate for Payer: UHCCP Medicaid |
$124.61
|
|
|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 94070
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$1,284.30 |
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: Aetna Medicare |
$60.37
|
| Rate for Payer: Aetna Medicare |
$60.37
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS MAPPO |
$58.05
|
| Rate for Payer: BCBS MAPPO |
$58.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,284.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,284.30
|
| Rate for Payer: BCN Commercial |
$88.94
|
| Rate for Payer: BCN Commercial |
$88.94
|
| Rate for Payer: BCN Medicare Advantage |
$58.05
|
| Rate for Payer: BCN Medicare Advantage |
$58.05
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$77.79
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$77.79
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.05
|
| Rate for Payer: Mclaren Medicaid |
$17.25
|
| Rate for Payer: Mclaren Medicaid |
$17.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.95
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Nomi Health Commercial |
$69.66
|
| Rate for Payer: Nomi Health Commercial |
$69.66
|
| Rate for Payer: PACE SWMI |
$58.05
|
| Rate for Payer: PACE SWMI |
$58.05
|
| Rate for Payer: PHP Medicare Advantage |
$58.05
|
| Rate for Payer: PHP Medicare Advantage |
$58.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health HMO/PPO |
$36.63
|
| Rate for Payer: Priority Health HMO/PPO |
$36.63
|
| Rate for Payer: Priority Health Medicare |
$58.63
|
| Rate for Payer: Priority Health Medicare |
$58.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.05
|
| Rate for Payer: UHC Exchange |
$58.05
|
| Rate for Payer: UHC Exchange |
$58.05
|
| Rate for Payer: UHC Medicare Advantage |
$58.05
|
| Rate for Payer: UHC Medicare Advantage |
$58.05
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
|
|
PR BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 31654
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$791.92 |
| Rate for Payer: Aetna Commercial |
$84.27
|
| Rate for Payer: Aetna Medicare |
$65.41
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS MAPPO |
$62.89
|
| Rate for Payer: BCBS Trust/PPO |
$791.92
|
| Rate for Payer: BCN Commercial |
$174.95
|
| Rate for Payer: BCN Medicare Advantage |
$62.89
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$90.56
|
| Rate for Payer: Cofinity Commercial |
$84.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.89
|
| Rate for Payer: Mclaren Medicaid |
$41.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.03
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Nomi Health Commercial |
$75.47
|
| Rate for Payer: PACE SWMI |
$62.89
|
| Rate for Payer: PHP Medicare Advantage |
$62.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health HMO/PPO |
$90.83
|
| Rate for Payer: Priority Health Medicare |
$63.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.89
|
| Rate for Payer: UHC Exchange |
$62.89
|
| Rate for Payer: UHC Medicare Advantage |
$62.89
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
|
|
PR BRONCHOPLASTY GRAFT REPAIR
|
Professional
|
Both
|
$2,953.00
|
|
|
Service Code
|
HCPCS 31770
|
| Min. Negotiated Rate |
$838.58 |
| Max. Negotiated Rate |
$1,919.45 |
| Rate for Payer: Aetna Commercial |
$1,710.70
|
| Rate for Payer: Aetna Medicare |
$1,327.71
|
| Rate for Payer: BCBS Complete |
$880.51
|
| Rate for Payer: BCBS MAPPO |
$1,276.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,379.92
|
| Rate for Payer: BCN Commercial |
$1,909.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,276.64
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,838.36
|
| Rate for Payer: Cofinity Commercial |
$1,710.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,276.64
|
| Rate for Payer: Mclaren Medicaid |
$838.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,340.47
|
| Rate for Payer: Meridian Medicaid |
$880.51
|
| Rate for Payer: Nomi Health Commercial |
$1,531.97
|
| Rate for Payer: PACE SWMI |
$1,276.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,276.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$838.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,919.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,818.64
|
| Rate for Payer: Priority Health Medicare |
$1,289.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,818.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,276.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,276.64
|
| Rate for Payer: UHC Exchange |
$1,276.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,276.64
|
| Rate for Payer: UHCCP Medicaid |
$838.58
|
|
|
PR BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS 31625
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$508.71 |
| Rate for Payer: Aetna Commercial |
$196.14
|
| Rate for Payer: Aetna Medicare |
$152.22
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$146.37
|
| Rate for Payer: BCBS Trust/PPO |
$463.32
|
| Rate for Payer: BCN Commercial |
$508.71
|
| Rate for Payer: BCN Medicare Advantage |
$146.37
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cofinity Commercial |
$210.77
|
| Rate for Payer: Cofinity Commercial |
$196.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.37
|
| Rate for Payer: Mclaren Medicaid |
$97.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.69
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Nomi Health Commercial |
$175.64
|
| Rate for Payer: PACE SWMI |
$146.37
|
| Rate for Payer: PHP Medicare Advantage |
$146.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.20
|
| Rate for Payer: Priority Health HMO/PPO |
$212.27
|
| Rate for Payer: Priority Health Medicare |
$147.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.37
|
| Rate for Payer: UHC Exchange |
$146.37
|
| Rate for Payer: UHC Medicare Advantage |
$146.37
|
| Rate for Payer: UHCCP Medicaid |
$97.55
|
|
|
PR BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
HCPCS 31629
|
| Min. Negotiated Rate |
$116.94 |
| Max. Negotiated Rate |
$818.35 |
| Rate for Payer: Aetna Commercial |
$235.33
|
| Rate for Payer: Aetna Medicare |
$182.64
|
| Rate for Payer: BCBS Complete |
$122.79
|
| Rate for Payer: BCBS MAPPO |
$175.62
|
| Rate for Payer: BCBS Trust/PPO |
$499.77
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$175.62
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cofinity Commercial |
$252.89
|
| Rate for Payer: Cofinity Commercial |
$235.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.62
|
| Rate for Payer: Mclaren Medicaid |
$116.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.40
|
| Rate for Payer: Meridian Medicaid |
$122.79
|
| Rate for Payer: Nomi Health Commercial |
$210.74
|
| Rate for Payer: PACE SWMI |
$175.62
|
| Rate for Payer: PHP Medicare Advantage |
$175.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.35
|
| Rate for Payer: Priority Health HMO/PPO |
$253.51
|
| Rate for Payer: Priority Health Medicare |
$177.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.62
|
| Rate for Payer: UHC Exchange |
$175.62
|
| Rate for Payer: UHC Medicare Advantage |
$175.62
|
| Rate for Payer: UHCCP Medicaid |
$116.94
|
|
|
PR BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 31627
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$1,591.62 |
| Rate for Payer: Aetna Commercial |
$121.34
|
| Rate for Payer: Aetna Medicare |
$94.17
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCBS MAPPO |
$90.55
|
| Rate for Payer: BCBS Trust/PPO |
$684.15
|
| Rate for Payer: BCN Commercial |
$1,591.62
|
| Rate for Payer: BCN Medicare Advantage |
$90.55
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$130.39
|
| Rate for Payer: Cofinity Commercial |
$121.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.55
|
| Rate for Payer: Mclaren Medicaid |
$60.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.08
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Nomi Health Commercial |
$108.66
|
| Rate for Payer: PACE SWMI |
$90.55
|
| Rate for Payer: PHP Medicare Advantage |
$90.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.45
|
| Rate for Payer: Priority Health HMO/PPO |
$130.70
|
| Rate for Payer: Priority Health Medicare |
$91.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.55
|
| Rate for Payer: UHC Exchange |
$90.55
|
| Rate for Payer: UHC Medicare Advantage |
$90.55
|
| Rate for Payer: UHCCP Medicaid |
$60.07
|
|
|
PR BRONCHOSCOPY W/EXCISION TUMOR
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 31640
|
| Min. Negotiated Rate |
$154.21 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna Commercial |
$310.36
|
| Rate for Payer: Aetna Medicare |
$240.87
|
| Rate for Payer: BCBS Complete |
$161.92
|
| Rate for Payer: BCBS MAPPO |
$231.61
|
| Rate for Payer: BCBS Trust/PPO |
$852.15
|
| Rate for Payer: BCN Commercial |
$354.29
|
| Rate for Payer: BCN Medicare Advantage |
$231.61
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$333.52
|
| Rate for Payer: Cofinity Commercial |
$310.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.61
|
| Rate for Payer: Mclaren Medicaid |
$154.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.19
|
| Rate for Payer: Meridian Medicaid |
$161.92
|
| Rate for Payer: Nomi Health Commercial |
$277.93
|
| Rate for Payer: PACE SWMI |
$231.61
|
| Rate for Payer: PHP Medicare Advantage |
$231.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health HMO/PPO |
$335.55
|
| Rate for Payer: Priority Health Medicare |
$233.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.61
|
| Rate for Payer: UHC Exchange |
$231.61
|
| Rate for Payer: UHC Medicare Advantage |
$231.61
|
| Rate for Payer: UHCCP Medicaid |
$154.21
|
|
