|
PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR
|
Professional
|
Both
|
$1,398.00
|
|
|
Service Code
|
HCPCS 33223
|
| Min. Negotiated Rate |
$232.17 |
| Max. Negotiated Rate |
$1,048.50 |
| Rate for Payer: Aetna Commercial |
$550.24
|
| Rate for Payer: Aetna Medicare |
$699.00
|
| Rate for Payer: BCBS Complete |
$243.78
|
| Rate for Payer: BCN Commercial |
$603.55
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Cash Price |
$1,118.40
|
| Rate for Payer: Mclaren Medicaid |
$232.17
|
| Rate for Payer: Meridian Medicaid |
$243.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,048.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$649.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$649.05
|
| Rate for Payer: UHC Medicaid |
$232.17
|
| Rate for Payer: UHCCP Medicaid |
$232.17
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$1,186.00
|
|
|
Service Code
|
HCPCS 33222
|
| Min. Negotiated Rate |
$197.88 |
| Max. Negotiated Rate |
$889.50 |
| Rate for Payer: Aetna Commercial |
$456.42
|
| Rate for Payer: Aetna Medicare |
$593.00
|
| Rate for Payer: BCBS Complete |
$207.77
|
| Rate for Payer: BCN Commercial |
$508.94
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Mclaren Medicaid |
$197.88
|
| Rate for Payer: Meridian Medicaid |
$207.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$547.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.29
|
| Rate for Payer: UHC Medicaid |
$197.88
|
| Rate for Payer: UHCCP Medicaid |
$197.88
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 93297
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$89.64 |
| Rate for Payer: Aetna Commercial |
$35.35
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: BCN Commercial |
$89.64
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.19
|
|
|
PR REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 93299
|
| Min. Negotiated Rate |
$95.60 |
| Max. Negotiated Rate |
$179.25 |
| Rate for Payer: Aetna Medicare |
$119.50
|
| Rate for Payer: BCBS Complete |
$95.60
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.25
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$18.74 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: Aetna Medicare |
$32.00
|
| Rate for Payer: BCBS Complete |
$19.68
|
| Rate for Payer: BCN Commercial |
$43.33
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Mclaren Medicaid |
$18.74
|
| Rate for Payer: Meridian Medicaid |
$19.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.18
|
| Rate for Payer: UHC Medicaid |
$18.74
|
| Rate for Payer: UHCCP Medicaid |
$18.74
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Commercial |
$31.79
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.40
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$150.39 |
| Rate for Payer: Aetna Commercial |
$35.35
|
| Rate for Payer: Aetna Medicare |
$28.50
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.94
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 99453
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$30.38 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: BCN Commercial |
$30.38
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
|
|
PR REM MNTR PHYSIOL PARAM DEV SPLY W/REC 16-30 DAYS
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$57.00 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Commercial |
$58.13
|
| Rate for Payer: Aetna Medicare |
$57.00
|
| Rate for Payer: BCN Commercial |
$66.24
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.58
|
|
|
PR REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS 93264
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$78.00 |
| Rate for Payer: Aetna Commercial |
$47.30
|
| Rate for Payer: Aetna Medicare |
$52.00
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Mclaren Medicaid |
$18.96
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.69
|
| Rate for Payer: UHC Medicaid |
$18.96
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
|
|
PR REMOT IMAGE SUBMIT BY PT
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS G2010
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: Aetna Medicare |
$12.50
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCN Commercial |
$13.45
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.09
|
| Rate for Payer: UHC Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
PR REMOVAL ANAL SETON OTHER MARKER
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 46030
|
| Min. Negotiated Rate |
$99.20 |
| Max. Negotiated Rate |
$186.00 |
| Rate for Payer: Aetna Commercial |
$119.25
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: BCBS Complete |
$99.20
|
| Rate for Payer: BCN Commercial |
$130.47
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.97
|
|
|
PR REMOVAL ANKLE IMPLANT
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 27704
|
| Min. Negotiated Rate |
$337.61 |
| Max. Negotiated Rate |
$1,407.75 |
| Rate for Payer: Aetna Commercial |
$760.19
|
| Rate for Payer: Aetna Medicare |
$938.50
|
| Rate for Payer: BCBS Complete |
$354.49
|
| Rate for Payer: BCN Commercial |
$861.01
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Mclaren Medicaid |
$337.61
|
| Rate for Payer: Meridian Medicaid |
$354.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,407.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$920.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$920.39
|
| Rate for Payer: UHC Medicaid |
$337.61
|
| Rate for Payer: UHCCP Medicaid |
$337.61
|
|
|
PR REMOVAL ANTERIOR INSTRUMENTATION
|
Professional
|
Both
|
$4,164.00
|
|
|
Service Code
|
HCPCS 22855
|
| Min. Negotiated Rate |
$670.10 |
| Max. Negotiated Rate |
$3,123.00 |
| Rate for Payer: Aetna Commercial |
$1,487.03
|
| Rate for Payer: Aetna Medicare |
$2,082.00
|
| Rate for Payer: BCBS Complete |
$703.61
|
| Rate for Payer: BCN Commercial |
$1,848.54
|
| Rate for Payer: Cash Price |
$3,331.20
|
| Rate for Payer: Cash Price |
$3,331.20
|
| Rate for Payer: Mclaren Medicaid |
$670.10
|
| Rate for Payer: Meridian Medicaid |
$703.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,123.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$670.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,798.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,798.74
|
| Rate for Payer: UHC Medicaid |
$670.10
|
| Rate for Payer: UHCCP Medicaid |
$670.10
|
|
|
PR REMOVAL/BIVALVING FULL ARM/FULL LEG CAST
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 29705
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$90.75 |
| Rate for Payer: Aetna Commercial |
$61.11
|
| Rate for Payer: Aetna Medicare |
$60.50
|
| Rate for Payer: BCBS Complete |
$27.29
|
| Rate for Payer: BCN Commercial |
$67.72
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Mclaren Medicaid |
$25.99
|
| Rate for Payer: Meridian Medicaid |
$27.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.39
|
| Rate for Payer: UHC Medicaid |
$25.99
|
| Rate for Payer: UHCCP Medicaid |
$25.99
|
|
|
PR REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 59871
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$285.75 |
| Rate for Payer: Aetna Commercial |
$144.84
|
| Rate for Payer: Aetna Medicare |
$190.50
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCN Commercial |
$199.69
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Mclaren Medicaid |
$76.89
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.51
|
| Rate for Payer: UHC Medicaid |
$76.89
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
|
|
PR REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 21029
|
| Min. Negotiated Rate |
$364.23 |
| Max. Negotiated Rate |
$1,196.25 |
| Rate for Payer: Aetna Commercial |
$818.18
|
| Rate for Payer: Aetna Medicare |
$797.50
|
| Rate for Payer: BCBS Complete |
$382.44
|
| Rate for Payer: BCN Commercial |
$950.64
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Mclaren Medicaid |
$364.23
|
| Rate for Payer: Meridian Medicaid |
$382.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,196.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,016.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,016.21
|
| Rate for Payer: UHC Medicaid |
$364.23
|
| Rate for Payer: UHCCP Medicaid |
$364.23
|
|
|
PR REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 64570
|
| Min. Negotiated Rate |
$488.62 |
| Max. Negotiated Rate |
$1,317.01 |
| Rate for Payer: Aetna Commercial |
$944.34
|
| Rate for Payer: Aetna Medicare |
$793.50
|
| Rate for Payer: BCBS Complete |
$513.05
|
| Rate for Payer: BCN Commercial |
$1,133.90
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Mclaren Medicaid |
$488.62
|
| Rate for Payer: Meridian Medicaid |
$513.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,190.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,317.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,317.01
|
| Rate for Payer: UHC Medicaid |
$488.62
|
| Rate for Payer: UHCCP Medicaid |
$488.62
|
|
|
PR REMOVAL DEEP DRUG DELIVERY DEVICE
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 20701
|
| Min. Negotiated Rate |
$34.93 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: Aetna Medicare |
$79.00
|
| Rate for Payer: BCBS Complete |
$36.68
|
| Rate for Payer: BCN Commercial |
$95.12
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Mclaren Medicaid |
$34.93
|
| Rate for Payer: Meridian Medicaid |
$36.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.67
|
| Rate for Payer: UHC Medicaid |
$34.93
|
| Rate for Payer: UHCCP Medicaid |
$34.93
|
|
|
PR REMOVAL EMBEDDED FOREIGN BODY EYELID
|
Professional
|
Both
|
$494.00
|
|
|
Service Code
|
HCPCS 67938
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$370.50 |
| Rate for Payer: Aetna Commercial |
$151.12
|
| Rate for Payer: Aetna Medicare |
$247.00
|
| Rate for Payer: BCBS Complete |
$67.09
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Mclaren Medicaid |
$63.90
|
| Rate for Payer: Meridian Medicaid |
$67.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.08
|
| Rate for Payer: UHC Medicaid |
$63.90
|
| Rate for Payer: UHCCP Medicaid |
$63.90
|
|
|
PR REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES
|
Professional
|
Both
|
$983.00
|
|
|
Service Code
|
HCPCS 20694
|
| Min. Negotiated Rate |
$209.38 |
| Max. Negotiated Rate |
$737.25 |
| Rate for Payer: Aetna Commercial |
$448.62
|
| Rate for Payer: Aetna Medicare |
$491.50
|
| Rate for Payer: BCBS Complete |
$219.85
|
| Rate for Payer: BCN Commercial |
$525.37
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Mclaren Medicaid |
$209.38
|
| Rate for Payer: Meridian Medicaid |
$219.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$737.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$561.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$561.61
|
| Rate for Payer: UHC Medicaid |
$209.38
|
| Rate for Payer: UHCCP Medicaid |
$209.38
|
|
|
PR REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 65205
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Medicare |
$100.00
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Mclaren Medicaid |
$15.55
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.17
|
| Rate for Payer: UHC Medicaid |
$15.55
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
PR REMOVAL FOREIGN BODY DEEP PENILE TISSUE
|
Professional
|
Both
|
$876.00
|
|
|
Service Code
|
HCPCS 54115
|
| Min. Negotiated Rate |
$252.62 |
| Max. Negotiated Rate |
$701.94 |
| Rate for Payer: Aetna Commercial |
$543.74
|
| Rate for Payer: Aetna Medicare |
$438.00
|
| Rate for Payer: BCBS Complete |
$265.25
|
| Rate for Payer: BCN Commercial |
$644.38
|
| Rate for Payer: Cash Price |
$700.80
|
| Rate for Payer: Cash Price |
$700.80
|
| Rate for Payer: Mclaren Medicaid |
$252.62
|
| Rate for Payer: Meridian Medicaid |
$265.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$701.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$701.94
|
| Rate for Payer: UHC Medicaid |
$252.62
|
| Rate for Payer: UHCCP Medicaid |
$252.62
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
OP
|
$1,147.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$202.22 |
| Max. Negotiated Rate |
$1,032.30 |
| Rate for Payer: Aetna Commercial |
$974.95
|
| Rate for Payer: Aetna Medicare |
$298.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$358.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$358.44
|
| Rate for Payer: BCBS Complete |
$212.31
|
| Rate for Payer: BCBS MAPPO |
$286.75
|
| Rate for Payer: BCBS Trust/PPO |
$942.95
|
| Rate for Payer: BCN Commercial |
$942.95
|
| Rate for Payer: BCN Medicare Advantage |
$286.75
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$986.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$917.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.75
|
| Rate for Payer: Healthscope Commercial |
$1,032.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.25
|
| Rate for Payer: Mclaren Medicaid |
$202.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.09
|
| Rate for Payer: Meridian Medicaid |
$212.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$315.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$974.95
|
| Rate for Payer: Nomi Health Commercial |
$940.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PACE Senior Care Partners |
$272.41
|
| Rate for Payer: PACE SWMI |
$286.75
|
| Rate for Payer: PHP Commercial |
$974.95
|
| Rate for Payer: PHP Medicare Advantage |
$286.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$997.89
|
| Rate for Payer: Priority Health Medicare |
$289.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$798.31
|
| Rate for Payer: Railroad Medicare Medicare |
$286.75
|
| Rate for Payer: UHC Core |
$957.75
|
| Rate for Payer: UHC Exchange |
$286.75
|
| Rate for Payer: UHC Medicaid |
$202.22
|
| Rate for Payer: UHC Medicare Advantage |
$286.75
|
| Rate for Payer: UHCCP Medicaid |
$202.22
|
| Rate for Payer: VA VA |
$286.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.25
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 27372
|
| Min. Negotiated Rate |
$249.64 |
| Max. Negotiated Rate |
$860.25 |
| Rate for Payer: Aetna Commercial |
$533.27
|
| Rate for Payer: Aetna Medicare |
$573.50
|
| Rate for Payer: BCBS Complete |
$262.12
|
| Rate for Payer: BCN Commercial |
$614.51
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Mclaren Medicaid |
$249.64
|
| Rate for Payer: Meridian Medicaid |
$262.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$656.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.90
|
| Rate for Payer: UHC Medicaid |
$249.64
|
| Rate for Payer: UHCCP Medicaid |
$249.64
|
|
