|
PR MGMT LVR HEMRRG CPLX SUTR WND/INJ
|
Professional
|
Both
|
$3,386.00
|
|
|
Service Code
|
HCPCS 47360
|
| Min. Negotiated Rate |
$331.24 |
| Max. Negotiated Rate |
$3,287.35 |
| Rate for Payer: Aetna Commercial |
$2,498.14
|
| Rate for Payer: Aetna Medicare |
$1,938.85
|
| Rate for Payer: BCBS Complete |
$1,254.68
|
| Rate for Payer: BCBS MAPPO |
$1,864.28
|
| Rate for Payer: BCBS Trust/PPO |
$331.24
|
| Rate for Payer: BCN Commercial |
$2,732.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,864.28
|
| Rate for Payer: Cash Price |
$2,708.80
|
| Rate for Payer: Cash Price |
$2,708.80
|
| Rate for Payer: Cofinity Commercial |
$2,684.56
|
| Rate for Payer: Cofinity Commercial |
$2,498.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,864.28
|
| Rate for Payer: Mclaren Medicaid |
$1,194.93
|
| Rate for Payer: Meridian Medicaid |
$1,254.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,957.49
|
| Rate for Payer: PACE SWMI |
$1,864.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,864.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,194.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,370.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,287.35
|
| Rate for Payer: Priority Health Medicare |
$1,864.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,287.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,864.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,864.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,920.21
|
|
|
PR MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ
|
Professional
|
Both
|
$2,846.00
|
|
|
Service Code
|
HCPCS 47350
|
| Min. Negotiated Rate |
$870.32 |
| Max. Negotiated Rate |
$2,400.11 |
| Rate for Payer: Aetna Commercial |
$1,819.29
|
| Rate for Payer: Aetna Medicare |
$1,411.99
|
| Rate for Payer: BCBS Complete |
$913.84
|
| Rate for Payer: BCBS MAPPO |
$1,357.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,888.67
|
| Rate for Payer: BCN Commercial |
$1,994.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,357.68
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cofinity Commercial |
$1,819.29
|
| Rate for Payer: Cofinity Commercial |
$1,955.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,357.68
|
| Rate for Payer: Mclaren Medicaid |
$870.32
|
| Rate for Payer: Meridian Medicaid |
$913.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,425.56
|
| Rate for Payer: PACE SWMI |
$1,357.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,357.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$870.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,992.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,400.11
|
| Rate for Payer: Priority Health Medicare |
$1,357.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,400.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,357.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,357.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,398.41
|
|
|
PR MH PARTIAL HOSP TX UNDER 24H
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS H0035
|
| Min. Negotiated Rate |
$101.60 |
| Max. Negotiated Rate |
$268.86 |
| Rate for Payer: Aetna Commercial |
$268.86
|
| Rate for Payer: BCBS Complete |
$101.60
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.80
|
|
|
PR MICRONEEDLING PIN ADB/THIGHS/BACK
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 00108
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.00
|
|
|
PR MICRONEEDLING PIN FULL FACE
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 00105
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
|
|
PR MICRONEEDLING PIN NECK
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 00107
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
|
|
PR MICRONEEDLING PIN UPPER OR LOWER FACE
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 00106
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
|
|
PR MICRONEEDLING SCARS - UP TO 4 INCHES
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 00109
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$35.00 |
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
|
|
PR MICRONEEDLING TAT RMVL 4-6 SQ INCHES
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 00122
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.00
|
|
|
PR MICRONEEDLING TAT RMVL 6-9 SQ INCHES
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 00123
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
|
|
PR MICRONEEDLING TAT RMVL 9-12 SQ INCHES
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 00124
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: BCBS Complete |
$80.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
|
|
PR MICRONEEDLING TAT RMVL UP TO 2 SQ INCH
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 00110
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
|
|
PR MICROSURG TQS REQ USE OPERATING MICROSCOPE
|
Professional
|
Both
|
$491.00
|
|
|
Service Code
|
HCPCS 69990
|
| Min. Negotiated Rate |
$138.88 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$292.64
|
| Rate for Payer: Aetna Medicare |
$227.13
|
| Rate for Payer: BCBS Complete |
$145.82
|
| Rate for Payer: BCBS MAPPO |
$218.39
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$349.21
|
| Rate for Payer: BCN Medicare Advantage |
$218.39
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cofinity Commercial |
$292.64
|
| Rate for Payer: Cofinity Commercial |
$314.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.39
|
| Rate for Payer: Mclaren Medicaid |
$138.88
|
| Rate for Payer: Meridian Medicaid |
$145.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$229.31
|
| Rate for Payer: PACE SWMI |
$218.39
|
| Rate for Payer: PHP Medicare Advantage |
$218.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.98
|
| Rate for Payer: Priority Health Medicare |
$218.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.39
|
| Rate for Payer: UHC Medicare Advantage |
$224.94
|
|
|
PR MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC
|
Professional
|
Both
|
$1,671.00
|
|
|
Service Code
|
HCPCS 69440
|
| Min. Negotiated Rate |
$446.02 |
| Max. Negotiated Rate |
$1,668.90 |
| Rate for Payer: Aetna Commercial |
$906.54
|
| Rate for Payer: Aetna Medicare |
$703.58
|
| Rate for Payer: BCBS Complete |
$468.32
|
| Rate for Payer: BCBS MAPPO |
$676.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,668.90
|
| Rate for Payer: BCN Commercial |
$1,024.27
|
| Rate for Payer: BCN Medicare Advantage |
$676.52
|
| Rate for Payer: Cash Price |
$1,336.80
|
| Rate for Payer: Cash Price |
$1,336.80
|
| Rate for Payer: Cofinity Commercial |
$906.54
|
| Rate for Payer: Cofinity Commercial |
$974.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.52
|
| Rate for Payer: Mclaren Medicaid |
$446.02
|
| Rate for Payer: Meridian Medicaid |
$468.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$710.35
|
| Rate for Payer: PACE SWMI |
$676.52
|
| Rate for Payer: PHP Medicare Advantage |
$676.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$988.18
|
| Rate for Payer: Priority Health Medicare |
$676.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$988.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.52
|
| Rate for Payer: UHC Medicare Advantage |
$696.82
|
|
|
PR MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES
|
Professional
|
Both
|
$2,914.00
|
|
|
Service Code
|
HCPCS 15730
|
| Min. Negotiated Rate |
$583.41 |
| Max. Negotiated Rate |
$2,089.09 |
| Rate for Payer: Aetna Commercial |
$1,191.07
|
| Rate for Payer: Aetna Medicare |
$924.41
|
| Rate for Payer: BCBS Complete |
$612.58
|
| Rate for Payer: BCBS MAPPO |
$888.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.99
|
| Rate for Payer: BCN Commercial |
$2,089.09
|
| Rate for Payer: BCN Medicare Advantage |
$888.86
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cash Price |
$2,331.20
|
| Rate for Payer: Cofinity Commercial |
$1,279.96
|
| Rate for Payer: Cofinity Commercial |
$1,191.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$888.86
|
| Rate for Payer: Mclaren Medicaid |
$583.41
|
| Rate for Payer: Meridian Medicaid |
$612.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$933.30
|
| Rate for Payer: PACE SWMI |
$888.86
|
| Rate for Payer: PHP Medicare Advantage |
$888.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,039.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,118.02
|
| Rate for Payer: Priority Health Medicare |
$888.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,118.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$888.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$888.86
|
| Rate for Payer: UHC Medicare Advantage |
$915.53
|
|
|
PR MIRENA, 52 MG
|
Professional
|
Both
|
$1,443.00
|
|
|
Service Code
|
HCPCS J7298
|
| Min. Negotiated Rate |
$1,010.10 |
| Max. Negotiated Rate |
$1,156.78 |
| Rate for Payer: Aetna Commercial |
$1,101.70
|
| Rate for Payer: BCBS Complete |
$1,156.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,103.90
|
| Rate for Payer: BCN Commercial |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,154.40
|
| Rate for Payer: Cash Price |
$1,154.40
|
| Rate for Payer: Mclaren Medicaid |
$1,101.70
|
| Rate for Payer: Meridian Medicaid |
$1,156.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,101.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,010.10
|
|
|
PR MISCELLANEOUS VISION SERVICE
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS V2799
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
|
|
PR MISOPROSTOL, ORAL, 200 MCG
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS S0191
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.80 |
| Rate for Payer: Aetna Commercial |
$0.96
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
|
|
PR MITOMYCIN INJECTION
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS J9280
|
| Min. Negotiated Rate |
$3.72 |
| Max. Negotiated Rate |
$113.79 |
| Rate for Payer: Aetna Commercial |
$105.89
|
| Rate for Payer: Aetna Medicare |
$82.18
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$79.02
|
| Rate for Payer: BCBS Trust/PPO |
$10.36
|
| Rate for Payer: BCN Commercial |
$3.72
|
| Rate for Payer: BCN Medicare Advantage |
$79.02
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$113.79
|
| Rate for Payer: Cofinity Commercial |
$105.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.98
|
| Rate for Payer: PACE SWMI |
$79.02
|
| Rate for Payer: PHP Medicare Advantage |
$79.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health Medicare |
$79.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.02
|
| Rate for Payer: UHC Medicare Advantage |
$81.39
|
|
|
PR MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG
|
Professional
|
Both
|
$975.00
|
|
|
Service Code
|
HCPCS 95805
|
| Min. Negotiated Rate |
$390.00 |
| Max. Negotiated Rate |
$682.50 |
| Rate for Payer: Aetna Commercial |
$522.65
|
| Rate for Payer: Aetna Commercial |
$522.65
|
| Rate for Payer: Aetna Medicare |
$405.64
|
| Rate for Payer: Aetna Medicare |
$405.64
|
| Rate for Payer: BCBS Complete |
$390.00
|
| Rate for Payer: BCBS Complete |
$96.00
|
| Rate for Payer: BCBS MAPPO |
$390.04
|
| Rate for Payer: BCBS MAPPO |
$390.04
|
| Rate for Payer: BCBS Trust/PPO |
$639.77
|
| Rate for Payer: BCBS Trust/PPO |
$639.77
|
| Rate for Payer: BCN Commercial |
$610.36
|
| Rate for Payer: BCN Commercial |
$610.36
|
| Rate for Payer: BCN Medicare Advantage |
$390.04
|
| Rate for Payer: BCN Medicare Advantage |
$390.04
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cash Price |
$780.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$522.65
|
| Rate for Payer: Cofinity Commercial |
$561.66
|
| Rate for Payer: Cofinity Commercial |
$522.65
|
| Rate for Payer: Cofinity Commercial |
$561.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$409.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$409.54
|
| Rate for Payer: PACE SWMI |
$390.04
|
| Rate for Payer: PACE SWMI |
$390.04
|
| Rate for Payer: PHP Medicare Advantage |
$390.04
|
| Rate for Payer: PHP Medicare Advantage |
$390.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.98
|
| Rate for Payer: Priority Health Medicare |
$390.04
|
| Rate for Payer: Priority Health Medicare |
$390.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.04
|
| Rate for Payer: UHC Medicare Advantage |
$401.74
|
| Rate for Payer: UHC Medicare Advantage |
$401.74
|
|
|
PR MNPJ W/ANES SHOULDER JT APPL FIXATION APPARATUS
|
Facility
|
IP
|
$903.00
|
|
|
Service Code
|
CPT 23700
|
| Hospital Charge Code |
23700
|
| Min. Negotiated Rate |
$550.74 |
| Max. Negotiated Rate |
$812.70 |
| Rate for Payer: Aetna Commercial |
$767.55
|
| Rate for Payer: BCBS Trust/PPO |
$697.84
|
| Rate for Payer: BCN Commercial |
$697.84
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$776.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$722.40
|
| Rate for Payer: Healthscope Commercial |
$812.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$677.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$767.55
|
| Rate for Payer: PHP Commercial |
$767.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$785.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$794.64
|
| Rate for Payer: UHC Core |
$754.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$677.25
|
|
|
PR MNPJ W/ANES SHOULDER JT APPL FIXATION APPARATUS
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 23700
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$632.10 |
| Rate for Payer: Aetna Commercial |
$258.62
|
| Rate for Payer: Aetna Medicare |
$200.72
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$193.00
|
| Rate for Payer: BCBS Trust/PPO |
$286.11
|
| Rate for Payer: BCN Commercial |
$288.81
|
| Rate for Payer: BCN Medicare Advantage |
$193.00
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$277.92
|
| Rate for Payer: Cofinity Commercial |
$258.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.00
|
| Rate for Payer: Mclaren Medicaid |
$126.95
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.65
|
| Rate for Payer: PACE SWMI |
$193.00
|
| Rate for Payer: PHP Medicare Advantage |
$193.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$301.79
|
| Rate for Payer: Priority Health Medicare |
$193.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.00
|
| Rate for Payer: UHC Medicare Advantage |
$198.79
|
|
|
PR MNPJ W/ANES SHOULDER JT APPL FIXATION APPARATUS
|
Facility
|
OP
|
$903.00
|
|
|
Service Code
|
CPT 23700
|
| Hospital Charge Code |
23700
|
| Min. Negotiated Rate |
$214.46 |
| Max. Negotiated Rate |
$1,107.03 |
| Rate for Payer: Aetna Commercial |
$767.55
|
| Rate for Payer: Aetna Medicare |
$234.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$282.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$282.19
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$225.75
|
| Rate for Payer: BCBS Trust/PPO |
$702.08
|
| Rate for Payer: BCN Commercial |
$702.08
|
| Rate for Payer: BCN Medicare Advantage |
$225.75
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$776.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$722.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.75
|
| Rate for Payer: Healthscope Commercial |
$812.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$677.25
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$237.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$259.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$767.55
|
| Rate for Payer: PACE Senior Care Partners |
$214.46
|
| Rate for Payer: PACE SWMI |
$225.75
|
| Rate for Payer: PHP Commercial |
$767.55
|
| Rate for Payer: PHP Medicare Advantage |
$225.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$785.61
|
| Rate for Payer: Priority Health Medicare |
$225.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.74
|
| Rate for Payer: Railroad Medicare Medicare |
$225.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$794.64
|
| Rate for Payer: UHC Core |
$754.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.75
|
| Rate for Payer: UHC Medicare Advantage |
$232.52
|
| Rate for Payer: VA VA |
$225.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$677.25
|
|
|
PR MNPJ W/ANES SHOULDER JT APPL FIXATION APPARATUS
|
Professional
|
Both
|
$903.00
|
|
|
Service Code
|
HCPCS 23700
|
| Hospital Charge Code |
23700
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$632.10 |
| Rate for Payer: Aetna Commercial |
$258.62
|
| Rate for Payer: Aetna Medicare |
$200.72
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$193.00
|
| Rate for Payer: BCBS Trust/PPO |
$286.11
|
| Rate for Payer: BCN Commercial |
$288.81
|
| Rate for Payer: BCN Medicare Advantage |
$193.00
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cash Price |
$722.40
|
| Rate for Payer: Cofinity Commercial |
$258.62
|
| Rate for Payer: Cofinity Commercial |
$277.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.00
|
| Rate for Payer: Mclaren Medicaid |
$126.95
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.65
|
| Rate for Payer: PACE SWMI |
$193.00
|
| Rate for Payer: PHP Medicare Advantage |
$193.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$301.79
|
| Rate for Payer: Priority Health Medicare |
$193.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.00
|
| Rate for Payer: UHC Medicare Advantage |
$198.79
|
|
|
PR MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 20950
|
| Min. Negotiated Rate |
$85.60 |
| Max. Negotiated Rate |
$29,358.48 |
| Rate for Payer: Aetna Commercial |
$114.70
|
| Rate for Payer: Aetna Medicare |
$89.02
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: BCBS MAPPO |
$85.60
|
| Rate for Payer: BCBS Trust/PPO |
$29,358.48
|
| Rate for Payer: BCN Commercial |
$387.52
|
| Rate for Payer: BCN Medicare Advantage |
$85.60
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$123.26
|
| Rate for Payer: Cofinity Commercial |
$114.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.88
|
| Rate for Payer: PACE SWMI |
$85.60
|
| Rate for Payer: PHP Medicare Advantage |
$85.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.29
|
| Rate for Payer: Priority Health Medicare |
$85.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.60
|
| Rate for Payer: UHC Medicare Advantage |
$88.17
|
|
