|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,378.00
|
|
|
Service Code
|
HCPCS 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 |
$468.82
|
| Rate for Payer: Cofinity Commercial |
$436.26
|
| 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
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$3,378.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$802.28 |
| Max. Negotiated Rate |
$3,040.20 |
| Rate for Payer: Aetna Commercial |
$2,871.30
|
| Rate for Payer: Aetna Medicare |
$878.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,055.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,055.62
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$844.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,626.40
|
| Rate for Payer: BCN Commercial |
$2,626.40
|
| Rate for Payer: BCN Medicare Advantage |
$844.50
|
| Rate for Payer: Cash Price |
$2,702.40
|
| 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: Health Alliance Plan Medicare Advantage |
$844.50
|
| Rate for Payer: Healthscope Commercial |
$3,040.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.50
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$886.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$971.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.30
|
| Rate for Payer: PACE Senior Care Partners |
$802.28
|
| Rate for Payer: PACE SWMI |
$844.50
|
| Rate for Payer: PHP Commercial |
$2,871.30
|
| Rate for Payer: PHP Medicare Advantage |
$844.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| 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 Medicare |
$844.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,060.24
|
| Rate for Payer: Railroad Medicare Medicare |
$844.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,972.64
|
| Rate for Payer: UHC Core |
$2,820.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$844.50
|
| Rate for Payer: UHC Medicare Advantage |
$869.84
|
| Rate for Payer: VA VA |
$844.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.50
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR
|
Professional
|
Both
|
$3,509.00
|
|
|
Service Code
|
HCPCS 36560
|
| Min. Negotiated Rate |
$244.31 |
| Max. Negotiated Rate |
$2,456.30 |
| Rate for Payer: Aetna Commercial |
$508.29
|
| Rate for Payer: Aetna Medicare |
$394.49
|
| Rate for Payer: BCBS Complete |
$256.53
|
| Rate for Payer: BCBS MAPPO |
$379.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,003.31
|
| Rate for Payer: BCN Commercial |
$1,825.70
|
| Rate for Payer: BCN Medicare Advantage |
$379.32
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cofinity Commercial |
$508.29
|
| Rate for Payer: Cofinity Commercial |
$546.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.32
|
| Rate for Payer: Mclaren Medicaid |
$244.31
|
| Rate for Payer: Meridian Medicaid |
$256.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$398.29
|
| Rate for Payer: PACE SWMI |
$379.32
|
| Rate for Payer: PHP Medicare Advantage |
$379.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,456.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$607.49
|
| Rate for Payer: Priority Health Medicare |
$379.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$607.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.32
|
| Rate for Payer: UHC Medicare Advantage |
$390.70
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PUMP
|
Professional
|
Both
|
$3,519.00
|
|
|
Service Code
|
HCPCS 36563
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$2,463.30 |
| Rate for Payer: Aetna Commercial |
$480.31
|
| Rate for Payer: Aetna Medicare |
$372.78
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS MAPPO |
$358.44
|
| Rate for Payer: BCBS Trust/PPO |
$742.79
|
| Rate for Payer: BCN Commercial |
$1,661.01
|
| Rate for Payer: BCN Medicare Advantage |
$358.44
|
| Rate for Payer: Cash Price |
$2,815.20
|
| Rate for Payer: Cash Price |
$2,815.20
|
| Rate for Payer: Cofinity Commercial |
$516.15
|
| Rate for Payer: Cofinity Commercial |
$480.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.44
|
| Rate for Payer: Mclaren Medicaid |
$228.34
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$376.36
|
| Rate for Payer: PACE SWMI |
$358.44
|
| Rate for Payer: PHP Medicare Advantage |
$358.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,463.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$573.98
|
| Rate for Payer: Priority Health Medicare |
$358.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$573.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.44
|
| Rate for Payer: UHC Medicare Advantage |
$369.19
|
|
|
PR INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>
|
Professional
|
Both
|
$1,943.00
|
|
|
Service Code
|
HCPCS 36558
|
| Min. Negotiated Rate |
$162.52 |
| Max. Negotiated Rate |
$1,620.82 |
| Rate for Payer: Aetna Commercial |
$339.88
|
| Rate for Payer: Aetna Medicare |
$263.79
|
| Rate for Payer: BCBS Complete |
$170.65
|
| Rate for Payer: BCBS MAPPO |
$253.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,620.82
|
| Rate for Payer: BCN Commercial |
$1,224.63
|
| Rate for Payer: BCN Medicare Advantage |
$253.64
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cofinity Commercial |
$365.24
|
| Rate for Payer: Cofinity Commercial |
$339.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.64
|
| Rate for Payer: Mclaren Medicaid |
$162.52
|
| Rate for Payer: Meridian Medicaid |
$170.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$266.32
|
| Rate for Payer: PACE SWMI |
$253.64
|
| Rate for Payer: PHP Medicare Advantage |
$253.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$406.95
|
| Rate for Payer: Priority Health Medicare |
$253.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$406.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.64
|
| Rate for Payer: UHC Medicare Advantage |
$261.25
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$1,704.00
|
|
|
Service Code
|
HCPCS 36565
|
| Min. Negotiated Rate |
$212.57 |
| Max. Negotiated Rate |
$1,210.95 |
| Rate for Payer: Aetna Commercial |
$442.72
|
| Rate for Payer: Aetna Medicare |
$343.61
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS MAPPO |
$330.39
|
| Rate for Payer: BCBS Trust/PPO |
$705.81
|
| Rate for Payer: BCN Commercial |
$1,210.95
|
| Rate for Payer: BCN Medicare Advantage |
$330.39
|
| Rate for Payer: Cash Price |
$1,363.20
|
| Rate for Payer: Cash Price |
$1,363.20
|
| Rate for Payer: Cofinity Commercial |
$475.76
|
| Rate for Payer: Cofinity Commercial |
$442.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.39
|
| Rate for Payer: Mclaren Medicaid |
$212.57
|
| Rate for Payer: Meridian Medicaid |
$223.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$346.91
|
| Rate for Payer: PACE SWMI |
$330.39
|
| Rate for Payer: PHP Medicare Advantage |
$330.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,192.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.17
|
| Rate for Payer: Priority Health Medicare |
$330.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$527.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.39
|
| Rate for Payer: UHC Medicare Advantage |
$340.30
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT
|
Professional
|
Both
|
$2,850.00
|
|
|
Service Code
|
HCPCS 36566
|
| Min. Negotiated Rate |
$224.72 |
| Max. Negotiated Rate |
$6,274.62 |
| Rate for Payer: Aetna Commercial |
$469.83
|
| Rate for Payer: Aetna Medicare |
$364.64
|
| Rate for Payer: BCBS Complete |
$235.96
|
| Rate for Payer: BCBS MAPPO |
$350.62
|
| Rate for Payer: BCBS Trust/PPO |
$907.09
|
| Rate for Payer: BCN Commercial |
$6,274.62
|
| Rate for Payer: BCN Medicare Advantage |
$350.62
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cofinity Commercial |
$504.89
|
| Rate for Payer: Cofinity Commercial |
$469.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.62
|
| Rate for Payer: Mclaren Medicaid |
$224.72
|
| Rate for Payer: Meridian Medicaid |
$235.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$368.15
|
| Rate for Payer: PACE SWMI |
$350.62
|
| Rate for Payer: PHP Medicare Advantage |
$350.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,995.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.68
|
| Rate for Payer: Priority Health Medicare |
$350.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.62
|
| Rate for Payer: UHC Medicare Advantage |
$361.14
|
|
|
PR INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL
|
Professional
|
Both
|
$1,484.00
|
|
|
Service Code
|
HCPCS 33206
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$1,398.41 |
| Rate for Payer: Aetna Commercial |
$597.84
|
| Rate for Payer: Aetna Medicare |
$464.00
|
| Rate for Payer: BCBS Complete |
$299.91
|
| Rate for Payer: BCBS MAPPO |
$446.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,398.41
|
| Rate for Payer: BCN Commercial |
$658.25
|
| Rate for Payer: BCN Medicare Advantage |
$446.15
|
| Rate for Payer: Cash Price |
$1,187.20
|
| Rate for Payer: Cash Price |
$1,187.20
|
| Rate for Payer: Cofinity Commercial |
$642.46
|
| Rate for Payer: Cofinity Commercial |
$597.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.15
|
| Rate for Payer: Mclaren Medicaid |
$285.63
|
| Rate for Payer: Meridian Medicaid |
$299.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$468.46
|
| Rate for Payer: PACE SWMI |
$446.15
|
| Rate for Payer: PHP Medicare Advantage |
$446.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.55
|
| Rate for Payer: Priority Health Medicare |
$446.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$446.15
|
| Rate for Payer: UHC Medicare Advantage |
$459.53
|
|
|
PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS 33208
|
| Min. Negotiated Rate |
$324.83 |
| Max. Negotiated Rate |
$1,548.45 |
| Rate for Payer: Aetna Commercial |
$682.42
|
| Rate for Payer: Aetna Medicare |
$529.64
|
| Rate for Payer: BCBS Complete |
$341.07
|
| Rate for Payer: BCBS MAPPO |
$509.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.45
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Medicare Advantage |
$509.27
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cofinity Commercial |
$733.35
|
| Rate for Payer: Cofinity Commercial |
$682.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.27
|
| Rate for Payer: Mclaren Medicaid |
$324.83
|
| Rate for Payer: Meridian Medicaid |
$341.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$534.73
|
| Rate for Payer: PACE SWMI |
$509.27
|
| Rate for Payer: PHP Medicare Advantage |
$509.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$814.96
|
| Rate for Payer: Priority Health Medicare |
$509.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$814.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$509.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.27
|
| Rate for Payer: UHC Medicare Advantage |
$524.55
|
|
|
PR INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR
|
Professional
|
Both
|
$1,780.00
|
|
|
Service Code
|
HCPCS 33207
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,343.47 |
| Rate for Payer: Aetna Commercial |
$629.42
|
| Rate for Payer: Aetna Medicare |
$488.51
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$469.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,343.47
|
| Rate for Payer: BCN Commercial |
$690.99
|
| Rate for Payer: BCN Medicare Advantage |
$469.72
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cofinity Commercial |
$629.42
|
| Rate for Payer: Cofinity Commercial |
$676.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$469.72
|
| Rate for Payer: Mclaren Medicaid |
$300.12
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$493.21
|
| Rate for Payer: PACE SWMI |
$469.72
|
| Rate for Payer: PHP Medicare Advantage |
$469.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.20
|
| Rate for Payer: Priority Health Medicare |
$469.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$469.72
|
| Rate for Payer: UHC Medicare Advantage |
$483.81
|
|
|
PR INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS
|
Professional
|
Both
|
$1,246.00
|
|
|
Service Code
|
HCPCS 33213
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$1,352.98 |
| Rate for Payer: Aetna Commercial |
$441.78
|
| Rate for Payer: Aetna Medicare |
$342.88
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS MAPPO |
$329.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.98
|
| Rate for Payer: BCN Commercial |
$486.24
|
| Rate for Payer: BCN Medicare Advantage |
$329.69
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cofinity Commercial |
$474.75
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.69
|
| Rate for Payer: Mclaren Medicaid |
$213.00
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$346.17
|
| Rate for Payer: PACE SWMI |
$329.69
|
| Rate for Payer: PHP Medicare Advantage |
$329.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.30
|
| Rate for Payer: Priority Health Medicare |
$329.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.58
|
|
|
PR INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
HCPCS 33221
|
| Min. Negotiated Rate |
$224.93 |
| Max. Negotiated Rate |
$1,089.35 |
| Rate for Payer: Aetna Commercial |
$471.64
|
| Rate for Payer: Aetna Medicare |
$366.05
|
| Rate for Payer: BCBS Complete |
$236.18
|
| Rate for Payer: BCBS MAPPO |
$351.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.35
|
| Rate for Payer: BCN Commercial |
$519.95
|
| Rate for Payer: BCN Medicare Advantage |
$351.97
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cofinity Commercial |
$471.64
|
| Rate for Payer: Cofinity Commercial |
$506.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.97
|
| Rate for Payer: Mclaren Medicaid |
$224.93
|
| Rate for Payer: Meridian Medicaid |
$236.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$369.57
|
| Rate for Payer: PACE SWMI |
$351.97
|
| Rate for Payer: PHP Medicare Advantage |
$351.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$566.00
|
| Rate for Payer: Priority Health Medicare |
$351.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$566.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.97
|
| Rate for Payer: UHC Medicare Advantage |
$362.53
|
|
|
PR INS PM PLS GEN W/EXIST SINGLE LEAD
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 33212
|
| Min. Negotiated Rate |
$203.42 |
| Max. Negotiated Rate |
$1,488.75 |
| Rate for Payer: Aetna Commercial |
$422.11
|
| Rate for Payer: Aetna Medicare |
$327.61
|
| Rate for Payer: BCBS Complete |
$213.59
|
| Rate for Payer: BCBS MAPPO |
$315.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,488.75
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: BCN Medicare Advantage |
$315.01
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$453.61
|
| Rate for Payer: Cofinity Commercial |
$422.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.01
|
| Rate for Payer: Mclaren Medicaid |
$203.42
|
| Rate for Payer: Meridian Medicaid |
$213.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$330.76
|
| Rate for Payer: PACE SWMI |
$315.01
|
| Rate for Payer: PHP Medicare Advantage |
$315.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.90
|
| Rate for Payer: Priority Health Medicare |
$315.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$315.01
|
| Rate for Payer: UHC Medicare Advantage |
$324.46
|
|
|
PR INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 33270
|
| Min. Negotiated Rate |
$351.45 |
| Max. Negotiated Rate |
$1,575.39 |
| Rate for Payer: Aetna Commercial |
$739.36
|
| Rate for Payer: Aetna Medicare |
$573.83
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS MAPPO |
$551.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.39
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$551.76
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$739.36
|
| Rate for Payer: Cofinity Commercial |
$794.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.76
|
| Rate for Payer: Mclaren Medicaid |
$351.45
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$579.35
|
| Rate for Payer: PACE SWMI |
$551.76
|
| Rate for Payer: PHP Medicare Advantage |
$551.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.12
|
| Rate for Payer: Priority Health Medicare |
$551.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$884.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$551.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.76
|
| Rate for Payer: UHC Medicare Advantage |
$568.31
|
|
|
PR INSRT CH WALL RESPIR ELTRD/RA & CONJ PULSE GEN
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 0466T
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.50
|
|
|
PR INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 32562
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$724.30 |
| Rate for Payer: Aetna Commercial |
$79.27
|
| Rate for Payer: Aetna Medicare |
$61.53
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS MAPPO |
$59.16
|
| Rate for Payer: BCBS Trust/PPO |
$724.30
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: BCN Medicare Advantage |
$59.16
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$85.19
|
| Rate for Payer: Cofinity Commercial |
$79.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.16
|
| Rate for Payer: Mclaren Medicaid |
$37.70
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.12
|
| Rate for Payer: PACE SWMI |
$59.16
|
| Rate for Payer: PHP Medicare Advantage |
$59.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.96
|
| Rate for Payer: Priority Health Medicare |
$59.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.16
|
| Rate for Payer: UHC Medicare Advantage |
$60.93
|
|
|
PR INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 32560
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$722.19 |
| Rate for Payer: Aetna Commercial |
$100.19
|
| Rate for Payer: Aetna Medicare |
$77.76
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$74.77
|
| Rate for Payer: BCBS Trust/PPO |
$722.19
|
| Rate for Payer: BCN Commercial |
$373.84
|
| Rate for Payer: BCN Medicare Advantage |
$74.77
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Commercial |
$107.67
|
| Rate for Payer: Cofinity Commercial |
$100.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.77
|
| Rate for Payer: Mclaren Medicaid |
$47.71
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.51
|
| Rate for Payer: PACE SWMI |
$74.77
|
| Rate for Payer: PHP Medicare Advantage |
$74.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.26
|
| Rate for Payer: Priority Health Medicare |
$74.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.77
|
| Rate for Payer: UHC Medicare Advantage |
$77.01
|
|
|
PR INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 32561
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$892.83 |
| Rate for Payer: Aetna Commercial |
$89.22
|
| Rate for Payer: Aetna Medicare |
$69.24
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS MAPPO |
$66.58
|
| Rate for Payer: BCBS Trust/PPO |
$892.83
|
| Rate for Payer: BCN Commercial |
$136.83
|
| Rate for Payer: BCN Medicare Advantage |
$66.58
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$89.22
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.58
|
| Rate for Payer: Mclaren Medicaid |
$42.17
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.91
|
| Rate for Payer: PACE SWMI |
$66.58
|
| Rate for Payer: PHP Medicare Advantage |
$66.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.15
|
| Rate for Payer: Priority Health Medicare |
$66.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
|
|
PR INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 99174
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$544.15 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$544.15
|
| Rate for Payer: BCN Commercial |
$8.80
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.08
|
|
|
PR INSULIN INJECTION
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS J1815
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna Commercial |
$0.30
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT DIRECT
|
Professional
|
Both
|
$1,927.00
|
|
|
Service Code
|
HCPCS 48520
|
| Min. Negotiated Rate |
$260.45 |
| Max. Negotiated Rate |
$1,935.02 |
| Rate for Payer: Aetna Commercial |
$1,468.84
|
| Rate for Payer: Aetna Medicare |
$1,140.00
|
| Rate for Payer: BCBS Complete |
$738.72
|
| Rate for Payer: BCBS MAPPO |
$1,096.15
|
| Rate for Payer: BCBS Trust/PPO |
$260.45
|
| Rate for Payer: BCN Commercial |
$1,608.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.15
|
| Rate for Payer: Cash Price |
$1,541.60
|
| Rate for Payer: Cash Price |
$1,541.60
|
| Rate for Payer: Cofinity Commercial |
$1,578.46
|
| Rate for Payer: Cofinity Commercial |
$1,468.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.15
|
| Rate for Payer: Mclaren Medicaid |
$703.54
|
| Rate for Payer: Meridian Medicaid |
$738.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,150.96
|
| Rate for Payer: PACE SWMI |
$1,096.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.02
|
| Rate for Payer: Priority Health Medicare |
$1,096.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,935.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,096.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,129.03
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y
|
Professional
|
Both
|
$2,830.00
|
|
|
Service Code
|
HCPCS 48540
|
| Min. Negotiated Rate |
$502.41 |
| Max. Negotiated Rate |
$2,296.04 |
| Rate for Payer: Aetna Commercial |
$1,745.35
|
| Rate for Payer: Aetna Medicare |
$1,354.60
|
| Rate for Payer: BCBS Complete |
$876.71
|
| Rate for Payer: BCBS MAPPO |
$1,302.50
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: BCN Commercial |
$1,908.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,302.50
|
| Rate for Payer: Cash Price |
$2,264.00
|
| Rate for Payer: Cash Price |
$2,264.00
|
| Rate for Payer: Cofinity Commercial |
$1,745.35
|
| Rate for Payer: Cofinity Commercial |
$1,875.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,302.50
|
| Rate for Payer: Mclaren Medicaid |
$834.96
|
| Rate for Payer: Meridian Medicaid |
$876.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,367.62
|
| Rate for Payer: PACE SWMI |
$1,302.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,302.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,296.04
|
| Rate for Payer: Priority Health Medicare |
$1,302.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,296.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,302.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,302.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,341.58
|
|
|
PR INTENSIVE OUTPATIENT PSYCHIA
|
Professional
|
Both
|
$127.00
|
|
|
Service Code
|
HCPCS S9480
|
| Min. Negotiated Rate |
$50.80 |
| Max. Negotiated Rate |
$820.98 |
| Rate for Payer: Aetna Commercial |
$63.28
|
| Rate for Payer: BCBS Complete |
$50.80
|
| Rate for Payer: BCBS Trust/PPO |
$820.98
|
| Rate for Payer: BCN Commercial |
$256.38
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.90
|
|
|
PR INTER DEVC REMOTE 30D
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS G2066
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$1,033.35 |
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.35
|
| Rate for Payer: BCN Commercial |
$32.38
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.70
|
|
|
PR INTERMITTENT URINARY CATH
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS A4353
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.71 |
| Rate for Payer: Aetna Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCN Commercial |
$7.71
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.70
|
|
