|
PR ONDANSETRON HCL INJECTION
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS J2405
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.10
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$0.09
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.04
|
| Rate for Payer: BCN Medicare Advantage |
$0.09
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$0.13
|
| Rate for Payer: Cofinity Commercial |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.10
|
| Rate for Payer: Nomi Health Commercial |
$0.11
|
| Rate for Payer: PACE SWMI |
$0.09
|
| Rate for Payer: PHP Medicare Advantage |
$0.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$0.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.09
|
| Rate for Payer: UHC Exchange |
$0.09
|
| Rate for Payer: UHC Medicare Advantage |
$0.09
|
|
|
PR ONE AREA LIPOSUCTION - 1 AREA 1.0 HR
|
Professional
|
Both
|
$2,040.00
|
|
|
Service Code
|
HCPCS 00527
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$816.00 |
| Max. Negotiated Rate |
$1,326.00 |
| Rate for Payer: Aetna Medicare |
$1,020.00
|
| Rate for Payer: BCBS Complete |
$816.00
|
| Rate for Payer: Cash Price |
$1,632.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.00
|
|
|
PR ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 99422
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$1,260.52 |
| Rate for Payer: Aetna Commercial |
$32.39
|
| Rate for Payer: Aetna Medicare |
$25.14
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$24.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$42.64
|
| Rate for Payer: BCN Medicare Advantage |
$24.17
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$32.39
|
| Rate for Payer: Cofinity Commercial |
$34.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.17
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.38
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE SWMI |
$24.17
|
| Rate for Payer: PHP Medicare Advantage |
$24.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Medicare |
$24.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.17
|
| Rate for Payer: UHC Exchange |
$24.17
|
| Rate for Payer: UHC Medicare Advantage |
$24.17
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
|
|
PR ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 99423
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$873.28 |
| Rate for Payer: Aetna Commercial |
$50.13
|
| Rate for Payer: Aetna Medicare |
$38.91
|
| Rate for Payer: BCBS Complete |
$26.39
|
| Rate for Payer: BCBS MAPPO |
$37.41
|
| Rate for Payer: BCBS Trust/PPO |
$873.28
|
| Rate for Payer: BCN Commercial |
$49.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.41
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$53.87
|
| Rate for Payer: Cofinity Commercial |
$50.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.41
|
| Rate for Payer: Mclaren Medicaid |
$25.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.28
|
| Rate for Payer: Meridian Medicaid |
$26.39
|
| Rate for Payer: Nomi Health Commercial |
$44.89
|
| Rate for Payer: PACE SWMI |
$37.41
|
| Rate for Payer: PHP Medicare Advantage |
$37.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO |
$44.89
|
| Rate for Payer: Priority Health Medicare |
$37.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.41
|
| Rate for Payer: UHC Exchange |
$37.41
|
| Rate for Payer: UHC Medicare Advantage |
$37.41
|
| Rate for Payer: UHCCP Medicaid |
$25.13
|
|
|
PR ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 99421
|
| Min. Negotiated Rate |
$8.09 |
| Max. Negotiated Rate |
$1,630.70 |
| Rate for Payer: Aetna Commercial |
$16.20
|
| Rate for Payer: Aetna Medicare |
$12.57
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,630.70
|
| Rate for Payer: BCN Commercial |
$21.51
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$17.41
|
| Rate for Payer: Cofinity Commercial |
$16.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Mclaren Medicaid |
$8.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Nomi Health Commercial |
$14.51
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO |
$14.22
|
| Rate for Payer: Priority Health Medicare |
$12.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.09
|
| Rate for Payer: UHC Exchange |
$12.09
|
| Rate for Payer: UHC Medicare Advantage |
$12.09
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
|
|
PR OOPHORECTOMY PARTIAL/TOTAL UNI/BI
|
Professional
|
Both
|
$2,819.00
|
|
|
Service Code
|
HCPCS 58940
|
| Min. Negotiated Rate |
$144.75 |
| Max. Negotiated Rate |
$1,832.35 |
| Rate for Payer: Aetna Commercial |
$712.57
|
| Rate for Payer: Aetna Medicare |
$553.04
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS MAPPO |
$531.77
|
| Rate for Payer: BCBS Trust/PPO |
$144.75
|
| Rate for Payer: BCN Commercial |
$818.04
|
| Rate for Payer: BCN Medicare Advantage |
$531.77
|
| Rate for Payer: Cash Price |
$2,255.20
|
| Rate for Payer: Cash Price |
$2,255.20
|
| Rate for Payer: Cofinity Commercial |
$765.75
|
| Rate for Payer: Cofinity Commercial |
$712.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.77
|
| Rate for Payer: Mclaren Medicaid |
$357.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$558.36
|
| Rate for Payer: Meridian Medicaid |
$375.73
|
| Rate for Payer: Nomi Health Commercial |
$638.12
|
| Rate for Payer: PACE SWMI |
$531.77
|
| Rate for Payer: PHP Medicare Advantage |
$531.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,832.35
|
| Rate for Payer: Priority Health HMO/PPO |
$833.36
|
| Rate for Payer: Priority Health Medicare |
$537.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$833.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$531.77
|
| Rate for Payer: UHC Exchange |
$531.77
|
| Rate for Payer: UHC Medicare Advantage |
$531.77
|
| Rate for Payer: UHCCP Medicaid |
$357.84
|
|
|
PR OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY
|
Professional
|
Both
|
$2,306.00
|
|
|
Service Code
|
HCPCS 58943
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$1,797.18 |
| Rate for Payer: Aetna Commercial |
$1,544.22
|
| Rate for Payer: Aetna Medicare |
$1,198.50
|
| Rate for Payer: BCBS Complete |
$810.96
|
| Rate for Payer: BCBS MAPPO |
$1,152.40
|
| Rate for Payer: BCBS Trust/PPO |
$132.60
|
| Rate for Payer: BCN Commercial |
$1,713.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,152.40
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cash Price |
$1,844.80
|
| Rate for Payer: Cofinity Commercial |
$1,659.46
|
| Rate for Payer: Cofinity Commercial |
$1,544.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,152.40
|
| Rate for Payer: Mclaren Medicaid |
$772.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,210.02
|
| Rate for Payer: Meridian Medicaid |
$810.96
|
| Rate for Payer: Nomi Health Commercial |
$1,382.88
|
| Rate for Payer: PACE SWMI |
$1,152.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,152.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$772.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,498.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,797.18
|
| Rate for Payer: Priority Health Medicare |
$1,163.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,152.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,152.40
|
| Rate for Payer: UHC Exchange |
$1,152.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,152.40
|
| Rate for Payer: UHCCP Medicaid |
$772.34
|
|
|
PROPAFENONE 150 MG TABLET
|
Facility
|
OP
|
$241.30
|
|
|
Service Code
|
NDC 53489055101
|
| Hospital Charge Code |
11146
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.31 |
| Max. Negotiated Rate |
$217.17 |
| Rate for Payer: Aetna Commercial |
$205.10
|
| Rate for Payer: Aetna Medicare |
$62.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.41
|
| Rate for Payer: BCBS Complete |
$96.52
|
| Rate for Payer: BCBS MAPPO |
$60.32
|
| Rate for Payer: BCBS Trust/PPO |
$198.37
|
| Rate for Payer: BCN Commercial |
$187.61
|
| Rate for Payer: BCN Medicare Advantage |
$60.32
|
| Rate for Payer: Cash Price |
$193.04
|
| Rate for Payer: Cofinity Commercial |
$207.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$217.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.10
|
| Rate for Payer: Nomi Health Commercial |
$197.87
|
| Rate for Payer: PACE Senior Care Partners |
$57.31
|
| Rate for Payer: PACE SWMI |
$60.32
|
| Rate for Payer: PHP Commercial |
$205.10
|
| Rate for Payer: PHP Medicare Advantage |
$60.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.84
|
| Rate for Payer: Priority Health HMO/PPO |
$209.93
|
| Rate for Payer: Priority Health Medicare |
$60.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.67
|
| Rate for Payer: Railroad Medicare Medicare |
$60.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.34
|
| Rate for Payer: UHC Core |
$201.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.32
|
| Rate for Payer: UHC Exchange |
$60.32
|
| Rate for Payer: UHC Medicare Advantage |
$60.32
|
| Rate for Payer: VA VA |
$60.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.98
|
|
|
PROPAFENONE 150 MG TABLET
|
Facility
|
IP
|
$241.30
|
|
|
Service Code
|
NDC 53489055101
|
| Hospital Charge Code |
11146
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$156.84 |
| Max. Negotiated Rate |
$217.17 |
| Rate for Payer: Aetna Commercial |
$205.10
|
| Rate for Payer: BCBS Trust/PPO |
$196.97
|
| Rate for Payer: BCN Commercial |
$186.48
|
| Rate for Payer: Cash Price |
$193.04
|
| Rate for Payer: Cofinity Commercial |
$207.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.04
|
| Rate for Payer: Healthscope Commercial |
$217.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.10
|
| Rate for Payer: Nomi Health Commercial |
$197.87
|
| Rate for Payer: PHP Commercial |
$205.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.84
|
| Rate for Payer: Priority Health HMO/PPO |
$209.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.34
|
| Rate for Payer: UHC Core |
$201.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.98
|
|
|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
OP
|
$113.72
|
|
|
Service Code
|
NDC 17478026312
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.01 |
| Max. Negotiated Rate |
$102.35 |
| Rate for Payer: Aetna Commercial |
$96.66
|
| Rate for Payer: Aetna Medicare |
$29.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.54
|
| Rate for Payer: BCBS Complete |
$45.49
|
| Rate for Payer: BCBS MAPPO |
$28.43
|
| Rate for Payer: BCBS Trust/PPO |
$93.49
|
| Rate for Payer: BCN Commercial |
$88.42
|
| Rate for Payer: BCN Medicare Advantage |
$28.43
|
| Rate for Payer: Cash Price |
$90.98
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.43
|
| Rate for Payer: Healthscope Commercial |
$102.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.66
|
| Rate for Payer: Nomi Health Commercial |
$93.25
|
| Rate for Payer: PACE Senior Care Partners |
$27.01
|
| Rate for Payer: PACE SWMI |
$28.43
|
| Rate for Payer: PHP Commercial |
$96.66
|
| Rate for Payer: PHP Medicare Advantage |
$28.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.92
|
| Rate for Payer: Priority Health HMO/PPO |
$98.94
|
| Rate for Payer: Priority Health Medicare |
$28.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.19
|
| Rate for Payer: Railroad Medicare Medicare |
$28.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.07
|
| Rate for Payer: UHC Core |
$94.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.43
|
| Rate for Payer: UHC Exchange |
$28.43
|
| Rate for Payer: UHC Medicare Advantage |
$28.43
|
| Rate for Payer: VA VA |
$28.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.29
|
|
|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
IP
|
$113.72
|
|
|
Service Code
|
NDC 17478026312
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.92 |
| Max. Negotiated Rate |
$102.35 |
| Rate for Payer: Aetna Commercial |
$96.66
|
| Rate for Payer: BCBS Trust/PPO |
$92.83
|
| Rate for Payer: BCN Commercial |
$87.88
|
| Rate for Payer: Cash Price |
$90.98
|
| Rate for Payer: Cofinity Commercial |
$97.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.98
|
| Rate for Payer: Healthscope Commercial |
$102.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.66
|
| Rate for Payer: Nomi Health Commercial |
$93.25
|
| Rate for Payer: PHP Commercial |
$96.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.92
|
| Rate for Payer: Priority Health HMO/PPO |
$98.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.07
|
| Rate for Payer: UHC Core |
$94.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.29
|
|
|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
OP
|
$97.65
|
|
|
Service Code
|
NDC 61314001601
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$23.19 |
| Max. Negotiated Rate |
$87.88 |
| Rate for Payer: Aetna Commercial |
$83.00
|
| Rate for Payer: Aetna Medicare |
$25.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.52
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: BCBS MAPPO |
$24.41
|
| Rate for Payer: BCBS Trust/PPO |
$80.28
|
| Rate for Payer: BCN Commercial |
$75.92
|
| Rate for Payer: BCN Medicare Advantage |
$24.41
|
| Rate for Payer: Cash Price |
$78.12
|
| Rate for Payer: Cofinity Commercial |
$83.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.41
|
| Rate for Payer: Healthscope Commercial |
$87.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.00
|
| Rate for Payer: Nomi Health Commercial |
$80.07
|
| Rate for Payer: PACE Senior Care Partners |
$23.19
|
| Rate for Payer: PACE SWMI |
$24.41
|
| Rate for Payer: PHP Commercial |
$83.00
|
| Rate for Payer: PHP Medicare Advantage |
$24.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.47
|
| Rate for Payer: Priority Health HMO/PPO |
$84.96
|
| Rate for Payer: Priority Health Medicare |
$24.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.43
|
| Rate for Payer: Railroad Medicare Medicare |
$24.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.93
|
| Rate for Payer: UHC Core |
$81.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.41
|
| Rate for Payer: UHC Exchange |
$24.41
|
| Rate for Payer: UHC Medicare Advantage |
$24.41
|
| Rate for Payer: VA VA |
$24.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.24
|
|
|
PROPARACAINE 0.5 % EYE DROPS
|
Facility
|
IP
|
$97.65
|
|
|
Service Code
|
NDC 61314001601
|
| Hospital Charge Code |
6644
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$87.88 |
| Rate for Payer: Aetna Commercial |
$83.00
|
| Rate for Payer: BCBS Trust/PPO |
$79.71
|
| Rate for Payer: BCN Commercial |
$75.46
|
| Rate for Payer: Cash Price |
$78.12
|
| Rate for Payer: Cofinity Commercial |
$83.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.12
|
| Rate for Payer: Healthscope Commercial |
$87.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.00
|
| Rate for Payer: Nomi Health Commercial |
$80.07
|
| Rate for Payer: PHP Commercial |
$83.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.47
|
| Rate for Payer: Priority Health HMO/PPO |
$84.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.93
|
| Rate for Payer: UHC Core |
$81.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.24
|
|
|
PR OPEN ABLATION 1/>RENAL MASS LESION CRYOSURGICAL
|
Professional
|
Both
|
$2,527.00
|
|
|
Service Code
|
HCPCS 50250
|
| Min. Negotiated Rate |
$775.11 |
| Max. Negotiated Rate |
$4,748.36 |
| Rate for Payer: Aetna Commercial |
$1,552.95
|
| Rate for Payer: Aetna Medicare |
$1,205.28
|
| Rate for Payer: BCBS Complete |
$813.87
|
| Rate for Payer: BCBS MAPPO |
$1,158.92
|
| Rate for Payer: BCBS Trust/PPO |
$4,748.36
|
| Rate for Payer: BCN Commercial |
$1,748.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,158.92
|
| Rate for Payer: Cash Price |
$2,021.60
|
| Rate for Payer: Cash Price |
$2,021.60
|
| Rate for Payer: Cofinity Commercial |
$1,668.84
|
| Rate for Payer: Cofinity Commercial |
$1,552.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,158.92
|
| Rate for Payer: Mclaren Medicaid |
$775.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,216.87
|
| Rate for Payer: Meridian Medicaid |
$813.87
|
| Rate for Payer: Nomi Health Commercial |
$1,390.70
|
| Rate for Payer: PACE SWMI |
$1,158.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,158.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,642.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,926.94
|
| Rate for Payer: Priority Health Medicare |
$1,170.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,926.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,158.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,158.92
|
| Rate for Payer: UHC Exchange |
$1,158.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,158.92
|
| Rate for Payer: UHCCP Medicaid |
$775.11
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Facility
|
OP
|
$901.00
|
|
|
Service Code
|
CPT 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$213.99 |
| Max. Negotiated Rate |
$2,848.40 |
| Rate for Payer: Aetna Commercial |
$765.85
|
| Rate for Payer: Aetna Medicare |
$234.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$281.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$281.56
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$225.25
|
| Rate for Payer: BCBS Trust/PPO |
$740.71
|
| Rate for Payer: BCN Commercial |
$700.53
|
| Rate for Payer: BCN Medicare Advantage |
$225.25
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$774.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.25
|
| Rate for Payer: Healthscope Commercial |
$810.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.75
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.51
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$259.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.85
|
| Rate for Payer: Nomi Health Commercial |
$738.82
|
| Rate for Payer: PACE Senior Care Partners |
$213.99
|
| Rate for Payer: PACE SWMI |
$225.25
|
| Rate for Payer: PHP Commercial |
$765.85
|
| Rate for Payer: PHP Medicare Advantage |
$225.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.65
|
| Rate for Payer: Priority Health HMO/PPO |
$783.87
|
| Rate for Payer: Priority Health Medicare |
$227.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$603.67
|
| Rate for Payer: Railroad Medicare Medicare |
$225.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.88
|
| Rate for Payer: UHC Core |
$752.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.25
|
| Rate for Payer: UHC Exchange |
$225.25
|
| Rate for Payer: UHC Medicare Advantage |
$225.25
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$225.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.75
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$289.47 |
| Max. Negotiated Rate |
$900.10 |
| Rate for Payer: Aetna Commercial |
$580.80
|
| Rate for Payer: Aetna Medicare |
$450.77
|
| Rate for Payer: BCBS Complete |
$303.94
|
| Rate for Payer: BCBS MAPPO |
$433.43
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$654.83
|
| Rate for Payer: BCN Medicare Advantage |
$433.43
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$624.14
|
| Rate for Payer: Cofinity Commercial |
$580.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.43
|
| Rate for Payer: Mclaren Medicaid |
$289.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.10
|
| Rate for Payer: Meridian Medicaid |
$303.94
|
| Rate for Payer: Nomi Health Commercial |
$520.12
|
| Rate for Payer: PACE SWMI |
$433.43
|
| Rate for Payer: PHP Medicare Advantage |
$433.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.65
|
| Rate for Payer: Priority Health HMO/PPO |
$900.10
|
| Rate for Payer: Priority Health Medicare |
$437.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$900.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.43
|
| Rate for Payer: UHC Exchange |
$433.43
|
| Rate for Payer: UHC Medicare Advantage |
$433.43
|
| Rate for Payer: UHCCP Medicaid |
$289.47
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Facility
|
IP
|
$901.00
|
|
|
Service Code
|
CPT 38531
|
| Hospital Charge Code |
38531
|
| Min. Negotiated Rate |
$585.65 |
| Max. Negotiated Rate |
$810.90 |
| Rate for Payer: Aetna Commercial |
$765.85
|
| Rate for Payer: BCBS Trust/PPO |
$735.49
|
| Rate for Payer: BCN Commercial |
$696.29
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$774.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.80
|
| Rate for Payer: Healthscope Commercial |
$810.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.85
|
| Rate for Payer: Nomi Health Commercial |
$738.82
|
| Rate for Payer: PHP Commercial |
$765.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.65
|
| Rate for Payer: Priority Health HMO/PPO |
$783.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$603.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.88
|
| Rate for Payer: UHC Core |
$752.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.75
|
|
|
PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 38531
|
| Min. Negotiated Rate |
$289.47 |
| Max. Negotiated Rate |
$900.10 |
| Rate for Payer: Aetna Commercial |
$580.80
|
| Rate for Payer: Aetna Medicare |
$450.77
|
| Rate for Payer: BCBS Complete |
$303.94
|
| Rate for Payer: BCBS MAPPO |
$433.43
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$654.83
|
| Rate for Payer: BCN Medicare Advantage |
$433.43
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$624.14
|
| Rate for Payer: Cofinity Commercial |
$580.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.43
|
| Rate for Payer: Mclaren Medicaid |
$289.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.10
|
| Rate for Payer: Meridian Medicaid |
$303.94
|
| Rate for Payer: Nomi Health Commercial |
$520.12
|
| Rate for Payer: PACE SWMI |
$433.43
|
| Rate for Payer: PHP Medicare Advantage |
$433.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.65
|
| Rate for Payer: Priority Health HMO/PPO |
$900.10
|
| Rate for Payer: Priority Health Medicare |
$437.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$900.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.43
|
| Rate for Payer: UHC Exchange |
$433.43
|
| Rate for Payer: UHC Medicare Advantage |
$433.43
|
| Rate for Payer: UHCCP Medicaid |
$289.47
|
|
|
PR OPEN CLOSURE MAJOR BRONCHIAL FISTULA
|
Professional
|
Both
|
$4,782.00
|
|
|
Service Code
|
HCPCS 32815
|
| Min. Negotiated Rate |
$1,282.18 |
| Max. Negotiated Rate |
$4,031.10 |
| Rate for Payer: Aetna Commercial |
$3,603.76
|
| Rate for Payer: Aetna Medicare |
$2,796.94
|
| Rate for Payer: BCBS Complete |
$1,853.17
|
| Rate for Payer: BCBS MAPPO |
$2,689.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.18
|
| Rate for Payer: BCN Commercial |
$4,031.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,689.37
|
| Rate for Payer: Cash Price |
$3,825.60
|
| Rate for Payer: Cash Price |
$3,825.60
|
| Rate for Payer: Cofinity Commercial |
$3,603.76
|
| Rate for Payer: Cofinity Commercial |
$3,872.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,689.37
|
| Rate for Payer: Mclaren Medicaid |
$1,764.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,823.84
|
| Rate for Payer: Meridian Medicaid |
$1,853.17
|
| Rate for Payer: Nomi Health Commercial |
$3,227.24
|
| Rate for Payer: PACE SWMI |
$2,689.37
|
| Rate for Payer: PHP Medicare Advantage |
$2,689.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,764.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,108.30
|
| Rate for Payer: Priority Health HMO/PPO |
$3,829.63
|
| Rate for Payer: Priority Health Medicare |
$2,716.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,829.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,689.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,689.37
|
| Rate for Payer: UHC Exchange |
$2,689.37
|
| Rate for Payer: UHC Medicare Advantage |
$2,689.37
|
| Rate for Payer: UHCCP Medicaid |
$1,764.92
|
|
|
PR OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM
|
Professional
|
Both
|
$4,070.00
|
|
|
Service Code
|
HCPCS 49188
|
| Min. Negotiated Rate |
$1,284.82 |
| Max. Negotiated Rate |
$2,791.57 |
| Rate for Payer: Aetna Commercial |
$2,597.71
|
| Rate for Payer: Aetna Medicare |
$2,016.13
|
| Rate for Payer: BCBS Complete |
$1,349.06
|
| Rate for Payer: BCBS MAPPO |
$1,938.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,938.59
|
| Rate for Payer: Cash Price |
$3,256.00
|
| Rate for Payer: Cash Price |
$3,256.00
|
| Rate for Payer: Cofinity Commercial |
$2,597.71
|
| Rate for Payer: Cofinity Commercial |
$2,791.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,938.59
|
| Rate for Payer: Mclaren Medicaid |
$1,284.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,035.52
|
| Rate for Payer: Meridian Medicaid |
$1,349.06
|
| Rate for Payer: Nomi Health Commercial |
$2,326.31
|
| Rate for Payer: PACE SWMI |
$1,938.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,938.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,284.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,645.50
|
| Rate for Payer: Priority Health Medicare |
$1,957.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,938.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,938.59
|
| Rate for Payer: UHC Exchange |
$1,938.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,938.59
|
| Rate for Payer: UHCCP Medicaid |
$1,284.82
|
|
|
PR OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS
|
Professional
|
Both
|
$2,694.00
|
|
|
Service Code
|
HCPCS 49186
|
| Min. Negotiated Rate |
$841.35 |
| Max. Negotiated Rate |
$1,821.02 |
| Rate for Payer: Aetna Commercial |
$1,694.56
|
| Rate for Payer: Aetna Medicare |
$1,315.18
|
| Rate for Payer: BCBS Complete |
$883.42
|
| Rate for Payer: BCBS MAPPO |
$1,264.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,264.60
|
| Rate for Payer: Cash Price |
$2,155.20
|
| Rate for Payer: Cash Price |
$2,155.20
|
| Rate for Payer: Cofinity Commercial |
$1,694.56
|
| Rate for Payer: Cofinity Commercial |
$1,821.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,264.60
|
| Rate for Payer: Mclaren Medicaid |
$841.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,327.83
|
| Rate for Payer: Meridian Medicaid |
$883.42
|
| Rate for Payer: Nomi Health Commercial |
$1,517.52
|
| Rate for Payer: PACE SWMI |
$1,264.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,264.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.10
|
| Rate for Payer: Priority Health Medicare |
$1,277.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,264.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,264.60
|
| Rate for Payer: UHC Exchange |
$1,264.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,264.60
|
| Rate for Payer: UHCCP Medicaid |
$841.35
|
|
|
PR OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB
|
Professional
|
Both
|
$1,287.00
|
|
|
Service Code
|
HCPCS 35600
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$1,077.73 |
| Rate for Payer: Aetna Commercial |
$238.71
|
| Rate for Payer: Aetna Medicare |
$185.27
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$178.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.73
|
| Rate for Payer: BCN Commercial |
$264.86
|
| Rate for Payer: BCN Medicare Advantage |
$178.14
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cofinity Commercial |
$238.71
|
| Rate for Payer: Cofinity Commercial |
$256.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.14
|
| Rate for Payer: Mclaren Medicaid |
$116.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.05
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Nomi Health Commercial |
$213.77
|
| Rate for Payer: PACE SWMI |
$178.14
|
| Rate for Payer: PHP Medicare Advantage |
$178.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.55
|
| Rate for Payer: Priority Health HMO/PPO |
$289.31
|
| Rate for Payer: Priority Health Medicare |
$179.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.14
|
| Rate for Payer: UHC Exchange |
$178.14
|
| Rate for Payer: UHC Medicare Advantage |
$178.14
|
| Rate for Payer: UHCCP Medicaid |
$116.09
|
|
|
PR OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 64568
|
| Min. Negotiated Rate |
$390.86 |
| Max. Negotiated Rate |
$1,259.70 |
| Rate for Payer: Aetna Commercial |
$780.87
|
| Rate for Payer: Aetna Medicare |
$606.05
|
| Rate for Payer: BCBS Complete |
$410.40
|
| Rate for Payer: BCBS MAPPO |
$582.74
|
| Rate for Payer: BCBS Trust/PPO |
$462.79
|
| Rate for Payer: BCN Commercial |
$879.62
|
| Rate for Payer: BCN Medicare Advantage |
$582.74
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$839.15
|
| Rate for Payer: Cofinity Commercial |
$780.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.74
|
| Rate for Payer: Mclaren Medicaid |
$390.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.88
|
| Rate for Payer: Meridian Medicaid |
$410.40
|
| Rate for Payer: Nomi Health Commercial |
$699.29
|
| Rate for Payer: PACE SWMI |
$582.74
|
| Rate for Payer: PHP Medicare Advantage |
$582.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,036.77
|
| Rate for Payer: Priority Health Medicare |
$588.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,036.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$582.74
|
| Rate for Payer: UHC Exchange |
$582.74
|
| Rate for Payer: UHC Medicare Advantage |
$582.74
|
| Rate for Payer: UHCCP Medicaid |
$390.86
|
|
|
PR OPEN IMPLANTATION NEA PERIPHERAL NERVE
|
Professional
|
Both
|
$995.00
|
|
|
Service Code
|
HCPCS 64575
|
| Min. Negotiated Rate |
$202.99 |
| Max. Negotiated Rate |
$646.75 |
| Rate for Payer: Aetna Commercial |
$402.11
|
| Rate for Payer: Aetna Medicare |
$312.08
|
| Rate for Payer: BCBS Complete |
$213.14
|
| Rate for Payer: BCBS MAPPO |
$300.08
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$447.63
|
| Rate for Payer: BCN Medicare Advantage |
$300.08
|
| Rate for Payer: Cash Price |
$796.00
|
| Rate for Payer: Cash Price |
$796.00
|
| Rate for Payer: Cofinity Commercial |
$432.12
|
| Rate for Payer: Cofinity Commercial |
$402.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.08
|
| Rate for Payer: Mclaren Medicaid |
$202.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.08
|
| Rate for Payer: Meridian Medicaid |
$213.14
|
| Rate for Payer: Nomi Health Commercial |
$360.10
|
| Rate for Payer: PACE SWMI |
$300.08
|
| Rate for Payer: PHP Medicare Advantage |
$300.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.75
|
| Rate for Payer: Priority Health HMO/PPO |
$539.15
|
| Rate for Payer: Priority Health Medicare |
$303.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$539.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.08
|
| Rate for Payer: UHC Exchange |
$300.08
|
| Rate for Payer: UHC Medicare Advantage |
$300.08
|
| Rate for Payer: UHCCP Medicaid |
$202.99
|
|
|
PR OPEN IMPLANTATION NEA SACRAL NERVE
|
Professional
|
Both
|
$1,517.00
|
|
|
Service Code
|
HCPCS 64581
|
| Min. Negotiated Rate |
$338.11 |
| Max. Negotiated Rate |
$1,115.82 |
| Rate for Payer: Aetna Commercial |
$844.82
|
| Rate for Payer: Aetna Medicare |
$655.68
|
| Rate for Payer: BCBS Complete |
$441.04
|
| Rate for Payer: BCBS MAPPO |
$630.46
|
| Rate for Payer: BCBS Trust/PPO |
$338.11
|
| Rate for Payer: BCN Commercial |
$950.47
|
| Rate for Payer: BCN Medicare Advantage |
$630.46
|
| Rate for Payer: Cash Price |
$1,213.60
|
| Rate for Payer: Cash Price |
$1,213.60
|
| Rate for Payer: Cofinity Commercial |
$907.86
|
| Rate for Payer: Cofinity Commercial |
$844.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.46
|
| Rate for Payer: Mclaren Medicaid |
$420.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$661.98
|
| Rate for Payer: Meridian Medicaid |
$441.04
|
| Rate for Payer: Nomi Health Commercial |
$756.55
|
| Rate for Payer: PACE SWMI |
$630.46
|
| Rate for Payer: PHP Medicare Advantage |
$630.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,115.82
|
| Rate for Payer: Priority Health Medicare |
$636.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,115.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$630.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$630.46
|
| Rate for Payer: UHC Exchange |
$630.46
|
| Rate for Payer: UHC Medicare Advantage |
$630.46
|
| Rate for Payer: UHCCP Medicaid |
$420.04
|
|
