PR LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS
|
Professional
|
Both
|
$912.00
|
|
Service Code
|
HCPCS 38308
|
Min. Negotiated Rate |
$302.46 |
Max. Negotiated Rate |
$1,010.46 |
Rate for Payer: Aetna Commercial |
$616.21
|
Rate for Payer: Aetna Medicare |
$478.25
|
Rate for Payer: BCBS Complete |
$317.58
|
Rate for Payer: BCBS MAPPO |
$459.86
|
Rate for Payer: BCBS Trust/PPO |
$635.54
|
Rate for Payer: BCN Commercial |
$681.71
|
Rate for Payer: BCN Medicare Advantage |
$459.86
|
Rate for Payer: Cash Price |
$729.60
|
Rate for Payer: Cash Price |
$729.60
|
Rate for Payer: Cofinity Commercial |
$662.20
|
Rate for Payer: Cofinity Commercial |
$616.21
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.86
|
Rate for Payer: Mclaren Medicaid |
$302.46
|
Rate for Payer: Meridian Medicaid |
$317.58
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$482.85
|
Rate for Payer: PACE SWMI |
$459.86
|
Rate for Payer: PHP Medicare Advantage |
$459.86
|
Rate for Payer: Priority Health Choice Medicaid |
$302.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,010.46
|
Rate for Payer: Priority Health Medicare |
$459.86
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,010.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$459.86
|
Rate for Payer: UHC Dual Complete DSNP |
$459.86
|
Rate for Payer: UHC Medicare Advantage |
$473.66
|
|
PR LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Professional
|
Both
|
$511.00
|
|
Service Code
|
HCPCS 54162
|
Min. Negotiated Rate |
$128.23 |
Max. Negotiated Rate |
$1,225.13 |
Rate for Payer: Aetna Commercial |
$262.13
|
Rate for Payer: Aetna Medicare |
$203.44
|
Rate for Payer: BCBS Complete |
$134.64
|
Rate for Payer: BCBS MAPPO |
$195.62
|
Rate for Payer: BCBS Trust/PPO |
$1,225.13
|
Rate for Payer: BCN Commercial |
$374.33
|
Rate for Payer: BCN Medicare Advantage |
$195.62
|
Rate for Payer: Cash Price |
$408.80
|
Rate for Payer: Cash Price |
$408.80
|
Rate for Payer: Cofinity Commercial |
$281.69
|
Rate for Payer: Cofinity Commercial |
$262.13
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.62
|
Rate for Payer: Mclaren Medicaid |
$128.23
|
Rate for Payer: Meridian Medicaid |
$134.64
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.40
|
Rate for Payer: PACE SWMI |
$195.62
|
Rate for Payer: PHP Medicare Advantage |
$195.62
|
Rate for Payer: Priority Health Choice Medicaid |
$128.23
|
Rate for Payer: Priority Health Cigna Priority Health |
$357.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.97
|
Rate for Payer: Priority Health Medicare |
$195.62
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$320.97
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$195.62
|
Rate for Payer: UHC Dual Complete DSNP |
$195.62
|
Rate for Payer: UHC Medicare Advantage |
$201.49
|
|
PR LYSIS INTRANASAL SYNECHIA
|
Professional
|
Both
|
$506.00
|
|
Service Code
|
HCPCS 30560
|
Min. Negotiated Rate |
$97.55 |
Max. Negotiated Rate |
$805.66 |
Rate for Payer: Aetna Commercial |
$194.94
|
Rate for Payer: Aetna Medicare |
$151.30
|
Rate for Payer: BCBS Complete |
$102.43
|
Rate for Payer: BCBS MAPPO |
$145.48
|
Rate for Payer: BCBS Trust/PPO |
$805.66
|
Rate for Payer: BCN Commercial |
$479.88
|
Rate for Payer: BCN Medicare Advantage |
$145.48
|
Rate for Payer: Cash Price |
$404.80
|
Rate for Payer: Cash Price |
$404.80
|
Rate for Payer: Cofinity Commercial |
$209.49
|
Rate for Payer: Cofinity Commercial |
$194.94
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.48
|
Rate for Payer: Mclaren Medicaid |
$97.55
|
Rate for Payer: Meridian Medicaid |
$102.43
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.75
|
Rate for Payer: PACE SWMI |
$145.48
|
Rate for Payer: PHP Medicare Advantage |
$145.48
|
Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
Rate for Payer: Priority Health Cigna Priority Health |
$354.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.69
|
Rate for Payer: Priority Health Medicare |
$145.48
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$210.69
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$145.48
|
Rate for Payer: UHC Dual Complete DSNP |
$145.48
|
Rate for Payer: UHC Medicare Advantage |
$149.84
|
|
PR LYSIS LABIAL ADHESIONS
|
Professional
|
Both
|
$482.00
|
|
Service Code
|
HCPCS 56441
|
Min. Negotiated Rate |
$100.32 |
Max. Negotiated Rate |
$488.15 |
Rate for Payer: Aetna Commercial |
$202.77
|
Rate for Payer: Aetna Medicare |
$157.37
|
Rate for Payer: BCBS Complete |
$105.34
|
Rate for Payer: BCBS MAPPO |
$151.32
|
Rate for Payer: BCBS Trust/PPO |
$488.15
|
Rate for Payer: BCN Commercial |
$270.24
|
Rate for Payer: BCN Medicare Advantage |
$151.32
|
Rate for Payer: Cash Price |
$385.60
|
Rate for Payer: Cash Price |
$385.60
|
Rate for Payer: Cofinity Commercial |
$217.90
|
Rate for Payer: Cofinity Commercial |
$202.77
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.32
|
Rate for Payer: Mclaren Medicaid |
$100.32
|
Rate for Payer: Meridian Medicaid |
$105.34
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.89
|
Rate for Payer: PACE SWMI |
$151.32
|
Rate for Payer: PHP Medicare Advantage |
$151.32
|
Rate for Payer: Priority Health Choice Medicaid |
$100.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$337.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.15
|
Rate for Payer: Priority Health Medicare |
$151.32
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$220.15
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$151.32
|
Rate for Payer: UHC Dual Complete DSNP |
$151.32
|
Rate for Payer: UHC Medicare Advantage |
$155.86
|
|
PR LYSIS OF ADHESIONS SALPINX/OVARY
|
Professional
|
Both
|
$2,380.00
|
|
Service Code
|
HCPCS 58740
|
Min. Negotiated Rate |
$207.09 |
Max. Negotiated Rate |
$1,666.00 |
Rate for Payer: Aetna Commercial |
$1,200.45
|
Rate for Payer: Aetna Medicare |
$931.69
|
Rate for Payer: BCBS Complete |
$608.33
|
Rate for Payer: BCBS MAPPO |
$895.86
|
Rate for Payer: BCBS Trust/PPO |
$207.09
|
Rate for Payer: BCN Commercial |
$1,323.34
|
Rate for Payer: BCN Medicare Advantage |
$895.86
|
Rate for Payer: Cash Price |
$1,904.00
|
Rate for Payer: Cash Price |
$1,904.00
|
Rate for Payer: Cofinity Commercial |
$1,290.04
|
Rate for Payer: Cofinity Commercial |
$1,200.45
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.86
|
Rate for Payer: Mclaren Medicaid |
$579.36
|
Rate for Payer: Meridian Medicaid |
$608.33
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$940.65
|
Rate for Payer: PACE SWMI |
$895.86
|
Rate for Payer: PHP Medicare Advantage |
$895.86
|
Rate for Payer: Priority Health Choice Medicaid |
$579.36
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,666.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,282.04
|
Rate for Payer: Priority Health Medicare |
$895.86
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,282.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$895.86
|
Rate for Payer: UHC Dual Complete DSNP |
$895.86
|
Rate for Payer: UHC Medicare Advantage |
$922.74
|
|
PR MA/EC CONTRACEPTIVEINJECTION
|
Professional
|
Both
|
$33.00
|
|
Service Code
|
HCPCS J1056
|
Min. Negotiated Rate |
$13.20 |
Max. Negotiated Rate |
$23.10 |
Rate for Payer: BCBS Complete |
$13.20
|
Rate for Payer: Cash Price |
$26.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$23.10
|
|
PR MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC
|
Professional
|
Both
|
$3,282.00
|
|
Service Code
|
HCPCS 32820
|
Min. Negotiated Rate |
$841.78 |
Max. Negotiated Rate |
$2,297.40 |
Rate for Payer: Aetna Commercial |
$1,756.57
|
Rate for Payer: Aetna Medicare |
$1,363.30
|
Rate for Payer: BCBS Complete |
$883.87
|
Rate for Payer: BCBS MAPPO |
$1,310.87
|
Rate for Payer: BCBS Trust/PPO |
$878.56
|
Rate for Payer: BCN Commercial |
$1,919.52
|
Rate for Payer: BCN Medicare Advantage |
$1,310.87
|
Rate for Payer: Cash Price |
$2,625.60
|
Rate for Payer: Cash Price |
$2,625.60
|
Rate for Payer: Cofinity Commercial |
$1,887.65
|
Rate for Payer: Cofinity Commercial |
$1,756.57
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,310.87
|
Rate for Payer: Mclaren Medicaid |
$841.78
|
Rate for Payer: Meridian Medicaid |
$883.87
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,376.41
|
Rate for Payer: PACE SWMI |
$1,310.87
|
Rate for Payer: PHP Medicare Advantage |
$1,310.87
|
Rate for Payer: Priority Health Choice Medicaid |
$841.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,297.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,818.84
|
Rate for Payer: Priority Health Medicare |
$1,310.87
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,818.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,310.87
|
Rate for Payer: UHC Dual Complete DSNP |
$1,310.87
|
Rate for Payer: UHC Medicare Advantage |
$1,350.20
|
|
PR Makena, 10 mg
|
Professional
|
Both
|
$2.50
|
|
Service Code
|
HCPCS J1726
|
Min. Negotiated Rate |
$1.00 |
Max. Negotiated Rate |
$19.41 |
Rate for Payer: Aetna Commercial |
$19.41
|
Rate for Payer: BCBS Complete |
$1.00
|
Rate for Payer: BCBS Trust/PPO |
$6.80
|
Rate for Payer: BCN Commercial |
$6.80
|
Rate for Payer: Cash Price |
$2.00
|
Rate for Payer: Cash Price |
$2.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$1.75
|
|
PR MAMMAPLASTY AUGMENTATION - GEL
|
Professional
|
Both
|
$4,840.00
|
|
Service Code
|
HCPCS 00261
|
Hospital Revenue Code
|
990
|
Min. Negotiated Rate |
$1,936.00 |
Max. Negotiated Rate |
$3,388.00 |
Rate for Payer: BCBS Complete |
$1,936.00
|
Rate for Payer: Cash Price |
$3,872.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,388.00
|
|
PR MAMMAPLASTY AUGMENTATION - SALINE
|
Professional
|
Both
|
$3,700.00
|
|
Service Code
|
HCPCS 00262
|
Hospital Revenue Code
|
990
|
Min. Negotiated Rate |
$1,480.00 |
Max. Negotiated Rate |
$2,590.00 |
Rate for Payer: BCBS Complete |
$1,480.00
|
Rate for Payer: Cash Price |
$2,960.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,590.00
|
|
PR MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD
|
Professional
|
Both
|
$402.00
|
|
Service Code
|
HCPCS 26341
|
Min. Negotiated Rate |
$50.69 |
Max. Negotiated Rate |
$354.49 |
Rate for Payer: Aetna Commercial |
$102.66
|
Rate for Payer: Aetna Medicare |
$79.67
|
Rate for Payer: BCBS Complete |
$53.22
|
Rate for Payer: BCBS MAPPO |
$76.61
|
Rate for Payer: BCBS Trust/PPO |
$354.49
|
Rate for Payer: BCN Commercial |
$173.48
|
Rate for Payer: BCN Medicare Advantage |
$76.61
|
Rate for Payer: Cash Price |
$321.60
|
Rate for Payer: Cash Price |
$321.60
|
Rate for Payer: Cofinity Commercial |
$110.32
|
Rate for Payer: Cofinity Commercial |
$102.66
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.61
|
Rate for Payer: Mclaren Medicaid |
$50.69
|
Rate for Payer: Meridian Medicaid |
$53.22
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$80.44
|
Rate for Payer: PACE SWMI |
$76.61
|
Rate for Payer: PHP Medicare Advantage |
$76.61
|
Rate for Payer: Priority Health Choice Medicaid |
$50.69
|
Rate for Payer: Priority Health Cigna Priority Health |
$281.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.51
|
Rate for Payer: Priority Health Medicare |
$76.61
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$120.51
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$76.61
|
Rate for Payer: UHC Dual Complete DSNP |
$76.61
|
Rate for Payer: UHC Medicare Advantage |
$78.91
|
|
PR MANIPULATION ANKLE UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$618.00
|
|
Service Code
|
HCPCS 27860
|
Min. Negotiated Rate |
$105.44 |
Max. Negotiated Rate |
$1,252.07 |
Rate for Payer: Aetna Commercial |
$216.14
|
Rate for Payer: Aetna Medicare |
$167.75
|
Rate for Payer: BCBS Complete |
$110.71
|
Rate for Payer: BCBS MAPPO |
$161.30
|
Rate for Payer: BCBS Trust/PPO |
$1,252.07
|
Rate for Payer: BCN Commercial |
$240.92
|
Rate for Payer: BCN Medicare Advantage |
$161.30
|
Rate for Payer: Cash Price |
$494.40
|
Rate for Payer: Cash Price |
$494.40
|
Rate for Payer: Cofinity Commercial |
$232.27
|
Rate for Payer: Cofinity Commercial |
$216.14
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.30
|
Rate for Payer: Mclaren Medicaid |
$105.44
|
Rate for Payer: Meridian Medicaid |
$110.71
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$169.36
|
Rate for Payer: PACE SWMI |
$161.30
|
Rate for Payer: PHP Medicare Advantage |
$161.30
|
Rate for Payer: Priority Health Choice Medicaid |
$105.44
|
Rate for Payer: Priority Health Cigna Priority Health |
$432.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.74
|
Rate for Payer: Priority Health Medicare |
$161.30
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$251.74
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$161.30
|
Rate for Payer: UHC Dual Complete DSNP |
$161.30
|
Rate for Payer: UHC Medicare Advantage |
$166.14
|
|
PR MANIPULATION ELBOW UNDER ANESTHESIA
|
Professional
|
Both
|
$702.00
|
|
Service Code
|
HCPCS 24300
|
Min. Negotiated Rate |
$92.45 |
Max. Negotiated Rate |
$678.14 |
Rate for Payer: Aetna Commercial |
$571.23
|
Rate for Payer: Aetna Medicare |
$443.34
|
Rate for Payer: BCBS Complete |
$303.94
|
Rate for Payer: BCBS MAPPO |
$426.29
|
Rate for Payer: BCBS Trust/PPO |
$92.45
|
Rate for Payer: BCN Commercial |
$648.96
|
Rate for Payer: BCN Medicare Advantage |
$426.29
|
Rate for Payer: Cash Price |
$561.60
|
Rate for Payer: Cash Price |
$561.60
|
Rate for Payer: Cofinity Commercial |
$571.23
|
Rate for Payer: Cofinity Commercial |
$613.86
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.29
|
Rate for Payer: Mclaren Medicaid |
$289.47
|
Rate for Payer: Meridian Medicaid |
$303.94
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$447.60
|
Rate for Payer: PACE SWMI |
$426.29
|
Rate for Payer: PHP Medicare Advantage |
$426.29
|
Rate for Payer: Priority Health Choice Medicaid |
$289.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$678.14
|
Rate for Payer: Priority Health Medicare |
$426.29
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$678.14
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$426.29
|
Rate for Payer: UHC Dual Complete DSNP |
$426.29
|
Rate for Payer: UHC Medicare Advantage |
$439.08
|
|
PR MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Professional
|
Both
|
$700.00
|
|
Service Code
|
HCPCS 26340
|
Min. Negotiated Rate |
$108.30 |
Max. Negotiated Rate |
$552.01 |
Rate for Payer: Aetna Commercial |
$462.31
|
Rate for Payer: Aetna Medicare |
$358.81
|
Rate for Payer: BCBS Complete |
$247.14
|
Rate for Payer: BCBS MAPPO |
$345.01
|
Rate for Payer: BCBS Trust/PPO |
$108.30
|
Rate for Payer: BCN Commercial |
$528.26
|
Rate for Payer: BCN Medicare Advantage |
$345.01
|
Rate for Payer: Cash Price |
$560.00
|
Rate for Payer: Cash Price |
$560.00
|
Rate for Payer: Cofinity Commercial |
$496.81
|
Rate for Payer: Cofinity Commercial |
$462.31
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.01
|
Rate for Payer: Mclaren Medicaid |
$235.37
|
Rate for Payer: Meridian Medicaid |
$247.14
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$362.26
|
Rate for Payer: PACE SWMI |
$345.01
|
Rate for Payer: PHP Medicare Advantage |
$345.01
|
Rate for Payer: Priority Health Choice Medicaid |
$235.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$552.01
|
Rate for Payer: Priority Health Medicare |
$345.01
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$552.01
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$345.01
|
Rate for Payer: UHC Dual Complete DSNP |
$345.01
|
Rate for Payer: UHC Medicare Advantage |
$355.36
|
|
PR MANIPULATION HIP JOINT GENERAL ANESTHESIA
|
Professional
|
Both
|
$988.00
|
|
Service Code
|
HCPCS 27275
|
Min. Negotiated Rate |
$119.49 |
Max. Negotiated Rate |
$4,431.91 |
Rate for Payer: Aetna Commercial |
$241.84
|
Rate for Payer: Aetna Medicare |
$187.70
|
Rate for Payer: BCBS Complete |
$125.46
|
Rate for Payer: BCBS MAPPO |
$180.48
|
Rate for Payer: BCBS Trust/PPO |
$4,431.91
|
Rate for Payer: BCN Commercial |
$270.73
|
Rate for Payer: BCN Medicare Advantage |
$180.48
|
Rate for Payer: Cash Price |
$790.40
|
Rate for Payer: Cash Price |
$790.40
|
Rate for Payer: Cofinity Commercial |
$259.89
|
Rate for Payer: Cofinity Commercial |
$241.84
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.48
|
Rate for Payer: Mclaren Medicaid |
$119.49
|
Rate for Payer: Meridian Medicaid |
$125.46
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$189.50
|
Rate for Payer: PACE SWMI |
$180.48
|
Rate for Payer: PHP Medicare Advantage |
$180.48
|
Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$691.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.91
|
Rate for Payer: Priority Health Medicare |
$180.48
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$282.91
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$180.48
|
Rate for Payer: UHC Dual Complete DSNP |
$180.48
|
Rate for Payer: UHC Medicare Advantage |
$185.89
|
|
PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA
|
Facility
|
IP
|
$656.00
|
|
Service Code
|
CPT 27570
|
Hospital Charge Code |
27570
|
Min. Negotiated Rate |
$400.09 |
Max. Negotiated Rate |
$590.40 |
Rate for Payer: Aetna Commercial |
$557.60
|
Rate for Payer: BCBS Trust/PPO |
$506.96
|
Rate for Payer: BCN Commercial |
$506.96
|
Rate for Payer: Cash Price |
$524.80
|
Rate for Payer: Cofinity Commercial |
$564.16
|
Rate for Payer: Encore Health Key Benefits Commercial |
$524.80
|
Rate for Payer: Healthscope Commercial |
$590.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$557.60
|
Rate for Payer: PHP Commercial |
$557.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$459.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.72
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$400.09
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$577.28
|
Rate for Payer: UHC Core |
$547.76
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.00
|
|
PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$656.00
|
|
Service Code
|
HCPCS 27570
|
Min. Negotiated Rate |
$100.11 |
Max. Negotiated Rate |
$1,799.92 |
Rate for Payer: Aetna Commercial |
$201.47
|
Rate for Payer: Aetna Medicare |
$156.36
|
Rate for Payer: BCBS Complete |
$105.12
|
Rate for Payer: BCBS MAPPO |
$150.35
|
Rate for Payer: BCBS Trust/PPO |
$1,799.92
|
Rate for Payer: BCN Commercial |
$226.26
|
Rate for Payer: BCN Medicare Advantage |
$150.35
|
Rate for Payer: Cash Price |
$524.80
|
Rate for Payer: Cash Price |
$524.80
|
Rate for Payer: Cofinity Commercial |
$216.50
|
Rate for Payer: Cofinity Commercial |
$201.47
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.35
|
Rate for Payer: Mclaren Medicaid |
$100.11
|
Rate for Payer: Meridian Medicaid |
$105.12
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.87
|
Rate for Payer: PACE SWMI |
$150.35
|
Rate for Payer: PHP Medicare Advantage |
$150.35
|
Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$459.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.43
|
Rate for Payer: Priority Health Medicare |
$150.35
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$236.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$150.35
|
Rate for Payer: UHC Dual Complete DSNP |
$150.35
|
Rate for Payer: UHC Medicare Advantage |
$154.86
|
|
PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA
|
Facility
|
OP
|
$656.00
|
|
Service Code
|
CPT 27570
|
Hospital Charge Code |
27570
|
Min. Negotiated Rate |
$155.80 |
Max. Negotiated Rate |
$1,107.03 |
Rate for Payer: Aetna Commercial |
$557.60
|
Rate for Payer: Aetna Medicare |
$170.56
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.00
|
Rate for Payer: Amish Plain Church Group Commercial |
$205.00
|
Rate for Payer: BCBS Complete |
$1,107.03
|
Rate for Payer: BCBS MAPPO |
$164.00
|
Rate for Payer: BCBS Trust/PPO |
$510.04
|
Rate for Payer: BCN Commercial |
$510.04
|
Rate for Payer: BCN Medicare Advantage |
$164.00
|
Rate for Payer: Cash Price |
$524.80
|
Rate for Payer: Cash Price |
$524.80
|
Rate for Payer: Cofinity Commercial |
$564.16
|
Rate for Payer: Encore Health Key Benefits Commercial |
$524.80
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.00
|
Rate for Payer: Healthscope Commercial |
$590.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.00
|
Rate for Payer: Mclaren Medicaid |
$1,054.31
|
Rate for Payer: Meridian Medicaid |
$1,107.03
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.20
|
Rate for Payer: MI Amish Medical Board Commercial |
$188.60
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$557.60
|
Rate for Payer: PACE Senior Care Partners |
$155.80
|
Rate for Payer: PACE SWMI |
$164.00
|
Rate for Payer: PHP Commercial |
$557.60
|
Rate for Payer: PHP Medicare Advantage |
$164.00
|
Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
Rate for Payer: Priority Health Cigna Priority Health |
$459.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.72
|
Rate for Payer: Priority Health Medicare |
$164.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$400.09
|
Rate for Payer: Railroad Medicare Medicare |
$164.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$577.28
|
Rate for Payer: UHC Core |
$547.76
|
Rate for Payer: UHC Dual Complete DSNP |
$164.00
|
Rate for Payer: UHC Medicare Advantage |
$168.92
|
Rate for Payer: VA VA |
$164.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.00
|
|
PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$656.00
|
|
Service Code
|
HCPCS 27570
|
Hospital Charge Code |
27570
|
Min. Negotiated Rate |
$100.11 |
Max. Negotiated Rate |
$1,799.92 |
Rate for Payer: Aetna Commercial |
$201.47
|
Rate for Payer: Aetna Medicare |
$156.36
|
Rate for Payer: BCBS Complete |
$105.12
|
Rate for Payer: BCBS MAPPO |
$150.35
|
Rate for Payer: BCBS Trust/PPO |
$1,799.92
|
Rate for Payer: BCN Commercial |
$226.26
|
Rate for Payer: BCN Medicare Advantage |
$150.35
|
Rate for Payer: Cash Price |
$524.80
|
Rate for Payer: Cash Price |
$524.80
|
Rate for Payer: Cofinity Commercial |
$216.50
|
Rate for Payer: Cofinity Commercial |
$201.47
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.35
|
Rate for Payer: Mclaren Medicaid |
$100.11
|
Rate for Payer: Meridian Medicaid |
$105.12
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.87
|
Rate for Payer: PACE SWMI |
$150.35
|
Rate for Payer: PHP Medicare Advantage |
$150.35
|
Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$459.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.43
|
Rate for Payer: Priority Health Medicare |
$150.35
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$236.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$150.35
|
Rate for Payer: UHC Dual Complete DSNP |
$150.35
|
Rate for Payer: UHC Medicare Advantage |
$154.86
|
|
PR MANIPULATION SPINE REQUIRING ANESTHESIA
|
Professional
|
Both
|
$477.00
|
|
Service Code
|
HCPCS 22505
|
Min. Negotiated Rate |
$35.00 |
Max. Negotiated Rate |
$333.90 |
Rate for Payer: Aetna Commercial |
$171.25
|
Rate for Payer: Aetna Medicare |
$132.91
|
Rate for Payer: BCBS Complete |
$87.90
|
Rate for Payer: BCBS MAPPO |
$127.80
|
Rate for Payer: BCBS Trust/PPO |
$35.00
|
Rate for Payer: BCN Commercial |
$209.31
|
Rate for Payer: BCN Medicare Advantage |
$127.80
|
Rate for Payer: Cash Price |
$381.60
|
Rate for Payer: Cash Price |
$381.60
|
Rate for Payer: Cofinity Commercial |
$184.03
|
Rate for Payer: Cofinity Commercial |
$171.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.80
|
Rate for Payer: Mclaren Medicaid |
$83.71
|
Rate for Payer: Meridian Medicaid |
$87.90
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.19
|
Rate for Payer: PACE SWMI |
$127.80
|
Rate for Payer: PHP Medicare Advantage |
$127.80
|
Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$333.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.64
|
Rate for Payer: Priority Health Medicare |
$127.80
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$198.64
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$127.80
|
Rate for Payer: UHC Dual Complete DSNP |
$127.80
|
Rate for Payer: UHC Medicare Advantage |
$131.63
|
|
PR MANIPULATION WRIST UNDER ANESTHESIA
|
Professional
|
Both
|
$673.00
|
|
Service Code
|
HCPCS 25259
|
Min. Negotiated Rate |
$284.57 |
Max. Negotiated Rate |
$1,324.45 |
Rate for Payer: Aetna Commercial |
$566.34
|
Rate for Payer: Aetna Medicare |
$439.55
|
Rate for Payer: BCBS Complete |
$298.80
|
Rate for Payer: BCBS MAPPO |
$422.64
|
Rate for Payer: BCBS Trust/PPO |
$1,324.45
|
Rate for Payer: BCN Commercial |
$643.10
|
Rate for Payer: BCN Medicare Advantage |
$422.64
|
Rate for Payer: Cash Price |
$538.40
|
Rate for Payer: Cash Price |
$538.40
|
Rate for Payer: Cofinity Commercial |
$566.34
|
Rate for Payer: Cofinity Commercial |
$608.60
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.64
|
Rate for Payer: Mclaren Medicaid |
$284.57
|
Rate for Payer: Meridian Medicaid |
$298.80
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$443.77
|
Rate for Payer: PACE SWMI |
$422.64
|
Rate for Payer: PHP Medicare Advantage |
$422.64
|
Rate for Payer: Priority Health Choice Medicaid |
$284.57
|
Rate for Payer: Priority Health Cigna Priority Health |
$471.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$672.02
|
Rate for Payer: Priority Health Medicare |
$422.64
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$672.02
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$422.64
|
Rate for Payer: UHC Dual Complete DSNP |
$422.64
|
Rate for Payer: UHC Medicare Advantage |
$435.32
|
|
PR MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV
|
Professional
|
Both
|
$167.00
|
|
Service Code
|
HCPCS 20700
|
Min. Negotiated Rate |
$53.68 |
Max. Negotiated Rate |
$1,725.86 |
Rate for Payer: Aetna Commercial |
$111.92
|
Rate for Payer: Aetna Medicare |
$86.86
|
Rate for Payer: BCBS Complete |
$56.36
|
Rate for Payer: BCBS MAPPO |
$83.52
|
Rate for Payer: BCBS Trust/PPO |
$1,725.86
|
Rate for Payer: BCN Commercial |
$122.66
|
Rate for Payer: BCN Medicare Advantage |
$83.52
|
Rate for Payer: Cash Price |
$133.60
|
Rate for Payer: Cash Price |
$133.60
|
Rate for Payer: Cofinity Commercial |
$120.27
|
Rate for Payer: Cofinity Commercial |
$111.92
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.52
|
Rate for Payer: Mclaren Medicaid |
$53.68
|
Rate for Payer: Meridian Medicaid |
$56.36
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.70
|
Rate for Payer: PACE SWMI |
$83.52
|
Rate for Payer: PHP Medicare Advantage |
$83.52
|
Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.18
|
Rate for Payer: Priority Health Medicare |
$83.52
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$128.18
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$83.52
|
Rate for Payer: UHC Dual Complete DSNP |
$83.52
|
Rate for Payer: UHC Medicare Advantage |
$86.03
|
|
PR MANUAL PREP&INSJ INTRAMEDULLARY DRUG DLVR DEVICE
|
Professional
|
Both
|
$286.00
|
|
Service Code
|
HCPCS 20702
|
Min. Negotiated Rate |
$35.00 |
Max. Negotiated Rate |
$216.00 |
Rate for Payer: Aetna Commercial |
$188.77
|
Rate for Payer: Aetna Medicare |
$146.50
|
Rate for Payer: BCBS Complete |
$94.83
|
Rate for Payer: BCBS MAPPO |
$140.87
|
Rate for Payer: BCBS Trust/PPO |
$35.00
|
Rate for Payer: BCN Commercial |
$206.71
|
Rate for Payer: BCN Medicare Advantage |
$140.87
|
Rate for Payer: Cash Price |
$228.80
|
Rate for Payer: Cash Price |
$228.80
|
Rate for Payer: Cofinity Commercial |
$202.85
|
Rate for Payer: Cofinity Commercial |
$188.77
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.87
|
Rate for Payer: Mclaren Medicaid |
$90.31
|
Rate for Payer: Meridian Medicaid |
$94.83
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.91
|
Rate for Payer: PACE SWMI |
$140.87
|
Rate for Payer: PHP Medicare Advantage |
$140.87
|
Rate for Payer: Priority Health Choice Medicaid |
$90.31
|
Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.00
|
Rate for Payer: Priority Health Medicare |
$140.87
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$216.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$140.87
|
Rate for Payer: UHC Dual Complete DSNP |
$140.87
|
Rate for Payer: UHC Medicare Advantage |
$145.10
|
|
PR MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES
|
Professional
|
Both
|
$48.00
|
|
Service Code
|
HCPCS 97140
|
Min. Negotiated Rate |
$19.20 |
Max. Negotiated Rate |
$1,604.98 |
Rate for Payer: Aetna Commercial |
$35.32
|
Rate for Payer: Aetna Medicare |
$27.41
|
Rate for Payer: BCBS Complete |
$19.20
|
Rate for Payer: BCBS MAPPO |
$26.36
|
Rate for Payer: BCBS Trust/PPO |
$1,604.98
|
Rate for Payer: BCN Commercial |
$26.43
|
Rate for Payer: BCN Medicare Advantage |
$26.36
|
Rate for Payer: Cash Price |
$38.40
|
Rate for Payer: Cash Price |
$38.40
|
Rate for Payer: Cofinity Commercial |
$37.96
|
Rate for Payer: Cofinity Commercial |
$35.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.36
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.68
|
Rate for Payer: PACE SWMI |
$26.36
|
Rate for Payer: PHP Medicare Advantage |
$26.36
|
Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.00
|
Rate for Payer: Priority Health Medicare |
$26.36
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$75.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$26.36
|
Rate for Payer: UHC Dual Complete DSNP |
$26.36
|
Rate for Payer: UHC Medicare Advantage |
$27.15
|
|
PR MARSUPIALIZATION BARTHOLINS GLAND CYST
|
Professional
|
Both
|
$770.00
|
|
Service Code
|
HCPCS 56440
|
Min. Negotiated Rate |
$116.94 |
Max. Negotiated Rate |
$539.00 |
Rate for Payer: Aetna Commercial |
$239.82
|
Rate for Payer: Aetna Medicare |
$186.13
|
Rate for Payer: BCBS Complete |
$122.79
|
Rate for Payer: BCBS MAPPO |
$178.97
|
Rate for Payer: BCBS Trust/PPO |
$226.64
|
Rate for Payer: BCN Commercial |
$265.35
|
Rate for Payer: BCN Medicare Advantage |
$178.97
|
Rate for Payer: Cash Price |
$616.00
|
Rate for Payer: Cash Price |
$616.00
|
Rate for Payer: Cofinity Commercial |
$257.72
|
Rate for Payer: Cofinity Commercial |
$239.82
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.97
|
Rate for Payer: Mclaren Medicaid |
$116.94
|
Rate for Payer: Meridian Medicaid |
$122.79
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$187.92
|
Rate for Payer: PACE SWMI |
$178.97
|
Rate for Payer: PHP Medicare Advantage |
$178.97
|
Rate for Payer: Priority Health Choice Medicaid |
$116.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$539.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$257.07
|
Rate for Payer: Priority Health Medicare |
$178.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$257.07
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$178.97
|
Rate for Payer: UHC Dual Complete DSNP |
$178.97
|
Rate for Payer: UHC Medicare Advantage |
$184.34
|
|