|
PR BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 31631
|
| Min. Negotiated Rate |
$142.07 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: Aetna Commercial |
$285.98
|
| Rate for Payer: Aetna Medicare |
$221.96
|
| Rate for Payer: BCBS Complete |
$149.17
|
| Rate for Payer: BCBS MAPPO |
$213.42
|
| Rate for Payer: BCN Commercial |
$323.50
|
| Rate for Payer: BCN Medicare Advantage |
$213.42
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$307.32
|
| Rate for Payer: Cofinity Commercial |
$285.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.42
|
| Rate for Payer: Mclaren Medicaid |
$142.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.09
|
| Rate for Payer: Meridian Medicaid |
$149.17
|
| Rate for Payer: Nomi Health Commercial |
$256.10
|
| Rate for Payer: PACE SWMI |
$213.42
|
| Rate for Payer: PHP Medicare Advantage |
$213.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO |
$307.28
|
| Rate for Payer: Priority Health Medicare |
$215.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.42
|
| Rate for Payer: UHC Exchange |
$213.42
|
| Rate for Payer: UHC Medicare Advantage |
$213.42
|
| Rate for Payer: UHCCP Medicaid |
$142.07
|
|
|
PR BRONCHOSCOPY W/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 31635
|
| Min. Negotiated Rate |
$109.91 |
| Max. Negotiated Rate |
$972.60 |
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: Aetna Medicare |
$171.55
|
| Rate for Payer: BCBS Complete |
$115.41
|
| Rate for Payer: BCBS MAPPO |
$164.95
|
| Rate for Payer: BCBS Trust/PPO |
$972.60
|
| Rate for Payer: BCN Commercial |
$425.15
|
| Rate for Payer: BCN Medicare Advantage |
$164.95
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$237.53
|
| Rate for Payer: Cofinity Commercial |
$221.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.95
|
| Rate for Payer: Mclaren Medicaid |
$109.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.20
|
| Rate for Payer: Meridian Medicaid |
$115.41
|
| Rate for Payer: Nomi Health Commercial |
$197.94
|
| Rate for Payer: PACE SWMI |
$164.95
|
| Rate for Payer: PHP Medicare Advantage |
$164.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.05
|
| Rate for Payer: Priority Health HMO/PPO |
$238.68
|
| Rate for Payer: Priority Health Medicare |
$166.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.95
|
| Rate for Payer: UHC Exchange |
$164.95
|
| Rate for Payer: UHC Medicare Advantage |
$164.95
|
| Rate for Payer: UHCCP Medicaid |
$109.91
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 31645
|
| Min. Negotiated Rate |
$92.23 |
| Max. Negotiated Rate |
$667.24 |
| Rate for Payer: Aetna Commercial |
$185.27
|
| Rate for Payer: Aetna Medicare |
$143.79
|
| Rate for Payer: BCBS Complete |
$96.84
|
| Rate for Payer: BCBS MAPPO |
$138.26
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$397.30
|
| Rate for Payer: BCN Medicare Advantage |
$138.26
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cofinity Commercial |
$199.09
|
| Rate for Payer: Cofinity Commercial |
$185.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.26
|
| Rate for Payer: Mclaren Medicaid |
$92.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.17
|
| Rate for Payer: Meridian Medicaid |
$96.84
|
| Rate for Payer: Nomi Health Commercial |
$165.91
|
| Rate for Payer: PACE SWMI |
$138.26
|
| Rate for Payer: PHP Medicare Advantage |
$138.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.85
|
| Rate for Payer: Priority Health HMO/PPO |
$200.21
|
| Rate for Payer: Priority Health Medicare |
$139.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.26
|
| Rate for Payer: UHC Exchange |
$138.26
|
| Rate for Payer: UHC Medicare Advantage |
$138.26
|
| Rate for Payer: UHCCP Medicaid |
$92.23
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 31646
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,008.00 |
| Rate for Payer: Aetna Commercial |
$179.64
|
| Rate for Payer: Aetna Medicare |
$139.42
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$134.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.00
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: BCN Medicare Advantage |
$134.06
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$193.05
|
| Rate for Payer: Cofinity Commercial |
$179.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.06
|
| Rate for Payer: Mclaren Medicaid |
$89.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.76
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Nomi Health Commercial |
$160.87
|
| Rate for Payer: PACE SWMI |
$134.06
|
| Rate for Payer: PHP Medicare Advantage |
$134.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.10
|
| Rate for Payer: Priority Health HMO/PPO |
$193.27
|
| Rate for Payer: Priority Health Medicare |
$135.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.06
|
| Rate for Payer: UHC Exchange |
$134.06
|
| Rate for Payer: UHC Medicare Advantage |
$134.06
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 31628
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$915.54 |
| Rate for Payer: Aetna Commercial |
$220.35
|
| Rate for Payer: Aetna Medicare |
$171.02
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$164.44
|
| Rate for Payer: BCBS Trust/PPO |
$915.54
|
| Rate for Payer: BCN Commercial |
$597.26
|
| Rate for Payer: BCN Medicare Advantage |
$164.44
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$236.79
|
| Rate for Payer: Cofinity Commercial |
$220.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.44
|
| Rate for Payer: Mclaren Medicaid |
$109.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.66
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Nomi Health Commercial |
$197.33
|
| Rate for Payer: PACE SWMI |
$164.44
|
| Rate for Payer: PHP Medicare Advantage |
$164.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health HMO/PPO |
$238.68
|
| Rate for Payer: Priority Health Medicare |
$166.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.44
|
| Rate for Payer: UHC Exchange |
$164.44
|
| Rate for Payer: UHC Medicare Advantage |
$164.44
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 31632
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$996.90 |
| Rate for Payer: Aetna Commercial |
$60.96
|
| Rate for Payer: Aetna Medicare |
$47.31
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS MAPPO |
$45.49
|
| Rate for Payer: BCBS Trust/PPO |
$996.90
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$45.49
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$65.51
|
| Rate for Payer: Cofinity Commercial |
$60.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.49
|
| Rate for Payer: Mclaren Medicaid |
$30.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.76
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Nomi Health Commercial |
$54.59
|
| Rate for Payer: PACE SWMI |
$45.49
|
| Rate for Payer: PHP Medicare Advantage |
$45.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.85
|
| Rate for Payer: Priority Health HMO/PPO |
$66.27
|
| Rate for Payer: Priority Health Medicare |
$45.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.49
|
| Rate for Payer: UHC Exchange |
$45.49
|
| Rate for Payer: UHC Medicare Advantage |
$45.49
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 31633
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$724.83 |
| Rate for Payer: Aetna Commercial |
$79.62
|
| Rate for Payer: Aetna Medicare |
$61.80
|
| Rate for Payer: BCBS Complete |
$41.38
|
| Rate for Payer: BCBS MAPPO |
$59.42
|
| Rate for Payer: BCBS Trust/PPO |
$724.83
|
| Rate for Payer: BCN Commercial |
$115.82
|
| Rate for Payer: BCN Medicare Advantage |
$59.42
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$85.56
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.42
|
| Rate for Payer: Mclaren Medicaid |
$39.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.39
|
| Rate for Payer: Meridian Medicaid |
$41.38
|
| Rate for Payer: Nomi Health Commercial |
$71.30
|
| Rate for Payer: PACE SWMI |
$59.42
|
| Rate for Payer: PHP Medicare Advantage |
$59.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.35
|
| Rate for Payer: Priority Health HMO/PPO |
$85.28
|
| Rate for Payer: Priority Health Medicare |
$60.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.42
|
| Rate for Payer: UHC Exchange |
$59.42
|
| Rate for Payer: UHC Medicare Advantage |
$59.42
|
| Rate for Payer: UHCCP Medicaid |
$39.41
|
|
|
PR BROWLIFT
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 00532
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,060.80 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: BCBS Complete |
$1,060.80
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
|
|
PR BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY
|
Professional
|
Both
|
$5,993.00
|
|
|
Service Code
|
HCPCS 58954
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$3,895.45 |
| Rate for Payer: Aetna Commercial |
$2,792.36
|
| Rate for Payer: Aetna Medicare |
$2,167.20
|
| Rate for Payer: BCBS Complete |
$1,459.98
|
| Rate for Payer: BCBS MAPPO |
$2,083.85
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$3,158.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,083.85
|
| Rate for Payer: Cash Price |
$4,794.40
|
| Rate for Payer: Cash Price |
$4,794.40
|
| Rate for Payer: Cofinity Commercial |
$3,000.74
|
| Rate for Payer: Cofinity Commercial |
$2,792.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,083.85
|
| Rate for Payer: Mclaren Medicaid |
$1,390.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,188.04
|
| Rate for Payer: Meridian Medicaid |
$1,459.98
|
| Rate for Payer: Nomi Health Commercial |
$2,500.62
|
| Rate for Payer: PACE SWMI |
$2,083.85
|
| Rate for Payer: PHP Medicare Advantage |
$2,083.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,390.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,895.45
|
| Rate for Payer: Priority Health HMO/PPO |
$3,235.71
|
| Rate for Payer: Priority Health Medicare |
$2,104.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,235.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,083.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,083.85
|
| Rate for Payer: UHC Exchange |
$2,083.85
|
| Rate for Payer: UHC Medicare Advantage |
$2,083.85
|
| Rate for Payer: UHCCP Medicaid |
$1,390.46
|
|
|
PR BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION
|
Professional
|
Both
|
$5,240.00
|
|
|
Service Code
|
HCPCS 58953
|
| Min. Negotiated Rate |
$131.55 |
| Max. Negotiated Rate |
$3,406.00 |
| Rate for Payer: Aetna Commercial |
$2,578.79
|
| Rate for Payer: Aetna Medicare |
$2,001.45
|
| Rate for Payer: BCBS Complete |
$1,349.06
|
| Rate for Payer: BCBS MAPPO |
$1,924.47
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCN Commercial |
$2,921.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,924.47
|
| Rate for Payer: Cash Price |
$4,192.00
|
| Rate for Payer: Cash Price |
$4,192.00
|
| Rate for Payer: Cofinity Commercial |
$2,771.24
|
| Rate for Payer: Cofinity Commercial |
$2,578.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,924.47
|
| Rate for Payer: Mclaren Medicaid |
$1,284.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,020.69
|
| Rate for Payer: Meridian Medicaid |
$1,349.06
|
| Rate for Payer: Nomi Health Commercial |
$2,309.36
|
| Rate for Payer: PACE SWMI |
$1,924.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,924.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,284.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,406.00
|
| Rate for Payer: Priority Health HMO/PPO |
$2,990.17
|
| Rate for Payer: Priority Health Medicare |
$1,943.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,990.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,924.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,924.47
|
| Rate for Payer: UHC Exchange |
$1,924.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,924.47
|
| Rate for Payer: UHCCP Medicaid |
$1,284.82
|
|
|
PR BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC
|
Professional
|
Both
|
$2,430.00
|
|
|
Service Code
|
HCPCS 58956
|
| Min. Negotiated Rate |
$502.94 |
| Max. Negotiated Rate |
$2,035.29 |
| Rate for Payer: Aetna Commercial |
$1,753.00
|
| Rate for Payer: Aetna Medicare |
$1,360.54
|
| Rate for Payer: BCBS Complete |
$918.31
|
| Rate for Payer: BCBS MAPPO |
$1,308.21
|
| Rate for Payer: BCBS Trust/PPO |
$502.94
|
| Rate for Payer: BCN Commercial |
$1,986.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,308.21
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Cofinity Commercial |
$1,883.82
|
| Rate for Payer: Cofinity Commercial |
$1,753.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,308.21
|
| Rate for Payer: Mclaren Medicaid |
$874.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,373.62
|
| Rate for Payer: Meridian Medicaid |
$918.31
|
| Rate for Payer: Nomi Health Commercial |
$1,569.85
|
| Rate for Payer: PACE SWMI |
$1,308.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,308.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$874.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,579.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,035.29
|
| Rate for Payer: Priority Health Medicare |
$1,321.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,035.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,308.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,308.21
|
| Rate for Payer: UHC Exchange |
$1,308.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,308.21
|
| Rate for Payer: UHCCP Medicaid |
$874.58
|
|
|
PR BUDESONIDE NON-COMP UNIT
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS J7626
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$5.85 |
| Rate for Payer: Aetna Commercial |
$1.71
|
| Rate for Payer: Aetna Medicare |
$1.33
|
| Rate for Payer: BCBS Complete |
$3.60
|
| Rate for Payer: BCBS MAPPO |
$1.28
|
| Rate for Payer: BCN Commercial |
$0.07
|
| Rate for Payer: BCN Medicare Advantage |
$1.28
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$1.84
|
| Rate for Payer: Cofinity Commercial |
$1.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.34
|
| Rate for Payer: Nomi Health Commercial |
$1.53
|
| Rate for Payer: PACE SWMI |
$1.28
|
| Rate for Payer: PHP Medicare Advantage |
$1.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.85
|
| Rate for Payer: Priority Health Medicare |
$1.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.28
|
| Rate for Payer: UHC Exchange |
$1.28
|
| Rate for Payer: UHC Medicare Advantage |
$1.28
|
|
|
PR BURR HOLE FOR VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$1,871.00
|
|
|
Service Code
|
HCPCS 61120
|
| Min. Negotiated Rate |
$493.73 |
| Max. Negotiated Rate |
$1,670.48 |
| Rate for Payer: Aetna Commercial |
$997.19
|
| Rate for Payer: Aetna Medicare |
$773.94
|
| Rate for Payer: BCBS Complete |
$518.42
|
| Rate for Payer: BCBS MAPPO |
$744.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.48
|
| Rate for Payer: BCN Commercial |
$1,112.23
|
| Rate for Payer: BCN Medicare Advantage |
$744.17
|
| Rate for Payer: Cash Price |
$1,496.80
|
| Rate for Payer: Cash Price |
$1,496.80
|
| Rate for Payer: Cofinity Commercial |
$997.19
|
| Rate for Payer: Cofinity Commercial |
$1,071.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$744.17
|
| Rate for Payer: Mclaren Medicaid |
$493.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$781.38
|
| Rate for Payer: Meridian Medicaid |
$518.42
|
| Rate for Payer: Nomi Health Commercial |
$893.00
|
| Rate for Payer: PACE SWMI |
$744.17
|
| Rate for Payer: PHP Medicare Advantage |
$744.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$751.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,309.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$744.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$744.17
|
| Rate for Payer: UHC Exchange |
$744.17
|
| Rate for Payer: UHC Medicare Advantage |
$744.17
|
| Rate for Payer: UHCCP Medicaid |
$493.73
|
|
|
PR BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE
|
Professional
|
Both
|
$2,554.00
|
|
|
Service Code
|
HCPCS 61210
|
| Min. Negotiated Rate |
$235.79 |
| Max. Negotiated Rate |
$1,660.10 |
| Rate for Payer: Aetna Commercial |
$486.63
|
| Rate for Payer: Aetna Medicare |
$377.69
|
| Rate for Payer: BCBS Complete |
$247.58
|
| Rate for Payer: BCBS MAPPO |
$363.16
|
| Rate for Payer: BCBS Trust/PPO |
$324.90
|
| Rate for Payer: BCN Commercial |
$745.05
|
| Rate for Payer: BCN Medicare Advantage |
$363.16
|
| Rate for Payer: Cash Price |
$2,043.20
|
| Rate for Payer: Cash Price |
$2,043.20
|
| Rate for Payer: Cofinity Commercial |
$522.95
|
| Rate for Payer: Cofinity Commercial |
$486.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.16
|
| Rate for Payer: Mclaren Medicaid |
$235.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.32
|
| Rate for Payer: Meridian Medicaid |
$247.58
|
| Rate for Payer: Nomi Health Commercial |
$435.79
|
| Rate for Payer: PACE SWMI |
$363.16
|
| Rate for Payer: PHP Medicare Advantage |
$363.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,660.10
|
| Rate for Payer: Priority Health HMO/PPO |
$627.29
|
| Rate for Payer: Priority Health Medicare |
$366.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$627.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.16
|
| Rate for Payer: UHC Exchange |
$363.16
|
| Rate for Payer: UHC Medicare Advantage |
$363.16
|
| Rate for Payer: UHCCP Medicaid |
$235.79
|
|
|
PR BURR HOLE/TREPHINE STTL EXPL N/FLWD OTH SURG
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 61250
|
| Min. Negotiated Rate |
$570.41 |
| Max. Negotiated Rate |
$1,771.25 |
| Rate for Payer: Aetna Commercial |
$1,155.60
|
| Rate for Payer: Aetna Medicare |
$896.89
|
| Rate for Payer: BCBS Complete |
$598.93
|
| Rate for Payer: BCBS MAPPO |
$862.39
|
| Rate for Payer: BCBS Trust/PPO |
$918.19
|
| Rate for Payer: BCN Commercial |
$1,288.16
|
| Rate for Payer: BCN Medicare Advantage |
$862.39
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,241.84
|
| Rate for Payer: Cofinity Commercial |
$1,155.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.39
|
| Rate for Payer: Mclaren Medicaid |
$570.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.51
|
| Rate for Payer: Meridian Medicaid |
$598.93
|
| Rate for Payer: Nomi Health Commercial |
$1,034.87
|
| Rate for Payer: PACE SWMI |
$862.39
|
| Rate for Payer: PHP Medicare Advantage |
$862.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,512.79
|
| Rate for Payer: Priority Health Medicare |
$871.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,512.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$862.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$862.39
|
| Rate for Payer: UHC Exchange |
$862.39
|
| Rate for Payer: UHC Medicare Advantage |
$862.39
|
| Rate for Payer: UHCCP Medicaid |
$570.41
|
|
|
PR BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION
|
Professional
|
Both
|
$4,613.00
|
|
|
Service Code
|
HCPCS 61140
|
| Min. Negotiated Rate |
$832.83 |
| Max. Negotiated Rate |
$2,998.45 |
| Rate for Payer: Aetna Commercial |
$1,690.46
|
| Rate for Payer: Aetna Medicare |
$1,312.00
|
| Rate for Payer: BCBS Complete |
$874.47
|
| Rate for Payer: BCBS MAPPO |
$1,261.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,274.79
|
| Rate for Payer: BCN Commercial |
$2,604.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,261.54
|
| Rate for Payer: Cash Price |
$3,690.40
|
| Rate for Payer: Cash Price |
$3,690.40
|
| Rate for Payer: Cofinity Commercial |
$1,816.62
|
| Rate for Payer: Cofinity Commercial |
$1,690.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,261.54
|
| Rate for Payer: Mclaren Medicaid |
$832.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,324.62
|
| Rate for Payer: Meridian Medicaid |
$874.47
|
| Rate for Payer: Nomi Health Commercial |
$1,513.85
|
| Rate for Payer: PACE SWMI |
$1,261.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,261.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$832.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,998.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,213.44
|
| Rate for Payer: Priority Health Medicare |
$1,274.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,213.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,261.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,261.54
|
| Rate for Payer: UHC Exchange |
$1,261.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,261.54
|
| Rate for Payer: UHCCP Medicaid |
$832.83
|
|
|
PR BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST
|
Professional
|
Both
|
$4,121.00
|
|
|
Service Code
|
HCPCS 61150
|
| Min. Negotiated Rate |
$614.94 |
| Max. Negotiated Rate |
$2,768.67 |
| Rate for Payer: Aetna Commercial |
$1,798.49
|
| Rate for Payer: Aetna Medicare |
$1,395.85
|
| Rate for Payer: BCBS Complete |
$927.26
|
| Rate for Payer: BCBS MAPPO |
$1,342.16
|
| Rate for Payer: BCBS Trust/PPO |
$614.94
|
| Rate for Payer: BCN Commercial |
$2,768.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,342.16
|
| Rate for Payer: Cash Price |
$3,296.80
|
| Rate for Payer: Cash Price |
$3,296.80
|
| Rate for Payer: Cofinity Commercial |
$1,932.71
|
| Rate for Payer: Cofinity Commercial |
$1,798.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,342.16
|
| Rate for Payer: Mclaren Medicaid |
$883.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,409.27
|
| Rate for Payer: Meridian Medicaid |
$927.26
|
| Rate for Payer: Nomi Health Commercial |
$1,610.59
|
| Rate for Payer: PACE SWMI |
$1,342.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,342.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$883.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,678.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,344.81
|
| Rate for Payer: Priority Health Medicare |
$1,355.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,344.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,342.16
|
| Rate for Payer: UHC Exchange |
$1,342.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,342.16
|
| Rate for Payer: UHCCP Medicaid |
$883.10
|
|
|
PR BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL
|
Professional
|
Both
|
$3,685.00
|
|
|
Service Code
|
HCPCS 61156
|
| Min. Negotiated Rate |
$284.75 |
| Max. Negotiated Rate |
$2,525.30 |
| Rate for Payer: Aetna Commercial |
$1,652.78
|
| Rate for Payer: Aetna Medicare |
$1,282.76
|
| Rate for Payer: BCBS Complete |
$851.89
|
| Rate for Payer: BCBS MAPPO |
$1,233.42
|
| Rate for Payer: BCBS Trust/PPO |
$284.75
|
| Rate for Payer: BCN Commercial |
$2,525.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,233.42
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Cofinity Commercial |
$1,776.12
|
| Rate for Payer: Cofinity Commercial |
$1,652.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,233.42
|
| Rate for Payer: Mclaren Medicaid |
$811.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,295.09
|
| Rate for Payer: Meridian Medicaid |
$851.89
|
| Rate for Payer: Nomi Health Commercial |
$1,480.10
|
| Rate for Payer: PACE SWMI |
$1,233.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,233.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$811.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,395.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,152.58
|
| Rate for Payer: Priority Health Medicare |
$1,245.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,152.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,233.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,233.42
|
| Rate for Payer: UHC Exchange |
$1,233.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,233.42
|
| Rate for Payer: UHCCP Medicaid |
$811.32
|
|
|
PR BURR HOLE W/EVAC&/DRG HEMATOMA EXTRADURAL/SDRL
|
Professional
|
Both
|
$4,188.00
|
|
|
Service Code
|
HCPCS 61154
|
| Min. Negotiated Rate |
$757.05 |
| Max. Negotiated Rate |
$2,722.20 |
| Rate for Payer: Aetna Commercial |
$1,697.34
|
| Rate for Payer: Aetna Medicare |
$1,317.34
|
| Rate for Payer: BCBS Complete |
$879.16
|
| Rate for Payer: BCBS MAPPO |
$1,266.67
|
| Rate for Payer: BCBS Trust/PPO |
$757.05
|
| Rate for Payer: BCN Commercial |
$2,621.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,266.67
|
| Rate for Payer: Cash Price |
$3,350.40
|
| Rate for Payer: Cash Price |
$3,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,824.00
|
| Rate for Payer: Cofinity Commercial |
$1,697.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,266.67
|
| Rate for Payer: Mclaren Medicaid |
$837.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,330.00
|
| Rate for Payer: Meridian Medicaid |
$879.16
|
| Rate for Payer: Nomi Health Commercial |
$1,520.00
|
| Rate for Payer: PACE SWMI |
$1,266.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,266.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,722.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,224.24
|
| Rate for Payer: Priority Health Medicare |
$1,279.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,224.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,266.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,266.67
|
| Rate for Payer: UHC Exchange |
$1,266.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,266.67
|
| Rate for Payer: UHCCP Medicaid |
$837.30
|
|
|
PR BUTORPHANOL TARTRATE 1 MG
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS J0595
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$7.28 |
| Rate for Payer: Aetna Commercial |
$6.77
|
| Rate for Payer: Aetna Medicare |
$5.26
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$5.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.72
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: BCN Medicare Advantage |
$5.05
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$6.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.31
|
| Rate for Payer: Nomi Health Commercial |
$6.06
|
| Rate for Payer: PACE SWMI |
$5.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.05
|
| Rate for Payer: UHC Exchange |
$5.05
|
| Rate for Payer: UHC Medicare Advantage |
$5.05
|
|
|
PR BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 49180
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$553.66 |
| Rate for Payer: Aetna Commercial |
$104.95
|
| Rate for Payer: Aetna Medicare |
$81.45
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$78.32
|
| Rate for Payer: BCBS Trust/PPO |
$553.66
|
| Rate for Payer: BCN Commercial |
$256.56
|
| Rate for Payer: BCN Medicare Advantage |
$78.32
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cofinity Commercial |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.32
|
| Rate for Payer: Mclaren Medicaid |
$51.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.24
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Nomi Health Commercial |
$93.98
|
| Rate for Payer: PACE SWMI |
$78.32
|
| Rate for Payer: PHP Medicare Advantage |
$78.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.00
|
| Rate for Payer: Priority Health HMO/PPO |
$144.38
|
| Rate for Payer: Priority Health Medicare |
$79.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.32
|
| Rate for Payer: UHC Exchange |
$78.32
|
| Rate for Payer: UHC Medicare Advantage |
$78.32
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR BX ANORECTAL WALL ANAL APPROACH
|
Professional
|
Both
|
$769.00
|
|
|
Service Code
|
HCPCS 45100
|
| Min. Negotiated Rate |
$196.81 |
| Max. Negotiated Rate |
$547.67 |
| Rate for Payer: Aetna Commercial |
$388.84
|
| Rate for Payer: Aetna Medicare |
$301.79
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$290.18
|
| Rate for Payer: BCBS Trust/PPO |
$534.64
|
| Rate for Payer: BCN Commercial |
$443.72
|
| Rate for Payer: BCN Medicare Advantage |
$290.18
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cofinity Commercial |
$417.86
|
| Rate for Payer: Cofinity Commercial |
$388.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.18
|
| Rate for Payer: Mclaren Medicaid |
$196.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.69
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Nomi Health Commercial |
$348.22
|
| Rate for Payer: PACE SWMI |
$290.18
|
| Rate for Payer: PHP Medicare Advantage |
$290.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.85
|
| Rate for Payer: Priority Health HMO/PPO |
$547.67
|
| Rate for Payer: Priority Health Medicare |
$293.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.18
|
| Rate for Payer: UHC Exchange |
$290.18
|
| Rate for Payer: UHC Medicare Advantage |
$290.18
|
| Rate for Payer: UHCCP Medicaid |
$196.81
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 19100
|
| Hospital Charge Code |
19100
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$89.14
|
| Rate for Payer: Aetna Medicare |
$69.18
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$66.52
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: BCN Medicare Advantage |
$66.52
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$95.79
|
| Rate for Payer: Cofinity Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.52
|
| Rate for Payer: Mclaren Medicaid |
$43.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.85
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Nomi Health Commercial |
$79.82
|
| Rate for Payer: PACE SWMI |
$66.52
|
| Rate for Payer: PHP Medicare Advantage |
$66.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health HMO/PPO |
$93.01
|
| Rate for Payer: Priority Health Medicare |
$67.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.52
|
| Rate for Payer: UHC Exchange |
$66.52
|
| Rate for Payer: UHC Medicare Advantage |
$66.52
|
| Rate for Payer: UHCCP Medicaid |
$43.67
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 19100
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$89.14
|
| Rate for Payer: Aetna Medicare |
$69.18
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$66.52
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: BCN Medicare Advantage |
$66.52
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$95.79
|
| Rate for Payer: Cofinity Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.52
|
| Rate for Payer: Mclaren Medicaid |
$43.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.85
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Nomi Health Commercial |
$79.82
|
| Rate for Payer: PACE SWMI |
$66.52
|
| Rate for Payer: PHP Medicare Advantage |
$66.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health HMO/PPO |
$93.01
|
| Rate for Payer: Priority Health Medicare |
$67.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.52
|
| Rate for Payer: UHC Exchange |
$66.52
|
| Rate for Payer: UHC Medicare Advantage |
$66.52
|
| Rate for Payer: UHCCP Medicaid |
$43.67
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Facility
|
IP
|
$299.00
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
19100
|
| Min. Negotiated Rate |
$194.35 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Aetna Commercial |
$254.15
|
| Rate for Payer: BCBS Trust/PPO |
$244.07
|
| Rate for Payer: BCN Commercial |
$231.07
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$257.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.20
|
| Rate for Payer: Healthscope Commercial |
$269.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.15
|
| Rate for Payer: Nomi Health Commercial |
$245.18
|
| Rate for Payer: PHP Commercial |
$254.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health HMO/PPO |
$260.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.12
|
| Rate for Payer: UHC Core |
$249.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.25
|
|
