|
PR RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD
|
Professional
|
Both
|
$2,245.00
|
|
|
Service Code
|
HCPCS 54417
|
| Min. Negotiated Rate |
$571.69 |
| Max. Negotiated Rate |
$2,176.77 |
| Rate for Payer: Aetna Commercial |
$1,176.59
|
| Rate for Payer: Aetna Medicare |
$913.17
|
| Rate for Payer: BCBS Complete |
$600.27
|
| Rate for Payer: BCBS MAPPO |
$878.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,176.77
|
| Rate for Payer: BCN Commercial |
$1,295.97
|
| Rate for Payer: BCN Medicare Advantage |
$878.05
|
| Rate for Payer: Cash Price |
$1,796.00
|
| Rate for Payer: Cash Price |
$1,796.00
|
| Rate for Payer: Cofinity Commercial |
$1,264.39
|
| Rate for Payer: Cofinity Commercial |
$1,176.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$878.05
|
| Rate for Payer: Mclaren Medicaid |
$571.69
|
| Rate for Payer: Meridian Medicaid |
$600.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$921.95
|
| Rate for Payer: PACE SWMI |
$878.05
|
| Rate for Payer: PHP Medicare Advantage |
$878.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,433.03
|
| Rate for Payer: Priority Health Medicare |
$878.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,433.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$878.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$878.05
|
| Rate for Payer: UHC Medicare Advantage |
$904.39
|
|
|
PR RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 50387
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$3,379.54 |
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: Aetna Medicare |
$84.55
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS MAPPO |
$81.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,379.54
|
| Rate for Payer: BCN Commercial |
$822.45
|
| Rate for Payer: BCN Medicare Advantage |
$81.30
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$108.94
|
| Rate for Payer: Cofinity Commercial |
$117.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.30
|
| Rate for Payer: Mclaren Medicaid |
$51.55
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.36
|
| Rate for Payer: PACE SWMI |
$81.30
|
| Rate for Payer: PHP Medicare Advantage |
$81.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.31
|
| Rate for Payer: Priority Health Medicare |
$81.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.30
|
| Rate for Payer: UHC Medicare Advantage |
$83.74
|
|
|
PR RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 69711
|
| Min. Negotiated Rate |
$539.10 |
| Max. Negotiated Rate |
$3,026.10 |
| Rate for Payer: Aetna Commercial |
$1,102.97
|
| Rate for Payer: Aetna Medicare |
$856.03
|
| Rate for Payer: BCBS Complete |
$566.06
|
| Rate for Payer: BCBS MAPPO |
$823.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,026.10
|
| Rate for Payer: BCN Commercial |
$1,238.80
|
| Rate for Payer: BCN Medicare Advantage |
$823.11
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,185.28
|
| Rate for Payer: Cofinity Commercial |
$1,102.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$823.11
|
| Rate for Payer: Mclaren Medicaid |
$539.10
|
| Rate for Payer: Meridian Medicaid |
$566.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$864.27
|
| Rate for Payer: PACE SWMI |
$823.11
|
| Rate for Payer: PHP Medicare Advantage |
$823.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,165.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,195.15
|
| Rate for Payer: Priority Health Medicare |
$823.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,195.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$823.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$823.11
|
| Rate for Payer: UHC Medicare Advantage |
$847.80
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,123.00
|
|
|
Service Code
|
HCPCS 19330
|
| Min. Negotiated Rate |
$414.50 |
| Max. Negotiated Rate |
$947.54 |
| Rate for Payer: Aetna Commercial |
$850.99
|
| Rate for Payer: Aetna Medicare |
$660.47
|
| Rate for Payer: BCBS Complete |
$435.22
|
| Rate for Payer: BCBS MAPPO |
$635.07
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$947.54
|
| Rate for Payer: BCN Medicare Advantage |
$635.07
|
| Rate for Payer: Cash Price |
$898.40
|
| Rate for Payer: Cash Price |
$898.40
|
| Rate for Payer: Cofinity Commercial |
$914.50
|
| Rate for Payer: Cofinity Commercial |
$850.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$635.07
|
| Rate for Payer: Mclaren Medicaid |
$414.50
|
| Rate for Payer: Meridian Medicaid |
$435.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$666.82
|
| Rate for Payer: PACE SWMI |
$635.07
|
| Rate for Payer: PHP Medicare Advantage |
$635.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$786.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.00
|
| Rate for Payer: Priority Health Medicare |
$635.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$635.07
|
| Rate for Payer: UHC Medicare Advantage |
$654.12
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$40.85 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna Commercial |
$146.20
|
| Rate for Payer: Aetna Medicare |
$44.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.75
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$43.00
|
| Rate for Payer: BCBS Trust/PPO |
$133.73
|
| Rate for Payer: BCN Commercial |
$133.73
|
| Rate for Payer: BCN Medicare Advantage |
$43.00
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$147.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$154.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.00
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$146.20
|
| Rate for Payer: PACE Senior Care Partners |
$40.85
|
| Rate for Payer: PACE SWMI |
$43.00
|
| Rate for Payer: PHP Commercial |
$146.20
|
| Rate for Payer: PHP Medicare Advantage |
$43.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.64
|
| Rate for Payer: Priority Health Medicare |
$43.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.90
|
| Rate for Payer: Railroad Medicare Medicare |
$43.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.36
|
| Rate for Payer: UHC Core |
$143.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.00
|
| Rate for Payer: UHC Medicare Advantage |
$44.29
|
| Rate for Payer: VA VA |
$43.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.00
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$104.90 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna Commercial |
$146.20
|
| Rate for Payer: BCBS Trust/PPO |
$132.92
|
| Rate for Payer: BCN Commercial |
$132.92
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$147.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.60
|
| Rate for Payer: Healthscope Commercial |
$154.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$146.20
|
| Rate for Payer: PHP Commercial |
$146.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.36
|
| Rate for Payer: UHC Core |
$143.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.00
|
|
|
PR RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR
|
Professional
|
Both
|
$3,865.00
|
|
|
Service Code
|
HCPCS 63662
|
| Min. Negotiated Rate |
$553.59 |
| Max. Negotiated Rate |
$2,705.50 |
| Rate for Payer: Aetna Commercial |
$1,132.61
|
| Rate for Payer: Aetna Medicare |
$879.04
|
| Rate for Payer: BCBS Complete |
$581.27
|
| Rate for Payer: BCBS MAPPO |
$845.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.15
|
| Rate for Payer: BCN Commercial |
$1,251.99
|
| Rate for Payer: BCN Medicare Advantage |
$845.23
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cofinity Commercial |
$1,132.61
|
| Rate for Payer: Cofinity Commercial |
$1,217.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$845.23
|
| Rate for Payer: Mclaren Medicaid |
$553.59
|
| Rate for Payer: Meridian Medicaid |
$581.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$887.49
|
| Rate for Payer: PACE SWMI |
$845.23
|
| Rate for Payer: PHP Medicare Advantage |
$845.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,705.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,450.66
|
| Rate for Payer: Priority Health Medicare |
$845.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,450.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$845.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$845.23
|
| Rate for Payer: UHC Medicare Advantage |
$870.59
|
|
|
PR RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 63661
|
| Min. Negotiated Rate |
$211.94 |
| Max. Negotiated Rate |
$1,249.50 |
| Rate for Payer: Aetna Commercial |
$433.20
|
| Rate for Payer: Aetna Medicare |
$336.21
|
| Rate for Payer: BCBS Complete |
$222.54
|
| Rate for Payer: BCBS MAPPO |
$323.28
|
| Rate for Payer: BCBS Trust/PPO |
$409.43
|
| Rate for Payer: BCN Commercial |
$1,003.26
|
| Rate for Payer: BCN Medicare Advantage |
$323.28
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$465.52
|
| Rate for Payer: Cofinity Commercial |
$433.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.28
|
| Rate for Payer: Mclaren Medicaid |
$211.94
|
| Rate for Payer: Meridian Medicaid |
$222.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$339.44
|
| Rate for Payer: PACE SWMI |
$323.28
|
| Rate for Payer: PHP Medicare Advantage |
$323.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,249.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.89
|
| Rate for Payer: Priority Health Medicare |
$323.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.28
|
| Rate for Payer: UHC Medicare Advantage |
$332.98
|
|
|
PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS
|
Professional
|
Both
|
$1,486.00
|
|
|
Service Code
|
HCPCS 62365
|
| Min. Negotiated Rate |
$178.57 |
| Max. Negotiated Rate |
$1,040.20 |
| Rate for Payer: Aetna Commercial |
$391.32
|
| Rate for Payer: Aetna Medicare |
$303.71
|
| Rate for Payer: BCBS Complete |
$202.63
|
| Rate for Payer: BCBS MAPPO |
$292.03
|
| Rate for Payer: BCBS Trust/PPO |
$178.57
|
| Rate for Payer: BCN Commercial |
$434.93
|
| Rate for Payer: BCN Medicare Advantage |
$292.03
|
| Rate for Payer: Cash Price |
$1,188.80
|
| Rate for Payer: Cash Price |
$1,188.80
|
| Rate for Payer: Cofinity Commercial |
$420.52
|
| Rate for Payer: Cofinity Commercial |
$391.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.03
|
| Rate for Payer: Mclaren Medicaid |
$192.98
|
| Rate for Payer: Meridian Medicaid |
$202.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$306.63
|
| Rate for Payer: PACE SWMI |
$292.03
|
| Rate for Payer: PHP Medicare Advantage |
$292.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,040.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$503.95
|
| Rate for Payer: Priority Health Medicare |
$292.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.03
|
| Rate for Payer: UHC Medicare Advantage |
$300.79
|
|
|
PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
|
Professional
|
Both
|
$1,596.00
|
|
|
Service Code
|
HCPCS 26392
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$1,551.86 |
| Rate for Payer: Aetna Commercial |
$1,315.33
|
| Rate for Payer: Aetna Medicare |
$1,020.85
|
| Rate for Payer: BCBS Complete |
$679.00
|
| Rate for Payer: BCBS MAPPO |
$981.59
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$1,485.09
|
| Rate for Payer: BCN Medicare Advantage |
$981.59
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cofinity Commercial |
$1,413.49
|
| Rate for Payer: Cofinity Commercial |
$1,315.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.59
|
| Rate for Payer: Mclaren Medicaid |
$646.67
|
| Rate for Payer: Meridian Medicaid |
$679.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,030.67
|
| Rate for Payer: PACE SWMI |
$981.59
|
| Rate for Payer: PHP Medicare Advantage |
$981.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$646.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,551.86
|
| Rate for Payer: Priority Health Medicare |
$981.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,551.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$981.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,011.04
|
|
|
PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL
|
Professional
|
Both
|
$463.00
|
|
|
Service Code
|
HCPCS 46754
|
| Min. Negotiated Rate |
$156.13 |
| Max. Negotiated Rate |
$512.14 |
| Rate for Payer: Aetna Commercial |
$314.24
|
| Rate for Payer: Aetna Medicare |
$243.89
|
| Rate for Payer: BCBS Complete |
$163.94
|
| Rate for Payer: BCBS MAPPO |
$234.51
|
| Rate for Payer: BCBS Trust/PPO |
$396.75
|
| Rate for Payer: BCN Commercial |
$512.14
|
| Rate for Payer: BCN Medicare Advantage |
$234.51
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cofinity Commercial |
$337.69
|
| Rate for Payer: Cofinity Commercial |
$314.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.51
|
| Rate for Payer: Mclaren Medicaid |
$156.13
|
| Rate for Payer: Meridian Medicaid |
$163.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$246.24
|
| Rate for Payer: PACE SWMI |
$234.51
|
| Rate for Payer: PHP Medicare Advantage |
$234.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.10
|
| Rate for Payer: Priority Health Medicare |
$234.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.51
|
| Rate for Payer: UHC Medicare Advantage |
$241.55
|
|
|
PR RMVL TRANSVNS PM ELTRD DUAL LEAD SYS
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 33235
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$1,206.11 |
| Rate for Payer: Aetna Commercial |
$836.91
|
| Rate for Payer: Aetna Medicare |
$649.54
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS MAPPO |
$624.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.11
|
| Rate for Payer: BCN Commercial |
$921.64
|
| Rate for Payer: BCN Medicare Advantage |
$624.56
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$899.37
|
| Rate for Payer: Cofinity Commercial |
$836.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.56
|
| Rate for Payer: Mclaren Medicaid |
$399.80
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$655.79
|
| Rate for Payer: PACE SWMI |
$624.56
|
| Rate for Payer: PHP Medicare Advantage |
$624.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.27
|
| Rate for Payer: Priority Health Medicare |
$624.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,003.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.56
|
| Rate for Payer: UHC Medicare Advantage |
$643.30
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
IP
|
$702.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$428.15 |
| Max. Negotiated Rate |
$631.80 |
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: BCBS Trust/PPO |
$542.51
|
| Rate for Payer: BCN Commercial |
$542.51
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$603.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.60
|
| Rate for Payer: Healthscope Commercial |
$631.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$596.70
|
| Rate for Payer: PHP Commercial |
$596.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$428.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.76
|
| Rate for Payer: UHC Core |
$586.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.50
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 36590
|
| Hospital Charge Code |
36590
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$1,132.68 |
| Rate for Payer: Aetna Commercial |
$249.07
|
| Rate for Payer: Aetna Medicare |
$193.30
|
| Rate for Payer: BCBS Complete |
$125.70
|
| Rate for Payer: BCBS MAPPO |
$185.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.68
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$185.87
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$249.07
|
| Rate for Payer: Cofinity Commercial |
$267.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.87
|
| Rate for Payer: Mclaren Medicaid |
$119.71
|
| Rate for Payer: Meridian Medicaid |
$125.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.16
|
| Rate for Payer: PACE SWMI |
$185.87
|
| Rate for Payer: PHP Medicare Advantage |
$185.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.97
|
| Rate for Payer: Priority Health Medicare |
$185.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.87
|
| Rate for Payer: UHC Medicare Advantage |
$191.45
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 36590
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$1,132.68 |
| Rate for Payer: Aetna Commercial |
$249.07
|
| Rate for Payer: Aetna Medicare |
$193.30
|
| Rate for Payer: BCBS Complete |
$125.70
|
| Rate for Payer: BCBS MAPPO |
$185.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.68
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$185.87
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$267.65
|
| Rate for Payer: Cofinity Commercial |
$249.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.87
|
| Rate for Payer: Mclaren Medicaid |
$119.71
|
| Rate for Payer: Meridian Medicaid |
$125.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.16
|
| Rate for Payer: PACE SWMI |
$185.87
|
| Rate for Payer: PHP Medicare Advantage |
$185.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.97
|
| Rate for Payer: Priority Health Medicare |
$185.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.87
|
| Rate for Payer: UHC Medicare Advantage |
$191.45
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
OP
|
$702.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$166.72 |
| Max. Negotiated Rate |
$1,103.12 |
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: Aetna Medicare |
$182.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.38
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$175.50
|
| Rate for Payer: BCBS Trust/PPO |
$545.80
|
| Rate for Payer: BCN Commercial |
$545.80
|
| Rate for Payer: BCN Medicare Advantage |
$175.50
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$603.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.50
|
| Rate for Payer: Healthscope Commercial |
$631.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.50
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$596.70
|
| Rate for Payer: PACE Senior Care Partners |
$166.72
|
| Rate for Payer: PACE SWMI |
$175.50
|
| Rate for Payer: PHP Commercial |
$596.70
|
| Rate for Payer: PHP Medicare Advantage |
$175.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.74
|
| Rate for Payer: Priority Health Medicare |
$175.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$428.15
|
| Rate for Payer: Railroad Medicare Medicare |
$175.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.76
|
| Rate for Payer: UHC Core |
$586.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.50
|
| Rate for Payer: UHC Medicare Advantage |
$180.76
|
| Rate for Payer: VA VA |
$175.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.50
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 36589
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$1,048.15 |
| Rate for Payer: Aetna Commercial |
$178.89
|
| Rate for Payer: Aetna Medicare |
$138.84
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$133.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.15
|
| Rate for Payer: BCN Commercial |
$240.92
|
| Rate for Payer: BCN Medicare Advantage |
$133.50
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Cofinity Commercial |
$192.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.50
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.18
|
| Rate for Payer: PACE SWMI |
$133.50
|
| Rate for Payer: PHP Medicare Advantage |
$133.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.90
|
| Rate for Payer: Priority Health Medicare |
$133.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.50
|
| Rate for Payer: UHC Medicare Advantage |
$137.50
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
IP
|
$421.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$256.77 |
| Max. Negotiated Rate |
$378.90 |
| Rate for Payer: Aetna Commercial |
$357.85
|
| Rate for Payer: BCBS Trust/PPO |
$325.35
|
| Rate for Payer: BCN Commercial |
$325.35
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$362.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.80
|
| Rate for Payer: Healthscope Commercial |
$378.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.85
|
| Rate for Payer: PHP Commercial |
$357.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$366.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.48
|
| Rate for Payer: UHC Core |
$351.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.75
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$1,048.15 |
| Rate for Payer: Aetna Commercial |
$178.89
|
| Rate for Payer: Aetna Medicare |
$138.84
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$133.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.15
|
| Rate for Payer: BCN Commercial |
$240.92
|
| Rate for Payer: BCN Medicare Advantage |
$133.50
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$192.24
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.50
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.18
|
| Rate for Payer: PACE SWMI |
$133.50
|
| Rate for Payer: PHP Medicare Advantage |
$133.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.90
|
| Rate for Payer: Priority Health Medicare |
$133.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.50
|
| Rate for Payer: UHC Medicare Advantage |
$137.50
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
OP
|
$421.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$99.99 |
| Max. Negotiated Rate |
$432.70 |
| Rate for Payer: Aetna Commercial |
$357.85
|
| Rate for Payer: Aetna Medicare |
$109.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.56
|
| Rate for Payer: BCBS Complete |
$432.70
|
| Rate for Payer: BCBS MAPPO |
$105.25
|
| Rate for Payer: BCBS Trust/PPO |
$327.33
|
| Rate for Payer: BCN Commercial |
$327.33
|
| Rate for Payer: BCN Medicare Advantage |
$105.25
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$362.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.25
|
| Rate for Payer: Healthscope Commercial |
$378.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.75
|
| Rate for Payer: Mclaren Medicaid |
$412.10
|
| Rate for Payer: Meridian Medicaid |
$432.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.85
|
| Rate for Payer: PACE Senior Care Partners |
$99.99
|
| Rate for Payer: PACE SWMI |
$105.25
|
| Rate for Payer: PHP Commercial |
$357.85
|
| Rate for Payer: PHP Medicare Advantage |
$105.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$366.27
|
| Rate for Payer: Priority Health Medicare |
$105.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.77
|
| Rate for Payer: Railroad Medicare Medicare |
$105.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.48
|
| Rate for Payer: UHC Core |
$351.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.25
|
| Rate for Payer: UHC Medicare Advantage |
$108.41
|
| Rate for Payer: VA VA |
$105.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.75
|
|
|
PR RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11983
|
| Min. Negotiated Rate |
$65.60 |
| Max. Negotiated Rate |
$532.50 |
| Rate for Payer: Aetna Commercial |
$137.67
|
| Rate for Payer: Aetna Medicare |
$106.85
|
| Rate for Payer: BCBS Complete |
$68.88
|
| Rate for Payer: BCBS MAPPO |
$102.74
|
| Rate for Payer: BCBS Trust/PPO |
$532.50
|
| Rate for Payer: BCN Commercial |
$208.18
|
| Rate for Payer: BCN Medicare Advantage |
$102.74
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$137.67
|
| Rate for Payer: Cofinity Commercial |
$147.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.74
|
| Rate for Payer: Mclaren Medicaid |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$68.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.88
|
| Rate for Payer: PACE SWMI |
$102.74
|
| Rate for Payer: PHP Medicare Advantage |
$102.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.60
|
| Rate for Payer: Priority Health Medicare |
$102.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.74
|
| Rate for Payer: UHC Medicare Advantage |
$105.82
|
|
|
PR RNL EXPL X NECESSITATING OTH SPEC PX
|
Professional
|
Both
|
$2,465.00
|
|
|
Service Code
|
HCPCS 50010
|
| Min. Negotiated Rate |
$449.64 |
| Max. Negotiated Rate |
$3,137.57 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: Aetna Medicare |
$763.07
|
| Rate for Payer: BCBS Complete |
$472.12
|
| Rate for Payer: BCBS MAPPO |
$733.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,137.57
|
| Rate for Payer: BCN Commercial |
$1,082.91
|
| Rate for Payer: BCN Medicare Advantage |
$733.72
|
| Rate for Payer: Cash Price |
$1,972.00
|
| Rate for Payer: Cash Price |
$1,972.00
|
| Rate for Payer: Cofinity Commercial |
$983.18
|
| Rate for Payer: Cofinity Commercial |
$1,056.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$733.72
|
| Rate for Payer: Mclaren Medicaid |
$449.64
|
| Rate for Payer: Meridian Medicaid |
$472.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$770.41
|
| Rate for Payer: PACE SWMI |
$733.72
|
| Rate for Payer: PHP Medicare Advantage |
$733.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,725.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,197.43
|
| Rate for Payer: Priority Health Medicare |
$733.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,197.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$733.72
|
| Rate for Payer: UHC Medicare Advantage |
$755.73
|
|
|
PR RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY
|
Professional
|
Both
|
$1,359.00
|
|
|
Service Code
|
HCPCS 50575
|
| Min. Negotiated Rate |
$446.66 |
| Max. Negotiated Rate |
$1,123.94 |
| Rate for Payer: Aetna Commercial |
$929.37
|
| Rate for Payer: Aetna Medicare |
$721.30
|
| Rate for Payer: BCBS Complete |
$468.99
|
| Rate for Payer: BCBS MAPPO |
$693.56
|
| Rate for Payer: BCBS Trust/PPO |
$838.41
|
| Rate for Payer: BCN Commercial |
$1,016.45
|
| Rate for Payer: BCN Medicare Advantage |
$693.56
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cofinity Commercial |
$929.37
|
| Rate for Payer: Cofinity Commercial |
$998.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$693.56
|
| Rate for Payer: Mclaren Medicaid |
$446.66
|
| Rate for Payer: Meridian Medicaid |
$468.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$728.24
|
| Rate for Payer: PACE SWMI |
$693.56
|
| Rate for Payer: PHP Medicare Advantage |
$693.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$951.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,123.94
|
| Rate for Payer: Priority Health Medicare |
$693.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,123.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$693.56
|
| Rate for Payer: UHC Medicare Advantage |
$714.37
|
|
|
PR ROBOTIC SURGICAL SYSTEM
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS S2900
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$486.56 |
| Rate for Payer: Aetna Commercial |
$318.14
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$50.51
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
|
|
PR ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 95852
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$1,012.22 |
| Rate for Payer: Aetna Commercial |
$7.14
|
| Rate for Payer: Aetna Medicare |
$5.54
|
| Rate for Payer: BCBS Complete |
$3.58
|
| Rate for Payer: BCBS MAPPO |
$5.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.22
|
| Rate for Payer: BCN Commercial |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$5.33
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$7.68
|
| Rate for Payer: Cofinity Commercial |
$7.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.33
|
| Rate for Payer: Mclaren Medicaid |
$3.41
|
| Rate for Payer: Meridian Medicaid |
$3.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.60
|
| Rate for Payer: PACE SWMI |
$5.33
|
| Rate for Payer: PHP Medicare Advantage |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.18
|
| Rate for Payer: Priority Health Medicare |
$5.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.33
|
| Rate for Payer: UHC Medicare Advantage |
$5.49
|
|
