|
PR INSERT CANNULA PROLONG CP INSUFF
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 36822
|
| Min. Negotiated Rate |
$632.80 |
| Max. Negotiated Rate |
$1,028.30 |
| Rate for Payer: Aetna Medicare |
$791.00
|
| Rate for Payer: BCBS Complete |
$632.80
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,028.30
|
|
|
PR INSERT GASTROSTOMY TUBE PERCUTANEOUS
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 49440
|
| Min. Negotiated Rate |
$128.01 |
| Max. Negotiated Rate |
$1,231.95 |
| Rate for Payer: Aetna Commercial |
$257.24
|
| Rate for Payer: Aetna Medicare |
$199.65
|
| Rate for Payer: BCBS Complete |
$134.41
|
| Rate for Payer: BCBS MAPPO |
$191.97
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$1,231.95
|
| Rate for Payer: BCN Medicare Advantage |
$191.97
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$276.44
|
| Rate for Payer: Cofinity Commercial |
$257.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.97
|
| Rate for Payer: Mclaren Medicaid |
$128.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.57
|
| Rate for Payer: Meridian Medicaid |
$134.41
|
| Rate for Payer: Nomi Health Commercial |
$230.36
|
| Rate for Payer: PACE SWMI |
$191.97
|
| Rate for Payer: PHP Medicare Advantage |
$191.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health HMO/PPO |
$353.77
|
| Rate for Payer: Priority Health Medicare |
$193.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.97
|
| Rate for Payer: UHC Exchange |
$191.97
|
| Rate for Payer: UHC Medicare Advantage |
$191.97
|
| Rate for Payer: UHCCP Medicaid |
$128.01
|
|
|
PR INSERTION BREAST IMPLANT SAME DAY OF MASTECTOMY
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
HCPCS 19340
|
| Min. Negotiated Rate |
$491.82 |
| Max. Negotiated Rate |
$1,114.10 |
| Rate for Payer: Aetna Commercial |
$975.45
|
| Rate for Payer: Aetna Medicare |
$757.07
|
| Rate for Payer: BCBS Complete |
$516.41
|
| Rate for Payer: BCBS MAPPO |
$727.95
|
| Rate for Payer: BCBS Trust/PPO |
$562.50
|
| Rate for Payer: BCN Commercial |
$1,112.23
|
| Rate for Payer: BCN Medicare Advantage |
$727.95
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cofinity Commercial |
$975.45
|
| Rate for Payer: Cofinity Commercial |
$1,048.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.95
|
| Rate for Payer: Mclaren Medicaid |
$491.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.35
|
| Rate for Payer: Meridian Medicaid |
$516.41
|
| Rate for Payer: Nomi Health Commercial |
$873.54
|
| Rate for Payer: PACE SWMI |
$727.95
|
| Rate for Payer: PHP Medicare Advantage |
$727.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,114.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,032.63
|
| Rate for Payer: Priority Health Medicare |
$735.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,032.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$727.95
|
| Rate for Payer: UHC Exchange |
$727.95
|
| Rate for Payer: UHC Medicare Advantage |
$727.95
|
| Rate for Payer: UHCCP Medicaid |
$491.82
|
|
|
PR INSERTION CERVICAL DILATOR SEPARATE PROCEDURE
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 59200
|
| Min. Negotiated Rate |
$61.94 |
| Max. Negotiated Rate |
$155.89 |
| Rate for Payer: Aetna Commercial |
$88.37
|
| Rate for Payer: Aetna Medicare |
$68.59
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCBS MAPPO |
$65.95
|
| Rate for Payer: BCBS Trust/PPO |
$90.87
|
| Rate for Payer: BCN Commercial |
$155.89
|
| Rate for Payer: BCN Medicare Advantage |
$65.95
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$94.97
|
| Rate for Payer: Cofinity Commercial |
$88.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.25
|
| Rate for Payer: Nomi Health Commercial |
$79.14
|
| Rate for Payer: PACE SWMI |
$65.95
|
| Rate for Payer: PHP Medicare Advantage |
$65.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.70
|
| Rate for Payer: Priority Health HMO/PPO |
$61.94
|
| Rate for Payer: Priority Health Medicare |
$66.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.95
|
| Rate for Payer: UHC Exchange |
$65.95
|
| Rate for Payer: UHC Medicare Advantage |
$65.95
|
|
|
PR INSERTION DRUG DELIVERY IMPLANT
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 11981
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$977.96 |
| Rate for Payer: Aetna Commercial |
$81.42
|
| Rate for Payer: Aetna Medicare |
$63.19
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$60.76
|
| Rate for Payer: BCBS Trust/PPO |
$977.96
|
| Rate for Payer: BCN Commercial |
$147.09
|
| Rate for Payer: BCN Medicare Advantage |
$60.76
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$81.42
|
| Rate for Payer: Cofinity Commercial |
$87.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.76
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.80
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Nomi Health Commercial |
$72.91
|
| Rate for Payer: PACE SWMI |
$60.76
|
| Rate for Payer: PHP Medicare Advantage |
$60.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.55
|
| Rate for Payer: Priority Health HMO/PPO |
$84.44
|
| Rate for Payer: Priority Health Medicare |
$61.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.76
|
| Rate for Payer: UHC Exchange |
$60.76
|
| Rate for Payer: UHC Medicare Advantage |
$60.76
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
PR INSERTION EPICARDIAL ELECTRODE OPEN
|
Professional
|
Both
|
$2,372.00
|
|
|
Service Code
|
HCPCS 33202
|
| Min. Negotiated Rate |
$487.56 |
| Max. Negotiated Rate |
$1,541.80 |
| Rate for Payer: Aetna Commercial |
$990.09
|
| Rate for Payer: Aetna Medicare |
$768.42
|
| Rate for Payer: BCBS Complete |
$511.94
|
| Rate for Payer: BCBS MAPPO |
$738.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.69
|
| Rate for Payer: BCN Commercial |
$1,110.28
|
| Rate for Payer: BCN Medicare Advantage |
$738.87
|
| Rate for Payer: Cash Price |
$1,897.60
|
| Rate for Payer: Cash Price |
$1,897.60
|
| Rate for Payer: Cofinity Commercial |
$990.09
|
| Rate for Payer: Cofinity Commercial |
$1,063.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$738.87
|
| Rate for Payer: Mclaren Medicaid |
$487.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$775.81
|
| Rate for Payer: Meridian Medicaid |
$511.94
|
| Rate for Payer: Nomi Health Commercial |
$886.64
|
| Rate for Payer: PACE SWMI |
$738.87
|
| Rate for Payer: PHP Medicare Advantage |
$738.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,541.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,213.10
|
| Rate for Payer: Priority Health Medicare |
$746.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,213.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$738.87
|
| Rate for Payer: UHC Exchange |
$738.87
|
| Rate for Payer: UHC Medicare Advantage |
$738.87
|
| Rate for Payer: UHCCP Medicaid |
$487.56
|
|
|
PR INSERTION FLOW DIRECTED CATHETER FOR MONITORING
|
Professional
|
Both
|
$853.00
|
|
|
Service Code
|
HCPCS 93503
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$554.45 |
| Rate for Payer: Aetna Commercial |
$111.51
|
| Rate for Payer: Aetna Medicare |
$86.55
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCBS MAPPO |
$83.22
|
| Rate for Payer: BCBS Trust/PPO |
$456.45
|
| Rate for Payer: BCN Commercial |
$126.08
|
| Rate for Payer: BCN Medicare Advantage |
$83.22
|
| Rate for Payer: Cash Price |
$682.40
|
| Rate for Payer: Cash Price |
$682.40
|
| Rate for Payer: Cofinity Commercial |
$119.84
|
| Rate for Payer: Cofinity Commercial |
$111.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.22
|
| Rate for Payer: Mclaren Medicaid |
$54.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.38
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Nomi Health Commercial |
$99.86
|
| Rate for Payer: PACE SWMI |
$83.22
|
| Rate for Payer: PHP Medicare Advantage |
$83.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$554.45
|
| Rate for Payer: Priority Health HMO/PPO |
$121.01
|
| Rate for Payer: Priority Health Medicare |
$84.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.22
|
| Rate for Payer: UHC Exchange |
$83.22
|
| Rate for Payer: UHC Medicare Advantage |
$83.22
|
| Rate for Payer: UHCCP Medicaid |
$54.95
|
|
|
PR INSERTION INDWELLING TUNNELED PLEURAL CATHETER
|
Professional
|
Both
|
$1,950.00
|
|
|
Service Code
|
HCPCS 32550
|
| Min. Negotiated Rate |
$128.23 |
| Max. Negotiated Rate |
$1,267.50 |
| Rate for Payer: Aetna Commercial |
$258.74
|
| Rate for Payer: Aetna Medicare |
$200.81
|
| Rate for Payer: BCBS Complete |
$134.64
|
| Rate for Payer: BCBS MAPPO |
$193.09
|
| Rate for Payer: BCBS Trust/PPO |
$421.58
|
| Rate for Payer: BCN Commercial |
$1,161.10
|
| Rate for Payer: BCN Medicare Advantage |
$193.09
|
| Rate for Payer: Cash Price |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,560.00
|
| Rate for Payer: Cofinity Commercial |
$278.05
|
| Rate for Payer: Cofinity Commercial |
$258.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.09
|
| Rate for Payer: Mclaren Medicaid |
$128.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.74
|
| Rate for Payer: Meridian Medicaid |
$134.64
|
| Rate for Payer: Nomi Health Commercial |
$231.71
|
| Rate for Payer: PACE SWMI |
$193.09
|
| Rate for Payer: PHP Medicare Advantage |
$193.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,267.50
|
| Rate for Payer: Priority Health HMO/PPO |
$278.09
|
| Rate for Payer: Priority Health Medicare |
$195.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.09
|
| Rate for Payer: UHC Exchange |
$193.09
|
| Rate for Payer: UHC Medicare Advantage |
$193.09
|
| Rate for Payer: UHCCP Medicaid |
$128.23
|
|
|
PR INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 33967
|
| Min. Negotiated Rate |
$161.67 |
| Max. Negotiated Rate |
$815.17 |
| Rate for Payer: Aetna Commercial |
$330.87
|
| Rate for Payer: Aetna Medicare |
$256.80
|
| Rate for Payer: BCBS Complete |
$169.75
|
| Rate for Payer: BCBS MAPPO |
$246.92
|
| Rate for Payer: BCBS Trust/PPO |
$815.17
|
| Rate for Payer: BCN Commercial |
$367.97
|
| Rate for Payer: BCN Medicare Advantage |
$246.92
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$355.56
|
| Rate for Payer: Cofinity Commercial |
$330.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.92
|
| Rate for Payer: Mclaren Medicaid |
$161.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.27
|
| Rate for Payer: Meridian Medicaid |
$169.75
|
| Rate for Payer: Nomi Health Commercial |
$296.30
|
| Rate for Payer: PACE SWMI |
$246.92
|
| Rate for Payer: PHP Medicare Advantage |
$246.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$161.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$402.60
|
| Rate for Payer: Priority Health Medicare |
$249.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.92
|
| Rate for Payer: UHC Exchange |
$246.92
|
| Rate for Payer: UHC Medicare Advantage |
$246.92
|
| Rate for Payer: UHCCP Medicaid |
$161.67
|
|
|
PR INSERTION INTRAUTERINE DEVICE IUD
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
58300
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$192.40 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Aetna Commercial |
$251.60
|
| Rate for Payer: BCBS Trust/PPO |
$241.62
|
| Rate for Payer: BCN Commercial |
$228.75
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cofinity Commercial |
$254.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.80
|
| Rate for Payer: Healthscope Commercial |
$266.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.60
|
| Rate for Payer: Nomi Health Commercial |
$242.72
|
| Rate for Payer: PHP Commercial |
$251.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.40
|
| Rate for Payer: Priority Health HMO/PPO |
$257.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.48
|
| Rate for Payer: UHC Core |
$247.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.00
|
|
|
PR INSERTION INTRAUTERINE DEVICE IUD
|
Facility
|
OP
|
$296.00
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
58300
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.30 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Aetna Commercial |
$251.60
|
| Rate for Payer: Aetna Medicare |
$76.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.50
|
| Rate for Payer: BCBS Complete |
$118.40
|
| Rate for Payer: BCBS MAPPO |
$74.00
|
| Rate for Payer: BCBS Trust/PPO |
$243.34
|
| Rate for Payer: BCN Commercial |
$230.14
|
| Rate for Payer: BCN Medicare Advantage |
$74.00
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cofinity Commercial |
$254.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.00
|
| Rate for Payer: Healthscope Commercial |
$266.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.60
|
| Rate for Payer: Nomi Health Commercial |
$242.72
|
| Rate for Payer: PACE Senior Care Partners |
$70.30
|
| Rate for Payer: PACE SWMI |
$74.00
|
| Rate for Payer: PHP Commercial |
$251.60
|
| Rate for Payer: PHP Medicare Advantage |
$74.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.40
|
| Rate for Payer: Priority Health HMO/PPO |
$257.52
|
| Rate for Payer: Priority Health Medicare |
$74.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.32
|
| Rate for Payer: Railroad Medicare Medicare |
$74.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.48
|
| Rate for Payer: UHC Core |
$247.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.00
|
| Rate for Payer: UHC Exchange |
$74.00
|
| Rate for Payer: UHC Medicare Advantage |
$74.00
|
| Rate for Payer: VA VA |
$74.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.00
|
|
|
PR INSERTION INTRAUTERINE DEVICE IUD
|
Professional
|
Both
|
$296.00
|
|
|
Service Code
|
HCPCS 58300
|
| Hospital Charge Code |
58300
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$417.36 |
| Rate for Payer: Aetna Commercial |
$60.86
|
| Rate for Payer: Aetna Medicare |
$148.00
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS Trust/PPO |
$417.36
|
| Rate for Payer: BCN Commercial |
$130.36
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Mclaren Medicaid |
$32.16
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.40
|
| Rate for Payer: Priority Health HMO/PPO |
$74.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.41
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
|
|
PR INSERTION INTRAUTERINE DEVICE IUD
|
Professional
|
Both
|
$296.00
|
|
|
Service Code
|
HCPCS 58300
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$417.36 |
| Rate for Payer: Aetna Commercial |
$60.86
|
| Rate for Payer: Aetna Medicare |
$148.00
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS Trust/PPO |
$417.36
|
| Rate for Payer: BCN Commercial |
$130.36
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Mclaren Medicaid |
$32.16
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.40
|
| Rate for Payer: Priority Health HMO/PPO |
$74.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.41
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
|
|
PR INSERTION PICC W/O IMG GDN < 5 YR
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 36568
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$967.32 |
| Rate for Payer: Aetna Commercial |
$119.17
|
| Rate for Payer: Aetna Medicare |
$92.49
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$88.93
|
| Rate for Payer: BCBS Trust/PPO |
$967.32
|
| Rate for Payer: BCN Commercial |
$132.43
|
| Rate for Payer: BCN Medicare Advantage |
$88.93
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$128.06
|
| Rate for Payer: Cofinity Commercial |
$119.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.93
|
| Rate for Payer: Mclaren Medicaid |
$58.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.38
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$106.72
|
| Rate for Payer: PACE SWMI |
$88.93
|
| Rate for Payer: PHP Medicare Advantage |
$88.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.10
|
| Rate for Payer: Priority Health HMO/PPO |
$143.60
|
| Rate for Payer: Priority Health Medicare |
$89.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.93
|
| Rate for Payer: UHC Exchange |
$88.93
|
| Rate for Payer: UHC Medicare Advantage |
$88.93
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
|
|
PR INSERTION PICC W/O IMG GDN 5 YR/>
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 36569
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$563.70 |
| Rate for Payer: Aetna Commercial |
$121.58
|
| Rate for Payer: Aetna Medicare |
$94.36
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS MAPPO |
$90.73
|
| Rate for Payer: BCBS Trust/PPO |
$563.70
|
| Rate for Payer: BCN Commercial |
$134.38
|
| Rate for Payer: BCN Medicare Advantage |
$90.73
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$130.65
|
| Rate for Payer: Cofinity Commercial |
$121.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.73
|
| Rate for Payer: Mclaren Medicaid |
$59.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.27
|
| Rate for Payer: Meridian Medicaid |
$62.84
|
| Rate for Payer: Nomi Health Commercial |
$108.88
|
| Rate for Payer: PACE SWMI |
$90.73
|
| Rate for Payer: PHP Medicare Advantage |
$90.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
| Rate for Payer: Priority Health HMO/PPO |
$148.38
|
| Rate for Payer: Priority Health Medicare |
$91.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.73
|
| Rate for Payer: UHC Exchange |
$90.73
|
| Rate for Payer: UHC Medicare Advantage |
$90.73
|
| Rate for Payer: UHCCP Medicaid |
$59.85
|
|
|
PR INSERTION PICC W/RS&I < 5 YR
|
Professional
|
Both
|
$844.00
|
|
|
Service Code
|
HCPCS 36572
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$1,072.45 |
| Rate for Payer: Aetna Commercial |
$104.29
|
| Rate for Payer: Aetna Medicare |
$80.94
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCBS MAPPO |
$77.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.45
|
| Rate for Payer: BCN Commercial |
$552.21
|
| Rate for Payer: BCN Medicare Advantage |
$77.83
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cash Price |
$675.20
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Cofinity Commercial |
$104.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.83
|
| Rate for Payer: Mclaren Medicaid |
$51.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.72
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Nomi Health Commercial |
$93.40
|
| Rate for Payer: PACE SWMI |
$77.83
|
| Rate for Payer: PHP Medicare Advantage |
$77.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.60
|
| Rate for Payer: Priority Health HMO/PPO |
$126.57
|
| Rate for Payer: Priority Health Medicare |
$78.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.83
|
| Rate for Payer: UHC Exchange |
$77.83
|
| Rate for Payer: UHC Medicare Advantage |
$77.83
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
|
|
PR INSERTION PICC W/RS&I 5 YR/>
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 36573
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$921.36 |
| Rate for Payer: Aetna Commercial |
$105.63
|
| Rate for Payer: Aetna Medicare |
$81.98
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$78.83
|
| Rate for Payer: BCBS Trust/PPO |
$921.36
|
| Rate for Payer: BCN Commercial |
$565.89
|
| Rate for Payer: BCN Medicare Advantage |
$78.83
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cofinity Commercial |
$113.52
|
| Rate for Payer: Cofinity Commercial |
$105.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.83
|
| Rate for Payer: Mclaren Medicaid |
$52.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.77
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$94.60
|
| Rate for Payer: PACE SWMI |
$78.83
|
| Rate for Payer: PHP Medicare Advantage |
$78.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.40
|
| Rate for Payer: Priority Health HMO/PPO |
$129.76
|
| Rate for Payer: Priority Health Medicare |
$79.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.83
|
| Rate for Payer: UHC Exchange |
$78.83
|
| Rate for Payer: UHC Medicare Advantage |
$78.83
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
|
|
PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 33285
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$6,374.79 |
| Rate for Payer: Aetna Commercial |
$111.76
|
| Rate for Payer: Aetna Medicare |
$86.74
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCBS MAPPO |
$83.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,495.09
|
| Rate for Payer: BCN Commercial |
$6,374.79
|
| Rate for Payer: BCN Medicare Advantage |
$83.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cofinity Commercial |
$120.10
|
| Rate for Payer: Cofinity Commercial |
$111.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.40
|
| Rate for Payer: Mclaren Medicaid |
$54.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.57
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Nomi Health Commercial |
$100.08
|
| Rate for Payer: PACE SWMI |
$83.40
|
| Rate for Payer: PHP Medicare Advantage |
$83.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.20
|
| Rate for Payer: Priority Health HMO/PPO |
$136.68
|
| Rate for Payer: Priority Health Medicare |
$84.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.40
|
| Rate for Payer: UHC Exchange |
$83.40
|
| Rate for Payer: UHC Medicare Advantage |
$83.40
|
| Rate for Payer: UHCCP Medicaid |
$54.95
|
|
|
PR INSERTION TANDEM CUFF
|
Professional
|
Both
|
$1,517.00
|
|
|
Service Code
|
HCPCS 53444
|
| Min. Negotiated Rate |
$508.22 |
| Max. Negotiated Rate |
$2,999.16 |
| Rate for Payer: Aetna Commercial |
$1,016.43
|
| Rate for Payer: Aetna Medicare |
$788.87
|
| Rate for Payer: BCBS Complete |
$533.63
|
| Rate for Payer: BCBS MAPPO |
$758.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,999.16
|
| Rate for Payer: BCN Commercial |
$1,143.01
|
| Rate for Payer: BCN Medicare Advantage |
$758.53
|
| Rate for Payer: Cash Price |
$1,213.60
|
| Rate for Payer: Cash Price |
$1,213.60
|
| Rate for Payer: Cofinity Commercial |
$1,092.28
|
| Rate for Payer: Cofinity Commercial |
$1,016.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.53
|
| Rate for Payer: Mclaren Medicaid |
$508.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$796.46
|
| Rate for Payer: Meridian Medicaid |
$533.63
|
| Rate for Payer: Nomi Health Commercial |
$910.24
|
| Rate for Payer: PACE SWMI |
$758.53
|
| Rate for Payer: PHP Medicare Advantage |
$758.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,261.73
|
| Rate for Payer: Priority Health Medicare |
$766.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,261.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$758.53
|
| Rate for Payer: UHC Exchange |
$758.53
|
| Rate for Payer: UHC Medicare Advantage |
$758.53
|
| Rate for Payer: UHCCP Medicaid |
$508.22
|
|
|
PR INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN
|
Professional
|
Both
|
$1,308.00
|
|
|
Service Code
|
HCPCS 49421
|
| Min. Negotiated Rate |
$143.99 |
| Max. Negotiated Rate |
$2,980.67 |
| Rate for Payer: Aetna Commercial |
$294.53
|
| Rate for Payer: Aetna Medicare |
$228.59
|
| Rate for Payer: BCBS Complete |
$151.19
|
| Rate for Payer: BCBS MAPPO |
$219.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,980.67
|
| Rate for Payer: BCN Commercial |
$327.41
|
| Rate for Payer: BCN Medicare Advantage |
$219.80
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cofinity Commercial |
$316.51
|
| Rate for Payer: Cofinity Commercial |
$294.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.80
|
| Rate for Payer: Mclaren Medicaid |
$143.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.79
|
| Rate for Payer: Meridian Medicaid |
$151.19
|
| Rate for Payer: Nomi Health Commercial |
$263.76
|
| Rate for Payer: PACE SWMI |
$219.80
|
| Rate for Payer: PHP Medicare Advantage |
$219.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.20
|
| Rate for Payer: Priority Health HMO/PPO |
$401.50
|
| Rate for Payer: Priority Health Medicare |
$222.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.80
|
| Rate for Payer: UHC Exchange |
$219.80
|
| Rate for Payer: UHC Medicare Advantage |
$219.80
|
| Rate for Payer: UHCCP Medicaid |
$143.99
|
|
|
PR INSERTION VAGINAL RADIATION DEVICE
|
Professional
|
Both
|
$391.00
|
|
|
Service Code
|
HCPCS 57156
|
| Min. Negotiated Rate |
$97.77 |
| Max. Negotiated Rate |
$2,560.67 |
| Rate for Payer: Aetna Commercial |
$194.01
|
| Rate for Payer: Aetna Medicare |
$150.57
|
| Rate for Payer: BCBS Complete |
$102.66
|
| Rate for Payer: BCBS MAPPO |
$144.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,560.67
|
| Rate for Payer: BCN Commercial |
$335.23
|
| Rate for Payer: BCN Medicare Advantage |
$144.78
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cofinity Commercial |
$208.48
|
| Rate for Payer: Cofinity Commercial |
$194.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.78
|
| Rate for Payer: Mclaren Medicaid |
$97.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.02
|
| Rate for Payer: Meridian Medicaid |
$102.66
|
| Rate for Payer: Nomi Health Commercial |
$173.74
|
| Rate for Payer: PACE SWMI |
$144.78
|
| Rate for Payer: PHP Medicare Advantage |
$144.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.15
|
| Rate for Payer: Priority Health HMO/PPO |
$224.21
|
| Rate for Payer: Priority Health Medicare |
$146.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.78
|
| Rate for Payer: UHC Exchange |
$144.78
|
| Rate for Payer: UHC Medicare Advantage |
$144.78
|
| Rate for Payer: UHCCP Medicaid |
$97.77
|
|
|
PR INSERTION VASCULAR PEDICLE CARPAL BONE
|
Professional
|
Both
|
$1,235.00
|
|
|
Service Code
|
HCPCS 25430
|
| Min. Negotiated Rate |
$264.89 |
| Max. Negotiated Rate |
$1,135.78 |
| Rate for Payer: Aetna Commercial |
$949.58
|
| Rate for Payer: Aetna Medicare |
$736.99
|
| Rate for Payer: BCBS Complete |
$503.88
|
| Rate for Payer: BCBS MAPPO |
$708.64
|
| Rate for Payer: BCBS Trust/PPO |
$264.89
|
| Rate for Payer: BCN Commercial |
$1,079.97
|
| Rate for Payer: BCN Medicare Advantage |
$708.64
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cofinity Commercial |
$949.58
|
| Rate for Payer: Cofinity Commercial |
$1,020.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.64
|
| Rate for Payer: Mclaren Medicaid |
$479.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$744.07
|
| Rate for Payer: Meridian Medicaid |
$503.88
|
| Rate for Payer: Nomi Health Commercial |
$850.37
|
| Rate for Payer: PACE SWMI |
$708.64
|
| Rate for Payer: PHP Medicare Advantage |
$708.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,135.78
|
| Rate for Payer: Priority Health Medicare |
$715.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,135.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$708.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$708.64
|
| Rate for Payer: UHC Exchange |
$708.64
|
| Rate for Payer: UHC Medicare Advantage |
$708.64
|
| Rate for Payer: UHCCP Medicaid |
$479.89
|
|
|
PR INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 20650
|
| Min. Negotiated Rate |
$63.44 |
| Max. Negotiated Rate |
$332.30 |
| Rate for Payer: Aetna Commercial |
$216.08
|
| Rate for Payer: Aetna Medicare |
$167.70
|
| Rate for Payer: BCBS Complete |
$114.95
|
| Rate for Payer: BCBS MAPPO |
$161.25
|
| Rate for Payer: BCBS Trust/PPO |
$63.44
|
| Rate for Payer: BCN Commercial |
$332.30
|
| Rate for Payer: BCN Medicare Advantage |
$161.25
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$232.20
|
| Rate for Payer: Cofinity Commercial |
$216.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.25
|
| Rate for Payer: Mclaren Medicaid |
$109.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.31
|
| Rate for Payer: Meridian Medicaid |
$114.95
|
| Rate for Payer: Nomi Health Commercial |
$193.50
|
| Rate for Payer: PACE SWMI |
$161.25
|
| Rate for Payer: PHP Medicare Advantage |
$161.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health HMO/PPO |
$257.48
|
| Rate for Payer: Priority Health Medicare |
$162.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.25
|
| Rate for Payer: UHC Exchange |
$161.25
|
| Rate for Payer: UHC Medicare Advantage |
$161.25
|
| Rate for Payer: UHCCP Medicaid |
$109.48
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, EA ADD
|
Professional
|
Both
|
$529.00
|
|
|
Service Code
|
HCPCS 0172T
|
| Min. Negotiated Rate |
$211.60 |
| Max. Negotiated Rate |
$343.85 |
| Rate for Payer: Aetna Medicare |
$264.50
|
| Rate for Payer: BCBS Complete |
$211.60
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.85
|
|
|
PR INSERT POST SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR, SINGLE
|
Professional
|
Both
|
$2,734.00
|
|
|
Service Code
|
HCPCS 0171T
|
| Min. Negotiated Rate |
$1,093.60 |
| Max. Negotiated Rate |
$1,777.10 |
| Rate for Payer: Aetna Medicare |
$1,367.00
|
| Rate for Payer: BCBS Complete |
$1,093.60
|
| Rate for Payer: Cash Price |
$2,187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,777.10
|
|
