|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$130.65 |
| Max. Negotiated Rate |
$180.90 |
| Rate for Payer: Aetna Commercial |
$170.85
|
| Rate for Payer: Aetna Commercial |
$280.50
|
| Rate for Payer: BCBS Trust/PPO |
$164.08
|
| Rate for Payer: BCBS Trust/PPO |
$269.38
|
| Rate for Payer: BCN Commercial |
$155.33
|
| Rate for Payer: BCN Commercial |
$255.02
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$283.80
|
| Rate for Payer: Cofinity Commercial |
$172.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.80
|
| Rate for Payer: Healthscope Commercial |
$180.90
|
| Rate for Payer: Healthscope Commercial |
$297.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.50
|
| Rate for Payer: Nomi Health Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$270.60
|
| Rate for Payer: PHP Commercial |
$170.85
|
| Rate for Payer: PHP Commercial |
$280.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health HMO/PPO |
$287.10
|
| Rate for Payer: Priority Health HMO/PPO |
$174.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.40
|
| Rate for Payer: UHC Core |
$167.84
|
| Rate for Payer: UHC Core |
$275.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.50
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$1,902.94 |
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO |
$24.48
|
| Rate for Payer: Priority Health HMO/PPO |
$24.48
|
| Rate for Payer: Priority Health Medicare |
$45.91
|
| Rate for Payer: Priority Health Medicare |
$45.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Exchange |
$45.46
|
| Rate for Payer: UHC Exchange |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
IP
|
$176.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$114.40 |
| Max. Negotiated Rate |
$158.40 |
| Rate for Payer: Aetna Commercial |
$149.60
|
| Rate for Payer: Aetna Commercial |
$220.15
|
| Rate for Payer: BCBS Trust/PPO |
$143.67
|
| Rate for Payer: BCBS Trust/PPO |
$211.42
|
| Rate for Payer: BCN Commercial |
$136.01
|
| Rate for Payer: BCN Commercial |
$200.16
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$222.74
|
| Rate for Payer: Cofinity Commercial |
$151.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Healthscope Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$233.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Nomi Health Commercial |
$144.32
|
| Rate for Payer: Nomi Health Commercial |
$212.38
|
| Rate for Payer: PHP Commercial |
$149.60
|
| Rate for Payer: PHP Commercial |
$220.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health HMO/PPO |
$225.33
|
| Rate for Payer: Priority Health HMO/PPO |
$153.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.92
|
| Rate for Payer: UHC Core |
$146.96
|
| Rate for Payer: UHC Core |
$216.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.25
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 93320
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$1,902.94 |
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO |
$24.48
|
| Rate for Payer: Priority Health HMO/PPO |
$24.48
|
| Rate for Payer: Priority Health Medicare |
$45.91
|
| Rate for Payer: Priority Health Medicare |
$45.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Exchange |
$45.46
|
| Rate for Payer: UHC Exchange |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$61.51 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Aetna Commercial |
$220.15
|
| Rate for Payer: Aetna Commercial |
$149.60
|
| Rate for Payer: Aetna Medicare |
$67.34
|
| Rate for Payer: Aetna Medicare |
$45.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.00
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS MAPPO |
$44.00
|
| Rate for Payer: BCBS MAPPO |
$64.75
|
| Rate for Payer: BCBS Trust/PPO |
$212.92
|
| Rate for Payer: BCBS Trust/PPO |
$144.69
|
| Rate for Payer: BCN Commercial |
$201.37
|
| Rate for Payer: BCN Commercial |
$136.84
|
| Rate for Payer: BCN Medicare Advantage |
$64.75
|
| Rate for Payer: BCN Medicare Advantage |
$44.00
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$151.36
|
| Rate for Payer: Cofinity Commercial |
$222.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.75
|
| Rate for Payer: Healthscope Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$233.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: Nomi Health Commercial |
$212.38
|
| Rate for Payer: Nomi Health Commercial |
$144.32
|
| Rate for Payer: PACE Senior Care Partners |
$61.51
|
| Rate for Payer: PACE Senior Care Partners |
$41.80
|
| Rate for Payer: PACE SWMI |
$64.75
|
| Rate for Payer: PACE SWMI |
$44.00
|
| Rate for Payer: PHP Commercial |
$220.15
|
| Rate for Payer: PHP Commercial |
$149.60
|
| Rate for Payer: PHP Medicare Advantage |
$44.00
|
| Rate for Payer: PHP Medicare Advantage |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health HMO/PPO |
$153.12
|
| Rate for Payer: Priority Health HMO/PPO |
$225.33
|
| Rate for Payer: Priority Health Medicare |
$65.40
|
| Rate for Payer: Priority Health Medicare |
$44.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.92
|
| Rate for Payer: Railroad Medicare Medicare |
$44.00
|
| Rate for Payer: Railroad Medicare Medicare |
$64.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.92
|
| Rate for Payer: UHC Core |
$216.26
|
| Rate for Payer: UHC Core |
$146.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.00
|
| Rate for Payer: UHC Exchange |
$44.00
|
| Rate for Payer: UHC Exchange |
$64.75
|
| Rate for Payer: UHC Medicare Advantage |
$44.00
|
| Rate for Payer: UHC Medicare Advantage |
$64.75
|
| Rate for Payer: VA VA |
$44.00
|
| Rate for Payer: VA VA |
$64.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.00
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93321
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$2,553.80 |
| Rate for Payer: Aetna Commercial |
$29.91
|
| Rate for Payer: Aetna Medicare |
$23.21
|
| Rate for Payer: BCBS Complete |
$4.69
|
| Rate for Payer: BCBS MAPPO |
$22.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,553.80
|
| Rate for Payer: BCN Commercial |
$36.65
|
| Rate for Payer: BCN Medicare Advantage |
$22.32
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$32.14
|
| Rate for Payer: Cofinity Commercial |
$29.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.32
|
| Rate for Payer: Mclaren Medicaid |
$4.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.44
|
| Rate for Payer: Meridian Medicaid |
$4.69
|
| Rate for Payer: Nomi Health Commercial |
$26.78
|
| Rate for Payer: PACE SWMI |
$22.32
|
| Rate for Payer: PHP Medicare Advantage |
$22.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO |
$9.89
|
| Rate for Payer: Priority Health Medicare |
$22.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.32
|
| Rate for Payer: UHC Exchange |
$22.32
|
| Rate for Payer: UHC Medicare Advantage |
$22.32
|
| Rate for Payer: UHCCP Medicaid |
$4.47
|
|
|
PR DRAIN ABD ABSCESS PERCUTANEOUS
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
HCPCS 49021
|
| Min. Negotiated Rate |
$247.60 |
| Max. Negotiated Rate |
$402.35 |
| Rate for Payer: Aetna Medicare |
$309.50
|
| Rate for Payer: BCBS Complete |
$247.60
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.35
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 30000
|
| Min. Negotiated Rate |
$79.02 |
| Max. Negotiated Rate |
$1,942.56 |
| Rate for Payer: Aetna Commercial |
$154.70
|
| Rate for Payer: Aetna Medicare |
$120.07
|
| Rate for Payer: BCBS Complete |
$82.97
|
| Rate for Payer: BCBS MAPPO |
$115.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,942.56
|
| Rate for Payer: BCN Commercial |
$396.81
|
| Rate for Payer: BCN Medicare Advantage |
$115.45
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$166.25
|
| Rate for Payer: Cofinity Commercial |
$154.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.45
|
| Rate for Payer: Mclaren Medicaid |
$79.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.22
|
| Rate for Payer: Meridian Medicaid |
$82.97
|
| Rate for Payer: Nomi Health Commercial |
$138.54
|
| Rate for Payer: PACE SWMI |
$115.45
|
| Rate for Payer: PHP Medicare Advantage |
$115.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.10
|
| Rate for Payer: Priority Health HMO/PPO |
$170.10
|
| Rate for Payer: Priority Health Medicare |
$116.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.45
|
| Rate for Payer: UHC Exchange |
$115.45
|
| Rate for Payer: UHC Medicare Advantage |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$79.02
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS 30020
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$1,109.43 |
| Rate for Payer: Aetna Commercial |
$154.98
|
| Rate for Payer: Aetna Medicare |
$120.29
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$115.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.43
|
| Rate for Payer: BCN Commercial |
$401.20
|
| Rate for Payer: BCN Medicare Advantage |
$115.66
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cofinity Commercial |
$166.55
|
| Rate for Payer: Cofinity Commercial |
$154.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.66
|
| Rate for Payer: Mclaren Medicaid |
$79.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.44
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Nomi Health Commercial |
$138.79
|
| Rate for Payer: PACE SWMI |
$115.66
|
| Rate for Payer: PHP Medicare Advantage |
$115.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.60
|
| Rate for Payer: Priority Health HMO/PPO |
$172.41
|
| Rate for Payer: Priority Health Medicare |
$116.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.66
|
| Rate for Payer: UHC Exchange |
$115.66
|
| Rate for Payer: UHC Medicare Advantage |
$115.66
|
| Rate for Payer: UHCCP Medicaid |
$79.24
|
|
|
PR DRAINAGE ABSCESS PALATE UVULA
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 42000
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$237.98 |
| Rate for Payer: Aetna Commercial |
$138.07
|
| Rate for Payer: Aetna Medicare |
$107.16
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$103.04
|
| Rate for Payer: BCN Commercial |
$237.98
|
| Rate for Payer: BCN Medicare Advantage |
$103.04
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$148.38
|
| Rate for Payer: Cofinity Commercial |
$138.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.04
|
| Rate for Payer: Mclaren Medicaid |
$70.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.19
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Nomi Health Commercial |
$123.65
|
| Rate for Payer: PACE SWMI |
$103.04
|
| Rate for Payer: PHP Medicare Advantage |
$103.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.40
|
| Rate for Payer: Priority Health HMO/PPO |
$197.47
|
| Rate for Payer: Priority Health Medicare |
$104.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.04
|
| Rate for Payer: UHC Exchange |
$103.04
|
| Rate for Payer: UHC Medicare Advantage |
$103.04
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
|
PR DRAINAGE ABSCESS PAROTID COMPLICATED
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 42305
|
| Min. Negotiated Rate |
$200.75 |
| Max. Negotiated Rate |
$783.32 |
| Rate for Payer: Aetna Commercial |
$554.21
|
| Rate for Payer: Aetna Medicare |
$430.13
|
| Rate for Payer: BCBS Complete |
$294.33
|
| Rate for Payer: BCBS MAPPO |
$413.59
|
| Rate for Payer: BCBS Trust/PPO |
$200.75
|
| Rate for Payer: BCN Commercial |
$621.60
|
| Rate for Payer: BCN Medicare Advantage |
$413.59
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$595.57
|
| Rate for Payer: Cofinity Commercial |
$554.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.59
|
| Rate for Payer: Mclaren Medicaid |
$280.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.27
|
| Rate for Payer: Meridian Medicaid |
$294.33
|
| Rate for Payer: Nomi Health Commercial |
$496.31
|
| Rate for Payer: PACE SWMI |
$413.59
|
| Rate for Payer: PHP Medicare Advantage |
$413.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$280.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.95
|
| Rate for Payer: Priority Health HMO/PPO |
$783.32
|
| Rate for Payer: Priority Health Medicare |
$417.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.59
|
| Rate for Payer: UHC Exchange |
$413.59
|
| Rate for Payer: UHC Medicare Advantage |
$413.59
|
| Rate for Payer: UHCCP Medicaid |
$280.31
|
|
|
PR DRAINAGE ABSCESS PAROTID SIMPLE
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 42300
|
| Min. Negotiated Rate |
$101.18 |
| Max. Negotiated Rate |
$891.77 |
| Rate for Payer: Aetna Commercial |
$198.37
|
| Rate for Payer: Aetna Medicare |
$153.96
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS MAPPO |
$148.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.77
|
| Rate for Payer: BCN Commercial |
$319.11
|
| Rate for Payer: BCN Medicare Advantage |
$148.04
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$213.18
|
| Rate for Payer: Cofinity Commercial |
$198.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.04
|
| Rate for Payer: Mclaren Medicaid |
$101.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.44
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Nomi Health Commercial |
$177.65
|
| Rate for Payer: PACE SWMI |
$148.04
|
| Rate for Payer: PHP Medicare Advantage |
$148.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.85
|
| Rate for Payer: Priority Health HMO/PPO |
$282.78
|
| Rate for Payer: Priority Health Medicare |
$149.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.04
|
| Rate for Payer: UHC Exchange |
$148.04
|
| Rate for Payer: UHC Medicare Advantage |
$148.04
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
|
|
PR DRAINAGE DEEP PERIURETHRAL ABSCESS
|
Professional
|
Both
|
$815.00
|
|
|
Service Code
|
HCPCS 53040
|
| Min. Negotiated Rate |
$253.26 |
| Max. Negotiated Rate |
$758.64 |
| Rate for Payer: Aetna Commercial |
$503.85
|
| Rate for Payer: Aetna Medicare |
$391.05
|
| Rate for Payer: BCBS Complete |
$265.92
|
| Rate for Payer: BCBS MAPPO |
$376.01
|
| Rate for Payer: BCBS Trust/PPO |
$758.64
|
| Rate for Payer: BCN Commercial |
$568.33
|
| Rate for Payer: BCN Medicare Advantage |
$376.01
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cofinity Commercial |
$541.45
|
| Rate for Payer: Cofinity Commercial |
$503.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.01
|
| Rate for Payer: Mclaren Medicaid |
$253.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.81
|
| Rate for Payer: Meridian Medicaid |
$265.92
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: PACE SWMI |
$376.01
|
| Rate for Payer: PHP Medicare Advantage |
$376.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.75
|
| Rate for Payer: Priority Health HMO/PPO |
$627.94
|
| Rate for Payer: Priority Health Medicare |
$379.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$627.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.01
|
| Rate for Payer: UHC Exchange |
$376.01
|
| Rate for Payer: UHC Medicare Advantage |
$376.01
|
| Rate for Payer: UHCCP Medicaid |
$253.26
|
|
|
PR DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 69020
|
| Min. Negotiated Rate |
$92.66 |
| Max. Negotiated Rate |
$346.96 |
| Rate for Payer: Aetna Commercial |
$180.06
|
| Rate for Payer: Aetna Medicare |
$139.74
|
| Rate for Payer: BCBS Complete |
$97.29
|
| Rate for Payer: BCBS MAPPO |
$134.37
|
| Rate for Payer: BCBS Trust/PPO |
$282.64
|
| Rate for Payer: BCN Commercial |
$346.96
|
| Rate for Payer: BCN Medicare Advantage |
$134.37
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cofinity Commercial |
$193.49
|
| Rate for Payer: Cofinity Commercial |
$180.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.37
|
| Rate for Payer: Mclaren Medicaid |
$92.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.09
|
| Rate for Payer: Meridian Medicaid |
$97.29
|
| Rate for Payer: Nomi Health Commercial |
$161.24
|
| Rate for Payer: PACE SWMI |
$134.37
|
| Rate for Payer: PHP Medicare Advantage |
$134.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.00
|
| Rate for Payer: Priority Health HMO/PPO |
$212.05
|
| Rate for Payer: Priority Health Medicare |
$135.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.37
|
| Rate for Payer: UHC Exchange |
$134.37
|
| Rate for Payer: UHC Medicare Advantage |
$134.37
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA COMP
|
Professional
|
Both
|
$385.00
|
|
|
Service Code
|
HCPCS 69005
|
| Min. Negotiated Rate |
$104.37 |
| Max. Negotiated Rate |
$5,834.02 |
| Rate for Payer: Aetna Commercial |
$205.57
|
| Rate for Payer: Aetna Medicare |
$159.55
|
| Rate for Payer: BCBS Complete |
$109.59
|
| Rate for Payer: BCBS MAPPO |
$153.41
|
| Rate for Payer: BCBS Trust/PPO |
$5,834.02
|
| Rate for Payer: BCN Commercial |
$323.02
|
| Rate for Payer: BCN Medicare Advantage |
$153.41
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cofinity Commercial |
$220.91
|
| Rate for Payer: Cofinity Commercial |
$205.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.41
|
| Rate for Payer: Mclaren Medicaid |
$104.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.08
|
| Rate for Payer: Meridian Medicaid |
$109.59
|
| Rate for Payer: Nomi Health Commercial |
$184.09
|
| Rate for Payer: PACE SWMI |
$153.41
|
| Rate for Payer: PHP Medicare Advantage |
$153.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.25
|
| Rate for Payer: Priority Health HMO/PPO |
$237.84
|
| Rate for Payer: Priority Health Medicare |
$154.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.41
|
| Rate for Payer: UHC Exchange |
$153.41
|
| Rate for Payer: UHC Medicare Advantage |
$153.41
|
| Rate for Payer: UHCCP Medicaid |
$104.37
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 69000
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$5,524.43 |
| Rate for Payer: Aetna Commercial |
$158.33
|
| Rate for Payer: Aetna Medicare |
$122.89
|
| Rate for Payer: BCBS Complete |
$84.99
|
| Rate for Payer: BCBS MAPPO |
$118.16
|
| Rate for Payer: BCBS Trust/PPO |
$5,524.43
|
| Rate for Payer: BCN Commercial |
$275.12
|
| Rate for Payer: BCN Medicare Advantage |
$118.16
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$170.15
|
| Rate for Payer: Cofinity Commercial |
$158.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.16
|
| Rate for Payer: Mclaren Medicaid |
$80.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.07
|
| Rate for Payer: Meridian Medicaid |
$84.99
|
| Rate for Payer: Nomi Health Commercial |
$141.79
|
| Rate for Payer: PACE SWMI |
$118.16
|
| Rate for Payer: PHP Medicare Advantage |
$118.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health HMO/PPO |
$184.82
|
| Rate for Payer: Priority Health Medicare |
$119.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.16
|
| Rate for Payer: UHC Exchange |
$118.16
|
| Rate for Payer: UHC Medicare Advantage |
$118.16
|
| Rate for Payer: UHCCP Medicaid |
$80.94
|
|
|
PR DRAINAGE FINGER ABSCESS COMPLICATED
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 26011
|
| Min. Negotiated Rate |
$120.98 |
| Max. Negotiated Rate |
$712.98 |
| Rate for Payer: Aetna Commercial |
$237.69
|
| Rate for Payer: Aetna Medicare |
$184.48
|
| Rate for Payer: BCBS Complete |
$127.03
|
| Rate for Payer: BCBS MAPPO |
$177.38
|
| Rate for Payer: BCBS Trust/PPO |
$452.09
|
| Rate for Payer: BCN Commercial |
$712.98
|
| Rate for Payer: BCN Medicare Advantage |
$177.38
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cofinity Commercial |
$255.43
|
| Rate for Payer: Cofinity Commercial |
$237.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.38
|
| Rate for Payer: Mclaren Medicaid |
$120.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.25
|
| Rate for Payer: Meridian Medicaid |
$127.03
|
| Rate for Payer: Nomi Health Commercial |
$212.86
|
| Rate for Payer: PACE SWMI |
$177.38
|
| Rate for Payer: PHP Medicare Advantage |
$177.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.15
|
| Rate for Payer: Priority Health HMO/PPO |
$286.49
|
| Rate for Payer: Priority Health Medicare |
$179.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.38
|
| Rate for Payer: UHC Exchange |
$177.38
|
| Rate for Payer: UHC Medicare Advantage |
$177.38
|
| Rate for Payer: UHCCP Medicaid |
$120.98
|
|
|
PR DRAINAGE FINGER ABSCESS SIMPLE
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 26010
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$509.69 |
| Rate for Payer: Aetna Commercial |
$179.51
|
| Rate for Payer: Aetna Medicare |
$139.32
|
| Rate for Payer: BCBS Complete |
$96.39
|
| Rate for Payer: BCBS MAPPO |
$133.96
|
| Rate for Payer: BCBS Trust/PPO |
$348.51
|
| Rate for Payer: BCN Commercial |
$509.69
|
| Rate for Payer: BCN Medicare Advantage |
$133.96
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cofinity Commercial |
$192.90
|
| Rate for Payer: Cofinity Commercial |
$179.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.96
|
| Rate for Payer: Mclaren Medicaid |
$91.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.66
|
| Rate for Payer: Meridian Medicaid |
$96.39
|
| Rate for Payer: Nomi Health Commercial |
$160.75
|
| Rate for Payer: PACE SWMI |
$133.96
|
| Rate for Payer: PHP Medicare Advantage |
$133.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.40
|
| Rate for Payer: Priority Health HMO/PPO |
$218.82
|
| Rate for Payer: Priority Health Medicare |
$135.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$218.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.96
|
| Rate for Payer: UHC Exchange |
$133.96
|
| Rate for Payer: UHC Medicare Advantage |
$133.96
|
| Rate for Payer: UHCCP Medicaid |
$91.80
|
|
|
PR DRAINAGE OF PALMAR BURSA MULTIPLE BURSA
|
Professional
|
Both
|
$3,178.00
|
|
|
Service Code
|
HCPCS 26030
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$2,065.70 |
| Rate for Payer: Aetna Commercial |
$637.71
|
| Rate for Payer: Aetna Medicare |
$494.94
|
| Rate for Payer: BCBS Complete |
$339.95
|
| Rate for Payer: BCBS MAPPO |
$475.90
|
| Rate for Payer: BCBS Trust/PPO |
$104.00
|
| Rate for Payer: BCN Commercial |
$727.15
|
| Rate for Payer: BCN Medicare Advantage |
$475.90
|
| Rate for Payer: Cash Price |
$2,542.40
|
| Rate for Payer: Cash Price |
$2,542.40
|
| Rate for Payer: Cofinity Commercial |
$685.30
|
| Rate for Payer: Cofinity Commercial |
$637.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.90
|
| Rate for Payer: Mclaren Medicaid |
$323.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.70
|
| Rate for Payer: Meridian Medicaid |
$339.95
|
| Rate for Payer: Nomi Health Commercial |
$571.08
|
| Rate for Payer: PACE SWMI |
$475.90
|
| Rate for Payer: PHP Medicare Advantage |
$475.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,065.70
|
| Rate for Payer: Priority Health HMO/PPO |
$765.32
|
| Rate for Payer: Priority Health Medicare |
$480.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$765.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$475.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.90
|
| Rate for Payer: UHC Exchange |
$475.90
|
| Rate for Payer: UHC Medicare Advantage |
$475.90
|
| Rate for Payer: UHCCP Medicaid |
$323.76
|
|
|
PR DRAINAGE OF PALMAR BURSA SINGLE BURSA
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 26025
|
| Min. Negotiated Rate |
$84.90 |
| Max. Negotiated Rate |
$885.95 |
| Rate for Payer: Aetna Commercial |
$541.29
|
| Rate for Payer: Aetna Medicare |
$420.11
|
| Rate for Payer: BCBS Complete |
$289.18
|
| Rate for Payer: BCBS MAPPO |
$403.95
|
| Rate for Payer: BCBS Trust/PPO |
$84.90
|
| Rate for Payer: BCN Commercial |
$621.60
|
| Rate for Payer: BCN Medicare Advantage |
$403.95
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$581.69
|
| Rate for Payer: Cofinity Commercial |
$541.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.95
|
| Rate for Payer: Mclaren Medicaid |
$275.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.15
|
| Rate for Payer: Meridian Medicaid |
$289.18
|
| Rate for Payer: Nomi Health Commercial |
$484.74
|
| Rate for Payer: PACE SWMI |
$403.95
|
| Rate for Payer: PHP Medicare Advantage |
$403.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: Priority Health HMO/PPO |
$653.37
|
| Rate for Payer: Priority Health Medicare |
$407.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.95
|
| Rate for Payer: UHC Exchange |
$403.95
|
| Rate for Payer: UHC Medicare Advantage |
$403.95
|
| Rate for Payer: UHCCP Medicaid |
$275.41
|
|
|
PR DRAINAGE OF RETROPERITONEAL ABSCESS OPEN
|
Professional
|
Both
|
$2,249.00
|
|
|
Service Code
|
HCPCS 49060
|
| Min. Negotiated Rate |
$709.29 |
| Max. Negotiated Rate |
$1,957.42 |
| Rate for Payer: Aetna Commercial |
$1,433.85
|
| Rate for Payer: Aetna Medicare |
$1,112.84
|
| Rate for Payer: BCBS Complete |
$744.75
|
| Rate for Payer: BCBS MAPPO |
$1,070.04
|
| Rate for Payer: BCBS Trust/PPO |
$798.26
|
| Rate for Payer: BCN Commercial |
$1,595.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,070.04
|
| Rate for Payer: Cash Price |
$1,799.20
|
| Rate for Payer: Cash Price |
$1,799.20
|
| Rate for Payer: Cofinity Commercial |
$1,540.86
|
| Rate for Payer: Cofinity Commercial |
$1,433.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,070.04
|
| Rate for Payer: Mclaren Medicaid |
$709.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.54
|
| Rate for Payer: Meridian Medicaid |
$744.75
|
| Rate for Payer: Nomi Health Commercial |
$1,284.05
|
| Rate for Payer: PACE SWMI |
$1,070.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,070.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,461.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,957.42
|
| Rate for Payer: Priority Health Medicare |
$1,080.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,957.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,070.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,070.04
|
| Rate for Payer: UHC Exchange |
$1,070.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,070.04
|
| Rate for Payer: UHCCP Medicaid |
$709.29
|
|
|
PR DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Professional
|
Both
|
$1,725.00
|
|
|
Service Code
|
HCPCS 58822
|
| Min. Negotiated Rate |
$280.53 |
| Max. Negotiated Rate |
$1,121.25 |
| Rate for Payer: Aetna Commercial |
$917.79
|
| Rate for Payer: Aetna Medicare |
$712.32
|
| Rate for Payer: BCBS Complete |
$481.30
|
| Rate for Payer: BCBS MAPPO |
$684.92
|
| Rate for Payer: BCBS Trust/PPO |
$280.53
|
| Rate for Payer: BCN Commercial |
$1,050.17
|
| Rate for Payer: BCN Medicare Advantage |
$684.92
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cofinity Commercial |
$986.28
|
| Rate for Payer: Cofinity Commercial |
$917.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.92
|
| Rate for Payer: Mclaren Medicaid |
$458.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.17
|
| Rate for Payer: Meridian Medicaid |
$481.30
|
| Rate for Payer: Nomi Health Commercial |
$821.90
|
| Rate for Payer: PACE SWMI |
$684.92
|
| Rate for Payer: PHP Medicare Advantage |
$684.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,121.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,070.46
|
| Rate for Payer: Priority Health Medicare |
$691.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,070.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$684.92
|
| Rate for Payer: UHC Exchange |
$684.92
|
| Rate for Payer: UHC Medicare Advantage |
$684.92
|
| Rate for Payer: UHCCP Medicaid |
$458.38
|
|
|
PR DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN
|
Professional
|
Both
|
$897.00
|
|
|
Service Code
|
HCPCS 58820
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$583.05 |
| Rate for Payer: Aetna Commercial |
$431.95
|
| Rate for Payer: Aetna Medicare |
$335.24
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS MAPPO |
$322.35
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$500.41
|
| Rate for Payer: BCN Medicare Advantage |
$322.35
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cofinity Commercial |
$464.18
|
| Rate for Payer: Cofinity Commercial |
$431.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.35
|
| Rate for Payer: Mclaren Medicaid |
$218.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.47
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Nomi Health Commercial |
$386.82
|
| Rate for Payer: PACE SWMI |
$322.35
|
| Rate for Payer: PHP Medicare Advantage |
$322.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.05
|
| Rate for Payer: Priority Health HMO/PPO |
$510.43
|
| Rate for Payer: Priority Health Medicare |
$325.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$510.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.35
|
| Rate for Payer: UHC Exchange |
$322.35
|
| Rate for Payer: UHC Medicare Advantage |
$322.35
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
|
|
PR DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL
|
Professional
|
Both
|
$1,612.00
|
|
|
Service Code
|
HCPCS 58805
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,047.80 |
| Rate for Payer: Aetna Commercial |
$546.29
|
| Rate for Payer: Aetna Medicare |
$423.99
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$407.68
|
| Rate for Payer: BCBS Trust/PPO |
$275.77
|
| Rate for Payer: BCN Commercial |
$630.89
|
| Rate for Payer: BCN Medicare Advantage |
$407.68
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cofinity Commercial |
$587.06
|
| Rate for Payer: Cofinity Commercial |
$546.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.68
|
| Rate for Payer: Mclaren Medicaid |
$274.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.06
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Nomi Health Commercial |
$489.22
|
| Rate for Payer: PACE SWMI |
$407.68
|
| Rate for Payer: PHP Medicare Advantage |
$407.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.80
|
| Rate for Payer: Priority Health HMO/PPO |
$643.87
|
| Rate for Payer: Priority Health Medicare |
$411.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$643.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.68
|
| Rate for Payer: UHC Exchange |
$407.68
|
| Rate for Payer: UHC Medicare Advantage |
$407.68
|
| Rate for Payer: UHCCP Medicaid |
$274.77
|
|
|
PR DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR
|
Professional
|
Both
|
$993.00
|
|
|
Service Code
|
HCPCS 58800
|
| Min. Negotiated Rate |
$203.63 |
| Max. Negotiated Rate |
$645.45 |
| Rate for Payer: Aetna Commercial |
$404.29
|
| Rate for Payer: Aetna Medicare |
$313.78
|
| Rate for Payer: BCBS Complete |
$213.81
|
| Rate for Payer: BCBS MAPPO |
$301.71
|
| Rate for Payer: BCBS Trust/PPO |
$503.47
|
| Rate for Payer: BCN Commercial |
$535.10
|
| Rate for Payer: BCN Medicare Advantage |
$301.71
|
| Rate for Payer: Cash Price |
$794.40
|
| Rate for Payer: Cash Price |
$794.40
|
| Rate for Payer: Cofinity Commercial |
$434.46
|
| Rate for Payer: Cofinity Commercial |
$404.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.71
|
| Rate for Payer: Mclaren Medicaid |
$203.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.80
|
| Rate for Payer: Meridian Medicaid |
$213.81
|
| Rate for Payer: Nomi Health Commercial |
$362.05
|
| Rate for Payer: PACE SWMI |
$301.71
|
| Rate for Payer: PHP Medicare Advantage |
$301.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$645.45
|
| Rate for Payer: Priority Health HMO/PPO |
$474.71
|
| Rate for Payer: Priority Health Medicare |
$304.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$474.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.71
|
| Rate for Payer: UHC Exchange |
$301.71
|
| Rate for Payer: UHC Medicare Advantage |
$301.71
|
| Rate for Payer: UHCCP Medicaid |
$203.63
|
|
