|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
IP
|
$1,092.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$666.01 |
| Max. Negotiated Rate |
$982.80 |
| Rate for Payer: Aetna Commercial |
$928.20
|
| Rate for Payer: BCBS Trust/PPO |
$843.90
|
| Rate for Payer: BCN Commercial |
$843.90
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$939.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.60
|
| Rate for Payer: Healthscope Commercial |
$982.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$928.20
|
| Rate for Payer: PHP Commercial |
$928.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$666.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.96
|
| Rate for Payer: UHC Core |
$911.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.00
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
OP
|
$1,092.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$259.35 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$928.20
|
| Rate for Payer: Aetna Medicare |
$283.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$341.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$341.25
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$273.00
|
| Rate for Payer: BCBS Trust/PPO |
$849.03
|
| Rate for Payer: BCN Commercial |
$849.03
|
| Rate for Payer: BCN Medicare Advantage |
$273.00
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$939.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.00
|
| Rate for Payer: Healthscope Commercial |
$982.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.00
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$313.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$928.20
|
| Rate for Payer: PACE Senior Care Partners |
$259.35
|
| Rate for Payer: PACE SWMI |
$273.00
|
| Rate for Payer: PHP Commercial |
$928.20
|
| Rate for Payer: PHP Medicare Advantage |
$273.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.04
|
| Rate for Payer: Priority Health Medicare |
$273.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$666.01
|
| Rate for Payer: Railroad Medicare Medicare |
$273.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.96
|
| Rate for Payer: UHC Core |
$911.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.00
|
| Rate for Payer: UHC Medicare Advantage |
$281.19
|
| Rate for Payer: VA VA |
$273.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.00
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 27372
|
| Min. Negotiated Rate |
$259.65 |
| Max. Negotiated Rate |
$3,545.42 |
| Rate for Payer: Aetna Commercial |
$529.13
|
| Rate for Payer: Aetna Medicare |
$410.66
|
| Rate for Payer: BCBS Complete |
$272.63
|
| Rate for Payer: BCBS MAPPO |
$394.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,545.42
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$394.87
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$529.13
|
| Rate for Payer: Cofinity Commercial |
$568.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.87
|
| Rate for Payer: Mclaren Medicaid |
$259.65
|
| Rate for Payer: Meridian Medicaid |
$272.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$414.61
|
| Rate for Payer: PACE SWMI |
$394.87
|
| Rate for Payer: PHP Medicare Advantage |
$394.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.38
|
| Rate for Payer: Priority Health Medicare |
$394.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.87
|
| Rate for Payer: UHC Medicare Advantage |
$406.72
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 27372
|
| Hospital Charge Code |
27372
|
| Min. Negotiated Rate |
$259.65 |
| Max. Negotiated Rate |
$3,545.42 |
| Rate for Payer: Aetna Commercial |
$529.13
|
| Rate for Payer: Aetna Medicare |
$410.66
|
| Rate for Payer: BCBS Complete |
$272.63
|
| Rate for Payer: BCBS MAPPO |
$394.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,545.42
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$394.87
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$568.61
|
| Rate for Payer: Cofinity Commercial |
$529.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.87
|
| Rate for Payer: Mclaren Medicaid |
$259.65
|
| Rate for Payer: Meridian Medicaid |
$272.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$414.61
|
| Rate for Payer: PACE SWMI |
$394.87
|
| Rate for Payer: PHP Medicare Advantage |
$394.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.38
|
| Rate for Payer: Priority Health Medicare |
$394.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.87
|
| Rate for Payer: UHC Medicare Advantage |
$406.72
|
|
|
PR REMOVAL FOREIGN BODY FOOT COMPLICATED
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 28193
|
| Min. Negotiated Rate |
$235.15 |
| Max. Negotiated Rate |
$1,271.09 |
| Rate for Payer: Aetna Commercial |
$478.15
|
| Rate for Payer: Aetna Medicare |
$371.10
|
| Rate for Payer: BCBS Complete |
$246.91
|
| Rate for Payer: BCBS MAPPO |
$356.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.09
|
| Rate for Payer: BCN Commercial |
$756.96
|
| Rate for Payer: BCN Medicare Advantage |
$356.83
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$513.84
|
| Rate for Payer: Cofinity Commercial |
$478.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.83
|
| Rate for Payer: Mclaren Medicaid |
$235.15
|
| Rate for Payer: Meridian Medicaid |
$246.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$374.67
|
| Rate for Payer: PACE SWMI |
$356.83
|
| Rate for Payer: PHP Medicare Advantage |
$356.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$556.10
|
| Rate for Payer: Priority Health Medicare |
$356.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$556.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.83
|
| Rate for Payer: UHC Medicare Advantage |
$367.53
|
|
|
PR REMOVAL FOREIGN BODY FOOT DEEP
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 28192
|
| Min. Negotiated Rate |
$199.79 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: Aetna Commercial |
$404.44
|
| Rate for Payer: Aetna Medicare |
$313.89
|
| Rate for Payer: BCBS Complete |
$209.78
|
| Rate for Payer: BCBS MAPPO |
$301.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.05
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: BCN Medicare Advantage |
$301.82
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$404.44
|
| Rate for Payer: Cofinity Commercial |
$434.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.82
|
| Rate for Payer: Mclaren Medicaid |
$199.79
|
| Rate for Payer: Meridian Medicaid |
$209.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.91
|
| Rate for Payer: PACE SWMI |
$301.82
|
| Rate for Payer: PHP Medicare Advantage |
$301.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.33
|
| Rate for Payer: Priority Health Medicare |
$301.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.82
|
| Rate for Payer: UHC Medicare Advantage |
$310.87
|
|
|
PR REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS
|
Professional
|
Both
|
$586.00
|
|
|
Service Code
|
HCPCS 28190
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$996.37 |
| Rate for Payer: Aetna Commercial |
$172.12
|
| Rate for Payer: Aetna Medicare |
$133.59
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCBS MAPPO |
$128.45
|
| Rate for Payer: BCBS Trust/PPO |
$996.37
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$128.45
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cofinity Commercial |
$172.12
|
| Rate for Payer: Cofinity Commercial |
$184.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.45
|
| Rate for Payer: Mclaren Medicaid |
$85.20
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.87
|
| Rate for Payer: PACE SWMI |
$128.45
|
| Rate for Payer: PHP Medicare Advantage |
$128.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.69
|
| Rate for Payer: Priority Health Medicare |
$128.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.45
|
| Rate for Payer: UHC Medicare Advantage |
$132.30
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES
|
Professional
|
Both
|
$362.00
|
|
|
Service Code
|
HCPCS 30310
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$1,405.81 |
| Rate for Payer: Aetna Commercial |
$270.76
|
| Rate for Payer: Aetna Medicare |
$210.14
|
| Rate for Payer: BCBS Complete |
$140.90
|
| Rate for Payer: BCBS MAPPO |
$202.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.81
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Medicare Advantage |
$202.06
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Commercial |
$290.97
|
| Rate for Payer: Cofinity Commercial |
$270.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.06
|
| Rate for Payer: Mclaren Medicaid |
$134.19
|
| Rate for Payer: Meridian Medicaid |
$140.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.16
|
| Rate for Payer: PACE SWMI |
$202.06
|
| Rate for Payer: PHP Medicare Advantage |
$202.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.72
|
| Rate for Payer: Priority Health Medicare |
$202.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.06
|
| Rate for Payer: UHC Medicare Advantage |
$208.12
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
HCPCS 30300
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$829.43 |
| Rate for Payer: Aetna Commercial |
$160.81
|
| Rate for Payer: Aetna Medicare |
$124.81
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$120.01
|
| Rate for Payer: BCBS Trust/PPO |
$829.43
|
| Rate for Payer: BCN Commercial |
$311.29
|
| Rate for Payer: BCN Medicare Advantage |
$120.01
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cofinity Commercial |
$160.81
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.01
|
| Rate for Payer: Mclaren Medicaid |
$79.24
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.01
|
| Rate for Payer: PACE SWMI |
$120.01
|
| Rate for Payer: PHP Medicare Advantage |
$120.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.65
|
| Rate for Payer: Priority Health Medicare |
$120.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.01
|
| Rate for Payer: UHC Medicare Advantage |
$123.61
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$201.88 |
| Max. Negotiated Rate |
$297.90 |
| Rate for Payer: Aetna Commercial |
$281.35
|
| Rate for Payer: BCBS Trust/PPO |
$255.80
|
| Rate for Payer: BCN Commercial |
$255.80
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cofinity Commercial |
$284.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.80
|
| Rate for Payer: Healthscope Commercial |
$297.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.35
|
| Rate for Payer: PHP Commercial |
$281.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.28
|
| Rate for Payer: UHC Core |
$276.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.25
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$78.61 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$281.35
|
| Rate for Payer: Aetna Medicare |
$86.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.44
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$82.75
|
| Rate for Payer: BCBS Trust/PPO |
$257.35
|
| Rate for Payer: BCN Commercial |
$257.35
|
| Rate for Payer: BCN Medicare Advantage |
$82.75
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cofinity Commercial |
$284.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.75
|
| Rate for Payer: Healthscope Commercial |
$297.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.25
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.35
|
| Rate for Payer: PACE Senior Care Partners |
$78.61
|
| Rate for Payer: PACE SWMI |
$82.75
|
| Rate for Payer: PHP Commercial |
$281.35
|
| Rate for Payer: PHP Medicare Advantage |
$82.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.97
|
| Rate for Payer: Priority Health Medicare |
$82.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.88
|
| Rate for Payer: Railroad Medicare Medicare |
$82.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.28
|
| Rate for Payer: UHC Core |
$276.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.75
|
| Rate for Payer: UHC Medicare Advantage |
$85.23
|
| Rate for Payer: VA VA |
$82.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.25
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
20520
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$191.71
|
| Rate for Payer: Aetna Medicare |
$148.79
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$143.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$143.07
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cofinity Commercial |
$191.71
|
| Rate for Payer: Cofinity Commercial |
$206.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.07
|
| Rate for Payer: Mclaren Medicaid |
$95.21
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.22
|
| Rate for Payer: PACE SWMI |
$143.07
|
| Rate for Payer: PHP Medicare Advantage |
$143.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.68
|
| Rate for Payer: Priority Health Medicare |
$143.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.07
|
| Rate for Payer: UHC Medicare Advantage |
$147.36
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 20520
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$191.71
|
| Rate for Payer: Aetna Medicare |
$148.79
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$143.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$143.07
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cofinity Commercial |
$206.02
|
| Rate for Payer: Cofinity Commercial |
$191.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.07
|
| Rate for Payer: Mclaren Medicaid |
$95.21
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.22
|
| Rate for Payer: PACE SWMI |
$143.07
|
| Rate for Payer: PHP Medicare Advantage |
$143.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.68
|
| Rate for Payer: Priority Health Medicare |
$143.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.07
|
| Rate for Payer: UHC Medicare Advantage |
$147.36
|
|
|
PR REMOVAL FOREIGN BODY PELVIS/HIP DEEP
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 27087
|
| Min. Negotiated Rate |
$397.88 |
| Max. Negotiated Rate |
$1,172.30 |
| Rate for Payer: Aetna Commercial |
$817.92
|
| Rate for Payer: Aetna Medicare |
$634.81
|
| Rate for Payer: BCBS Complete |
$417.77
|
| Rate for Payer: BCBS MAPPO |
$610.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,172.30
|
| Rate for Payer: BCN Commercial |
$906.01
|
| Rate for Payer: BCN Medicare Advantage |
$610.39
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$878.96
|
| Rate for Payer: Cofinity Commercial |
$817.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.39
|
| Rate for Payer: Mclaren Medicaid |
$397.88
|
| Rate for Payer: Meridian Medicaid |
$417.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$640.91
|
| Rate for Payer: PACE SWMI |
$610.39
|
| Rate for Payer: PHP Medicare Advantage |
$610.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$946.75
|
| Rate for Payer: Priority Health Medicare |
$610.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$610.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.39
|
| Rate for Payer: UHC Medicare Advantage |
$628.70
|
|
|
PR REMOVAL FOREIGN BODY PHARYNX
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 42809
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$300.53 |
| Rate for Payer: Aetna Commercial |
$166.47
|
| Rate for Payer: Aetna Medicare |
$129.20
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$124.23
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$300.53
|
| Rate for Payer: BCN Medicare Advantage |
$124.23
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Cofinity Commercial |
$166.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.23
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$130.44
|
| Rate for Payer: PACE SWMI |
$124.23
|
| Rate for Payer: PHP Medicare Advantage |
$124.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.84
|
| Rate for Payer: Priority Health Medicare |
$124.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.23
|
| Rate for Payer: UHC Medicare Advantage |
$127.96
|
|
|
PR REMOVAL FOREIGN BODY SCROTUM
|
Professional
|
Both
|
$656.00
|
|
|
Service Code
|
HCPCS 55120
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$3,266.48 |
| Rate for Payer: Aetna Commercial |
$463.73
|
| Rate for Payer: Aetna Medicare |
$359.91
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS MAPPO |
$346.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,266.48
|
| Rate for Payer: BCN Commercial |
$514.58
|
| Rate for Payer: BCN Medicare Advantage |
$346.07
|
| Rate for Payer: Cash Price |
$524.80
|
| Rate for Payer: Cash Price |
$524.80
|
| Rate for Payer: Cofinity Commercial |
$498.34
|
| Rate for Payer: Cofinity Commercial |
$463.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.07
|
| Rate for Payer: Mclaren Medicaid |
$228.34
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$363.37
|
| Rate for Payer: PACE SWMI |
$346.07
|
| Rate for Payer: PHP Medicare Advantage |
$346.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$568.99
|
| Rate for Payer: Priority Health Medicare |
$346.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$568.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.07
|
| Rate for Payer: UHC Medicare Advantage |
$356.45
|
|
|
PR REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 23330
|
| Min. Negotiated Rate |
$64.52 |
| Max. Negotiated Rate |
$444.20 |
| Rate for Payer: Aetna Commercial |
$218.53
|
| Rate for Payer: Aetna Medicare |
$169.60
|
| Rate for Payer: BCBS Complete |
$114.28
|
| Rate for Payer: BCBS MAPPO |
$163.08
|
| Rate for Payer: BCBS Trust/PPO |
$64.52
|
| Rate for Payer: BCN Commercial |
$444.20
|
| Rate for Payer: BCN Medicare Advantage |
$163.08
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cofinity Commercial |
$234.84
|
| Rate for Payer: Cofinity Commercial |
$218.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.08
|
| Rate for Payer: Mclaren Medicaid |
$108.84
|
| Rate for Payer: Meridian Medicaid |
$114.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.23
|
| Rate for Payer: PACE SWMI |
$163.08
|
| Rate for Payer: PHP Medicare Advantage |
$163.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.85
|
| Rate for Payer: Priority Health Medicare |
$163.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.08
|
| Rate for Payer: UHC Medicare Advantage |
$167.97
|
|
|
PR REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
HCPCS 24201
|
| Min. Negotiated Rate |
$162.72 |
| Max. Negotiated Rate |
$810.72 |
| Rate for Payer: Aetna Commercial |
$485.03
|
| Rate for Payer: Aetna Medicare |
$376.44
|
| Rate for Payer: BCBS Complete |
$274.42
|
| Rate for Payer: BCBS MAPPO |
$361.96
|
| Rate for Payer: BCBS Trust/PPO |
$162.72
|
| Rate for Payer: BCN Commercial |
$810.72
|
| Rate for Payer: BCN Medicare Advantage |
$361.96
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cofinity Commercial |
$521.22
|
| Rate for Payer: Cofinity Commercial |
$485.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.96
|
| Rate for Payer: Mclaren Medicaid |
$261.35
|
| Rate for Payer: Meridian Medicaid |
$274.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$380.06
|
| Rate for Payer: PACE SWMI |
$361.96
|
| Rate for Payer: PHP Medicare Advantage |
$361.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$566.31
|
| Rate for Payer: Priority Health Medicare |
$361.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$566.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$361.96
|
| Rate for Payer: UHC Medicare Advantage |
$372.82
|
|
|
PR REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,064.00
|
|
|
Service Code
|
HCPCS 27090
|
| Min. Negotiated Rate |
$412.60 |
| Max. Negotiated Rate |
$1,444.80 |
| Rate for Payer: Aetna Commercial |
$1,099.79
|
| Rate for Payer: Aetna Medicare |
$853.57
|
| Rate for Payer: BCBS Complete |
$562.03
|
| Rate for Payer: BCBS MAPPO |
$820.74
|
| Rate for Payer: BCBS Trust/PPO |
$412.60
|
| Rate for Payer: BCN Commercial |
$1,222.67
|
| Rate for Payer: BCN Medicare Advantage |
$820.74
|
| Rate for Payer: Cash Price |
$1,651.20
|
| Rate for Payer: Cash Price |
$1,651.20
|
| Rate for Payer: Cofinity Commercial |
$1,099.79
|
| Rate for Payer: Cofinity Commercial |
$1,181.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.74
|
| Rate for Payer: Mclaren Medicaid |
$535.27
|
| Rate for Payer: Meridian Medicaid |
$562.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$861.78
|
| Rate for Payer: PACE SWMI |
$820.74
|
| Rate for Payer: PHP Medicare Advantage |
$820.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,444.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,277.65
|
| Rate for Payer: Priority Health Medicare |
$820.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,277.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$820.74
|
| Rate for Payer: UHC Medicare Advantage |
$845.36
|
|
|
PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 69210
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$2,090.48 |
| Rate for Payer: Aetna Commercial |
$43.19
|
| Rate for Payer: Aetna Medicare |
$33.52
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCBS MAPPO |
$32.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,090.48
|
| Rate for Payer: BCN Commercial |
$55.76
|
| Rate for Payer: BCN Medicare Advantage |
$32.23
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$43.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.23
|
| Rate for Payer: Mclaren Medicaid |
$20.66
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.84
|
| Rate for Payer: PACE SWMI |
$32.23
|
| Rate for Payer: PHP Medicare Advantage |
$32.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.73
|
| Rate for Payer: Priority Health Medicare |
$32.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.23
|
| Rate for Payer: UHC Medicare Advantage |
$33.20
|
|
|
PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 69209
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$2,108.45 |
| Rate for Payer: Aetna Commercial |
$19.11
|
| Rate for Payer: Aetna Medicare |
$14.83
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$14.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.45
|
| Rate for Payer: BCN Commercial |
$22.48
|
| Rate for Payer: BCN Medicare Advantage |
$14.26
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$20.53
|
| Rate for Payer: Cofinity Commercial |
$19.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.97
|
| Rate for Payer: PACE SWMI |
$14.26
|
| Rate for Payer: PHP Medicare Advantage |
$14.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.69
|
| Rate for Payer: Priority Health Medicare |
$14.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.26
|
| Rate for Payer: UHC Medicare Advantage |
$14.69
|
|
|
PR REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 57415
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$1,989.05 |
| Rate for Payer: Aetna Commercial |
$230.92
|
| Rate for Payer: Aetna Medicare |
$179.22
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCBS MAPPO |
$172.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.05
|
| Rate for Payer: BCN Commercial |
$257.53
|
| Rate for Payer: BCN Medicare Advantage |
$172.33
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$230.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.33
|
| Rate for Payer: Mclaren Medicaid |
$113.32
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$180.95
|
| Rate for Payer: PACE SWMI |
$172.33
|
| Rate for Payer: PHP Medicare Advantage |
$172.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.50
|
| Rate for Payer: Priority Health Medicare |
$172.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.33
|
| Rate for Payer: UHC Medicare Advantage |
$177.50
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$56.05 |
| Max. Negotiated Rate |
$484.61 |
| Rate for Payer: Aetna Commercial |
$200.60
|
| Rate for Payer: Aetna Medicare |
$61.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.75
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$59.00
|
| Rate for Payer: BCBS Trust/PPO |
$183.49
|
| Rate for Payer: BCN Commercial |
$183.49
|
| Rate for Payer: BCN Medicare Advantage |
$59.00
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$202.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.00
|
| Rate for Payer: Healthscope Commercial |
$212.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.00
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$200.60
|
| Rate for Payer: PACE Senior Care Partners |
$56.05
|
| Rate for Payer: PACE SWMI |
$59.00
|
| Rate for Payer: PHP Commercial |
$200.60
|
| Rate for Payer: PHP Medicare Advantage |
$59.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.32
|
| Rate for Payer: Priority Health Medicare |
$59.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.94
|
| Rate for Payer: Railroad Medicare Medicare |
$59.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.68
|
| Rate for Payer: UHC Core |
$197.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.00
|
| Rate for Payer: UHC Medicare Advantage |
$60.77
|
| Rate for Payer: VA VA |
$59.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.00
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 11976
|
| Hospital Charge Code |
11976
|
| Min. Negotiated Rate |
$59.00 |
| Max. Negotiated Rate |
$268.22 |
| Rate for Payer: Aetna Commercial |
$123.53
|
| Rate for Payer: Aetna Medicare |
$95.88
|
| Rate for Payer: BCBS Complete |
$61.95
|
| Rate for Payer: BCBS MAPPO |
$92.19
|
| Rate for Payer: BCBS Trust/PPO |
$268.22
|
| Rate for Payer: BCN Commercial |
$212.08
|
| Rate for Payer: BCN Medicare Advantage |
$92.19
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$123.53
|
| Rate for Payer: Cofinity Commercial |
$132.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.19
|
| Rate for Payer: Mclaren Medicaid |
$59.00
|
| Rate for Payer: Meridian Medicaid |
$61.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.80
|
| Rate for Payer: PACE SWMI |
$92.19
|
| Rate for Payer: PHP Medicare Advantage |
$92.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.45
|
| Rate for Payer: Priority Health Medicare |
$92.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.19
|
| Rate for Payer: UHC Medicare Advantage |
$94.96
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 11976
|
| Min. Negotiated Rate |
$59.00 |
| Max. Negotiated Rate |
$268.22 |
| Rate for Payer: Aetna Commercial |
$123.53
|
| Rate for Payer: Aetna Medicare |
$95.88
|
| Rate for Payer: BCBS Complete |
$61.95
|
| Rate for Payer: BCBS MAPPO |
$92.19
|
| Rate for Payer: BCBS Trust/PPO |
$268.22
|
| Rate for Payer: BCN Commercial |
$212.08
|
| Rate for Payer: BCN Medicare Advantage |
$92.19
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$132.75
|
| Rate for Payer: Cofinity Commercial |
$123.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.19
|
| Rate for Payer: Mclaren Medicaid |
$59.00
|
| Rate for Payer: Meridian Medicaid |
$61.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.80
|
| Rate for Payer: PACE SWMI |
$92.19
|
| Rate for Payer: PHP Medicare Advantage |
$92.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.45
|
| Rate for Payer: Priority Health Medicare |
$92.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.19
|
| Rate for Payer: UHC Medicare Advantage |
$94.96
|
|
