|
PR CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP
|
Professional
|
Both
|
$4,619.00
|
|
|
Service Code
|
HCPCS 33310
|
| Min. Negotiated Rate |
$738.05 |
| Max. Negotiated Rate |
$3,002.35 |
| Rate for Payer: Aetna Commercial |
$1,499.49
|
| Rate for Payer: Aetna Medicare |
$1,163.78
|
| Rate for Payer: BCBS Complete |
$774.95
|
| Rate for Payer: BCBS MAPPO |
$1,119.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.64
|
| Rate for Payer: BCN Commercial |
$1,678.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.02
|
| Rate for Payer: Cash Price |
$3,695.20
|
| Rate for Payer: Cash Price |
$3,695.20
|
| Rate for Payer: Cofinity Commercial |
$1,611.39
|
| Rate for Payer: Cofinity Commercial |
$1,499.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.02
|
| Rate for Payer: Mclaren Medicaid |
$738.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,174.97
|
| Rate for Payer: Meridian Medicaid |
$774.95
|
| Rate for Payer: Nomi Health Commercial |
$1,342.82
|
| Rate for Payer: PACE SWMI |
$1,119.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,002.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,830.55
|
| Rate for Payer: Priority Health Medicare |
$1,130.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,830.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,119.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,119.02
|
| Rate for Payer: UHC Exchange |
$1,119.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,119.02
|
| Rate for Payer: UHCCP Medicaid |
$738.05
|
|
|
PR CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 93660
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$3,564.97 |
| Rate for Payer: Aetna Commercial |
$202.47
|
| Rate for Payer: Aetna Medicare |
$157.14
|
| Rate for Payer: BCBS Complete |
$59.93
|
| Rate for Payer: BCBS MAPPO |
$151.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,564.97
|
| Rate for Payer: BCN Commercial |
$233.59
|
| Rate for Payer: BCN Medicare Advantage |
$151.10
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$217.58
|
| Rate for Payer: Cofinity Commercial |
$202.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.10
|
| Rate for Payer: Mclaren Medicaid |
$57.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.66
|
| Rate for Payer: Meridian Medicaid |
$59.93
|
| Rate for Payer: Nomi Health Commercial |
$181.32
|
| Rate for Payer: PACE SWMI |
$151.10
|
| Rate for Payer: PHP Medicare Advantage |
$151.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health HMO/PPO |
$125.72
|
| Rate for Payer: Priority Health Medicare |
$152.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.10
|
| Rate for Payer: UHC Exchange |
$151.10
|
| Rate for Payer: UHC Medicare Advantage |
$151.10
|
| Rate for Payer: UHCCP Medicaid |
$57.08
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Professional
|
Both
|
$501.00
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
92960
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$325.65 |
| Rate for Payer: Aetna Commercial |
$136.28
|
| Rate for Payer: Aetna Medicare |
$105.77
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$248.59
|
| Rate for Payer: BCN Medicare Advantage |
$101.70
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$146.45
|
| Rate for Payer: Cofinity Commercial |
$136.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.70
|
| Rate for Payer: Mclaren Medicaid |
$68.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.78
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Nomi Health Commercial |
$122.04
|
| Rate for Payer: PACE SWMI |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$101.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO |
$149.72
|
| Rate for Payer: Priority Health Medicare |
$102.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.70
|
| Rate for Payer: UHC Exchange |
$101.70
|
| Rate for Payer: UHC Medicare Advantage |
$101.70
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Facility
|
OP
|
$501.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
92960
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$118.99 |
| Max. Negotiated Rate |
$486.76 |
| Rate for Payer: Aetna Commercial |
$425.85
|
| Rate for Payer: Aetna Medicare |
$130.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.56
|
| Rate for Payer: BCBS Complete |
$486.76
|
| Rate for Payer: BCBS MAPPO |
$125.25
|
| Rate for Payer: BCBS Trust/PPO |
$411.87
|
| Rate for Payer: BCN Commercial |
$389.53
|
| Rate for Payer: BCN Medicare Advantage |
$125.25
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$430.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.25
|
| Rate for Payer: Healthscope Commercial |
$450.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.75
|
| Rate for Payer: Mclaren Medicaid |
$463.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.51
|
| Rate for Payer: Meridian Medicaid |
$486.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.85
|
| Rate for Payer: Nomi Health Commercial |
$410.82
|
| Rate for Payer: PACE Senior Care Partners |
$118.99
|
| Rate for Payer: PACE SWMI |
$125.25
|
| Rate for Payer: PHP Commercial |
$425.85
|
| Rate for Payer: PHP Medicare Advantage |
$125.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO |
$435.87
|
| Rate for Payer: Priority Health Medicare |
$126.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.67
|
| Rate for Payer: Railroad Medicare Medicare |
$125.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.88
|
| Rate for Payer: UHC Core |
$418.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.25
|
| Rate for Payer: UHC Exchange |
$125.25
|
| Rate for Payer: UHC Medicare Advantage |
$125.25
|
| Rate for Payer: UHCCP Medicaid |
$463.55
|
| Rate for Payer: VA VA |
$125.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.75
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Professional
|
Both
|
$501.00
|
|
|
Service Code
|
HCPCS 92960
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$325.65 |
| Rate for Payer: Aetna Commercial |
$136.28
|
| Rate for Payer: Aetna Medicare |
$105.77
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$248.59
|
| Rate for Payer: BCN Medicare Advantage |
$101.70
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$146.45
|
| Rate for Payer: Cofinity Commercial |
$136.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.70
|
| Rate for Payer: Mclaren Medicaid |
$68.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.78
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Nomi Health Commercial |
$122.04
|
| Rate for Payer: PACE SWMI |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$101.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO |
$149.72
|
| Rate for Payer: Priority Health Medicare |
$102.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.70
|
| Rate for Payer: UHC Exchange |
$101.70
|
| Rate for Payer: UHC Medicare Advantage |
$101.70
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Facility
|
IP
|
$501.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
92960
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$325.65 |
| Max. Negotiated Rate |
$450.90 |
| Rate for Payer: Aetna Commercial |
$425.85
|
| Rate for Payer: BCBS Trust/PPO |
$408.97
|
| Rate for Payer: BCN Commercial |
$387.17
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$430.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.80
|
| Rate for Payer: Healthscope Commercial |
$450.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.85
|
| Rate for Payer: Nomi Health Commercial |
$410.82
|
| Rate for Payer: PHP Commercial |
$425.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO |
$435.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.88
|
| Rate for Payer: UHC Core |
$418.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.75
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX
|
Professional
|
Both
|
$502.00
|
|
|
Service Code
|
HCPCS 92961
|
| Min. Negotiated Rate |
$101.96 |
| Max. Negotiated Rate |
$349.89 |
| Rate for Payer: Aetna Commercial |
$310.25
|
| Rate for Payer: Aetna Medicare |
$240.79
|
| Rate for Payer: BCBS Complete |
$160.14
|
| Rate for Payer: BCBS MAPPO |
$231.53
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: BCN Commercial |
$349.89
|
| Rate for Payer: BCN Medicare Advantage |
$231.53
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cofinity Commercial |
$310.25
|
| Rate for Payer: Cofinity Commercial |
$333.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.53
|
| Rate for Payer: Mclaren Medicaid |
$152.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.11
|
| Rate for Payer: Meridian Medicaid |
$160.14
|
| Rate for Payer: Nomi Health Commercial |
$277.84
|
| Rate for Payer: PACE SWMI |
$231.53
|
| Rate for Payer: PHP Medicare Advantage |
$231.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.30
|
| Rate for Payer: Priority Health HMO/PPO |
$337.12
|
| Rate for Payer: Priority Health Medicare |
$233.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$337.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.53
|
| Rate for Payer: UHC Exchange |
$231.53
|
| Rate for Payer: UHC Medicare Advantage |
$231.53
|
| Rate for Payer: UHCCP Medicaid |
$152.51
|
|
|
PR CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 96161
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$179.62 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCBS Trust/PPO |
$179.62
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: BCN Medicare Advantage |
$2.65
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$3.55
|
| Rate for Payer: Cofinity Commercial |
$3.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.78
|
| Rate for Payer: Nomi Health Commercial |
$3.18
|
| Rate for Payer: PACE SWMI |
$2.65
|
| Rate for Payer: PHP Medicare Advantage |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
| Rate for Payer: Priority Health HMO/PPO |
$5.43
|
| Rate for Payer: Priority Health Medicare |
$2.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.65
|
| Rate for Payer: UHC Exchange |
$2.65
|
| Rate for Payer: UHC Medicare Advantage |
$2.65
|
|
|
PR CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 99484
|
| Min. Negotiated Rate |
$27.26 |
| Max. Negotiated Rate |
$594.87 |
| Rate for Payer: Aetna Commercial |
$54.70
|
| Rate for Payer: Aetna Medicare |
$42.45
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$40.82
|
| Rate for Payer: BCBS Trust/PPO |
$594.87
|
| Rate for Payer: BCN Commercial |
$58.04
|
| Rate for Payer: BCN Medicare Advantage |
$40.82
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$58.78
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.82
|
| Rate for Payer: Mclaren Medicaid |
$27.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.86
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: Nomi Health Commercial |
$48.98
|
| Rate for Payer: PACE SWMI |
$40.82
|
| Rate for Payer: PHP Medicare Advantage |
$40.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health HMO/PPO |
$58.79
|
| Rate for Payer: Priority Health Medicare |
$41.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.82
|
| Rate for Payer: UHC Exchange |
$40.82
|
| Rate for Payer: UHC Medicare Advantage |
$40.82
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
|
|
PR CARPECTOMY 1 BONE
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 25210
|
| Min. Negotiated Rate |
$325.68 |
| Max. Negotiated Rate |
$1,105.65 |
| Rate for Payer: Aetna Commercial |
$640.43
|
| Rate for Payer: Aetna Medicare |
$497.05
|
| Rate for Payer: BCBS Complete |
$341.96
|
| Rate for Payer: BCBS MAPPO |
$477.93
|
| Rate for Payer: BCBS Trust/PPO |
$637.66
|
| Rate for Payer: BCN Commercial |
$731.55
|
| Rate for Payer: BCN Medicare Advantage |
$477.93
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$688.22
|
| Rate for Payer: Cofinity Commercial |
$640.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.93
|
| Rate for Payer: Mclaren Medicaid |
$325.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.83
|
| Rate for Payer: Meridian Medicaid |
$341.96
|
| Rate for Payer: Nomi Health Commercial |
$573.52
|
| Rate for Payer: PACE SWMI |
$477.93
|
| Rate for Payer: PHP Medicare Advantage |
$477.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO |
$770.41
|
| Rate for Payer: Priority Health Medicare |
$482.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$770.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.93
|
| Rate for Payer: UHC Exchange |
$477.93
|
| Rate for Payer: UHC Medicare Advantage |
$477.93
|
| Rate for Payer: UHCCP Medicaid |
$325.68
|
|
|
PR CARPECTOMY 1 BONE
|
Facility
|
IP
|
$1,701.00
|
|
|
Service Code
|
CPT 25210
|
| Hospital Charge Code |
25210
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$1,105.65 |
| Max. Negotiated Rate |
$1,530.90 |
| Rate for Payer: Aetna Commercial |
$1,445.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.53
|
| Rate for Payer: BCN Commercial |
$1,314.53
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$1,462.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.80
|
| Rate for Payer: Healthscope Commercial |
$1,530.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,445.85
|
| Rate for Payer: Nomi Health Commercial |
$1,394.82
|
| Rate for Payer: PHP Commercial |
$1,445.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,479.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,139.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,496.88
|
| Rate for Payer: UHC Core |
$1,420.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.75
|
|
|
PR CARPECTOMY 1 BONE
|
Facility
|
OP
|
$1,701.00
|
|
|
Service Code
|
CPT 25210
|
| Hospital Charge Code |
25210
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$403.99 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$1,445.85
|
| Rate for Payer: Aetna Medicare |
$442.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$531.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$531.56
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$425.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,398.39
|
| Rate for Payer: BCN Commercial |
$1,322.53
|
| Rate for Payer: BCN Medicare Advantage |
$425.25
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$1,462.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.25
|
| Rate for Payer: Healthscope Commercial |
$1,530.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.75
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.51
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$489.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,445.85
|
| Rate for Payer: Nomi Health Commercial |
$1,394.82
|
| Rate for Payer: PACE Senior Care Partners |
$403.99
|
| Rate for Payer: PACE SWMI |
$425.25
|
| Rate for Payer: PHP Commercial |
$1,445.85
|
| Rate for Payer: PHP Medicare Advantage |
$425.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,479.87
|
| Rate for Payer: Priority Health Medicare |
$429.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,139.67
|
| Rate for Payer: Railroad Medicare Medicare |
$425.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,496.88
|
| Rate for Payer: UHC Core |
$1,420.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.25
|
| Rate for Payer: UHC Exchange |
$425.25
|
| Rate for Payer: UHC Medicare Advantage |
$425.25
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$425.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.75
|
|
|
PR CARPECTOMY 1 BONE
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 25210
|
| Hospital Charge Code |
25210
|
| Min. Negotiated Rate |
$325.68 |
| Max. Negotiated Rate |
$1,105.65 |
| Rate for Payer: Aetna Commercial |
$640.43
|
| Rate for Payer: Aetna Medicare |
$497.05
|
| Rate for Payer: BCBS Complete |
$341.96
|
| Rate for Payer: BCBS MAPPO |
$477.93
|
| Rate for Payer: BCBS Trust/PPO |
$637.66
|
| Rate for Payer: BCN Commercial |
$731.55
|
| Rate for Payer: BCN Medicare Advantage |
$477.93
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$688.22
|
| Rate for Payer: Cofinity Commercial |
$640.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.93
|
| Rate for Payer: Mclaren Medicaid |
$325.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.83
|
| Rate for Payer: Meridian Medicaid |
$341.96
|
| Rate for Payer: Nomi Health Commercial |
$573.52
|
| Rate for Payer: PACE SWMI |
$477.93
|
| Rate for Payer: PHP Medicare Advantage |
$477.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO |
$770.41
|
| Rate for Payer: Priority Health Medicare |
$482.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$770.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.93
|
| Rate for Payer: UHC Exchange |
$477.93
|
| Rate for Payer: UHC Medicare Advantage |
$477.93
|
| Rate for Payer: UHCCP Medicaid |
$325.68
|
|
|
PR CARPECTOMY ALL BONES PROXIMAL ROW
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 25215
|
| Min. Negotiated Rate |
$407.47 |
| Max. Negotiated Rate |
$1,487.85 |
| Rate for Payer: Aetna Commercial |
$804.16
|
| Rate for Payer: Aetna Medicare |
$624.12
|
| Rate for Payer: BCBS Complete |
$427.84
|
| Rate for Payer: BCBS MAPPO |
$600.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.98
|
| Rate for Payer: BCN Commercial |
$916.27
|
| Rate for Payer: BCN Medicare Advantage |
$600.12
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cofinity Commercial |
$864.17
|
| Rate for Payer: Cofinity Commercial |
$804.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.12
|
| Rate for Payer: Mclaren Medicaid |
$407.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.13
|
| Rate for Payer: Meridian Medicaid |
$427.84
|
| Rate for Payer: Nomi Health Commercial |
$720.14
|
| Rate for Payer: PACE SWMI |
$600.12
|
| Rate for Payer: PHP Medicare Advantage |
$600.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.85
|
| Rate for Payer: Priority Health HMO/PPO |
$963.27
|
| Rate for Payer: Priority Health Medicare |
$606.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$963.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$600.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.12
|
| Rate for Payer: UHC Exchange |
$600.12
|
| Rate for Payer: UHC Medicare Advantage |
$600.12
|
| Rate for Payer: UHCCP Medicaid |
$407.47
|
|
|
PR CARTILAGE GRAFT COSTOCHONDRAL
|
Professional
|
Both
|
$939.00
|
|
|
Service Code
|
HCPCS 20910
|
| Min. Negotiated Rate |
$312.90 |
| Max. Negotiated Rate |
$8,557.53 |
| Rate for Payer: Aetna Commercial |
$614.46
|
| Rate for Payer: Aetna Medicare |
$476.89
|
| Rate for Payer: BCBS Complete |
$328.54
|
| Rate for Payer: BCBS MAPPO |
$458.55
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCN Commercial |
$701.25
|
| Rate for Payer: BCN Medicare Advantage |
$458.55
|
| Rate for Payer: Cash Price |
$751.20
|
| Rate for Payer: Cash Price |
$751.20
|
| Rate for Payer: Cofinity Commercial |
$660.31
|
| Rate for Payer: Cofinity Commercial |
$614.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.55
|
| Rate for Payer: Mclaren Medicaid |
$312.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$481.48
|
| Rate for Payer: Meridian Medicaid |
$328.54
|
| Rate for Payer: Nomi Health Commercial |
$550.26
|
| Rate for Payer: PACE SWMI |
$458.55
|
| Rate for Payer: PHP Medicare Advantage |
$458.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.35
|
| Rate for Payer: Priority Health HMO/PPO |
$740.39
|
| Rate for Payer: Priority Health Medicare |
$463.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$740.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$458.55
|
| Rate for Payer: UHC Exchange |
$458.55
|
| Rate for Payer: UHC Medicare Advantage |
$458.55
|
| Rate for Payer: UHCCP Medicaid |
$312.90
|
|
|
PR CARTILAGE GRAFT NASAL SEPTUM
|
Professional
|
Both
|
$1,056.00
|
|
|
Service Code
|
HCPCS 20912
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$743.95 |
| Rate for Payer: Aetna Commercial |
$615.57
|
| Rate for Payer: Aetna Medicare |
$477.76
|
| Rate for Payer: BCBS Complete |
$327.87
|
| Rate for Payer: BCBS MAPPO |
$459.38
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$459.38
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cofinity Commercial |
$661.51
|
| Rate for Payer: Cofinity Commercial |
$615.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.38
|
| Rate for Payer: Mclaren Medicaid |
$312.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$482.35
|
| Rate for Payer: Meridian Medicaid |
$327.87
|
| Rate for Payer: Nomi Health Commercial |
$551.26
|
| Rate for Payer: PACE SWMI |
$459.38
|
| Rate for Payer: PHP Medicare Advantage |
$459.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$686.40
|
| Rate for Payer: Priority Health HMO/PPO |
$743.95
|
| Rate for Payer: Priority Health Medicare |
$463.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$743.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$459.38
|
| Rate for Payer: UHC Exchange |
$459.38
|
| Rate for Payer: UHC Medicare Advantage |
$459.38
|
| Rate for Payer: UHCCP Medicaid |
$312.26
|
|
|
PR CA SCREEN;FLEXI SIGMOIDSCOPE
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
HCPCS G0104
|
| Hospital Charge Code |
G0104
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$266.50 |
| Max. Negotiated Rate |
$369.00 |
| Rate for Payer: Aetna Commercial |
$348.50
|
| Rate for Payer: BCBS Trust/PPO |
$334.68
|
| Rate for Payer: BCN Commercial |
$316.85
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$352.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.00
|
| Rate for Payer: Healthscope Commercial |
$369.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.50
|
| Rate for Payer: Nomi Health Commercial |
$336.20
|
| Rate for Payer: PHP Commercial |
$348.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO |
$356.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.80
|
| Rate for Payer: UHC Core |
$342.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.50
|
|
|
PR CA SCREEN;FLEXI SIGMOIDSCOPE
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS G0104
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$1,681.05 |
| Rate for Payer: Aetna Commercial |
$71.73
|
| Rate for Payer: Aetna Medicare |
$55.67
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$53.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.05
|
| Rate for Payer: BCN Commercial |
$273.17
|
| Rate for Payer: BCN Medicare Advantage |
$53.53
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$77.08
|
| Rate for Payer: Cofinity Commercial |
$71.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.53
|
| Rate for Payer: Mclaren Medicaid |
$36.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.21
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Nomi Health Commercial |
$64.24
|
| Rate for Payer: PACE SWMI |
$53.53
|
| Rate for Payer: PHP Medicare Advantage |
$53.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO |
$100.83
|
| Rate for Payer: Priority Health Medicare |
$54.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.53
|
| Rate for Payer: UHC Exchange |
$53.53
|
| Rate for Payer: UHC Medicare Advantage |
$53.53
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
|
|
PR CA SCREEN;FLEXI SIGMOIDSCOPE
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS G0104
|
| Hospital Charge Code |
G0104
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$1,681.05 |
| Rate for Payer: Aetna Commercial |
$71.73
|
| Rate for Payer: Aetna Medicare |
$55.67
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$53.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.05
|
| Rate for Payer: BCN Commercial |
$273.17
|
| Rate for Payer: BCN Medicare Advantage |
$53.53
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$77.08
|
| Rate for Payer: Cofinity Commercial |
$71.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.53
|
| Rate for Payer: Mclaren Medicaid |
$36.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.21
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Nomi Health Commercial |
$64.24
|
| Rate for Payer: PACE SWMI |
$53.53
|
| Rate for Payer: PHP Medicare Advantage |
$53.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO |
$100.83
|
| Rate for Payer: Priority Health Medicare |
$54.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.53
|
| Rate for Payer: UHC Exchange |
$53.53
|
| Rate for Payer: UHC Medicare Advantage |
$53.53
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
|
|
PR CA SCREEN;FLEXI SIGMOIDSCOPE
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
HCPCS G0104
|
| Hospital Charge Code |
G0104
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$97.38 |
| Max. Negotiated Rate |
$678.18 |
| Rate for Payer: Aetna Commercial |
$348.50
|
| Rate for Payer: Aetna Medicare |
$106.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.12
|
| Rate for Payer: BCBS Complete |
$678.18
|
| Rate for Payer: BCBS MAPPO |
$102.50
|
| Rate for Payer: BCBS Trust/PPO |
$337.06
|
| Rate for Payer: BCN Commercial |
$318.78
|
| Rate for Payer: BCN Medicare Advantage |
$102.50
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$352.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.50
|
| Rate for Payer: Healthscope Commercial |
$369.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.50
|
| Rate for Payer: Mclaren Medicaid |
$645.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.62
|
| Rate for Payer: Meridian Medicaid |
$678.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.50
|
| Rate for Payer: Nomi Health Commercial |
$336.20
|
| Rate for Payer: PACE Senior Care Partners |
$97.38
|
| Rate for Payer: PACE SWMI |
$102.50
|
| Rate for Payer: PHP Commercial |
$348.50
|
| Rate for Payer: PHP Medicare Advantage |
$102.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO |
$356.70
|
| Rate for Payer: Priority Health Medicare |
$103.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.70
|
| Rate for Payer: Railroad Medicare Medicare |
$102.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.80
|
| Rate for Payer: UHC Core |
$342.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.50
|
| Rate for Payer: UHC Exchange |
$102.50
|
| Rate for Payer: UHC Medicare Advantage |
$102.50
|
| Rate for Payer: UHCCP Medicaid |
$645.84
|
| Rate for Payer: VA VA |
$102.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.50
|
|
|
PR CA SCREEN;PELVIC/BREAST EXAM
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS G0101
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$1,696.90 |
| Rate for Payer: Aetna Commercial |
$34.40
|
| Rate for Payer: Aetna Medicare |
$26.70
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS MAPPO |
$25.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,696.90
|
| Rate for Payer: BCN Commercial |
$57.17
|
| Rate for Payer: BCN Medicare Advantage |
$25.67
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$36.96
|
| Rate for Payer: Cofinity Commercial |
$34.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.67
|
| Rate for Payer: Mclaren Medicaid |
$17.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.95
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Nomi Health Commercial |
$30.80
|
| Rate for Payer: PACE SWMI |
$25.67
|
| Rate for Payer: PHP Medicare Advantage |
$25.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.20
|
| Rate for Payer: Priority Health HMO/PPO |
$36.80
|
| Rate for Payer: Priority Health Medicare |
$25.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.67
|
| Rate for Payer: UHC Exchange |
$25.67
|
| Rate for Payer: UHC Medicare Advantage |
$25.67
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
|
|
PR CAST SUP GAUNTLET FIBERGLASS
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS Q4014
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$36.40 |
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCN Commercial |
$26.15
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
|
|
PR CAST SUP LNG ARM SPLINT FBRG
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS Q4018
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCN Commercial |
$14.28
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
|
|
PR CAST SUP LNG ARM SPLINT PLST
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS Q4017
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCN Commercial |
$8.96
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
|
|
PR CAST SUP LNG ARM SPLNT PED F
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS Q4020
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCN Commercial |
$7.17
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
|
