|
PR RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA
|
Professional
|
Both
|
$2,431.00
|
|
|
Service Code
|
HCPCS 33974
|
| Min. Negotiated Rate |
$560.40 |
| Max. Negotiated Rate |
$2,513.12 |
| Rate for Payer: Aetna Commercial |
$1,170.38
|
| Rate for Payer: Aetna Medicare |
$908.36
|
| Rate for Payer: BCBS Complete |
$588.42
|
| Rate for Payer: BCBS MAPPO |
$873.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,513.12
|
| Rate for Payer: BCN Commercial |
$1,280.82
|
| Rate for Payer: BCN Medicare Advantage |
$873.42
|
| Rate for Payer: Cash Price |
$1,944.80
|
| Rate for Payer: Cash Price |
$1,944.80
|
| Rate for Payer: Cofinity Commercial |
$1,257.72
|
| Rate for Payer: Cofinity Commercial |
$1,170.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.42
|
| Rate for Payer: Mclaren Medicaid |
$560.40
|
| Rate for Payer: Meridian Medicaid |
$588.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$917.09
|
| Rate for Payer: PACE SWMI |
$873.42
|
| Rate for Payer: PHP Medicare Advantage |
$873.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,394.26
|
| Rate for Payer: Priority Health Medicare |
$873.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,394.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$873.42
|
| Rate for Payer: UHC Medicare Advantage |
$899.62
|
|
|
PR RMVL BONE FLAP/PROSTHETIC PLATE SKULL
|
Professional
|
Both
|
$3,305.00
|
|
|
Service Code
|
HCPCS 62142
|
| Min. Negotiated Rate |
$581.92 |
| Max. Negotiated Rate |
$2,313.50 |
| Rate for Payer: Aetna Commercial |
$1,198.86
|
| Rate for Payer: Aetna Medicare |
$930.46
|
| Rate for Payer: BCBS Complete |
$611.02
|
| Rate for Payer: BCBS MAPPO |
$894.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.75
|
| Rate for Payer: BCN Commercial |
$1,831.09
|
| Rate for Payer: BCN Medicare Advantage |
$894.67
|
| Rate for Payer: Cash Price |
$2,644.00
|
| Rate for Payer: Cash Price |
$2,644.00
|
| Rate for Payer: Cofinity Commercial |
$1,288.32
|
| Rate for Payer: Cofinity Commercial |
$1,198.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$894.67
|
| Rate for Payer: Mclaren Medicaid |
$581.92
|
| Rate for Payer: Meridian Medicaid |
$611.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$939.40
|
| Rate for Payer: PACE SWMI |
$894.67
|
| Rate for Payer: PHP Medicare Advantage |
$894.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,313.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,529.36
|
| Rate for Payer: Priority Health Medicare |
$894.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,529.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$894.67
|
| Rate for Payer: UHC Medicare Advantage |
$921.51
|
|
|
PR RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT
|
Professional
|
Both
|
$2,164.00
|
|
|
Service Code
|
HCPCS 62256
|
| Min. Negotiated Rate |
$87.02 |
| Max. Negotiated Rate |
$1,514.80 |
| Rate for Payer: Aetna Commercial |
$818.39
|
| Rate for Payer: Aetna Medicare |
$635.17
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS MAPPO |
$610.74
|
| Rate for Payer: BCBS Trust/PPO |
$87.02
|
| Rate for Payer: BCN Commercial |
$1,256.21
|
| Rate for Payer: BCN Medicare Advantage |
$610.74
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Cofinity Commercial |
$818.39
|
| Rate for Payer: Cofinity Commercial |
$879.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.74
|
| Rate for Payer: Mclaren Medicaid |
$400.87
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$641.28
|
| Rate for Payer: PACE SWMI |
$610.74
|
| Rate for Payer: PHP Medicare Advantage |
$610.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,514.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.21
|
| Rate for Payer: Priority Health Medicare |
$610.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,049.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$610.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.74
|
| Rate for Payer: UHC Medicare Advantage |
$629.06
|
|
|
PR RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT
|
Professional
|
Both
|
$5,026.00
|
|
|
Service Code
|
HCPCS 62258
|
| Min. Negotiated Rate |
$586.41 |
| Max. Negotiated Rate |
$3,518.20 |
| Rate for Payer: Aetna Commercial |
$1,500.41
|
| Rate for Payer: Aetna Medicare |
$1,164.50
|
| Rate for Payer: BCBS Complete |
$761.08
|
| Rate for Payer: BCBS MAPPO |
$1,119.71
|
| Rate for Payer: BCBS Trust/PPO |
$586.41
|
| Rate for Payer: BCN Commercial |
$2,282.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.71
|
| Rate for Payer: Cash Price |
$4,020.80
|
| Rate for Payer: Cash Price |
$4,020.80
|
| Rate for Payer: Cofinity Commercial |
$1,500.41
|
| Rate for Payer: Cofinity Commercial |
$1,612.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.71
|
| Rate for Payer: Mclaren Medicaid |
$724.84
|
| Rate for Payer: Meridian Medicaid |
$761.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,175.70
|
| Rate for Payer: PACE SWMI |
$1,119.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$724.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,518.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,906.47
|
| Rate for Payer: Priority Health Medicare |
$1,119.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,906.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,119.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,119.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,153.30
|
|
|
PR RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 97602
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$917.66 |
| Rate for Payer: Aetna Commercial |
$89.75
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCBS Trust/PPO |
$917.66
|
| Rate for Payer: BCN Commercial |
$167.04
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.57
|
|
|
PR RMVL EMBEDDED FB VESTIBULE MOUTH COMP
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 40805
|
| Min. Negotiated Rate |
$126.52 |
| Max. Negotiated Rate |
$526.19 |
| Rate for Payer: Aetna Commercial |
$256.46
|
| Rate for Payer: Aetna Medicare |
$199.05
|
| Rate for Payer: BCBS Complete |
$132.85
|
| Rate for Payer: BCBS MAPPO |
$191.39
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: BCN Commercial |
$416.35
|
| Rate for Payer: BCN Medicare Advantage |
$191.39
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$256.46
|
| Rate for Payer: Cofinity Commercial |
$275.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.39
|
| Rate for Payer: Mclaren Medicaid |
$126.52
|
| Rate for Payer: Meridian Medicaid |
$132.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$200.96
|
| Rate for Payer: PACE SWMI |
$191.39
|
| Rate for Payer: PHP Medicare Advantage |
$191.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$345.73
|
| Rate for Payer: Priority Health Medicare |
$191.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$345.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.39
|
| Rate for Payer: UHC Medicare Advantage |
$197.13
|
|
|
PR RMVL EMBEDDED FB VESTIBULE MOUTH SMPL
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 40804
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: Aetna Commercial |
$146.35
|
| Rate for Payer: Aetna Medicare |
$113.59
|
| Rate for Payer: BCBS Complete |
$76.93
|
| Rate for Payer: BCBS MAPPO |
$109.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.05
|
| Rate for Payer: BCN Commercial |
$275.12
|
| Rate for Payer: BCN Medicare Advantage |
$109.22
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$157.28
|
| Rate for Payer: Cofinity Commercial |
$146.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.22
|
| Rate for Payer: Mclaren Medicaid |
$73.27
|
| Rate for Payer: Meridian Medicaid |
$76.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$114.68
|
| Rate for Payer: PACE SWMI |
$109.22
|
| Rate for Payer: PHP Medicare Advantage |
$109.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.74
|
| Rate for Payer: Priority Health Medicare |
$109.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.22
|
| Rate for Payer: UHC Medicare Advantage |
$112.50
|
|
|
PR RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT
|
Professional
|
Both
|
$1,625.00
|
|
|
Service Code
|
HCPCS 63746
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,137.50 |
| Rate for Payer: Aetna Commercial |
$820.00
|
| Rate for Payer: Aetna Medicare |
$636.42
|
| Rate for Payer: BCBS Complete |
$420.68
|
| Rate for Payer: BCBS MAPPO |
$611.94
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: BCN Commercial |
$999.20
|
| Rate for Payer: BCN Medicare Advantage |
$611.94
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cofinity Commercial |
$881.19
|
| Rate for Payer: Cofinity Commercial |
$820.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$611.94
|
| Rate for Payer: Mclaren Medicaid |
$400.65
|
| Rate for Payer: Meridian Medicaid |
$420.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$642.54
|
| Rate for Payer: PACE SWMI |
$611.94
|
| Rate for Payer: PHP Medicare Advantage |
$611.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,051.48
|
| Rate for Payer: Priority Health Medicare |
$611.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$611.94
|
| Rate for Payer: UHC Medicare Advantage |
$630.30
|
|
|
PR RMVL FB XTRNL AUDITORY CANAL ANES
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 69205
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$1,749.20 |
| Rate for Payer: Aetna Commercial |
$125.37
|
| Rate for Payer: Aetna Medicare |
$97.30
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$93.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,749.20
|
| Rate for Payer: BCN Commercial |
$140.74
|
| Rate for Payer: BCN Medicare Advantage |
$93.56
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$125.37
|
| Rate for Payer: Cofinity Commercial |
$134.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.56
|
| Rate for Payer: Mclaren Medicaid |
$61.34
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.24
|
| Rate for Payer: PACE SWMI |
$93.56
|
| Rate for Payer: PHP Medicare Advantage |
$93.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.79
|
| Rate for Payer: Priority Health Medicare |
$93.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.56
|
| Rate for Payer: UHC Medicare Advantage |
$96.37
|
|
|
PR RMVL FB XTRNL AUDITORY CANAL W/O ANES
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 69200
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$1,294.34 |
| Rate for Payer: Aetna Commercial |
$62.27
|
| Rate for Payer: Aetna Medicare |
$48.33
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS MAPPO |
$46.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,294.34
|
| Rate for Payer: BCN Commercial |
$117.77
|
| Rate for Payer: BCN Medicare Advantage |
$46.47
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$62.27
|
| Rate for Payer: Cofinity Commercial |
$66.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.47
|
| Rate for Payer: Mclaren Medicaid |
$30.25
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.79
|
| Rate for Payer: PACE SWMI |
$46.47
|
| Rate for Payer: PHP Medicare Advantage |
$46.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.47
|
| Rate for Payer: Priority Health Medicare |
$46.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.47
|
| Rate for Payer: UHC Medicare Advantage |
$47.86
|
|
|
PR RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 65220
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$303.77 |
| Rate for Payer: Aetna Commercial |
$54.50
|
| Rate for Payer: Aetna Medicare |
$42.30
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS MAPPO |
$40.67
|
| Rate for Payer: BCBS Trust/PPO |
$303.77
|
| Rate for Payer: BCN Commercial |
$87.96
|
| Rate for Payer: BCN Medicare Advantage |
$40.67
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$54.50
|
| Rate for Payer: Cofinity Commercial |
$58.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.67
|
| Rate for Payer: Mclaren Medicaid |
$26.20
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.70
|
| Rate for Payer: PACE SWMI |
$40.67
|
| Rate for Payer: PHP Medicare Advantage |
$40.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.00
|
| Rate for Payer: Priority Health Medicare |
$40.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.67
|
| Rate for Payer: UHC Medicare Advantage |
$41.89
|
|
|
PR RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 65222
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$260.45 |
| Rate for Payer: Aetna Commercial |
$64.51
|
| Rate for Payer: Aetna Medicare |
$50.07
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS MAPPO |
$48.14
|
| Rate for Payer: BCBS Trust/PPO |
$260.45
|
| Rate for Payer: BCN Commercial |
$97.74
|
| Rate for Payer: BCN Medicare Advantage |
$48.14
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$69.32
|
| Rate for Payer: Cofinity Commercial |
$64.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.14
|
| Rate for Payer: Mclaren Medicaid |
$31.74
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.55
|
| Rate for Payer: PACE SWMI |
$48.14
|
| Rate for Payer: PHP Medicare Advantage |
$48.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.05
|
| Rate for Payer: Priority Health Medicare |
$48.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.14
|
| Rate for Payer: UHC Medicare Advantage |
$49.58
|
|
|
PR RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 65210
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$264.15 |
| Rate for Payer: Aetna Commercial |
$46.62
|
| Rate for Payer: Aetna Medicare |
$36.18
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$34.79
|
| Rate for Payer: BCBS Trust/PPO |
$264.15
|
| Rate for Payer: BCN Commercial |
$44.76
|
| Rate for Payer: BCN Medicare Advantage |
$34.79
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Cofinity Commercial |
$46.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.53
|
| Rate for Payer: PACE SWMI |
$34.79
|
| Rate for Payer: PHP Medicare Advantage |
$34.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.05
|
| Rate for Payer: Priority Health Medicare |
$34.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.79
|
| Rate for Payer: UHC Medicare Advantage |
$35.83
|
|
|
PR RMVL FECAL IMPACTION/FB SPX UNDER ANES
|
Professional
|
Both
|
$601.00
|
|
|
Service Code
|
HCPCS 45915
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$1,239.39 |
| Rate for Payer: Aetna Commercial |
$301.02
|
| Rate for Payer: Aetna Medicare |
$233.63
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS MAPPO |
$224.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.39
|
| Rate for Payer: BCN Commercial |
$518.49
|
| Rate for Payer: BCN Medicare Advantage |
$224.64
|
| Rate for Payer: Cash Price |
$480.80
|
| Rate for Payer: Cash Price |
$480.80
|
| Rate for Payer: Cofinity Commercial |
$323.48
|
| Rate for Payer: Cofinity Commercial |
$301.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.64
|
| Rate for Payer: Mclaren Medicaid |
$146.76
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$235.87
|
| Rate for Payer: PACE SWMI |
$224.64
|
| Rate for Payer: PHP Medicare Advantage |
$224.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$403.36
|
| Rate for Payer: Priority Health Medicare |
$224.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.64
|
| Rate for Payer: UHC Medicare Advantage |
$231.38
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Facility
|
IP
|
$753.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
20525
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$459.25 |
| Max. Negotiated Rate |
$677.70 |
| Rate for Payer: Aetna Commercial |
$640.05
|
| Rate for Payer: BCBS Trust/PPO |
$581.92
|
| Rate for Payer: BCN Commercial |
$581.92
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$647.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$602.40
|
| Rate for Payer: Healthscope Commercial |
$677.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$564.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$640.05
|
| Rate for Payer: PHP Commercial |
$640.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$459.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.64
|
| Rate for Payer: UHC Core |
$628.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$564.75
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 20525
|
| Hospital Charge Code |
20525
|
| Min. Negotiated Rate |
$158.69 |
| Max. Negotiated Rate |
$684.64 |
| Rate for Payer: Aetna Commercial |
$324.88
|
| Rate for Payer: Aetna Medicare |
$252.15
|
| Rate for Payer: BCBS Complete |
$166.62
|
| Rate for Payer: BCBS MAPPO |
$242.45
|
| Rate for Payer: BCBS Trust/PPO |
$195.38
|
| Rate for Payer: BCN Commercial |
$684.64
|
| Rate for Payer: BCN Medicare Advantage |
$242.45
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$349.13
|
| Rate for Payer: Cofinity Commercial |
$324.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.45
|
| Rate for Payer: Mclaren Medicaid |
$158.69
|
| Rate for Payer: Meridian Medicaid |
$166.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.57
|
| Rate for Payer: PACE SWMI |
$242.45
|
| Rate for Payer: PHP Medicare Advantage |
$242.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.38
|
| Rate for Payer: Priority Health Medicare |
$242.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.45
|
| Rate for Payer: UHC Medicare Advantage |
$249.72
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Facility
|
OP
|
$753.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
20525
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$178.84 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$640.05
|
| Rate for Payer: Aetna Medicare |
$195.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$235.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$235.31
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$188.25
|
| Rate for Payer: BCBS Trust/PPO |
$585.46
|
| Rate for Payer: BCN Commercial |
$585.46
|
| Rate for Payer: BCN Medicare Advantage |
$188.25
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$647.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$602.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.25
|
| Rate for Payer: Healthscope Commercial |
$677.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$564.75
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$197.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$640.05
|
| Rate for Payer: PACE Senior Care Partners |
$178.84
|
| Rate for Payer: PACE SWMI |
$188.25
|
| Rate for Payer: PHP Commercial |
$640.05
|
| Rate for Payer: PHP Medicare Advantage |
$188.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.11
|
| Rate for Payer: Priority Health Medicare |
$188.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$459.25
|
| Rate for Payer: Railroad Medicare Medicare |
$188.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.64
|
| Rate for Payer: UHC Core |
$628.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.25
|
| Rate for Payer: UHC Medicare Advantage |
$193.90
|
| Rate for Payer: VA VA |
$188.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$564.75
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 20525
|
| Min. Negotiated Rate |
$158.69 |
| Max. Negotiated Rate |
$684.64 |
| Rate for Payer: Aetna Commercial |
$324.88
|
| Rate for Payer: Aetna Medicare |
$252.15
|
| Rate for Payer: BCBS Complete |
$166.62
|
| Rate for Payer: BCBS MAPPO |
$242.45
|
| Rate for Payer: BCBS Trust/PPO |
$195.38
|
| Rate for Payer: BCN Commercial |
$684.64
|
| Rate for Payer: BCN Medicare Advantage |
$242.45
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$349.13
|
| Rate for Payer: Cofinity Commercial |
$324.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.45
|
| Rate for Payer: Mclaren Medicaid |
$158.69
|
| Rate for Payer: Meridian Medicaid |
$166.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.57
|
| Rate for Payer: PACE SWMI |
$242.45
|
| Rate for Payer: PHP Medicare Advantage |
$242.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.38
|
| Rate for Payer: Priority Health Medicare |
$242.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.45
|
| Rate for Payer: UHC Medicare Advantage |
$249.72
|
|
|
PR RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 27086
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$459.36 |
| Rate for Payer: Aetna Commercial |
$220.34
|
| Rate for Payer: Aetna Medicare |
$171.01
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$164.43
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: BCN Commercial |
$459.36
|
| Rate for Payer: BCN Medicare Advantage |
$164.43
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$236.78
|
| Rate for Payer: Cofinity Commercial |
$220.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.43
|
| Rate for Payer: Mclaren Medicaid |
$109.70
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.65
|
| Rate for Payer: PACE SWMI |
$164.43
|
| Rate for Payer: PHP Medicare Advantage |
$164.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.90
|
| Rate for Payer: Priority Health Medicare |
$164.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.43
|
| Rate for Payer: UHC Medicare Advantage |
$169.36
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Facility
|
OP
|
$322.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
24200
|
| Min. Negotiated Rate |
$76.48 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$273.70
|
| Rate for Payer: Aetna Medicare |
$83.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.62
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$80.50
|
| Rate for Payer: BCBS Trust/PPO |
$250.36
|
| Rate for Payer: BCN Commercial |
$250.36
|
| Rate for Payer: BCN Medicare Advantage |
$80.50
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$276.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.50
|
| Rate for Payer: Healthscope Commercial |
$289.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.50
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.70
|
| Rate for Payer: PACE Senior Care Partners |
$76.48
|
| Rate for Payer: PACE SWMI |
$80.50
|
| Rate for Payer: PHP Commercial |
$273.70
|
| Rate for Payer: PHP Medicare Advantage |
$80.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.14
|
| Rate for Payer: Priority Health Medicare |
$80.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.39
|
| Rate for Payer: Railroad Medicare Medicare |
$80.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.36
|
| Rate for Payer: UHC Core |
$268.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.50
|
| Rate for Payer: UHC Medicare Advantage |
$82.92
|
| Rate for Payer: VA VA |
$80.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.50
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 24200
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$318.13 |
| Rate for Payer: Aetna Commercial |
$182.96
|
| Rate for Payer: Aetna Medicare |
$142.00
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$136.54
|
| Rate for Payer: BCBS Trust/PPO |
$116.23
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$136.54
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$196.62
|
| Rate for Payer: Cofinity Commercial |
$182.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.54
|
| Rate for Payer: Mclaren Medicaid |
$91.59
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$143.37
|
| Rate for Payer: PACE SWMI |
$136.54
|
| Rate for Payer: PHP Medicare Advantage |
$136.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.97
|
| Rate for Payer: Priority Health Medicare |
$136.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.54
|
| Rate for Payer: UHC Medicare Advantage |
$140.64
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Facility
|
IP
|
$322.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
24200
|
| Min. Negotiated Rate |
$196.39 |
| Max. Negotiated Rate |
$289.80 |
| Rate for Payer: Aetna Commercial |
$273.70
|
| Rate for Payer: BCBS Trust/PPO |
$248.84
|
| Rate for Payer: BCN Commercial |
$248.84
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$276.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Healthscope Commercial |
$289.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.70
|
| Rate for Payer: PHP Commercial |
$273.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.36
|
| Rate for Payer: UHC Core |
$268.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.50
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 24200
|
| Hospital Charge Code |
24200
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$318.13 |
| Rate for Payer: Aetna Commercial |
$182.96
|
| Rate for Payer: Aetna Medicare |
$142.00
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$136.54
|
| Rate for Payer: BCBS Trust/PPO |
$116.23
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$136.54
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$196.62
|
| Rate for Payer: Cofinity Commercial |
$182.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.54
|
| Rate for Payer: Mclaren Medicaid |
$91.59
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$143.37
|
| Rate for Payer: PACE SWMI |
$136.54
|
| Rate for Payer: PHP Medicare Advantage |
$136.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.97
|
| Rate for Payer: Priority Health Medicare |
$136.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.54
|
| Rate for Payer: UHC Medicare Advantage |
$140.64
|
|
|
PR RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA
|
Professional
|
Both
|
$3,227.94
|
|
|
Service Code
|
HCPCS 27091
|
| Min. Negotiated Rate |
$538.87 |
| Max. Negotiated Rate |
$2,429.16 |
| Rate for Payer: Aetna Commercial |
$2,102.90
|
| Rate for Payer: Aetna Medicare |
$1,632.10
|
| Rate for Payer: BCBS Complete |
$1,069.94
|
| Rate for Payer: BCBS MAPPO |
$1,569.33
|
| Rate for Payer: BCBS Trust/PPO |
$538.87
|
| Rate for Payer: BCN Commercial |
$2,324.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,569.33
|
| Rate for Payer: Cash Price |
$2,582.35
|
| Rate for Payer: Cash Price |
$2,582.35
|
| Rate for Payer: Cofinity Commercial |
$2,259.84
|
| Rate for Payer: Cofinity Commercial |
$2,102.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,569.33
|
| Rate for Payer: Mclaren Medicaid |
$1,018.99
|
| Rate for Payer: Meridian Medicaid |
$1,069.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,647.80
|
| Rate for Payer: PACE SWMI |
$1,569.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,569.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,018.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,259.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,429.16
|
| Rate for Payer: Priority Health Medicare |
$1,569.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,429.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,569.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,569.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,616.41
|
|
|
PR RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 33971
|
| Min. Negotiated Rate |
$446.02 |
| Max. Negotiated Rate |
$1,801.80 |
| Rate for Payer: Aetna Commercial |
$929.92
|
| Rate for Payer: Aetna Medicare |
$721.73
|
| Rate for Payer: BCBS Complete |
$468.32
|
| Rate for Payer: BCBS MAPPO |
$693.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.81
|
| Rate for Payer: BCN Commercial |
$1,016.94
|
| Rate for Payer: BCN Medicare Advantage |
$693.97
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$929.92
|
| Rate for Payer: Cofinity Commercial |
$999.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$693.97
|
| Rate for Payer: Mclaren Medicaid |
$446.02
|
| Rate for Payer: Meridian Medicaid |
$468.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$728.67
|
| Rate for Payer: PACE SWMI |
$693.97
|
| Rate for Payer: PHP Medicare Advantage |
$693.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.00
|
| Rate for Payer: Priority Health Medicare |
$693.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,107.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$693.97
|
| Rate for Payer: UHC Medicare Advantage |
$714.79
|
|
