|
PR OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR
|
Professional
|
Both
|
$1,389.00
|
|
|
Service Code
|
HCPCS 28306
|
| Min. Negotiated Rate |
$263.27 |
| Max. Negotiated Rate |
$1,500.90 |
| Rate for Payer: Aetna Commercial |
$531.47
|
| Rate for Payer: Aetna Medicare |
$412.48
|
| Rate for Payer: BCBS Complete |
$276.43
|
| Rate for Payer: BCBS MAPPO |
$396.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.90
|
| Rate for Payer: BCN Commercial |
$886.46
|
| Rate for Payer: BCN Medicare Advantage |
$396.62
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cofinity Commercial |
$571.13
|
| Rate for Payer: Cofinity Commercial |
$531.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.62
|
| Rate for Payer: Mclaren Medicaid |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$276.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$416.45
|
| Rate for Payer: PACE SWMI |
$396.62
|
| Rate for Payer: PHP Medicare Advantage |
$396.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.90
|
| Rate for Payer: Priority Health Medicare |
$396.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$618.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.62
|
| Rate for Payer: UHC Medicare Advantage |
$408.52
|
|
|
PR OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 28308
|
| Min. Negotiated Rate |
$250.91 |
| Max. Negotiated Rate |
$1,566.94 |
| Rate for Payer: Aetna Commercial |
$504.40
|
| Rate for Payer: Aetna Medicare |
$391.48
|
| Rate for Payer: BCBS Complete |
$263.46
|
| Rate for Payer: BCBS MAPPO |
$376.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.94
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$376.42
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cofinity Commercial |
$542.04
|
| Rate for Payer: Cofinity Commercial |
$504.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.42
|
| Rate for Payer: Mclaren Medicaid |
$250.91
|
| Rate for Payer: Meridian Medicaid |
$263.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$395.24
|
| Rate for Payer: PACE SWMI |
$376.42
|
| Rate for Payer: PHP Medicare Advantage |
$376.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.29
|
| Rate for Payer: Priority Health Medicare |
$376.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$589.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.42
|
| Rate for Payer: UHC Medicare Advantage |
$387.71
|
|
|
PR OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 63295
|
| Min. Negotiated Rate |
$210.44 |
| Max. Negotiated Rate |
$871.50 |
| Rate for Payer: Aetna Commercial |
$446.07
|
| Rate for Payer: Aetna Medicare |
$346.21
|
| Rate for Payer: BCBS Complete |
$220.96
|
| Rate for Payer: BCBS MAPPO |
$332.89
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$483.30
|
| Rate for Payer: BCN Medicare Advantage |
$332.89
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cofinity Commercial |
$479.36
|
| Rate for Payer: Cofinity Commercial |
$446.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.89
|
| Rate for Payer: Mclaren Medicaid |
$210.44
|
| Rate for Payer: Meridian Medicaid |
$220.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$349.53
|
| Rate for Payer: PACE SWMI |
$332.89
|
| Rate for Payer: PHP Medicare Advantage |
$332.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.99
|
| Rate for Payer: Priority Health Medicare |
$332.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$559.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.89
|
| Rate for Payer: UHC Medicare Advantage |
$342.88
|
|
|
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$135.40
|
|
|
Service Code
|
HCPCS J2720
|
| Hospital Charge Code |
6677
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$82.58 |
| Max. Negotiated Rate |
$121.86 |
| Rate for Payer: Aetna Commercial |
$115.09
|
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: BCBS Trust/PPO |
$104.64
|
| Rate for Payer: BCBS Trust/PPO |
$34.84
|
| Rate for Payer: BCN Commercial |
$104.64
|
| Rate for Payer: BCN Commercial |
$34.84
|
| Rate for Payer: Cash Price |
$108.32
|
| Rate for Payer: Cash Price |
$36.06
|
| Rate for Payer: Cofinity Commercial |
$38.77
|
| Rate for Payer: Cofinity Commercial |
$116.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.06
|
| Rate for Payer: Healthscope Commercial |
$40.57
|
| Rate for Payer: Healthscope Commercial |
$121.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.32
|
| Rate for Payer: PHP Commercial |
$115.09
|
| Rate for Payer: PHP Commercial |
$38.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.15
|
| Rate for Payer: UHC Core |
$113.06
|
| Rate for Payer: UHC Core |
$37.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.81
|
|
|
PROTEIN SUPPLEMENT ORAL
|
Facility
|
IP
|
$3.43
|
|
|
Service Code
|
NDC 4390028430
|
| Hospital Charge Code |
150950
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$3.09 |
| Rate for Payer: Aetna Commercial |
$2.92
|
| Rate for Payer: BCBS Trust/PPO |
$2.65
|
| Rate for Payer: BCN Commercial |
$2.65
|
| Rate for Payer: Cash Price |
$2.74
|
| Rate for Payer: Cofinity Commercial |
$2.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.74
|
| Rate for Payer: Healthscope Commercial |
$3.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.92
|
| Rate for Payer: PHP Commercial |
$2.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.02
|
| Rate for Payer: UHC Core |
$2.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.57
|
|
|
PR OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA
|
Professional
|
Both
|
$4,394.00
|
|
|
Service Code
|
HCPCS 61345
|
| Min. Negotiated Rate |
$660.90 |
| Max. Negotiated Rate |
$4,181.49 |
| Rate for Payer: Aetna Commercial |
$2,758.31
|
| Rate for Payer: Aetna Medicare |
$2,140.78
|
| Rate for Payer: BCBS Complete |
$1,391.55
|
| Rate for Payer: BCBS MAPPO |
$2,058.44
|
| Rate for Payer: BCBS Trust/PPO |
$660.90
|
| Rate for Payer: BCN Commercial |
$4,181.49
|
| Rate for Payer: BCN Medicare Advantage |
$2,058.44
|
| Rate for Payer: Cash Price |
$3,515.20
|
| Rate for Payer: Cash Price |
$3,515.20
|
| Rate for Payer: Cofinity Commercial |
$2,964.15
|
| Rate for Payer: Cofinity Commercial |
$2,758.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,058.44
|
| Rate for Payer: Mclaren Medicaid |
$1,325.29
|
| Rate for Payer: Meridian Medicaid |
$1,391.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,161.36
|
| Rate for Payer: PACE SWMI |
$2,058.44
|
| Rate for Payer: PHP Medicare Advantage |
$2,058.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,325.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,075.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,492.46
|
| Rate for Payer: Priority Health Medicare |
$2,058.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,492.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,058.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,058.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,120.19
|
|
|
PR OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 92502
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$1,298.03 |
| Rate for Payer: Aetna Commercial |
$123.09
|
| Rate for Payer: Aetna Medicare |
$95.53
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS MAPPO |
$91.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,298.03
|
| Rate for Payer: BCN Commercial |
$137.32
|
| Rate for Payer: BCN Medicare Advantage |
$91.86
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cofinity Commercial |
$132.28
|
| Rate for Payer: Cofinity Commercial |
$123.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.86
|
| Rate for Payer: Mclaren Medicaid |
$60.71
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.45
|
| Rate for Payer: PACE SWMI |
$91.86
|
| Rate for Payer: PHP Medicare Advantage |
$91.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.21
|
| Rate for Payer: Priority Health Medicare |
$91.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.86
|
| Rate for Payer: UHC Medicare Advantage |
$94.62
|
|
|
PR OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 69300
|
| Min. Negotiated Rate |
$302.89 |
| Max. Negotiated Rate |
$1,934.63 |
| Rate for Payer: Aetna Commercial |
$614.89
|
| Rate for Payer: Aetna Medicare |
$477.22
|
| Rate for Payer: BCBS Complete |
$318.03
|
| Rate for Payer: BCBS MAPPO |
$458.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.63
|
| Rate for Payer: BCN Commercial |
$958.30
|
| Rate for Payer: BCN Medicare Advantage |
$458.87
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$614.89
|
| Rate for Payer: Cofinity Commercial |
$660.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.87
|
| Rate for Payer: Mclaren Medicaid |
$302.89
|
| Rate for Payer: Meridian Medicaid |
$318.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$481.81
|
| Rate for Payer: PACE SWMI |
$458.87
|
| Rate for Payer: PHP Medicare Advantage |
$458.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.34
|
| Rate for Payer: Priority Health Medicare |
$458.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$663.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$458.87
|
| Rate for Payer: UHC Medicare Advantage |
$472.64
|
|
|
PR OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 93797
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$118.87 |
| Rate for Payer: Aetna Commercial |
$11.56
|
| Rate for Payer: Aetna Medicare |
$8.98
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$8.63
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.63
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$11.56
|
| Rate for Payer: Cofinity Commercial |
$12.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.63
|
| Rate for Payer: Mclaren Medicaid |
$5.54
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.06
|
| Rate for Payer: PACE SWMI |
$8.63
|
| Rate for Payer: PHP Medicare Advantage |
$8.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.29
|
| Rate for Payer: Priority Health Medicare |
$8.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.63
|
| Rate for Payer: UHC Medicare Advantage |
$8.89
|
|
|
PR OVARIAN CYSTECTOMY UNI/BI
|
Professional
|
Both
|
$2,338.00
|
|
|
Service Code
|
HCPCS 58925
|
| Min. Negotiated Rate |
$164.83 |
| Max. Negotiated Rate |
$1,636.60 |
| Rate for Payer: Aetna Commercial |
$1,021.17
|
| Rate for Payer: Aetna Medicare |
$792.55
|
| Rate for Payer: BCBS Complete |
$517.98
|
| Rate for Payer: BCBS MAPPO |
$762.07
|
| Rate for Payer: BCBS Trust/PPO |
$164.83
|
| Rate for Payer: BCN Commercial |
$1,126.89
|
| Rate for Payer: BCN Medicare Advantage |
$762.07
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cofinity Commercial |
$1,097.38
|
| Rate for Payer: Cofinity Commercial |
$1,021.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.07
|
| Rate for Payer: Mclaren Medicaid |
$493.31
|
| Rate for Payer: Meridian Medicaid |
$517.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$800.17
|
| Rate for Payer: PACE SWMI |
$762.07
|
| Rate for Payer: PHP Medicare Advantage |
$762.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,091.72
|
| Rate for Payer: Priority Health Medicare |
$762.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,091.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$762.07
|
| Rate for Payer: UHC Medicare Advantage |
$784.93
|
|
|
PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$116.90
|
|
|
Service Code
|
NDC 0254-1007-52
|
| Hospital Charge Code |
17934
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$71.30 |
| Max. Negotiated Rate |
$105.21 |
| Rate for Payer: Aetna Commercial |
$99.36
|
| Rate for Payer: BCBS Trust/PPO |
$90.34
|
| Rate for Payer: BCN Commercial |
$90.34
|
| Rate for Payer: Cash Price |
$93.52
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.52
|
| Rate for Payer: Healthscope Commercial |
$105.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.36
|
| Rate for Payer: PHP Commercial |
$99.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.87
|
| Rate for Payer: UHC Core |
$97.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.68
|
|
|
PR OVINE, UP TO 999 USP UNITS
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J3471
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Aetna Commercial |
$0.66
|
| Rate for Payer: Aetna Medicare |
$0.51
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.49
|
| Rate for Payer: BCBS Trust/PPO |
$0.50
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Medicare Advantage |
$0.49
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.66
|
| Rate for Payer: Cofinity Commercial |
$0.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.52
|
| Rate for Payer: PACE SWMI |
$0.49
|
| Rate for Payer: PHP Medicare Advantage |
$0.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.40
|
| Rate for Payer: Priority Health Medicare |
$0.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.49
|
| Rate for Payer: UHC Medicare Advantage |
$0.51
|
|
|
PR PACKING STRIPS, NON-IMPREG
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS A6407
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Aetna Commercial |
$1.74
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCN Commercial |
$2.06
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
|
|
PR PALATOPHARYNGOPLASTY
|
Professional
|
Both
|
$2,424.00
|
|
|
Service Code
|
HCPCS 42145
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$1,696.80 |
| Rate for Payer: Aetna Commercial |
$905.76
|
| Rate for Payer: Aetna Medicare |
$702.98
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS MAPPO |
$675.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.94
|
| Rate for Payer: BCN Commercial |
$1,011.07
|
| Rate for Payer: BCN Medicare Advantage |
$675.94
|
| Rate for Payer: Cash Price |
$1,939.20
|
| Rate for Payer: Cash Price |
$1,939.20
|
| Rate for Payer: Cofinity Commercial |
$973.35
|
| Rate for Payer: Cofinity Commercial |
$905.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.94
|
| Rate for Payer: Mclaren Medicaid |
$442.83
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$709.74
|
| Rate for Payer: PACE SWMI |
$675.94
|
| Rate for Payer: PHP Medicare Advantage |
$675.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,696.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,216.52
|
| Rate for Payer: Priority Health Medicare |
$675.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,216.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$675.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.94
|
| Rate for Payer: UHC Medicare Advantage |
$696.22
|
|
|
PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS
|
Professional
|
Both
|
$7,449.00
|
|
|
Service Code
|
HCPCS 48160
|
| Min. Negotiated Rate |
$809.36 |
| Max. Negotiated Rate |
$5,468.15 |
| Rate for Payer: Aetna Commercial |
$4,176.69
|
| Rate for Payer: BCBS Complete |
$2,979.60
|
| Rate for Payer: BCBS Trust/PPO |
$809.36
|
| Rate for Payer: BCN Commercial |
$2,480.87
|
| Rate for Payer: Cash Price |
$5,959.20
|
| Rate for Payer: Cash Price |
$5,959.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,214.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,468.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,468.15
|
|
|
PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST
|
Professional
|
Both
|
$3,379.00
|
|
|
Service Code
|
HCPCS 48548
|
| Min. Negotiated Rate |
$484.98 |
| Max. Negotiated Rate |
$2,932.80 |
| Rate for Payer: Aetna Commercial |
$2,229.76
|
| Rate for Payer: Aetna Medicare |
$1,730.56
|
| Rate for Payer: BCBS Complete |
$1,120.49
|
| Rate for Payer: BCBS MAPPO |
$1,664.00
|
| Rate for Payer: BCBS Trust/PPO |
$484.98
|
| Rate for Payer: BCN Commercial |
$2,437.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,664.00
|
| Rate for Payer: Cash Price |
$2,703.20
|
| Rate for Payer: Cash Price |
$2,703.20
|
| Rate for Payer: Cofinity Commercial |
$2,229.76
|
| Rate for Payer: Cofinity Commercial |
$2,396.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,664.00
|
| Rate for Payer: Mclaren Medicaid |
$1,067.13
|
| Rate for Payer: Meridian Medicaid |
$1,120.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,747.20
|
| Rate for Payer: PACE SWMI |
$1,664.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,664.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,067.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,365.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,932.80
|
| Rate for Payer: Priority Health Medicare |
$1,664.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,932.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,664.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,664.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,713.92
|
|
|
PR PANCREATORRHAPHY INJURY
|
Professional
|
Both
|
$3,208.00
|
|
|
Service Code
|
HCPCS 48545
|
| Min. Negotiated Rate |
$525.66 |
| Max. Negotiated Rate |
$2,366.00 |
| Rate for Payer: Aetna Commercial |
$1,796.20
|
| Rate for Payer: Aetna Medicare |
$1,394.07
|
| Rate for Payer: BCBS Complete |
$904.22
|
| Rate for Payer: BCBS MAPPO |
$1,340.45
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$1,966.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,340.45
|
| Rate for Payer: Cash Price |
$2,566.40
|
| Rate for Payer: Cash Price |
$2,566.40
|
| Rate for Payer: Cofinity Commercial |
$1,930.25
|
| Rate for Payer: Cofinity Commercial |
$1,796.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,340.45
|
| Rate for Payer: Mclaren Medicaid |
$861.16
|
| Rate for Payer: Meridian Medicaid |
$904.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,407.47
|
| Rate for Payer: PACE SWMI |
$1,340.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,340.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$861.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,366.00
|
| Rate for Payer: Priority Health Medicare |
$1,340.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,366.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,340.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,380.66
|
|
|
PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC
|
Professional
|
Both
|
$2,485.00
|
|
|
Service Code
|
HCPCS 60505
|
| Min. Negotiated Rate |
$576.38 |
| Max. Negotiated Rate |
$2,042.19 |
| Rate for Payer: Aetna Commercial |
$1,856.33
|
| Rate for Payer: Aetna Medicare |
$1,440.73
|
| Rate for Payer: BCBS Complete |
$941.57
|
| Rate for Payer: BCBS MAPPO |
$1,385.32
|
| Rate for Payer: BCBS Trust/PPO |
$576.38
|
| Rate for Payer: BCN Commercial |
$2,042.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,385.32
|
| Rate for Payer: Cash Price |
$1,988.00
|
| Rate for Payer: Cash Price |
$1,988.00
|
| Rate for Payer: Cofinity Commercial |
$1,994.86
|
| Rate for Payer: Cofinity Commercial |
$1,856.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,385.32
|
| Rate for Payer: Mclaren Medicaid |
$896.73
|
| Rate for Payer: Meridian Medicaid |
$941.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,454.59
|
| Rate for Payer: PACE SWMI |
$1,385.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,385.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$896.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,739.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,977.27
|
| Rate for Payer: Priority Health Medicare |
$1,385.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,977.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,385.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,385.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,426.88
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$153.15 |
| Max. Negotiated Rate |
$663.02 |
| Rate for Payer: Aetna Commercial |
$321.77
|
| Rate for Payer: Aetna Medicare |
$249.74
|
| Rate for Payer: BCBS Complete |
$160.81
|
| Rate for Payer: BCBS MAPPO |
$240.13
|
| Rate for Payer: BCBS Trust/PPO |
$663.02
|
| Rate for Payer: BCN Commercial |
$350.87
|
| Rate for Payer: BCN Medicare Advantage |
$240.13
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$345.79
|
| Rate for Payer: Cofinity Commercial |
$321.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.13
|
| Rate for Payer: Mclaren Medicaid |
$153.15
|
| Rate for Payer: Meridian Medicaid |
$160.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$252.14
|
| Rate for Payer: PACE SWMI |
$240.13
|
| Rate for Payer: PHP Medicare Advantage |
$240.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.72
|
| Rate for Payer: Priority Health Medicare |
$240.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$339.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.13
|
| Rate for Payer: UHC Medicare Advantage |
$247.33
|
|
|
PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS
|
Professional
|
Both
|
$3,438.00
|
|
|
Service Code
|
HCPCS 60500
|
| Min. Negotiated Rate |
$621.96 |
| Max. Negotiated Rate |
$3,645.80 |
| Rate for Payer: Aetna Commercial |
$1,289.31
|
| Rate for Payer: Aetna Medicare |
$1,000.66
|
| Rate for Payer: BCBS Complete |
$653.06
|
| Rate for Payer: BCBS MAPPO |
$962.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,645.80
|
| Rate for Payer: BCN Commercial |
$1,419.12
|
| Rate for Payer: BCN Medicare Advantage |
$962.17
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cofinity Commercial |
$1,385.52
|
| Rate for Payer: Cofinity Commercial |
$1,289.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.17
|
| Rate for Payer: Mclaren Medicaid |
$621.96
|
| Rate for Payer: Meridian Medicaid |
$653.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,010.28
|
| Rate for Payer: PACE SWMI |
$962.17
|
| Rate for Payer: PHP Medicare Advantage |
$962.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,406.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,374.00
|
| Rate for Payer: Priority Health Medicare |
$962.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,374.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$962.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$962.17
|
| Rate for Payer: UHC Medicare Advantage |
$991.04
|
|
|
PR PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR
|
Professional
|
Both
|
$3,803.00
|
|
|
Service Code
|
HCPCS 60502
|
| Min. Negotiated Rate |
$834.96 |
| Max. Negotiated Rate |
$2,662.10 |
| Rate for Payer: Aetna Commercial |
$1,730.97
|
| Rate for Payer: Aetna Medicare |
$1,343.44
|
| Rate for Payer: BCBS Complete |
$876.71
|
| Rate for Payer: BCBS MAPPO |
$1,291.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.71
|
| Rate for Payer: BCN Commercial |
$1,902.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,291.77
|
| Rate for Payer: Cash Price |
$3,042.40
|
| Rate for Payer: Cash Price |
$3,042.40
|
| Rate for Payer: Cofinity Commercial |
$1,730.97
|
| Rate for Payer: Cofinity Commercial |
$1,860.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,291.77
|
| Rate for Payer: Mclaren Medicaid |
$834.96
|
| Rate for Payer: Meridian Medicaid |
$876.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,356.36
|
| Rate for Payer: PACE SWMI |
$1,291.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,291.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,662.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,841.95
|
| Rate for Payer: Priority Health Medicare |
$1,291.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,841.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,291.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,291.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,330.52
|
|
|
PR PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH
|
Professional
|
Both
|
$1,892.00
|
|
|
Service Code
|
HCPCS 57285
|
| Min. Negotiated Rate |
$444.53 |
| Max. Negotiated Rate |
$2,721.80 |
| Rate for Payer: Aetna Commercial |
$919.27
|
| Rate for Payer: Aetna Medicare |
$713.46
|
| Rate for Payer: BCBS Complete |
$466.76
|
| Rate for Payer: BCBS MAPPO |
$686.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,721.80
|
| Rate for Payer: BCN Commercial |
$1,014.98
|
| Rate for Payer: BCN Medicare Advantage |
$686.02
|
| Rate for Payer: Cash Price |
$1,513.60
|
| Rate for Payer: Cash Price |
$1,513.60
|
| Rate for Payer: Cofinity Commercial |
$987.87
|
| Rate for Payer: Cofinity Commercial |
$919.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.02
|
| Rate for Payer: Mclaren Medicaid |
$444.53
|
| Rate for Payer: Meridian Medicaid |
$466.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$720.32
|
| Rate for Payer: PACE SWMI |
$686.02
|
| Rate for Payer: PHP Medicare Advantage |
$686.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$983.31
|
| Rate for Payer: Priority Health Medicare |
$686.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$983.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$686.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.02
|
| Rate for Payer: UHC Medicare Advantage |
$706.60
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 11055
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$242.22 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$16.42
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$15.79
|
| Rate for Payer: BCBS Trust/PPO |
$242.22
|
| Rate for Payer: BCN Commercial |
$105.06
|
| Rate for Payer: BCN Medicare Advantage |
$15.79
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$22.74
|
| Rate for Payer: Cofinity Commercial |
$21.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.79
|
| Rate for Payer: Mclaren Medicaid |
$9.80
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.58
|
| Rate for Payer: PACE SWMI |
$15.79
|
| Rate for Payer: PHP Medicare Advantage |
$15.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.32
|
| Rate for Payer: Priority Health Medicare |
$15.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.79
|
| Rate for Payer: UHC Medicare Advantage |
$16.26
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 11056
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$569.29 |
| Rate for Payer: Aetna Commercial |
$29.21
|
| Rate for Payer: Aetna Medicare |
$22.67
|
| Rate for Payer: BCBS Complete |
$14.54
|
| Rate for Payer: BCBS MAPPO |
$21.80
|
| Rate for Payer: BCBS Trust/PPO |
$569.29
|
| Rate for Payer: BCN Commercial |
$120.70
|
| Rate for Payer: BCN Medicare Advantage |
$21.80
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Cofinity Commercial |
$31.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.80
|
| Rate for Payer: Mclaren Medicaid |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.89
|
| Rate for Payer: PACE SWMI |
$21.80
|
| Rate for Payer: PHP Medicare Advantage |
$21.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.72
|
| Rate for Payer: Priority Health Medicare |
$21.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.80
|
| Rate for Payer: UHC Medicare Advantage |
$22.45
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 11057
|
| Min. Negotiated Rate |
$18.11 |
| Max. Negotiated Rate |
$131.45 |
| Rate for Payer: Aetna Commercial |
$37.68
|
| Rate for Payer: Aetna Medicare |
$29.24
|
| Rate for Payer: BCBS Complete |
$19.02
|
| Rate for Payer: BCBS MAPPO |
$28.12
|
| Rate for Payer: BCBS Trust/PPO |
$18.83
|
| Rate for Payer: BCN Commercial |
$131.45
|
| Rate for Payer: BCN Medicare Advantage |
$28.12
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$37.68
|
| Rate for Payer: Cofinity Commercial |
$40.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.12
|
| Rate for Payer: Mclaren Medicaid |
$18.11
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.53
|
| Rate for Payer: PACE SWMI |
$28.12
|
| Rate for Payer: PHP Medicare Advantage |
$28.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.53
|
| Rate for Payer: Priority Health Medicare |
$28.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.12
|
| Rate for Payer: UHC Medicare Advantage |
$28.96
|
|
