|
PR ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN
|
Professional
|
Both
|
$7,084.00
|
|
|
Service Code
|
HCPCS 62010
|
| Min. Negotiated Rate |
$967.87 |
| Max. Negotiated Rate |
$5,313.00 |
| Rate for Payer: Aetna Commercial |
$1,985.02
|
| Rate for Payer: Aetna Medicare |
$3,542.00
|
| Rate for Payer: BCBS Complete |
$1,016.26
|
| Rate for Payer: BCN Commercial |
$3,245.85
|
| Rate for Payer: Cash Price |
$5,667.20
|
| Rate for Payer: Cash Price |
$5,667.20
|
| Rate for Payer: Mclaren Medicaid |
$967.87
|
| Rate for Payer: Meridian Medicaid |
$1,016.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,313.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$967.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,728.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,728.87
|
| Rate for Payer: UHC Medicaid |
$967.87
|
| Rate for Payer: UHCCP Medicaid |
$967.87
|
|
|
PR E/M ANNUAL NURSING FACILITY ASSESS STABLE 30 MIN
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 99318
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$111.75 |
| Rate for Payer: Aetna Medicare |
$74.50
|
| Rate for Payer: BCBS Complete |
$59.60
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
|
|
PR EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART
|
Professional
|
Both
|
$2,407.00
|
|
|
Service Code
|
HCPCS 34101
|
| Min. Negotiated Rate |
$346.76 |
| Max. Negotiated Rate |
$1,805.25 |
| Rate for Payer: Aetna Commercial |
$800.84
|
| Rate for Payer: Aetna Medicare |
$1,203.50
|
| Rate for Payer: BCBS Complete |
$364.10
|
| Rate for Payer: BCN Commercial |
$874.95
|
| Rate for Payer: Cash Price |
$1,925.60
|
| Rate for Payer: Cash Price |
$1,925.60
|
| Rate for Payer: Mclaren Medicaid |
$346.76
|
| Rate for Payer: Meridian Medicaid |
$364.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,805.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$940.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$940.90
|
| Rate for Payer: UHC Medicaid |
$346.76
|
| Rate for Payer: UHCCP Medicaid |
$346.76
|
|
|
PR EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART
|
Professional
|
Both
|
$2,095.00
|
|
|
Service Code
|
HCPCS 34001
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,571.25 |
| Rate for Payer: Aetna Commercial |
$1,229.89
|
| Rate for Payer: Aetna Medicare |
$1,047.50
|
| Rate for Payer: BCBS Complete |
$559.12
|
| Rate for Payer: BCN Commercial |
$1,340.07
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Cash Price |
$1,676.00
|
| Rate for Payer: Mclaren Medicaid |
$532.50
|
| Rate for Payer: Meridian Medicaid |
$559.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,571.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$532.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,441.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,441.07
|
| Rate for Payer: UHC Medicaid |
$532.50
|
| Rate for Payer: UHCCP Medicaid |
$532.50
|
|
|
PR EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 34201
|
| Min. Negotiated Rate |
$591.29 |
| Max. Negotiated Rate |
$1,603.87 |
| Rate for Payer: Aetna Commercial |
$1,375.38
|
| Rate for Payer: Aetna Medicare |
$1,027.50
|
| Rate for Payer: BCBS Complete |
$620.85
|
| Rate for Payer: BCN Commercial |
$1,491.46
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Mclaren Medicaid |
$591.29
|
| Rate for Payer: Meridian Medicaid |
$620.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,541.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,603.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,603.87
|
| Rate for Payer: UHC Medicaid |
$591.29
|
| Rate for Payer: UHCCP Medicaid |
$591.29
|
|
|
PR EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY
|
Professional
|
Both
|
$2,070.00
|
|
|
Service Code
|
HCPCS 34051
|
| Min. Negotiated Rate |
$615.57 |
| Max. Negotiated Rate |
$1,577.63 |
| Rate for Payer: Aetna Commercial |
$1,330.19
|
| Rate for Payer: Aetna Medicare |
$1,035.00
|
| Rate for Payer: BCBS Complete |
$646.35
|
| Rate for Payer: BCN Commercial |
$1,467.05
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Mclaren Medicaid |
$615.57
|
| Rate for Payer: Meridian Medicaid |
$646.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,552.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$615.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,577.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,577.63
|
| Rate for Payer: UHC Medicaid |
$615.57
|
| Rate for Payer: UHCCP Medicaid |
$615.57
|
|
|
PR EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC
|
Professional
|
Both
|
$2,036.00
|
|
|
Service Code
|
HCPCS 34203
|
| Min. Negotiated Rate |
$549.97 |
| Max. Negotiated Rate |
$1,527.00 |
| Rate for Payer: Aetna Commercial |
$1,273.42
|
| Rate for Payer: Aetna Medicare |
$1,018.00
|
| Rate for Payer: BCBS Complete |
$577.47
|
| Rate for Payer: BCN Commercial |
$1,387.88
|
| Rate for Payer: Cash Price |
$1,628.80
|
| Rate for Payer: Cash Price |
$1,628.80
|
| Rate for Payer: Mclaren Medicaid |
$549.97
|
| Rate for Payer: Meridian Medicaid |
$577.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,492.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,492.49
|
| Rate for Payer: UHC Medicaid |
$549.97
|
| Rate for Payer: UHCCP Medicaid |
$549.97
|
|
|
PR EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART
|
Professional
|
Both
|
$2,812.00
|
|
|
Service Code
|
HCPCS 34151
|
| Min. Negotiated Rate |
$805.57 |
| Max. Negotiated Rate |
$2,187.57 |
| Rate for Payer: Aetna Commercial |
$1,868.74
|
| Rate for Payer: Aetna Medicare |
$1,406.00
|
| Rate for Payer: BCBS Complete |
$845.85
|
| Rate for Payer: BCN Commercial |
$2,034.25
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Mclaren Medicaid |
$805.57
|
| Rate for Payer: Meridian Medicaid |
$845.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,109.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$805.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,187.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,187.57
|
| Rate for Payer: UHC Medicaid |
$805.57
|
| Rate for Payer: UHCCP Medicaid |
$805.57
|
|
|
PR EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC
|
Professional
|
Both
|
$1,296.00
|
|
|
Service Code
|
HCPCS 34111
|
| Min. Negotiated Rate |
$346.98 |
| Max. Negotiated Rate |
$972.00 |
| Rate for Payer: Aetna Commercial |
$804.67
|
| Rate for Payer: Aetna Medicare |
$648.00
|
| Rate for Payer: BCBS Complete |
$364.33
|
| Rate for Payer: BCN Commercial |
$872.96
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Mclaren Medicaid |
$346.98
|
| Rate for Payer: Meridian Medicaid |
$364.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$938.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$938.75
|
| Rate for Payer: UHC Medicaid |
$346.98
|
| Rate for Payer: UHCCP Medicaid |
$346.98
|
|
|
PR EMERGENCY DEPARTMENT VISIT HIGH MDM
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
HCPCS 99285
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$299.15 |
| Rate for Payer: Aetna Commercial |
$179.88
|
| Rate for Payer: Aetna Medicare |
$191.00
|
| Rate for Payer: BCBS Complete |
$114.73
|
| Rate for Payer: BCN Commercial |
$259.95
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Mclaren Medicaid |
$109.27
|
| Rate for Payer: Meridian Medicaid |
$114.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$299.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.15
|
| Rate for Payer: UHC Medicaid |
$109.27
|
| Rate for Payer: UHCCP Medicaid |
$109.27
|
|
|
PR EMERGENCY DEPARTMENT VISIT LOW MDM
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 99283
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$133.50 |
| Rate for Payer: Aetna Commercial |
$72.50
|
| Rate for Payer: Aetna Medicare |
$89.00
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$114.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.00
|
| Rate for Payer: UHC Medicaid |
$44.30
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 99281
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$22.17
|
| Rate for Payer: Aetna Medicare |
$48.00
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCN Commercial |
$16.93
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Mclaren Medicaid |
$7.03
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.89
|
| Rate for Payer: UHC Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
|
|
PR EMERGENCY DEPARTMENT VISIT MODERATE MDM
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 99284
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$203.10 |
| Rate for Payer: Aetna Commercial |
$123.22
|
| Rate for Payer: Aetna Medicare |
$128.00
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCN Commercial |
$179.28
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Mclaren Medicaid |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.10
|
| Rate for Payer: UHC Medicaid |
$75.40
|
| Rate for Payer: UHCCP Medicaid |
$75.40
|
|
|
PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 99282
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Aetna Commercial |
$42.97
|
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCN Commercial |
$62.25
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Mclaren Medicaid |
$25.77
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.81
|
| Rate for Payer: UHC Medicaid |
$25.77
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 51784
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$83.00
|
| Rate for Payer: Aetna Medicare |
$202.50
|
| Rate for Payer: BCN Commercial |
$95.61
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.16
|
|
|
PR ENDOBRONCHIAL U/S ADD-ON
|
Professional
|
Both
|
$478.00
|
|
|
Service Code
|
HCPCS 31620
|
| Min. Negotiated Rate |
$191.20 |
| Max. Negotiated Rate |
$358.50 |
| Rate for Payer: Aetna Medicare |
$239.00
|
| Rate for Payer: BCBS Complete |
$191.20
|
| Rate for Payer: Cash Price |
$382.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.50
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Facility
|
IP
|
$321.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
57505
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$223.42 |
| Max. Negotiated Rate |
$288.90 |
| Rate for Payer: Aetna Commercial |
$272.85
|
| Rate for Payer: BCBS Trust/PPO |
$265.11
|
| Rate for Payer: BCN Commercial |
$265.11
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$276.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.80
|
| Rate for Payer: Healthscope Commercial |
$288.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.85
|
| Rate for Payer: Nomi Health Commercial |
$263.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PHP Commercial |
$272.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$279.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.42
|
| Rate for Payer: UHC Core |
$268.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.75
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 57505
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$240.75 |
| Rate for Payer: Aetna Commercial |
$124.37
|
| Rate for Payer: Aetna Medicare |
$160.50
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCN Commercial |
$129.59
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.43
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 57505
|
| Hospital Charge Code |
57505
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$240.75 |
| Rate for Payer: Aetna Commercial |
$124.37
|
| Rate for Payer: Aetna Medicare |
$160.50
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCN Commercial |
$129.59
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.43
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Facility
|
OP
|
$321.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
57505
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$56.59 |
| Max. Negotiated Rate |
$288.90 |
| Rate for Payer: Aetna Commercial |
$272.85
|
| Rate for Payer: Aetna Medicare |
$83.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.31
|
| Rate for Payer: BCBS Complete |
$59.42
|
| Rate for Payer: BCBS MAPPO |
$80.25
|
| Rate for Payer: BCBS Trust/PPO |
$263.89
|
| Rate for Payer: BCCCP Commercial |
$145.60
|
| Rate for Payer: BCN Commercial |
$263.89
|
| Rate for Payer: BCN Medicare Advantage |
$80.25
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$276.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.25
|
| Rate for Payer: Healthscope Commercial |
$288.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.75
|
| Rate for Payer: Mclaren Medicaid |
$56.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.26
|
| Rate for Payer: Meridian Medicaid |
$59.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.85
|
| Rate for Payer: Nomi Health Commercial |
$263.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PACE Senior Care Partners |
$76.24
|
| Rate for Payer: PACE SWMI |
$80.25
|
| Rate for Payer: PHP Commercial |
$272.85
|
| Rate for Payer: PHP Medicare Advantage |
$80.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$279.27
|
| Rate for Payer: Priority Health Medicare |
$81.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.42
|
| Rate for Payer: Railroad Medicare Medicare |
$80.25
|
| Rate for Payer: UHC Core |
$268.04
|
| Rate for Payer: UHC Exchange |
$80.25
|
| Rate for Payer: UHC Medicaid |
$56.59
|
| Rate for Payer: UHC Medicare Advantage |
$80.25
|
| Rate for Payer: UHCCP Medicaid |
$56.59
|
| Rate for Payer: VA VA |
$80.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.75
|
|
|
PR END OF LIFE COUNSELING
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS S0257
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$47.64 |
| Rate for Payer: Aetna Commercial |
$3.85
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCN Commercial |
$29.04
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.64
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 92979
|
| Min. Negotiated Rate |
$110.06 |
| Max. Negotiated Rate |
$237.00 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$158.00
|
| Rate for Payer: BCN Commercial |
$110.06
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$227.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.18
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 92978
|
| Min. Negotiated Rate |
$137.95 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Aetna Commercial |
$348.91
|
| Rate for Payer: Aetna Medicare |
$258.00
|
| Rate for Payer: BCN Commercial |
$137.95
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$374.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.38
|
|
|
PR ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID
|
Professional
|
Both
|
$2,104.00
|
|
|
Service Code
|
HCPCS 58353
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$1,578.00 |
| Rate for Payer: Aetna Commercial |
$274.07
|
| Rate for Payer: Aetna Medicare |
$1,052.00
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCN Commercial |
$346.10
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Mclaren Medicaid |
$129.93
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$350.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.52
|
| Rate for Payer: UHC Medicaid |
$129.93
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
|
|
PR ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 58110
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Commercial |
$49.01
|
| Rate for Payer: Aetna Medicare |
$68.50
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCN Commercial |
$60.25
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.03
|
| Rate for Payer: UHC Medicaid |
$22.58
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
|
