|
PR PROCTOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$3,174.00
|
|
|
Service Code
|
HCPCS 45540
|
| Min. Negotiated Rate |
$621.32 |
| Max. Negotiated Rate |
$2,380.50 |
| Rate for Payer: Aetna Commercial |
$1,412.95
|
| Rate for Payer: Aetna Medicare |
$1,587.00
|
| Rate for Payer: BCBS Complete |
$652.39
|
| Rate for Payer: BCN Commercial |
$1,568.14
|
| Rate for Payer: Cash Price |
$2,539.20
|
| Rate for Payer: Cash Price |
$2,539.20
|
| Rate for Payer: Mclaren Medicaid |
$621.32
|
| Rate for Payer: Meridian Medicaid |
$652.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,380.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,910.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,910.68
|
| Rate for Payer: UHC Medicaid |
$621.32
|
| Rate for Payer: UHCCP Medicaid |
$621.32
|
|
|
PR PROCTOPEXY PERINEAL APPROACH
|
Professional
|
Both
|
$1,708.00
|
|
|
Service Code
|
HCPCS 45541
|
| Min. Negotiated Rate |
$568.07 |
| Max. Negotiated Rate |
$1,718.95 |
| Rate for Payer: Aetna Commercial |
$1,266.92
|
| Rate for Payer: Aetna Medicare |
$854.00
|
| Rate for Payer: BCBS Complete |
$596.47
|
| Rate for Payer: BCN Commercial |
$1,410.78
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Mclaren Medicaid |
$568.07
|
| Rate for Payer: Meridian Medicaid |
$596.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,718.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,718.95
|
| Rate for Payer: UHC Medicaid |
$568.07
|
| Rate for Payer: UHCCP Medicaid |
$568.07
|
|
|
PR PROCTOPEXY W/SIGMOID RESCJ ABDL APPR
|
Professional
|
Both
|
$3,801.00
|
|
|
Service Code
|
HCPCS 45550
|
| Min. Negotiated Rate |
$862.44 |
| Max. Negotiated Rate |
$2,850.75 |
| Rate for Payer: Aetna Commercial |
$1,961.26
|
| Rate for Payer: Aetna Medicare |
$1,900.50
|
| Rate for Payer: BCBS Complete |
$905.56
|
| Rate for Payer: BCN Commercial |
$2,168.70
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Mclaren Medicaid |
$862.44
|
| Rate for Payer: Meridian Medicaid |
$905.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,850.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$862.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,642.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,642.43
|
| Rate for Payer: UHC Medicaid |
$862.44
|
| Rate for Payer: UHCCP Medicaid |
$862.44
|
|
|
PR PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE
|
Professional
|
Both
|
$1,738.00
|
|
|
Service Code
|
HCPCS 45505
|
| Min. Negotiated Rate |
$378.93 |
| Max. Negotiated Rate |
$1,303.50 |
| Rate for Payer: Aetna Commercial |
$801.01
|
| Rate for Payer: Aetna Medicare |
$869.00
|
| Rate for Payer: BCBS Complete |
$397.88
|
| Rate for Payer: BCN Commercial |
$909.81
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Mclaren Medicaid |
$378.93
|
| Rate for Payer: Meridian Medicaid |
$397.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,303.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,108.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,108.54
|
| Rate for Payer: UHC Medicaid |
$378.93
|
| Rate for Payer: UHCCP Medicaid |
$378.93
|
|
|
PR PROCTOPLASTY STENOSIS
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 45500
|
| Min. Negotiated Rate |
$363.59 |
| Max. Negotiated Rate |
$1,054.54 |
| Rate for Payer: Aetna Commercial |
$764.12
|
| Rate for Payer: Aetna Medicare |
$587.00
|
| Rate for Payer: BCBS Complete |
$381.77
|
| Rate for Payer: BCN Commercial |
$865.49
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Mclaren Medicaid |
$363.59
|
| Rate for Payer: Meridian Medicaid |
$381.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$880.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,054.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,054.54
|
| Rate for Payer: UHC Medicaid |
$363.59
|
| Rate for Payer: UHCCP Medicaid |
$363.59
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$35.79 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna Commercial |
$172.55
|
| Rate for Payer: Aetna Medicare |
$52.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.44
|
| Rate for Payer: BCBS Complete |
$37.58
|
| Rate for Payer: BCBS MAPPO |
$50.75
|
| Rate for Payer: BCBS Trust/PPO |
$166.89
|
| Rate for Payer: BCN Commercial |
$166.89
|
| Rate for Payer: BCN Medicare Advantage |
$50.75
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$174.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.75
|
| Rate for Payer: Healthscope Commercial |
$182.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.25
|
| Rate for Payer: Mclaren Medicaid |
$35.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.29
|
| Rate for Payer: Meridian Medicaid |
$37.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.55
|
| Rate for Payer: Nomi Health Commercial |
$166.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: PACE Senior Care Partners |
$48.21
|
| Rate for Payer: PACE SWMI |
$50.75
|
| Rate for Payer: PHP Commercial |
$172.55
|
| Rate for Payer: PHP Medicare Advantage |
$50.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.61
|
| Rate for Payer: Priority Health Medicare |
$51.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.29
|
| Rate for Payer: Railroad Medicare Medicare |
$50.75
|
| Rate for Payer: UHC Core |
$169.50
|
| Rate for Payer: UHC Exchange |
$50.75
|
| Rate for Payer: UHC Medicaid |
$35.79
|
| Rate for Payer: UHC Medicare Advantage |
$50.75
|
| Rate for Payer: UHCCP Medicaid |
$35.79
|
| Rate for Payer: VA VA |
$50.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.25
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$141.29 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna Commercial |
$172.55
|
| Rate for Payer: BCBS Trust/PPO |
$167.66
|
| Rate for Payer: BCN Commercial |
$167.66
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$174.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.40
|
| Rate for Payer: Healthscope Commercial |
$182.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.55
|
| Rate for Payer: Nomi Health Commercial |
$166.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: PHP Commercial |
$172.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.29
|
| Rate for Payer: UHC Core |
$169.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.25
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 45300
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$152.25 |
| Rate for Payer: Aetna Commercial |
$64.28
|
| Rate for Payer: Aetna Medicare |
$101.50
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCN Commercial |
$57.33
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Mclaren Medicaid |
$28.76
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.59
|
| Rate for Payer: UHC Medicaid |
$28.76
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 45300
|
| Hospital Charge Code |
45300
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$152.25 |
| Rate for Payer: Aetna Commercial |
$64.28
|
| Rate for Payer: Aetna Medicare |
$101.50
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCN Commercial |
$57.33
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Mclaren Medicaid |
$28.76
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.59
|
| Rate for Payer: UHC Medicaid |
$28.76
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR PROCTOSGMDSC RIGID ABLATION LESION
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
HCPCS 45320
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$372.00 |
| Rate for Payer: Aetna Commercial |
$140.99
|
| Rate for Payer: Aetna Medicare |
$248.00
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCN Commercial |
$158.86
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$193.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.56
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR PROCTOSGMDSC RIGID CONTROL BLEEDING
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 45317
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$349.50 |
| Rate for Payer: Aetna Commercial |
$146.55
|
| Rate for Payer: Aetna Medicare |
$233.00
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCN Commercial |
$165.33
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Mclaren Medicaid |
$65.39
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$349.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$201.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.44
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR PROCTOSGMDSC RIGID DCMPRN VOLVULUS
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 45321
|
| Min. Negotiated Rate |
$62.62 |
| Max. Negotiated Rate |
$303.00 |
| Rate for Payer: Aetna Commercial |
$139.15
|
| Rate for Payer: Aetna Medicare |
$202.00
|
| Rate for Payer: BCBS Complete |
$65.75
|
| Rate for Payer: BCN Commercial |
$156.37
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Mclaren Medicaid |
$62.62
|
| Rate for Payer: Meridian Medicaid |
$65.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.53
|
| Rate for Payer: UHC Medicaid |
$62.62
|
| Rate for Payer: UHCCP Medicaid |
$62.62
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 45308
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: Aetna Medicare |
$160.00
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Mclaren Medicaid |
$51.97
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$155.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.34
|
| Rate for Payer: UHC Medicaid |
$51.97
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 45309
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$291.00 |
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: Aetna Medicare |
$194.00
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCN Commercial |
$135.45
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Mclaren Medicaid |
$54.95
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$165.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.03
|
| Rate for Payer: UHC Medicaid |
$54.95
|
| Rate for Payer: UHCCP Medicaid |
$54.95
|
|
|
PR PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
HCPCS 45315
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$372.00 |
| Rate for Payer: Aetna Commercial |
$142.82
|
| Rate for Payer: Aetna Medicare |
$248.00
|
| Rate for Payer: BCBS Complete |
$67.09
|
| Rate for Payer: BCN Commercial |
$159.85
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Mclaren Medicaid |
$63.90
|
| Rate for Payer: Meridian Medicaid |
$67.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.76
|
| Rate for Payer: UHC Medicaid |
$63.90
|
| Rate for Payer: UHCCP Medicaid |
$63.90
|
|
|
PR PROCTOSGMDSC RIGID TNDSC STENT PLMT
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 45327
|
| Min. Negotiated Rate |
$70.08 |
| Max. Negotiated Rate |
$215.40 |
| Rate for Payer: Aetna Commercial |
$156.63
|
| Rate for Payer: Aetna Medicare |
$115.50
|
| Rate for Payer: BCBS Complete |
$73.58
|
| Rate for Payer: BCN Commercial |
$176.78
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Mclaren Medicaid |
$70.08
|
| Rate for Payer: Meridian Medicaid |
$73.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.40
|
| Rate for Payer: UHC Medicaid |
$70.08
|
| Rate for Payer: UHCCP Medicaid |
$70.08
|
|
|
PR PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 45305
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$96.87
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCN Commercial |
$109.55
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Mclaren Medicaid |
$44.09
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.48
|
| Rate for Payer: UHC Medicaid |
$44.09
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR PROCTOSGMDSC RIGID W/DILATION
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 45303
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$160.50 |
| Rate for Payer: Aetna Commercial |
$112.11
|
| Rate for Payer: Aetna Medicare |
$107.00
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Mclaren Medicaid |
$51.12
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$155.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.34
|
| Rate for Payer: UHC Medicaid |
$51.12
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
|
|
PR PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 45307
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$261.75 |
| Rate for Payer: Aetna Commercial |
$127.11
|
| Rate for Payer: Aetna Medicare |
$174.50
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCN Commercial |
$151.39
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Mclaren Medicaid |
$61.13
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.45
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 95115
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Commercial |
$9.04
|
| Rate for Payer: Aetna Medicare |
$12.50
|
| Rate for Payer: BCN Commercial |
$15.93
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.72
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 95117
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$24.75 |
| Rate for Payer: Aetna Commercial |
$11.04
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCN Commercial |
$18.43
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.65
|
|
|
PR PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 0389T
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Aetna Medicare |
$47.50
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 93280
|
| Min. Negotiated Rate |
$101.66 |
| Max. Negotiated Rate |
$170.25 |
| Rate for Payer: Aetna Commercial |
$101.66
|
| Rate for Payer: Aetna Medicare |
$113.50
|
| Rate for Payer: BCN Commercial |
$115.53
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.80
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 93281
|
| Min. Negotiated Rate |
$108.43 |
| Max. Negotiated Rate |
$177.75 |
| Rate for Payer: Aetna Commercial |
$108.43
|
| Rate for Payer: Aetna Medicare |
$118.50
|
| Rate for Payer: BCN Commercial |
$123.00
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.91
|
|
|
PR PROGRAMMED STIMJ & PACG AFTER IV DRUG INFUSION
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 93623
|
| Min. Negotiated Rate |
$100.82 |
| Max. Negotiated Rate |
$1,619.31 |
| Rate for Payer: Aetna Commercial |
$217.76
|
| Rate for Payer: Aetna Commercial |
$217.76
|
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: Aetna Medicare |
$171.50
|
| Rate for Payer: BCN Commercial |
$1,619.31
|
| Rate for Payer: BCN Commercial |
$1,619.31
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.82
|
|
