|
PR SUPERVISION NURS FACILITY PATIENT MO 15-29 MIN
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 99379
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$2,731.31 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,731.31
|
| Rate for Payer: BCN Commercial |
$98.23
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.53
|
|
|
PR SUPERVISION NURS FACILITY PATIENT MONTH 30 MIN/>
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 99380
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$843.17 |
| Rate for Payer: Aetna Commercial |
$87.31
|
| Rate for Payer: BCBS Complete |
$68.00
|
| Rate for Payer: BCBS Trust/PPO |
$843.17
|
| Rate for Payer: BCN Commercial |
$146.11
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.08
|
|
|
PR SUPERVISION PT HOME HEALTH AGENCY MONTH 30 MIN/>
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 99375
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$2,731.31 |
| Rate for Payer: Aetna Commercial |
$87.31
|
| Rate for Payer: BCBS Complete |
$72.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,731.31
|
| Rate for Payer: BCN Commercial |
$146.11
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.08
|
|
|
PR SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY
|
Professional
|
Both
|
$3,176.00
|
|
|
Service Code
|
HCPCS 58180
|
| Min. Negotiated Rate |
$161.66 |
| Max. Negotiated Rate |
$2,223.20 |
| Rate for Payer: Aetna Commercial |
$1,276.18
|
| Rate for Payer: Aetna Medicare |
$990.46
|
| Rate for Payer: BCBS Complete |
$647.69
|
| Rate for Payer: BCBS MAPPO |
$952.37
|
| Rate for Payer: BCBS Trust/PPO |
$161.66
|
| Rate for Payer: BCN Commercial |
$1,403.97
|
| Rate for Payer: BCN Medicare Advantage |
$952.37
|
| Rate for Payer: Cash Price |
$2,540.80
|
| Rate for Payer: Cash Price |
$2,540.80
|
| Rate for Payer: Cofinity Commercial |
$1,371.41
|
| Rate for Payer: Cofinity Commercial |
$1,276.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$952.37
|
| Rate for Payer: Mclaren Medicaid |
$616.85
|
| Rate for Payer: Meridian Medicaid |
$647.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$999.99
|
| Rate for Payer: PACE SWMI |
$952.37
|
| Rate for Payer: PHP Medicare Advantage |
$952.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,223.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,360.15
|
| Rate for Payer: Priority Health Medicare |
$952.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,360.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$952.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$952.37
|
| Rate for Payer: UHC Medicare Advantage |
$980.94
|
|
|
PR SUPRAHYOID LYMPHADENECTOMY
|
Professional
|
Both
|
$1,431.00
|
|
|
Service Code
|
HCPCS 38700
|
| Min. Negotiated Rate |
$494.49 |
| Max. Negotiated Rate |
$1,752.90 |
| Rate for Payer: Aetna Commercial |
$1,066.80
|
| Rate for Payer: Aetna Medicare |
$827.96
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: BCBS MAPPO |
$796.12
|
| Rate for Payer: BCBS Trust/PPO |
$494.49
|
| Rate for Payer: BCN Commercial |
$1,182.60
|
| Rate for Payer: BCN Medicare Advantage |
$796.12
|
| Rate for Payer: Cash Price |
$1,144.80
|
| Rate for Payer: Cash Price |
$1,144.80
|
| Rate for Payer: Cofinity Commercial |
$1,066.80
|
| Rate for Payer: Cofinity Commercial |
$1,146.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.12
|
| Rate for Payer: Mclaren Medicaid |
$516.95
|
| Rate for Payer: Meridian Medicaid |
$542.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$835.93
|
| Rate for Payer: PACE SWMI |
$796.12
|
| Rate for Payer: PHP Medicare Advantage |
$796.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,752.90
|
| Rate for Payer: Priority Health Medicare |
$796.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,752.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$796.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.12
|
| Rate for Payer: UHC Medicare Advantage |
$820.00
|
|
|
PR SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 36253
|
| Min. Negotiated Rate |
$219.18 |
| Max. Negotiated Rate |
$2,962.36 |
| Rate for Payer: Aetna Commercial |
$461.62
|
| Rate for Payer: Aetna Medicare |
$358.27
|
| Rate for Payer: BCBS Complete |
$230.14
|
| Rate for Payer: BCBS MAPPO |
$344.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,416.90
|
| Rate for Payer: BCN Commercial |
$2,962.36
|
| Rate for Payer: BCN Medicare Advantage |
$344.49
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$461.62
|
| Rate for Payer: Cofinity Commercial |
$496.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.49
|
| Rate for Payer: Mclaren Medicaid |
$219.18
|
| Rate for Payer: Meridian Medicaid |
$230.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$361.71
|
| Rate for Payer: PACE SWMI |
$344.49
|
| Rate for Payer: PHP Medicare Advantage |
$344.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.39
|
| Rate for Payer: Priority Health Medicare |
$344.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.49
|
| Rate for Payer: UHC Medicare Advantage |
$354.82
|
|
|
PR SUPVJ PT HOME HEALTH AGENCY MO 15-29 MINUTES
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 99374
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$2,302.33 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,302.33
|
| Rate for Payer: BCN Commercial |
$98.23
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.53
|
|
|
PR SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR
|
Professional
|
Both
|
$720.00
|
|
|
Service Code
|
HCPCS 31820
|
| Min. Negotiated Rate |
$214.28 |
| Max. Negotiated Rate |
$1,141.66 |
| Rate for Payer: Aetna Commercial |
$436.92
|
| Rate for Payer: Aetna Medicare |
$339.10
|
| Rate for Payer: BCBS Complete |
$224.99
|
| Rate for Payer: BCBS MAPPO |
$326.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,141.66
|
| Rate for Payer: BCN Commercial |
$656.30
|
| Rate for Payer: BCN Medicare Advantage |
$326.06
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cofinity Commercial |
$436.92
|
| Rate for Payer: Cofinity Commercial |
$469.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.06
|
| Rate for Payer: Mclaren Medicaid |
$214.28
|
| Rate for Payer: Meridian Medicaid |
$224.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$342.36
|
| Rate for Payer: PACE SWMI |
$326.06
|
| Rate for Payer: PHP Medicare Advantage |
$326.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$462.11
|
| Rate for Payer: Priority Health Medicare |
$326.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$462.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.06
|
| Rate for Payer: UHC Medicare Advantage |
$335.84
|
|
|
PR SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
HCPCS 31825
|
| Min. Negotiated Rate |
$313.11 |
| Max. Negotiated Rate |
$1,118.94 |
| Rate for Payer: Aetna Commercial |
$640.90
|
| Rate for Payer: Aetna Medicare |
$497.41
|
| Rate for Payer: BCBS Complete |
$328.77
|
| Rate for Payer: BCBS MAPPO |
$478.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.94
|
| Rate for Payer: BCN Commercial |
$906.01
|
| Rate for Payer: BCN Medicare Advantage |
$478.28
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cofinity Commercial |
$688.72
|
| Rate for Payer: Cofinity Commercial |
$640.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.28
|
| Rate for Payer: Mclaren Medicaid |
$313.11
|
| Rate for Payer: Meridian Medicaid |
$328.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$502.19
|
| Rate for Payer: PACE SWMI |
$478.28
|
| Rate for Payer: PHP Medicare Advantage |
$478.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.51
|
| Rate for Payer: Priority Health Medicare |
$478.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$676.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.28
|
| Rate for Payer: UHC Medicare Advantage |
$492.63
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Professional
|
Both
|
$2,919.00
|
|
|
Service Code
|
HCPCS 29828
|
| Min. Negotiated Rate |
$590.22 |
| Max. Negotiated Rate |
$2,043.30 |
| Rate for Payer: Aetna Commercial |
$1,209.26
|
| Rate for Payer: Aetna Medicare |
$938.53
|
| Rate for Payer: BCBS Complete |
$619.73
|
| Rate for Payer: BCBS MAPPO |
$902.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,677.88
|
| Rate for Payer: BCN Commercial |
$1,343.38
|
| Rate for Payer: BCN Medicare Advantage |
$902.43
|
| Rate for Payer: Cash Price |
$2,335.20
|
| Rate for Payer: Cash Price |
$2,335.20
|
| Rate for Payer: Cofinity Commercial |
$1,209.26
|
| Rate for Payer: Cofinity Commercial |
$1,299.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.43
|
| Rate for Payer: Mclaren Medicaid |
$590.22
|
| Rate for Payer: Meridian Medicaid |
$619.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$947.55
|
| Rate for Payer: PACE SWMI |
$902.43
|
| Rate for Payer: PHP Medicare Advantage |
$902.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,043.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,403.78
|
| Rate for Payer: Priority Health Medicare |
$902.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,403.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$902.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.43
|
| Rate for Payer: UHC Medicare Advantage |
$929.50
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Facility
|
OP
|
$2,919.00
|
|
|
Service Code
|
CPT 29828
|
| Hospital Charge Code |
29828
|
| Min. Negotiated Rate |
$693.26 |
| Max. Negotiated Rate |
$4,927.66 |
| Rate for Payer: Aetna Commercial |
$2,481.15
|
| Rate for Payer: Aetna Medicare |
$758.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$912.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$912.19
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$729.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,269.52
|
| Rate for Payer: BCN Commercial |
$2,269.52
|
| Rate for Payer: BCN Medicare Advantage |
$729.75
|
| Rate for Payer: Cash Price |
$2,335.20
|
| Rate for Payer: Cash Price |
$2,335.20
|
| Rate for Payer: Cofinity Commercial |
$2,510.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,335.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$729.75
|
| Rate for Payer: Healthscope Commercial |
$2,627.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,189.25
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$766.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$839.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,481.15
|
| Rate for Payer: PACE Senior Care Partners |
$693.26
|
| Rate for Payer: PACE SWMI |
$729.75
|
| Rate for Payer: PHP Commercial |
$2,481.15
|
| Rate for Payer: PHP Medicare Advantage |
$729.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,043.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,539.53
|
| Rate for Payer: Priority Health Medicare |
$729.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,780.30
|
| Rate for Payer: Railroad Medicare Medicare |
$729.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,568.72
|
| Rate for Payer: UHC Core |
$2,437.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$729.75
|
| Rate for Payer: UHC Medicare Advantage |
$751.64
|
| Rate for Payer: VA VA |
$729.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,189.25
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Facility
|
IP
|
$2,919.00
|
|
|
Service Code
|
CPT 29828
|
| Hospital Charge Code |
29828
|
| Min. Negotiated Rate |
$1,780.30 |
| Max. Negotiated Rate |
$2,627.10 |
| Rate for Payer: Aetna Commercial |
$2,481.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,255.80
|
| Rate for Payer: BCN Commercial |
$2,255.80
|
| Rate for Payer: Cash Price |
$2,335.20
|
| Rate for Payer: Cofinity Commercial |
$2,510.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,335.20
|
| Rate for Payer: Healthscope Commercial |
$2,627.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,189.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,481.15
|
| Rate for Payer: PHP Commercial |
$2,481.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,043.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,539.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,780.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,568.72
|
| Rate for Payer: UHC Core |
$2,437.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,189.25
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS
|
Professional
|
Both
|
$2,919.00
|
|
|
Service Code
|
HCPCS 29828
|
| Hospital Charge Code |
29828
|
| Min. Negotiated Rate |
$590.22 |
| Max. Negotiated Rate |
$2,043.30 |
| Rate for Payer: Aetna Commercial |
$1,209.26
|
| Rate for Payer: Aetna Medicare |
$938.53
|
| Rate for Payer: BCBS Complete |
$619.73
|
| Rate for Payer: BCBS MAPPO |
$902.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,677.88
|
| Rate for Payer: BCN Commercial |
$1,343.38
|
| Rate for Payer: BCN Medicare Advantage |
$902.43
|
| Rate for Payer: Cash Price |
$2,335.20
|
| Rate for Payer: Cash Price |
$2,335.20
|
| Rate for Payer: Cofinity Commercial |
$1,209.26
|
| Rate for Payer: Cofinity Commercial |
$1,299.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.43
|
| Rate for Payer: Mclaren Medicaid |
$590.22
|
| Rate for Payer: Meridian Medicaid |
$619.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$947.55
|
| Rate for Payer: PACE SWMI |
$902.43
|
| Rate for Payer: PHP Medicare Advantage |
$902.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,043.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,403.78
|
| Rate for Payer: Priority Health Medicare |
$902.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,403.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$902.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.43
|
| Rate for Payer: UHC Medicare Advantage |
$929.50
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Facility
|
OP
|
$3,173.00
|
|
|
Service Code
|
CPT 29806
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$753.59 |
| Max. Negotiated Rate |
$4,927.66 |
| Rate for Payer: Aetna Commercial |
$2,697.05
|
| Rate for Payer: Aetna Medicare |
$824.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$991.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$991.56
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$793.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,467.01
|
| Rate for Payer: BCN Commercial |
$2,467.01
|
| Rate for Payer: BCN Medicare Advantage |
$793.25
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cofinity Commercial |
$2,728.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.25
|
| Rate for Payer: Healthscope Commercial |
$2,855.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,379.75
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$832.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$912.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,697.05
|
| Rate for Payer: PACE Senior Care Partners |
$753.59
|
| Rate for Payer: PACE SWMI |
$793.25
|
| Rate for Payer: PHP Commercial |
$2,697.05
|
| Rate for Payer: PHP Medicare Advantage |
$793.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,760.51
|
| Rate for Payer: Priority Health Medicare |
$793.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,935.21
|
| Rate for Payer: Railroad Medicare Medicare |
$793.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,792.24
|
| Rate for Payer: UHC Core |
$2,649.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$793.25
|
| Rate for Payer: UHC Medicare Advantage |
$817.05
|
| Rate for Payer: VA VA |
$793.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,379.75
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Facility
|
IP
|
$3,173.00
|
|
|
Service Code
|
CPT 29806
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$1,935.21 |
| Max. Negotiated Rate |
$2,855.70 |
| Rate for Payer: Aetna Commercial |
$2,697.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,452.09
|
| Rate for Payer: BCN Commercial |
$2,452.09
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cofinity Commercial |
$2,728.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.40
|
| Rate for Payer: Healthscope Commercial |
$2,855.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,379.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,697.05
|
| Rate for Payer: PHP Commercial |
$2,697.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,760.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,935.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,792.24
|
| Rate for Payer: UHC Core |
$2,649.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,379.75
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Professional
|
Both
|
$3,173.00
|
|
|
Service Code
|
HCPCS 29806
|
| Hospital Charge Code |
29806
|
| Min. Negotiated Rate |
$682.03 |
| Max. Negotiated Rate |
$2,221.10 |
| Rate for Payer: Aetna Commercial |
$1,395.80
|
| Rate for Payer: Aetna Medicare |
$1,083.31
|
| Rate for Payer: BCBS Complete |
$716.13
|
| Rate for Payer: BCBS MAPPO |
$1,041.64
|
| Rate for Payer: BCBS Trust/PPO |
$846.86
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.64
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cofinity Commercial |
$1,395.80
|
| Rate for Payer: Cofinity Commercial |
$1,499.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.64
|
| Rate for Payer: Mclaren Medicaid |
$682.03
|
| Rate for Payer: Meridian Medicaid |
$716.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,093.72
|
| Rate for Payer: PACE SWMI |
$1,041.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,620.29
|
| Rate for Payer: Priority Health Medicare |
$1,041.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,620.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,041.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,041.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.89
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY
|
Professional
|
Both
|
$3,173.00
|
|
|
Service Code
|
HCPCS 29806
|
| Min. Negotiated Rate |
$682.03 |
| Max. Negotiated Rate |
$2,221.10 |
| Rate for Payer: Aetna Commercial |
$1,395.80
|
| Rate for Payer: Aetna Medicare |
$1,083.31
|
| Rate for Payer: BCBS Complete |
$716.13
|
| Rate for Payer: BCBS MAPPO |
$1,041.64
|
| Rate for Payer: BCBS Trust/PPO |
$846.86
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.64
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cash Price |
$2,538.40
|
| Rate for Payer: Cofinity Commercial |
$1,499.96
|
| Rate for Payer: Cofinity Commercial |
$1,395.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.64
|
| Rate for Payer: Mclaren Medicaid |
$682.03
|
| Rate for Payer: Meridian Medicaid |
$716.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,093.72
|
| Rate for Payer: PACE SWMI |
$1,041.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$682.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,620.29
|
| Rate for Payer: Priority Health Medicare |
$1,041.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,620.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,041.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,041.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.89
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY
|
Professional
|
Both
|
$2,223.00
|
|
|
Service Code
|
HCPCS 29821
|
| Min. Negotiated Rate |
$384.04 |
| Max. Negotiated Rate |
$1,682.64 |
| Rate for Payer: Aetna Commercial |
$784.32
|
| Rate for Payer: Aetna Medicare |
$608.72
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS MAPPO |
$585.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,682.64
|
| Rate for Payer: BCN Commercial |
$875.23
|
| Rate for Payer: BCN Medicare Advantage |
$585.31
|
| Rate for Payer: Cash Price |
$1,778.40
|
| Rate for Payer: Cash Price |
$1,778.40
|
| Rate for Payer: Cofinity Commercial |
$784.32
|
| Rate for Payer: Cofinity Commercial |
$842.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.31
|
| Rate for Payer: Mclaren Medicaid |
$384.04
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$614.58
|
| Rate for Payer: PACE SWMI |
$585.31
|
| Rate for Payer: PHP Medicare Advantage |
$585.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$914.57
|
| Rate for Payer: Priority Health Medicare |
$585.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$914.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.31
|
| Rate for Payer: UHC Medicare Advantage |
$602.87
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 29824
|
| Min. Negotiated Rate |
$438.57 |
| Max. Negotiated Rate |
$1,443.40 |
| Rate for Payer: Aetna Commercial |
$894.05
|
| Rate for Payer: Aetna Medicare |
$693.89
|
| Rate for Payer: BCBS Complete |
$460.50
|
| Rate for Payer: BCBS MAPPO |
$667.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.60
|
| Rate for Payer: BCN Commercial |
$1,098.74
|
| Rate for Payer: BCN Medicare Advantage |
$667.20
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$960.77
|
| Rate for Payer: Cofinity Commercial |
$894.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.20
|
| Rate for Payer: Mclaren Medicaid |
$438.57
|
| Rate for Payer: Meridian Medicaid |
$460.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$700.56
|
| Rate for Payer: PACE SWMI |
$667.20
|
| Rate for Payer: PHP Medicare Advantage |
$667.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.75
|
| Rate for Payer: Priority Health Medicare |
$667.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,042.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$667.20
|
| Rate for Payer: UHC Medicare Advantage |
$687.22
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Facility
|
IP
|
$2,062.00
|
|
|
Service Code
|
CPT 29824
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$1,257.61 |
| Max. Negotiated Rate |
$1,855.80 |
| Rate for Payer: Aetna Commercial |
$1,752.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,593.51
|
| Rate for Payer: BCN Commercial |
$1,593.51
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$1,773.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,649.60
|
| Rate for Payer: Healthscope Commercial |
$1,855.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,546.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,752.70
|
| Rate for Payer: PHP Commercial |
$1,752.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,793.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,257.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,814.56
|
| Rate for Payer: UHC Core |
$1,721.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,546.50
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Facility
|
OP
|
$2,062.00
|
|
|
Service Code
|
CPT 29824
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$489.72 |
| Max. Negotiated Rate |
$2,229.50 |
| Rate for Payer: Aetna Commercial |
$1,752.70
|
| Rate for Payer: Aetna Medicare |
$536.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$644.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$644.38
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$515.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.20
|
| Rate for Payer: BCN Commercial |
$1,603.20
|
| Rate for Payer: BCN Medicare Advantage |
$515.50
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$1,773.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,649.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.50
|
| Rate for Payer: Healthscope Commercial |
$1,855.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,546.50
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$541.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$592.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,752.70
|
| Rate for Payer: PACE Senior Care Partners |
$489.72
|
| Rate for Payer: PACE SWMI |
$515.50
|
| Rate for Payer: PHP Commercial |
$1,752.70
|
| Rate for Payer: PHP Medicare Advantage |
$515.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,793.94
|
| Rate for Payer: Priority Health Medicare |
$515.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,257.61
|
| Rate for Payer: Railroad Medicare Medicare |
$515.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,814.56
|
| Rate for Payer: UHC Core |
$1,721.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$515.50
|
| Rate for Payer: UHC Medicare Advantage |
$530.96
|
| Rate for Payer: VA VA |
$515.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,546.50
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 29824
|
| Hospital Charge Code |
29824
|
| Min. Negotiated Rate |
$438.57 |
| Max. Negotiated Rate |
$1,443.40 |
| Rate for Payer: Aetna Commercial |
$894.05
|
| Rate for Payer: Aetna Medicare |
$693.89
|
| Rate for Payer: BCBS Complete |
$460.50
|
| Rate for Payer: BCBS MAPPO |
$667.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.60
|
| Rate for Payer: BCN Commercial |
$1,098.74
|
| Rate for Payer: BCN Medicare Advantage |
$667.20
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$894.05
|
| Rate for Payer: Cofinity Commercial |
$960.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.20
|
| Rate for Payer: Mclaren Medicaid |
$438.57
|
| Rate for Payer: Meridian Medicaid |
$460.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$700.56
|
| Rate for Payer: PACE SWMI |
$667.20
|
| Rate for Payer: PHP Medicare Advantage |
$667.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,042.75
|
| Rate for Payer: Priority Health Medicare |
$667.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,042.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$667.20
|
| Rate for Payer: UHC Medicare Advantage |
$687.22
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,158.00
|
|
|
Service Code
|
HCPCS 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$351.45 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$714.13
|
| Rate for Payer: Aetna Medicare |
$554.25
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS MAPPO |
$532.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: BCN Commercial |
$878.68
|
| Rate for Payer: BCN Medicare Advantage |
$532.93
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cofinity Commercial |
$714.13
|
| Rate for Payer: Cofinity Commercial |
$767.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.93
|
| Rate for Payer: Mclaren Medicaid |
$351.45
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$559.58
|
| Rate for Payer: PACE SWMI |
$532.93
|
| Rate for Payer: PHP Medicare Advantage |
$532.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.89
|
| Rate for Payer: Priority Health Medicare |
$532.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$833.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$532.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$532.93
|
| Rate for Payer: UHC Medicare Advantage |
$548.92
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Professional
|
Both
|
$2,158.00
|
|
|
Service Code
|
HCPCS 29822
|
| Min. Negotiated Rate |
$351.45 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$714.13
|
| Rate for Payer: Aetna Medicare |
$554.25
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS MAPPO |
$532.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: BCN Commercial |
$878.68
|
| Rate for Payer: BCN Medicare Advantage |
$532.93
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cofinity Commercial |
$714.13
|
| Rate for Payer: Cofinity Commercial |
$767.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.93
|
| Rate for Payer: Mclaren Medicaid |
$351.45
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$559.58
|
| Rate for Payer: PACE SWMI |
$532.93
|
| Rate for Payer: PHP Medicare Advantage |
$532.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.89
|
| Rate for Payer: Priority Health Medicare |
$532.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$833.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$532.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$532.93
|
| Rate for Payer: UHC Medicare Advantage |
$548.92
|
|
|
PR SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2
|
Facility
|
IP
|
$2,158.00
|
|
|
Service Code
|
CPT 29822
|
| Hospital Charge Code |
29822
|
| Min. Negotiated Rate |
$1,316.16 |
| Max. Negotiated Rate |
$1,942.20 |
| Rate for Payer: Aetna Commercial |
$1,834.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,667.70
|
| Rate for Payer: BCN Commercial |
$1,667.70
|
| Rate for Payer: Cash Price |
$1,726.40
|
| Rate for Payer: Cofinity Commercial |
$1,855.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.40
|
| Rate for Payer: Healthscope Commercial |
$1,942.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,618.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,834.30
|
| Rate for Payer: PHP Commercial |
$1,834.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,877.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,316.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,899.04
|
| Rate for Payer: UHC Core |
$1,801.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,618.50
|
|
