|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Facility
|
OP
|
$283.00
|
|
|
Service Code
|
CPT 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$67.21 |
| Max. Negotiated Rate |
$254.70 |
| Rate for Payer: Aetna Commercial |
$240.55
|
| Rate for Payer: Aetna Medicare |
$73.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.44
|
| Rate for Payer: BCBS Complete |
$113.20
|
| Rate for Payer: BCBS MAPPO |
$70.75
|
| Rate for Payer: BCBS Trust/PPO |
$232.65
|
| Rate for Payer: BCN Commercial |
$220.03
|
| Rate for Payer: BCN Medicare Advantage |
$70.75
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$243.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.75
|
| Rate for Payer: Healthscope Commercial |
$254.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.55
|
| Rate for Payer: Nomi Health Commercial |
$232.06
|
| Rate for Payer: PACE Senior Care Partners |
$67.21
|
| Rate for Payer: PACE SWMI |
$70.75
|
| Rate for Payer: PHP Commercial |
$240.55
|
| Rate for Payer: PHP Medicare Advantage |
$70.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health HMO/PPO |
$246.21
|
| Rate for Payer: Priority Health Medicare |
$71.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.61
|
| Rate for Payer: Railroad Medicare Medicare |
$70.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.04
|
| Rate for Payer: UHC Core |
$236.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.75
|
| Rate for Payer: UHC Exchange |
$70.75
|
| Rate for Payer: UHC Medicare Advantage |
$70.75
|
| Rate for Payer: VA VA |
$70.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.25
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$113.20 |
| Max. Negotiated Rate |
$200.32 |
| Rate for Payer: Aetna Commercial |
$186.41
|
| Rate for Payer: Aetna Medicare |
$144.67
|
| Rate for Payer: BCBS Complete |
$113.20
|
| Rate for Payer: BCBS MAPPO |
$139.11
|
| Rate for Payer: BCN Medicare Advantage |
$139.11
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$200.32
|
| Rate for Payer: Cofinity Commercial |
$186.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.07
|
| Rate for Payer: Nomi Health Commercial |
$166.93
|
| Rate for Payer: PACE SWMI |
$139.11
|
| Rate for Payer: PHP Medicare Advantage |
$139.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health Medicare |
$140.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.11
|
| Rate for Payer: UHC Exchange |
$139.11
|
| Rate for Payer: UHC Medicare Advantage |
$139.11
|
|
|
PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS
|
Facility
|
IP
|
$283.00
|
|
|
Service Code
|
CPT 20985
|
| Hospital Charge Code |
20985
|
| Min. Negotiated Rate |
$183.95 |
| Max. Negotiated Rate |
$254.70 |
| Rate for Payer: Aetna Commercial |
$240.55
|
| Rate for Payer: BCBS Trust/PPO |
$231.01
|
| Rate for Payer: BCN Commercial |
$218.70
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$243.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.40
|
| Rate for Payer: Healthscope Commercial |
$254.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.55
|
| Rate for Payer: Nomi Health Commercial |
$232.06
|
| Rate for Payer: PHP Commercial |
$240.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health HMO/PPO |
$246.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.04
|
| Rate for Payer: UHC Core |
$236.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.25
|
|
|
PR CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT
|
Professional
|
Both
|
$7,294.00
|
|
|
Service Code
|
HCPCS 61582
|
| Min. Negotiated Rate |
$2,917.60 |
| Max. Negotiated Rate |
$4,741.10 |
| Rate for Payer: Aetna Commercial |
$3,925.76
|
| Rate for Payer: Aetna Medicare |
$3,046.86
|
| Rate for Payer: BCBS Complete |
$2,917.60
|
| Rate for Payer: BCBS MAPPO |
$2,929.67
|
| Rate for Payer: BCN Medicare Advantage |
$2,929.67
|
| Rate for Payer: Cash Price |
$5,835.20
|
| Rate for Payer: Cash Price |
$5,835.20
|
| Rate for Payer: Cofinity Commercial |
$4,218.72
|
| Rate for Payer: Cofinity Commercial |
$3,925.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,929.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,076.15
|
| Rate for Payer: Nomi Health Commercial |
$3,515.60
|
| Rate for Payer: PACE SWMI |
$2,929.67
|
| Rate for Payer: PHP Medicare Advantage |
$2,929.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,741.10
|
| Rate for Payer: Priority Health Medicare |
$2,958.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,929.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,929.67
|
| Rate for Payer: UHC Exchange |
$2,929.67
|
| Rate for Payer: UHC Medicare Advantage |
$2,929.67
|
|
|
PR CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE
|
Professional
|
Both
|
$7,968.00
|
|
|
Service Code
|
HCPCS 61583
|
| Min. Negotiated Rate |
$2,860.79 |
| Max. Negotiated Rate |
$5,179.20 |
| Rate for Payer: Aetna Commercial |
$3,833.46
|
| Rate for Payer: Aetna Medicare |
$2,975.22
|
| Rate for Payer: BCBS Complete |
$3,187.20
|
| Rate for Payer: BCBS MAPPO |
$2,860.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,860.79
|
| Rate for Payer: Cash Price |
$6,374.40
|
| Rate for Payer: Cash Price |
$6,374.40
|
| Rate for Payer: Cofinity Commercial |
$4,119.54
|
| Rate for Payer: Cofinity Commercial |
$3,833.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,860.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,003.83
|
| Rate for Payer: Nomi Health Commercial |
$3,432.95
|
| Rate for Payer: PACE SWMI |
$2,860.79
|
| Rate for Payer: PHP Medicare Advantage |
$2,860.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,179.20
|
| Rate for Payer: Priority Health Medicare |
$2,889.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,860.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,860.79
|
| Rate for Payer: UHC Exchange |
$2,860.79
|
| Rate for Payer: UHC Medicare Advantage |
$2,860.79
|
|
|
PR CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP
|
Professional
|
Both
|
$3,387.00
|
|
|
Service Code
|
HCPCS 61557
|
| Min. Negotiated Rate |
$1,354.80 |
| Max. Negotiated Rate |
$2,411.16 |
| Rate for Payer: Aetna Commercial |
$2,243.72
|
| Rate for Payer: Aetna Medicare |
$1,741.40
|
| Rate for Payer: BCBS Complete |
$1,354.80
|
| Rate for Payer: BCBS MAPPO |
$1,674.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,674.42
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cofinity Commercial |
$2,411.16
|
| Rate for Payer: Cofinity Commercial |
$2,243.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,674.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,758.14
|
| Rate for Payer: Nomi Health Commercial |
$2,009.30
|
| Rate for Payer: PACE SWMI |
$1,674.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,674.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,201.55
|
| Rate for Payer: Priority Health Medicare |
$1,691.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,674.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,674.42
|
| Rate for Payer: UHC Exchange |
$1,674.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,674.42
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN
|
Professional
|
Both
|
$9,394.00
|
|
|
Service Code
|
HCPCS 61570
|
| Min. Negotiated Rate |
$1,857.11 |
| Max. Negotiated Rate |
$6,106.10 |
| Rate for Payer: Aetna Commercial |
$2,488.53
|
| Rate for Payer: Aetna Medicare |
$1,931.39
|
| Rate for Payer: BCBS Complete |
$3,757.60
|
| Rate for Payer: BCBS MAPPO |
$1,857.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,857.11
|
| Rate for Payer: Cash Price |
$7,515.20
|
| Rate for Payer: Cash Price |
$7,515.20
|
| Rate for Payer: Cofinity Commercial |
$2,674.24
|
| Rate for Payer: Cofinity Commercial |
$2,488.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,857.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,949.97
|
| Rate for Payer: Nomi Health Commercial |
$2,228.53
|
| Rate for Payer: PACE SWMI |
$1,857.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,857.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,106.10
|
| Rate for Payer: Priority Health Medicare |
$1,875.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,857.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,857.11
|
| Rate for Payer: UHC Exchange |
$1,857.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,857.11
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL
|
Professional
|
Both
|
$4,188.00
|
|
|
Service Code
|
HCPCS 61305
|
| Min. Negotiated Rate |
$1,675.20 |
| Max. Negotiated Rate |
$2,866.20 |
| Rate for Payer: Aetna Commercial |
$2,667.16
|
| Rate for Payer: Aetna Medicare |
$2,070.04
|
| Rate for Payer: BCBS Complete |
$1,675.20
|
| Rate for Payer: BCBS MAPPO |
$1,990.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,990.42
|
| Rate for Payer: Cash Price |
$3,350.40
|
| Rate for Payer: Cash Price |
$3,350.40
|
| Rate for Payer: Cofinity Commercial |
$2,866.20
|
| Rate for Payer: Cofinity Commercial |
$2,667.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,990.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,089.94
|
| Rate for Payer: Nomi Health Commercial |
$2,388.50
|
| Rate for Payer: PACE SWMI |
$1,990.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,990.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,722.20
|
| Rate for Payer: Priority Health Medicare |
$2,010.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,990.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,990.42
|
| Rate for Payer: UHC Exchange |
$1,990.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,990.42
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL
|
Professional
|
Both
|
$5,463.00
|
|
|
Service Code
|
HCPCS 61304
|
| Min. Negotiated Rate |
$1,626.97 |
| Max. Negotiated Rate |
$3,550.95 |
| Rate for Payer: Aetna Commercial |
$2,180.14
|
| Rate for Payer: Aetna Medicare |
$1,692.05
|
| Rate for Payer: BCBS Complete |
$2,185.20
|
| Rate for Payer: BCBS MAPPO |
$1,626.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,626.97
|
| Rate for Payer: Cash Price |
$4,370.40
|
| Rate for Payer: Cash Price |
$4,370.40
|
| Rate for Payer: Cofinity Commercial |
$2,342.84
|
| Rate for Payer: Cofinity Commercial |
$2,180.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,626.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,708.32
|
| Rate for Payer: Nomi Health Commercial |
$1,952.36
|
| Rate for Payer: PACE SWMI |
$1,626.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,626.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,550.95
|
| Rate for Payer: Priority Health Medicare |
$1,643.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,626.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,626.97
|
| Rate for Payer: UHC Exchange |
$1,626.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,626.97
|
|
|
PR CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN
|
Professional
|
Both
|
$8,983.00
|
|
|
Service Code
|
HCPCS 61571
|
| Min. Negotiated Rate |
$1,976.86 |
| Max. Negotiated Rate |
$5,838.95 |
| Rate for Payer: Aetna Commercial |
$2,648.99
|
| Rate for Payer: Aetna Medicare |
$2,055.93
|
| Rate for Payer: BCBS Complete |
$3,593.20
|
| Rate for Payer: BCBS MAPPO |
$1,976.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,976.86
|
| Rate for Payer: Cash Price |
$7,186.40
|
| Rate for Payer: Cash Price |
$7,186.40
|
| Rate for Payer: Cofinity Commercial |
$2,846.68
|
| Rate for Payer: Cofinity Commercial |
$2,648.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,976.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,075.70
|
| Rate for Payer: Nomi Health Commercial |
$2,372.23
|
| Rate for Payer: PACE SWMI |
$1,976.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,976.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,838.95
|
| Rate for Payer: Priority Health Medicare |
$1,996.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,976.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,976.86
|
| Rate for Payer: UHC Exchange |
$1,976.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,976.86
|
|
|
PR CRANIECTOMY FOR OSTEOMYELITIS
|
Professional
|
Both
|
$5,360.00
|
|
|
Service Code
|
HCPCS 61501
|
| Min. Negotiated Rate |
$1,103.87 |
| Max. Negotiated Rate |
$3,484.00 |
| Rate for Payer: Aetna Commercial |
$1,479.19
|
| Rate for Payer: Aetna Medicare |
$1,148.02
|
| Rate for Payer: BCBS Complete |
$2,144.00
|
| Rate for Payer: BCBS MAPPO |
$1,103.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.87
|
| Rate for Payer: Cash Price |
$4,288.00
|
| Rate for Payer: Cash Price |
$4,288.00
|
| Rate for Payer: Cofinity Commercial |
$1,589.57
|
| Rate for Payer: Cofinity Commercial |
$1,479.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,159.06
|
| Rate for Payer: Nomi Health Commercial |
$1,324.64
|
| Rate for Payer: PACE SWMI |
$1,103.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,484.00
|
| Rate for Payer: Priority Health Medicare |
$1,114.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,103.87
|
| Rate for Payer: UHC Exchange |
$1,103.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,103.87
|
|
|
PR CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NRV
|
Professional
|
Both
|
$6,301.00
|
|
|
Service Code
|
HCPCS 61460
|
| Min. Negotiated Rate |
$2,090.12 |
| Max. Negotiated Rate |
$4,095.65 |
| Rate for Payer: Aetna Commercial |
$2,800.76
|
| Rate for Payer: Aetna Medicare |
$2,173.72
|
| Rate for Payer: BCBS Complete |
$2,520.40
|
| Rate for Payer: BCBS MAPPO |
$2,090.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,090.12
|
| Rate for Payer: Cash Price |
$5,040.80
|
| Rate for Payer: Cash Price |
$5,040.80
|
| Rate for Payer: Cofinity Commercial |
$3,009.77
|
| Rate for Payer: Cofinity Commercial |
$2,800.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,090.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,194.63
|
| Rate for Payer: Nomi Health Commercial |
$2,508.14
|
| Rate for Payer: PACE SWMI |
$2,090.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,090.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,095.65
|
| Rate for Payer: Priority Health Medicare |
$2,111.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,090.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,090.12
|
| Rate for Payer: UHC Exchange |
$2,090.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,090.12
|
|
|
PR CRANIECTOMY W/EXCISION TUMOR/OTH BONE LESION SKL
|
Professional
|
Both
|
$2,739.00
|
|
|
Service Code
|
HCPCS 61500
|
| Min. Negotiated Rate |
$1,095.60 |
| Max. Negotiated Rate |
$1,822.52 |
| Rate for Payer: Aetna Commercial |
$1,695.96
|
| Rate for Payer: Aetna Medicare |
$1,316.27
|
| Rate for Payer: BCBS Complete |
$1,095.60
|
| Rate for Payer: BCBS MAPPO |
$1,265.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,265.64
|
| Rate for Payer: Cash Price |
$2,191.20
|
| Rate for Payer: Cash Price |
$2,191.20
|
| Rate for Payer: Cofinity Commercial |
$1,822.52
|
| Rate for Payer: Cofinity Commercial |
$1,695.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,265.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,328.92
|
| Rate for Payer: Nomi Health Commercial |
$1,518.77
|
| Rate for Payer: PACE SWMI |
$1,265.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,265.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,780.35
|
| Rate for Payer: Priority Health Medicare |
$1,278.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,265.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,265.64
|
| Rate for Payer: UHC Exchange |
$1,265.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,265.64
|
|
|
PR CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ
|
Professional
|
Both
|
$5,312.00
|
|
|
Service Code
|
HCPCS 61580
|
| Min. Negotiated Rate |
$2,124.80 |
| Max. Negotiated Rate |
$3,452.80 |
| Rate for Payer: Aetna Commercial |
$3,174.67
|
| Rate for Payer: Aetna Medicare |
$2,463.93
|
| Rate for Payer: BCBS Complete |
$2,124.80
|
| Rate for Payer: BCBS MAPPO |
$2,369.16
|
| Rate for Payer: BCN Medicare Advantage |
$2,369.16
|
| Rate for Payer: Cash Price |
$4,249.60
|
| Rate for Payer: Cash Price |
$4,249.60
|
| Rate for Payer: Cofinity Commercial |
$3,411.59
|
| Rate for Payer: Cofinity Commercial |
$3,174.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,369.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,487.62
|
| Rate for Payer: Nomi Health Commercial |
$2,842.99
|
| Rate for Payer: PACE SWMI |
$2,369.16
|
| Rate for Payer: PHP Medicare Advantage |
$2,369.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,452.80
|
| Rate for Payer: Priority Health Medicare |
$2,392.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,369.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,369.16
|
| Rate for Payer: UHC Exchange |
$2,369.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,369.16
|
|
|
PR CRANIOPLASTY SKULL DEFECT <5 CM DIAMETER
|
Professional
|
Both
|
$5,342.00
|
|
|
Service Code
|
HCPCS 62140
|
| Min. Negotiated Rate |
$1,006.89 |
| Max. Negotiated Rate |
$3,472.30 |
| Rate for Payer: Aetna Commercial |
$1,349.23
|
| Rate for Payer: Aetna Medicare |
$1,047.17
|
| Rate for Payer: BCBS Complete |
$2,136.80
|
| Rate for Payer: BCBS MAPPO |
$1,006.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.89
|
| Rate for Payer: Cash Price |
$4,273.60
|
| Rate for Payer: Cash Price |
$4,273.60
|
| Rate for Payer: Cofinity Commercial |
$1,449.92
|
| Rate for Payer: Cofinity Commercial |
$1,349.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,057.23
|
| Rate for Payer: Nomi Health Commercial |
$1,208.27
|
| Rate for Payer: PACE SWMI |
$1,006.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,472.30
|
| Rate for Payer: Priority Health Medicare |
$1,016.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,006.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,006.89
|
| Rate for Payer: UHC Exchange |
$1,006.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,006.89
|
|
|
PR CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER
|
Professional
|
Both
|
$6,362.00
|
|
|
Service Code
|
HCPCS 62141
|
| Min. Negotiated Rate |
$1,131.89 |
| Max. Negotiated Rate |
$4,135.30 |
| Rate for Payer: Aetna Commercial |
$1,516.73
|
| Rate for Payer: Aetna Medicare |
$1,177.17
|
| Rate for Payer: BCBS Complete |
$2,544.80
|
| Rate for Payer: BCBS MAPPO |
$1,131.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,131.89
|
| Rate for Payer: Cash Price |
$5,089.60
|
| Rate for Payer: Cash Price |
$5,089.60
|
| Rate for Payer: Cofinity Commercial |
$1,629.92
|
| Rate for Payer: Cofinity Commercial |
$1,516.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,131.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,188.48
|
| Rate for Payer: Nomi Health Commercial |
$1,358.27
|
| Rate for Payer: PACE SWMI |
$1,131.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,131.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,135.30
|
| Rate for Payer: Priority Health Medicare |
$1,143.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,131.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,131.89
|
| Rate for Payer: UHC Exchange |
$1,131.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,131.89
|
|
|
PR CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG
|
Professional
|
Both
|
$5,986.00
|
|
|
Service Code
|
HCPCS 62145
|
| Min. Negotiated Rate |
$1,388.99 |
| Max. Negotiated Rate |
$3,890.90 |
| Rate for Payer: Aetna Commercial |
$1,861.25
|
| Rate for Payer: Aetna Medicare |
$1,444.55
|
| Rate for Payer: BCBS Complete |
$2,394.40
|
| Rate for Payer: BCBS MAPPO |
$1,388.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,388.99
|
| Rate for Payer: Cash Price |
$4,788.80
|
| Rate for Payer: Cash Price |
$4,788.80
|
| Rate for Payer: Cofinity Commercial |
$2,000.15
|
| Rate for Payer: Cofinity Commercial |
$1,861.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,388.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,458.44
|
| Rate for Payer: Nomi Health Commercial |
$1,666.79
|
| Rate for Payer: PACE SWMI |
$1,388.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,388.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,890.90
|
| Rate for Payer: Priority Health Medicare |
$1,402.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,388.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,388.99
|
| Rate for Payer: UHC Exchange |
$1,388.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,388.99
|
|
|
PR CRANIOPLASTY W/AUTOGRAFT <5 CM DIAMETER
|
Professional
|
Both
|
$6,377.00
|
|
|
Service Code
|
HCPCS 62146
|
| Min. Negotiated Rate |
$1,242.36 |
| Max. Negotiated Rate |
$4,145.05 |
| Rate for Payer: Aetna Commercial |
$1,664.76
|
| Rate for Payer: Aetna Medicare |
$1,292.05
|
| Rate for Payer: BCBS Complete |
$2,550.80
|
| Rate for Payer: BCBS MAPPO |
$1,242.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,242.36
|
| Rate for Payer: Cash Price |
$5,101.60
|
| Rate for Payer: Cash Price |
$5,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,789.00
|
| Rate for Payer: Cofinity Commercial |
$1,664.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,242.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,304.48
|
| Rate for Payer: Nomi Health Commercial |
$1,490.83
|
| Rate for Payer: PACE SWMI |
$1,242.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,242.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,145.05
|
| Rate for Payer: Priority Health Medicare |
$1,254.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,242.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,242.36
|
| Rate for Payer: UHC Exchange |
$1,242.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,242.36
|
|
|
PR CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER
|
Professional
|
Both
|
$7,296.00
|
|
|
Service Code
|
HCPCS 62147
|
| Min. Negotiated Rate |
$1,414.70 |
| Max. Negotiated Rate |
$4,742.40 |
| Rate for Payer: Aetna Commercial |
$1,895.70
|
| Rate for Payer: Aetna Medicare |
$1,471.29
|
| Rate for Payer: BCBS Complete |
$2,918.40
|
| Rate for Payer: BCBS MAPPO |
$1,414.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,414.70
|
| Rate for Payer: Cash Price |
$5,836.80
|
| Rate for Payer: Cash Price |
$5,836.80
|
| Rate for Payer: Cofinity Commercial |
$2,037.17
|
| Rate for Payer: Cofinity Commercial |
$1,895.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,414.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,485.43
|
| Rate for Payer: Nomi Health Commercial |
$1,697.64
|
| Rate for Payer: PACE SWMI |
$1,414.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,414.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,742.40
|
| Rate for Payer: Priority Health Medicare |
$1,428.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,414.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,414.70
|
| Rate for Payer: UHC Exchange |
$1,414.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,414.70
|
|
|
PR CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG
|
Professional
|
Both
|
$7,866.00
|
|
|
Service Code
|
HCPCS 61540
|
| Min. Negotiated Rate |
$2,159.58 |
| Max. Negotiated Rate |
$5,112.90 |
| Rate for Payer: Aetna Commercial |
$2,893.84
|
| Rate for Payer: Aetna Medicare |
$2,245.96
|
| Rate for Payer: BCBS Complete |
$3,146.40
|
| Rate for Payer: BCBS MAPPO |
$2,159.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,159.58
|
| Rate for Payer: Cash Price |
$6,292.80
|
| Rate for Payer: Cash Price |
$6,292.80
|
| Rate for Payer: Cofinity Commercial |
$3,109.80
|
| Rate for Payer: Cofinity Commercial |
$2,893.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,159.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,267.56
|
| Rate for Payer: Nomi Health Commercial |
$2,591.50
|
| Rate for Payer: PACE SWMI |
$2,159.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,159.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,112.90
|
| Rate for Payer: Priority Health Medicare |
$2,181.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,159.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,159.58
|
| Rate for Payer: UHC Exchange |
$2,159.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,159.58
|
|
|
PR CRANIOTOMY EXCISION CRANIOPHARYNGIOMA
|
Professional
|
Both
|
$6,696.00
|
|
|
Service Code
|
HCPCS 61545
|
| Min. Negotiated Rate |
$2,678.40 |
| Max. Negotiated Rate |
$4,550.52 |
| Rate for Payer: Aetna Commercial |
$4,234.51
|
| Rate for Payer: Aetna Medicare |
$3,286.48
|
| Rate for Payer: BCBS Complete |
$2,678.40
|
| Rate for Payer: BCBS MAPPO |
$3,160.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,160.08
|
| Rate for Payer: Cash Price |
$5,356.80
|
| Rate for Payer: Cash Price |
$5,356.80
|
| Rate for Payer: Cofinity Commercial |
$4,550.52
|
| Rate for Payer: Cofinity Commercial |
$4,234.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,160.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,318.08
|
| Rate for Payer: Nomi Health Commercial |
$3,792.10
|
| Rate for Payer: PACE SWMI |
$3,160.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,160.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,352.40
|
| Rate for Payer: Priority Health Medicare |
$3,191.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,160.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,160.08
|
| Rate for Payer: UHC Exchange |
$3,160.08
|
| Rate for Payer: UHC Medicare Advantage |
$3,160.08
|
|
|
PR CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE
|
Professional
|
Both
|
$5,612.00
|
|
|
Service Code
|
HCPCS 62121
|
| Min. Negotiated Rate |
$1,495.12 |
| Max. Negotiated Rate |
$3,647.80 |
| Rate for Payer: Aetna Commercial |
$2,003.46
|
| Rate for Payer: Aetna Medicare |
$1,554.92
|
| Rate for Payer: BCBS Complete |
$2,244.80
|
| Rate for Payer: BCBS MAPPO |
$1,495.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,495.12
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cash Price |
$4,489.60
|
| Rate for Payer: Cofinity Commercial |
$2,152.97
|
| Rate for Payer: Cofinity Commercial |
$2,003.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,495.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,569.88
|
| Rate for Payer: Nomi Health Commercial |
$1,794.14
|
| Rate for Payer: PACE SWMI |
$1,495.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,495.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,647.80
|
| Rate for Payer: Priority Health Medicare |
$1,510.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,495.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,495.12
|
| Rate for Payer: UHC Exchange |
$1,495.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,495.12
|
|
|
PR CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY
|
Professional
|
Both
|
$7,067.00
|
|
|
Service Code
|
HCPCS 61537
|
| Min. Negotiated Rate |
$2,439.18 |
| Max. Negotiated Rate |
$4,593.55 |
| Rate for Payer: Aetna Commercial |
$3,268.50
|
| Rate for Payer: Aetna Medicare |
$2,536.75
|
| Rate for Payer: BCBS Complete |
$2,826.80
|
| Rate for Payer: BCBS MAPPO |
$2,439.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,439.18
|
| Rate for Payer: Cash Price |
$5,653.60
|
| Rate for Payer: Cash Price |
$5,653.60
|
| Rate for Payer: Cofinity Commercial |
$3,512.42
|
| Rate for Payer: Cofinity Commercial |
$3,268.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,439.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,561.14
|
| Rate for Payer: Nomi Health Commercial |
$2,927.02
|
| Rate for Payer: PACE SWMI |
$2,439.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,439.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,593.55
|
| Rate for Payer: Priority Health Medicare |
$2,463.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,439.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,439.18
|
| Rate for Payer: UHC Exchange |
$2,439.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,439.18
|
|
|
PR CRICOPHARYNGEAL MYOTOMY
|
Professional
|
Both
|
$2,284.00
|
|
|
Service Code
|
HCPCS 43030
|
| Min. Negotiated Rate |
$502.34 |
| Max. Negotiated Rate |
$1,484.60 |
| Rate for Payer: Aetna Commercial |
$673.14
|
| Rate for Payer: Aetna Medicare |
$522.43
|
| Rate for Payer: BCBS Complete |
$913.60
|
| Rate for Payer: BCBS MAPPO |
$502.34
|
| Rate for Payer: BCN Medicare Advantage |
$502.34
|
| Rate for Payer: Cash Price |
$1,827.20
|
| Rate for Payer: Cash Price |
$1,827.20
|
| Rate for Payer: Cofinity Commercial |
$723.37
|
| Rate for Payer: Cofinity Commercial |
$673.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.46
|
| Rate for Payer: Nomi Health Commercial |
$602.81
|
| Rate for Payer: PACE SWMI |
$502.34
|
| Rate for Payer: PHP Medicare Advantage |
$502.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,484.60
|
| Rate for Payer: Priority Health Medicare |
$507.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.34
|
| Rate for Payer: UHC Exchange |
$502.34
|
| Rate for Payer: UHC Medicare Advantage |
$502.34
|
|
|
PR CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 99292
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$146.82 |
| Rate for Payer: Aetna Commercial |
$136.63
|
| Rate for Payer: Aetna Medicare |
$106.04
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS MAPPO |
$101.96
|
| Rate for Payer: BCN Medicare Advantage |
$101.96
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$146.82
|
| Rate for Payer: Cofinity Commercial |
$136.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.06
|
| Rate for Payer: Nomi Health Commercial |
$122.35
|
| Rate for Payer: PACE SWMI |
$101.96
|
| Rate for Payer: PHP Medicare Advantage |
$101.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health Medicare |
$102.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.96
|
| Rate for Payer: UHC Exchange |
$101.96
|
| Rate for Payer: UHC Medicare Advantage |
$101.96
|
|
