|
PR CLOSURE ENTEROSTOMY LG/SMALL INTESTINE
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 44620
|
| Min. Negotiated Rate |
$210.79 |
| Max. Negotiated Rate |
$1,542.78 |
| Rate for Payer: Aetna Commercial |
$1,115.83
|
| Rate for Payer: Aetna Medicare |
$866.02
|
| Rate for Payer: BCBS Complete |
$581.04
|
| Rate for Payer: BCBS MAPPO |
$832.71
|
| Rate for Payer: BCBS Trust/PPO |
$210.79
|
| Rate for Payer: BCN Commercial |
$1,258.83
|
| Rate for Payer: BCN Medicare Advantage |
$832.71
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,199.10
|
| Rate for Payer: Cofinity Commercial |
$1,115.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.71
|
| Rate for Payer: Mclaren Medicaid |
$553.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$874.35
|
| Rate for Payer: Meridian Medicaid |
$581.04
|
| Rate for Payer: Nomi Health Commercial |
$999.25
|
| Rate for Payer: PACE SWMI |
$832.71
|
| Rate for Payer: PHP Medicare Advantage |
$832.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,542.78
|
| Rate for Payer: Priority Health Medicare |
$841.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,542.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$832.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$832.71
|
| Rate for Payer: UHC Exchange |
$832.71
|
| Rate for Payer: UHC Medicare Advantage |
$832.71
|
| Rate for Payer: UHCCP Medicaid |
$553.37
|
|
|
PR CLOSURE GASTROCOLIC FISTULA
|
Professional
|
Both
|
$3,893.00
|
|
|
Service Code
|
HCPCS 43880
|
| Min. Negotiated Rate |
$198.11 |
| Max. Negotiated Rate |
$2,873.80 |
| Rate for Payer: Aetna Commercial |
$2,095.77
|
| Rate for Payer: Aetna Medicare |
$1,626.57
|
| Rate for Payer: BCBS Complete |
$1,083.14
|
| Rate for Payer: BCBS MAPPO |
$1,564.01
|
| Rate for Payer: BCBS Trust/PPO |
$198.11
|
| Rate for Payer: BCN Commercial |
$2,311.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,564.01
|
| Rate for Payer: Cash Price |
$3,114.40
|
| Rate for Payer: Cash Price |
$3,114.40
|
| Rate for Payer: Cofinity Commercial |
$2,252.17
|
| Rate for Payer: Cofinity Commercial |
$2,095.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,564.01
|
| Rate for Payer: Mclaren Medicaid |
$1,031.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,642.21
|
| Rate for Payer: Meridian Medicaid |
$1,083.14
|
| Rate for Payer: Nomi Health Commercial |
$1,876.81
|
| Rate for Payer: PACE SWMI |
$1,564.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,564.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,031.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,530.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,873.80
|
| Rate for Payer: Priority Health Medicare |
$1,579.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,873.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,564.01
|
| Rate for Payer: UHC Exchange |
$1,564.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,564.01
|
| Rate for Payer: UHCCP Medicaid |
$1,031.56
|
|
|
PR CLOSURE GASTROSTOMY SURG
|
Professional
|
Both
|
$1,955.00
|
|
|
Service Code
|
HCPCS 43870
|
| Min. Negotiated Rate |
$202.87 |
| Max. Negotiated Rate |
$1,273.14 |
| Rate for Payer: Aetna Commercial |
$921.16
|
| Rate for Payer: Aetna Medicare |
$714.93
|
| Rate for Payer: BCBS Complete |
$479.50
|
| Rate for Payer: BCBS MAPPO |
$687.43
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$1,038.93
|
| Rate for Payer: BCN Medicare Advantage |
$687.43
|
| Rate for Payer: Cash Price |
$1,564.00
|
| Rate for Payer: Cash Price |
$1,564.00
|
| Rate for Payer: Cofinity Commercial |
$989.90
|
| Rate for Payer: Cofinity Commercial |
$921.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.43
|
| Rate for Payer: Mclaren Medicaid |
$456.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.80
|
| Rate for Payer: Meridian Medicaid |
$479.50
|
| Rate for Payer: Nomi Health Commercial |
$824.92
|
| Rate for Payer: PACE SWMI |
$687.43
|
| Rate for Payer: PHP Medicare Advantage |
$687.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,270.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,273.14
|
| Rate for Payer: Priority Health Medicare |
$694.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,273.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$687.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.43
|
| Rate for Payer: UHC Exchange |
$687.43
|
| Rate for Payer: UHC Medicare Advantage |
$687.43
|
| Rate for Payer: UHCCP Medicaid |
$456.67
|
|
|
PR CLOSURE INTESTINAL CUTANEOUS FISTULA
|
Professional
|
Both
|
$2,546.00
|
|
|
Service Code
|
HCPCS 44640
|
| Min. Negotiated Rate |
$175.40 |
| Max. Negotiated Rate |
$2,484.81 |
| Rate for Payer: Aetna Commercial |
$1,805.96
|
| Rate for Payer: Aetna Medicare |
$1,401.64
|
| Rate for Payer: BCBS Complete |
$935.53
|
| Rate for Payer: BCBS MAPPO |
$1,347.73
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$2,026.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,347.73
|
| Rate for Payer: Cash Price |
$2,036.80
|
| Rate for Payer: Cash Price |
$2,036.80
|
| Rate for Payer: Cofinity Commercial |
$1,940.73
|
| Rate for Payer: Cofinity Commercial |
$1,805.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,347.73
|
| Rate for Payer: Mclaren Medicaid |
$890.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,415.12
|
| Rate for Payer: Meridian Medicaid |
$935.53
|
| Rate for Payer: Nomi Health Commercial |
$1,617.28
|
| Rate for Payer: PACE SWMI |
$1,347.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,347.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$890.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.90
|
| Rate for Payer: Priority Health HMO/PPO |
$2,484.81
|
| Rate for Payer: Priority Health Medicare |
$1,361.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,484.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,347.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,347.73
|
| Rate for Payer: UHC Exchange |
$1,347.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,347.73
|
| Rate for Payer: UHCCP Medicaid |
$890.98
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 40830
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$805.66 |
| Rate for Payer: Aetna Commercial |
$185.12
|
| Rate for Payer: Aetna Medicare |
$143.68
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$138.15
|
| Rate for Payer: BCBS Trust/PPO |
$805.66
|
| Rate for Payer: BCN Commercial |
$332.79
|
| Rate for Payer: BCN Medicare Advantage |
$138.15
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$198.94
|
| Rate for Payer: Cofinity Commercial |
$185.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.15
|
| Rate for Payer: Mclaren Medicaid |
$94.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.06
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Nomi Health Commercial |
$165.78
|
| Rate for Payer: PACE SWMI |
$138.15
|
| Rate for Payer: PHP Medicare Advantage |
$138.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health HMO/PPO |
$260.72
|
| Rate for Payer: Priority Health Medicare |
$139.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.15
|
| Rate for Payer: UHC Exchange |
$138.15
|
| Rate for Payer: UHC Medicare Advantage |
$138.15
|
| Rate for Payer: UHCCP Medicaid |
$94.79
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 40831
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$949.88 |
| Rate for Payer: Aetna Commercial |
$256.05
|
| Rate for Payer: Aetna Medicare |
$198.72
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$191.08
|
| Rate for Payer: BCBS Trust/PPO |
$949.88
|
| Rate for Payer: BCN Commercial |
$436.39
|
| Rate for Payer: BCN Medicare Advantage |
$191.08
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$275.16
|
| Rate for Payer: Cofinity Commercial |
$256.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.08
|
| Rate for Payer: Mclaren Medicaid |
$131.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.63
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$229.30
|
| Rate for Payer: PACE SWMI |
$191.08
|
| Rate for Payer: PHP Medicare Advantage |
$191.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health HMO/PPO |
$359.74
|
| Rate for Payer: Priority Health Medicare |
$192.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$359.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.08
|
| Rate for Payer: UHC Exchange |
$191.08
|
| Rate for Payer: UHC Medicare Advantage |
$191.08
|
| Rate for Payer: UHCCP Medicaid |
$131.00
|
|
|
PR CLOSURE RECTOURETHRAL FISTULA
|
Professional
|
Both
|
$3,283.00
|
|
|
Service Code
|
HCPCS 45820
|
| Min. Negotiated Rate |
$527.24 |
| Max. Negotiated Rate |
$2,281.98 |
| Rate for Payer: Aetna Commercial |
$1,658.04
|
| Rate for Payer: Aetna Medicare |
$1,286.83
|
| Rate for Payer: BCBS Complete |
$861.27
|
| Rate for Payer: BCBS MAPPO |
$1,237.34
|
| Rate for Payer: BCBS Trust/PPO |
$527.24
|
| Rate for Payer: BCN Commercial |
$1,862.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.34
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cofinity Commercial |
$1,781.77
|
| Rate for Payer: Cofinity Commercial |
$1,658.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.34
|
| Rate for Payer: Mclaren Medicaid |
$820.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.21
|
| Rate for Payer: Meridian Medicaid |
$861.27
|
| Rate for Payer: Nomi Health Commercial |
$1,484.81
|
| Rate for Payer: PACE SWMI |
$1,237.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,133.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,281.98
|
| Rate for Payer: Priority Health Medicare |
$1,249.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,281.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,237.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,237.34
|
| Rate for Payer: UHC Exchange |
$1,237.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,237.34
|
| Rate for Payer: UHCCP Medicaid |
$820.26
|
|
|
PR CLOSURE RECTOVESICAL FISTULA
|
Professional
|
Both
|
$2,859.00
|
|
|
Service Code
|
HCPCS 45800
|
| Min. Negotiated Rate |
$818.35 |
| Max. Negotiated Rate |
$2,276.01 |
| Rate for Payer: Aetna Commercial |
$1,654.14
|
| Rate for Payer: Aetna Medicare |
$1,283.81
|
| Rate for Payer: BCBS Complete |
$859.27
|
| Rate for Payer: BCBS MAPPO |
$1,234.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.43
|
| Rate for Payer: BCN Commercial |
$1,857.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,234.43
|
| Rate for Payer: Cash Price |
$2,287.20
|
| Rate for Payer: Cash Price |
$2,287.20
|
| Rate for Payer: Cofinity Commercial |
$1,777.58
|
| Rate for Payer: Cofinity Commercial |
$1,654.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,234.43
|
| Rate for Payer: Mclaren Medicaid |
$818.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,296.15
|
| Rate for Payer: Meridian Medicaid |
$859.27
|
| Rate for Payer: Nomi Health Commercial |
$1,481.32
|
| Rate for Payer: PACE SWMI |
$1,234.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,234.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,858.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,276.01
|
| Rate for Payer: Priority Health Medicare |
$1,246.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,276.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,234.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,234.43
|
| Rate for Payer: UHC Exchange |
$1,234.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,234.43
|
| Rate for Payer: UHCCP Medicaid |
$818.35
|
|
|
PR CLOSURE SALIVARY FISTULA
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 42600
|
| Min. Negotiated Rate |
$231.11 |
| Max. Negotiated Rate |
$808.27 |
| Rate for Payer: Aetna Commercial |
$455.55
|
| Rate for Payer: Aetna Medicare |
$353.56
|
| Rate for Payer: BCBS Complete |
$242.67
|
| Rate for Payer: BCBS MAPPO |
$339.96
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: BCN Medicare Advantage |
$339.96
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cofinity Commercial |
$489.54
|
| Rate for Payer: Cofinity Commercial |
$455.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.96
|
| Rate for Payer: Mclaren Medicaid |
$231.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.96
|
| Rate for Payer: Meridian Medicaid |
$242.67
|
| Rate for Payer: Nomi Health Commercial |
$407.95
|
| Rate for Payer: PACE SWMI |
$339.96
|
| Rate for Payer: PHP Medicare Advantage |
$339.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.70
|
| Rate for Payer: Priority Health HMO/PPO |
$645.51
|
| Rate for Payer: Priority Health Medicare |
$343.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$645.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.96
|
| Rate for Payer: UHC Exchange |
$339.96
|
| Rate for Payer: UHC Medicare Advantage |
$339.96
|
| Rate for Payer: UHCCP Medicaid |
$231.11
|
|
|
PR CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH
|
Professional
|
Both
|
$963.00
|
|
|
Service Code
|
HCPCS 57320
|
| Min. Negotiated Rate |
$362.31 |
| Max. Negotiated Rate |
$1,656.75 |
| Rate for Payer: Aetna Commercial |
$722.62
|
| Rate for Payer: Aetna Medicare |
$560.84
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS MAPPO |
$539.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,656.75
|
| Rate for Payer: BCN Commercial |
$831.73
|
| Rate for Payer: BCN Medicare Advantage |
$539.27
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cofinity Commercial |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$722.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.27
|
| Rate for Payer: Mclaren Medicaid |
$362.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$566.23
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Nomi Health Commercial |
$647.12
|
| Rate for Payer: PACE SWMI |
$539.27
|
| Rate for Payer: PHP Medicare Advantage |
$539.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.95
|
| Rate for Payer: Priority Health HMO/PPO |
$847.74
|
| Rate for Payer: Priority Health Medicare |
$544.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$847.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$539.27
|
| Rate for Payer: UHC Exchange |
$539.27
|
| Rate for Payer: UHC Medicare Advantage |
$539.27
|
| Rate for Payer: UHCCP Medicaid |
$362.31
|
|
|
PR CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 23540
|
| Min. Negotiated Rate |
$159.54 |
| Max. Negotiated Rate |
$393.06 |
| Rate for Payer: Aetna Commercial |
$310.42
|
| Rate for Payer: Aetna Medicare |
$240.93
|
| Rate for Payer: BCBS Complete |
$167.52
|
| Rate for Payer: BCBS MAPPO |
$231.66
|
| Rate for Payer: BCBS Trust/PPO |
$393.06
|
| Rate for Payer: BCN Commercial |
$361.13
|
| Rate for Payer: BCN Medicare Advantage |
$231.66
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$333.59
|
| Rate for Payer: Cofinity Commercial |
$310.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.66
|
| Rate for Payer: Mclaren Medicaid |
$159.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.24
|
| Rate for Payer: Meridian Medicaid |
$167.52
|
| Rate for Payer: Nomi Health Commercial |
$277.99
|
| Rate for Payer: PACE SWMI |
$231.66
|
| Rate for Payer: PHP Medicare Advantage |
$231.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.70
|
| Rate for Payer: Priority Health HMO/PPO |
$378.09
|
| Rate for Payer: Priority Health Medicare |
$233.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$378.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.66
|
| Rate for Payer: UHC Exchange |
$231.66
|
| Rate for Payer: UHC Medicare Advantage |
$231.66
|
| Rate for Payer: UHCCP Medicaid |
$159.54
|
|
|
PR CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 23500
|
| Min. Negotiated Rate |
$155.49 |
| Max. Negotiated Rate |
$365.36 |
| Rate for Payer: Aetna Commercial |
$302.12
|
| Rate for Payer: Aetna Medicare |
$234.48
|
| Rate for Payer: BCBS Complete |
$163.26
|
| Rate for Payer: BCBS MAPPO |
$225.46
|
| Rate for Payer: BCBS Trust/PPO |
$226.26
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$225.46
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cofinity Commercial |
$324.66
|
| Rate for Payer: Cofinity Commercial |
$302.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.46
|
| Rate for Payer: Mclaren Medicaid |
$155.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.73
|
| Rate for Payer: Meridian Medicaid |
$163.26
|
| Rate for Payer: Nomi Health Commercial |
$270.55
|
| Rate for Payer: PACE SWMI |
$225.46
|
| Rate for Payer: PHP Medicare Advantage |
$225.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.40
|
| Rate for Payer: Priority Health HMO/PPO |
$365.36
|
| Rate for Payer: Priority Health Medicare |
$227.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$365.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.46
|
| Rate for Payer: UHC Exchange |
$225.46
|
| Rate for Payer: UHC Medicare Advantage |
$225.46
|
| Rate for Payer: UHCCP Medicaid |
$155.49
|
|
|
PR CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 24500
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$548.60 |
| Rate for Payer: Aetna Commercial |
$438.14
|
| Rate for Payer: Aetna Medicare |
$340.05
|
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: BCBS MAPPO |
$326.97
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$544.87
|
| Rate for Payer: BCN Medicare Advantage |
$326.97
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cofinity Commercial |
$470.84
|
| Rate for Payer: Cofinity Commercial |
$438.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.97
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.32
|
| Rate for Payer: Meridian Medicaid |
$236.40
|
| Rate for Payer: Nomi Health Commercial |
$392.36
|
| Rate for Payer: PACE SWMI |
$326.97
|
| Rate for Payer: PHP Medicare Advantage |
$326.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.60
|
| Rate for Payer: Priority Health HMO/PPO |
$533.28
|
| Rate for Payer: Priority Health Medicare |
$330.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.97
|
| Rate for Payer: UHC Exchange |
$326.97
|
| Rate for Payer: UHC Medicare Advantage |
$326.97
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
|
|
PR CLSD TX PELVIC RING FX W/MANIPULATION W/ANES
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 27198
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$2,080.97 |
| Rate for Payer: Aetna Commercial |
$408.41
|
| Rate for Payer: Aetna Medicare |
$316.97
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$304.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,080.97
|
| Rate for Payer: BCN Commercial |
$461.32
|
| Rate for Payer: BCN Medicare Advantage |
$304.78
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Cofinity Commercial |
$408.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.78
|
| Rate for Payer: Mclaren Medicaid |
$204.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.02
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Nomi Health Commercial |
$365.74
|
| Rate for Payer: PACE SWMI |
$304.78
|
| Rate for Payer: PHP Medicare Advantage |
$304.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.35
|
| Rate for Payer: Priority Health HMO/PPO |
$483.42
|
| Rate for Payer: Priority Health Medicare |
$307.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$304.78
|
| Rate for Payer: UHC Exchange |
$304.78
|
| Rate for Payer: UHC Medicare Advantage |
$304.78
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR CLSD TX PELVIC RING FX W/O MANIPULATION
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 27197
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$1,831.62 |
| Rate for Payer: Aetna Commercial |
$168.33
|
| Rate for Payer: Aetna Medicare |
$130.64
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$125.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.62
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$125.62
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$180.89
|
| Rate for Payer: Cofinity Commercial |
$168.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.62
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.90
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Nomi Health Commercial |
$150.74
|
| Rate for Payer: PACE SWMI |
$125.62
|
| Rate for Payer: PHP Medicare Advantage |
$125.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO |
$205.58
|
| Rate for Payer: Priority Health Medicare |
$126.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.62
|
| Rate for Payer: UHC Exchange |
$125.62
|
| Rate for Payer: UHC Medicare Advantage |
$125.62
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 23655
|
| Min. Negotiated Rate |
$270.30 |
| Max. Negotiated Rate |
$670.15 |
| Rate for Payer: Aetna Commercial |
$530.47
|
| Rate for Payer: Aetna Medicare |
$411.70
|
| Rate for Payer: BCBS Complete |
$283.82
|
| Rate for Payer: BCBS MAPPO |
$395.87
|
| Rate for Payer: BCBS Trust/PPO |
$372.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$395.87
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$570.05
|
| Rate for Payer: Cofinity Commercial |
$530.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.87
|
| Rate for Payer: Mclaren Medicaid |
$270.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.66
|
| Rate for Payer: Meridian Medicaid |
$283.82
|
| Rate for Payer: Nomi Health Commercial |
$475.04
|
| Rate for Payer: PACE SWMI |
$395.87
|
| Rate for Payer: PHP Medicare Advantage |
$395.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.15
|
| Rate for Payer: Priority Health HMO/PPO |
$641.16
|
| Rate for Payer: Priority Health Medicare |
$399.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$641.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.87
|
| Rate for Payer: UHC Exchange |
$395.87
|
| Rate for Payer: UHC Medicare Advantage |
$395.87
|
| Rate for Payer: UHCCP Medicaid |
$270.30
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 23650
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$498.94 |
| Rate for Payer: Aetna Commercial |
$397.31
|
| Rate for Payer: Aetna Medicare |
$308.36
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS MAPPO |
$296.50
|
| Rate for Payer: BCBS Trust/PPO |
$328.60
|
| Rate for Payer: BCN Commercial |
$498.94
|
| Rate for Payer: BCN Medicare Advantage |
$296.50
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cofinity Commercial |
$426.96
|
| Rate for Payer: Cofinity Commercial |
$397.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.50
|
| Rate for Payer: Mclaren Medicaid |
$202.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.32
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Nomi Health Commercial |
$355.80
|
| Rate for Payer: PACE SWMI |
$296.50
|
| Rate for Payer: PHP Medicare Advantage |
$296.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health HMO/PPO |
$478.33
|
| Rate for Payer: Priority Health Medicare |
$299.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.50
|
| Rate for Payer: UHC Exchange |
$296.50
|
| Rate for Payer: UHC Medicare Advantage |
$296.50
|
| Rate for Payer: UHCCP Medicaid |
$202.56
|
|
|
PR CLSR ANAL FSTL W/RCT ADVMNT FLAP
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 46288
|
| Min. Negotiated Rate |
$362.53 |
| Max. Negotiated Rate |
$2,458.18 |
| Rate for Payer: Aetna Commercial |
$717.74
|
| Rate for Payer: Aetna Medicare |
$557.06
|
| Rate for Payer: BCBS Complete |
$380.66
|
| Rate for Payer: BCBS MAPPO |
$535.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.18
|
| Rate for Payer: BCN Commercial |
$818.53
|
| Rate for Payer: BCN Medicare Advantage |
$535.63
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cofinity Commercial |
$771.31
|
| Rate for Payer: Cofinity Commercial |
$717.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.63
|
| Rate for Payer: Mclaren Medicaid |
$362.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.41
|
| Rate for Payer: Meridian Medicaid |
$380.66
|
| Rate for Payer: Nomi Health Commercial |
$642.76
|
| Rate for Payer: PACE SWMI |
$535.63
|
| Rate for Payer: PHP Medicare Advantage |
$535.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,007.05
|
| Rate for Payer: Priority Health Medicare |
$540.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,007.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.63
|
| Rate for Payer: UHC Exchange |
$535.63
|
| Rate for Payer: UHC Medicare Advantage |
$535.63
|
| Rate for Payer: UHCCP Medicaid |
$362.53
|
|
|
PR CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA
|
Professional
|
Both
|
$1,872.00
|
|
|
Service Code
|
HCPCS 32810
|
| Min. Negotiated Rate |
$573.18 |
| Max. Negotiated Rate |
$1,299.88 |
| Rate for Payer: Aetna Commercial |
$1,161.71
|
| Rate for Payer: Aetna Medicare |
$901.63
|
| Rate for Payer: BCBS Complete |
$601.84
|
| Rate for Payer: BCBS MAPPO |
$866.95
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,299.88
|
| Rate for Payer: BCN Medicare Advantage |
$866.95
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cash Price |
$1,497.60
|
| Rate for Payer: Cofinity Commercial |
$1,248.41
|
| Rate for Payer: Cofinity Commercial |
$1,161.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.95
|
| Rate for Payer: Mclaren Medicaid |
$573.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$910.30
|
| Rate for Payer: Meridian Medicaid |
$601.84
|
| Rate for Payer: Nomi Health Commercial |
$1,040.34
|
| Rate for Payer: PACE SWMI |
$866.95
|
| Rate for Payer: PHP Medicare Advantage |
$866.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,242.10
|
| Rate for Payer: Priority Health Medicare |
$875.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,242.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$866.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$866.95
|
| Rate for Payer: UHC Exchange |
$866.95
|
| Rate for Payer: UHC Medicare Advantage |
$866.95
|
| Rate for Payer: UHCCP Medicaid |
$573.18
|
|
|
PR CLSR ENTEROENTERIC/ENTEROCOLIC FSTL
|
Professional
|
Both
|
$2,579.00
|
|
|
Service Code
|
HCPCS 44650
|
| Min. Negotiated Rate |
$245.13 |
| Max. Negotiated Rate |
$2,561.78 |
| Rate for Payer: Aetna Commercial |
$1,856.82
|
| Rate for Payer: Aetna Medicare |
$1,441.12
|
| Rate for Payer: BCBS Complete |
$962.59
|
| Rate for Payer: BCBS MAPPO |
$1,385.69
|
| Rate for Payer: BCBS Trust/PPO |
$245.13
|
| Rate for Payer: BCN Commercial |
$2,089.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,385.69
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cash Price |
$2,063.20
|
| Rate for Payer: Cofinity Commercial |
$1,995.39
|
| Rate for Payer: Cofinity Commercial |
$1,856.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,385.69
|
| Rate for Payer: Mclaren Medicaid |
$916.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,454.97
|
| Rate for Payer: Meridian Medicaid |
$962.59
|
| Rate for Payer: Nomi Health Commercial |
$1,662.83
|
| Rate for Payer: PACE SWMI |
$1,385.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,385.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$916.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,676.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,561.78
|
| Rate for Payer: Priority Health Medicare |
$1,399.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,561.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,385.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,385.69
|
| Rate for Payer: UHC Exchange |
$1,385.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,385.69
|
| Rate for Payer: UHCCP Medicaid |
$916.75
|
|
|
PR CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ
|
Professional
|
Both
|
$3,576.00
|
|
|
Service Code
|
HCPCS 44661
|
| Min. Negotiated Rate |
$246.19 |
| Max. Negotiated Rate |
$2,739.56 |
| Rate for Payer: Aetna Commercial |
$1,995.19
|
| Rate for Payer: Aetna Medicare |
$1,548.51
|
| Rate for Payer: BCBS Complete |
$1,034.16
|
| Rate for Payer: BCBS MAPPO |
$1,488.95
|
| Rate for Payer: BCBS Trust/PPO |
$246.19
|
| Rate for Payer: BCN Commercial |
$2,239.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,488.95
|
| Rate for Payer: Cash Price |
$2,860.80
|
| Rate for Payer: Cash Price |
$2,860.80
|
| Rate for Payer: Cofinity Commercial |
$2,144.09
|
| Rate for Payer: Cofinity Commercial |
$1,995.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,488.95
|
| Rate for Payer: Mclaren Medicaid |
$984.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,563.40
|
| Rate for Payer: Meridian Medicaid |
$1,034.16
|
| Rate for Payer: Nomi Health Commercial |
$1,786.74
|
| Rate for Payer: PACE SWMI |
$1,488.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,488.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$984.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,324.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,739.56
|
| Rate for Payer: Priority Health Medicare |
$1,503.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,739.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,488.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,488.95
|
| Rate for Payer: UHC Exchange |
$1,488.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,488.95
|
| Rate for Payer: UHCCP Medicaid |
$984.91
|
|
|
PR CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ
|
Professional
|
Both
|
$2,662.00
|
|
|
Service Code
|
HCPCS 44660
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$2,387.58 |
| Rate for Payer: Aetna Commercial |
$1,727.31
|
| Rate for Payer: Aetna Medicare |
$1,340.60
|
| Rate for Payer: BCBS Complete |
$897.73
|
| Rate for Payer: BCBS MAPPO |
$1,289.04
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,934.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,289.04
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cofinity Commercial |
$1,856.22
|
| Rate for Payer: Cofinity Commercial |
$1,727.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,289.04
|
| Rate for Payer: Mclaren Medicaid |
$854.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,353.49
|
| Rate for Payer: Meridian Medicaid |
$897.73
|
| Rate for Payer: Nomi Health Commercial |
$1,546.85
|
| Rate for Payer: PACE SWMI |
$1,289.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,289.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$854.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,730.30
|
| Rate for Payer: Priority Health HMO/PPO |
$2,387.58
|
| Rate for Payer: Priority Health Medicare |
$1,301.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,387.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,289.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,289.04
|
| Rate for Payer: UHC Exchange |
$1,289.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,289.04
|
| Rate for Payer: UHCCP Medicaid |
$854.98
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL CRV APPR
|
Professional
|
Both
|
$2,693.00
|
|
|
Service Code
|
HCPCS 43420
|
| Min. Negotiated Rate |
$654.12 |
| Max. Negotiated Rate |
$1,826.76 |
| Rate for Payer: Aetna Commercial |
$1,304.85
|
| Rate for Payer: Aetna Medicare |
$1,012.72
|
| Rate for Payer: BCBS Complete |
$686.83
|
| Rate for Payer: BCBS MAPPO |
$973.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.77
|
| Rate for Payer: BCN Commercial |
$1,490.95
|
| Rate for Payer: BCN Medicare Advantage |
$973.77
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cash Price |
$2,154.40
|
| Rate for Payer: Cofinity Commercial |
$1,402.23
|
| Rate for Payer: Cofinity Commercial |
$1,304.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$973.77
|
| Rate for Payer: Mclaren Medicaid |
$654.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,022.46
|
| Rate for Payer: Meridian Medicaid |
$686.83
|
| Rate for Payer: Nomi Health Commercial |
$1,168.52
|
| Rate for Payer: PACE SWMI |
$973.77
|
| Rate for Payer: PHP Medicare Advantage |
$973.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,826.76
|
| Rate for Payer: Priority Health Medicare |
$983.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,826.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$973.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$973.77
|
| Rate for Payer: UHC Exchange |
$973.77
|
| Rate for Payer: UHC Medicare Advantage |
$973.77
|
| Rate for Payer: UHCCP Medicaid |
$654.12
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,177.00
|
|
|
Service Code
|
HCPCS 43425
|
| Min. Negotiated Rate |
$914.84 |
| Max. Negotiated Rate |
$2,715.05 |
| Rate for Payer: Aetna Commercial |
$1,862.05
|
| Rate for Payer: Aetna Medicare |
$1,445.17
|
| Rate for Payer: BCBS Complete |
$960.58
|
| Rate for Payer: BCBS MAPPO |
$1,389.59
|
| Rate for Payer: BCBS Trust/PPO |
$986.34
|
| Rate for Payer: BCN Commercial |
$2,080.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.59
|
| Rate for Payer: Cash Price |
$3,341.60
|
| Rate for Payer: Cash Price |
$3,341.60
|
| Rate for Payer: Cofinity Commercial |
$2,001.01
|
| Rate for Payer: Cofinity Commercial |
$1,862.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.59
|
| Rate for Payer: Mclaren Medicaid |
$914.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,459.07
|
| Rate for Payer: Meridian Medicaid |
$960.58
|
| Rate for Payer: Nomi Health Commercial |
$1,667.51
|
| Rate for Payer: PACE SWMI |
$1,389.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$914.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,715.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,552.82
|
| Rate for Payer: Priority Health Medicare |
$1,403.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,552.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,389.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.59
|
| Rate for Payer: UHC Exchange |
$1,389.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.59
|
| Rate for Payer: UHCCP Medicaid |
$914.84
|
|
|
PR CLSR LACRIMAL PUNCTUM PLUG EACH
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 68761
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$1,031.77 |
| Rate for Payer: Aetna Commercial |
$144.04
|
| Rate for Payer: Aetna Medicare |
$111.79
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$107.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.77
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$107.49
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$154.79
|
| Rate for Payer: Cofinity Commercial |
$144.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.49
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.86
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Nomi Health Commercial |
$128.99
|
| Rate for Payer: PACE SWMI |
$107.49
|
| Rate for Payer: PHP Medicare Advantage |
$107.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health HMO/PPO |
$204.13
|
| Rate for Payer: Priority Health Medicare |
$108.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.49
|
| Rate for Payer: UHC Exchange |
$107.49
|
| Rate for Payer: UHC Medicare Advantage |
$107.49
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
