|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$229.83 |
| Max. Negotiated Rate |
$2,489.35 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$353.28
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Mclaren Medicaid |
$229.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO |
$639.55
|
| Rate for Payer: Priority Health Medicare |
$343.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Exchange |
$339.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
| Rate for Payer: UHCCP Medicaid |
$229.83
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$229.83 |
| Max. Negotiated Rate |
$2,489.35 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$353.28
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Mclaren Medicaid |
$229.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO |
$639.55
|
| Rate for Payer: Priority Health Medicare |
$343.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Exchange |
$339.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
| Rate for Payer: UHCCP Medicaid |
$229.83
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$713.70 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Aetna Commercial |
$933.30
|
| Rate for Payer: BCBS Trust/PPO |
$896.30
|
| Rate for Payer: BCN Commercial |
$848.53
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$944.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Healthscope Commercial |
$988.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: Nomi Health Commercial |
$900.36
|
| Rate for Payer: PHP Commercial |
$933.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO |
$955.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$735.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$966.24
|
| Rate for Payer: UHC Core |
$916.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.50
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$260.78 |
| Max. Negotiated Rate |
$2,039.92 |
| Rate for Payer: Aetna Commercial |
$933.30
|
| Rate for Payer: Aetna Medicare |
$285.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$343.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$343.12
|
| Rate for Payer: BCBS Complete |
$2,039.92
|
| Rate for Payer: BCBS MAPPO |
$274.50
|
| Rate for Payer: BCBS Trust/PPO |
$902.67
|
| Rate for Payer: BCN Commercial |
$853.70
|
| Rate for Payer: BCN Medicare Advantage |
$274.50
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$944.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.50
|
| Rate for Payer: Healthscope Commercial |
$988.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.50
|
| Rate for Payer: Mclaren Medicaid |
$1,942.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.22
|
| Rate for Payer: Meridian Medicaid |
$2,039.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: Nomi Health Commercial |
$900.36
|
| Rate for Payer: PACE Senior Care Partners |
$260.78
|
| Rate for Payer: PACE SWMI |
$274.50
|
| Rate for Payer: PHP Commercial |
$933.30
|
| Rate for Payer: PHP Medicare Advantage |
$274.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,942.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO |
$955.26
|
| Rate for Payer: Priority Health Medicare |
$277.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$735.66
|
| Rate for Payer: Railroad Medicare Medicare |
$274.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$966.24
|
| Rate for Payer: UHC Core |
$916.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.50
|
| Rate for Payer: UHC Exchange |
$274.50
|
| Rate for Payer: UHC Medicare Advantage |
$274.50
|
| Rate for Payer: UHCCP Medicaid |
$1,942.66
|
| Rate for Payer: VA VA |
$274.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.50
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
IP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$733.85 |
| Max. Negotiated Rate |
$1,016.10 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: BCBS Trust/PPO |
$921.60
|
| Rate for Payer: BCN Commercial |
$872.49
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: Nomi Health Commercial |
$925.78
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO |
$982.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$993.52
|
| Rate for Payer: UHC Core |
$942.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.75
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
OP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$268.14 |
| Max. Negotiated Rate |
$2,039.92 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna Medicare |
$293.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$352.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$352.81
|
| Rate for Payer: BCBS Complete |
$2,039.92
|
| Rate for Payer: BCBS MAPPO |
$282.25
|
| Rate for Payer: BCBS Trust/PPO |
$928.15
|
| Rate for Payer: BCN Commercial |
$877.80
|
| Rate for Payer: BCN Medicare Advantage |
$282.25
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.25
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.75
|
| Rate for Payer: Mclaren Medicaid |
$1,942.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.36
|
| Rate for Payer: Meridian Medicaid |
$2,039.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$324.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: Nomi Health Commercial |
$925.78
|
| Rate for Payer: PACE Senior Care Partners |
$268.14
|
| Rate for Payer: PACE SWMI |
$282.25
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: PHP Medicare Advantage |
$282.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,942.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO |
$982.23
|
| Rate for Payer: Priority Health Medicare |
$285.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.43
|
| Rate for Payer: Railroad Medicare Medicare |
$282.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$993.52
|
| Rate for Payer: UHC Core |
$942.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.25
|
| Rate for Payer: UHC Exchange |
$282.25
|
| Rate for Payer: UHC Medicare Advantage |
$282.25
|
| Rate for Payer: UHCCP Medicaid |
$1,942.66
|
| Rate for Payer: VA VA |
$282.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.75
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$207.89 |
| Max. Negotiated Rate |
$1,253.13 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$319.06
|
| Rate for Payer: BCBS Complete |
$218.28
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.13
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Mclaren Medicaid |
$207.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Meridian Medicaid |
$218.28
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO |
$574.52
|
| Rate for Payer: Priority Health Medicare |
$309.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$574.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Exchange |
$306.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
| Rate for Payer: UHCCP Medicaid |
$207.89
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$207.89 |
| Max. Negotiated Rate |
$1,253.13 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$319.06
|
| Rate for Payer: BCBS Complete |
$218.28
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.13
|
| Rate for Payer: BCN Commercial |
$704.18
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Mclaren Medicaid |
$207.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Meridian Medicaid |
$218.28
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO |
$574.52
|
| Rate for Payer: Priority Health Medicare |
$309.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$574.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Exchange |
$306.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
| Rate for Payer: UHCCP Medicaid |
$207.89
|
|
|
PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
HCPCS 46257
|
| Min. Negotiated Rate |
$270.51 |
| Max. Negotiated Rate |
$1,554.26 |
| Rate for Payer: Aetna Commercial |
$532.68
|
| Rate for Payer: Aetna Medicare |
$413.42
|
| Rate for Payer: BCBS Complete |
$284.04
|
| Rate for Payer: BCBS MAPPO |
$397.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,554.26
|
| Rate for Payer: BCN Commercial |
$610.36
|
| Rate for Payer: BCN Medicare Advantage |
$397.52
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cofinity Commercial |
$572.43
|
| Rate for Payer: Cofinity Commercial |
$532.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.52
|
| Rate for Payer: Mclaren Medicaid |
$270.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.40
|
| Rate for Payer: Meridian Medicaid |
$284.04
|
| Rate for Payer: Nomi Health Commercial |
$477.02
|
| Rate for Payer: PACE SWMI |
$397.52
|
| Rate for Payer: PHP Medicare Advantage |
$397.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.95
|
| Rate for Payer: Priority Health HMO/PPO |
$750.52
|
| Rate for Payer: Priority Health Medicare |
$401.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$750.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.52
|
| Rate for Payer: UHC Exchange |
$397.52
|
| Rate for Payer: UHC Medicare Advantage |
$397.52
|
| Rate for Payer: UHCCP Medicaid |
$270.51
|
|
|
PR HEMORRHOIDOPEXY STAPLING
|
Professional
|
Both
|
$646.00
|
|
|
Service Code
|
HCPCS 46947
|
| Min. Negotiated Rate |
$251.77 |
| Max. Negotiated Rate |
$2,172.37 |
| Rate for Payer: Aetna Commercial |
$501.51
|
| Rate for Payer: Aetna Medicare |
$389.23
|
| Rate for Payer: BCBS Complete |
$264.36
|
| Rate for Payer: BCBS MAPPO |
$374.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,172.37
|
| Rate for Payer: BCN Commercial |
$570.29
|
| Rate for Payer: BCN Medicare Advantage |
$374.26
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Cofinity Commercial |
$538.93
|
| Rate for Payer: Cofinity Commercial |
$501.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.26
|
| Rate for Payer: Mclaren Medicaid |
$251.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.97
|
| Rate for Payer: Meridian Medicaid |
$264.36
|
| Rate for Payer: Nomi Health Commercial |
$449.11
|
| Rate for Payer: PACE SWMI |
$374.26
|
| Rate for Payer: PHP Medicare Advantage |
$374.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.90
|
| Rate for Payer: Priority Health HMO/PPO |
$702.79
|
| Rate for Payer: Priority Health Medicare |
$378.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.26
|
| Rate for Payer: UHC Exchange |
$374.26
|
| Rate for Payer: UHC Medicare Advantage |
$374.26
|
| Rate for Payer: UHCCP Medicaid |
$251.77
|
|
|
PR HEPATECTOMY RESCJ PARTIAL LOBECTOMY
|
Professional
|
Both
|
$4,633.00
|
|
|
Service Code
|
HCPCS 47120
|
| Min. Negotiated Rate |
$1,495.26 |
| Max. Negotiated Rate |
$4,170.79 |
| Rate for Payer: Aetna Commercial |
$3,030.91
|
| Rate for Payer: Aetna Medicare |
$2,352.34
|
| Rate for Payer: BCBS Complete |
$1,570.02
|
| Rate for Payer: BCBS MAPPO |
$2,261.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,491.46
|
| Rate for Payer: BCN Commercial |
$3,402.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,261.87
|
| Rate for Payer: Cash Price |
$3,706.40
|
| Rate for Payer: Cash Price |
$3,706.40
|
| Rate for Payer: Cofinity Commercial |
$3,257.09
|
| Rate for Payer: Cofinity Commercial |
$3,030.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,261.87
|
| Rate for Payer: Mclaren Medicaid |
$1,495.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,374.96
|
| Rate for Payer: Meridian Medicaid |
$1,570.02
|
| Rate for Payer: Nomi Health Commercial |
$2,714.24
|
| Rate for Payer: PACE SWMI |
$2,261.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,261.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,495.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,011.45
|
| Rate for Payer: Priority Health HMO/PPO |
$4,170.79
|
| Rate for Payer: Priority Health Medicare |
$2,284.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,170.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,261.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,261.87
|
| Rate for Payer: UHC Exchange |
$2,261.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,261.87
|
| Rate for Payer: UHCCP Medicaid |
$1,495.26
|
|
|
PR HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY
|
Professional
|
Both
|
$6,159.00
|
|
|
Service Code
|
HCPCS 47130
|
| Min. Negotiated Rate |
$2,109.13 |
| Max. Negotiated Rate |
$5,882.42 |
| Rate for Payer: Aetna Commercial |
$4,292.53
|
| Rate for Payer: Aetna Medicare |
$3,331.52
|
| Rate for Payer: BCBS Complete |
$2,214.59
|
| Rate for Payer: BCBS MAPPO |
$3,203.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.86
|
| Rate for Payer: BCN Commercial |
$4,804.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,203.38
|
| Rate for Payer: Cash Price |
$4,927.20
|
| Rate for Payer: Cash Price |
$4,927.20
|
| Rate for Payer: Cofinity Commercial |
$4,292.53
|
| Rate for Payer: Cofinity Commercial |
$4,612.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,203.38
|
| Rate for Payer: Mclaren Medicaid |
$2,109.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,363.55
|
| Rate for Payer: Meridian Medicaid |
$2,214.59
|
| Rate for Payer: Nomi Health Commercial |
$3,844.06
|
| Rate for Payer: PACE SWMI |
$3,203.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,203.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,109.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,003.35
|
| Rate for Payer: Priority Health HMO/PPO |
$5,882.42
|
| Rate for Payer: Priority Health Medicare |
$3,235.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,882.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,203.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,203.38
|
| Rate for Payer: UHC Exchange |
$3,203.38
|
| Rate for Payer: UHC Medicare Advantage |
$3,203.38
|
| Rate for Payer: UHCCP Medicaid |
$2,109.13
|
|
|
PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 90636
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$134.53 |
| Rate for Payer: Aetna Commercial |
$123.57
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$134.53
|
| Rate for Payer: BCN Commercial |
$134.53
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
|
|
PR HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 90371
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$188.16 |
| Rate for Payer: Aetna Commercial |
$175.09
|
| Rate for Payer: Aetna Medicare |
$135.89
|
| Rate for Payer: BCBS Complete |
$72.80
|
| Rate for Payer: BCBS MAPPO |
$130.66
|
| Rate for Payer: BCBS Trust/PPO |
$151.61
|
| Rate for Payer: BCN Commercial |
$146.22
|
| Rate for Payer: BCN Medicare Advantage |
$130.66
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$188.16
|
| Rate for Payer: Cofinity Commercial |
$175.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.20
|
| Rate for Payer: Nomi Health Commercial |
$156.80
|
| Rate for Payer: PACE SWMI |
$130.66
|
| Rate for Payer: PHP Medicare Advantage |
$130.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health Medicare |
$131.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.66
|
| Rate for Payer: UHC Exchange |
$130.66
|
| Rate for Payer: UHC Medicare Advantage |
$130.66
|
|
|
PR HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 47010
|
| Min. Negotiated Rate |
$241.96 |
| Max. Negotiated Rate |
$2,172.79 |
| Rate for Payer: Aetna Commercial |
$1,576.36
|
| Rate for Payer: Aetna Medicare |
$1,223.45
|
| Rate for Payer: BCBS Complete |
$819.45
|
| Rate for Payer: BCBS MAPPO |
$1,176.39
|
| Rate for Payer: BCBS Trust/PPO |
$241.96
|
| Rate for Payer: BCN Commercial |
$1,771.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,176.39
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cofinity Commercial |
$1,694.00
|
| Rate for Payer: Cofinity Commercial |
$1,576.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,176.39
|
| Rate for Payer: Mclaren Medicaid |
$780.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,235.21
|
| Rate for Payer: Meridian Medicaid |
$819.45
|
| Rate for Payer: Nomi Health Commercial |
$1,411.67
|
| Rate for Payer: PACE SWMI |
$1,176.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,176.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,172.79
|
| Rate for Payer: Priority Health Medicare |
$1,188.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,172.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,176.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,176.39
|
| Rate for Payer: UHC Exchange |
$1,176.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,176.39
|
| Rate for Payer: UHCCP Medicaid |
$780.43
|
|
|
PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 90633
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$38.42 |
| Rate for Payer: Aetna Commercial |
$38.42
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$31.32
|
| Rate for Payer: BCN Commercial |
$31.32
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 90632
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$104.66 |
| Rate for Payer: Aetna Commercial |
$97.40
|
| Rate for Payer: Aetna Medicare |
$75.59
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$72.68
|
| Rate for Payer: BCBS Trust/PPO |
$72.34
|
| Rate for Payer: BCN Commercial |
$73.37
|
| Rate for Payer: BCN Medicare Advantage |
$72.68
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$97.40
|
| Rate for Payer: Cofinity Commercial |
$104.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.32
|
| Rate for Payer: Nomi Health Commercial |
$87.22
|
| Rate for Payer: PACE SWMI |
$72.68
|
| Rate for Payer: PHP Medicare Advantage |
$72.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
| Rate for Payer: Priority Health Medicare |
$73.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.68
|
| Rate for Payer: UHC Exchange |
$72.68
|
| Rate for Payer: UHC Medicare Advantage |
$72.68
|
|
|
PR HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 90743
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$108.21 |
| Rate for Payer: Aetna Commercial |
$100.69
|
| Rate for Payer: Aetna Medicare |
$78.15
|
| Rate for Payer: BCBS Complete |
$41.20
|
| Rate for Payer: BCBS MAPPO |
$75.14
|
| Rate for Payer: BCBS Trust/PPO |
$76.66
|
| Rate for Payer: BCN Commercial |
$65.05
|
| Rate for Payer: BCN Medicare Advantage |
$75.14
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$108.21
|
| Rate for Payer: Cofinity Commercial |
$100.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.90
|
| Rate for Payer: Nomi Health Commercial |
$90.17
|
| Rate for Payer: PACE SWMI |
$75.14
|
| Rate for Payer: PHP Medicare Advantage |
$75.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health Medicare |
$75.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.14
|
| Rate for Payer: UHC Exchange |
$75.14
|
| Rate for Payer: UHC Medicare Advantage |
$75.14
|
|
|
PR HEPB VACCINE ADULT 2/4 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 90739
|
| Min. Negotiated Rate |
$130.40 |
| Max. Negotiated Rate |
$255.68 |
| Rate for Payer: Aetna Commercial |
$237.92
|
| Rate for Payer: Aetna Medicare |
$184.66
|
| Rate for Payer: BCBS Complete |
$130.40
|
| Rate for Payer: BCBS MAPPO |
$177.56
|
| Rate for Payer: BCBS Trust/PPO |
$166.39
|
| Rate for Payer: BCN Commercial |
$132.46
|
| Rate for Payer: BCN Medicare Advantage |
$177.56
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cofinity Commercial |
$255.68
|
| Rate for Payer: Cofinity Commercial |
$237.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.43
|
| Rate for Payer: Nomi Health Commercial |
$213.07
|
| Rate for Payer: PACE SWMI |
$177.56
|
| Rate for Payer: PHP Medicare Advantage |
$177.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.90
|
| Rate for Payer: Priority Health Medicare |
$179.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.56
|
| Rate for Payer: UHC Exchange |
$177.56
|
| Rate for Payer: UHC Medicare Advantage |
$177.56
|
|
|
PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS 90746
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$101.34 |
| Rate for Payer: Aetna Commercial |
$94.30
|
| Rate for Payer: Aetna Medicare |
$73.19
|
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCBS MAPPO |
$70.38
|
| Rate for Payer: BCBS Trust/PPO |
$73.05
|
| Rate for Payer: BCN Commercial |
$65.05
|
| Rate for Payer: BCN Medicare Advantage |
$70.38
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$94.30
|
| Rate for Payer: Cofinity Commercial |
$101.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.89
|
| Rate for Payer: Nomi Health Commercial |
$84.45
|
| Rate for Payer: PACE SWMI |
$70.38
|
| Rate for Payer: PHP Medicare Advantage |
$70.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.95
|
| Rate for Payer: Priority Health Medicare |
$71.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.38
|
| Rate for Payer: UHC Exchange |
$70.38
|
| Rate for Payer: UHC Medicare Advantage |
$70.38
|
|
|
PR HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 90744
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$45.61 |
| Rate for Payer: Aetna Commercial |
$42.44
|
| Rate for Payer: Aetna Medicare |
$32.94
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$31.67
|
| Rate for Payer: BCBS Trust/PPO |
$31.03
|
| Rate for Payer: BCN Commercial |
$25.88
|
| Rate for Payer: BCN Medicare Advantage |
$31.67
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Cofinity Commercial |
$42.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.25
|
| Rate for Payer: Nomi Health Commercial |
$38.01
|
| Rate for Payer: PACE SWMI |
$31.67
|
| Rate for Payer: PHP Medicare Advantage |
$31.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health Medicare |
$31.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.67
|
| Rate for Payer: UHC Exchange |
$31.67
|
| Rate for Payer: UHC Medicare Advantage |
$31.67
|
|
|
PR HFO FLEXION GLOVE PRE OTS
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS L3912
|
| Min. Negotiated Rate |
$39.60 |
| Max. Negotiated Rate |
$91.04 |
| Rate for Payer: BCBS Complete |
$39.60
|
| Rate for Payer: BCN Commercial |
$91.04
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.35
|
|
|
PR HFO NONTORSION JNTS PRE CST
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
HCPCS L3929
|
| Min. Negotiated Rate |
$34.40 |
| Max. Negotiated Rate |
$78.93 |
| Rate for Payer: BCBS Complete |
$34.40
|
| Rate for Payer: BCN Commercial |
$78.93
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
|
|
PR HFO W/JOINT(S) CF
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS L3921
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$277.59 |
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCN Commercial |
$277.59
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.00
|
|
|
PR HFO W/O JOINTS CF
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS L3913
|
| Min. Negotiated Rate |
$101.20 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: BCBS Complete |
$101.20
|
| Rate for Payer: BCN Commercial |
$234.03
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.45
|
|
