|
PR COMPRE EP EVAL ABLTJ 3D MAPG TX SVT
|
Professional
|
Both
|
$1,754.00
|
|
|
Service Code
|
HCPCS 93653
|
| Min. Negotiated Rate |
$701.60 |
| Max. Negotiated Rate |
$1,141.36 |
| Rate for Payer: Aetna Commercial |
$1,062.10
|
| Rate for Payer: Aetna Medicare |
$824.31
|
| Rate for Payer: BCBS Complete |
$701.60
|
| Rate for Payer: BCBS MAPPO |
$792.61
|
| Rate for Payer: BCN Medicare Advantage |
$792.61
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cofinity Commercial |
$1,141.36
|
| Rate for Payer: Cofinity Commercial |
$1,062.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$792.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$832.24
|
| Rate for Payer: Nomi Health Commercial |
$951.13
|
| Rate for Payer: PACE SWMI |
$792.61
|
| Rate for Payer: PHP Medicare Advantage |
$792.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,140.10
|
| Rate for Payer: Priority Health Medicare |
$800.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$792.61
|
| Rate for Payer: UHC Exchange |
$792.61
|
| Rate for Payer: UHC Medicare Advantage |
$792.61
|
|
|
PR COMPRE EP EVAL ABLTJ 3D MAPG TX VT
|
Professional
|
Both
|
$2,350.00
|
|
|
Service Code
|
HCPCS 93654
|
| Min. Negotiated Rate |
$940.00 |
| Max. Negotiated Rate |
$1,527.50 |
| Rate for Payer: Aetna Commercial |
$1,280.34
|
| Rate for Payer: Aetna Medicare |
$993.70
|
| Rate for Payer: BCBS Complete |
$940.00
|
| Rate for Payer: BCBS MAPPO |
$955.48
|
| Rate for Payer: BCN Medicare Advantage |
$955.48
|
| Rate for Payer: Cash Price |
$1,880.00
|
| Rate for Payer: Cash Price |
$1,880.00
|
| Rate for Payer: Cofinity Commercial |
$1,375.89
|
| Rate for Payer: Cofinity Commercial |
$1,280.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$955.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,003.25
|
| Rate for Payer: Nomi Health Commercial |
$1,146.58
|
| Rate for Payer: PACE SWMI |
$955.48
|
| Rate for Payer: PHP Medicare Advantage |
$955.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,527.50
|
| Rate for Payer: Priority Health Medicare |
$965.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$955.48
|
| Rate for Payer: UHC Exchange |
$955.48
|
| Rate for Payer: UHC Medicare Advantage |
$955.48
|
|
|
PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION
|
Professional
|
Both
|
$1,842.00
|
|
|
Service Code
|
HCPCS 93656
|
| Min. Negotiated Rate |
$736.80 |
| Max. Negotiated Rate |
$1,293.22 |
| Rate for Payer: Aetna Commercial |
$1,203.41
|
| Rate for Payer: Aetna Medicare |
$933.99
|
| Rate for Payer: BCBS Complete |
$736.80
|
| Rate for Payer: BCBS MAPPO |
$898.07
|
| Rate for Payer: BCN Medicare Advantage |
$898.07
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cofinity Commercial |
$1,293.22
|
| Rate for Payer: Cofinity Commercial |
$1,203.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$942.97
|
| Rate for Payer: Nomi Health Commercial |
$1,077.68
|
| Rate for Payer: PACE SWMI |
$898.07
|
| Rate for Payer: PHP Medicare Advantage |
$898.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.30
|
| Rate for Payer: Priority Health Medicare |
$907.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$898.07
|
| Rate for Payer: UHC Exchange |
$898.07
|
| Rate for Payer: UHC Medicare Advantage |
$898.07
|
|
|
PR COMPRE EP EVAL R ATR VNTRC PACG&REC HIS BNDL REC
|
Professional
|
Both
|
$1,319.00
|
|
|
Service Code
|
HCPCS 93620
|
| Min. Negotiated Rate |
$527.60 |
| Max. Negotiated Rate |
$857.35 |
| Rate for Payer: Aetna Medicare |
$659.50
|
| Rate for Payer: BCBS Complete |
$527.60
|
| Rate for Payer: Cash Price |
$1,055.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$857.35
|
|
|
PR COMPRE EP EVAL W/L ATRIAL PACG&REC C SINS/L ATR
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 93621
|
| Min. Negotiated Rate |
$98.00 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Medicare |
$122.50
|
| Rate for Payer: BCBS Complete |
$98.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.25
|
|
|
PR CONDITIONING PLAY AUDIOMETRY
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 92582
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$113.85 |
| Rate for Payer: Aetna Commercial |
$105.94
|
| Rate for Payer: Aetna Medicare |
$82.22
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS MAPPO |
$79.06
|
| Rate for Payer: BCN Medicare Advantage |
$79.06
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$105.94
|
| Rate for Payer: Cofinity Commercial |
$113.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.01
|
| Rate for Payer: Nomi Health Commercial |
$94.87
|
| Rate for Payer: PACE SWMI |
$79.06
|
| Rate for Payer: PHP Medicare Advantage |
$79.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health Medicare |
$79.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.06
|
| Rate for Payer: UHC Exchange |
$79.06
|
| Rate for Payer: UHC Medicare Advantage |
$79.06
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 57522
|
| Min. Negotiated Rate |
$243.52 |
| Max. Negotiated Rate |
$600.60 |
| Rate for Payer: Aetna Commercial |
$326.32
|
| Rate for Payer: Aetna Medicare |
$253.26
|
| Rate for Payer: BCBS Complete |
$369.60
|
| Rate for Payer: BCBS MAPPO |
$243.52
|
| Rate for Payer: BCN Medicare Advantage |
$243.52
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$350.67
|
| Rate for Payer: Cofinity Commercial |
$326.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.70
|
| Rate for Payer: Nomi Health Commercial |
$292.22
|
| Rate for Payer: PACE SWMI |
$243.52
|
| Rate for Payer: PHP Medicare Advantage |
$243.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health Medicare |
$245.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.52
|
| Rate for Payer: UHC Exchange |
$243.52
|
| Rate for Payer: UHC Medicare Advantage |
$243.52
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
OP
|
$924.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
57522
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$219.45 |
| Max. Negotiated Rate |
$2,413.90 |
| Rate for Payer: Aetna Commercial |
$785.40
|
| Rate for Payer: Aetna Medicare |
$240.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.75
|
| Rate for Payer: BCBS Complete |
$2,413.90
|
| Rate for Payer: BCBS MAPPO |
$231.00
|
| Rate for Payer: BCBS Trust/PPO |
$759.62
|
| Rate for Payer: BCN Commercial |
$718.41
|
| Rate for Payer: BCN Medicare Advantage |
$231.00
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$794.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.00
|
| Rate for Payer: Healthscope Commercial |
$831.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.00
|
| Rate for Payer: Mclaren Medicaid |
$2,298.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.55
|
| Rate for Payer: Meridian Medicaid |
$2,413.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.40
|
| Rate for Payer: Nomi Health Commercial |
$757.68
|
| Rate for Payer: PACE Senior Care Partners |
$219.45
|
| Rate for Payer: PACE SWMI |
$231.00
|
| Rate for Payer: PHP Commercial |
$785.40
|
| Rate for Payer: PHP Medicare Advantage |
$231.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO |
$803.88
|
| Rate for Payer: Priority Health Medicare |
$233.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.08
|
| Rate for Payer: Railroad Medicare Medicare |
$231.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.12
|
| Rate for Payer: UHC Core |
$771.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.00
|
| Rate for Payer: UHC Exchange |
$231.00
|
| Rate for Payer: UHC Medicare Advantage |
$231.00
|
| Rate for Payer: UHCCP Medicaid |
$2,298.80
|
| Rate for Payer: VA VA |
$231.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.00
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
IP
|
$924.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
57522
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$600.60 |
| Max. Negotiated Rate |
$831.60 |
| Rate for Payer: Aetna Commercial |
$785.40
|
| Rate for Payer: BCBS Trust/PPO |
$754.26
|
| Rate for Payer: BCN Commercial |
$714.07
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$794.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.20
|
| Rate for Payer: Healthscope Commercial |
$831.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.40
|
| Rate for Payer: Nomi Health Commercial |
$757.68
|
| Rate for Payer: PHP Commercial |
$785.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO |
$803.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.12
|
| Rate for Payer: UHC Core |
$771.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.00
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 57522
|
| Hospital Charge Code |
57522
|
| Min. Negotiated Rate |
$243.52 |
| Max. Negotiated Rate |
$600.60 |
| Rate for Payer: Aetna Commercial |
$326.32
|
| Rate for Payer: Aetna Medicare |
$253.26
|
| Rate for Payer: BCBS Complete |
$369.60
|
| Rate for Payer: BCBS MAPPO |
$243.52
|
| Rate for Payer: BCN Medicare Advantage |
$243.52
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$350.67
|
| Rate for Payer: Cofinity Commercial |
$326.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.70
|
| Rate for Payer: Nomi Health Commercial |
$292.22
|
| Rate for Payer: PACE SWMI |
$243.52
|
| Rate for Payer: PHP Medicare Advantage |
$243.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health Medicare |
$245.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.52
|
| Rate for Payer: UHC Exchange |
$243.52
|
| Rate for Payer: UHC Medicare Advantage |
$243.52
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 57520
|
| Min. Negotiated Rate |
$282.59 |
| Max. Negotiated Rate |
$675.35 |
| Rate for Payer: Aetna Commercial |
$378.67
|
| Rate for Payer: Aetna Medicare |
$293.89
|
| Rate for Payer: BCBS Complete |
$415.60
|
| Rate for Payer: BCBS MAPPO |
$282.59
|
| Rate for Payer: BCN Medicare Advantage |
$282.59
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cofinity Commercial |
$406.93
|
| Rate for Payer: Cofinity Commercial |
$378.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.72
|
| Rate for Payer: Nomi Health Commercial |
$339.11
|
| Rate for Payer: PACE SWMI |
$282.59
|
| Rate for Payer: PHP Medicare Advantage |
$282.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.35
|
| Rate for Payer: Priority Health Medicare |
$285.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.59
|
| Rate for Payer: UHC Exchange |
$282.59
|
| Rate for Payer: UHC Medicare Advantage |
$282.59
|
|
|
PR CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 57291
|
| Min. Negotiated Rate |
$526.11 |
| Max. Negotiated Rate |
$1,105.65 |
| Rate for Payer: Aetna Commercial |
$704.99
|
| Rate for Payer: Aetna Medicare |
$547.15
|
| Rate for Payer: BCBS Complete |
$680.40
|
| Rate for Payer: BCBS MAPPO |
$526.11
|
| Rate for Payer: BCN Medicare Advantage |
$526.11
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$704.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.42
|
| Rate for Payer: Nomi Health Commercial |
$631.33
|
| Rate for Payer: PACE SWMI |
$526.11
|
| Rate for Payer: PHP Medicare Advantage |
$526.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health Medicare |
$531.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$526.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.11
|
| Rate for Payer: UHC Exchange |
$526.11
|
| Rate for Payer: UHC Medicare Advantage |
$526.11
|
|
|
PR CONSULTS
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 00125
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Medicare |
$255.00
|
| Rate for Payer: BCBS Complete |
$204.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
|
|
PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 95250
|
| Min. Negotiated Rate |
$109.60 |
| Max. Negotiated Rate |
$183.37 |
| Rate for Payer: Aetna Commercial |
$170.64
|
| Rate for Payer: Aetna Medicare |
$132.43
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: BCBS MAPPO |
$127.34
|
| Rate for Payer: BCN Medicare Advantage |
$127.34
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Commercial |
$183.37
|
| Rate for Payer: Cofinity Commercial |
$170.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$152.81
|
| Rate for Payer: PACE SWMI |
$127.34
|
| Rate for Payer: PHP Medicare Advantage |
$127.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health Medicare |
$128.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.34
|
| Rate for Payer: UHC Exchange |
$127.34
|
| Rate for Payer: UHC Medicare Advantage |
$127.34
|
|
|
PR CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 95249
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$84.50 |
| Rate for Payer: Aetna Commercial |
$78.63
|
| Rate for Payer: Aetna Medicare |
$61.03
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS MAPPO |
$58.68
|
| Rate for Payer: BCN Medicare Advantage |
$58.68
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$78.63
|
| Rate for Payer: Cofinity Commercial |
$84.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.61
|
| Rate for Payer: Nomi Health Commercial |
$70.42
|
| Rate for Payer: PACE SWMI |
$58.68
|
| Rate for Payer: PHP Medicare Advantage |
$58.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Medicare |
$59.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.68
|
| Rate for Payer: UHC Exchange |
$58.68
|
| Rate for Payer: UHC Medicare Advantage |
$58.68
|
|
|
PR CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN
|
Professional
|
Both
|
$3,434.00
|
|
|
Service Code
|
HCPCS 50825
|
| Min. Negotiated Rate |
$1,373.60 |
| Max. Negotiated Rate |
$2,258.48 |
| Rate for Payer: Aetna Commercial |
$2,101.64
|
| Rate for Payer: Aetna Medicare |
$1,631.13
|
| Rate for Payer: BCBS Complete |
$1,373.60
|
| Rate for Payer: BCBS MAPPO |
$1,568.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.39
|
| Rate for Payer: Cash Price |
$2,747.20
|
| Rate for Payer: Cash Price |
$2,747.20
|
| Rate for Payer: Cofinity Commercial |
$2,258.48
|
| Rate for Payer: Cofinity Commercial |
$2,101.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.81
|
| Rate for Payer: Nomi Health Commercial |
$1,882.07
|
| Rate for Payer: PACE SWMI |
$1,568.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,232.10
|
| Rate for Payer: Priority Health Medicare |
$1,584.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,568.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.39
|
| Rate for Payer: UHC Exchange |
$1,568.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.39
|
|
|
PR CONTINENT ILEOSTOMY KOCK PROCEDURE SPX
|
Professional
|
Both
|
$4,041.00
|
|
|
Service Code
|
HCPCS 44316
|
| Min. Negotiated Rate |
$1,376.44 |
| Max. Negotiated Rate |
$2,626.65 |
| Rate for Payer: Aetna Commercial |
$1,844.43
|
| Rate for Payer: Aetna Medicare |
$1,431.50
|
| Rate for Payer: BCBS Complete |
$1,616.40
|
| Rate for Payer: BCBS MAPPO |
$1,376.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,376.44
|
| Rate for Payer: Cash Price |
$3,232.80
|
| Rate for Payer: Cash Price |
$3,232.80
|
| Rate for Payer: Cofinity Commercial |
$1,982.07
|
| Rate for Payer: Cofinity Commercial |
$1,844.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,376.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,445.26
|
| Rate for Payer: Nomi Health Commercial |
$1,651.73
|
| Rate for Payer: PACE SWMI |
$1,376.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,376.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,626.65
|
| Rate for Payer: Priority Health Medicare |
$1,390.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,376.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,376.44
|
| Rate for Payer: UHC Exchange |
$1,376.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,376.44
|
|
|
PR CONT INTRAOP NEURO MONITOR
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS G0453
|
| Min. Negotiated Rate |
$29.77 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna Medicare |
$30.96
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$29.77
|
| Rate for Payer: BCN Medicare Advantage |
$29.77
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$42.87
|
| Rate for Payer: Cofinity Commercial |
$39.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.26
|
| Rate for Payer: Nomi Health Commercial |
$35.72
|
| Rate for Payer: PACE SWMI |
$29.77
|
| Rate for Payer: PHP Medicare Advantage |
$29.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Medicare |
$30.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.77
|
| Rate for Payer: UHC Exchange |
$29.77
|
| Rate for Payer: UHC Medicare Advantage |
$29.77
|
|
|
PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 95251
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$48.10 |
| Rate for Payer: Aetna Commercial |
$43.83
|
| Rate for Payer: Aetna Medicare |
$34.02
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS MAPPO |
$32.71
|
| Rate for Payer: BCN Medicare Advantage |
$32.71
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$47.10
|
| Rate for Payer: Cofinity Commercial |
$43.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.35
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE SWMI |
$32.71
|
| Rate for Payer: PHP Medicare Advantage |
$32.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health Medicare |
$33.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.71
|
| Rate for Payer: UHC Exchange |
$32.71
|
| Rate for Payer: UHC Medicare Advantage |
$32.71
|
|
|
PR CONTINUOUS INHALATION TREATMENT 1ST HR
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 94644
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$73.66 |
| Rate for Payer: Aetna Commercial |
$68.54
|
| Rate for Payer: Aetna Medicare |
$53.20
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$51.15
|
| Rate for Payer: BCN Medicare Advantage |
$51.15
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$73.66
|
| Rate for Payer: Cofinity Commercial |
$68.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.71
|
| Rate for Payer: Nomi Health Commercial |
$61.38
|
| Rate for Payer: PACE SWMI |
$51.15
|
| Rate for Payer: PHP Medicare Advantage |
$51.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Medicare |
$51.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.15
|
| Rate for Payer: UHC Exchange |
$51.15
|
| Rate for Payer: UHC Medicare Advantage |
$51.15
|
|
|
PR CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 49465
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$40.94 |
| Rate for Payer: Aetna Commercial |
$38.10
|
| Rate for Payer: Aetna Medicare |
$29.57
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$28.43
|
| Rate for Payer: BCN Medicare Advantage |
$28.43
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$38.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.85
|
| Rate for Payer: Nomi Health Commercial |
$34.12
|
| Rate for Payer: PACE SWMI |
$28.43
|
| Rate for Payer: PHP Medicare Advantage |
$28.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health Medicare |
$28.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.43
|
| Rate for Payer: UHC Exchange |
$28.43
|
| Rate for Payer: UHC Medicare Advantage |
$28.43
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX
|
Professional
|
Both
|
$396.00
|
|
|
Service Code
|
HCPCS 30903
|
| Min. Negotiated Rate |
$75.09 |
| Max. Negotiated Rate |
$257.40 |
| Rate for Payer: Aetna Commercial |
$100.62
|
| Rate for Payer: Aetna Medicare |
$78.09
|
| Rate for Payer: BCBS Complete |
$158.40
|
| Rate for Payer: BCBS MAPPO |
$75.09
|
| Rate for Payer: BCN Medicare Advantage |
$75.09
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cofinity Commercial |
$108.13
|
| Rate for Payer: Cofinity Commercial |
$100.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.84
|
| Rate for Payer: Nomi Health Commercial |
$90.11
|
| Rate for Payer: PACE SWMI |
$75.09
|
| Rate for Payer: PHP Medicare Advantage |
$75.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.40
|
| Rate for Payer: Priority Health Medicare |
$75.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.09
|
| Rate for Payer: UHC Exchange |
$75.09
|
| Rate for Payer: UHC Medicare Advantage |
$75.09
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 30901
|
| Min. Negotiated Rate |
$54.49 |
| Max. Negotiated Rate |
$171.60 |
| Rate for Payer: Aetna Commercial |
$73.02
|
| Rate for Payer: Aetna Medicare |
$56.67
|
| Rate for Payer: BCBS Complete |
$105.60
|
| Rate for Payer: BCBS MAPPO |
$54.49
|
| Rate for Payer: BCN Medicare Advantage |
$54.49
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$78.47
|
| Rate for Payer: Cofinity Commercial |
$73.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.21
|
| Rate for Payer: Nomi Health Commercial |
$65.39
|
| Rate for Payer: PACE SWMI |
$54.49
|
| Rate for Payer: PHP Medicare Advantage |
$54.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.60
|
| Rate for Payer: Priority Health Medicare |
$55.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.49
|
| Rate for Payer: UHC Exchange |
$54.49
|
| Rate for Payer: UHC Medicare Advantage |
$54.49
|
|
|
PR CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 42960
|
| Min. Negotiated Rate |
$130.40 |
| Max. Negotiated Rate |
$222.06 |
| Rate for Payer: Aetna Commercial |
$206.64
|
| Rate for Payer: Aetna Medicare |
$160.38
|
| Rate for Payer: BCBS Complete |
$130.40
|
| Rate for Payer: BCBS MAPPO |
$154.21
|
| Rate for Payer: BCN Medicare Advantage |
$154.21
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cofinity Commercial |
$222.06
|
| Rate for Payer: Cofinity Commercial |
$206.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.92
|
| Rate for Payer: Nomi Health Commercial |
$185.05
|
| Rate for Payer: PACE SWMI |
$154.21
|
| Rate for Payer: PHP Medicare Advantage |
$154.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.90
|
| Rate for Payer: Priority Health Medicare |
$155.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.21
|
| Rate for Payer: UHC Exchange |
$154.21
|
| Rate for Payer: UHC Medicare Advantage |
$154.21
|
|
|
PR CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$2,096.00
|
|
|
Service Code
|
HCPCS 49446
|
| Min. Negotiated Rate |
$138.32 |
| Max. Negotiated Rate |
$1,362.40 |
| Rate for Payer: Aetna Commercial |
$185.35
|
| Rate for Payer: Aetna Medicare |
$143.85
|
| Rate for Payer: BCBS Complete |
$838.40
|
| Rate for Payer: BCBS MAPPO |
$138.32
|
| Rate for Payer: BCN Medicare Advantage |
$138.32
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cofinity Commercial |
$199.18
|
| Rate for Payer: Cofinity Commercial |
$185.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.24
|
| Rate for Payer: Nomi Health Commercial |
$165.98
|
| Rate for Payer: PACE SWMI |
$138.32
|
| Rate for Payer: PHP Medicare Advantage |
$138.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.40
|
| Rate for Payer: Priority Health Medicare |
$139.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.32
|
| Rate for Payer: UHC Exchange |
$138.32
|
| Rate for Payer: UHC Medicare Advantage |
$138.32
|
|
