|
PR GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 94727
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$251.47 |
| Rate for Payer: Aetna Commercial |
$54.54
|
| Rate for Payer: Aetna Medicare |
$42.33
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$40.70
|
| Rate for Payer: BCBS Trust/PPO |
$251.47
|
| Rate for Payer: BCN Commercial |
$63.53
|
| Rate for Payer: BCN Medicare Advantage |
$40.70
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$58.61
|
| Rate for Payer: Cofinity Commercial |
$54.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.70
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.74
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Nomi Health Commercial |
$48.84
|
| Rate for Payer: PACE SWMI |
$40.70
|
| Rate for Payer: PHP Medicare Advantage |
$40.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.95
|
| Rate for Payer: Priority Health HMO/PPO |
$15.83
|
| Rate for Payer: Priority Health Medicare |
$41.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.70
|
| Rate for Payer: UHC Exchange |
$40.70
|
| Rate for Payer: UHC Medicare Advantage |
$40.70
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
|
|
PR GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 43753
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$192.83 |
| Rate for Payer: Aetna Commercial |
$27.80
|
| Rate for Payer: Aetna Medicare |
$21.58
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$20.75
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$31.27
|
| Rate for Payer: BCN Medicare Advantage |
$20.75
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$29.88
|
| Rate for Payer: Cofinity Commercial |
$27.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.75
|
| Rate for Payer: Mclaren Medicaid |
$13.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.79
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Nomi Health Commercial |
$24.90
|
| Rate for Payer: PACE SWMI |
$20.75
|
| Rate for Payer: PHP Medicare Advantage |
$20.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health HMO/PPO |
$38.17
|
| Rate for Payer: Priority Health Medicare |
$20.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.75
|
| Rate for Payer: UHC Exchange |
$20.75
|
| Rate for Payer: UHC Medicare Advantage |
$20.75
|
| Rate for Payer: UHCCP Medicaid |
$13.63
|
|
|
PR GASTROCNEMIUS RECESSION
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 27687
|
| Min. Negotiated Rate |
$296.71 |
| Max. Negotiated Rate |
$2,402.71 |
| Rate for Payer: Aetna Commercial |
$585.22
|
| Rate for Payer: Aetna Medicare |
$454.20
|
| Rate for Payer: BCBS Complete |
$311.55
|
| Rate for Payer: BCBS MAPPO |
$436.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,402.71
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: BCN Medicare Advantage |
$436.73
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$628.89
|
| Rate for Payer: Cofinity Commercial |
$585.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.73
|
| Rate for Payer: Mclaren Medicaid |
$296.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.57
|
| Rate for Payer: Meridian Medicaid |
$311.55
|
| Rate for Payer: Nomi Health Commercial |
$524.08
|
| Rate for Payer: PACE SWMI |
$436.73
|
| Rate for Payer: PHP Medicare Advantage |
$436.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.70
|
| Rate for Payer: Priority Health HMO/PPO |
$702.74
|
| Rate for Payer: Priority Health Medicare |
$441.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.73
|
| Rate for Payer: UHC Exchange |
$436.73
|
| Rate for Payer: UHC Medicare Advantage |
$436.73
|
| Rate for Payer: UHCCP Medicaid |
$296.71
|
|
|
PR GASTRODUODENOSTOMY
|
Professional
|
Both
|
$2,486.00
|
|
|
Service Code
|
HCPCS 43810
|
| Min. Negotiated Rate |
$486.56 |
| Max. Negotiated Rate |
$1,823.20 |
| Rate for Payer: Aetna Commercial |
$1,328.28
|
| Rate for Payer: Aetna Medicare |
$1,030.90
|
| Rate for Payer: BCBS Complete |
$687.73
|
| Rate for Payer: BCBS MAPPO |
$991.25
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,485.09
|
| Rate for Payer: BCN Medicare Advantage |
$991.25
|
| Rate for Payer: Cash Price |
$1,988.80
|
| Rate for Payer: Cash Price |
$1,988.80
|
| Rate for Payer: Cofinity Commercial |
$1,427.40
|
| Rate for Payer: Cofinity Commercial |
$1,328.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$991.25
|
| Rate for Payer: Mclaren Medicaid |
$654.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,040.81
|
| Rate for Payer: Meridian Medicaid |
$687.73
|
| Rate for Payer: Nomi Health Commercial |
$1,189.50
|
| Rate for Payer: PACE SWMI |
$991.25
|
| Rate for Payer: PHP Medicare Advantage |
$991.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,615.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,823.20
|
| Rate for Payer: Priority Health Medicare |
$1,001.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,823.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$991.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$991.25
|
| Rate for Payer: UHC Exchange |
$991.25
|
| Rate for Payer: UHC Medicare Advantage |
$991.25
|
| Rate for Payer: UHCCP Medicaid |
$654.98
|
|
|
PR GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 91034
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$1,518.86 |
| Rate for Payer: Aetna Commercial |
$225.66
|
| Rate for Payer: Aetna Commercial |
$225.66
|
| Rate for Payer: Aetna Medicare |
$175.14
|
| Rate for Payer: Aetna Medicare |
$175.14
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$168.40
|
| Rate for Payer: BCBS MAPPO |
$168.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.86
|
| Rate for Payer: BCN Commercial |
$281.97
|
| Rate for Payer: BCN Commercial |
$281.97
|
| Rate for Payer: BCN Medicare Advantage |
$168.40
|
| Rate for Payer: BCN Medicare Advantage |
$168.40
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$242.50
|
| Rate for Payer: Cofinity Commercial |
$225.66
|
| Rate for Payer: Cofinity Commercial |
$242.50
|
| Rate for Payer: Cofinity Commercial |
$225.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.40
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.82
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Nomi Health Commercial |
$202.08
|
| Rate for Payer: Nomi Health Commercial |
$202.08
|
| Rate for Payer: PACE SWMI |
$168.40
|
| Rate for Payer: PACE SWMI |
$168.40
|
| Rate for Payer: PHP Medicare Advantage |
$168.40
|
| Rate for Payer: PHP Medicare Advantage |
$168.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health HMO/PPO |
$66.04
|
| Rate for Payer: Priority Health HMO/PPO |
$66.04
|
| Rate for Payer: Priority Health Medicare |
$170.08
|
| Rate for Payer: Priority Health Medicare |
$170.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$168.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$168.40
|
| Rate for Payer: UHC Exchange |
$168.40
|
| Rate for Payer: UHC Exchange |
$168.40
|
| Rate for Payer: UHC Medicare Advantage |
$168.40
|
| Rate for Payer: UHC Medicare Advantage |
$168.40
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
PR GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 91037
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$963.09 |
| Rate for Payer: Aetna Commercial |
$199.89
|
| Rate for Payer: Aetna Commercial |
$199.89
|
| Rate for Payer: Aetna Medicare |
$155.14
|
| Rate for Payer: Aetna Medicare |
$155.14
|
| Rate for Payer: BCBS Complete |
$32.20
|
| Rate for Payer: BCBS Complete |
$32.20
|
| Rate for Payer: BCBS MAPPO |
$149.17
|
| Rate for Payer: BCBS MAPPO |
$149.17
|
| Rate for Payer: BCBS Trust/PPO |
$963.09
|
| Rate for Payer: BCBS Trust/PPO |
$963.09
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Medicare Advantage |
$149.17
|
| Rate for Payer: BCN Medicare Advantage |
$149.17
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$199.89
|
| Rate for Payer: Cofinity Commercial |
$214.80
|
| Rate for Payer: Cofinity Commercial |
$199.89
|
| Rate for Payer: Cofinity Commercial |
$214.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.17
|
| Rate for Payer: Mclaren Medicaid |
$30.67
|
| Rate for Payer: Mclaren Medicaid |
$30.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.63
|
| Rate for Payer: Meridian Medicaid |
$32.20
|
| Rate for Payer: Meridian Medicaid |
$32.20
|
| Rate for Payer: Nomi Health Commercial |
$179.00
|
| Rate for Payer: Nomi Health Commercial |
$179.00
|
| Rate for Payer: PACE SWMI |
$149.17
|
| Rate for Payer: PACE SWMI |
$149.17
|
| Rate for Payer: PHP Medicare Advantage |
$149.17
|
| Rate for Payer: PHP Medicare Advantage |
$149.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO |
$64.68
|
| Rate for Payer: Priority Health HMO/PPO |
$64.68
|
| Rate for Payer: Priority Health Medicare |
$150.66
|
| Rate for Payer: Priority Health Medicare |
$150.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.17
|
| Rate for Payer: UHC Exchange |
$149.17
|
| Rate for Payer: UHC Exchange |
$149.17
|
| Rate for Payer: UHC Medicare Advantage |
$149.17
|
| Rate for Payer: UHC Medicare Advantage |
$149.17
|
| Rate for Payer: UHCCP Medicaid |
$30.67
|
| Rate for Payer: UHCCP Medicaid |
$30.67
|
|
|
PR GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD
|
Professional
|
Both
|
$875.00
|
|
|
Service Code
|
HCPCS 91035
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$976.30 |
| Rate for Payer: Aetna Commercial |
$525.51
|
| Rate for Payer: Aetna Commercial |
$525.51
|
| Rate for Payer: Aetna Medicare |
$407.86
|
| Rate for Payer: Aetna Medicare |
$407.86
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCBS MAPPO |
$392.17
|
| Rate for Payer: BCBS MAPPO |
$392.17
|
| Rate for Payer: BCBS Trust/PPO |
$976.30
|
| Rate for Payer: BCBS Trust/PPO |
$976.30
|
| Rate for Payer: BCN Commercial |
$677.30
|
| Rate for Payer: BCN Commercial |
$677.30
|
| Rate for Payer: BCN Medicare Advantage |
$392.17
|
| Rate for Payer: BCN Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Cofinity Commercial |
$525.51
|
| Rate for Payer: Cofinity Commercial |
$564.72
|
| Rate for Payer: Cofinity Commercial |
$525.51
|
| Rate for Payer: Cofinity Commercial |
$564.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.17
|
| Rate for Payer: Mclaren Medicaid |
$51.12
|
| Rate for Payer: Mclaren Medicaid |
$51.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.78
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Nomi Health Commercial |
$470.60
|
| Rate for Payer: Nomi Health Commercial |
$470.60
|
| Rate for Payer: PACE SWMI |
$392.17
|
| Rate for Payer: PACE SWMI |
$392.17
|
| Rate for Payer: PHP Medicare Advantage |
$392.17
|
| Rate for Payer: PHP Medicare Advantage |
$392.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.75
|
| Rate for Payer: Priority Health HMO/PPO |
$108.11
|
| Rate for Payer: Priority Health HMO/PPO |
$108.11
|
| Rate for Payer: Priority Health Medicare |
$396.09
|
| Rate for Payer: Priority Health Medicare |
$396.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.17
|
| Rate for Payer: UHC Exchange |
$392.17
|
| Rate for Payer: UHC Exchange |
$392.17
|
| Rate for Payer: UHC Medicare Advantage |
$392.17
|
| Rate for Payer: UHC Medicare Advantage |
$392.17
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
|
|
PR GASTROJEJUNOSTOMY W/O VAGOTOMY
|
Professional
|
Both
|
$2,621.00
|
|
|
Service Code
|
HCPCS 43820
|
| Min. Negotiated Rate |
$864.78 |
| Max. Negotiated Rate |
$2,409.05 |
| Rate for Payer: Aetna Commercial |
$1,752.87
|
| Rate for Payer: Aetna Medicare |
$1,360.43
|
| Rate for Payer: BCBS Complete |
$908.02
|
| Rate for Payer: BCBS MAPPO |
$1,308.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,050.26
|
| Rate for Payer: BCN Commercial |
$1,961.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,308.11
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,883.68
|
| Rate for Payer: Cofinity Commercial |
$1,752.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,308.11
|
| Rate for Payer: Mclaren Medicaid |
$864.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,373.52
|
| Rate for Payer: Meridian Medicaid |
$908.02
|
| Rate for Payer: Nomi Health Commercial |
$1,569.73
|
| Rate for Payer: PACE SWMI |
$1,308.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,308.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$864.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,409.05
|
| Rate for Payer: Priority Health Medicare |
$1,321.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,409.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,308.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,308.11
|
| Rate for Payer: UHC Exchange |
$1,308.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,308.11
|
| Rate for Payer: UHCCP Medicaid |
$864.78
|
|
|
PR GASTROJEJUNOSTOMY W/VAGOTOMY ANY TYPE
|
Professional
|
Both
|
$2,581.00
|
|
|
Service Code
|
HCPCS 43825
|
| Min. Negotiated Rate |
$669.36 |
| Max. Negotiated Rate |
$2,349.98 |
| Rate for Payer: Aetna Commercial |
$1,711.54
|
| Rate for Payer: Aetna Medicare |
$1,328.36
|
| Rate for Payer: BCBS Complete |
$886.11
|
| Rate for Payer: BCBS MAPPO |
$1,277.27
|
| Rate for Payer: BCBS Trust/PPO |
$669.36
|
| Rate for Payer: BCN Commercial |
$1,915.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,277.27
|
| Rate for Payer: Cash Price |
$2,064.80
|
| Rate for Payer: Cash Price |
$2,064.80
|
| Rate for Payer: Cofinity Commercial |
$1,839.27
|
| Rate for Payer: Cofinity Commercial |
$1,711.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,277.27
|
| Rate for Payer: Mclaren Medicaid |
$843.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,341.13
|
| Rate for Payer: Meridian Medicaid |
$886.11
|
| Rate for Payer: Nomi Health Commercial |
$1,532.72
|
| Rate for Payer: PACE SWMI |
$1,277.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,277.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$843.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,349.98
|
| Rate for Payer: Priority Health Medicare |
$1,290.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,349.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,277.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,277.27
|
| Rate for Payer: UHC Exchange |
$1,277.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,277.27
|
| Rate for Payer: UHCCP Medicaid |
$843.91
|
|
|
PR GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ
|
Professional
|
Both
|
$2,821.00
|
|
|
Service Code
|
HCPCS 43840
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$2,434.10 |
| Rate for Payer: Aetna Commercial |
$1,772.31
|
| Rate for Payer: Aetna Medicare |
$1,375.52
|
| Rate for Payer: BCBS Complete |
$917.86
|
| Rate for Payer: BCBS MAPPO |
$1,322.62
|
| Rate for Payer: BCBS Trust/PPO |
$75.56
|
| Rate for Payer: BCN Commercial |
$1,984.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,322.62
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cofinity Commercial |
$1,904.57
|
| Rate for Payer: Cofinity Commercial |
$1,772.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,322.62
|
| Rate for Payer: Mclaren Medicaid |
$874.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,388.75
|
| Rate for Payer: Meridian Medicaid |
$917.86
|
| Rate for Payer: Nomi Health Commercial |
$1,587.14
|
| Rate for Payer: PACE SWMI |
$1,322.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,322.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$874.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,833.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,434.10
|
| Rate for Payer: Priority Health Medicare |
$1,335.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,434.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,322.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,322.62
|
| Rate for Payer: UHC Exchange |
$1,322.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,322.62
|
| Rate for Payer: UHCCP Medicaid |
$874.15
|
|
|
PR GASTROSTOMY OPEN NEONATAL FOR FEEDING
|
Professional
|
Both
|
$2,132.00
|
|
|
Service Code
|
HCPCS 43831
|
| Min. Negotiated Rate |
$394.90 |
| Max. Negotiated Rate |
$1,385.80 |
| Rate for Payer: Aetna Commercial |
$789.25
|
| Rate for Payer: Aetna Medicare |
$612.55
|
| Rate for Payer: BCBS Complete |
$414.64
|
| Rate for Payer: BCBS MAPPO |
$588.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,286.41
|
| Rate for Payer: BCN Commercial |
$895.74
|
| Rate for Payer: BCN Medicare Advantage |
$588.99
|
| Rate for Payer: Cash Price |
$1,705.60
|
| Rate for Payer: Cash Price |
$1,705.60
|
| Rate for Payer: Cofinity Commercial |
$848.15
|
| Rate for Payer: Cofinity Commercial |
$789.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.99
|
| Rate for Payer: Mclaren Medicaid |
$394.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.44
|
| Rate for Payer: Meridian Medicaid |
$414.64
|
| Rate for Payer: Nomi Health Commercial |
$706.79
|
| Rate for Payer: PACE SWMI |
$588.99
|
| Rate for Payer: PHP Medicare Advantage |
$588.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,385.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,100.71
|
| Rate for Payer: Priority Health Medicare |
$594.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$588.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$588.99
|
| Rate for Payer: UHC Exchange |
$588.99
|
| Rate for Payer: UHC Medicare Advantage |
$588.99
|
| Rate for Payer: UHCCP Medicaid |
$394.90
|
|
|
PR GASTROSTOMY OPEN W/CONSTJ GASTRIC TUBE
|
Professional
|
Both
|
$2,934.00
|
|
|
Service Code
|
HCPCS 43832
|
| Min. Negotiated Rate |
$673.72 |
| Max. Negotiated Rate |
$1,907.10 |
| Rate for Payer: Aetna Commercial |
$1,364.23
|
| Rate for Payer: Aetna Medicare |
$1,058.80
|
| Rate for Payer: BCBS Complete |
$707.41
|
| Rate for Payer: BCBS MAPPO |
$1,018.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.84
|
| Rate for Payer: BCN Commercial |
$1,523.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,018.08
|
| Rate for Payer: Cash Price |
$2,347.20
|
| Rate for Payer: Cash Price |
$2,347.20
|
| Rate for Payer: Cofinity Commercial |
$1,466.04
|
| Rate for Payer: Cofinity Commercial |
$1,364.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,018.08
|
| Rate for Payer: Mclaren Medicaid |
$673.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,068.98
|
| Rate for Payer: Meridian Medicaid |
$707.41
|
| Rate for Payer: Nomi Health Commercial |
$1,221.70
|
| Rate for Payer: PACE SWMI |
$1,018.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,018.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,907.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,876.88
|
| Rate for Payer: Priority Health Medicare |
$1,028.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,876.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,018.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,018.08
|
| Rate for Payer: UHC Exchange |
$1,018.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,018.08
|
| Rate for Payer: UHCCP Medicaid |
$673.72
|
|
|
PR GASTROSTOMY OPEN W/O CONSTJ GASTRIC TUBE SPX
|
Professional
|
Both
|
$2,132.00
|
|
|
Service Code
|
HCPCS 43830
|
| Min. Negotiated Rate |
$281.06 |
| Max. Negotiated Rate |
$1,385.80 |
| Rate for Payer: Aetna Commercial |
$912.51
|
| Rate for Payer: Aetna Medicare |
$708.22
|
| Rate for Payer: BCBS Complete |
$476.15
|
| Rate for Payer: BCBS MAPPO |
$680.98
|
| Rate for Payer: BCBS Trust/PPO |
$281.06
|
| Rate for Payer: BCN Commercial |
$1,030.14
|
| Rate for Payer: BCN Medicare Advantage |
$680.98
|
| Rate for Payer: Cash Price |
$1,705.60
|
| Rate for Payer: Cash Price |
$1,705.60
|
| Rate for Payer: Cofinity Commercial |
$980.61
|
| Rate for Payer: Cofinity Commercial |
$912.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.98
|
| Rate for Payer: Mclaren Medicaid |
$453.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$715.03
|
| Rate for Payer: Meridian Medicaid |
$476.15
|
| Rate for Payer: Nomi Health Commercial |
$817.18
|
| Rate for Payer: PACE SWMI |
$680.98
|
| Rate for Payer: PHP Medicare Advantage |
$680.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,385.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,264.18
|
| Rate for Payer: Priority Health Medicare |
$687.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,264.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.98
|
| Rate for Payer: UHC Exchange |
$680.98
|
| Rate for Payer: UHC Medicare Advantage |
$680.98
|
| Rate for Payer: UHCCP Medicaid |
$453.48
|
|
|
PR GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$2,256.00
|
|
|
Service Code
|
HCPCS 43500
|
| Min. Negotiated Rate |
$508.22 |
| Max. Negotiated Rate |
$1,939.39 |
| Rate for Payer: Aetna Commercial |
$1,027.26
|
| Rate for Payer: Aetna Medicare |
$797.27
|
| Rate for Payer: BCBS Complete |
$533.63
|
| Rate for Payer: BCBS MAPPO |
$766.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,939.39
|
| Rate for Payer: BCN Commercial |
$1,144.97
|
| Rate for Payer: BCN Medicare Advantage |
$766.61
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cofinity Commercial |
$1,103.92
|
| Rate for Payer: Cofinity Commercial |
$1,027.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.61
|
| Rate for Payer: Mclaren Medicaid |
$508.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$804.94
|
| Rate for Payer: Meridian Medicaid |
$533.63
|
| Rate for Payer: Nomi Health Commercial |
$919.93
|
| Rate for Payer: PACE SWMI |
$766.61
|
| Rate for Payer: PHP Medicare Advantage |
$766.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,466.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,412.74
|
| Rate for Payer: Priority Health Medicare |
$774.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,412.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$766.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$766.61
|
| Rate for Payer: UHC Exchange |
$766.61
|
| Rate for Payer: UHC Medicare Advantage |
$766.61
|
| Rate for Payer: UHCCP Medicaid |
$508.22
|
|
|
PR GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER
|
Professional
|
Both
|
$3,976.00
|
|
|
Service Code
|
HCPCS 43501
|
| Min. Negotiated Rate |
$864.57 |
| Max. Negotiated Rate |
$2,584.40 |
| Rate for Payer: Aetna Commercial |
$1,752.75
|
| Rate for Payer: Aetna Medicare |
$1,360.34
|
| Rate for Payer: BCBS Complete |
$907.80
|
| Rate for Payer: BCBS MAPPO |
$1,308.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.41
|
| Rate for Payer: BCN Commercial |
$1,964.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,308.02
|
| Rate for Payer: Cash Price |
$3,180.80
|
| Rate for Payer: Cash Price |
$3,180.80
|
| Rate for Payer: Cofinity Commercial |
$1,883.55
|
| Rate for Payer: Cofinity Commercial |
$1,752.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,308.02
|
| Rate for Payer: Mclaren Medicaid |
$864.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,373.42
|
| Rate for Payer: Meridian Medicaid |
$907.80
|
| Rate for Payer: Nomi Health Commercial |
$1,569.62
|
| Rate for Payer: PACE SWMI |
$1,308.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,308.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$864.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,584.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,420.98
|
| Rate for Payer: Priority Health Medicare |
$1,321.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,420.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,308.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,308.02
|
| Rate for Payer: UHC Exchange |
$1,308.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,308.02
|
| Rate for Payer: UHCCP Medicaid |
$864.57
|
|
|
PR GEL-ONE
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS J7326
|
| Min. Negotiated Rate |
$506.67 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Aetna Commercial |
$702.18
|
| Rate for Payer: Aetna Medicare |
$544.98
|
| Rate for Payer: BCBS Complete |
$546.80
|
| Rate for Payer: BCBS MAPPO |
$524.02
|
| Rate for Payer: BCBS Trust/PPO |
$506.67
|
| Rate for Payer: BCN Commercial |
$1,159.20
|
| Rate for Payer: BCN Medicare Advantage |
$524.02
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$754.58
|
| Rate for Payer: Cofinity Commercial |
$702.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$550.22
|
| Rate for Payer: Nomi Health Commercial |
$628.82
|
| Rate for Payer: PACE SWMI |
$524.02
|
| Rate for Payer: PHP Medicare Advantage |
$524.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.55
|
| Rate for Payer: Priority Health Medicare |
$529.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.02
|
| Rate for Payer: UHC Exchange |
$524.02
|
| Rate for Payer: UHC Medicare Advantage |
$524.02
|
|
|
PR GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP
|
Professional
|
Both
|
$3,417.00
|
|
|
Service Code
|
HCPCS 91112
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$2,415.54 |
| Rate for Payer: Aetna Commercial |
$1,813.27
|
| Rate for Payer: Aetna Commercial |
$1,813.27
|
| Rate for Payer: Aetna Medicare |
$1,407.32
|
| Rate for Payer: Aetna Medicare |
$1,407.32
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$1,353.19
|
| Rate for Payer: BCBS MAPPO |
$1,353.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.20
|
| Rate for Payer: BCN Commercial |
$2,415.54
|
| Rate for Payer: BCN Commercial |
$2,415.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,353.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,353.19
|
| Rate for Payer: Cash Price |
$2,733.60
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$2,733.60
|
| Rate for Payer: Cofinity Commercial |
$1,813.27
|
| Rate for Payer: Cofinity Commercial |
$1,948.59
|
| Rate for Payer: Cofinity Commercial |
$1,948.59
|
| Rate for Payer: Cofinity Commercial |
$1,813.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.19
|
| Rate for Payer: Mclaren Medicaid |
$66.03
|
| Rate for Payer: Mclaren Medicaid |
$66.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,420.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,420.85
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Nomi Health Commercial |
$1,623.83
|
| Rate for Payer: Nomi Health Commercial |
$1,623.83
|
| Rate for Payer: PACE SWMI |
$1,353.19
|
| Rate for Payer: PACE SWMI |
$1,353.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,353.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,353.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.40
|
| Rate for Payer: Priority Health HMO/PPO |
$140.22
|
| Rate for Payer: Priority Health HMO/PPO |
$140.22
|
| Rate for Payer: Priority Health Medicare |
$1,366.72
|
| Rate for Payer: Priority Health Medicare |
$1,366.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,353.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,353.19
|
| Rate for Payer: UHC Exchange |
$1,353.19
|
| Rate for Payer: UHC Exchange |
$1,353.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,353.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,353.19
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
|
|
PR GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 91110
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$1,091.21 |
| Rate for Payer: Aetna Commercial |
$834.31
|
| Rate for Payer: Aetna Medicare |
$647.52
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCBS MAPPO |
$622.62
|
| Rate for Payer: BCBS Trust/PPO |
$910.79
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| Rate for Payer: BCN Medicare Advantage |
$622.62
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$896.57
|
| Rate for Payer: Cofinity Commercial |
$834.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.62
|
| Rate for Payer: Mclaren Medicaid |
$70.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$653.75
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Nomi Health Commercial |
$747.14
|
| Rate for Payer: PACE SWMI |
$622.62
|
| Rate for Payer: PHP Medicare Advantage |
$622.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.70
|
| Rate for Payer: Priority Health HMO/PPO |
$149.27
|
| Rate for Payer: Priority Health Medicare |
$628.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$622.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$622.62
|
| Rate for Payer: UHC Exchange |
$622.62
|
| Rate for Payer: UHC Medicare Advantage |
$622.62
|
| Rate for Payer: UHCCP Medicaid |
$70.29
|
|
|
PR GLOSSECTOMY HEMIGLOSSECTOMY
|
Professional
|
Both
|
$2,388.00
|
|
|
Service Code
|
HCPCS 41130
|
| Min. Negotiated Rate |
$761.81 |
| Max. Negotiated Rate |
$2,339.24 |
| Rate for Payer: Aetna Commercial |
$1,634.44
|
| Rate for Payer: Aetna Medicare |
$1,268.52
|
| Rate for Payer: BCBS Complete |
$876.49
|
| Rate for Payer: BCBS MAPPO |
$1,219.73
|
| Rate for Payer: BCBS Trust/PPO |
$761.81
|
| Rate for Payer: BCN Commercial |
$1,923.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,219.73
|
| Rate for Payer: Cash Price |
$1,910.40
|
| Rate for Payer: Cash Price |
$1,910.40
|
| Rate for Payer: Cofinity Commercial |
$1,756.41
|
| Rate for Payer: Cofinity Commercial |
$1,634.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,219.73
|
| Rate for Payer: Mclaren Medicaid |
$834.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,280.72
|
| Rate for Payer: Meridian Medicaid |
$876.49
|
| Rate for Payer: Nomi Health Commercial |
$1,463.68
|
| Rate for Payer: PACE SWMI |
$1,219.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,219.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,552.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,339.24
|
| Rate for Payer: Priority Health Medicare |
$1,231.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,339.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,219.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,219.73
|
| Rate for Payer: UHC Exchange |
$1,219.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,219.73
|
| Rate for Payer: UHCCP Medicaid |
$834.75
|
|
|
PR GLOSSECTOMY <ONE-HALF TONGUE
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 41120
|
| Min. Negotiated Rate |
$640.83 |
| Max. Negotiated Rate |
$1,891.20 |
| Rate for Payer: Aetna Commercial |
$1,311.81
|
| Rate for Payer: Aetna Medicare |
$1,018.12
|
| Rate for Payer: BCBS Complete |
$708.30
|
| Rate for Payer: BCBS MAPPO |
$978.96
|
| Rate for Payer: BCBS Trust/PPO |
$640.83
|
| Rate for Payer: BCN Commercial |
$1,557.41
|
| Rate for Payer: BCN Medicare Advantage |
$978.96
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cofinity Commercial |
$1,409.70
|
| Rate for Payer: Cofinity Commercial |
$1,311.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$978.96
|
| Rate for Payer: Mclaren Medicaid |
$674.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,027.91
|
| Rate for Payer: Meridian Medicaid |
$708.30
|
| Rate for Payer: Nomi Health Commercial |
$1,174.75
|
| Rate for Payer: PACE SWMI |
$978.96
|
| Rate for Payer: PHP Medicare Advantage |
$978.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,235.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,891.20
|
| Rate for Payer: Priority Health Medicare |
$988.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,891.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$978.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$978.96
|
| Rate for Payer: UHC Exchange |
$978.96
|
| Rate for Payer: UHC Medicare Advantage |
$978.96
|
| Rate for Payer: UHCCP Medicaid |
$674.57
|
|
|
PR GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ
|
Professional
|
Both
|
$3,945.00
|
|
|
Service Code
|
HCPCS 41135
|
| Min. Negotiated Rate |
$438.49 |
| Max. Negotiated Rate |
$3,855.19 |
| Rate for Payer: Aetna Commercial |
$2,715.38
|
| Rate for Payer: Aetna Medicare |
$2,107.46
|
| Rate for Payer: BCBS Complete |
$1,444.33
|
| Rate for Payer: BCBS MAPPO |
$2,026.40
|
| Rate for Payer: BCBS Trust/PPO |
$438.49
|
| Rate for Payer: BCN Commercial |
$3,161.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,026.40
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cash Price |
$3,156.00
|
| Rate for Payer: Cofinity Commercial |
$2,918.02
|
| Rate for Payer: Cofinity Commercial |
$2,715.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,026.40
|
| Rate for Payer: Mclaren Medicaid |
$1,375.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,127.72
|
| Rate for Payer: Meridian Medicaid |
$1,444.33
|
| Rate for Payer: Nomi Health Commercial |
$2,431.68
|
| Rate for Payer: PACE SWMI |
$2,026.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,026.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,375.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.25
|
| Rate for Payer: Priority Health HMO/PPO |
$3,855.19
|
| Rate for Payer: Priority Health Medicare |
$2,046.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,855.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,026.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,026.40
|
| Rate for Payer: UHC Exchange |
$2,026.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,026.40
|
| Rate for Payer: UHCCP Medicaid |
$1,375.55
|
|
|
PR GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ
|
Professional
|
Both
|
$4,098.00
|
|
|
Service Code
|
HCPCS 41150
|
| Min. Negotiated Rate |
$567.92 |
| Max. Negotiated Rate |
$3,911.86 |
| Rate for Payer: Aetna Commercial |
$2,751.07
|
| Rate for Payer: Aetna Medicare |
$2,135.16
|
| Rate for Payer: BCBS Complete |
$1,464.91
|
| Rate for Payer: BCBS MAPPO |
$2,053.04
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCN Commercial |
$3,210.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,053.04
|
| Rate for Payer: Cash Price |
$3,278.40
|
| Rate for Payer: Cash Price |
$3,278.40
|
| Rate for Payer: Cofinity Commercial |
$2,956.38
|
| Rate for Payer: Cofinity Commercial |
$2,751.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,053.04
|
| Rate for Payer: Mclaren Medicaid |
$1,395.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,155.69
|
| Rate for Payer: Meridian Medicaid |
$1,464.91
|
| Rate for Payer: Nomi Health Commercial |
$2,463.65
|
| Rate for Payer: PACE SWMI |
$2,053.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,053.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,395.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.70
|
| Rate for Payer: Priority Health HMO/PPO |
$3,911.86
|
| Rate for Payer: Priority Health Medicare |
$2,073.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,911.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,053.04
|
| Rate for Payer: UHC Exchange |
$2,053.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,053.04
|
| Rate for Payer: UHCCP Medicaid |
$1,395.15
|
|
|
PR GONIOSCOPY SEPARATE PROCEDURE
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 92020
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$1,100.98 |
| Rate for Payer: Aetna Commercial |
$25.23
|
| Rate for Payer: Aetna Medicare |
$19.58
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS MAPPO |
$18.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.98
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$18.83
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Cofinity Commercial |
$25.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.83
|
| Rate for Payer: Mclaren Medicaid |
$12.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.77
|
| Rate for Payer: Meridian Medicaid |
$13.42
|
| Rate for Payer: Nomi Health Commercial |
$22.60
|
| Rate for Payer: PACE SWMI |
$18.83
|
| Rate for Payer: PHP Medicare Advantage |
$18.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health HMO/PPO |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$19.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.83
|
| Rate for Payer: UHC Exchange |
$18.83
|
| Rate for Payer: UHC Medicare Advantage |
$18.83
|
| Rate for Payer: UHCCP Medicaid |
$12.78
|
|
|
PR GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA
|
Professional
|
Both
|
$1,703.00
|
|
|
Service Code
|
HCPCS 15760
|
| Min. Negotiated Rate |
$449.86 |
| Max. Negotiated Rate |
$12,622.63 |
| Rate for Payer: Aetna Commercial |
$887.55
|
| Rate for Payer: Aetna Medicare |
$688.84
|
| Rate for Payer: BCBS Complete |
$472.35
|
| Rate for Payer: BCBS MAPPO |
$662.35
|
| Rate for Payer: BCBS Trust/PPO |
$12,622.63
|
| Rate for Payer: BCN Commercial |
$1,239.29
|
| Rate for Payer: BCN Medicare Advantage |
$662.35
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cofinity Commercial |
$953.78
|
| Rate for Payer: Cofinity Commercial |
$887.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$662.35
|
| Rate for Payer: Mclaren Medicaid |
$449.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$695.47
|
| Rate for Payer: Meridian Medicaid |
$472.35
|
| Rate for Payer: Nomi Health Commercial |
$794.82
|
| Rate for Payer: PACE SWMI |
$662.35
|
| Rate for Payer: PHP Medicare Advantage |
$662.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,106.95
|
| Rate for Payer: Priority Health HMO/PPO |
$946.83
|
| Rate for Payer: Priority Health Medicare |
$668.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$662.35
|
| Rate for Payer: UHC Exchange |
$662.35
|
| Rate for Payer: UHC Medicare Advantage |
$662.35
|
| Rate for Payer: UHCCP Medicaid |
$449.86
|
|
|
PR GRAFT DERMA-FAT-FASCIA
|
Professional
|
Both
|
$1,469.00
|
|
|
Service Code
|
HCPCS 15770
|
| Min. Negotiated Rate |
$435.80 |
| Max. Negotiated Rate |
$12,622.63 |
| Rate for Payer: Aetna Commercial |
$859.15
|
| Rate for Payer: Aetna Medicare |
$666.81
|
| Rate for Payer: BCBS Complete |
$457.59
|
| Rate for Payer: BCBS MAPPO |
$641.16
|
| Rate for Payer: BCBS Trust/PPO |
$12,622.63
|
| Rate for Payer: BCN Commercial |
$982.24
|
| Rate for Payer: BCN Medicare Advantage |
$641.16
|
| Rate for Payer: Cash Price |
$1,175.20
|
| Rate for Payer: Cash Price |
$1,175.20
|
| Rate for Payer: Cofinity Commercial |
$923.27
|
| Rate for Payer: Cofinity Commercial |
$859.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.16
|
| Rate for Payer: Mclaren Medicaid |
$435.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.22
|
| Rate for Payer: Meridian Medicaid |
$457.59
|
| Rate for Payer: Nomi Health Commercial |
$769.39
|
| Rate for Payer: PACE SWMI |
$641.16
|
| Rate for Payer: PHP Medicare Advantage |
$641.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$954.85
|
| Rate for Payer: Priority Health HMO/PPO |
$917.03
|
| Rate for Payer: Priority Health Medicare |
$647.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.16
|
| Rate for Payer: UHC Exchange |
$641.16
|
| Rate for Payer: UHC Medicare Advantage |
$641.16
|
| Rate for Payer: UHCCP Medicaid |
$435.80
|
|
