|
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 |
$1,792.80 |
| Max. Negotiated Rate |
$2,920.08 |
| Rate for Payer: Aetna Commercial |
$2,717.29
|
| Rate for Payer: Aetna Medicare |
$2,108.94
|
| Rate for Payer: BCBS Complete |
$1,792.80
|
| Rate for Payer: BCBS MAPPO |
$2,027.83
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,129.22
|
| 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 Cigna Priority Health |
$2,913.30
|
| Rate for Payer: Priority Health Medicare |
$2,048.11
|
| 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
|
|
|
PR OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 92502
|
| Min. Negotiated Rate |
$89.47 |
| Max. Negotiated Rate |
$216.45 |
| Rate for Payer: Aetna Commercial |
$119.89
|
| Rate for Payer: Aetna Medicare |
$93.05
|
| Rate for Payer: BCBS Complete |
$133.20
|
| Rate for Payer: BCBS MAPPO |
$89.47
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.94
|
| 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 Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health Medicare |
$90.36
|
| 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
|
|
|
PR OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ
|
Professional
|
Both
|
$1,581.00
|
|
|
Service Code
|
HCPCS 69300
|
| Min. Negotiated Rate |
$447.13 |
| Max. Negotiated Rate |
$1,027.65 |
| Rate for Payer: Aetna Commercial |
$599.15
|
| Rate for Payer: Aetna Medicare |
$465.02
|
| Rate for Payer: BCBS Complete |
$632.40
|
| Rate for Payer: BCBS MAPPO |
$447.13
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.49
|
| 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 Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health Medicare |
$451.60
|
| 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
|
|
|
PR OVARIAN CYSTECTOMY UNI/BI
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 58925
|
| Min. Negotiated Rate |
$739.77 |
| 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 |
$954.00
|
| Rate for Payer: BCBS MAPPO |
$739.77
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.76
|
| 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 Cigna Priority Health |
$1,550.25
|
| Rate for Payer: Priority Health Medicare |
$747.17
|
| 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
|
|
|
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 |
$87.67
|
| 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 |
$87.67
|
|
|
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 |
$29.23
|
| Rate for Payer: BCBS Trust/PPO |
$96.10
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$29.23
|
| 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 |
$29.23
|
| Rate for Payer: Healthscope Commercial |
$105.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.67
|
| 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 |
$29.23
|
| Rate for Payer: PHP Commercial |
$99.36
|
| Rate for Payer: PHP Medicare Advantage |
$29.23
|
| 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 |
$29.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.87
|
| Rate for Payer: UHC Core |
$97.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.23
|
| Rate for Payer: UHC Exchange |
$29.23
|
| Rate for Payer: UHC Medicare Advantage |
$29.23
|
| Rate for Payer: VA VA |
$29.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.67
|
|
|
PR OVINE, UP TO 999 USP UNITS
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J3471
|
| Min. Negotiated Rate |
$0.50 |
| 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: 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 |
$0.53
|
| 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 |
$0.51
|
| 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 |
$2.40 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Aetna Commercial |
$3.50
|
| Rate for Payer: Aetna Medicare |
$2.71
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$2.61
|
| Rate for Payer: BCN Medicare Advantage |
$2.61
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$3.76
|
| Rate for Payer: Cofinity Commercial |
$3.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.74
|
| Rate for Payer: Nomi Health Commercial |
$3.13
|
| Rate for Payer: PACE SWMI |
$2.61
|
| Rate for Payer: PHP Medicare Advantage |
$2.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.90
|
| Rate for Payer: Priority Health Medicare |
$2.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.61
|
| Rate for Payer: UHC Exchange |
$2.61
|
| Rate for Payer: UHC Medicare Advantage |
$2.61
|
|
|
PR PALATOPHARYNGOPLASTY
|
Professional
|
Both
|
$2,472.00
|
|
|
Service Code
|
HCPCS 42145
|
| Min. Negotiated Rate |
$652.82 |
| 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 |
$988.80
|
| Rate for Payer: BCBS MAPPO |
$652.82
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$685.46
|
| 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 Cigna Priority Health |
$1,606.80
|
| Rate for Payer: Priority Health Medicare |
$659.35
|
| 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
|
|
|
PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS
|
Professional
|
Both
|
$7,598.00
|
|
|
Service Code
|
HCPCS 48160
|
| Min. Negotiated Rate |
$3,039.20 |
| Max. Negotiated Rate |
$4,938.70 |
| Rate for Payer: Aetna Medicare |
$3,799.00
|
| Rate for Payer: BCBS Complete |
$3,039.20
|
| Rate for Payer: Cash Price |
$6,078.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,938.70
|
|
|
PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST
|
Professional
|
Both
|
$3,447.00
|
|
|
Service Code
|
HCPCS 48548
|
| Min. Negotiated Rate |
$1,378.80 |
| Max. Negotiated Rate |
$2,338.95 |
| Rate for Payer: Aetna Commercial |
$2,176.52
|
| Rate for Payer: Aetna Medicare |
$1,689.24
|
| Rate for Payer: BCBS Complete |
$1,378.80
|
| Rate for Payer: BCBS MAPPO |
$1,624.27
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,705.48
|
| 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 Cigna Priority Health |
$2,240.55
|
| Rate for Payer: Priority Health Medicare |
$1,640.51
|
| 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
|
|
|
PR PANCREATORRHAPHY INJURY
|
Professional
|
Both
|
$3,272.00
|
|
|
Service Code
|
HCPCS 48545
|
| Min. Negotiated Rate |
$1,308.80 |
| Max. Negotiated Rate |
$2,126.80 |
| Rate for Payer: Aetna Commercial |
$1,755.16
|
| Rate for Payer: Aetna Medicare |
$1,362.21
|
| Rate for Payer: BCBS Complete |
$1,308.80
|
| Rate for Payer: BCBS MAPPO |
$1,309.82
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,375.31
|
| 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 Cigna Priority Health |
$2,126.80
|
| Rate for Payer: Priority Health Medicare |
$1,322.92
|
| 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
|
|
|
PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC
|
Professional
|
Both
|
$2,535.00
|
|
|
Service Code
|
HCPCS 60505
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$1,919.59 |
| Rate for Payer: Aetna Commercial |
$1,786.29
|
| Rate for Payer: Aetna Medicare |
$1,386.37
|
| Rate for Payer: BCBS Complete |
$1,014.00
|
| Rate for Payer: BCBS MAPPO |
$1,333.05
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,399.70
|
| 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 Cigna Priority Health |
$1,647.75
|
| Rate for Payer: Priority Health Medicare |
$1,346.38
|
| 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
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$194.00 |
| Max. Negotiated Rate |
$334.37 |
| Rate for Payer: Aetna Commercial |
$311.15
|
| Rate for Payer: Aetna Medicare |
$241.49
|
| Rate for Payer: BCBS Complete |
$194.00
|
| Rate for Payer: BCBS MAPPO |
$232.20
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.81
|
| 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 Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health Medicare |
$234.52
|
| 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
|
|
|
PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS
|
Professional
|
Both
|
$3,507.00
|
|
|
Service Code
|
HCPCS 60500
|
| Min. Negotiated Rate |
$937.84 |
| Max. Negotiated Rate |
$2,279.55 |
| Rate for Payer: Aetna Commercial |
$1,256.71
|
| Rate for Payer: Aetna Medicare |
$975.35
|
| Rate for Payer: BCBS Complete |
$1,402.80
|
| Rate for Payer: BCBS MAPPO |
$937.84
|
| Rate for Payer: BCN Medicare Advantage |
$937.84
|
| Rate for Payer: Cash Price |
$2,805.60
|
| Rate for Payer: Cash Price |
$2,805.60
|
| Rate for Payer: Cofinity Commercial |
$1,350.49
|
| Rate for Payer: Cofinity Commercial |
$1,256.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$937.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$984.73
|
| Rate for Payer: Nomi Health Commercial |
$1,125.41
|
| Rate for Payer: PACE SWMI |
$937.84
|
| Rate for Payer: PHP Medicare Advantage |
$937.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,279.55
|
| Rate for Payer: Priority Health Medicare |
$947.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$937.84
|
| Rate for Payer: UHC Exchange |
$937.84
|
| Rate for Payer: UHC Medicare Advantage |
$937.84
|
|
|
PR PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR
|
Professional
|
Both
|
$3,879.00
|
|
|
Service Code
|
HCPCS 60502
|
| Min. Negotiated Rate |
$1,262.30 |
| Max. Negotiated Rate |
$2,521.35 |
| Rate for Payer: Aetna Commercial |
$1,691.48
|
| Rate for Payer: Aetna Medicare |
$1,312.79
|
| Rate for Payer: BCBS Complete |
$1,551.60
|
| Rate for Payer: BCBS MAPPO |
$1,262.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,262.30
|
| Rate for Payer: Cash Price |
$3,103.20
|
| Rate for Payer: Cash Price |
$3,103.20
|
| Rate for Payer: Cofinity Commercial |
$1,817.71
|
| Rate for Payer: Cofinity Commercial |
$1,691.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,262.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,325.41
|
| Rate for Payer: Nomi Health Commercial |
$1,514.76
|
| Rate for Payer: PACE SWMI |
$1,262.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,262.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.35
|
| Rate for Payer: Priority Health Medicare |
$1,274.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,262.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,262.30
|
| Rate for Payer: UHC Exchange |
$1,262.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,262.30
|
|
|
PR PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 57285
|
| Min. Negotiated Rate |
$663.43 |
| Max. Negotiated Rate |
$1,254.50 |
| Rate for Payer: Aetna Commercial |
$889.00
|
| Rate for Payer: Aetna Medicare |
$689.97
|
| Rate for Payer: BCBS Complete |
$772.00
|
| Rate for Payer: BCBS MAPPO |
$663.43
|
| Rate for Payer: BCN Medicare Advantage |
$663.43
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$955.34
|
| Rate for Payer: Cofinity Commercial |
$889.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.60
|
| Rate for Payer: Nomi Health Commercial |
$796.12
|
| Rate for Payer: PACE SWMI |
$663.43
|
| Rate for Payer: PHP Medicare Advantage |
$663.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.50
|
| Rate for Payer: Priority Health Medicare |
$670.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.43
|
| Rate for Payer: UHC Exchange |
$663.43
|
| Rate for Payer: UHC Medicare Advantage |
$663.43
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 11055
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$74.75 |
| Rate for Payer: Aetna Commercial |
$19.86
|
| Rate for Payer: Aetna Medicare |
$15.41
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$14.82
|
| Rate for Payer: BCN Medicare Advantage |
$14.82
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$21.34
|
| Rate for Payer: Cofinity Commercial |
$19.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.56
|
| Rate for Payer: Nomi Health Commercial |
$17.78
|
| Rate for Payer: PACE SWMI |
$14.82
|
| Rate for Payer: PHP Medicare Advantage |
$14.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.75
|
| Rate for Payer: Priority Health Medicare |
$14.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.82
|
| Rate for Payer: UHC Exchange |
$14.82
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 11056
|
| Min. Negotiated Rate |
$21.23 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Commercial |
$28.45
|
| Rate for Payer: Aetna Medicare |
$22.08
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$21.23
|
| Rate for Payer: BCN Medicare Advantage |
$21.23
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$30.57
|
| Rate for Payer: Cofinity Commercial |
$28.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.29
|
| Rate for Payer: Nomi Health Commercial |
$25.48
|
| Rate for Payer: PACE SWMI |
$21.23
|
| Rate for Payer: PHP Medicare Advantage |
$21.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$21.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.23
|
| Rate for Payer: UHC Exchange |
$21.23
|
| Rate for Payer: UHC Medicare Advantage |
$21.23
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 11057
|
| Min. Negotiated Rate |
$26.96 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna Commercial |
$36.13
|
| Rate for Payer: Aetna Medicare |
$28.04
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCBS MAPPO |
$26.96
|
| Rate for Payer: BCN Medicare Advantage |
$26.96
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$38.82
|
| Rate for Payer: Cofinity Commercial |
$36.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.31
|
| Rate for Payer: Nomi Health Commercial |
$32.35
|
| Rate for Payer: PACE SWMI |
$26.96
|
| Rate for Payer: PHP Medicare Advantage |
$26.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health Medicare |
$27.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.96
|
| Rate for Payer: UHC Exchange |
$26.96
|
| Rate for Payer: UHC Medicare Advantage |
$26.96
|
|
|
PR PARTIAL EXCISION BONE CLAVICLE
|
Professional
|
Both
|
$1,421.00
|
|
|
Service Code
|
HCPCS 23180
|
| Min. Negotiated Rate |
$568.40 |
| Max. Negotiated Rate |
$960.58 |
| Rate for Payer: Aetna Commercial |
$893.87
|
| Rate for Payer: Aetna Medicare |
$693.75
|
| Rate for Payer: BCBS Complete |
$568.40
|
| Rate for Payer: BCBS MAPPO |
$667.07
|
| Rate for Payer: BCN Medicare Advantage |
$667.07
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cofinity Commercial |
$960.58
|
| Rate for Payer: Cofinity Commercial |
$893.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.42
|
| Rate for Payer: Nomi Health Commercial |
$800.48
|
| Rate for Payer: PACE SWMI |
$667.07
|
| Rate for Payer: PHP Medicare Advantage |
$667.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.65
|
| Rate for Payer: Priority Health Medicare |
$673.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$667.07
|
| Rate for Payer: UHC Exchange |
$667.07
|
| Rate for Payer: UHC Medicare Advantage |
$667.07
|
|
|
PR PARTIAL EXCISION BONE FIBULA
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 27641
|
| Min. Negotiated Rate |
$632.08 |
| Max. Negotiated Rate |
$1,550.25 |
| Rate for Payer: Aetna Commercial |
$846.99
|
| Rate for Payer: Aetna Medicare |
$657.36
|
| Rate for Payer: BCBS Complete |
$954.00
|
| Rate for Payer: BCBS MAPPO |
$632.08
|
| Rate for Payer: BCN Medicare Advantage |
$632.08
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cofinity Commercial |
$910.20
|
| Rate for Payer: Cofinity Commercial |
$846.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.68
|
| Rate for Payer: Nomi Health Commercial |
$758.50
|
| Rate for Payer: PACE SWMI |
$632.08
|
| Rate for Payer: PHP Medicare Advantage |
$632.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,550.25
|
| Rate for Payer: Priority Health Medicare |
$638.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.08
|
| Rate for Payer: UHC Exchange |
$632.08
|
| Rate for Payer: UHC Medicare Advantage |
$632.08
|
|
|
PR PARTIAL EXCISION BONE HUMERUS
|
Professional
|
Both
|
$1,429.00
|
|
|
Service Code
|
HCPCS 24140
|
| Min. Negotiated Rate |
$571.60 |
| Max. Negotiated Rate |
$980.01 |
| Rate for Payer: Aetna Commercial |
$911.95
|
| Rate for Payer: Aetna Medicare |
$707.78
|
| Rate for Payer: BCBS Complete |
$571.60
|
| Rate for Payer: BCBS MAPPO |
$680.56
|
| Rate for Payer: BCN Medicare Advantage |
$680.56
|
| Rate for Payer: Cash Price |
$1,143.20
|
| Rate for Payer: Cash Price |
$1,143.20
|
| Rate for Payer: Cofinity Commercial |
$980.01
|
| Rate for Payer: Cofinity Commercial |
$911.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.59
|
| Rate for Payer: Nomi Health Commercial |
$816.67
|
| Rate for Payer: PACE SWMI |
$680.56
|
| Rate for Payer: PHP Medicare Advantage |
$680.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.85
|
| Rate for Payer: Priority Health Medicare |
$687.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.56
|
| Rate for Payer: UHC Exchange |
$680.56
|
| Rate for Payer: UHC Medicare Advantage |
$680.56
|
|
