|
PR CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$3,009.00
|
|
|
Service Code
|
HCPCS 47605
|
| Min. Negotiated Rate |
$725.69 |
| Max. Negotiated Rate |
$2,020.67 |
| Rate for Payer: Aetna Commercial |
$1,468.84
|
| Rate for Payer: Aetna Medicare |
$1,140.00
|
| Rate for Payer: BCBS Complete |
$761.97
|
| Rate for Payer: BCBS MAPPO |
$1,096.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.79
|
| Rate for Payer: BCN Commercial |
$1,648.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.15
|
| Rate for Payer: Cash Price |
$2,407.20
|
| Rate for Payer: Cash Price |
$2,407.20
|
| 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 |
$725.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.96
|
| Rate for Payer: Meridian Medicaid |
$761.97
|
| Rate for Payer: Nomi Health Commercial |
$1,315.38
|
| Rate for Payer: PACE SWMI |
$1,096.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,955.85
|
| Rate for Payer: Priority Health HMO/PPO |
$2,020.67
|
| Rate for Payer: Priority Health Medicare |
$1,107.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,020.67
|
| 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 Exchange |
$1,096.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,096.15
|
| Rate for Payer: UHCCP Medicaid |
$725.69
|
|
|
PR CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT
|
Professional
|
Both
|
$3,310.00
|
|
|
Service Code
|
HCPCS 47610
|
| Min. Negotiated Rate |
$141.58 |
| Max. Negotiated Rate |
$2,235.43 |
| Rate for Payer: Aetna Commercial |
$1,634.95
|
| Rate for Payer: Aetna Medicare |
$1,268.91
|
| Rate for Payer: BCBS Complete |
$846.74
|
| Rate for Payer: BCBS MAPPO |
$1,220.11
|
| Rate for Payer: BCBS Trust/PPO |
$141.58
|
| Rate for Payer: BCN Commercial |
$1,829.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,220.11
|
| Rate for Payer: Cash Price |
$2,648.00
|
| Rate for Payer: Cash Price |
$2,648.00
|
| Rate for Payer: Cofinity Commercial |
$1,756.96
|
| Rate for Payer: Cofinity Commercial |
$1,634.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,220.11
|
| Rate for Payer: Mclaren Medicaid |
$806.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,281.12
|
| Rate for Payer: Meridian Medicaid |
$846.74
|
| Rate for Payer: Nomi Health Commercial |
$1,464.13
|
| Rate for Payer: PACE SWMI |
$1,220.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,220.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$806.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,151.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,235.43
|
| Rate for Payer: Priority Health Medicare |
$1,232.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,235.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,220.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,220.11
|
| Rate for Payer: UHC Exchange |
$1,220.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,220.11
|
| Rate for Payer: UHCCP Medicaid |
$806.42
|
|
|
PR CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 47490
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$4,357.95 |
| Rate for Payer: Aetna Commercial |
$413.66
|
| Rate for Payer: Aetna Medicare |
$321.05
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$308.70
|
| Rate for Payer: BCBS Trust/PPO |
$4,357.95
|
| Rate for Payer: BCN Commercial |
$480.37
|
| Rate for Payer: BCN Medicare Advantage |
$308.70
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$444.53
|
| Rate for Payer: Cofinity Commercial |
$413.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.70
|
| Rate for Payer: Mclaren Medicaid |
$210.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.14
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Nomi Health Commercial |
$370.44
|
| Rate for Payer: PACE SWMI |
$308.70
|
| Rate for Payer: PHP Medicare Advantage |
$308.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.05
|
| Rate for Payer: Priority Health HMO/PPO |
$584.06
|
| Rate for Payer: Priority Health Medicare |
$311.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$584.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.70
|
| Rate for Payer: UHC Exchange |
$308.70
|
| Rate for Payer: UHC Medicare Advantage |
$308.70
|
| Rate for Payer: UHCCP Medicaid |
$210.23
|
|
|
PR CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,405.00
|
|
|
Service Code
|
HCPCS 47420
|
| Min. Negotiated Rate |
$856.69 |
| Max. Negotiated Rate |
$2,396.52 |
| Rate for Payer: Aetna Commercial |
$1,734.58
|
| Rate for Payer: Aetna Medicare |
$1,346.24
|
| Rate for Payer: BCBS Complete |
$899.52
|
| Rate for Payer: BCBS MAPPO |
$1,294.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.71
|
| Rate for Payer: BCN Commercial |
$1,943.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,294.46
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cofinity Commercial |
$1,864.02
|
| Rate for Payer: Cofinity Commercial |
$1,734.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,294.46
|
| Rate for Payer: Mclaren Medicaid |
$856.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,359.18
|
| Rate for Payer: Meridian Medicaid |
$899.52
|
| Rate for Payer: Nomi Health Commercial |
$1,553.35
|
| Rate for Payer: PACE SWMI |
$1,294.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,294.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,396.52
|
| Rate for Payer: Priority Health Medicare |
$1,307.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,396.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,294.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,294.46
|
| Rate for Payer: UHC Exchange |
$1,294.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,294.46
|
| Rate for Payer: UHCCP Medicaid |
$856.69
|
|
|
PR CHOLERA IMMUNIZATION,INJECTABLE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 90725
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
|
|
PR CHOLINESTERASE INHIBITOR CHALLENGE TEST
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 95857
|
| Min. Negotiated Rate |
$17.89 |
| Max. Negotiated Rate |
$220.30 |
| Rate for Payer: Aetna Commercial |
$35.67
|
| Rate for Payer: Aetna Medicare |
$27.68
|
| Rate for Payer: BCBS Complete |
$18.78
|
| Rate for Payer: BCBS MAPPO |
$26.62
|
| Rate for Payer: BCBS Trust/PPO |
$220.30
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.62
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Cofinity Commercial |
$35.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.62
|
| Rate for Payer: Mclaren Medicaid |
$17.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.95
|
| Rate for Payer: Meridian Medicaid |
$18.78
|
| Rate for Payer: Nomi Health Commercial |
$31.94
|
| Rate for Payer: PACE SWMI |
$26.62
|
| Rate for Payer: PHP Medicare Advantage |
$26.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health HMO/PPO |
$37.99
|
| Rate for Payer: Priority Health Medicare |
$26.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.62
|
| Rate for Payer: UHC Exchange |
$26.62
|
| Rate for Payer: UHC Medicare Advantage |
$26.62
|
| Rate for Payer: UHCCP Medicaid |
$17.89
|
|
|
PR CHORIONIC VILLUS SAMPLING
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 59015
|
| Min. Negotiated Rate |
$83.92 |
| Max. Negotiated Rate |
$258.70 |
| Rate for Payer: Aetna Commercial |
$171.56
|
| Rate for Payer: Aetna Medicare |
$133.15
|
| Rate for Payer: BCBS Complete |
$88.12
|
| Rate for Payer: BCBS MAPPO |
$128.03
|
| Rate for Payer: BCBS Trust/PPO |
$143.17
|
| Rate for Payer: BCN Commercial |
$231.15
|
| Rate for Payer: BCN Medicare Advantage |
$128.03
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$184.36
|
| Rate for Payer: Cofinity Commercial |
$171.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.03
|
| Rate for Payer: Mclaren Medicaid |
$83.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.43
|
| Rate for Payer: Meridian Medicaid |
$88.12
|
| Rate for Payer: Nomi Health Commercial |
$153.64
|
| Rate for Payer: PACE SWMI |
$128.03
|
| Rate for Payer: PHP Medicare Advantage |
$128.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.70
|
| Rate for Payer: Priority Health HMO/PPO |
$183.98
|
| Rate for Payer: Priority Health Medicare |
$129.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.03
|
| Rate for Payer: UHC Exchange |
$128.03
|
| Rate for Payer: UHC Medicare Advantage |
$128.03
|
| Rate for Payer: UHCCP Medicaid |
$83.92
|
|
|
PR CHROMOTUBATION OVIDUCT W/MATERIALS
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 58350
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$508.22 |
| Rate for Payer: Aetna Commercial |
$118.56
|
| Rate for Payer: Aetna Medicare |
$92.02
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS MAPPO |
$88.48
|
| Rate for Payer: BCBS Trust/PPO |
$508.22
|
| Rate for Payer: BCN Commercial |
$228.22
|
| Rate for Payer: BCN Medicare Advantage |
$88.48
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$127.41
|
| Rate for Payer: Cofinity Commercial |
$118.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.48
|
| Rate for Payer: Mclaren Medicaid |
$60.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.90
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Nomi Health Commercial |
$106.18
|
| Rate for Payer: PACE SWMI |
$88.48
|
| Rate for Payer: PHP Medicare Advantage |
$88.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO |
$142.86
|
| Rate for Payer: Priority Health Medicare |
$89.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.48
|
| Rate for Payer: UHC Exchange |
$88.48
|
| Rate for Payer: UHC Medicare Advantage |
$88.48
|
| Rate for Payer: UHCCP Medicaid |
$60.71
|
|
|
PR CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE
|
Professional
|
Both
|
$3,535.00
|
|
|
Service Code
|
HCPCS 24940
|
| Min. Negotiated Rate |
$602.42 |
| Max. Negotiated Rate |
$11,675.93 |
| Rate for Payer: Aetna Commercial |
$1,439.82
|
| Rate for Payer: Aetna Medicare |
$1,767.50
|
| Rate for Payer: BCBS Complete |
$632.54
|
| Rate for Payer: BCBS Trust/PPO |
$730.11
|
| Rate for Payer: BCN Commercial |
$11,675.93
|
| Rate for Payer: Cash Price |
$2,828.00
|
| Rate for Payer: Cash Price |
$2,828.00
|
| Rate for Payer: Mclaren Medicaid |
$602.42
|
| Rate for Payer: Meridian Medicaid |
$632.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,680.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,680.25
|
| Rate for Payer: UHCCP Medicaid |
$602.42
|
|
|
PR CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT
|
Professional
|
Both
|
$646.00
|
|
|
Service Code
|
HCPCS 94772
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$544.82 |
| Rate for Payer: Aetna Commercial |
$318.52
|
| Rate for Payer: Aetna Medicare |
$323.00
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS Trust/PPO |
$518.79
|
| Rate for Payer: BCN Commercial |
$544.82
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Mclaren Medicaid |
$36.85
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.90
|
| Rate for Payer: Priority Health HMO/PPO |
$170.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.98
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,543.00
|
|
|
Service Code
|
HCPCS 54161
|
| Hospital Charge Code |
54161
|
| Min. Negotiated Rate |
$127.16 |
| Max. Negotiated Rate |
$1,002.95 |
| Rate for Payer: Aetna Commercial |
$253.09
|
| Rate for Payer: Aetna Medicare |
$196.42
|
| Rate for Payer: BCBS Complete |
$133.52
|
| Rate for Payer: BCBS MAPPO |
$188.87
|
| Rate for Payer: BCBS Trust/PPO |
$496.07
|
| Rate for Payer: BCN Commercial |
$285.39
|
| Rate for Payer: BCN Medicare Advantage |
$188.87
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cofinity Commercial |
$271.97
|
| Rate for Payer: Cofinity Commercial |
$253.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.87
|
| Rate for Payer: Mclaren Medicaid |
$127.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.31
|
| Rate for Payer: Meridian Medicaid |
$133.52
|
| Rate for Payer: Nomi Health Commercial |
$226.64
|
| Rate for Payer: PACE SWMI |
$188.87
|
| Rate for Payer: PHP Medicare Advantage |
$188.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.95
|
| Rate for Payer: Priority Health HMO/PPO |
$315.30
|
| Rate for Payer: Priority Health Medicare |
$190.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$315.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.87
|
| Rate for Payer: UHC Exchange |
$188.87
|
| Rate for Payer: UHC Medicare Advantage |
$188.87
|
| Rate for Payer: UHCCP Medicaid |
$127.16
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
IP
|
$1,543.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,002.95 |
| Max. Negotiated Rate |
$1,388.70 |
| Rate for Payer: Aetna Commercial |
$1,311.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.55
|
| Rate for Payer: BCN Commercial |
$1,192.43
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cofinity Commercial |
$1,326.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,234.40
|
| Rate for Payer: Healthscope Commercial |
$1,388.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,157.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,311.55
|
| Rate for Payer: Nomi Health Commercial |
$1,265.26
|
| Rate for Payer: PHP Commercial |
$1,311.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,342.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,033.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,357.84
|
| Rate for Payer: UHC Core |
$1,288.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,157.25
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
OP
|
$1,543.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$366.46 |
| Max. Negotiated Rate |
$1,523.78 |
| Rate for Payer: Aetna Commercial |
$1,311.55
|
| Rate for Payer: Aetna Medicare |
$401.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$482.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$482.19
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$385.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,268.50
|
| Rate for Payer: BCN Commercial |
$1,199.68
|
| Rate for Payer: BCN Medicare Advantage |
$385.75
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cofinity Commercial |
$1,326.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,234.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$385.75
|
| Rate for Payer: Healthscope Commercial |
$1,388.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,157.25
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$405.04
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$443.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,311.55
|
| Rate for Payer: Nomi Health Commercial |
$1,265.26
|
| Rate for Payer: PACE Senior Care Partners |
$366.46
|
| Rate for Payer: PACE SWMI |
$385.75
|
| Rate for Payer: PHP Commercial |
$1,311.55
|
| Rate for Payer: PHP Medicare Advantage |
$385.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,342.41
|
| Rate for Payer: Priority Health Medicare |
$389.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,033.81
|
| Rate for Payer: Railroad Medicare Medicare |
$385.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,357.84
|
| Rate for Payer: UHC Core |
$1,288.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$385.75
|
| Rate for Payer: UHC Exchange |
$385.75
|
| Rate for Payer: UHC Medicare Advantage |
$385.75
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$385.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,157.25
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,543.00
|
|
|
Service Code
|
HCPCS 54161
|
| Min. Negotiated Rate |
$127.16 |
| Max. Negotiated Rate |
$1,002.95 |
| Rate for Payer: Aetna Commercial |
$253.09
|
| Rate for Payer: Aetna Medicare |
$196.42
|
| Rate for Payer: BCBS Complete |
$133.52
|
| Rate for Payer: BCBS MAPPO |
$188.87
|
| Rate for Payer: BCBS Trust/PPO |
$496.07
|
| Rate for Payer: BCN Commercial |
$285.39
|
| Rate for Payer: BCN Medicare Advantage |
$188.87
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cofinity Commercial |
$271.97
|
| Rate for Payer: Cofinity Commercial |
$253.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.87
|
| Rate for Payer: Mclaren Medicaid |
$127.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.31
|
| Rate for Payer: Meridian Medicaid |
$133.52
|
| Rate for Payer: Nomi Health Commercial |
$226.64
|
| Rate for Payer: PACE SWMI |
$188.87
|
| Rate for Payer: PHP Medicare Advantage |
$188.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.95
|
| Rate for Payer: Priority Health HMO/PPO |
$315.30
|
| Rate for Payer: Priority Health Medicare |
$190.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$315.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.87
|
| Rate for Payer: UHC Exchange |
$188.87
|
| Rate for Payer: UHC Medicare Advantage |
$188.87
|
| Rate for Payer: UHCCP Medicaid |
$127.16
|
|
|
PR CIRCUMCISION NEONATE
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
HCPCS 54160
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$2,797.35 |
| Rate for Payer: Aetna Commercial |
$185.60
|
| Rate for Payer: Aetna Medicare |
$144.05
|
| Rate for Payer: BCBS Complete |
$97.73
|
| Rate for Payer: BCBS MAPPO |
$138.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,797.35
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: BCN Medicare Advantage |
$138.51
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cofinity Commercial |
$199.45
|
| Rate for Payer: Cofinity Commercial |
$185.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.51
|
| Rate for Payer: Mclaren Medicaid |
$93.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.44
|
| Rate for Payer: Meridian Medicaid |
$97.73
|
| Rate for Payer: Nomi Health Commercial |
$166.21
|
| Rate for Payer: PACE SWMI |
$138.51
|
| Rate for Payer: PHP Medicare Advantage |
$138.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.90
|
| Rate for Payer: Priority Health HMO/PPO |
$232.21
|
| Rate for Payer: Priority Health Medicare |
$139.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.51
|
| Rate for Payer: UHC Exchange |
$138.51
|
| Rate for Payer: UHC Medicare Advantage |
$138.51
|
| Rate for Payer: UHCCP Medicaid |
$93.08
|
|
|
PR CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 54150
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$1,797.28 |
| Rate for Payer: Aetna Commercial |
$123.39
|
| Rate for Payer: Aetna Medicare |
$95.76
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$92.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.28
|
| Rate for Payer: BCN Commercial |
$216.98
|
| Rate for Payer: BCN Medicare Advantage |
$92.08
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$132.60
|
| Rate for Payer: Cofinity Commercial |
$123.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.08
|
| Rate for Payer: Mclaren Medicaid |
$61.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.68
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Nomi Health Commercial |
$110.50
|
| Rate for Payer: PACE SWMI |
$92.08
|
| Rate for Payer: PHP Medicare Advantage |
$92.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health HMO/PPO |
$151.79
|
| Rate for Payer: Priority Health Medicare |
$93.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.08
|
| Rate for Payer: UHC Exchange |
$92.08
|
| Rate for Payer: UHC Medicare Advantage |
$92.08
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
|
|
PR CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 61050
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$519.32 |
| Rate for Payer: Aetna Commercial |
$102.70
|
| Rate for Payer: Aetna Medicare |
$79.71
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS MAPPO |
$76.64
|
| Rate for Payer: BCBS Trust/PPO |
$519.32
|
| Rate for Payer: BCN Commercial |
$115.82
|
| Rate for Payer: BCN Medicare Advantage |
$76.64
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$110.36
|
| Rate for Payer: Cofinity Commercial |
$102.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.64
|
| Rate for Payer: Mclaren Medicaid |
$51.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.47
|
| Rate for Payer: Meridian Medicaid |
$53.90
|
| Rate for Payer: Nomi Health Commercial |
$91.97
|
| Rate for Payer: PACE SWMI |
$76.64
|
| Rate for Payer: PHP Medicare Advantage |
$76.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.35
|
| Rate for Payer: Priority Health HMO/PPO |
$134.78
|
| Rate for Payer: Priority Health Medicare |
$77.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.64
|
| Rate for Payer: UHC Exchange |
$76.64
|
| Rate for Payer: UHC Medicare Advantage |
$76.64
|
| Rate for Payer: UHCCP Medicaid |
$51.33
|
|
|
PR CLAVICULECTOMY PARTIAL
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 23120
|
| Min. Negotiated Rate |
$34.34 |
| Max. Negotiated Rate |
$956.69 |
| Rate for Payer: Aetna Commercial |
$760.70
|
| Rate for Payer: Aetna Medicare |
$590.40
|
| Rate for Payer: BCBS Complete |
$405.26
|
| Rate for Payer: BCBS MAPPO |
$567.69
|
| Rate for Payer: BCBS Trust/PPO |
$34.34
|
| Rate for Payer: BCN Commercial |
$956.69
|
| Rate for Payer: BCN Medicare Advantage |
$567.69
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$817.47
|
| Rate for Payer: Cofinity Commercial |
$760.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$567.69
|
| Rate for Payer: Mclaren Medicaid |
$385.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$596.07
|
| Rate for Payer: Meridian Medicaid |
$405.26
|
| Rate for Payer: Nomi Health Commercial |
$681.23
|
| Rate for Payer: PACE SWMI |
$567.69
|
| Rate for Payer: PHP Medicare Advantage |
$567.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.80
|
| Rate for Payer: Priority Health HMO/PPO |
$915.96
|
| Rate for Payer: Priority Health Medicare |
$573.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$915.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$567.69
|
| Rate for Payer: UHC Exchange |
$567.69
|
| Rate for Payer: UHC Medicare Advantage |
$567.69
|
| Rate for Payer: UHCCP Medicaid |
$385.96
|
|
|
PR CLAVICULECTOMY TOTAL
|
Professional
|
Both
|
$1,599.00
|
|
|
Service Code
|
HCPCS 23125
|
| Min. Negotiated Rate |
$44.38 |
| Max. Negotiated Rate |
$1,100.67 |
| Rate for Payer: Aetna Commercial |
$920.77
|
| Rate for Payer: Aetna Medicare |
$714.63
|
| Rate for Payer: BCBS Complete |
$487.78
|
| Rate for Payer: BCBS MAPPO |
$687.14
|
| Rate for Payer: BCBS Trust/PPO |
$44.38
|
| Rate for Payer: BCN Commercial |
$1,047.24
|
| Rate for Payer: BCN Medicare Advantage |
$687.14
|
| Rate for Payer: Cash Price |
$1,279.20
|
| Rate for Payer: Cash Price |
$1,279.20
|
| Rate for Payer: Cofinity Commercial |
$989.48
|
| Rate for Payer: Cofinity Commercial |
$920.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.14
|
| Rate for Payer: Mclaren Medicaid |
$464.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.50
|
| Rate for Payer: Meridian Medicaid |
$487.78
|
| Rate for Payer: Nomi Health Commercial |
$824.57
|
| Rate for Payer: PACE SWMI |
$687.14
|
| Rate for Payer: PHP Medicare Advantage |
$687.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,039.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,100.67
|
| Rate for Payer: Priority Health Medicare |
$694.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$687.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.14
|
| Rate for Payer: UHC Exchange |
$687.14
|
| Rate for Payer: UHC Medicare Advantage |
$687.14
|
| Rate for Payer: UHCCP Medicaid |
$464.55
|
|
|
PR CLOSED RX PELVIC RING FX/SUBLUX
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 27193
|
| Min. Negotiated Rate |
$388.00 |
| Max. Negotiated Rate |
$630.50 |
| Rate for Payer: Aetna Medicare |
$485.00
|
| Rate for Payer: BCBS Complete |
$388.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.50
|
|
|
PR CLOSED RX PELV RING FX/SUBLUX,MANIP
|
Professional
|
Both
|
$1,941.00
|
|
|
Service Code
|
HCPCS 27194
|
| Min. Negotiated Rate |
$776.40 |
| Max. Negotiated Rate |
$1,261.65 |
| Rate for Payer: Aetna Medicare |
$970.50
|
| Rate for Payer: BCBS Complete |
$776.40
|
| Rate for Payer: Cash Price |
$1,552.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,261.65
|
|
|
PR CLOSED RX RIB FRACTURE
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 21800
|
| Min. Negotiated Rate |
$89.60 |
| Max. Negotiated Rate |
$145.60 |
| Rate for Payer: Aetna Medicare |
$112.00
|
| Rate for Payer: BCBS Complete |
$89.60
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
|
|
PR CLOSED TREATMENT COCCYGEAL FRACTURE
|
Professional
|
Both
|
$390.00
|
|
|
Service Code
|
HCPCS 27200
|
| Min. Negotiated Rate |
$129.29 |
| Max. Negotiated Rate |
$1,904.52 |
| Rate for Payer: Aetna Commercial |
$251.52
|
| Rate for Payer: Aetna Medicare |
$195.21
|
| Rate for Payer: BCBS Complete |
$135.75
|
| Rate for Payer: BCBS MAPPO |
$187.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,904.52
|
| Rate for Payer: BCN Commercial |
$279.53
|
| Rate for Payer: BCN Medicare Advantage |
$187.70
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$251.52
|
| Rate for Payer: Cofinity Commercial |
$270.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.70
|
| Rate for Payer: Mclaren Medicaid |
$129.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.08
|
| Rate for Payer: Meridian Medicaid |
$135.75
|
| Rate for Payer: Nomi Health Commercial |
$225.24
|
| Rate for Payer: PACE SWMI |
$187.70
|
| Rate for Payer: PHP Medicare Advantage |
$187.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.50
|
| Rate for Payer: Priority Health HMO/PPO |
$304.30
|
| Rate for Payer: Priority Health Medicare |
$189.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.70
|
| Rate for Payer: UHC Exchange |
$187.70
|
| Rate for Payer: UHC Medicare Advantage |
$187.70
|
| Rate for Payer: UHCCP Medicaid |
$129.29
|
|
|
PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 27768
|
| Min. Negotiated Rate |
$298.41 |
| Max. Negotiated Rate |
$3,241.12 |
| Rate for Payer: Aetna Commercial |
$584.84
|
| Rate for Payer: Aetna Medicare |
$453.91
|
| Rate for Payer: BCBS Complete |
$313.33
|
| Rate for Payer: BCBS MAPPO |
$436.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,241.12
|
| Rate for Payer: BCN Commercial |
$667.54
|
| Rate for Payer: BCN Medicare Advantage |
$436.45
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$628.49
|
| Rate for Payer: Cofinity Commercial |
$584.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.45
|
| Rate for Payer: Mclaren Medicaid |
$298.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.27
|
| Rate for Payer: Meridian Medicaid |
$313.33
|
| Rate for Payer: Nomi Health Commercial |
$523.74
|
| Rate for Payer: PACE SWMI |
$436.45
|
| Rate for Payer: PHP Medicare Advantage |
$436.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO |
$706.30
|
| Rate for Payer: Priority Health Medicare |
$440.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$706.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.45
|
| Rate for Payer: UHC Exchange |
$436.45
|
| Rate for Payer: UHC Medicare Advantage |
$436.45
|
| Rate for Payer: UHCCP Medicaid |
$298.41
|
|
|
PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 27767
|
| Min. Negotiated Rate |
$196.81 |
| Max. Negotiated Rate |
$563.09 |
| Rate for Payer: Aetna Commercial |
$380.72
|
| Rate for Payer: Aetna Medicare |
$295.48
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$284.12
|
| Rate for Payer: BCBS Trust/PPO |
$563.09
|
| Rate for Payer: BCN Commercial |
$438.35
|
| Rate for Payer: BCN Medicare Advantage |
$284.12
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$409.13
|
| Rate for Payer: Cofinity Commercial |
$380.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.12
|
| Rate for Payer: Mclaren Medicaid |
$196.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.33
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Nomi Health Commercial |
$340.94
|
| Rate for Payer: PACE SWMI |
$284.12
|
| Rate for Payer: PHP Medicare Advantage |
$284.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.55
|
| Rate for Payer: Priority Health HMO/PPO |
$461.02
|
| Rate for Payer: Priority Health Medicare |
$286.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$284.12
|
| Rate for Payer: UHC Exchange |
$284.12
|
| Rate for Payer: UHC Medicare Advantage |
$284.12
|
| Rate for Payer: UHCCP Medicaid |
$196.81
|
|
