|
PR INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN
|
Professional
|
Both
|
$1,331.00
|
|
|
Service Code
|
HCPCS 33970
|
| Min. Negotiated Rate |
$219.82 |
| Max. Negotiated Rate |
$979.47 |
| Rate for Payer: Aetna Commercial |
$466.37
|
| Rate for Payer: Aetna Medicare |
$361.96
|
| Rate for Payer: BCBS Complete |
$230.81
|
| Rate for Payer: BCBS MAPPO |
$348.04
|
| Rate for Payer: BCBS Trust/PPO |
$979.47
|
| Rate for Payer: BCN Commercial |
$505.29
|
| Rate for Payer: BCN Medicare Advantage |
$348.04
|
| Rate for Payer: Cash Price |
$1,064.80
|
| Rate for Payer: Cash Price |
$1,064.80
|
| Rate for Payer: Cofinity Commercial |
$501.18
|
| Rate for Payer: Cofinity Commercial |
$466.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.04
|
| Rate for Payer: Mclaren Medicaid |
$219.82
|
| Rate for Payer: Meridian Medicaid |
$230.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$365.44
|
| Rate for Payer: PACE SWMI |
$348.04
|
| Rate for Payer: PHP Medicare Advantage |
$348.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$931.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.04
|
| Rate for Payer: Priority Health Medicare |
$348.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.04
|
| Rate for Payer: UHC Medicare Advantage |
$358.48
|
|
|
PR INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 57267
|
| Min. Negotiated Rate |
$158.90 |
| Max. Negotiated Rate |
$1,692.14 |
| Rate for Payer: Aetna Commercial |
$333.04
|
| Rate for Payer: Aetna Medicare |
$258.48
|
| Rate for Payer: BCBS Complete |
$166.84
|
| Rate for Payer: BCBS MAPPO |
$248.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,692.14
|
| Rate for Payer: BCN Commercial |
$363.58
|
| Rate for Payer: BCN Medicare Advantage |
$248.54
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$333.04
|
| Rate for Payer: Cofinity Commercial |
$357.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.54
|
| Rate for Payer: Mclaren Medicaid |
$158.90
|
| Rate for Payer: Meridian Medicaid |
$166.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$260.97
|
| Rate for Payer: PACE SWMI |
$248.54
|
| Rate for Payer: PHP Medicare Advantage |
$248.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.23
|
| Rate for Payer: Priority Health Medicare |
$248.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$248.54
|
| Rate for Payer: UHC Medicare Advantage |
$256.00
|
|
|
PR INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH
|
Professional
|
Both
|
$1,437.00
|
|
|
Service Code
|
HCPCS 54405
|
| Min. Negotiated Rate |
$156.83 |
| Max. Negotiated Rate |
$1,288.75 |
| Rate for Payer: Aetna Commercial |
$1,058.25
|
| Rate for Payer: Aetna Medicare |
$821.33
|
| Rate for Payer: BCBS Complete |
$539.45
|
| Rate for Payer: BCBS MAPPO |
$789.74
|
| Rate for Payer: BCBS Trust/PPO |
$156.83
|
| Rate for Payer: BCN Commercial |
$1,165.50
|
| Rate for Payer: BCN Medicare Advantage |
$789.74
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cofinity Commercial |
$1,058.25
|
| Rate for Payer: Cofinity Commercial |
$1,137.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.74
|
| Rate for Payer: Mclaren Medicaid |
$513.76
|
| Rate for Payer: Meridian Medicaid |
$539.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$829.23
|
| Rate for Payer: PACE SWMI |
$789.74
|
| Rate for Payer: PHP Medicare Advantage |
$789.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,005.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,288.75
|
| Rate for Payer: Priority Health Medicare |
$789.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,288.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$789.74
|
| Rate for Payer: UHC Medicare Advantage |
$813.43
|
|
|
PR INSJ NON-NDWELLG BLADDER CATHETER
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS 51701
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$661.43 |
| Rate for Payer: Aetna Commercial |
$33.57
|
| Rate for Payer: Aetna Medicare |
$26.05
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$25.05
|
| Rate for Payer: BCBS Trust/PPO |
$661.43
|
| Rate for Payer: BCN Commercial |
$52.23
|
| Rate for Payer: BCN Medicare Advantage |
$25.05
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cofinity Commercial |
$36.07
|
| Rate for Payer: Cofinity Commercial |
$33.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.05
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.30
|
| Rate for Payer: PACE SWMI |
$25.05
|
| Rate for Payer: PHP Medicare Advantage |
$25.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.53
|
| Rate for Payer: Priority Health Medicare |
$25.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.05
|
| Rate for Payer: UHC Medicare Advantage |
$25.80
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y
|
Professional
|
Both
|
$983.00
|
|
|
Service Code
|
HCPCS 36555
|
| Min. Negotiated Rate |
$52.82 |
| Max. Negotiated Rate |
$898.64 |
| Rate for Payer: Aetna Commercial |
$112.08
|
| Rate for Payer: Aetna Medicare |
$86.99
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: BCBS MAPPO |
$83.64
|
| Rate for Payer: BCBS Trust/PPO |
$898.64
|
| Rate for Payer: BCN Commercial |
$277.56
|
| Rate for Payer: BCN Medicare Advantage |
$83.64
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cofinity Commercial |
$120.44
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.64
|
| Rate for Payer: Mclaren Medicaid |
$52.82
|
| Rate for Payer: Meridian Medicaid |
$55.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.82
|
| Rate for Payer: PACE SWMI |
$83.64
|
| Rate for Payer: PHP Medicare Advantage |
$83.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$688.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.46
|
| Rate for Payer: Priority Health Medicare |
$83.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.64
|
| Rate for Payer: UHC Medicare Advantage |
$86.15
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 36556
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$589.40 |
| Rate for Payer: Aetna Commercial |
$111.31
|
| Rate for Payer: Aetna Medicare |
$86.39
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$83.07
|
| Rate for Payer: BCBS Trust/PPO |
$253.58
|
| Rate for Payer: BCN Commercial |
$313.24
|
| Rate for Payer: BCN Medicare Advantage |
$83.07
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$119.62
|
| Rate for Payer: Cofinity Commercial |
$111.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.07
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.22
|
| Rate for Payer: PACE SWMI |
$83.07
|
| Rate for Payer: PHP Medicare Advantage |
$83.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.93
|
| Rate for Payer: Priority Health Medicare |
$83.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.07
|
| Rate for Payer: UHC Medicare Advantage |
$85.56
|
|
|
PR INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID
|
Professional
|
Both
|
$1,565.00
|
|
|
Service Code
|
HCPCS 54400
|
| Min. Negotiated Rate |
$199.17 |
| Max. Negotiated Rate |
$1,095.50 |
| Rate for Payer: Aetna Commercial |
$696.42
|
| Rate for Payer: Aetna Medicare |
$540.51
|
| Rate for Payer: BCBS Complete |
$356.95
|
| Rate for Payer: BCBS MAPPO |
$519.72
|
| Rate for Payer: BCBS Trust/PPO |
$199.17
|
| Rate for Payer: BCN Commercial |
$769.17
|
| Rate for Payer: BCN Medicare Advantage |
$519.72
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cofinity Commercial |
$748.40
|
| Rate for Payer: Cofinity Commercial |
$696.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.72
|
| Rate for Payer: Mclaren Medicaid |
$339.95
|
| Rate for Payer: Meridian Medicaid |
$356.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$545.71
|
| Rate for Payer: PACE SWMI |
$519.72
|
| Rate for Payer: PHP Medicare Advantage |
$519.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.52
|
| Rate for Payer: Priority Health Medicare |
$519.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.72
|
| Rate for Payer: UHC Medicare Advantage |
$535.31
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY
|
Professional
|
Both
|
$879.00
|
|
|
Service Code
|
HCPCS 33990
|
| Min. Negotiated Rate |
$224.72 |
| Max. Negotiated Rate |
$1,090.41 |
| Rate for Payer: Aetna Commercial |
$474.60
|
| Rate for Payer: Aetna Medicare |
$368.35
|
| Rate for Payer: BCBS Complete |
$235.96
|
| Rate for Payer: BCBS MAPPO |
$354.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.41
|
| Rate for Payer: BCN Commercial |
$515.07
|
| Rate for Payer: BCN Medicare Advantage |
$354.18
|
| Rate for Payer: Cash Price |
$703.20
|
| Rate for Payer: Cash Price |
$703.20
|
| Rate for Payer: Cofinity Commercial |
$474.60
|
| Rate for Payer: Cofinity Commercial |
$510.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.18
|
| Rate for Payer: Mclaren Medicaid |
$224.72
|
| Rate for Payer: Meridian Medicaid |
$235.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.89
|
| Rate for Payer: PACE SWMI |
$354.18
|
| Rate for Payer: PHP Medicare Advantage |
$354.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.68
|
| Rate for Payer: Priority Health Medicare |
$354.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.18
|
| Rate for Payer: UHC Medicare Advantage |
$364.81
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL&VEN ACCESS
|
Professional
|
Both
|
$3,314.00
|
|
|
Service Code
|
HCPCS 33991
|
| Min. Negotiated Rate |
$282.01 |
| Max. Negotiated Rate |
$2,319.80 |
| Rate for Payer: Aetna Commercial |
$599.66
|
| Rate for Payer: Aetna Medicare |
$465.41
|
| Rate for Payer: BCBS Complete |
$296.11
|
| Rate for Payer: BCBS MAPPO |
$447.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.43
|
| Rate for Payer: BCN Commercial |
$648.47
|
| Rate for Payer: BCN Medicare Advantage |
$447.51
|
| Rate for Payer: Cash Price |
$2,651.20
|
| Rate for Payer: Cash Price |
$2,651.20
|
| Rate for Payer: Cofinity Commercial |
$644.41
|
| Rate for Payer: Cofinity Commercial |
$599.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.51
|
| Rate for Payer: Mclaren Medicaid |
$282.01
|
| Rate for Payer: Meridian Medicaid |
$296.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$469.89
|
| Rate for Payer: PACE SWMI |
$447.51
|
| Rate for Payer: PHP Medicare Advantage |
$447.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,319.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$705.90
|
| Rate for Payer: Priority Health Medicare |
$447.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$705.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$447.51
|
| Rate for Payer: UHC Medicare Advantage |
$460.94
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,699.00
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
36571
|
| Min. Negotiated Rate |
$197.88 |
| Max. Negotiated Rate |
$1,860.89 |
| Rate for Payer: Aetna Commercial |
$410.44
|
| Rate for Payer: Aetna Medicare |
$318.55
|
| Rate for Payer: BCBS Complete |
$207.77
|
| Rate for Payer: BCBS MAPPO |
$306.30
|
| Rate for Payer: BCBS Trust/PPO |
$651.39
|
| Rate for Payer: BCN Commercial |
$1,860.89
|
| Rate for Payer: BCN Medicare Advantage |
$306.30
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$410.44
|
| Rate for Payer: Cofinity Commercial |
$441.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.30
|
| Rate for Payer: Mclaren Medicaid |
$197.88
|
| Rate for Payer: Meridian Medicaid |
$207.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$321.62
|
| Rate for Payer: PACE SWMI |
$306.30
|
| Rate for Payer: PHP Medicare Advantage |
$306.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,189.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.53
|
| Rate for Payer: Priority Health Medicare |
$306.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.30
|
| Rate for Payer: UHC Medicare Advantage |
$315.49
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,699.00
|
|
|
Service Code
|
HCPCS 36571
|
| Min. Negotiated Rate |
$197.88 |
| Max. Negotiated Rate |
$1,860.89 |
| Rate for Payer: Aetna Commercial |
$410.44
|
| Rate for Payer: Aetna Medicare |
$318.55
|
| Rate for Payer: BCBS Complete |
$207.77
|
| Rate for Payer: BCBS MAPPO |
$306.30
|
| Rate for Payer: BCBS Trust/PPO |
$651.39
|
| Rate for Payer: BCN Commercial |
$1,860.89
|
| Rate for Payer: BCN Medicare Advantage |
$306.30
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$410.44
|
| Rate for Payer: Cofinity Commercial |
$441.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.30
|
| Rate for Payer: Mclaren Medicaid |
$197.88
|
| Rate for Payer: Meridian Medicaid |
$207.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$321.62
|
| Rate for Payer: PACE SWMI |
$306.30
|
| Rate for Payer: PHP Medicare Advantage |
$306.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,189.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.53
|
| Rate for Payer: Priority Health Medicare |
$306.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.30
|
| Rate for Payer: UHC Medicare Advantage |
$315.49
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$1,699.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,036.22 |
| Max. Negotiated Rate |
$1,529.10 |
| Rate for Payer: Aetna Commercial |
$1,444.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.99
|
| Rate for Payer: BCN Commercial |
$1,312.99
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,461.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.20
|
| Rate for Payer: Healthscope Commercial |
$1,529.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,274.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,444.15
|
| Rate for Payer: PHP Commercial |
$1,444.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,189.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,478.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,036.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,495.12
|
| Rate for Payer: UHC Core |
$1,418.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,274.25
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$1,699.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$403.51 |
| Max. Negotiated Rate |
$2,195.52 |
| Rate for Payer: Aetna Commercial |
$1,444.15
|
| Rate for Payer: Aetna Medicare |
$441.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$530.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$530.94
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$424.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.97
|
| Rate for Payer: BCN Commercial |
$1,320.97
|
| Rate for Payer: BCN Medicare Advantage |
$424.75
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,461.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.75
|
| Rate for Payer: Healthscope Commercial |
$1,529.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,274.25
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$445.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$488.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,444.15
|
| Rate for Payer: PACE Senior Care Partners |
$403.51
|
| Rate for Payer: PACE SWMI |
$424.75
|
| Rate for Payer: PHP Commercial |
$1,444.15
|
| Rate for Payer: PHP Medicare Advantage |
$424.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,189.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,478.13
|
| Rate for Payer: Priority Health Medicare |
$424.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,036.22
|
| Rate for Payer: Railroad Medicare Medicare |
$424.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,495.12
|
| Rate for Payer: UHC Core |
$1,418.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$424.75
|
| Rate for Payer: UHC Medicare Advantage |
$437.49
|
| Rate for Payer: VA VA |
$424.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,274.25
|
|
|
PR INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 19342
|
| Min. Negotiated Rate |
$488.41 |
| Max. Negotiated Rate |
$1,594.65 |
| Rate for Payer: Aetna Commercial |
$1,000.26
|
| Rate for Payer: Aetna Medicare |
$776.32
|
| Rate for Payer: BCBS Complete |
$512.83
|
| Rate for Payer: BCBS MAPPO |
$746.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.65
|
| Rate for Payer: BCN Commercial |
$1,114.67
|
| Rate for Payer: BCN Medicare Advantage |
$746.46
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cofinity Commercial |
$1,074.90
|
| Rate for Payer: Cofinity Commercial |
$1,000.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.46
|
| Rate for Payer: Mclaren Medicaid |
$488.41
|
| Rate for Payer: Meridian Medicaid |
$512.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$783.78
|
| Rate for Payer: PACE SWMI |
$746.46
|
| Rate for Payer: PHP Medicare Advantage |
$746.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,150.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$937.58
|
| Rate for Payer: Priority Health Medicare |
$746.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$746.46
|
| Rate for Payer: UHC Medicare Advantage |
$768.85
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 61886
|
| Min. Negotiated Rate |
$575.74 |
| Max. Negotiated Rate |
$1,804.66 |
| Rate for Payer: Aetna Commercial |
$1,171.23
|
| Rate for Payer: Aetna Medicare |
$909.01
|
| Rate for Payer: BCBS Complete |
$604.53
|
| Rate for Payer: BCBS MAPPO |
$874.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.41
|
| Rate for Payer: BCN Commercial |
$1,804.66
|
| Rate for Payer: BCN Medicare Advantage |
$874.05
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$1,171.23
|
| Rate for Payer: Cofinity Commercial |
$1,258.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$874.05
|
| Rate for Payer: Mclaren Medicaid |
$575.74
|
| Rate for Payer: Meridian Medicaid |
$604.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$917.75
|
| Rate for Payer: PACE SWMI |
$874.05
|
| Rate for Payer: PHP Medicare Advantage |
$874.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,507.29
|
| Rate for Payer: Priority Health Medicare |
$874.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,507.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$874.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$874.05
|
| Rate for Payer: UHC Medicare Advantage |
$900.27
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR
|
Professional
|
Both
|
$1,622.00
|
|
|
Service Code
|
HCPCS 61885
|
| Min. Negotiated Rate |
$345.06 |
| Max. Negotiated Rate |
$1,135.40 |
| Rate for Payer: Aetna Commercial |
$703.53
|
| Rate for Payer: Aetna Medicare |
$546.02
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCBS MAPPO |
$525.02
|
| Rate for Payer: BCBS Trust/PPO |
$810.94
|
| Rate for Payer: BCN Commercial |
$1,084.02
|
| Rate for Payer: BCN Medicare Advantage |
$525.02
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cofinity Commercial |
$703.53
|
| Rate for Payer: Cofinity Commercial |
$756.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.02
|
| Rate for Payer: Mclaren Medicaid |
$345.06
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$551.27
|
| Rate for Payer: PACE SWMI |
$525.02
|
| Rate for Payer: PHP Medicare Advantage |
$525.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,135.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$905.40
|
| Rate for Payer: Priority Health Medicare |
$525.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$905.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.02
|
| Rate for Payer: UHC Medicare Advantage |
$540.77
|
|
|
PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR
|
Professional
|
Both
|
$1,860.00
|
|
|
Service Code
|
HCPCS 33249
|
| Min. Negotiated Rate |
$571.91 |
| Max. Negotiated Rate |
$1,436.28 |
| Rate for Payer: Aetna Commercial |
$1,202.02
|
| Rate for Payer: Aetna Medicare |
$932.91
|
| Rate for Payer: BCBS Complete |
$600.51
|
| Rate for Payer: BCBS MAPPO |
$897.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$1,319.43
|
| Rate for Payer: BCN Medicare Advantage |
$897.03
|
| Rate for Payer: Cash Price |
$1,488.00
|
| Rate for Payer: Cash Price |
$1,488.00
|
| Rate for Payer: Cofinity Commercial |
$1,291.72
|
| Rate for Payer: Cofinity Commercial |
$1,202.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.03
|
| Rate for Payer: Mclaren Medicaid |
$571.91
|
| Rate for Payer: Meridian Medicaid |
$600.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$941.88
|
| Rate for Payer: PACE SWMI |
$897.03
|
| Rate for Payer: PHP Medicare Advantage |
$897.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,302.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,436.28
|
| Rate for Payer: Priority Health Medicare |
$897.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,436.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$897.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$897.03
|
| Rate for Payer: UHC Medicare Advantage |
$923.94
|
|
|
PR INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING
|
Professional
|
Both
|
$2,242.00
|
|
|
Service Code
|
HCPCS 63685
|
| Min. Negotiated Rate |
$218.96 |
| Max. Negotiated Rate |
$1,569.40 |
| Rate for Payer: Aetna Commercial |
$477.71
|
| Rate for Payer: Aetna Medicare |
$370.76
|
| Rate for Payer: BCBS Complete |
$229.91
|
| Rate for Payer: BCBS MAPPO |
$356.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.66
|
| Rate for Payer: BCN Commercial |
$529.73
|
| Rate for Payer: BCN Medicare Advantage |
$356.50
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cofinity Commercial |
$477.71
|
| Rate for Payer: Cofinity Commercial |
$513.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.50
|
| Rate for Payer: Mclaren Medicaid |
$218.96
|
| Rate for Payer: Meridian Medicaid |
$229.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$374.32
|
| Rate for Payer: PACE SWMI |
$356.50
|
| Rate for Payer: PHP Medicare Advantage |
$356.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,569.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.79
|
| Rate for Payer: Priority Health Medicare |
$356.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$613.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.50
|
| Rate for Payer: UHC Medicare Advantage |
$367.20
|
|
|
PR INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 33210
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$1,347.69 |
| Rate for Payer: Aetna Commercial |
$213.21
|
| Rate for Payer: Aetna Medicare |
$165.47
|
| Rate for Payer: BCBS Complete |
$105.57
|
| Rate for Payer: BCBS MAPPO |
$159.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.69
|
| Rate for Payer: BCN Commercial |
$231.63
|
| Rate for Payer: BCN Medicare Advantage |
$159.11
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$229.12
|
| Rate for Payer: Cofinity Commercial |
$213.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.11
|
| Rate for Payer: Mclaren Medicaid |
$100.54
|
| Rate for Payer: Meridian Medicaid |
$105.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.07
|
| Rate for Payer: PACE SWMI |
$159.11
|
| Rate for Payer: PHP Medicare Advantage |
$159.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$711.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.16
|
| Rate for Payer: Priority Health Medicare |
$159.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.11
|
| Rate for Payer: UHC Medicare Advantage |
$163.88
|
|
|
PR INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH
|
Professional
|
Both
|
$2,672.00
|
|
|
Service Code
|
HCPCS 61215
|
| Min. Negotiated Rate |
$338.67 |
| Max. Negotiated Rate |
$1,870.40 |
| Rate for Payer: Aetna Commercial |
$690.38
|
| Rate for Payer: Aetna Medicare |
$535.82
|
| Rate for Payer: BCBS Complete |
$355.60
|
| Rate for Payer: BCBS MAPPO |
$515.21
|
| Rate for Payer: BCBS Trust/PPO |
$682.56
|
| Rate for Payer: BCN Commercial |
$1,063.68
|
| Rate for Payer: BCN Medicare Advantage |
$515.21
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cofinity Commercial |
$741.90
|
| Rate for Payer: Cofinity Commercial |
$690.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.21
|
| Rate for Payer: Mclaren Medicaid |
$338.67
|
| Rate for Payer: Meridian Medicaid |
$355.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$540.97
|
| Rate for Payer: PACE SWMI |
$515.21
|
| Rate for Payer: PHP Medicare Advantage |
$515.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,870.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$888.40
|
| Rate for Payer: Priority Health Medicare |
$515.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$888.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$515.21
|
| Rate for Payer: UHC Medicare Advantage |
$530.67
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 51703
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$2,051.39 |
| Rate for Payer: Aetna Commercial |
$100.37
|
| Rate for Payer: Aetna Medicare |
$77.90
|
| Rate for Payer: BCBS Complete |
$50.55
|
| Rate for Payer: BCBS MAPPO |
$74.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,051.39
|
| Rate for Payer: BCN Commercial |
$218.93
|
| Rate for Payer: BCN Medicare Advantage |
$74.90
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$107.86
|
| Rate for Payer: Cofinity Commercial |
$100.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.90
|
| Rate for Payer: Mclaren Medicaid |
$48.14
|
| Rate for Payer: Meridian Medicaid |
$50.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.64
|
| Rate for Payer: PACE SWMI |
$74.90
|
| Rate for Payer: PHP Medicare Advantage |
$74.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.59
|
| Rate for Payer: Priority Health Medicare |
$74.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.90
|
| Rate for Payer: UHC Medicare Advantage |
$77.15
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 51702
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$1,962.63 |
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Medicare |
$25.68
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$24.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.63
|
| Rate for Payer: BCN Commercial |
$89.92
|
| Rate for Payer: BCN Medicare Advantage |
$24.69
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$35.55
|
| Rate for Payer: Cofinity Commercial |
$33.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.69
|
| Rate for Payer: Mclaren Medicaid |
$15.98
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.92
|
| Rate for Payer: PACE SWMI |
$24.69
|
| Rate for Payer: PHP Medicare Advantage |
$24.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.99
|
| Rate for Payer: Priority Health Medicare |
$24.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.69
|
| Rate for Payer: UHC Medicare Advantage |
$25.43
|
|
|
PR INSJ TESTICULAR PROSTH SEPARATE PROCEDURE
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 54660
|
| Min. Negotiated Rate |
$230.25 |
| Max. Negotiated Rate |
$2,434.41 |
| Rate for Payer: Aetna Commercial |
$467.95
|
| Rate for Payer: Aetna Medicare |
$363.19
|
| Rate for Payer: BCBS Complete |
$241.76
|
| Rate for Payer: BCBS MAPPO |
$349.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,434.41
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$349.22
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$502.88
|
| Rate for Payer: Cofinity Commercial |
$467.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.22
|
| Rate for Payer: Mclaren Medicaid |
$230.25
|
| Rate for Payer: Meridian Medicaid |
$241.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$366.68
|
| Rate for Payer: PACE SWMI |
$349.22
|
| Rate for Payer: PHP Medicare Advantage |
$349.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.40
|
| Rate for Payer: Priority Health Medicare |
$349.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$574.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.22
|
| Rate for Payer: UHC Medicare Advantage |
$359.70
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$3,378.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,060.24 |
| Max. Negotiated Rate |
$3,040.20 |
| Rate for Payer: Aetna Commercial |
$2,871.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,610.52
|
| Rate for Payer: BCN Commercial |
$2,610.52
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cofinity Commercial |
$2,905.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.40
|
| Rate for Payer: Healthscope Commercial |
$3,040.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.30
|
| Rate for Payer: PHP Commercial |
$2,871.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,938.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,060.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,972.64
|
| Rate for Payer: UHC Core |
$2,820.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.50
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,378.00
|
|
|
Service Code
|
HCPCS 36561
|
| Hospital Charge Code |
36561
|
| Min. Negotiated Rate |
$208.95 |
| Max. Negotiated Rate |
$2,364.60 |
| Rate for Payer: Aetna Commercial |
$436.26
|
| Rate for Payer: Aetna Medicare |
$338.59
|
| Rate for Payer: BCBS Complete |
$219.40
|
| Rate for Payer: BCBS MAPPO |
$325.57
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$325.57
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cofinity Commercial |
$436.26
|
| Rate for Payer: Cofinity Commercial |
$468.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.57
|
| Rate for Payer: Mclaren Medicaid |
$208.95
|
| Rate for Payer: Meridian Medicaid |
$219.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$341.85
|
| Rate for Payer: PACE SWMI |
$325.57
|
| Rate for Payer: PHP Medicare Advantage |
$325.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.85
|
| Rate for Payer: Priority Health Medicare |
$325.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$325.57
|
| Rate for Payer: UHC Medicare Advantage |
$335.34
|
|
