|
PR OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,786.00
|
|
|
Service Code
|
HCPCS 27535
|
| Min. Negotiated Rate |
$864.44 |
| Max. Negotiated Rate |
$1,810.90 |
| Rate for Payer: Aetna Commercial |
$1,158.35
|
| Rate for Payer: Aetna Medicare |
$899.02
|
| Rate for Payer: BCBS Complete |
$1,114.40
|
| Rate for Payer: BCBS MAPPO |
$864.44
|
| Rate for Payer: BCN Medicare Advantage |
$864.44
|
| Rate for Payer: Cash Price |
$2,228.80
|
| Rate for Payer: Cash Price |
$2,228.80
|
| Rate for Payer: Cofinity Commercial |
$1,244.79
|
| Rate for Payer: Cofinity Commercial |
$1,158.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.66
|
| Rate for Payer: Nomi Health Commercial |
$1,037.33
|
| Rate for Payer: PACE SWMI |
$864.44
|
| Rate for Payer: PHP Medicare Advantage |
$864.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,810.90
|
| Rate for Payer: Priority Health Medicare |
$873.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$864.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$864.44
|
| Rate for Payer: UHC Exchange |
$864.44
|
| Rate for Payer: UHC Medicare Advantage |
$864.44
|
|
|
PR OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC
|
Professional
|
Both
|
$2,108.00
|
|
|
Service Code
|
HCPCS 25685
|
| Min. Negotiated Rate |
$712.26 |
| Max. Negotiated Rate |
$1,370.20 |
| Rate for Payer: Aetna Commercial |
$954.43
|
| Rate for Payer: Aetna Medicare |
$740.75
|
| Rate for Payer: BCBS Complete |
$843.20
|
| Rate for Payer: BCBS MAPPO |
$712.26
|
| Rate for Payer: BCN Medicare Advantage |
$712.26
|
| Rate for Payer: Cash Price |
$1,686.40
|
| Rate for Payer: Cash Price |
$1,686.40
|
| Rate for Payer: Cofinity Commercial |
$954.43
|
| Rate for Payer: Cofinity Commercial |
$1,025.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$747.87
|
| Rate for Payer: Nomi Health Commercial |
$854.71
|
| Rate for Payer: PACE SWMI |
$712.26
|
| Rate for Payer: PHP Medicare Advantage |
$712.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,370.20
|
| Rate for Payer: Priority Health Medicare |
$719.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$712.26
|
| Rate for Payer: UHC Exchange |
$712.26
|
| Rate for Payer: UHC Medicare Advantage |
$712.26
|
|
|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP
|
Professional
|
Both
|
$4,168.00
|
|
|
Service Code
|
HCPCS 27823
|
| Min. Negotiated Rate |
$939.78 |
| Max. Negotiated Rate |
$2,709.20 |
| Rate for Payer: Aetna Commercial |
$1,259.31
|
| Rate for Payer: Aetna Medicare |
$977.37
|
| Rate for Payer: BCBS Complete |
$1,667.20
|
| Rate for Payer: BCBS MAPPO |
$939.78
|
| Rate for Payer: BCN Medicare Advantage |
$939.78
|
| Rate for Payer: Cash Price |
$3,334.40
|
| Rate for Payer: Cash Price |
$3,334.40
|
| Rate for Payer: Cofinity Commercial |
$1,353.28
|
| Rate for Payer: Cofinity Commercial |
$1,259.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$939.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$986.77
|
| Rate for Payer: Nomi Health Commercial |
$1,127.74
|
| Rate for Payer: PACE SWMI |
$939.78
|
| Rate for Payer: PHP Medicare Advantage |
$939.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.20
|
| Rate for Payer: Priority Health Medicare |
$949.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$939.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$939.78
|
| Rate for Payer: UHC Exchange |
$939.78
|
| Rate for Payer: UHC Medicare Advantage |
$939.78
|
|
|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP
|
Professional
|
Both
|
$3,537.00
|
|
|
Service Code
|
HCPCS 27822
|
| Min. Negotiated Rate |
$832.31 |
| Max. Negotiated Rate |
$2,299.05 |
| Rate for Payer: Aetna Commercial |
$1,115.30
|
| Rate for Payer: Aetna Medicare |
$865.60
|
| Rate for Payer: BCBS Complete |
$1,414.80
|
| Rate for Payer: BCBS MAPPO |
$832.31
|
| Rate for Payer: BCN Medicare Advantage |
$832.31
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cofinity Commercial |
$1,198.53
|
| Rate for Payer: Cofinity Commercial |
$1,115.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$873.93
|
| Rate for Payer: Nomi Health Commercial |
$998.77
|
| Rate for Payer: PACE SWMI |
$832.31
|
| Rate for Payer: PHP Medicare Advantage |
$832.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,299.05
|
| Rate for Payer: Priority Health Medicare |
$840.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$832.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$832.31
|
| Rate for Payer: UHC Exchange |
$832.31
|
| Rate for Payer: UHC Medicare Advantage |
$832.31
|
|
|
PR OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 92014
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$111.15 |
| Rate for Payer: Aetna Commercial |
$93.99
|
| Rate for Payer: Aetna Medicare |
$72.95
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: BCBS MAPPO |
$70.14
|
| Rate for Payer: BCN Medicare Advantage |
$70.14
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$93.99
|
| Rate for Payer: Cofinity Commercial |
$101.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.65
|
| Rate for Payer: Nomi Health Commercial |
$84.17
|
| Rate for Payer: PACE SWMI |
$70.14
|
| Rate for Payer: PHP Medicare Advantage |
$70.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health Medicare |
$70.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.14
|
| Rate for Payer: UHC Exchange |
$70.14
|
| Rate for Payer: UHC Medicare Advantage |
$70.14
|
|
|
PR OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 92004
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$135.85 |
| Rate for Payer: Aetna Commercial |
$116.46
|
| Rate for Payer: Aetna Medicare |
$90.39
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: BCBS MAPPO |
$86.91
|
| Rate for Payer: BCN Medicare Advantage |
$86.91
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$125.15
|
| Rate for Payer: Cofinity Commercial |
$116.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.26
|
| Rate for Payer: Nomi Health Commercial |
$104.29
|
| Rate for Payer: PACE SWMI |
$86.91
|
| Rate for Payer: PHP Medicare Advantage |
$86.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health Medicare |
$87.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.91
|
| Rate for Payer: UHC Exchange |
$86.91
|
| Rate for Payer: UHC Medicare Advantage |
$86.91
|
|
|
PR OPH SVCS MEDICAL XM&EVAL INTERMEDIATE EST PT
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 92012
|
| Min. Negotiated Rate |
$46.51 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna Commercial |
$62.32
|
| Rate for Payer: Aetna Medicare |
$48.37
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$46.51
|
| Rate for Payer: BCN Medicare Advantage |
$46.51
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.84
|
| Rate for Payer: Nomi Health Commercial |
$55.81
|
| Rate for Payer: PACE SWMI |
$46.51
|
| Rate for Payer: PHP Medicare Advantage |
$46.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health Medicare |
$46.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.51
|
| Rate for Payer: UHC Exchange |
$46.51
|
| Rate for Payer: UHC Medicare Advantage |
$46.51
|
|
|
PR OPH SVCS MEDICAL XM&EVAL INTERMEDIATE NEW PT
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 92002
|
| Min. Negotiated Rate |
$42.19 |
| Max. Negotiated Rate |
$72.15 |
| Rate for Payer: Aetna Commercial |
$56.53
|
| Rate for Payer: Aetna Medicare |
$43.88
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS MAPPO |
$42.19
|
| Rate for Payer: BCN Medicare Advantage |
$42.19
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$60.75
|
| Rate for Payer: Cofinity Commercial |
$56.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.30
|
| Rate for Payer: Nomi Health Commercial |
$50.63
|
| Rate for Payer: PACE SWMI |
$42.19
|
| Rate for Payer: PHP Medicare Advantage |
$42.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health Medicare |
$42.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.19
|
| Rate for Payer: UHC Exchange |
$42.19
|
| Rate for Payer: UHC Medicare Advantage |
$42.19
|
|
|
PR OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ
|
Professional
|
Both
|
$787.00
|
|
|
Service Code
|
HCPCS 34716
|
| Min. Negotiated Rate |
$314.80 |
| Max. Negotiated Rate |
$514.17 |
| Rate for Payer: Aetna Commercial |
$478.46
|
| Rate for Payer: Aetna Medicare |
$371.34
|
| Rate for Payer: BCBS Complete |
$314.80
|
| Rate for Payer: BCBS MAPPO |
$357.06
|
| Rate for Payer: BCN Medicare Advantage |
$357.06
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cofinity Commercial |
$514.17
|
| Rate for Payer: Cofinity Commercial |
$478.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.91
|
| Rate for Payer: Nomi Health Commercial |
$428.47
|
| Rate for Payer: PACE SWMI |
$357.06
|
| Rate for Payer: PHP Medicare Advantage |
$357.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.55
|
| Rate for Payer: Priority Health Medicare |
$360.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.06
|
| Rate for Payer: UHC Exchange |
$357.06
|
| Rate for Payer: UHC Medicare Advantage |
$357.06
|
|
|
PR OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 34834
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$188.50 |
| Rate for Payer: Aetna Commercial |
$166.36
|
| Rate for Payer: Aetna Medicare |
$129.12
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$124.15
|
| Rate for Payer: BCN Medicare Advantage |
$124.15
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$178.78
|
| Rate for Payer: Cofinity Commercial |
$166.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.36
|
| Rate for Payer: Nomi Health Commercial |
$148.98
|
| Rate for Payer: PACE SWMI |
$124.15
|
| Rate for Payer: PHP Medicare Advantage |
$124.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health Medicare |
$125.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.15
|
| Rate for Payer: UHC Exchange |
$124.15
|
| Rate for Payer: UHC Medicare Advantage |
$124.15
|
|
|
PR OPN FEM ART EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$1,267.00
|
|
|
Service Code
|
HCPCS 34812
|
| Min. Negotiated Rate |
$197.63 |
| Max. Negotiated Rate |
$823.55 |
| Rate for Payer: Aetna Commercial |
$264.82
|
| Rate for Payer: Aetna Medicare |
$205.54
|
| Rate for Payer: BCBS Complete |
$506.80
|
| Rate for Payer: BCBS MAPPO |
$197.63
|
| Rate for Payer: BCN Medicare Advantage |
$197.63
|
| Rate for Payer: Cash Price |
$1,013.60
|
| Rate for Payer: Cash Price |
$1,013.60
|
| Rate for Payer: Cofinity Commercial |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$264.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.51
|
| Rate for Payer: Nomi Health Commercial |
$237.16
|
| Rate for Payer: PACE SWMI |
$197.63
|
| Rate for Payer: PHP Medicare Advantage |
$197.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.55
|
| Rate for Payer: Priority Health Medicare |
$199.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.63
|
| Rate for Payer: UHC Exchange |
$197.63
|
| Rate for Payer: UHC Medicare Advantage |
$197.63
|
|
|
PR OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH
|
Professional
|
Both
|
$568.00
|
|
|
Service Code
|
HCPCS 34714
|
| Min. Negotiated Rate |
$227.20 |
| Max. Negotiated Rate |
$371.94 |
| Rate for Payer: Aetna Commercial |
$346.11
|
| Rate for Payer: Aetna Medicare |
$268.62
|
| Rate for Payer: BCBS Complete |
$227.20
|
| Rate for Payer: BCBS MAPPO |
$258.29
|
| Rate for Payer: BCN Medicare Advantage |
$258.29
|
| Rate for Payer: Cash Price |
$454.40
|
| Rate for Payer: Cash Price |
$454.40
|
| Rate for Payer: Cofinity Commercial |
$371.94
|
| Rate for Payer: Cofinity Commercial |
$346.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.20
|
| Rate for Payer: Nomi Health Commercial |
$309.95
|
| Rate for Payer: PACE SWMI |
$258.29
|
| Rate for Payer: PHP Medicare Advantage |
$258.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$369.20
|
| Rate for Payer: Priority Health Medicare |
$260.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.29
|
| Rate for Payer: UHC Exchange |
$258.29
|
| Rate for Payer: UHC Medicare Advantage |
$258.29
|
|
|
PR OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP
|
Professional
|
Both
|
$2,232.00
|
|
|
Service Code
|
HCPCS 34833
|
| Min. Negotiated Rate |
$378.73 |
| Max. Negotiated Rate |
$1,450.80 |
| Rate for Payer: Aetna Commercial |
$507.50
|
| Rate for Payer: Aetna Medicare |
$393.88
|
| Rate for Payer: BCBS Complete |
$892.80
|
| Rate for Payer: BCBS MAPPO |
$378.73
|
| Rate for Payer: BCN Medicare Advantage |
$378.73
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cofinity Commercial |
$545.37
|
| Rate for Payer: Cofinity Commercial |
$507.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.67
|
| Rate for Payer: Nomi Health Commercial |
$454.48
|
| Rate for Payer: PACE SWMI |
$378.73
|
| Rate for Payer: PHP Medicare Advantage |
$378.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,450.80
|
| Rate for Payer: Priority Health Medicare |
$382.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$378.73
|
| Rate for Payer: UHC Exchange |
$378.73
|
| Rate for Payer: UHC Medicare Advantage |
$378.73
|
|
|
PR OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH
|
Professional
|
Both
|
$4,812.00
|
|
|
Service Code
|
HCPCS 34830
|
| Min. Negotiated Rate |
$1,698.38 |
| Max. Negotiated Rate |
$3,127.80 |
| Rate for Payer: Aetna Commercial |
$2,275.83
|
| Rate for Payer: Aetna Medicare |
$1,766.32
|
| Rate for Payer: BCBS Complete |
$1,924.80
|
| Rate for Payer: BCBS MAPPO |
$1,698.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,698.38
|
| Rate for Payer: Cash Price |
$3,849.60
|
| Rate for Payer: Cash Price |
$3,849.60
|
| Rate for Payer: Cofinity Commercial |
$2,445.67
|
| Rate for Payer: Cofinity Commercial |
$2,275.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,698.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,783.30
|
| Rate for Payer: Nomi Health Commercial |
$2,038.06
|
| Rate for Payer: PACE SWMI |
$1,698.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,698.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,127.80
|
| Rate for Payer: Priority Health Medicare |
$1,715.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,698.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,698.38
|
| Rate for Payer: UHC Exchange |
$1,698.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,698.38
|
|
|
PR OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH
|
Professional
|
Both
|
$4,077.00
|
|
|
Service Code
|
HCPCS 34831
|
| Min. Negotiated Rate |
$1,630.80 |
| Max. Negotiated Rate |
$2,679.05 |
| Rate for Payer: Aetna Commercial |
$2,493.00
|
| Rate for Payer: Aetna Medicare |
$1,934.87
|
| Rate for Payer: BCBS Complete |
$1,630.80
|
| Rate for Payer: BCBS MAPPO |
$1,860.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,860.45
|
| Rate for Payer: Cash Price |
$3,261.60
|
| Rate for Payer: Cash Price |
$3,261.60
|
| Rate for Payer: Cofinity Commercial |
$2,679.05
|
| Rate for Payer: Cofinity Commercial |
$2,493.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,860.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,953.47
|
| Rate for Payer: Nomi Health Commercial |
$2,232.54
|
| Rate for Payer: PACE SWMI |
$1,860.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,860.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.05
|
| Rate for Payer: Priority Health Medicare |
$1,879.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,860.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,860.45
|
| Rate for Payer: UHC Exchange |
$1,860.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,860.45
|
|
|
PR OPN SUBCLA CRTD ART TRPOS NCK INC ULAT
|
Professional
|
Both
|
$3,200.00
|
|
|
Service Code
|
HCPCS 33889
|
| Min. Negotiated Rate |
$766.74 |
| Max. Negotiated Rate |
$2,080.00 |
| Rate for Payer: Aetna Commercial |
$1,027.43
|
| Rate for Payer: Aetna Medicare |
$797.41
|
| Rate for Payer: BCBS Complete |
$1,280.00
|
| Rate for Payer: BCBS MAPPO |
$766.74
|
| Rate for Payer: BCN Medicare Advantage |
$766.74
|
| Rate for Payer: Cash Price |
$2,560.00
|
| Rate for Payer: Cash Price |
$2,560.00
|
| Rate for Payer: Cofinity Commercial |
$1,104.11
|
| Rate for Payer: Cofinity Commercial |
$1,027.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$805.08
|
| Rate for Payer: Nomi Health Commercial |
$920.09
|
| Rate for Payer: PACE SWMI |
$766.74
|
| Rate for Payer: PHP Medicare Advantage |
$766.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,080.00
|
| Rate for Payer: Priority Health Medicare |
$774.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$766.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$766.74
|
| Rate for Payer: UHC Exchange |
$766.74
|
| Rate for Payer: UHC Medicare Advantage |
$766.74
|
|
|
PROPOFOL 10 MG/ML 20 ML VIAL (BULK CHARGE)
|
Facility
|
IP
|
$63.61
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.35 |
| Max. Negotiated Rate |
$57.25 |
| Rate for Payer: Aetna Commercial |
$54.07
|
| Rate for Payer: BCBS Trust/PPO |
$51.92
|
| Rate for Payer: BCN Commercial |
$49.16
|
| Rate for Payer: Cash Price |
$50.89
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.89
|
| Rate for Payer: Healthscope Commercial |
$57.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.07
|
| Rate for Payer: Nomi Health Commercial |
$52.16
|
| Rate for Payer: PHP Commercial |
$54.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.35
|
| Rate for Payer: Priority Health HMO/PPO |
$55.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.98
|
| Rate for Payer: UHC Core |
$53.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.71
|
|
|
PROPOFOL 10 MG/ML 20 ML VIAL (BULK CHARGE)
|
Facility
|
OP
|
$63.61
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.11 |
| Max. Negotiated Rate |
$57.25 |
| Rate for Payer: Aetna Commercial |
$54.07
|
| Rate for Payer: Aetna Medicare |
$16.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.88
|
| Rate for Payer: BCBS Complete |
$25.44
|
| Rate for Payer: BCBS MAPPO |
$15.90
|
| Rate for Payer: BCBS Trust/PPO |
$52.29
|
| Rate for Payer: BCN Commercial |
$49.46
|
| Rate for Payer: BCN Medicare Advantage |
$15.90
|
| Rate for Payer: Cash Price |
$50.89
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.90
|
| Rate for Payer: Healthscope Commercial |
$57.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.07
|
| Rate for Payer: Nomi Health Commercial |
$52.16
|
| Rate for Payer: PACE Senior Care Partners |
$15.11
|
| Rate for Payer: PACE SWMI |
$15.90
|
| Rate for Payer: PHP Commercial |
$54.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.35
|
| Rate for Payer: Priority Health HMO/PPO |
$55.34
|
| Rate for Payer: Priority Health Medicare |
$16.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.62
|
| Rate for Payer: Railroad Medicare Medicare |
$15.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.98
|
| Rate for Payer: UHC Core |
$53.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.90
|
| Rate for Payer: UHC Exchange |
$15.90
|
| Rate for Payer: UHC Medicare Advantage |
$15.90
|
| Rate for Payer: VA VA |
$15.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.71
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
IP
|
$77.12
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$50.13 |
| Max. Negotiated Rate |
$69.41 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: BCBS Trust/PPO |
$62.95
|
| Rate for Payer: BCN Commercial |
$59.60
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Nomi Health Commercial |
$63.24
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.13
|
| Rate for Payer: Priority Health HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC Core |
$64.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.84
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
OP
|
$77.12
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$69.41 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Medicare |
$20.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.10
|
| Rate for Payer: BCBS Complete |
$30.85
|
| Rate for Payer: BCBS MAPPO |
$19.28
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: BCN Commercial |
$59.96
|
| Rate for Payer: BCN Medicare Advantage |
$19.28
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.28
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Nomi Health Commercial |
$63.24
|
| Rate for Payer: PACE Senior Care Partners |
$18.32
|
| Rate for Payer: PACE SWMI |
$19.28
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Medicare Advantage |
$19.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.13
|
| Rate for Payer: Priority Health HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health Medicare |
$19.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.67
|
| Rate for Payer: Railroad Medicare Medicare |
$19.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC Core |
$64.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.28
|
| Rate for Payer: UHC Exchange |
$19.28
|
| Rate for Payer: UHC Medicare Advantage |
$19.28
|
| Rate for Payer: VA VA |
$19.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.84
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
OP
|
$77.12
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$69.41 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$46.36
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Commercial |
$61.65
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$76.47
|
| Rate for Payer: Aetna Commercial |
$57.66
|
| Rate for Payer: Aetna Commercial |
$52.90
|
| Rate for Payer: Aetna Commercial |
$67.11
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Aetna Medicare |
$26.73
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Aetna Medicare |
$20.05
|
| Rate for Payer: Aetna Medicare |
$20.53
|
| Rate for Payer: Aetna Medicare |
$22.44
|
| Rate for Payer: Aetna Medicare |
$23.39
|
| Rate for Payer: Aetna Medicare |
$17.64
|
| Rate for Payer: Aetna Medicare |
$18.86
|
| Rate for Payer: Aetna Medicare |
$14.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.20
|
| Rate for Payer: BCBS Complete |
$34.52
|
| Rate for Payer: BCBS Complete |
$24.89
|
| Rate for Payer: BCBS Complete |
$21.82
|
| Rate for Payer: BCBS Complete |
$26.01
|
| Rate for Payer: BCBS Complete |
$31.58
|
| Rate for Payer: BCBS Complete |
$27.13
|
| Rate for Payer: BCBS Complete |
$29.01
|
| Rate for Payer: BCBS Complete |
$35.99
|
| Rate for Payer: BCBS Complete |
$30.85
|
| Rate for Payer: BCBS Complete |
$41.13
|
| Rate for Payer: BCBS MAPPO |
$21.57
|
| Rate for Payer: BCBS MAPPO |
$16.96
|
| Rate for Payer: BCBS MAPPO |
$18.13
|
| Rate for Payer: BCBS MAPPO |
$19.74
|
| Rate for Payer: BCBS MAPPO |
$13.63
|
| Rate for Payer: BCBS MAPPO |
$25.70
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS MAPPO |
$22.49
|
| Rate for Payer: BCBS MAPPO |
$19.28
|
| Rate for Payer: BCBS Trust/PPO |
$73.96
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: BCBS Trust/PPO |
$55.76
|
| Rate for Payer: BCBS Trust/PPO |
$59.63
|
| Rate for Payer: BCBS Trust/PPO |
$70.95
|
| Rate for Payer: BCBS Trust/PPO |
$64.90
|
| Rate for Payer: BCBS Trust/PPO |
$84.53
|
| Rate for Payer: BCBS Trust/PPO |
$44.84
|
| Rate for Payer: BCBS Trust/PPO |
$51.16
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCN Commercial |
$50.56
|
| Rate for Payer: BCN Commercial |
$61.38
|
| Rate for Payer: BCN Commercial |
$42.40
|
| Rate for Payer: BCN Commercial |
$79.94
|
| Rate for Payer: BCN Commercial |
$56.39
|
| Rate for Payer: BCN Commercial |
$52.74
|
| Rate for Payer: BCN Commercial |
$69.95
|
| Rate for Payer: BCN Commercial |
$59.96
|
| Rate for Payer: BCN Commercial |
$67.10
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: BCN Medicare Advantage |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: BCN Medicare Advantage |
$21.57
|
| Rate for Payer: BCN Medicare Advantage |
$19.28
|
| Rate for Payer: BCN Medicare Advantage |
$22.49
|
| Rate for Payer: BCN Medicare Advantage |
$18.13
|
| Rate for Payer: BCN Medicare Advantage |
$16.96
|
| Rate for Payer: BCN Medicare Advantage |
$25.70
|
| Rate for Payer: BCN Medicare Advantage |
$13.63
|
| Rate for Payer: Cash Price |
$71.98
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$82.26
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$63.16
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$58.02
|
| Rate for Payer: Cash Price |
$54.26
|
| Rate for Payer: Cofinity Commercial |
$67.90
|
| Rate for Payer: Cofinity Commercial |
$88.43
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$62.38
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Commercial |
$58.33
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Cofinity Commercial |
$53.52
|
| Rate for Payer: Cofinity Commercial |
$77.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.96
|
| Rate for Payer: Healthscope Commercial |
$56.01
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$49.09
|
| Rate for Payer: Healthscope Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$61.05
|
| Rate for Payer: Healthscope Commercial |
$80.97
|
| Rate for Payer: Healthscope Commercial |
$65.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.90
|
| Rate for Payer: Nomi Health Commercial |
$84.31
|
| Rate for Payer: Nomi Health Commercial |
$53.32
|
| Rate for Payer: Nomi Health Commercial |
$64.74
|
| Rate for Payer: Nomi Health Commercial |
$70.77
|
| Rate for Payer: Nomi Health Commercial |
$63.24
|
| Rate for Payer: Nomi Health Commercial |
$55.62
|
| Rate for Payer: Nomi Health Commercial |
$51.03
|
| Rate for Payer: Nomi Health Commercial |
$59.47
|
| Rate for Payer: Nomi Health Commercial |
$73.78
|
| Rate for Payer: Nomi Health Commercial |
$44.72
|
| Rate for Payer: PACE Senior Care Partners |
$21.37
|
| Rate for Payer: PACE Senior Care Partners |
$16.11
|
| Rate for Payer: PACE Senior Care Partners |
$12.95
|
| Rate for Payer: PACE Senior Care Partners |
$17.23
|
| Rate for Payer: PACE Senior Care Partners |
$24.42
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE Senior Care Partners |
$15.44
|
| Rate for Payer: PACE Senior Care Partners |
$18.75
|
| Rate for Payer: PACE Senior Care Partners |
$20.50
|
| Rate for Payer: PACE Senior Care Partners |
$18.32
|
| Rate for Payer: PACE SWMI |
$16.96
|
| Rate for Payer: PACE SWMI |
$13.63
|
| Rate for Payer: PACE SWMI |
$25.70
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PACE SWMI |
$21.57
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PACE SWMI |
$19.74
|
| Rate for Payer: PACE SWMI |
$19.28
|
| Rate for Payer: PACE SWMI |
$18.13
|
| Rate for Payer: PACE SWMI |
$22.49
|
| Rate for Payer: PHP Commercial |
$76.47
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$61.65
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$46.36
|
| Rate for Payer: PHP Commercial |
$87.40
|
| Rate for Payer: PHP Commercial |
$52.90
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$67.11
|
| Rate for Payer: PHP Commercial |
$57.66
|
| Rate for Payer: PHP Medicare Advantage |
$21.57
|
| Rate for Payer: PHP Medicare Advantage |
$22.49
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: PHP Medicare Advantage |
$19.28
|
| Rate for Payer: PHP Medicare Advantage |
$16.96
|
| Rate for Payer: PHP Medicare Advantage |
$25.70
|
| Rate for Payer: PHP Medicare Advantage |
$13.63
|
| Rate for Payer: PHP Medicare Advantage |
$18.13
|
| Rate for Payer: PHP Medicare Advantage |
$19.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.45
|
| Rate for Payer: Priority Health HMO/PPO |
$68.69
|
| Rate for Payer: Priority Health HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health HMO/PPO |
$75.08
|
| Rate for Payer: Priority Health HMO/PPO |
$47.45
|
| Rate for Payer: Priority Health HMO/PPO |
$56.58
|
| Rate for Payer: Priority Health HMO/PPO |
$89.45
|
| Rate for Payer: Priority Health HMO/PPO |
$78.27
|
| Rate for Payer: Priority Health HMO/PPO |
$63.10
|
| Rate for Payer: Priority Health HMO/PPO |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO |
$54.14
|
| Rate for Payer: Priority Health Medicare |
$21.79
|
| Rate for Payer: Priority Health Medicare |
$18.31
|
| Rate for Payer: Priority Health Medicare |
$16.42
|
| Rate for Payer: Priority Health Medicare |
$19.47
|
| Rate for Payer: Priority Health Medicare |
$15.71
|
| Rate for Payer: Priority Health Medicare |
$19.93
|
| Rate for Payer: Priority Health Medicare |
$25.96
|
| Rate for Payer: Priority Health Medicare |
$13.77
|
| Rate for Payer: Priority Health Medicare |
$22.72
|
| Rate for Payer: Priority Health Medicare |
$17.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.45
|
| Rate for Payer: Railroad Medicare Medicare |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$22.49
|
| Rate for Payer: Railroad Medicare Medicare |
$13.63
|
| Rate for Payer: Railroad Medicare Medicare |
$19.74
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: Railroad Medicare Medicare |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: Railroad Medicare Medicare |
$16.96
|
| Rate for Payer: Railroad Medicare Medicare |
$21.57
|
| Rate for Payer: Railroad Medicare Medicare |
$18.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.94
|
| Rate for Payer: UHC Core |
$60.56
|
| Rate for Payer: UHC Core |
$54.30
|
| Rate for Payer: UHC Core |
$65.92
|
| Rate for Payer: UHC Core |
$56.64
|
| Rate for Payer: UHC Core |
$64.40
|
| Rate for Payer: UHC Core |
$75.12
|
| Rate for Payer: UHC Core |
$51.96
|
| Rate for Payer: UHC Core |
$72.06
|
| Rate for Payer: UHC Core |
$85.85
|
| Rate for Payer: UHC Core |
$45.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.96
|
| Rate for Payer: UHC Exchange |
$13.63
|
| Rate for Payer: UHC Exchange |
$19.28
|
| Rate for Payer: UHC Exchange |
$19.74
|
| Rate for Payer: UHC Exchange |
$25.70
|
| Rate for Payer: UHC Exchange |
$22.49
|
| Rate for Payer: UHC Exchange |
$15.56
|
| Rate for Payer: UHC Exchange |
$21.57
|
| Rate for Payer: UHC Exchange |
$18.13
|
| Rate for Payer: UHC Exchange |
$16.26
|
| Rate for Payer: UHC Exchange |
$16.96
|
| Rate for Payer: UHC Medicare Advantage |
$25.70
|
| Rate for Payer: UHC Medicare Advantage |
$21.57
|
| Rate for Payer: UHC Medicare Advantage |
$22.49
|
| Rate for Payer: UHC Medicare Advantage |
$16.26
|
| Rate for Payer: UHC Medicare Advantage |
$19.28
|
| Rate for Payer: UHC Medicare Advantage |
$19.74
|
| Rate for Payer: UHC Medicare Advantage |
$15.56
|
| Rate for Payer: UHC Medicare Advantage |
$18.13
|
| Rate for Payer: UHC Medicare Advantage |
$16.96
|
| Rate for Payer: UHC Medicare Advantage |
$13.63
|
| Rate for Payer: VA VA |
$21.57
|
| Rate for Payer: VA VA |
$19.74
|
| Rate for Payer: VA VA |
$19.28
|
| Rate for Payer: VA VA |
$25.70
|
| Rate for Payer: VA VA |
$18.13
|
| Rate for Payer: VA VA |
$22.49
|
| Rate for Payer: VA VA |
$13.63
|
| Rate for Payer: VA VA |
$16.26
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: VA VA |
$16.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.40
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
IP
|
$62.23
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.45 |
| Max. Negotiated Rate |
$56.01 |
| Rate for Payer: Aetna Commercial |
$52.90
|
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$61.65
|
| Rate for Payer: Aetna Commercial |
$67.11
|
| Rate for Payer: Aetna Commercial |
$57.66
|
| Rate for Payer: Aetna Commercial |
$76.47
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$46.36
|
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: BCBS Trust/PPO |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$70.45
|
| Rate for Payer: BCBS Trust/PPO |
$83.93
|
| Rate for Payer: BCBS Trust/PPO |
$64.45
|
| Rate for Payer: BCBS Trust/PPO |
$55.37
|
| Rate for Payer: BCBS Trust/PPO |
$50.80
|
| Rate for Payer: BCBS Trust/PPO |
$59.21
|
| Rate for Payer: BCBS Trust/PPO |
$62.95
|
| Rate for Payer: BCBS Trust/PPO |
$53.08
|
| Rate for Payer: BCBS Trust/PPO |
$73.44
|
| Rate for Payer: BCN Commercial |
$50.26
|
| Rate for Payer: BCN Commercial |
$79.46
|
| Rate for Payer: BCN Commercial |
$48.09
|
| Rate for Payer: BCN Commercial |
$61.01
|
| Rate for Payer: BCN Commercial |
$59.60
|
| Rate for Payer: BCN Commercial |
$66.69
|
| Rate for Payer: BCN Commercial |
$52.42
|
| Rate for Payer: BCN Commercial |
$69.53
|
| Rate for Payer: BCN Commercial |
$56.05
|
| Rate for Payer: BCN Commercial |
$42.15
|
| Rate for Payer: Cash Price |
$71.98
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$82.26
|
| Rate for Payer: Cash Price |
$54.26
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$63.16
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$58.02
|
| Rate for Payer: Cofinity Commercial |
$88.43
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$77.37
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$62.38
|
| Rate for Payer: Cofinity Commercial |
$58.33
|
| Rate for Payer: Cofinity Commercial |
$53.52
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Commercial |
$67.90
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.98
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Healthscope Commercial |
$61.05
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$80.97
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$49.09
|
| Rate for Payer: Healthscope Commercial |
$56.01
|
| Rate for Payer: Healthscope Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$65.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.47
|
| Rate for Payer: Nomi Health Commercial |
$84.31
|
| Rate for Payer: Nomi Health Commercial |
$53.32
|
| Rate for Payer: Nomi Health Commercial |
$64.74
|
| Rate for Payer: Nomi Health Commercial |
$63.24
|
| Rate for Payer: Nomi Health Commercial |
$70.77
|
| Rate for Payer: Nomi Health Commercial |
$44.72
|
| Rate for Payer: Nomi Health Commercial |
$51.03
|
| Rate for Payer: Nomi Health Commercial |
$59.47
|
| Rate for Payer: Nomi Health Commercial |
$55.62
|
| Rate for Payer: Nomi Health Commercial |
$73.78
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$57.66
|
| Rate for Payer: PHP Commercial |
$61.65
|
| Rate for Payer: PHP Commercial |
$52.90
|
| Rate for Payer: PHP Commercial |
$87.40
|
| Rate for Payer: PHP Commercial |
$46.36
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$67.11
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$76.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.32
|
| Rate for Payer: Priority Health HMO/PPO |
$63.10
|
| Rate for Payer: Priority Health HMO/PPO |
$78.27
|
| Rate for Payer: Priority Health HMO/PPO |
$54.14
|
| Rate for Payer: Priority Health HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health HMO/PPO |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO |
$75.08
|
| Rate for Payer: Priority Health HMO/PPO |
$68.69
|
| Rate for Payer: Priority Health HMO/PPO |
$56.58
|
| Rate for Payer: Priority Health HMO/PPO |
$89.45
|
| Rate for Payer: Priority Health HMO/PPO |
$47.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.23
|
| Rate for Payer: UHC Core |
$54.30
|
| Rate for Payer: UHC Core |
$60.56
|
| Rate for Payer: UHC Core |
$85.85
|
| Rate for Payer: UHC Core |
$45.54
|
| Rate for Payer: UHC Core |
$65.92
|
| Rate for Payer: UHC Core |
$72.06
|
| Rate for Payer: UHC Core |
$51.96
|
| Rate for Payer: UHC Core |
$64.40
|
| Rate for Payer: UHC Core |
$75.12
|
| Rate for Payer: UHC Core |
$56.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.84
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$65.03
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.27 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: BCBS Trust/PPO |
$53.08
|
| Rate for Payer: BCN Commercial |
$50.26
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Nomi Health Commercial |
$53.32
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.27
|
| Rate for Payer: Priority Health HMO/PPO |
$56.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.23
|
| Rate for Payer: UHC Core |
$54.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$65.03
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.44 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: BCBS Complete |
$26.01
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCN Commercial |
$50.56
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Nomi Health Commercial |
$53.32
|
| Rate for Payer: PACE Senior Care Partners |
$15.44
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.27
|
| Rate for Payer: Priority Health HMO/PPO |
$56.58
|
| Rate for Payer: Priority Health Medicare |
$16.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.57
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.23
|
| Rate for Payer: UHC Core |
$54.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.26
|
| Rate for Payer: UHC Exchange |
$16.26
|
| Rate for Payer: UHC Medicare Advantage |
$16.26
|
| Rate for Payer: VA VA |
$16.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
|
|
PR OPPONENSPLASTY OTHER METHODS
|
Professional
|
Both
|
$3,594.00
|
|
|
Service Code
|
HCPCS 26496
|
| Min. Negotiated Rate |
$854.20 |
| Max. Negotiated Rate |
$2,336.10 |
| Rate for Payer: Aetna Commercial |
$1,144.63
|
| Rate for Payer: Aetna Medicare |
$888.37
|
| Rate for Payer: BCBS Complete |
$1,437.60
|
| Rate for Payer: BCBS MAPPO |
$854.20
|
| Rate for Payer: BCN Medicare Advantage |
$854.20
|
| Rate for Payer: Cash Price |
$2,875.20
|
| Rate for Payer: Cash Price |
$2,875.20
|
| Rate for Payer: Cofinity Commercial |
$1,230.05
|
| Rate for Payer: Cofinity Commercial |
$1,144.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$896.91
|
| Rate for Payer: Nomi Health Commercial |
$1,025.04
|
| Rate for Payer: PACE SWMI |
$854.20
|
| Rate for Payer: PHP Medicare Advantage |
$854.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,336.10
|
| Rate for Payer: Priority Health Medicare |
$862.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$854.20
|
| Rate for Payer: UHC Exchange |
$854.20
|
| Rate for Payer: UHC Medicare Advantage |
$854.20
|
|
