|
PR OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 28310
|
| Min. Negotiated Rate |
$238.77 |
| Max. Negotiated Rate |
$1,691.62 |
| Rate for Payer: Aetna Commercial |
$471.40
|
| Rate for Payer: Aetna Medicare |
$365.86
|
| Rate for Payer: BCBS Complete |
$250.71
|
| Rate for Payer: BCBS MAPPO |
$351.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.62
|
| Rate for Payer: BCN Commercial |
$790.19
|
| Rate for Payer: BCN Medicare Advantage |
$351.79
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cofinity Commercial |
$506.58
|
| Rate for Payer: Cofinity Commercial |
$471.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.79
|
| Rate for Payer: Mclaren Medicaid |
$238.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.38
|
| Rate for Payer: Meridian Medicaid |
$250.71
|
| Rate for Payer: Nomi Health Commercial |
$422.15
|
| Rate for Payer: PACE SWMI |
$351.79
|
| Rate for Payer: PHP Medicare Advantage |
$351.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.40
|
| Rate for Payer: Priority Health HMO/PPO |
$561.27
|
| Rate for Payer: Priority Health Medicare |
$355.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$561.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.79
|
| Rate for Payer: UHC Exchange |
$351.79
|
| Rate for Payer: UHC Medicare Advantage |
$351.79
|
| Rate for Payer: UHCCP Medicaid |
$238.77
|
|
|
PR OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM
|
Professional
|
Both
|
$2,637.00
|
|
|
Service Code
|
HCPCS 22216
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$1,714.05 |
| Rate for Payer: Aetna Commercial |
$473.88
|
| Rate for Payer: Aetna Medicare |
$367.79
|
| Rate for Payer: BCBS Complete |
$243.78
|
| Rate for Payer: BCBS MAPPO |
$353.64
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: BCN Commercial |
$580.04
|
| Rate for Payer: BCN Medicare Advantage |
$353.64
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cash Price |
$2,109.60
|
| Rate for Payer: Cofinity Commercial |
$509.24
|
| Rate for Payer: Cofinity Commercial |
$473.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.64
|
| Rate for Payer: Mclaren Medicaid |
$232.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$371.32
|
| Rate for Payer: Meridian Medicaid |
$243.78
|
| Rate for Payer: Nomi Health Commercial |
$424.37
|
| Rate for Payer: PACE SWMI |
$353.64
|
| Rate for Payer: PHP Medicare Advantage |
$353.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,714.05
|
| Rate for Payer: Priority Health HMO/PPO |
$550.08
|
| Rate for Payer: Priority Health Medicare |
$357.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.64
|
| Rate for Payer: UHC Exchange |
$353.64
|
| Rate for Payer: UHC Medicare Advantage |
$353.64
|
| Rate for Payer: UHCCP Medicaid |
$232.17
|
|
|
PR OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
HCPCS 28305
|
| Min. Negotiated Rate |
$436.22 |
| Max. Negotiated Rate |
$1,202.94 |
| Rate for Payer: Aetna Commercial |
$866.93
|
| Rate for Payer: Aetna Medicare |
$672.84
|
| Rate for Payer: BCBS Complete |
$458.03
|
| Rate for Payer: BCBS MAPPO |
$646.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.94
|
| Rate for Payer: BCN Commercial |
$979.31
|
| Rate for Payer: BCN Medicare Advantage |
$646.96
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Cofinity Commercial |
$931.62
|
| Rate for Payer: Cofinity Commercial |
$866.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.96
|
| Rate for Payer: Mclaren Medicaid |
$436.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.31
|
| Rate for Payer: Meridian Medicaid |
$458.03
|
| Rate for Payer: Nomi Health Commercial |
$776.35
|
| Rate for Payer: PACE SWMI |
$646.96
|
| Rate for Payer: PHP Medicare Advantage |
$646.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,038.08
|
| Rate for Payer: Priority Health Medicare |
$653.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,038.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$646.96
|
| Rate for Payer: UHC Exchange |
$646.96
|
| Rate for Payer: UHC Medicare Advantage |
$646.96
|
| Rate for Payer: UHCCP Medicaid |
$436.22
|
|
|
PR OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT
|
Professional
|
Both
|
$3,962.00
|
|
|
Service Code
|
HCPCS 28309
|
| Min. Negotiated Rate |
$586.60 |
| Max. Negotiated Rate |
$2,575.30 |
| Rate for Payer: Aetna Commercial |
$1,166.72
|
| Rate for Payer: Aetna Medicare |
$905.52
|
| Rate for Payer: BCBS Complete |
$615.93
|
| Rate for Payer: BCBS MAPPO |
$870.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,728.07
|
| Rate for Payer: BCN Commercial |
$1,315.04
|
| Rate for Payer: BCN Medicare Advantage |
$870.69
|
| Rate for Payer: Cash Price |
$3,169.60
|
| Rate for Payer: Cash Price |
$3,169.60
|
| Rate for Payer: Cofinity Commercial |
$1,253.79
|
| Rate for Payer: Cofinity Commercial |
$1,166.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.69
|
| Rate for Payer: Mclaren Medicaid |
$586.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$914.22
|
| Rate for Payer: Meridian Medicaid |
$615.93
|
| Rate for Payer: Nomi Health Commercial |
$1,044.83
|
| Rate for Payer: PACE SWMI |
$870.69
|
| Rate for Payer: PHP Medicare Advantage |
$870.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$586.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,575.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,391.22
|
| Rate for Payer: Priority Health Medicare |
$879.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$870.69
|
| Rate for Payer: UHC Exchange |
$870.69
|
| Rate for Payer: UHC Medicare Advantage |
$870.69
|
| Rate for Payer: UHCCP Medicaid |
$586.60
|
|
|
PR OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR
|
Professional
|
Both
|
$1,417.00
|
|
|
Service Code
|
HCPCS 28306
|
| Min. Negotiated Rate |
$264.76 |
| Max. Negotiated Rate |
$1,500.90 |
| Rate for Payer: Aetna Commercial |
$523.06
|
| Rate for Payer: Aetna Medicare |
$405.95
|
| Rate for Payer: BCBS Complete |
$278.00
|
| Rate for Payer: BCBS MAPPO |
$390.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.90
|
| Rate for Payer: BCN Commercial |
$886.46
|
| Rate for Payer: BCN Medicare Advantage |
$390.34
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cofinity Commercial |
$562.09
|
| Rate for Payer: Cofinity Commercial |
$523.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.34
|
| Rate for Payer: Mclaren Medicaid |
$264.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.86
|
| Rate for Payer: Meridian Medicaid |
$278.00
|
| Rate for Payer: Nomi Health Commercial |
$468.41
|
| Rate for Payer: PACE SWMI |
$390.34
|
| Rate for Payer: PHP Medicare Advantage |
$390.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.05
|
| Rate for Payer: Priority Health HMO/PPO |
$628.95
|
| Rate for Payer: Priority Health Medicare |
$394.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$628.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.34
|
| Rate for Payer: UHC Exchange |
$390.34
|
| Rate for Payer: UHC Medicare Advantage |
$390.34
|
| Rate for Payer: UHCCP Medicaid |
$264.76
|
|
|
PR OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA
|
Professional
|
Both
|
$1,087.00
|
|
|
Service Code
|
HCPCS 28308
|
| Min. Negotiated Rate |
$252.83 |
| Max. Negotiated Rate |
$1,566.94 |
| Rate for Payer: Aetna Commercial |
$497.23
|
| Rate for Payer: Aetna Medicare |
$385.91
|
| Rate for Payer: BCBS Complete |
$265.47
|
| Rate for Payer: BCBS MAPPO |
$371.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.94
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$371.07
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cofinity Commercial |
$534.34
|
| Rate for Payer: Cofinity Commercial |
$497.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.07
|
| Rate for Payer: Mclaren Medicaid |
$252.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.62
|
| Rate for Payer: Meridian Medicaid |
$265.47
|
| Rate for Payer: Nomi Health Commercial |
$445.28
|
| Rate for Payer: PACE SWMI |
$371.07
|
| Rate for Payer: PHP Medicare Advantage |
$371.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$706.55
|
| Rate for Payer: Priority Health HMO/PPO |
$599.44
|
| Rate for Payer: Priority Health Medicare |
$374.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$599.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.07
|
| Rate for Payer: UHC Exchange |
$371.07
|
| Rate for Payer: UHC Medicare Advantage |
$371.07
|
| Rate for Payer: UHCCP Medicaid |
$252.83
|
|
|
PR OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX
|
Professional
|
Both
|
$1,270.00
|
|
|
Service Code
|
HCPCS 63295
|
| Min. Negotiated Rate |
$212.57 |
| Max. Negotiated Rate |
$825.50 |
| Rate for Payer: Aetna Commercial |
$438.74
|
| Rate for Payer: Aetna Medicare |
$340.52
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS MAPPO |
$327.42
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: BCN Commercial |
$483.30
|
| Rate for Payer: BCN Medicare Advantage |
$327.42
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cash Price |
$1,016.00
|
| Rate for Payer: Cofinity Commercial |
$471.48
|
| Rate for Payer: Cofinity Commercial |
$438.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.42
|
| Rate for Payer: Mclaren Medicaid |
$212.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.79
|
| Rate for Payer: Meridian Medicaid |
$223.20
|
| Rate for Payer: Nomi Health Commercial |
$392.90
|
| Rate for Payer: PACE SWMI |
$327.42
|
| Rate for Payer: PHP Medicare Advantage |
$327.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$825.50
|
| Rate for Payer: Priority Health HMO/PPO |
$561.89
|
| Rate for Payer: Priority Health Medicare |
$330.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$561.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.42
|
| Rate for Payer: UHC Exchange |
$327.42
|
| Rate for Payer: UHC Medicare Advantage |
$327.42
|
| Rate for Payer: UHCCP Medicaid |
$212.57
|
|
|
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$135.40
|
|
|
Service Code
|
HCPCS J2720
|
| Hospital Charge Code |
6677
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$88.01 |
| Max. Negotiated Rate |
$121.86 |
| Rate for Payer: Aetna Commercial |
$115.09
|
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: BCBS Trust/PPO |
$110.53
|
| Rate for Payer: BCBS Trust/PPO |
$36.80
|
| Rate for Payer: BCN Commercial |
$104.64
|
| Rate for Payer: BCN Commercial |
$34.84
|
| Rate for Payer: Cash Price |
$108.32
|
| Rate for Payer: Cash Price |
$36.06
|
| Rate for Payer: Cofinity Commercial |
$38.77
|
| Rate for Payer: Cofinity Commercial |
$116.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.32
|
| Rate for Payer: Healthscope Commercial |
$121.86
|
| Rate for Payer: Healthscope Commercial |
$40.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.32
|
| Rate for Payer: Nomi Health Commercial |
$111.03
|
| Rate for Payer: Nomi Health Commercial |
$36.97
|
| Rate for Payer: PHP Commercial |
$115.09
|
| Rate for Payer: PHP Commercial |
$38.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.01
|
| Rate for Payer: Priority Health HMO/PPO |
$39.22
|
| Rate for Payer: Priority Health HMO/PPO |
$117.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.67
|
| Rate for Payer: UHC Core |
$113.06
|
| Rate for Payer: UHC Core |
$37.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.81
|
|
|
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$45.08
|
|
|
Service Code
|
HCPCS J2720
|
| Hospital Charge Code |
6677
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.71 |
| Max. Negotiated Rate |
$40.57 |
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: Aetna Commercial |
$115.09
|
| Rate for Payer: Aetna Medicare |
$11.72
|
| Rate for Payer: Aetna Medicare |
$35.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.31
|
| Rate for Payer: BCBS Complete |
$54.16
|
| Rate for Payer: BCBS Complete |
$18.03
|
| Rate for Payer: BCBS MAPPO |
$33.85
|
| Rate for Payer: BCBS MAPPO |
$11.27
|
| Rate for Payer: BCBS Trust/PPO |
$37.06
|
| Rate for Payer: BCBS Trust/PPO |
$111.31
|
| Rate for Payer: BCN Commercial |
$35.05
|
| Rate for Payer: BCN Commercial |
$105.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.27
|
| Rate for Payer: BCN Medicare Advantage |
$33.85
|
| Rate for Payer: Cash Price |
$36.06
|
| Rate for Payer: Cash Price |
$108.32
|
| Rate for Payer: Cofinity Commercial |
$116.44
|
| Rate for Payer: Cofinity Commercial |
$38.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.27
|
| Rate for Payer: Healthscope Commercial |
$121.86
|
| Rate for Payer: Healthscope Commercial |
$40.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.09
|
| Rate for Payer: Nomi Health Commercial |
$36.97
|
| Rate for Payer: Nomi Health Commercial |
$111.03
|
| Rate for Payer: PACE Senior Care Partners |
$10.71
|
| Rate for Payer: PACE Senior Care Partners |
$32.16
|
| Rate for Payer: PACE SWMI |
$11.27
|
| Rate for Payer: PACE SWMI |
$33.85
|
| Rate for Payer: PHP Commercial |
$38.32
|
| Rate for Payer: PHP Commercial |
$115.09
|
| Rate for Payer: PHP Medicare Advantage |
$33.85
|
| Rate for Payer: PHP Medicare Advantage |
$11.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.01
|
| Rate for Payer: Priority Health HMO/PPO |
$117.80
|
| Rate for Payer: Priority Health HMO/PPO |
$39.22
|
| Rate for Payer: Priority Health Medicare |
$11.38
|
| Rate for Payer: Priority Health Medicare |
$34.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.72
|
| Rate for Payer: Railroad Medicare Medicare |
$33.85
|
| Rate for Payer: Railroad Medicare Medicare |
$11.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.67
|
| Rate for Payer: UHC Core |
$37.64
|
| Rate for Payer: UHC Core |
$113.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.85
|
| Rate for Payer: UHC Exchange |
$33.85
|
| Rate for Payer: UHC Exchange |
$11.27
|
| Rate for Payer: UHC Medicare Advantage |
$33.85
|
| Rate for Payer: UHC Medicare Advantage |
$11.27
|
| Rate for Payer: VA VA |
$33.85
|
| Rate for Payer: VA VA |
$11.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.55
|
|
|
PROTEIN SUPPLEMENT ORAL
|
Facility
|
OP
|
$3.43
|
|
|
Service Code
|
NDC 43900028430
|
| Hospital Charge Code |
150950
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$3.09 |
| Rate for Payer: Aetna Commercial |
$2.92
|
| Rate for Payer: Aetna Medicare |
$0.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.07
|
| Rate for Payer: BCBS Complete |
$1.37
|
| Rate for Payer: BCBS MAPPO |
$0.86
|
| Rate for Payer: BCBS Trust/PPO |
$2.82
|
| Rate for Payer: BCN Commercial |
$2.67
|
| Rate for Payer: BCN Medicare Advantage |
$0.86
|
| Rate for Payer: Cash Price |
$2.74
|
| Rate for Payer: Cofinity Commercial |
$2.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.86
|
| Rate for Payer: Healthscope Commercial |
$3.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.92
|
| Rate for Payer: Nomi Health Commercial |
$2.81
|
| Rate for Payer: PACE Senior Care Partners |
$0.81
|
| Rate for Payer: PACE SWMI |
$0.86
|
| Rate for Payer: PHP Commercial |
$2.92
|
| Rate for Payer: PHP Medicare Advantage |
$0.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.23
|
| Rate for Payer: Priority Health HMO/PPO |
$2.98
|
| Rate for Payer: Priority Health Medicare |
$0.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.30
|
| Rate for Payer: Railroad Medicare Medicare |
$0.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.02
|
| Rate for Payer: UHC Core |
$2.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.86
|
| Rate for Payer: UHC Exchange |
$0.86
|
| Rate for Payer: UHC Medicare Advantage |
$0.86
|
| Rate for Payer: VA VA |
$0.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.57
|
|
|
PROTEIN SUPPLEMENT ORAL
|
Facility
|
IP
|
$3.43
|
|
|
Service Code
|
NDC 43900028430
|
| Hospital Charge Code |
150950
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$3.09 |
| Rate for Payer: Aetna Commercial |
$2.92
|
| Rate for Payer: BCBS Trust/PPO |
$2.80
|
| Rate for Payer: BCN Commercial |
$2.65
|
| Rate for Payer: Cash Price |
$2.74
|
| Rate for Payer: Cofinity Commercial |
$2.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.74
|
| Rate for Payer: Healthscope Commercial |
$3.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.92
|
| Rate for Payer: Nomi Health Commercial |
$2.81
|
| Rate for Payer: PHP Commercial |
$2.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.23
|
| Rate for Payer: Priority Health HMO/PPO |
$2.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.02
|
| Rate for Payer: UHC Core |
$2.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.57
|
|
|
PR OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA
|
Professional
|
Both
|
$4,482.00
|
|
|
Service Code
|
HCPCS 61345
|
| Min. Negotiated Rate |
$660.90 |
| Max. Negotiated Rate |
$4,181.49 |
| Rate for Payer: Aetna Commercial |
$2,717.29
|
| Rate for Payer: Aetna Medicare |
$2,108.94
|
| Rate for Payer: BCBS Complete |
$1,397.81
|
| Rate for Payer: BCBS MAPPO |
$2,027.83
|
| Rate for Payer: BCBS Trust/PPO |
$660.90
|
| Rate for Payer: BCN Commercial |
$4,181.49
|
| Rate for Payer: BCN Medicare Advantage |
$2,027.83
|
| Rate for Payer: Cash Price |
$3,585.60
|
| Rate for Payer: Cash Price |
$3,585.60
|
| Rate for Payer: Cofinity Commercial |
$2,920.08
|
| Rate for Payer: Cofinity Commercial |
$2,717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,027.83
|
| Rate for Payer: Mclaren Medicaid |
$1,331.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,129.22
|
| Rate for Payer: Meridian Medicaid |
$1,397.81
|
| Rate for Payer: Nomi Health Commercial |
$2,433.40
|
| Rate for Payer: PACE SWMI |
$2,027.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,027.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,331.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.30
|
| Rate for Payer: Priority Health HMO/PPO |
$3,538.55
|
| Rate for Payer: Priority Health Medicare |
$2,048.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,538.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,027.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,027.83
|
| Rate for Payer: UHC Exchange |
$2,027.83
|
| Rate for Payer: UHC Medicare Advantage |
$2,027.83
|
| Rate for Payer: UHCCP Medicaid |
$1,331.25
|
|
|
PR OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 92502
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$1,298.03 |
| Rate for Payer: Aetna Commercial |
$119.89
|
| Rate for Payer: Aetna Medicare |
$93.05
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$89.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,298.03
|
| Rate for Payer: BCN Commercial |
$137.32
|
| Rate for Payer: BCN Medicare Advantage |
$89.47
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$128.84
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.47
|
| Rate for Payer: Mclaren Medicaid |
$60.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.94
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Nomi Health Commercial |
$107.36
|
| Rate for Payer: PACE SWMI |
$89.47
|
| Rate for Payer: PHP Medicare Advantage |
$89.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO |
$128.91
|
| Rate for Payer: Priority Health Medicare |
$90.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.47
|
| Rate for Payer: UHC Exchange |
$89.47
|
| Rate for Payer: UHC Medicare Advantage |
$89.47
|
| Rate for Payer: UHCCP Medicaid |
$60.92
|
|
|
PR OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ
|
Professional
|
Both
|
$1,581.00
|
|
|
Service Code
|
HCPCS 69300
|
| Min. Negotiated Rate |
$304.16 |
| Max. Negotiated Rate |
$1,934.63 |
| Rate for Payer: Aetna Commercial |
$599.15
|
| Rate for Payer: Aetna Medicare |
$465.02
|
| Rate for Payer: BCBS Complete |
$319.37
|
| Rate for Payer: BCBS MAPPO |
$447.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.63
|
| Rate for Payer: BCN Commercial |
$958.30
|
| Rate for Payer: BCN Medicare Advantage |
$447.13
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$643.87
|
| Rate for Payer: Cofinity Commercial |
$599.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.13
|
| Rate for Payer: Mclaren Medicaid |
$304.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.49
|
| Rate for Payer: Meridian Medicaid |
$319.37
|
| Rate for Payer: Nomi Health Commercial |
$536.56
|
| Rate for Payer: PACE SWMI |
$447.13
|
| Rate for Payer: PHP Medicare Advantage |
$447.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health HMO/PPO |
$691.63
|
| Rate for Payer: Priority Health Medicare |
$451.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$691.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$447.13
|
| Rate for Payer: UHC Exchange |
$447.13
|
| Rate for Payer: UHC Medicare Advantage |
$447.13
|
| Rate for Payer: UHCCP Medicaid |
$304.16
|
|
|
PR OVARIAN CYSTECTOMY UNI/BI
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 58925
|
| Min. Negotiated Rate |
$164.83 |
| Max. Negotiated Rate |
$1,550.25 |
| Rate for Payer: Aetna Commercial |
$991.29
|
| Rate for Payer: Aetna Medicare |
$769.36
|
| Rate for Payer: BCBS Complete |
$519.32
|
| Rate for Payer: BCBS MAPPO |
$739.77
|
| Rate for Payer: BCBS Trust/PPO |
$164.83
|
| Rate for Payer: BCN Commercial |
$1,126.89
|
| Rate for Payer: BCN Medicare Advantage |
$739.77
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cofinity Commercial |
$991.29
|
| Rate for Payer: Cofinity Commercial |
$1,065.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.77
|
| Rate for Payer: Mclaren Medicaid |
$494.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.76
|
| Rate for Payer: Meridian Medicaid |
$519.32
|
| Rate for Payer: Nomi Health Commercial |
$887.72
|
| Rate for Payer: PACE SWMI |
$739.77
|
| Rate for Payer: PHP Medicare Advantage |
$739.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$494.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,550.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,148.85
|
| Rate for Payer: Priority Health Medicare |
$747.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,148.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$739.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$739.77
|
| Rate for Payer: UHC Exchange |
$739.77
|
| Rate for Payer: UHC Medicare Advantage |
$739.77
|
| Rate for Payer: UHCCP Medicaid |
$494.59
|
|
|
PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$116.90
|
|
|
Service Code
|
NDC 00254100752
|
| Hospital Charge Code |
17934
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$105.21 |
| Rate for Payer: Aetna Commercial |
$99.36
|
| Rate for Payer: Aetna Medicare |
$30.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.53
|
| Rate for Payer: BCBS Complete |
$46.76
|
| Rate for Payer: BCBS MAPPO |
$29.22
|
| Rate for Payer: BCBS Trust/PPO |
$96.10
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$29.22
|
| Rate for Payer: Cash Price |
$93.52
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.22
|
| Rate for Payer: Healthscope Commercial |
$105.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.36
|
| Rate for Payer: Nomi Health Commercial |
$95.86
|
| Rate for Payer: PACE Senior Care Partners |
$27.76
|
| Rate for Payer: PACE SWMI |
$29.22
|
| Rate for Payer: PHP Commercial |
$99.36
|
| Rate for Payer: PHP Medicare Advantage |
$29.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.98
|
| Rate for Payer: Priority Health HMO/PPO |
$101.70
|
| Rate for Payer: Priority Health Medicare |
$29.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.32
|
| Rate for Payer: Railroad Medicare Medicare |
$29.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.87
|
| Rate for Payer: UHC Core |
$97.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.22
|
| Rate for Payer: UHC Exchange |
$29.22
|
| Rate for Payer: UHC Medicare Advantage |
$29.22
|
| Rate for Payer: VA VA |
$29.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.68
|
|
|
PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$116.90
|
|
|
Service Code
|
NDC 00254100752
|
| Hospital Charge Code |
17934
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.98 |
| Max. Negotiated Rate |
$105.21 |
| Rate for Payer: Aetna Commercial |
$99.36
|
| Rate for Payer: BCBS Trust/PPO |
$95.43
|
| Rate for Payer: BCN Commercial |
$90.34
|
| Rate for Payer: Cash Price |
$93.52
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.52
|
| Rate for Payer: Healthscope Commercial |
$105.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.36
|
| Rate for Payer: Nomi Health Commercial |
$95.86
|
| Rate for Payer: PHP Commercial |
$99.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.98
|
| Rate for Payer: Priority Health HMO/PPO |
$101.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.87
|
| Rate for Payer: UHC Core |
$97.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.68
|
|
|
PR OVINE, UP TO 999 USP UNITS
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J3471
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Aetna Commercial |
$0.67
|
| Rate for Payer: Aetna Medicare |
$0.52
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$0.50
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Medicare Advantage |
$0.50
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.72
|
| Rate for Payer: Cofinity Commercial |
$0.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.52
|
| Rate for Payer: Nomi Health Commercial |
$0.60
|
| Rate for Payer: PACE SWMI |
$0.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.30
|
| Rate for Payer: Priority Health Medicare |
$0.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.50
|
| Rate for Payer: UHC Exchange |
$0.50
|
| Rate for Payer: UHC Medicare Advantage |
$0.50
|
|
|
PR PACKING STRIPS, NON-IMPREG
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS A6407
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCN Commercial |
$2.06
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.90
|
|
|
PR PALATOPHARYNGOPLASTY
|
Professional
|
Both
|
$2,472.00
|
|
|
Service Code
|
HCPCS 42145
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$1,606.80 |
| Rate for Payer: Aetna Commercial |
$874.78
|
| Rate for Payer: Aetna Medicare |
$678.93
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS MAPPO |
$652.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.94
|
| Rate for Payer: BCN Commercial |
$1,011.07
|
| Rate for Payer: BCN Medicare Advantage |
$652.82
|
| Rate for Payer: Cash Price |
$1,977.60
|
| Rate for Payer: Cash Price |
$1,977.60
|
| Rate for Payer: Cofinity Commercial |
$940.06
|
| Rate for Payer: Cofinity Commercial |
$874.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.82
|
| Rate for Payer: Mclaren Medicaid |
$442.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.46
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Nomi Health Commercial |
$783.38
|
| Rate for Payer: PACE SWMI |
$652.82
|
| Rate for Payer: PHP Medicare Advantage |
$652.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,606.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,240.32
|
| Rate for Payer: Priority Health Medicare |
$659.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,240.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$652.82
|
| Rate for Payer: UHC Exchange |
$652.82
|
| Rate for Payer: UHC Medicare Advantage |
$652.82
|
| Rate for Payer: UHCCP Medicaid |
$442.83
|
|
|
PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS
|
Professional
|
Both
|
$7,598.00
|
|
|
Service Code
|
HCPCS 48160
|
| Min. Negotiated Rate |
$809.36 |
| Max. Negotiated Rate |
$5,573.98 |
| Rate for Payer: Aetna Commercial |
$4,176.69
|
| Rate for Payer: Aetna Medicare |
$3,799.00
|
| Rate for Payer: BCBS Complete |
$3,039.20
|
| Rate for Payer: BCBS Trust/PPO |
$809.36
|
| Rate for Payer: BCN Commercial |
$2,480.87
|
| Rate for Payer: Cash Price |
$6,078.40
|
| Rate for Payer: Cash Price |
$6,078.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,938.70
|
| Rate for Payer: Priority Health HMO/PPO |
$5,573.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,573.98
|
|
|
PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST
|
Professional
|
Both
|
$3,447.00
|
|
|
Service Code
|
HCPCS 48548
|
| Min. Negotiated Rate |
$484.98 |
| Max. Negotiated Rate |
$2,988.93 |
| Rate for Payer: Aetna Commercial |
$2,176.52
|
| Rate for Payer: Aetna Medicare |
$1,689.24
|
| Rate for Payer: BCBS Complete |
$1,125.41
|
| Rate for Payer: BCBS MAPPO |
$1,624.27
|
| Rate for Payer: BCBS Trust/PPO |
$484.98
|
| Rate for Payer: BCN Commercial |
$2,437.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,624.27
|
| Rate for Payer: Cash Price |
$2,757.60
|
| Rate for Payer: Cash Price |
$2,757.60
|
| Rate for Payer: Cofinity Commercial |
$2,338.95
|
| Rate for Payer: Cofinity Commercial |
$2,176.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,624.27
|
| Rate for Payer: Mclaren Medicaid |
$1,071.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,705.48
|
| Rate for Payer: Meridian Medicaid |
$1,125.41
|
| Rate for Payer: Nomi Health Commercial |
$1,949.12
|
| Rate for Payer: PACE SWMI |
$1,624.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,624.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,071.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,240.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,988.93
|
| Rate for Payer: Priority Health Medicare |
$1,640.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,988.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,624.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,624.27
|
| Rate for Payer: UHC Exchange |
$1,624.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,624.27
|
| Rate for Payer: UHCCP Medicaid |
$1,071.82
|
|
|
PR PANCREATORRHAPHY INJURY
|
Professional
|
Both
|
$3,272.00
|
|
|
Service Code
|
HCPCS 48545
|
| Min. Negotiated Rate |
$525.66 |
| Max. Negotiated Rate |
$2,412.02 |
| Rate for Payer: Aetna Commercial |
$1,755.16
|
| Rate for Payer: Aetna Medicare |
$1,362.21
|
| Rate for Payer: BCBS Complete |
$909.14
|
| Rate for Payer: BCBS MAPPO |
$1,309.82
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$1,966.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,309.82
|
| Rate for Payer: Cash Price |
$2,617.60
|
| Rate for Payer: Cash Price |
$2,617.60
|
| Rate for Payer: Cofinity Commercial |
$1,886.14
|
| Rate for Payer: Cofinity Commercial |
$1,755.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,309.82
|
| Rate for Payer: Mclaren Medicaid |
$865.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,375.31
|
| Rate for Payer: Meridian Medicaid |
$909.14
|
| Rate for Payer: Nomi Health Commercial |
$1,571.78
|
| Rate for Payer: PACE SWMI |
$1,309.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,309.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$865.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,412.02
|
| Rate for Payer: Priority Health Medicare |
$1,322.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,412.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,309.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,309.82
|
| Rate for Payer: UHC Exchange |
$1,309.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,309.82
|
| Rate for Payer: UHCCP Medicaid |
$865.85
|
|
|
PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC
|
Professional
|
Both
|
$2,535.00
|
|
|
Service Code
|
HCPCS 60505
|
| Min. Negotiated Rate |
$576.38 |
| Max. Negotiated Rate |
$2,267.07 |
| Rate for Payer: Aetna Commercial |
$1,786.29
|
| Rate for Payer: Aetna Medicare |
$1,386.37
|
| Rate for Payer: BCBS Complete |
$940.00
|
| Rate for Payer: BCBS MAPPO |
$1,333.05
|
| Rate for Payer: BCBS Trust/PPO |
$576.38
|
| Rate for Payer: BCN Commercial |
$2,042.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,333.05
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cash Price |
$2,028.00
|
| Rate for Payer: Cofinity Commercial |
$1,919.59
|
| Rate for Payer: Cofinity Commercial |
$1,786.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,333.05
|
| Rate for Payer: Mclaren Medicaid |
$895.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,399.70
|
| Rate for Payer: Meridian Medicaid |
$940.00
|
| Rate for Payer: Nomi Health Commercial |
$1,599.66
|
| Rate for Payer: PACE SWMI |
$1,333.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,333.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$895.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,647.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,267.07
|
| Rate for Payer: Priority Health Medicare |
$1,346.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,267.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,333.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,333.05
|
| Rate for Payer: UHC Exchange |
$1,333.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.05
|
| Rate for Payer: UHCCP Medicaid |
$895.24
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$153.15 |
| Max. Negotiated Rate |
$663.02 |
| Rate for Payer: Aetna Commercial |
$311.15
|
| Rate for Payer: Aetna Medicare |
$241.49
|
| Rate for Payer: BCBS Complete |
$160.81
|
| Rate for Payer: BCBS MAPPO |
$232.20
|
| Rate for Payer: BCBS Trust/PPO |
$663.02
|
| Rate for Payer: BCN Commercial |
$350.87
|
| Rate for Payer: BCN Medicare Advantage |
$232.20
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$334.37
|
| Rate for Payer: Cofinity Commercial |
$311.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.20
|
| Rate for Payer: Mclaren Medicaid |
$153.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.81
|
| Rate for Payer: Meridian Medicaid |
$160.81
|
| Rate for Payer: Nomi Health Commercial |
$278.64
|
| Rate for Payer: PACE SWMI |
$232.20
|
| Rate for Payer: PHP Medicare Advantage |
$232.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health HMO/PPO |
$387.18
|
| Rate for Payer: Priority Health Medicare |
$234.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$387.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.20
|
| Rate for Payer: UHC Exchange |
$232.20
|
| Rate for Payer: UHC Medicare Advantage |
$232.20
|
| Rate for Payer: UHCCP Medicaid |
$153.15
|
|
