|
PR MASTOID OBLITERATION SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,479.00
|
|
|
Service Code
|
HCPCS 69670
|
| Min. Negotiated Rate |
$602.79 |
| Max. Negotiated Rate |
$3,570.25 |
| Rate for Payer: Aetna Commercial |
$1,182.03
|
| Rate for Payer: Aetna Medicare |
$917.39
|
| Rate for Payer: BCBS Complete |
$632.93
|
| Rate for Payer: BCBS MAPPO |
$882.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,570.25
|
| Rate for Payer: BCN Commercial |
$1,394.20
|
| Rate for Payer: BCN Medicare Advantage |
$882.11
|
| Rate for Payer: Cash Price |
$2,783.20
|
| Rate for Payer: Cash Price |
$2,783.20
|
| Rate for Payer: Cofinity Commercial |
$1,270.24
|
| Rate for Payer: Cofinity Commercial |
$1,182.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$882.11
|
| Rate for Payer: Mclaren Medicaid |
$602.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$926.22
|
| Rate for Payer: Meridian Medicaid |
$632.93
|
| Rate for Payer: Nomi Health Commercial |
$1,058.53
|
| Rate for Payer: PACE SWMI |
$882.11
|
| Rate for Payer: PHP Medicare Advantage |
$882.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,261.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,385.20
|
| Rate for Payer: Priority Health Medicare |
$890.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,385.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$882.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$882.11
|
| Rate for Payer: UHC Exchange |
$882.11
|
| Rate for Payer: UHC Medicare Advantage |
$882.11
|
| Rate for Payer: UHCCP Medicaid |
$602.79
|
|
|
PR MASTOPEXY
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 19316
|
| Min. Negotiated Rate |
$293.06 |
| Max. Negotiated Rate |
$1,259.70 |
| Rate for Payer: Aetna Commercial |
$1,017.25
|
| Rate for Payer: Aetna Medicare |
$789.51
|
| Rate for Payer: BCBS Complete |
$538.10
|
| Rate for Payer: BCBS MAPPO |
$759.14
|
| Rate for Payer: BCBS Trust/PPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$1,159.64
|
| Rate for Payer: BCN Medicare Advantage |
$759.14
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,093.16
|
| Rate for Payer: Cofinity Commercial |
$1,017.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.14
|
| Rate for Payer: Mclaren Medicaid |
$512.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.10
|
| Rate for Payer: Meridian Medicaid |
$538.10
|
| Rate for Payer: Nomi Health Commercial |
$910.97
|
| Rate for Payer: PACE SWMI |
$759.14
|
| Rate for Payer: PHP Medicare Advantage |
$759.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,077.32
|
| Rate for Payer: Priority Health Medicare |
$766.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,077.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.14
|
| Rate for Payer: UHC Exchange |
$759.14
|
| Rate for Payer: UHC Medicare Advantage |
$759.14
|
| Rate for Payer: UHCCP Medicaid |
$512.48
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$203.42 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$401.97
|
| Rate for Payer: Aetna Medicare |
$311.98
|
| Rate for Payer: BCBS Complete |
$213.59
|
| Rate for Payer: BCBS MAPPO |
$299.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$692.46
|
| Rate for Payer: BCN Medicare Advantage |
$299.98
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$431.97
|
| Rate for Payer: Cofinity Commercial |
$401.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.98
|
| Rate for Payer: Mclaren Medicaid |
$203.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.98
|
| Rate for Payer: Meridian Medicaid |
$213.59
|
| Rate for Payer: Nomi Health Commercial |
$359.98
|
| Rate for Payer: PACE SWMI |
$299.98
|
| Rate for Payer: PHP Medicare Advantage |
$299.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health HMO/PPO |
$429.85
|
| Rate for Payer: Priority Health Medicare |
$302.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$429.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.98
|
| Rate for Payer: UHC Exchange |
$299.98
|
| Rate for Payer: UHC Medicare Advantage |
$299.98
|
| Rate for Payer: UHCCP Medicaid |
$203.42
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 19020
|
| Min. Negotiated Rate |
$203.42 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$401.97
|
| Rate for Payer: Aetna Medicare |
$311.98
|
| Rate for Payer: BCBS Complete |
$213.59
|
| Rate for Payer: BCBS MAPPO |
$299.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$692.46
|
| Rate for Payer: BCN Medicare Advantage |
$299.98
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$431.97
|
| Rate for Payer: Cofinity Commercial |
$401.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.98
|
| Rate for Payer: Mclaren Medicaid |
$203.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.98
|
| Rate for Payer: Meridian Medicaid |
$213.59
|
| Rate for Payer: Nomi Health Commercial |
$359.98
|
| Rate for Payer: PACE SWMI |
$299.98
|
| Rate for Payer: PHP Medicare Advantage |
$299.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health HMO/PPO |
$429.85
|
| Rate for Payer: Priority Health Medicare |
$302.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$429.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.98
|
| Rate for Payer: UHC Exchange |
$299.98
|
| Rate for Payer: UHC Medicare Advantage |
$299.98
|
| Rate for Payer: UHCCP Medicaid |
$203.42
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Facility
|
OP
|
$814.00
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$193.32 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$691.90
|
| Rate for Payer: Aetna Medicare |
$211.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$254.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$254.38
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$203.50
|
| Rate for Payer: BCBS Trust/PPO |
$669.19
|
| Rate for Payer: BCN Commercial |
$632.88
|
| Rate for Payer: BCN Medicare Advantage |
$203.50
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$700.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.50
|
| Rate for Payer: Healthscope Commercial |
$732.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.50
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.68
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.90
|
| Rate for Payer: Nomi Health Commercial |
$667.48
|
| Rate for Payer: PACE Senior Care Partners |
$193.32
|
| Rate for Payer: PACE SWMI |
$203.50
|
| Rate for Payer: PHP Commercial |
$691.90
|
| Rate for Payer: PHP Medicare Advantage |
$203.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health HMO/PPO |
$708.18
|
| Rate for Payer: Priority Health Medicare |
$205.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$545.38
|
| Rate for Payer: Railroad Medicare Medicare |
$203.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$716.32
|
| Rate for Payer: UHC Core |
$679.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.50
|
| Rate for Payer: UHC Exchange |
$203.50
|
| Rate for Payer: UHC Medicare Advantage |
$203.50
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$203.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.50
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Facility
|
IP
|
$814.00
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$529.10 |
| Max. Negotiated Rate |
$732.60 |
| Rate for Payer: Aetna Commercial |
$691.90
|
| Rate for Payer: BCBS Trust/PPO |
$664.47
|
| Rate for Payer: BCN Commercial |
$629.06
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$700.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.20
|
| Rate for Payer: Healthscope Commercial |
$732.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.90
|
| Rate for Payer: Nomi Health Commercial |
$667.48
|
| Rate for Payer: PHP Commercial |
$691.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health HMO/PPO |
$708.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$545.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$716.32
|
| Rate for Payer: UHC Core |
$679.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.50
|
|
|
PR MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 19305
|
| Min. Negotiated Rate |
$738.90 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$1,486.89
|
| Rate for Payer: Aetna Medicare |
$1,154.00
|
| Rate for Payer: BCBS Complete |
$775.84
|
| Rate for Payer: BCBS MAPPO |
$1,109.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$1,685.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,109.62
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,597.85
|
| Rate for Payer: Cofinity Commercial |
$1,486.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,109.62
|
| Rate for Payer: Mclaren Medicaid |
$738.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,165.10
|
| Rate for Payer: Meridian Medicaid |
$775.84
|
| Rate for Payer: Nomi Health Commercial |
$1,331.54
|
| Rate for Payer: PACE SWMI |
$1,109.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,109.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,563.61
|
| Rate for Payer: Priority Health Medicare |
$1,120.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,563.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,109.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,109.62
|
| Rate for Payer: UHC Exchange |
$1,109.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,109.62
|
| Rate for Payer: UHCCP Medicaid |
$738.90
|
|
|
PR MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 94200
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$2,544.29 |
| Rate for Payer: Aetna Commercial |
$18.18
|
| Rate for Payer: Aetna Medicare |
$14.11
|
| Rate for Payer: BCBS Complete |
$1.78
|
| Rate for Payer: BCBS MAPPO |
$13.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,544.29
|
| Rate for Payer: BCN Commercial |
$21.51
|
| Rate for Payer: BCN Medicare Advantage |
$13.57
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$18.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.57
|
| Rate for Payer: Mclaren Medicaid |
$1.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.25
|
| Rate for Payer: Meridian Medicaid |
$1.78
|
| Rate for Payer: Nomi Health Commercial |
$16.28
|
| Rate for Payer: PACE SWMI |
$13.57
|
| Rate for Payer: PHP Medicare Advantage |
$13.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health HMO/PPO |
$3.61
|
| Rate for Payer: Priority Health Medicare |
$13.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.57
|
| Rate for Payer: UHC Exchange |
$13.57
|
| Rate for Payer: UHC Medicare Advantage |
$13.57
|
| Rate for Payer: UHCCP Medicaid |
$1.70
|
|
|
PR MAXILLECTOMY W/O ORBITAL EXENTERATION
|
Professional
|
Both
|
$3,304.00
|
|
|
Service Code
|
HCPCS 31225
|
| Min. Negotiated Rate |
$904.98 |
| Max. Negotiated Rate |
$2,643.74 |
| Rate for Payer: Aetna Commercial |
$2,281.20
|
| Rate for Payer: Aetna Medicare |
$1,770.49
|
| Rate for Payer: BCBS Complete |
$1,209.27
|
| Rate for Payer: BCBS MAPPO |
$1,702.39
|
| Rate for Payer: BCBS Trust/PPO |
$904.98
|
| Rate for Payer: BCN Commercial |
$2,643.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,702.39
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cofinity Commercial |
$2,451.44
|
| Rate for Payer: Cofinity Commercial |
$2,281.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,702.39
|
| Rate for Payer: Mclaren Medicaid |
$1,151.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,787.51
|
| Rate for Payer: Meridian Medicaid |
$1,209.27
|
| Rate for Payer: Nomi Health Commercial |
$2,042.87
|
| Rate for Payer: PACE SWMI |
$1,702.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,702.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,151.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,147.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,505.97
|
| Rate for Payer: Priority Health Medicare |
$1,719.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,505.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,702.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,702.39
|
| Rate for Payer: UHC Exchange |
$1,702.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,702.39
|
| Rate for Payer: UHCCP Medicaid |
$1,151.69
|
|
|
PR MCCD, INITIAL RATE
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS G9001
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,218.26 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$81.50
|
| Rate for Payer: BCBS Complete |
$65.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.26
|
| Rate for Payer: BCN Commercial |
$136.23
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.95
|
|
|
PR MCCD,MAINTENANCE RATE
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS G9002
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$884.37 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS Trust/PPO |
$884.37
|
| Rate for Payer: BCN Commercial |
$68.13
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
|
|
PR MCCD,PHYS COOR-CARE OVRSGHT
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS G9008
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,823.69 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$43.50
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,823.69
|
| Rate for Payer: BCN Commercial |
$50.00
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
|
|
PR MCCD, SCH TEAM CONF
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS G9007
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,852.75 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,852.75
|
| Rate for Payer: BCN Commercial |
$28.81
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
|
|
PR MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 36596
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$745.43 |
| Rate for Payer: Aetna Commercial |
$57.96
|
| Rate for Payer: Aetna Medicare |
$44.98
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$43.25
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$167.13
|
| Rate for Payer: BCN Medicare Advantage |
$43.25
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Cofinity Commercial |
$57.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.25
|
| Rate for Payer: Mclaren Medicaid |
$28.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.41
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Nomi Health Commercial |
$51.90
|
| Rate for Payer: PACE SWMI |
$43.25
|
| Rate for Payer: PHP Medicare Advantage |
$43.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO |
$70.73
|
| Rate for Payer: Priority Health Medicare |
$43.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.25
|
| Rate for Payer: UHC Exchange |
$43.25
|
| Rate for Payer: UHC Medicare Advantage |
$43.25
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
PR MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 36595
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$871.31 |
| Rate for Payer: Aetna Commercial |
$228.68
|
| Rate for Payer: Aetna Medicare |
$177.49
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCBS MAPPO |
$170.66
|
| Rate for Payer: BCBS Trust/PPO |
$586.94
|
| Rate for Payer: BCN Commercial |
$871.31
|
| Rate for Payer: BCN Medicare Advantage |
$170.66
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cofinity Commercial |
$245.75
|
| Rate for Payer: Cofinity Commercial |
$228.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.66
|
| Rate for Payer: Mclaren Medicaid |
$113.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.19
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Nomi Health Commercial |
$204.79
|
| Rate for Payer: PACE SWMI |
$170.66
|
| Rate for Payer: PHP Medicare Advantage |
$170.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.30
|
| Rate for Payer: Priority Health HMO/PPO |
$281.33
|
| Rate for Payer: Priority Health Medicare |
$172.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.66
|
| Rate for Payer: UHC Exchange |
$170.66
|
| Rate for Payer: UHC Medicare Advantage |
$170.66
|
| Rate for Payer: UHCCP Medicaid |
$113.32
|
|
|
PR MD CERTIFICATION HHA PATIENT
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS G0180
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$76.60 |
| Rate for Payer: Aetna Commercial |
$66.61
|
| Rate for Payer: Aetna Medicare |
$51.70
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$49.71
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: BCN Commercial |
$75.75
|
| Rate for Payer: BCN Medicare Advantage |
$49.71
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$66.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.20
|
| Rate for Payer: Nomi Health Commercial |
$59.65
|
| Rate for Payer: PACE SWMI |
$49.71
|
| Rate for Payer: PHP Medicare Advantage |
$49.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.60
|
| Rate for Payer: Priority Health HMO/PPO |
$72.82
|
| Rate for Payer: Priority Health Medicare |
$50.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.71
|
| Rate for Payer: UHC Exchange |
$49.71
|
| Rate for Payer: UHC Medicare Advantage |
$49.71
|
|
|
PR MD INR TEST REVIE INTER MGMT
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0250
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$459.09 |
| Rate for Payer: Aetna Commercial |
$11.07
|
| Rate for Payer: Aetna Medicare |
$8.59
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$8.26
|
| Rate for Payer: BCBS Trust/PPO |
$459.09
|
| Rate for Payer: BCN Commercial |
$12.71
|
| Rate for Payer: BCN Medicare Advantage |
$8.26
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$11.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.67
|
| Rate for Payer: Nomi Health Commercial |
$9.91
|
| Rate for Payer: PACE SWMI |
$8.26
|
| Rate for Payer: PHP Medicare Advantage |
$8.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO |
$11.66
|
| Rate for Payer: Priority Health Medicare |
$8.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.26
|
| Rate for Payer: UHC Exchange |
$8.26
|
| Rate for Payer: UHC Medicare Advantage |
$8.26
|
|
|
PR MD RECERTIFICATION HHA PT
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS G0179
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$83.63 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$40.53
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$38.97
|
| Rate for Payer: BCBS Trust/PPO |
$83.63
|
| Rate for Payer: BCN Commercial |
$60.11
|
| Rate for Payer: BCN Medicare Advantage |
$38.97
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$56.12
|
| Rate for Payer: Cofinity Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.92
|
| Rate for Payer: Nomi Health Commercial |
$46.76
|
| Rate for Payer: PACE SWMI |
$38.97
|
| Rate for Payer: PHP Medicare Advantage |
$38.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO |
$56.99
|
| Rate for Payer: Priority Health Medicare |
$39.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.97
|
| Rate for Payer: UHC Exchange |
$38.97
|
| Rate for Payer: UHC Medicare Advantage |
$38.97
|
|
|
PR MD SERVICE REQUIRED FOR PMD
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS G0372
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$11.04
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$8.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$12.71
|
| Rate for Payer: BCN Medicare Advantage |
$8.24
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$11.87
|
| Rate for Payer: Cofinity Commercial |
$11.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.65
|
| Rate for Payer: Nomi Health Commercial |
$9.89
|
| Rate for Payer: PACE SWMI |
$8.24
|
| Rate for Payer: PHP Medicare Advantage |
$8.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO |
$11.75
|
| Rate for Payer: Priority Health Medicare |
$8.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.24
|
| Rate for Payer: UHC Exchange |
$8.24
|
| Rate for Payer: UHC Medicare Advantage |
$8.24
|
|
|
PR MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 90710
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$275.04 |
| Rate for Payer: Aetna Commercial |
$275.04
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS Trust/PPO |
$260.00
|
| Rate for Payer: BCN Commercial |
$258.46
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
|
|
PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 90707
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$53.50
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: BCBS Trust/PPO |
$88.32
|
| Rate for Payer: BCN Commercial |
$88.32
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.55
|
|
|
PR MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 51798
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$3,662.70 |
| Rate for Payer: Aetna Commercial |
$14.04
|
| Rate for Payer: Aetna Medicare |
$10.90
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$10.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,662.70
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: BCN Medicare Advantage |
$10.48
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$15.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.00
|
| Rate for Payer: Nomi Health Commercial |
$12.58
|
| Rate for Payer: PACE SWMI |
$10.48
|
| Rate for Payer: PHP Medicare Advantage |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health HMO/PPO |
$18.11
|
| Rate for Payer: Priority Health Medicare |
$10.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.48
|
| Rate for Payer: UHC Exchange |
$10.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.48
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 53020
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$359.24 |
| Rate for Payer: Aetna Commercial |
$123.33
|
| Rate for Payer: Aetna Medicare |
$95.72
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$92.04
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$138.79
|
| Rate for Payer: BCN Medicare Advantage |
$92.04
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$132.54
|
| Rate for Payer: Cofinity Commercial |
$123.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.04
|
| Rate for Payer: Mclaren Medicaid |
$61.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.64
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Nomi Health Commercial |
$110.45
|
| Rate for Payer: PACE SWMI |
$92.04
|
| Rate for Payer: PHP Medicare Advantage |
$92.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health HMO/PPO |
$152.86
|
| Rate for Payer: Priority Health Medicare |
$92.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.04
|
| Rate for Payer: UHC Exchange |
$92.04
|
| Rate for Payer: UHC Medicare Advantage |
$92.04
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX INFANT
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 53025
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$718.49 |
| Rate for Payer: Aetna Commercial |
$88.20
|
| Rate for Payer: Aetna Medicare |
$68.45
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$65.82
|
| Rate for Payer: BCBS Trust/PPO |
$718.49
|
| Rate for Payer: BCN Commercial |
$98.72
|
| Rate for Payer: BCN Medicare Advantage |
$65.82
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$94.78
|
| Rate for Payer: Cofinity Commercial |
$88.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.82
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.11
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Nomi Health Commercial |
$78.98
|
| Rate for Payer: PACE SWMI |
$65.82
|
| Rate for Payer: PHP Medicare Advantage |
$65.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO |
$109.18
|
| Rate for Payer: Priority Health Medicare |
$66.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.82
|
| Rate for Payer: UHC Exchange |
$65.82
|
| Rate for Payer: UHC Medicare Advantage |
$65.82
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
PR MEDIASTINOSCOPY INCL BIOPSIES WHEN PERFORMED
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 39400
|
| Min. Negotiated Rate |
$897.20 |
| Max. Negotiated Rate |
$1,457.95 |
| Rate for Payer: Aetna Medicare |
$1,121.50
|
| Rate for Payer: BCBS Complete |
$897.20
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
|
