|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 96170
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$113.38 |
| Rate for Payer: Aetna Commercial |
$84.24
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS Trust/PPO |
$66.04
|
| Rate for Payer: BCN Commercial |
$113.38
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health HMO/PPO |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.15
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 96171
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$102.49 |
| Rate for Payer: Aetna Commercial |
$30.11
|
| Rate for Payer: Aetna Medicare |
$28.50
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS Trust/PPO |
$102.49
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO |
$35.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.27
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 96167
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$115.70 |
| Rate for Payer: Aetna Commercial |
$84.00
|
| Rate for Payer: Aetna Medicare |
$65.20
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$62.69
|
| Rate for Payer: BCBS Trust/PPO |
$115.70
|
| Rate for Payer: BCN Commercial |
$99.69
|
| Rate for Payer: BCN Medicare Advantage |
$62.69
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cofinity Commercial |
$90.27
|
| Rate for Payer: Cofinity Commercial |
$84.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.69
|
| Rate for Payer: Mclaren Medicaid |
$41.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.82
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Nomi Health Commercial |
$75.23
|
| Rate for Payer: PACE SWMI |
$62.69
|
| Rate for Payer: PHP Medicare Advantage |
$62.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.25
|
| Rate for Payer: Priority Health HMO/PPO |
$84.12
|
| Rate for Payer: Priority Health Medicare |
$63.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.69
|
| Rate for Payer: UHC Exchange |
$62.69
|
| Rate for Payer: UHC Medicare Advantage |
$62.69
|
| Rate for Payer: UHCCP Medicaid |
$41.54
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 96168
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$168.53 |
| Rate for Payer: Aetna Commercial |
$30.18
|
| Rate for Payer: Aetna Medicare |
$23.42
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$22.52
|
| Rate for Payer: BCBS Trust/PPO |
$168.53
|
| Rate for Payer: BCN Commercial |
$35.19
|
| Rate for Payer: BCN Medicare Advantage |
$22.52
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$32.43
|
| Rate for Payer: Cofinity Commercial |
$30.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.52
|
| Rate for Payer: Mclaren Medicaid |
$14.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.65
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Nomi Health Commercial |
$27.02
|
| Rate for Payer: PACE SWMI |
$22.52
|
| Rate for Payer: PHP Medicare Advantage |
$22.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$29.85
|
| Rate for Payer: Priority Health Medicare |
$22.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.52
|
| Rate for Payer: UHC Exchange |
$22.52
|
| Rate for Payer: UHC Medicare Advantage |
$22.52
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 96158
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$831.54 |
| Rate for Payer: Aetna Commercial |
$79.25
|
| Rate for Payer: Aetna Medicare |
$61.51
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$59.14
|
| Rate for Payer: BCBS Trust/PPO |
$831.54
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$59.14
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$85.16
|
| Rate for Payer: Cofinity Commercial |
$79.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.14
|
| Rate for Payer: Mclaren Medicaid |
$39.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.10
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Nomi Health Commercial |
$70.97
|
| Rate for Payer: PACE SWMI |
$59.14
|
| Rate for Payer: PHP Medicare Advantage |
$59.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.40
|
| Rate for Payer: Priority Health HMO/PPO |
$79.61
|
| Rate for Payer: Priority Health Medicare |
$59.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.14
|
| Rate for Payer: UHC Exchange |
$59.14
|
| Rate for Payer: UHC Medicare Advantage |
$59.14
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 96159
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$208.15 |
| Rate for Payer: Aetna Commercial |
$27.11
|
| Rate for Payer: Aetna Medicare |
$21.04
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS MAPPO |
$20.23
|
| Rate for Payer: BCBS Trust/PPO |
$208.15
|
| Rate for Payer: BCN Commercial |
$32.25
|
| Rate for Payer: BCN Medicare Advantage |
$20.23
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$27.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.23
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.24
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Nomi Health Commercial |
$24.28
|
| Rate for Payer: PACE SWMI |
$20.23
|
| Rate for Payer: PHP Medicare Advantage |
$20.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO |
$26.69
|
| Rate for Payer: Priority Health Medicare |
$20.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.23
|
| Rate for Payer: UHC Exchange |
$20.23
|
| Rate for Payer: UHC Medicare Advantage |
$20.23
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
|
|
PR HEALTH RISK ASSESSMENT TEST
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 99420
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR HEARING AID CHECK BINAURAL
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 92593
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$392.83 |
| Rate for Payer: Aetna Commercial |
$39.35
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS Trust/PPO |
$392.83
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health HMO/PPO |
$50.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.21
|
|
|
PR HEARING AID CHECK MONAURAL
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 92592
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$2,403.24 |
| Rate for Payer: Aetna Commercial |
$23.53
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.24
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO |
$30.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.30
|
|
|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$864.19 |
| Rate for Payer: Aetna Commercial |
$76.88
|
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: BCBS Trust/PPO |
$864.19
|
| Rate for Payer: BCN Commercial |
$98.85
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO |
$97.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.70
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$1,399.47 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,399.47
|
| Rate for Payer: BCN Commercial |
$98.85
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO |
$76.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.89
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,516.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$3,585.40 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: Aetna Medicare |
$2,758.00
|
| Rate for Payer: BCBS Complete |
$2,206.40
|
| Rate for Payer: Cash Price |
$4,412.80
|
| Rate for Payer: Cash Price |
$4,412.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,585.40
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$434.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$88.69 |
| Max. Negotiated Rate |
$282.10 |
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna Medicare |
$217.00
|
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: BCBS Complete |
$173.60
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$732.93 |
| Max. Negotiated Rate |
$1,736.74 |
| Rate for Payer: Aetna Commercial |
$1,461.31
|
| Rate for Payer: Aetna Medicare |
$1,134.15
|
| Rate for Payer: BCBS Complete |
$769.58
|
| Rate for Payer: BCBS MAPPO |
$1,090.53
|
| Rate for Payer: BCBS Trust/PPO |
$984.22
|
| Rate for Payer: BCN Commercial |
$1,655.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.53
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,461.31
|
| Rate for Payer: Cofinity Commercial |
$1,570.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.53
|
| Rate for Payer: Mclaren Medicaid |
$732.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.06
|
| Rate for Payer: Meridian Medicaid |
$769.58
|
| Rate for Payer: Nomi Health Commercial |
$1,308.64
|
| Rate for Payer: PACE SWMI |
$1,090.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$732.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,736.74
|
| Rate for Payer: Priority Health Medicare |
$1,101.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,736.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,090.53
|
| Rate for Payer: UHC Exchange |
$1,090.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,090.53
|
| Rate for Payer: UHCCP Medicaid |
$732.93
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$697.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$888.60 |
| Rate for Payer: Aetna Commercial |
$342.29
|
| Rate for Payer: Aetna Medicare |
$265.66
|
| Rate for Payer: BCBS Complete |
$182.94
|
| Rate for Payer: BCBS MAPPO |
$255.44
|
| Rate for Payer: BCBS Trust/PPO |
$888.60
|
| Rate for Payer: BCN Commercial |
$592.77
|
| Rate for Payer: BCN Medicare Advantage |
$255.44
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cofinity Commercial |
$367.83
|
| Rate for Payer: Cofinity Commercial |
$342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.44
|
| Rate for Payer: Mclaren Medicaid |
$174.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.21
|
| Rate for Payer: Meridian Medicaid |
$182.94
|
| Rate for Payer: Nomi Health Commercial |
$306.53
|
| Rate for Payer: PACE SWMI |
$255.44
|
| Rate for Payer: PHP Medicare Advantage |
$255.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$453.05
|
| Rate for Payer: Priority Health HMO/PPO |
$412.18
|
| Rate for Payer: Priority Health Medicare |
$257.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.44
|
| Rate for Payer: UHC Exchange |
$255.44
|
| Rate for Payer: UHC Medicare Advantage |
$255.44
|
| Rate for Payer: UHCCP Medicaid |
$174.23
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$293.73 |
| Rate for Payer: Aetna Commercial |
$89.54
|
| Rate for Payer: Aetna Medicare |
$69.49
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$66.82
|
| Rate for Payer: BCBS Trust/PPO |
$293.73
|
| Rate for Payer: BCN Commercial |
$103.11
|
| Rate for Payer: BCN Medicare Advantage |
$66.82
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$96.22
|
| Rate for Payer: Cofinity Commercial |
$89.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.82
|
| Rate for Payer: Mclaren Medicaid |
$44.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.16
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Nomi Health Commercial |
$80.18
|
| Rate for Payer: PACE SWMI |
$66.82
|
| Rate for Payer: PHP Medicare Advantage |
$66.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO |
$94.98
|
| Rate for Payer: Priority Health Medicare |
$67.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.82
|
| Rate for Payer: UHC Exchange |
$66.82
|
| Rate for Payer: UHC Medicare Advantage |
$66.82
|
| Rate for Payer: UHCCP Medicaid |
$44.73
|
|
|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$129.66
|
| Rate for Payer: Aetna Medicare |
$100.63
|
| Rate for Payer: BCBS Complete |
$67.99
|
| Rate for Payer: BCBS MAPPO |
$96.76
|
| Rate for Payer: BCBS Trust/PPO |
$314.34
|
| Rate for Payer: BCN Commercial |
$146.60
|
| Rate for Payer: BCN Medicare Advantage |
$96.76
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$139.33
|
| Rate for Payer: Cofinity Commercial |
$129.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.76
|
| Rate for Payer: Mclaren Medicaid |
$64.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.60
|
| Rate for Payer: Meridian Medicaid |
$67.99
|
| Rate for Payer: Nomi Health Commercial |
$116.11
|
| Rate for Payer: PACE SWMI |
$96.76
|
| Rate for Payer: PHP Medicare Advantage |
$96.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO |
$136.60
|
| Rate for Payer: Priority Health Medicare |
$97.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.76
|
| Rate for Payer: UHC Exchange |
$96.76
|
| Rate for Payer: UHC Medicare Advantage |
$96.76
|
| Rate for Payer: UHCCP Medicaid |
$64.75
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$125.46 |
| Max. Negotiated Rate |
$1,246.26 |
| Rate for Payer: Aetna Commercial |
$245.77
|
| Rate for Payer: Aetna Medicare |
$190.75
|
| Rate for Payer: BCBS Complete |
$131.73
|
| Rate for Payer: BCBS MAPPO |
$183.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,246.26
|
| Rate for Payer: BCN Commercial |
$335.33
|
| Rate for Payer: BCN Medicare Advantage |
$183.41
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$264.11
|
| Rate for Payer: Cofinity Commercial |
$245.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.41
|
| Rate for Payer: Mclaren Medicaid |
$125.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.58
|
| Rate for Payer: Meridian Medicaid |
$131.73
|
| Rate for Payer: Nomi Health Commercial |
$220.09
|
| Rate for Payer: PACE SWMI |
$183.41
|
| Rate for Payer: PHP Medicare Advantage |
$183.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO |
$346.03
|
| Rate for Payer: Priority Health Medicare |
$185.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$346.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.41
|
| Rate for Payer: UHC Exchange |
$183.41
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
| Rate for Payer: UHCCP Medicaid |
$125.46
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$125.46 |
| Max. Negotiated Rate |
$1,246.26 |
| Rate for Payer: Aetna Commercial |
$245.77
|
| Rate for Payer: Aetna Medicare |
$190.75
|
| Rate for Payer: BCBS Complete |
$131.73
|
| Rate for Payer: BCBS MAPPO |
$183.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,246.26
|
| Rate for Payer: BCN Commercial |
$335.33
|
| Rate for Payer: BCN Medicare Advantage |
$183.41
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$264.11
|
| Rate for Payer: Cofinity Commercial |
$245.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.41
|
| Rate for Payer: Mclaren Medicaid |
$125.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.58
|
| Rate for Payer: Meridian Medicaid |
$131.73
|
| Rate for Payer: Nomi Health Commercial |
$220.09
|
| Rate for Payer: PACE SWMI |
$183.41
|
| Rate for Payer: PHP Medicare Advantage |
$183.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO |
$346.03
|
| Rate for Payer: Priority Health Medicare |
$185.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$346.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.41
|
| Rate for Payer: UHC Exchange |
$183.41
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
| Rate for Payer: UHCCP Medicaid |
$125.46
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$678.18 |
| Rate for Payer: Aetna Commercial |
$352.75
|
| Rate for Payer: Aetna Medicare |
$107.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.69
|
| Rate for Payer: BCBS Complete |
$678.18
|
| Rate for Payer: BCBS MAPPO |
$103.75
|
| Rate for Payer: BCBS Trust/PPO |
$341.17
|
| Rate for Payer: BCN Commercial |
$322.66
|
| Rate for Payer: BCN Medicare Advantage |
$103.75
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$356.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.75
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.25
|
| Rate for Payer: Mclaren Medicaid |
$645.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.94
|
| Rate for Payer: Meridian Medicaid |
$678.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: Nomi Health Commercial |
$340.30
|
| Rate for Payer: PACE Senior Care Partners |
$98.56
|
| Rate for Payer: PACE SWMI |
$103.75
|
| Rate for Payer: PHP Commercial |
$352.75
|
| Rate for Payer: PHP Medicare Advantage |
$103.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO |
$361.05
|
| Rate for Payer: Priority Health Medicare |
$104.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.05
|
| Rate for Payer: Railroad Medicare Medicare |
$103.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.20
|
| Rate for Payer: UHC Core |
$346.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.75
|
| Rate for Payer: UHC Exchange |
$103.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.75
|
| Rate for Payer: UHCCP Medicaid |
$645.84
|
| Rate for Payer: VA VA |
$103.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.25
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$269.75 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Aetna Commercial |
$352.75
|
| Rate for Payer: BCBS Trust/PPO |
$338.76
|
| Rate for Payer: BCN Commercial |
$320.71
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$356.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: Nomi Health Commercial |
$340.30
|
| Rate for Payer: PHP Commercial |
$352.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO |
$361.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.20
|
| Rate for Payer: UHC Core |
$346.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.25
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$312.68 |
| Max. Negotiated Rate |
$2,501.50 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$481.50
|
| Rate for Payer: BCBS Complete |
$328.31
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Mclaren Medicaid |
$312.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Meridian Medicaid |
$328.31
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO |
$868.65
|
| Rate for Payer: Priority Health Medicare |
$467.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$868.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Exchange |
$462.98
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
| Rate for Payer: UHCCP Medicaid |
$312.68
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$312.68 |
| Max. Negotiated Rate |
$2,501.50 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$481.50
|
| Rate for Payer: BCBS Complete |
$328.31
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Mclaren Medicaid |
$312.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Meridian Medicaid |
$328.31
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO |
$868.65
|
| Rate for Payer: Priority Health Medicare |
$467.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$868.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Exchange |
$462.98
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
| Rate for Payer: UHCCP Medicaid |
$312.68
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
OP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$383.32 |
| Max. Negotiated Rate |
$2,039.92 |
| Rate for Payer: Aetna Commercial |
$1,371.90
|
| Rate for Payer: Aetna Medicare |
$419.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$504.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$504.38
|
| Rate for Payer: BCBS Complete |
$2,039.92
|
| Rate for Payer: BCBS MAPPO |
$403.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.87
|
| Rate for Payer: BCN Commercial |
$1,254.88
|
| Rate for Payer: BCN Medicare Advantage |
$403.50
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,388.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.50
|
| Rate for Payer: Healthscope Commercial |
$1,452.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.50
|
| Rate for Payer: Mclaren Medicaid |
$1,942.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.68
|
| Rate for Payer: Meridian Medicaid |
$2,039.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$464.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: Nomi Health Commercial |
$1,323.48
|
| Rate for Payer: PACE Senior Care Partners |
$383.32
|
| Rate for Payer: PACE SWMI |
$403.50
|
| Rate for Payer: PHP Commercial |
$1,371.90
|
| Rate for Payer: PHP Medicare Advantage |
$403.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,942.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,404.18
|
| Rate for Payer: Priority Health Medicare |
$407.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.38
|
| Rate for Payer: Railroad Medicare Medicare |
$403.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.32
|
| Rate for Payer: UHC Core |
$1,347.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.50
|
| Rate for Payer: UHC Exchange |
$403.50
|
| Rate for Payer: UHC Medicare Advantage |
$403.50
|
| Rate for Payer: UHCCP Medicaid |
$1,942.66
|
| Rate for Payer: VA VA |
$403.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.50
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,049.10 |
| Max. Negotiated Rate |
$1,452.60 |
| Rate for Payer: Aetna Commercial |
$1,371.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.51
|
| Rate for Payer: BCN Commercial |
$1,247.30
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,388.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Healthscope Commercial |
$1,452.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: Nomi Health Commercial |
$1,323.48
|
| Rate for Payer: PHP Commercial |
$1,371.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,404.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.32
|
| Rate for Payer: UHC Core |
$1,347.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.50
|
|
