|
PR REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$1,720.00
|
|
|
Service Code
|
HCPCS 64583
|
| Min. Negotiated Rate |
$315.92 |
| Max. Negotiated Rate |
$1,462.56 |
| Rate for Payer: Aetna Commercial |
$1,142.63
|
| Rate for Payer: Aetna Medicare |
$886.82
|
| Rate for Payer: BCBS Complete |
$580.15
|
| Rate for Payer: BCBS MAPPO |
$852.71
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$1,262.26
|
| Rate for Payer: BCN Medicare Advantage |
$852.71
|
| Rate for Payer: Cash Price |
$1,376.00
|
| Rate for Payer: Cash Price |
$1,376.00
|
| Rate for Payer: Cofinity Commercial |
$1,142.63
|
| Rate for Payer: Cofinity Commercial |
$1,227.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$852.71
|
| Rate for Payer: Mclaren Medicaid |
$552.52
|
| Rate for Payer: Meridian Medicaid |
$580.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$895.35
|
| Rate for Payer: PACE SWMI |
$852.71
|
| Rate for Payer: PHP Medicare Advantage |
$852.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,462.56
|
| Rate for Payer: Priority Health Medicare |
$852.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,462.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$852.71
|
| Rate for Payer: UHC Medicare Advantage |
$878.29
|
|
|
PR REVJ/RPLMNT CH WAL RESPIR ELTRD & CONJ PULSE GEN
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 0467T
|
| Min. Negotiated Rate |
$320.00 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: BCBS Complete |
$320.00
|
| Rate for Payer: Cash Price |
$640.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.00
|
|
|
PR REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT
|
Professional
|
Both
|
$4,478.00
|
|
|
Service Code
|
HCPCS 27486
|
| Min. Negotiated Rate |
$899.71 |
| Max. Negotiated Rate |
$3,134.60 |
| Rate for Payer: Aetna Commercial |
$1,852.75
|
| Rate for Payer: Aetna Medicare |
$1,437.96
|
| Rate for Payer: BCBS Complete |
$944.70
|
| Rate for Payer: BCBS MAPPO |
$1,382.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.05
|
| Rate for Payer: BCN Commercial |
$2,050.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,382.65
|
| Rate for Payer: Cash Price |
$3,582.40
|
| Rate for Payer: Cash Price |
$3,582.40
|
| Rate for Payer: Cofinity Commercial |
$1,991.02
|
| Rate for Payer: Cofinity Commercial |
$1,852.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,382.65
|
| Rate for Payer: Mclaren Medicaid |
$899.71
|
| Rate for Payer: Meridian Medicaid |
$944.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,451.78
|
| Rate for Payer: PACE SWMI |
$1,382.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,382.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$899.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,134.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,142.69
|
| Rate for Payer: Priority Health Medicare |
$1,382.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,142.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,382.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,382.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,424.13
|
|
|
PR REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$2,978.08
|
|
|
Service Code
|
HCPCS 27137
|
| Min. Negotiated Rate |
$936.99 |
| Max. Negotiated Rate |
$2,232.56 |
| Rate for Payer: Aetna Commercial |
$1,934.41
|
| Rate for Payer: Aetna Medicare |
$1,501.33
|
| Rate for Payer: BCBS Complete |
$983.84
|
| Rate for Payer: BCBS MAPPO |
$1,443.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.31
|
| Rate for Payer: BCN Commercial |
$2,136.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,443.59
|
| Rate for Payer: Cash Price |
$2,382.46
|
| Rate for Payer: Cash Price |
$2,382.46
|
| Rate for Payer: Cofinity Commercial |
$2,078.77
|
| Rate for Payer: Cofinity Commercial |
$1,934.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,443.59
|
| Rate for Payer: Mclaren Medicaid |
$936.99
|
| Rate for Payer: Meridian Medicaid |
$983.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,515.77
|
| Rate for Payer: PACE SWMI |
$1,443.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,443.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$936.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,084.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,232.56
|
| Rate for Payer: Priority Health Medicare |
$1,443.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,232.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,443.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,443.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,486.90
|
|
|
PR REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,880.62
|
|
|
Service Code
|
HCPCS 27134
|
| Min. Negotiated Rate |
$409.96 |
| Max. Negotiated Rate |
$3,054.10 |
| Rate for Payer: Aetna Commercial |
$2,515.94
|
| Rate for Payer: Aetna Medicare |
$1,952.67
|
| Rate for Payer: BCBS Complete |
$1,275.70
|
| Rate for Payer: BCBS MAPPO |
$1,877.57
|
| Rate for Payer: BCBS Trust/PPO |
$409.96
|
| Rate for Payer: BCN Commercial |
$3,054.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,877.57
|
| Rate for Payer: Cash Price |
$3,104.50
|
| Rate for Payer: Cash Price |
$3,104.50
|
| Rate for Payer: Cofinity Commercial |
$2,515.94
|
| Rate for Payer: Cofinity Commercial |
$2,703.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,877.57
|
| Rate for Payer: Mclaren Medicaid |
$1,214.95
|
| Rate for Payer: Meridian Medicaid |
$1,275.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,971.45
|
| Rate for Payer: PACE SWMI |
$1,877.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,877.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,214.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,716.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,898.45
|
| Rate for Payer: Priority Health Medicare |
$1,877.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,898.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,877.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,877.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,933.90
|
|
|
PR REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT
|
Professional
|
Both
|
$3,095.16
|
|
|
Service Code
|
HCPCS 27138
|
| Min. Negotiated Rate |
$573.73 |
| Max. Negotiated Rate |
$2,318.86 |
| Rate for Payer: Aetna Commercial |
$2,009.79
|
| Rate for Payer: Aetna Medicare |
$1,559.83
|
| Rate for Payer: BCBS Complete |
$1,021.63
|
| Rate for Payer: BCBS MAPPO |
$1,499.84
|
| Rate for Payer: BCBS Trust/PPO |
$573.73
|
| Rate for Payer: BCN Commercial |
$2,219.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,499.84
|
| Rate for Payer: Cash Price |
$2,476.13
|
| Rate for Payer: Cash Price |
$2,476.13
|
| Rate for Payer: Cofinity Commercial |
$2,009.79
|
| Rate for Payer: Cofinity Commercial |
$2,159.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,499.84
|
| Rate for Payer: Mclaren Medicaid |
$972.98
|
| Rate for Payer: Meridian Medicaid |
$1,021.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,574.83
|
| Rate for Payer: PACE SWMI |
$1,499.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,499.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$972.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,166.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,318.86
|
| Rate for Payer: Priority Health Medicare |
$1,499.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,318.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,499.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,499.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,544.84
|
|
|
PR REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE
|
Professional
|
Both
|
$5,885.00
|
|
|
Service Code
|
HCPCS 27487
|
| Hospital Charge Code |
27487
|
| Min. Negotiated Rate |
$861.66 |
| Max. Negotiated Rate |
$4,119.50 |
| Rate for Payer: Aetna Commercial |
$2,313.35
|
| Rate for Payer: Aetna Medicare |
$1,795.44
|
| Rate for Payer: BCBS Complete |
$1,176.62
|
| Rate for Payer: BCBS MAPPO |
$1,726.38
|
| Rate for Payer: BCBS Trust/PPO |
$861.66
|
| Rate for Payer: BCN Commercial |
$2,813.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,726.38
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cofinity Commercial |
$2,485.99
|
| Rate for Payer: Cofinity Commercial |
$2,313.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,726.38
|
| Rate for Payer: Mclaren Medicaid |
$1,120.59
|
| Rate for Payer: Meridian Medicaid |
$1,176.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,812.70
|
| Rate for Payer: PACE SWMI |
$1,726.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,726.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,120.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,670.19
|
| Rate for Payer: Priority Health Medicare |
$1,726.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,670.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,726.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,726.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,778.17
|
|
|
PR REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE
|
Professional
|
Both
|
$5,885.00
|
|
|
Service Code
|
HCPCS 27487
|
| Min. Negotiated Rate |
$861.66 |
| Max. Negotiated Rate |
$4,119.50 |
| Rate for Payer: Aetna Commercial |
$2,313.35
|
| Rate for Payer: Aetna Medicare |
$1,795.44
|
| Rate for Payer: BCBS Complete |
$1,176.62
|
| Rate for Payer: BCBS MAPPO |
$1,726.38
|
| Rate for Payer: BCBS Trust/PPO |
$861.66
|
| Rate for Payer: BCN Commercial |
$2,813.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,726.38
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cofinity Commercial |
$2,485.99
|
| Rate for Payer: Cofinity Commercial |
$2,313.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,726.38
|
| Rate for Payer: Mclaren Medicaid |
$1,120.59
|
| Rate for Payer: Meridian Medicaid |
$1,176.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,812.70
|
| Rate for Payer: PACE SWMI |
$1,726.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,726.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,120.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,670.19
|
| Rate for Payer: Priority Health Medicare |
$1,726.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,670.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,726.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,726.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,778.17
|
|
|
PR REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE
|
Facility
|
OP
|
$5,885.00
|
|
|
Service Code
|
CPT 27487
|
| Hospital Charge Code |
27487
|
| Min. Negotiated Rate |
$1,397.69 |
| Max. Negotiated Rate |
$5,296.50 |
| Rate for Payer: Aetna Commercial |
$5,002.25
|
| Rate for Payer: Aetna Medicare |
$1,530.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,839.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,839.06
|
| Rate for Payer: BCBS Complete |
$2,354.00
|
| Rate for Payer: BCBS MAPPO |
$1,471.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,575.59
|
| Rate for Payer: BCN Commercial |
$4,575.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,471.25
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cofinity Commercial |
$5,061.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,708.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,471.25
|
| Rate for Payer: Healthscope Commercial |
$5,296.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,413.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,544.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,691.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,002.25
|
| Rate for Payer: PACE Senior Care Partners |
$1,397.69
|
| Rate for Payer: PACE SWMI |
$1,471.25
|
| Rate for Payer: PHP Commercial |
$5,002.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,471.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,119.95
|
| Rate for Payer: Priority Health Medicare |
$1,471.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,589.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,471.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,178.80
|
| Rate for Payer: UHC Core |
$4,913.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,471.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.39
|
| Rate for Payer: VA VA |
$1,471.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,413.75
|
|
|
PR REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE
|
Facility
|
IP
|
$5,885.00
|
|
|
Service Code
|
CPT 27487
|
| Hospital Charge Code |
27487
|
| Min. Negotiated Rate |
$3,589.26 |
| Max. Negotiated Rate |
$5,296.50 |
| Rate for Payer: Aetna Commercial |
$5,002.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,547.93
|
| Rate for Payer: BCN Commercial |
$4,547.93
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cofinity Commercial |
$5,061.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,708.00
|
| Rate for Payer: Healthscope Commercial |
$5,296.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,413.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,002.25
|
| Rate for Payer: PHP Commercial |
$5,002.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,119.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,589.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,178.80
|
| Rate for Payer: UHC Core |
$4,913.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,413.75
|
|
|
PR REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA
|
Professional
|
Both
|
$1,407.00
|
|
|
Service Code
|
HCPCS 50728
|
| Min. Negotiated Rate |
$356.07 |
| Max. Negotiated Rate |
$1,116.92 |
| Rate for Payer: Aetna Commercial |
$915.15
|
| Rate for Payer: Aetna Medicare |
$710.27
|
| Rate for Payer: BCBS Complete |
$468.77
|
| Rate for Payer: BCBS MAPPO |
$682.95
|
| Rate for Payer: BCBS Trust/PPO |
$356.07
|
| Rate for Payer: BCN Commercial |
$1,010.10
|
| Rate for Payer: BCN Medicare Advantage |
$682.95
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cash Price |
$1,125.60
|
| Rate for Payer: Cofinity Commercial |
$915.15
|
| Rate for Payer: Cofinity Commercial |
$983.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.95
|
| Rate for Payer: Mclaren Medicaid |
$446.45
|
| Rate for Payer: Meridian Medicaid |
$468.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$717.10
|
| Rate for Payer: PACE SWMI |
$682.95
|
| Rate for Payer: PHP Medicare Advantage |
$682.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,116.92
|
| Rate for Payer: Priority Health Medicare |
$682.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,116.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$682.95
|
| Rate for Payer: UHC Medicare Advantage |
$703.44
|
|
|
PR REVJ URINARY-CUTANEOUS ANASTAMOSIS
|
Professional
|
Both
|
$1,271.00
|
|
|
Service Code
|
HCPCS 50727
|
| Min. Negotiated Rate |
$328.02 |
| Max. Negotiated Rate |
$4,557.12 |
| Rate for Payer: Aetna Commercial |
$667.29
|
| Rate for Payer: Aetna Medicare |
$517.90
|
| Rate for Payer: BCBS Complete |
$344.42
|
| Rate for Payer: BCBS MAPPO |
$497.98
|
| Rate for Payer: BCBS Trust/PPO |
$4,557.12
|
| Rate for Payer: BCN Commercial |
$739.37
|
| Rate for Payer: BCN Medicare Advantage |
$497.98
|
| Rate for Payer: Cash Price |
$1,016.80
|
| Rate for Payer: Cash Price |
$1,016.80
|
| Rate for Payer: Cofinity Commercial |
$667.29
|
| Rate for Payer: Cofinity Commercial |
$717.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$497.98
|
| Rate for Payer: Mclaren Medicaid |
$328.02
|
| Rate for Payer: Meridian Medicaid |
$344.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$522.88
|
| Rate for Payer: PACE SWMI |
$497.98
|
| Rate for Payer: PHP Medicare Advantage |
$497.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.56
|
| Rate for Payer: Priority Health Medicare |
$497.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$817.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$497.98
|
| Rate for Payer: UHC Medicare Advantage |
$512.92
|
|
|
PR REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI
|
Professional
|
Both
|
$1,045.00
|
|
|
Service Code
|
HCPCS 37224
|
| Min. Negotiated Rate |
$275.62 |
| Max. Negotiated Rate |
$4,307.21 |
| Rate for Payer: Aetna Commercial |
$584.29
|
| Rate for Payer: Aetna Medicare |
$453.48
|
| Rate for Payer: BCBS Complete |
$289.40
|
| Rate for Payer: BCBS MAPPO |
$436.04
|
| Rate for Payer: BCBS Trust/PPO |
$622.87
|
| Rate for Payer: BCN Commercial |
$4,307.21
|
| Rate for Payer: BCN Medicare Advantage |
$436.04
|
| Rate for Payer: Cash Price |
$836.00
|
| Rate for Payer: Cash Price |
$836.00
|
| Rate for Payer: Cofinity Commercial |
$627.90
|
| Rate for Payer: Cofinity Commercial |
$584.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.04
|
| Rate for Payer: Mclaren Medicaid |
$275.62
|
| Rate for Payer: Meridian Medicaid |
$289.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$457.84
|
| Rate for Payer: PACE SWMI |
$436.04
|
| Rate for Payer: PHP Medicare Advantage |
$436.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$687.29
|
| Rate for Payer: Priority Health Medicare |
$436.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$687.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.04
|
| Rate for Payer: UHC Medicare Advantage |
$449.12
|
|
|
PR REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL
|
Professional
|
Both
|
$2,272.00
|
|
|
Service Code
|
HCPCS 37225
|
| Min. Negotiated Rate |
$370.83 |
| Max. Negotiated Rate |
$12,917.21 |
| Rate for Payer: Aetna Commercial |
$785.04
|
| Rate for Payer: Aetna Medicare |
$609.28
|
| Rate for Payer: BCBS Complete |
$389.37
|
| Rate for Payer: BCBS MAPPO |
$585.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.41
|
| Rate for Payer: BCN Commercial |
$12,917.21
|
| Rate for Payer: BCN Medicare Advantage |
$585.85
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cofinity Commercial |
$843.62
|
| Rate for Payer: Cofinity Commercial |
$785.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.85
|
| Rate for Payer: Mclaren Medicaid |
$370.83
|
| Rate for Payer: Meridian Medicaid |
$389.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$615.14
|
| Rate for Payer: PACE SWMI |
$585.85
|
| Rate for Payer: PHP Medicare Advantage |
$585.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$370.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,590.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$924.54
|
| Rate for Payer: Priority Health Medicare |
$585.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.85
|
| Rate for Payer: UHC Medicare Advantage |
$603.43
|
|
|
PR REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL
|
Professional
|
Both
|
$1,132.00
|
|
|
Service Code
|
HCPCS 37226
|
| Min. Negotiated Rate |
$321.42 |
| Max. Negotiated Rate |
$12,021.96 |
| Rate for Payer: Aetna Commercial |
$682.70
|
| Rate for Payer: Aetna Medicare |
$529.86
|
| Rate for Payer: BCBS Complete |
$337.49
|
| Rate for Payer: BCBS MAPPO |
$509.48
|
| Rate for Payer: BCBS Trust/PPO |
$496.60
|
| Rate for Payer: BCN Commercial |
$12,021.96
|
| Rate for Payer: BCN Medicare Advantage |
$509.48
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cofinity Commercial |
$733.65
|
| Rate for Payer: Cofinity Commercial |
$682.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.48
|
| Rate for Payer: Mclaren Medicaid |
$321.42
|
| Rate for Payer: Meridian Medicaid |
$337.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$534.95
|
| Rate for Payer: PACE SWMI |
$509.48
|
| Rate for Payer: PHP Medicare Advantage |
$509.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$802.73
|
| Rate for Payer: Priority Health Medicare |
$509.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$509.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.48
|
| Rate for Payer: UHC Medicare Advantage |
$524.76
|
|
|
PR REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL
|
Professional
|
Both
|
$1,928.00
|
|
|
Service Code
|
HCPCS 37227
|
| Min. Negotiated Rate |
$443.68 |
| Max. Negotiated Rate |
$16,544.66 |
| Rate for Payer: Aetna Commercial |
$942.73
|
| Rate for Payer: Aetna Medicare |
$731.67
|
| Rate for Payer: BCBS Complete |
$465.86
|
| Rate for Payer: BCBS MAPPO |
$703.53
|
| Rate for Payer: BCBS Trust/PPO |
$690.49
|
| Rate for Payer: BCN Commercial |
$16,544.66
|
| Rate for Payer: BCN Medicare Advantage |
$703.53
|
| Rate for Payer: Cash Price |
$1,542.40
|
| Rate for Payer: Cash Price |
$1,542.40
|
| Rate for Payer: Cofinity Commercial |
$942.73
|
| Rate for Payer: Cofinity Commercial |
$1,013.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.53
|
| Rate for Payer: Mclaren Medicaid |
$443.68
|
| Rate for Payer: Meridian Medicaid |
$465.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$738.71
|
| Rate for Payer: PACE SWMI |
$703.53
|
| Rate for Payer: PHP Medicare Advantage |
$703.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,349.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.13
|
| Rate for Payer: Priority Health Medicare |
$703.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$703.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$703.53
|
| Rate for Payer: UHC Medicare Advantage |
$724.64
|
|
|
PR REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL
|
Professional
|
Both
|
$489.00
|
|
|
Service Code
|
HCPCS 37223
|
| Min. Negotiated Rate |
$131.21 |
| Max. Negotiated Rate |
$1,876.52 |
| Rate for Payer: Aetna Commercial |
$278.71
|
| Rate for Payer: Aetna Medicare |
$216.31
|
| Rate for Payer: BCBS Complete |
$137.77
|
| Rate for Payer: BCBS MAPPO |
$207.99
|
| Rate for Payer: BCBS Trust/PPO |
$374.83
|
| Rate for Payer: BCN Commercial |
$1,876.52
|
| Rate for Payer: BCN Medicare Advantage |
$207.99
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cofinity Commercial |
$299.51
|
| Rate for Payer: Cofinity Commercial |
$278.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.99
|
| Rate for Payer: Mclaren Medicaid |
$131.21
|
| Rate for Payer: Meridian Medicaid |
$137.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$218.39
|
| Rate for Payer: PACE SWMI |
$207.99
|
| Rate for Payer: PHP Medicare Advantage |
$207.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.16
|
| Rate for Payer: Priority Health Medicare |
$207.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$327.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.99
|
| Rate for Payer: UHC Medicare Advantage |
$214.23
|
|
|
PR REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY
|
Professional
|
Both
|
$1,982.00
|
|
|
Service Code
|
HCPCS 37221
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$4,542.26 |
| Rate for Payer: Aetna Commercial |
$648.31
|
| Rate for Payer: Aetna Medicare |
$503.16
|
| Rate for Payer: BCBS Complete |
$320.71
|
| Rate for Payer: BCBS MAPPO |
$483.81
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$4,542.26
|
| Rate for Payer: BCN Medicare Advantage |
$483.81
|
| Rate for Payer: Cash Price |
$1,585.60
|
| Rate for Payer: Cash Price |
$1,585.60
|
| Rate for Payer: Cofinity Commercial |
$648.31
|
| Rate for Payer: Cofinity Commercial |
$696.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.81
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Meridian Medicaid |
$320.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$508.00
|
| Rate for Payer: PACE SWMI |
$483.81
|
| Rate for Payer: PHP Medicare Advantage |
$483.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.29
|
| Rate for Payer: Priority Health Medicare |
$483.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$762.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.81
|
| Rate for Payer: UHC Medicare Advantage |
$498.32
|
|
|
PR REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI
|
Professional
|
Both
|
$1,279.00
|
|
|
Service Code
|
HCPCS 37228
|
| Min. Negotiated Rate |
$335.05 |
| Max. Negotiated Rate |
$6,115.79 |
| Rate for Payer: Aetna Commercial |
$712.02
|
| Rate for Payer: Aetna Medicare |
$552.61
|
| Rate for Payer: BCBS Complete |
$351.80
|
| Rate for Payer: BCBS MAPPO |
$531.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,216.15
|
| Rate for Payer: BCN Commercial |
$6,115.79
|
| Rate for Payer: BCN Medicare Advantage |
$531.36
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Cofinity Commercial |
$712.02
|
| Rate for Payer: Cofinity Commercial |
$765.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.36
|
| Rate for Payer: Mclaren Medicaid |
$335.05
|
| Rate for Payer: Meridian Medicaid |
$351.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$557.93
|
| Rate for Payer: PACE SWMI |
$531.36
|
| Rate for Payer: PHP Medicare Advantage |
$531.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$837.29
|
| Rate for Payer: Priority Health Medicare |
$531.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$837.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$531.36
|
| Rate for Payer: UHC Medicare Advantage |
$547.30
|
|
|
PR REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL
|
Professional
|
Both
|
$4,266.00
|
|
|
Service Code
|
HCPCS 37232
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$2,986.20 |
| Rate for Payer: Aetna Commercial |
$261.19
|
| Rate for Payer: Aetna Medicare |
$202.72
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$194.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,565.35
|
| Rate for Payer: BCN Commercial |
$1,206.05
|
| Rate for Payer: BCN Medicare Advantage |
$194.92
|
| Rate for Payer: Cash Price |
$3,412.80
|
| Rate for Payer: Cash Price |
$3,412.80
|
| Rate for Payer: Cofinity Commercial |
$261.19
|
| Rate for Payer: Cofinity Commercial |
$280.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.92
|
| Rate for Payer: Mclaren Medicaid |
$123.33
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$204.67
|
| Rate for Payer: PACE SWMI |
$194.92
|
| Rate for Payer: PHP Medicare Advantage |
$194.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,986.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.47
|
| Rate for Payer: Priority Health Medicare |
$194.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.92
|
| Rate for Payer: UHC Medicare Advantage |
$200.77
|
|
|
PR REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL
|
Professional
|
Both
|
$2,679.00
|
|
|
Service Code
|
HCPCS 37229
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$13,126.37 |
| Rate for Payer: Aetna Commercial |
$910.84
|
| Rate for Payer: Aetna Medicare |
$706.92
|
| Rate for Payer: BCBS Complete |
$450.66
|
| Rate for Payer: BCBS MAPPO |
$679.73
|
| Rate for Payer: BCBS Trust/PPO |
$476.53
|
| Rate for Payer: BCN Commercial |
$13,126.37
|
| Rate for Payer: BCN Medicare Advantage |
$679.73
|
| Rate for Payer: Cash Price |
$2,143.20
|
| Rate for Payer: Cash Price |
$2,143.20
|
| Rate for Payer: Cofinity Commercial |
$978.81
|
| Rate for Payer: Cofinity Commercial |
$910.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.73
|
| Rate for Payer: Mclaren Medicaid |
$429.20
|
| Rate for Payer: Meridian Medicaid |
$450.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$713.72
|
| Rate for Payer: PACE SWMI |
$679.73
|
| Rate for Payer: PHP Medicare Advantage |
$679.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,875.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.95
|
| Rate for Payer: Priority Health Medicare |
$679.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,072.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$679.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.73
|
| Rate for Payer: UHC Medicare Advantage |
$700.12
|
|
|
PR REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL
|
Professional
|
Both
|
$1,119.00
|
|
|
Service Code
|
HCPCS 37233
|
| Min. Negotiated Rate |
$199.37 |
| Max. Negotiated Rate |
$1,531.51 |
| Rate for Payer: Aetna Commercial |
$423.17
|
| Rate for Payer: Aetna Medicare |
$328.43
|
| Rate for Payer: BCBS Complete |
$209.34
|
| Rate for Payer: BCBS MAPPO |
$315.80
|
| Rate for Payer: BCBS Trust/PPO |
$495.55
|
| Rate for Payer: BCN Commercial |
$1,531.51
|
| Rate for Payer: BCN Medicare Advantage |
$315.80
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$454.75
|
| Rate for Payer: Cofinity Commercial |
$423.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.80
|
| Rate for Payer: Mclaren Medicaid |
$199.37
|
| Rate for Payer: Meridian Medicaid |
$209.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$331.59
|
| Rate for Payer: PACE SWMI |
$315.80
|
| Rate for Payer: PHP Medicare Advantage |
$315.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.44
|
| Rate for Payer: Priority Health Medicare |
$315.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$498.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$315.80
|
| Rate for Payer: UHC Medicare Advantage |
$325.27
|
|
|
PR REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL
|
Professional
|
Both
|
$2,685.00
|
|
|
Service Code
|
HCPCS 37230
|
| Min. Negotiated Rate |
$429.41 |
| Max. Negotiated Rate |
$13,145.42 |
| Rate for Payer: Aetna Commercial |
$909.70
|
| Rate for Payer: Aetna Medicare |
$706.04
|
| Rate for Payer: BCBS Complete |
$450.88
|
| Rate for Payer: BCBS MAPPO |
$678.88
|
| Rate for Payer: BCBS Trust/PPO |
$709.51
|
| Rate for Payer: BCN Commercial |
$13,145.42
|
| Rate for Payer: BCN Medicare Advantage |
$678.88
|
| Rate for Payer: Cash Price |
$2,148.00
|
| Rate for Payer: Cash Price |
$2,148.00
|
| Rate for Payer: Cofinity Commercial |
$977.59
|
| Rate for Payer: Cofinity Commercial |
$909.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.88
|
| Rate for Payer: Mclaren Medicaid |
$429.41
|
| Rate for Payer: Meridian Medicaid |
$450.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$712.82
|
| Rate for Payer: PACE SWMI |
$678.88
|
| Rate for Payer: PHP Medicare Advantage |
$678.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,879.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,071.37
|
| Rate for Payer: Priority Health Medicare |
$678.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,071.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$678.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$678.88
|
| Rate for Payer: UHC Medicare Advantage |
$699.25
|
|
|
PR REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 37234
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$5,352.48 |
| Rate for Payer: Aetna Commercial |
$368.26
|
| Rate for Payer: Aetna Medicare |
$285.81
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$274.82
|
| Rate for Payer: BCBS Trust/PPO |
$790.87
|
| Rate for Payer: BCN Commercial |
$5,352.48
|
| Rate for Payer: BCN Medicare Advantage |
$274.82
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$395.74
|
| Rate for Payer: Cofinity Commercial |
$368.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.82
|
| Rate for Payer: Mclaren Medicaid |
$174.23
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.56
|
| Rate for Payer: PACE SWMI |
$274.82
|
| Rate for Payer: PHP Medicare Advantage |
$274.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$434.08
|
| Rate for Payer: Priority Health Medicare |
$274.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.82
|
| Rate for Payer: UHC Medicare Advantage |
$283.06
|
|
|
PR RHINOPLASTY EXTERNAL
|
Professional
|
Both
|
$3,100.00
|
|
|
Service Code
|
HCPCS 00536
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,240.00 |
| Max. Negotiated Rate |
$2,170.00 |
| Rate for Payer: BCBS Complete |
$1,240.00
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.00
|
|
