|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Facility
|
OP
|
$1,564.00
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
58563
|
| Min. Negotiated Rate |
$371.45 |
| Max. Negotiated Rate |
$3,671.97 |
| Rate for Payer: Aetna Commercial |
$1,329.40
|
| Rate for Payer: Aetna Medicare |
$406.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.75
|
| Rate for Payer: BCBS Complete |
$3,671.97
|
| Rate for Payer: BCBS MAPPO |
$391.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.76
|
| Rate for Payer: BCN Commercial |
$1,216.01
|
| Rate for Payer: BCN Medicare Advantage |
$391.00
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,345.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.00
|
| Rate for Payer: Healthscope Commercial |
$1,407.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,173.00
|
| Rate for Payer: Mclaren Medicaid |
$3,496.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.55
|
| Rate for Payer: Meridian Medicaid |
$3,671.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,329.40
|
| Rate for Payer: Nomi Health Commercial |
$1,282.48
|
| Rate for Payer: PACE Senior Care Partners |
$371.45
|
| Rate for Payer: PACE SWMI |
$391.00
|
| Rate for Payer: PHP Commercial |
$1,329.40
|
| Rate for Payer: PHP Medicare Advantage |
$391.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,496.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,360.68
|
| Rate for Payer: Priority Health Medicare |
$394.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,047.88
|
| Rate for Payer: Railroad Medicare Medicare |
$391.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,376.32
|
| Rate for Payer: UHC Core |
$1,305.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.00
|
| Rate for Payer: UHC Exchange |
$391.00
|
| Rate for Payer: UHC Medicare Advantage |
$391.00
|
| Rate for Payer: UHCCP Medicaid |
$3,496.88
|
| Rate for Payer: VA VA |
$391.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,173.00
|
|
|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 58563
|
| Hospital Charge Code |
58563
|
| Min. Negotiated Rate |
$14.26 |
| Max. Negotiated Rate |
$3,149.52 |
| Rate for Payer: Aetna Commercial |
$316.27
|
| Rate for Payer: Aetna Medicare |
$245.46
|
| Rate for Payer: BCBS Complete |
$164.61
|
| Rate for Payer: BCBS MAPPO |
$236.02
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCN Commercial |
$3,149.52
|
| Rate for Payer: BCN Medicare Advantage |
$236.02
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$339.87
|
| Rate for Payer: Cofinity Commercial |
$316.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.02
|
| Rate for Payer: Mclaren Medicaid |
$156.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.82
|
| Rate for Payer: Meridian Medicaid |
$164.61
|
| Rate for Payer: Nomi Health Commercial |
$283.22
|
| Rate for Payer: PACE SWMI |
$236.02
|
| Rate for Payer: PHP Medicare Advantage |
$236.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO |
$364.59
|
| Rate for Payer: Priority Health Medicare |
$238.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$364.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.02
|
| Rate for Payer: UHC Exchange |
$236.02
|
| Rate for Payer: UHC Medicare Advantage |
$236.02
|
| Rate for Payer: UHCCP Medicaid |
$156.77
|
|
|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 58563
|
| Min. Negotiated Rate |
$14.26 |
| Max. Negotiated Rate |
$3,149.52 |
| Rate for Payer: Aetna Commercial |
$316.27
|
| Rate for Payer: Aetna Medicare |
$245.46
|
| Rate for Payer: BCBS Complete |
$164.61
|
| Rate for Payer: BCBS MAPPO |
$236.02
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCN Commercial |
$3,149.52
|
| Rate for Payer: BCN Medicare Advantage |
$236.02
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$339.87
|
| Rate for Payer: Cofinity Commercial |
$316.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.02
|
| Rate for Payer: Mclaren Medicaid |
$156.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.82
|
| Rate for Payer: Meridian Medicaid |
$164.61
|
| Rate for Payer: Nomi Health Commercial |
$283.22
|
| Rate for Payer: PACE SWMI |
$236.02
|
| Rate for Payer: PHP Medicare Advantage |
$236.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO |
$364.59
|
| Rate for Payer: Priority Health Medicare |
$238.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$364.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.02
|
| Rate for Payer: UHC Exchange |
$236.02
|
| Rate for Payer: UHC Medicare Advantage |
$236.02
|
| Rate for Payer: UHCCP Medicaid |
$156.77
|
|
|
PR HYSTEROSCOPY ENDOMETRIAL ABLATION
|
Facility
|
IP
|
$1,564.00
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
58563
|
| Min. Negotiated Rate |
$1,016.60 |
| Max. Negotiated Rate |
$1,407.60 |
| Rate for Payer: Aetna Commercial |
$1,329.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,276.69
|
| Rate for Payer: BCN Commercial |
$1,208.66
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,345.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.20
|
| Rate for Payer: Healthscope Commercial |
$1,407.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,173.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,329.40
|
| Rate for Payer: Nomi Health Commercial |
$1,282.48
|
| Rate for Payer: PHP Commercial |
$1,329.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,360.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,047.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,376.32
|
| Rate for Payer: UHC Core |
$1,305.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,173.00
|
|
|
PR HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
HCPCS 58559
|
| Min. Negotiated Rate |
$180.84 |
| Max. Negotiated Rate |
$984.75 |
| Rate for Payer: Aetna Commercial |
$365.18
|
| Rate for Payer: Aetna Medicare |
$283.42
|
| Rate for Payer: BCBS Complete |
$189.88
|
| Rate for Payer: BCBS MAPPO |
$272.52
|
| Rate for Payer: BCBS Trust/PPO |
$498.19
|
| Rate for Payer: BCN Commercial |
$412.93
|
| Rate for Payer: BCN Medicare Advantage |
$272.52
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cofinity Commercial |
$392.43
|
| Rate for Payer: Cofinity Commercial |
$365.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.52
|
| Rate for Payer: Mclaren Medicaid |
$180.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.15
|
| Rate for Payer: Meridian Medicaid |
$189.88
|
| Rate for Payer: Nomi Health Commercial |
$327.02
|
| Rate for Payer: PACE SWMI |
$272.52
|
| Rate for Payer: PHP Medicare Advantage |
$272.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.75
|
| Rate for Payer: Priority Health HMO/PPO |
$421.14
|
| Rate for Payer: Priority Health Medicare |
$275.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$272.52
|
| Rate for Payer: UHC Exchange |
$272.52
|
| Rate for Payer: UHC Medicare Advantage |
$272.52
|
| Rate for Payer: UHCCP Medicaid |
$180.84
|
|
|
PR HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY
|
Professional
|
Both
|
$1,177.00
|
|
|
Service Code
|
HCPCS 58562
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$765.05 |
| Rate for Payer: Aetna Commercial |
$284.72
|
| Rate for Payer: Aetna Medicare |
$220.98
|
| Rate for Payer: BCBS Complete |
$148.28
|
| Rate for Payer: BCBS MAPPO |
$212.48
|
| Rate for Payer: BCBS Trust/PPO |
$13.74
|
| Rate for Payer: BCN Commercial |
$639.19
|
| Rate for Payer: BCN Medicare Advantage |
$212.48
|
| Rate for Payer: Cash Price |
$941.60
|
| Rate for Payer: Cash Price |
$941.60
|
| Rate for Payer: Cofinity Commercial |
$305.97
|
| Rate for Payer: Cofinity Commercial |
$284.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.48
|
| Rate for Payer: Mclaren Medicaid |
$141.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.10
|
| Rate for Payer: Meridian Medicaid |
$148.28
|
| Rate for Payer: Nomi Health Commercial |
$254.98
|
| Rate for Payer: PACE SWMI |
$212.48
|
| Rate for Payer: PHP Medicare Advantage |
$212.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$765.05
|
| Rate for Payer: Priority Health HMO/PPO |
$328.88
|
| Rate for Payer: Priority Health Medicare |
$214.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.48
|
| Rate for Payer: UHC Exchange |
$212.48
|
| Rate for Payer: UHC Medicare Advantage |
$212.48
|
| Rate for Payer: UHCCP Medicaid |
$141.22
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Facility
|
OP
|
$941.00
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
58561
|
| Min. Negotiated Rate |
$223.49 |
| Max. Negotiated Rate |
$3,671.97 |
| Rate for Payer: Aetna Commercial |
$799.85
|
| Rate for Payer: Aetna Medicare |
$244.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.06
|
| Rate for Payer: BCBS Complete |
$3,671.97
|
| Rate for Payer: BCBS MAPPO |
$235.25
|
| Rate for Payer: BCBS Trust/PPO |
$773.60
|
| Rate for Payer: BCN Commercial |
$731.63
|
| Rate for Payer: BCN Medicare Advantage |
$235.25
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$809.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.25
|
| Rate for Payer: Healthscope Commercial |
$846.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.75
|
| Rate for Payer: Mclaren Medicaid |
$3,496.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.01
|
| Rate for Payer: Meridian Medicaid |
$3,671.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.85
|
| Rate for Payer: Nomi Health Commercial |
$771.62
|
| Rate for Payer: PACE Senior Care Partners |
$223.49
|
| Rate for Payer: PACE SWMI |
$235.25
|
| Rate for Payer: PHP Commercial |
$799.85
|
| Rate for Payer: PHP Medicare Advantage |
$235.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,496.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO |
$818.67
|
| Rate for Payer: Priority Health Medicare |
$237.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$630.47
|
| Rate for Payer: Railroad Medicare Medicare |
$235.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$828.08
|
| Rate for Payer: UHC Core |
$785.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.25
|
| Rate for Payer: UHC Exchange |
$235.25
|
| Rate for Payer: UHC Medicare Advantage |
$235.25
|
| Rate for Payer: UHCCP Medicaid |
$3,496.88
|
| Rate for Payer: VA VA |
$235.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.75
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 58561
|
| Hospital Charge Code |
58561
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$611.65 |
| Rate for Payer: Aetna Commercial |
$460.57
|
| Rate for Payer: Aetna Medicare |
$357.46
|
| Rate for Payer: BCBS Complete |
$239.31
|
| Rate for Payer: BCBS MAPPO |
$343.71
|
| Rate for Payer: BCBS Trust/PPO |
$23.25
|
| Rate for Payer: BCN Commercial |
$520.44
|
| Rate for Payer: BCN Medicare Advantage |
$343.71
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$494.94
|
| Rate for Payer: Cofinity Commercial |
$460.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.71
|
| Rate for Payer: Mclaren Medicaid |
$227.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.90
|
| Rate for Payer: Meridian Medicaid |
$239.31
|
| Rate for Payer: Nomi Health Commercial |
$412.45
|
| Rate for Payer: PACE SWMI |
$343.71
|
| Rate for Payer: PHP Medicare Advantage |
$343.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO |
$530.78
|
| Rate for Payer: Priority Health Medicare |
$347.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.71
|
| Rate for Payer: UHC Exchange |
$343.71
|
| Rate for Payer: UHC Medicare Advantage |
$343.71
|
| Rate for Payer: UHCCP Medicaid |
$227.91
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 58561
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$611.65 |
| Rate for Payer: Aetna Commercial |
$460.57
|
| Rate for Payer: Aetna Medicare |
$357.46
|
| Rate for Payer: BCBS Complete |
$239.31
|
| Rate for Payer: BCBS MAPPO |
$343.71
|
| Rate for Payer: BCBS Trust/PPO |
$23.25
|
| Rate for Payer: BCN Commercial |
$520.44
|
| Rate for Payer: BCN Medicare Advantage |
$343.71
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$494.94
|
| Rate for Payer: Cofinity Commercial |
$460.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.71
|
| Rate for Payer: Mclaren Medicaid |
$227.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.90
|
| Rate for Payer: Meridian Medicaid |
$239.31
|
| Rate for Payer: Nomi Health Commercial |
$412.45
|
| Rate for Payer: PACE SWMI |
$343.71
|
| Rate for Payer: PHP Medicare Advantage |
$343.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO |
$530.78
|
| Rate for Payer: Priority Health Medicare |
$347.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.71
|
| Rate for Payer: UHC Exchange |
$343.71
|
| Rate for Payer: UHC Medicare Advantage |
$343.71
|
| Rate for Payer: UHCCP Medicaid |
$227.91
|
|
|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Facility
|
IP
|
$941.00
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
58561
|
| Min. Negotiated Rate |
$611.65 |
| Max. Negotiated Rate |
$846.90 |
| Rate for Payer: Aetna Commercial |
$799.85
|
| Rate for Payer: BCBS Trust/PPO |
$768.14
|
| Rate for Payer: BCN Commercial |
$727.20
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$809.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.80
|
| Rate for Payer: Healthscope Commercial |
$846.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.85
|
| Rate for Payer: Nomi Health Commercial |
$771.62
|
| Rate for Payer: PHP Commercial |
$799.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO |
$818.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$630.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$828.08
|
| Rate for Payer: UHC Core |
$785.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.75
|
|
|
PR HYSTEROTOMY ABDOMINAL
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 59100
|
| Min. Negotiated Rate |
$130.49 |
| Max. Negotiated Rate |
$1,260.30 |
| Rate for Payer: Aetna Commercial |
$1,119.72
|
| Rate for Payer: Aetna Medicare |
$869.03
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS MAPPO |
$835.61
|
| Rate for Payer: BCBS Trust/PPO |
$130.49
|
| Rate for Payer: BCN Commercial |
$1,260.30
|
| Rate for Payer: BCN Medicare Advantage |
$835.61
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,119.72
|
| Rate for Payer: Cofinity Commercial |
$1,203.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.61
|
| Rate for Payer: Mclaren Medicaid |
$551.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.39
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Nomi Health Commercial |
$1,002.73
|
| Rate for Payer: PACE SWMI |
$835.61
|
| Rate for Payer: PHP Medicare Advantage |
$835.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,208.65
|
| Rate for Payer: Priority Health Medicare |
$843.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,208.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.61
|
| Rate for Payer: UHC Exchange |
$835.61
|
| Rate for Payer: UHC Medicare Advantage |
$835.61
|
| Rate for Payer: UHCCP Medicaid |
$551.24
|
|
|
PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM USE
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 90750
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$187.08 |
| Rate for Payer: Aetna Commercial |
$187.08
|
| Rate for Payer: Aetna Medicare |
$85.50
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: BCBS Trust/PPO |
$175.26
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
|
|
PR I131 IODIDE CAP, RX
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS A9517
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$2,124.29 |
| Rate for Payer: Aetna Commercial |
$40.43
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.29
|
| Rate for Payer: BCN Commercial |
$23.73
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
|
|
PR ICAR CATH ABLATION DISCRETE MECHANISM ARRHYTHMIA
|
Professional
|
Both
|
$1,492.00
|
|
|
Service Code
|
HCPCS 93655
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$2,991.76 |
| Rate for Payer: Aetna Commercial |
$390.01
|
| Rate for Payer: Aetna Medicare |
$302.69
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS MAPPO |
$291.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,991.76
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$291.05
|
| Rate for Payer: Cash Price |
$1,193.60
|
| Rate for Payer: Cash Price |
$1,193.60
|
| Rate for Payer: Cofinity Commercial |
$390.01
|
| Rate for Payer: Cofinity Commercial |
$419.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.05
|
| Rate for Payer: Mclaren Medicaid |
$191.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.60
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Nomi Health Commercial |
$349.26
|
| Rate for Payer: PACE SWMI |
$291.05
|
| Rate for Payer: PHP Medicare Advantage |
$291.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.80
|
| Rate for Payer: Priority Health HMO/PPO |
$421.39
|
| Rate for Payer: Priority Health Medicare |
$293.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.05
|
| Rate for Payer: UHC Exchange |
$291.05
|
| Rate for Payer: UHC Medicare Advantage |
$291.05
|
| Rate for Payer: UHCCP Medicaid |
$191.27
|
|
|
PR ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 93650
|
| Min. Negotiated Rate |
$363.17 |
| Max. Negotiated Rate |
$2,821.65 |
| Rate for Payer: Aetna Commercial |
$738.98
|
| Rate for Payer: Aetna Medicare |
$573.54
|
| Rate for Payer: BCBS Complete |
$381.33
|
| Rate for Payer: BCBS MAPPO |
$551.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,821.65
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$551.48
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cofinity Commercial |
$794.13
|
| Rate for Payer: Cofinity Commercial |
$738.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.48
|
| Rate for Payer: Mclaren Medicaid |
$363.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.05
|
| Rate for Payer: Meridian Medicaid |
$381.33
|
| Rate for Payer: Nomi Health Commercial |
$661.78
|
| Rate for Payer: PACE SWMI |
$551.48
|
| Rate for Payer: PHP Medicare Advantage |
$551.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,196.00
|
| Rate for Payer: Priority Health HMO/PPO |
$800.43
|
| Rate for Payer: Priority Health Medicare |
$556.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$800.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$551.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.48
|
| Rate for Payer: UHC Exchange |
$551.48
|
| Rate for Payer: UHC Medicare Advantage |
$551.48
|
| Rate for Payer: UHCCP Medicaid |
$363.17
|
|
|
PR I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 42700
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$492.38 |
| Rate for Payer: Aetna Commercial |
$173.38
|
| Rate for Payer: Aetna Medicare |
$134.57
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$129.39
|
| Rate for Payer: BCBS Trust/PPO |
$492.38
|
| Rate for Payer: BCN Commercial |
$284.90
|
| Rate for Payer: BCN Medicare Advantage |
$129.39
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$186.32
|
| Rate for Payer: Cofinity Commercial |
$173.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.39
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.86
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Nomi Health Commercial |
$155.27
|
| Rate for Payer: PACE SWMI |
$129.39
|
| Rate for Payer: PHP Medicare Advantage |
$129.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO |
$245.79
|
| Rate for Payer: Priority Health Medicare |
$130.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.39
|
| Rate for Payer: UHC Exchange |
$129.39
|
| Rate for Payer: UHC Medicare Advantage |
$129.39
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 42720
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$692.06 |
| Rate for Payer: Aetna Commercial |
$494.58
|
| Rate for Payer: Aetna Medicare |
$383.85
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS MAPPO |
$369.09
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: BCN Commercial |
$657.27
|
| Rate for Payer: BCN Medicare Advantage |
$369.09
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$531.49
|
| Rate for Payer: Cofinity Commercial |
$494.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.09
|
| Rate for Payer: Mclaren Medicaid |
$248.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.54
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Nomi Health Commercial |
$442.91
|
| Rate for Payer: PACE SWMI |
$369.09
|
| Rate for Payer: PHP Medicare Advantage |
$369.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.55
|
| Rate for Payer: Priority Health HMO/PPO |
$692.06
|
| Rate for Payer: Priority Health Medicare |
$372.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$369.09
|
| Rate for Payer: UHC Exchange |
$369.09
|
| Rate for Payer: UHC Medicare Advantage |
$369.09
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 42725
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$1,436.59 |
| Rate for Payer: Aetna Commercial |
$1,025.14
|
| Rate for Payer: Aetna Medicare |
$795.63
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS MAPPO |
$765.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.83
|
| Rate for Payer: BCN Commercial |
$1,165.98
|
| Rate for Payer: BCN Medicare Advantage |
$765.03
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cofinity Commercial |
$1,101.64
|
| Rate for Payer: Cofinity Commercial |
$1,025.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.03
|
| Rate for Payer: Mclaren Medicaid |
$515.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.28
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Nomi Health Commercial |
$918.04
|
| Rate for Payer: PACE SWMI |
$765.03
|
| Rate for Payer: PHP Medicare Advantage |
$765.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$960.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,436.59
|
| Rate for Payer: Priority Health Medicare |
$772.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,436.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.03
|
| Rate for Payer: UHC Exchange |
$765.03
|
| Rate for Payer: UHC Medicare Advantage |
$765.03
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
|
|
PR I&D BELOW FASCIA FOOT 1 BURSAL SPACE
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 28002
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$564.20 |
| Rate for Payer: Aetna Commercial |
$179.72
|
| Rate for Payer: Aetna Medicare |
$139.48
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$134.12
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$359.18
|
| Rate for Payer: BCN Medicare Advantage |
$134.12
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cofinity Commercial |
$193.13
|
| Rate for Payer: Cofinity Commercial |
$179.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.12
|
| Rate for Payer: Mclaren Medicaid |
$89.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.83
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Nomi Health Commercial |
$160.94
|
| Rate for Payer: PACE SWMI |
$134.12
|
| Rate for Payer: PHP Medicare Advantage |
$134.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.20
|
| Rate for Payer: Priority Health HMO/PPO |
$213.21
|
| Rate for Payer: Priority Health Medicare |
$135.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.12
|
| Rate for Payer: UHC Exchange |
$134.12
|
| Rate for Payer: UHC Medicare Advantage |
$134.12
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
|
|
PR I&D BELOW FASCIA FOOT MULTIPLE AREAS
|
Professional
|
Both
|
$1,243.00
|
|
|
Service Code
|
HCPCS 28003
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$3,691.76 |
| Rate for Payer: Aetna Commercial |
$330.94
|
| Rate for Payer: Aetna Medicare |
$256.85
|
| Rate for Payer: BCBS Complete |
$172.43
|
| Rate for Payer: BCBS MAPPO |
$246.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,691.76
|
| Rate for Payer: BCN Commercial |
$554.65
|
| Rate for Payer: BCN Medicare Advantage |
$246.97
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cofinity Commercial |
$355.64
|
| Rate for Payer: Cofinity Commercial |
$330.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.97
|
| Rate for Payer: Mclaren Medicaid |
$164.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.32
|
| Rate for Payer: Meridian Medicaid |
$172.43
|
| Rate for Payer: Nomi Health Commercial |
$296.36
|
| Rate for Payer: PACE SWMI |
$246.97
|
| Rate for Payer: PHP Medicare Advantage |
$246.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.95
|
| Rate for Payer: Priority Health HMO/PPO |
$392.34
|
| Rate for Payer: Priority Health Medicare |
$249.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.97
|
| Rate for Payer: UHC Exchange |
$246.97
|
| Rate for Payer: UHC Medicare Advantage |
$246.97
|
| Rate for Payer: UHCCP Medicaid |
$164.22
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
|
IP
|
$1,665.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$1,082.25 |
| Max. Negotiated Rate |
$1,498.50 |
| Rate for Payer: Aetna Commercial |
$1,415.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.14
|
| Rate for Payer: BCN Commercial |
$1,286.71
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,431.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Healthscope Commercial |
$1,498.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,248.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: Nomi Health Commercial |
$1,365.30
|
| Rate for Payer: PHP Commercial |
$1,415.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,448.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,115.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,465.20
|
| Rate for Payer: UHC Core |
$1,390.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,248.75
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
|
OP
|
$1,665.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$395.44 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,415.25
|
| Rate for Payer: Aetna Medicare |
$432.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.31
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$416.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,368.80
|
| Rate for Payer: BCN Commercial |
$1,294.54
|
| Rate for Payer: BCN Medicare Advantage |
$416.25
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,431.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.25
|
| Rate for Payer: Healthscope Commercial |
$1,498.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,248.75
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.06
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$478.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: Nomi Health Commercial |
$1,365.30
|
| Rate for Payer: PACE Senior Care Partners |
$395.44
|
| Rate for Payer: PACE SWMI |
$416.25
|
| Rate for Payer: PHP Commercial |
$1,415.25
|
| Rate for Payer: PHP Medicare Advantage |
$416.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,448.55
|
| Rate for Payer: Priority Health Medicare |
$420.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,115.55
|
| Rate for Payer: Railroad Medicare Medicare |
$416.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,465.20
|
| Rate for Payer: UHC Core |
$1,390.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.25
|
| Rate for Payer: UHC Exchange |
$416.25
|
| Rate for Payer: UHC Medicare Advantage |
$416.25
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$416.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,248.75
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$332.71 |
| Max. Negotiated Rate |
$3,899.38 |
| Rate for Payer: Aetna Commercial |
$659.17
|
| Rate for Payer: Aetna Medicare |
$511.60
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS MAPPO |
$491.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.38
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$491.92
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$708.36
|
| Rate for Payer: Cofinity Commercial |
$659.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.92
|
| Rate for Payer: Mclaren Medicaid |
$332.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.52
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Nomi Health Commercial |
$590.30
|
| Rate for Payer: PACE SWMI |
$491.92
|
| Rate for Payer: PHP Medicare Advantage |
$491.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO |
$788.22
|
| Rate for Payer: Priority Health Medicare |
$496.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$788.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$491.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.92
|
| Rate for Payer: UHC Exchange |
$491.92
|
| Rate for Payer: UHC Medicare Advantage |
$491.92
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 27301
|
| Min. Negotiated Rate |
$332.71 |
| Max. Negotiated Rate |
$3,899.38 |
| Rate for Payer: Aetna Commercial |
$659.17
|
| Rate for Payer: Aetna Medicare |
$511.60
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS MAPPO |
$491.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.38
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$491.92
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$708.36
|
| Rate for Payer: Cofinity Commercial |
$659.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.92
|
| Rate for Payer: Mclaren Medicaid |
$332.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.52
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Nomi Health Commercial |
$590.30
|
| Rate for Payer: PACE SWMI |
$491.92
|
| Rate for Payer: PHP Medicare Advantage |
$491.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO |
$788.22
|
| Rate for Payer: Priority Health Medicare |
$496.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$788.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$491.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.92
|
| Rate for Payer: UHC Exchange |
$491.92
|
| Rate for Payer: UHC Medicare Advantage |
$491.92
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
|
|
PR I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR
|
Professional
|
Both
|
$2,460.00
|
|
|
Service Code
|
HCPCS 22010
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,599.00 |
| Rate for Payer: Aetna Commercial |
$1,273.05
|
| Rate for Payer: Aetna Medicare |
$988.04
|
| Rate for Payer: BCBS Complete |
$667.60
|
| Rate for Payer: BCBS MAPPO |
$950.04
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$1,424.01
|
| Rate for Payer: BCN Medicare Advantage |
$950.04
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$1,368.06
|
| Rate for Payer: Cofinity Commercial |
$1,273.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.04
|
| Rate for Payer: Mclaren Medicaid |
$635.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.54
|
| Rate for Payer: Meridian Medicaid |
$667.60
|
| Rate for Payer: Nomi Health Commercial |
$1,140.05
|
| Rate for Payer: PACE SWMI |
$950.04
|
| Rate for Payer: PHP Medicare Advantage |
$950.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$635.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,599.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,503.69
|
| Rate for Payer: Priority Health Medicare |
$959.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,503.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$950.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.04
|
| Rate for Payer: UHC Exchange |
$950.04
|
| Rate for Payer: UHC Medicare Advantage |
$950.04
|
| Rate for Payer: UHCCP Medicaid |
$635.81
|
|
