|
PR RMVL EMBEDDED FB VESTIBULE MOUTH SMPL
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 40804
|
| Min. Negotiated Rate |
$73.70 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$149.26
|
| Rate for Payer: Aetna Medicare |
$175.00
|
| Rate for Payer: BCBS Complete |
$77.39
|
| Rate for Payer: BCN Commercial |
$178.77
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Mclaren Medicaid |
$73.70
|
| Rate for Payer: Meridian Medicaid |
$77.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$217.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.82
|
| Rate for Payer: UHC Medicaid |
$73.70
|
| Rate for Payer: UHCCP Medicaid |
$73.70
|
|
|
PR RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT
|
Professional
|
Both
|
$1,708.00
|
|
|
Service Code
|
HCPCS 63746
|
| Min. Negotiated Rate |
$410.24 |
| Max. Negotiated Rate |
$1,281.00 |
| Rate for Payer: Aetna Commercial |
$781.78
|
| Rate for Payer: Aetna Medicare |
$854.00
|
| Rate for Payer: BCBS Complete |
$430.75
|
| Rate for Payer: BCN Commercial |
$1,035.60
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Mclaren Medicaid |
$410.24
|
| Rate for Payer: Meridian Medicaid |
$430.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,094.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,094.90
|
| Rate for Payer: UHC Medicaid |
$410.24
|
| Rate for Payer: UHCCP Medicaid |
$410.24
|
|
|
PR RMVL FB XTRNL AUDITORY CANAL ANES
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 69205
|
| Min. Negotiated Rate |
$55.81 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Aetna Commercial |
$106.72
|
| Rate for Payer: Aetna Medicare |
$97.00
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCN Commercial |
$142.92
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Mclaren Medicaid |
$55.81
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.21
|
| Rate for Payer: UHC Medicaid |
$55.81
|
| Rate for Payer: UHCCP Medicaid |
$55.81
|
|
|
PR RMVL FB XTRNL AUDITORY CANAL W/O ANES
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 69200
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$53.13
|
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Mclaren Medicaid |
$26.63
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.86
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
|
|
PR RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 65220
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$55.19
|
| Rate for Payer: Aetna Medicare |
$85.00
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCN Commercial |
$60.76
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Mclaren Medicaid |
$24.07
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.16
|
| Rate for Payer: UHC Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
|
|
PR RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 65222
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$141.00 |
| Rate for Payer: Aetna Commercial |
$66.76
|
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCN Commercial |
$73.70
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Mclaren Medicaid |
$26.63
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.32
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
|
|
PR RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 65210
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$150.75 |
| Rate for Payer: Aetna Commercial |
$48.17
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Mclaren Medicaid |
$19.17
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.41
|
| Rate for Payer: UHC Medicaid |
$19.17
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
|
|
PR RMVL FECAL IMPACTION/FB SPX UNDER ANES
|
Professional
|
Both
|
$631.00
|
|
|
Service Code
|
HCPCS 45915
|
| Min. Negotiated Rate |
$147.82 |
| Max. Negotiated Rate |
$473.25 |
| Rate for Payer: Aetna Commercial |
$308.27
|
| Rate for Payer: Aetna Medicare |
$315.50
|
| Rate for Payer: BCBS Complete |
$155.21
|
| Rate for Payer: BCN Commercial |
$347.09
|
| Rate for Payer: Cash Price |
$504.80
|
| Rate for Payer: Cash Price |
$504.80
|
| Rate for Payer: Mclaren Medicaid |
$147.82
|
| Rate for Payer: Meridian Medicaid |
$155.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$473.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$422.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$422.92
|
| Rate for Payer: UHC Medicaid |
$147.82
|
| Rate for Payer: UHCCP Medicaid |
$147.82
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 20525
|
| Min. Negotiated Rate |
$148.67 |
| Max. Negotiated Rate |
$593.25 |
| Rate for Payer: Aetna Commercial |
$328.41
|
| Rate for Payer: Aetna Medicare |
$395.50
|
| Rate for Payer: BCBS Complete |
$156.10
|
| Rate for Payer: BCN Commercial |
$376.48
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Mclaren Medicaid |
$148.67
|
| Rate for Payer: Meridian Medicaid |
$156.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$402.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.44
|
| Rate for Payer: UHC Medicaid |
$148.67
|
| Rate for Payer: UHCCP Medicaid |
$148.67
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Facility
|
IP
|
$791.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
20525
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$550.54 |
| Max. Negotiated Rate |
$711.90 |
| Rate for Payer: Aetna Commercial |
$672.35
|
| Rate for Payer: BCBS Trust/PPO |
$653.29
|
| Rate for Payer: BCN Commercial |
$653.29
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$680.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.80
|
| Rate for Payer: Healthscope Commercial |
$711.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$593.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.35
|
| Rate for Payer: Nomi Health Commercial |
$648.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: PHP Commercial |
$672.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$688.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.54
|
| Rate for Payer: UHC Core |
$660.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$593.25
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 20525
|
| Hospital Charge Code |
20525
|
| Min. Negotiated Rate |
$148.67 |
| Max. Negotiated Rate |
$593.25 |
| Rate for Payer: Aetna Commercial |
$328.41
|
| Rate for Payer: Aetna Medicare |
$395.50
|
| Rate for Payer: BCBS Complete |
$156.10
|
| Rate for Payer: BCN Commercial |
$376.48
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Mclaren Medicaid |
$148.67
|
| Rate for Payer: Meridian Medicaid |
$156.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$402.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.44
|
| Rate for Payer: UHC Medicaid |
$148.67
|
| Rate for Payer: UHCCP Medicaid |
$148.67
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Facility
|
OP
|
$791.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
20525
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$139.45 |
| Max. Negotiated Rate |
$711.90 |
| Rate for Payer: Aetna Commercial |
$672.35
|
| Rate for Payer: Aetna Medicare |
$205.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.19
|
| Rate for Payer: BCBS Complete |
$146.41
|
| Rate for Payer: BCBS MAPPO |
$197.75
|
| Rate for Payer: BCBS Trust/PPO |
$650.28
|
| Rate for Payer: BCN Commercial |
$650.28
|
| Rate for Payer: BCN Medicare Advantage |
$197.75
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$680.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.75
|
| Rate for Payer: Healthscope Commercial |
$711.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$593.25
|
| Rate for Payer: Mclaren Medicaid |
$139.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.64
|
| Rate for Payer: Meridian Medicaid |
$146.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.35
|
| Rate for Payer: Nomi Health Commercial |
$648.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: PACE Senior Care Partners |
$187.86
|
| Rate for Payer: PACE SWMI |
$197.75
|
| Rate for Payer: PHP Commercial |
$672.35
|
| Rate for Payer: PHP Medicare Advantage |
$197.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$688.17
|
| Rate for Payer: Priority Health Medicare |
$199.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.54
|
| Rate for Payer: Railroad Medicare Medicare |
$197.75
|
| Rate for Payer: UHC Core |
$660.49
|
| Rate for Payer: UHC Exchange |
$197.75
|
| Rate for Payer: UHC Medicaid |
$139.45
|
| Rate for Payer: UHC Medicare Advantage |
$197.75
|
| Rate for Payer: UHCCP Medicaid |
$139.45
|
| Rate for Payer: VA VA |
$197.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$593.25
|
|
|
PR RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS
|
Professional
|
Both
|
$418.00
|
|
|
Service Code
|
HCPCS 27086
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$313.50 |
| Rate for Payer: Aetna Commercial |
$222.58
|
| Rate for Payer: Aetna Medicare |
$209.00
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCN Commercial |
$258.45
|
| Rate for Payer: Cash Price |
$334.40
|
| Rate for Payer: Cash Price |
$334.40
|
| Rate for Payer: Mclaren Medicaid |
$106.71
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$313.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$276.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.28
|
| Rate for Payer: UHC Medicaid |
$106.71
|
| Rate for Payer: UHCCP Medicaid |
$106.71
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 24200
|
| Min. Negotiated Rate |
$91.38 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$187.10
|
| Rate for Payer: Aetna Medicare |
$169.00
|
| Rate for Payer: BCBS Complete |
$95.95
|
| Rate for Payer: BCN Commercial |
$218.61
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Mclaren Medicaid |
$91.38
|
| Rate for Payer: Meridian Medicaid |
$95.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.69
|
| Rate for Payer: UHC Medicaid |
$91.38
|
| Rate for Payer: UHCCP Medicaid |
$91.38
|
|
|
PR RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA
|
Professional
|
Both
|
$3,391.00
|
|
|
Service Code
|
HCPCS 27091
|
| Min. Negotiated Rate |
$916.54 |
| Max. Negotiated Rate |
$2,567.41 |
| Rate for Payer: Aetna Commercial |
$2,131.08
|
| Rate for Payer: Aetna Medicare |
$1,695.50
|
| Rate for Payer: BCBS Complete |
$962.37
|
| Rate for Payer: BCN Commercial |
$2,401.76
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Cash Price |
$2,712.80
|
| Rate for Payer: Mclaren Medicaid |
$916.54
|
| Rate for Payer: Meridian Medicaid |
$962.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,543.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$916.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,567.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,567.41
|
| Rate for Payer: UHC Medicaid |
$916.54
|
| Rate for Payer: UHCCP Medicaid |
$916.54
|
|
|
PR RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF
|
Professional
|
Both
|
$2,704.00
|
|
|
Service Code
|
HCPCS 33971
|
| Min. Negotiated Rate |
$428.13 |
| Max. Negotiated Rate |
$2,028.00 |
| Rate for Payer: Aetna Commercial |
$939.89
|
| Rate for Payer: Aetna Medicare |
$1,352.00
|
| Rate for Payer: BCBS Complete |
$449.54
|
| Rate for Payer: BCN Commercial |
$1,044.26
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Mclaren Medicaid |
$428.13
|
| Rate for Payer: Meridian Medicaid |
$449.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,028.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,122.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,122.98
|
| Rate for Payer: UHC Medicaid |
$428.13
|
| Rate for Payer: UHCCP Medicaid |
$428.13
|
|
|
PR RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 33284
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Aetna Medicare |
$252.50
|
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.75
|
|
|
PR RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 33262
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$590.14 |
| Rate for Payer: Aetna Commercial |
$501.00
|
| Rate for Payer: Aetna Medicare |
$345.50
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Mclaren Medicaid |
$210.02
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$518.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$590.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$590.14
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
|
|
PR RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 33263
|
| Min. Negotiated Rate |
$218.33 |
| Max. Negotiated Rate |
$613.70 |
| Rate for Payer: Aetna Commercial |
$521.20
|
| Rate for Payer: Aetna Medicare |
$405.50
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCN Commercial |
$570.69
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Mclaren Medicaid |
$218.33
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$608.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$613.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$613.70
|
| Rate for Payer: UHC Medicaid |
$218.33
|
| Rate for Payer: UHCCP Medicaid |
$218.33
|
|
|
PR RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD
|
Professional
|
Both
|
$847.00
|
|
|
Service Code
|
HCPCS 33264
|
| Min. Negotiated Rate |
$226.63 |
| Max. Negotiated Rate |
$639.41 |
| Rate for Payer: Aetna Commercial |
$544.48
|
| Rate for Payer: Aetna Medicare |
$423.50
|
| Rate for Payer: BCBS Complete |
$237.96
|
| Rate for Payer: BCN Commercial |
$594.59
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Mclaren Medicaid |
$226.63
|
| Rate for Payer: Meridian Medicaid |
$237.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$635.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$639.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.41
|
| Rate for Payer: UHC Medicaid |
$226.63
|
| Rate for Payer: UHCCP Medicaid |
$226.63
|
|
|
PR RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH
|
Professional
|
Both
|
$1,434.00
|
|
|
Service Code
|
HCPCS 54406
|
| Min. Negotiated Rate |
$423.44 |
| Max. Negotiated Rate |
$1,195.04 |
| Rate for Payer: Aetna Commercial |
$938.52
|
| Rate for Payer: Aetna Medicare |
$717.00
|
| Rate for Payer: BCBS Complete |
$444.61
|
| Rate for Payer: BCN Commercial |
$1,097.05
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Mclaren Medicaid |
$423.44
|
| Rate for Payer: Meridian Medicaid |
$444.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,075.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,195.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,195.04
|
| Rate for Payer: UHC Medicaid |
$423.44
|
| Rate for Payer: UHCCP Medicaid |
$423.44
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY
|
Professional
|
Both
|
$3,802.00
|
|
|
Service Code
|
HCPCS 32484
|
| Min. Negotiated Rate |
$862.86 |
| Max. Negotiated Rate |
$2,851.50 |
| Rate for Payer: Aetna Commercial |
$1,853.16
|
| Rate for Payer: Aetna Medicare |
$1,901.00
|
| Rate for Payer: BCBS Complete |
$906.00
|
| Rate for Payer: BCN Commercial |
$2,118.91
|
| Rate for Payer: Cash Price |
$3,041.60
|
| Rate for Payer: Cash Price |
$3,041.60
|
| Rate for Payer: Mclaren Medicaid |
$862.86
|
| Rate for Payer: Meridian Medicaid |
$906.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,851.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$862.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,995.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,995.38
|
| Rate for Payer: UHC Medicaid |
$862.86
|
| Rate for Payer: UHCCP Medicaid |
$862.86
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC
|
Professional
|
Both
|
$5,523.00
|
|
|
Service Code
|
HCPCS 32482
|
| Min. Negotiated Rate |
$959.14 |
| Max. Negotiated Rate |
$4,142.25 |
| Rate for Payer: Aetna Commercial |
$2,045.67
|
| Rate for Payer: Aetna Medicare |
$2,761.50
|
| Rate for Payer: BCBS Complete |
$1,007.10
|
| Rate for Payer: BCN Commercial |
$2,341.01
|
| Rate for Payer: Cash Price |
$4,418.40
|
| Rate for Payer: Cash Price |
$4,418.40
|
| Rate for Payer: Mclaren Medicaid |
$959.14
|
| Rate for Payer: Meridian Medicaid |
$1,007.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,142.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$959.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,204.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,204.54
|
| Rate for Payer: UHC Medicaid |
$959.14
|
| Rate for Payer: UHCCP Medicaid |
$959.14
|
|
|
PR RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT
|
Professional
|
Both
|
$4,909.00
|
|
|
Service Code
|
HCPCS 32480
|
| Min. Negotiated Rate |
$894.39 |
| Max. Negotiated Rate |
$3,681.75 |
| Rate for Payer: Aetna Commercial |
$1,911.03
|
| Rate for Payer: Aetna Medicare |
$2,454.50
|
| Rate for Payer: BCBS Complete |
$939.11
|
| Rate for Payer: BCN Commercial |
$2,187.13
|
| Rate for Payer: Cash Price |
$3,927.20
|
| Rate for Payer: Cash Price |
$3,927.20
|
| Rate for Payer: Mclaren Medicaid |
$894.39
|
| Rate for Payer: Meridian Medicaid |
$939.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,681.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$894.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,059.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,059.63
|
| Rate for Payer: UHC Medicaid |
$894.39
|
| Rate for Payer: UHCCP Medicaid |
$894.39
|
|
|
PR RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC
|
Professional
|
Both
|
$4,617.00
|
|
|
Service Code
|
HCPCS 32488
|
| Min. Negotiated Rate |
$1,427.95 |
| Max. Negotiated Rate |
$3,521.22 |
| Rate for Payer: Aetna Commercial |
$3,091.30
|
| Rate for Payer: Aetna Medicare |
$2,308.50
|
| Rate for Payer: BCBS Complete |
$1,499.35
|
| Rate for Payer: BCN Commercial |
$3,521.22
|
| Rate for Payer: Cash Price |
$3,693.60
|
| Rate for Payer: Cash Price |
$3,693.60
|
| Rate for Payer: Mclaren Medicaid |
$1,427.95
|
| Rate for Payer: Meridian Medicaid |
$1,499.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,462.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,427.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,315.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,315.95
|
| Rate for Payer: UHC Medicaid |
$1,427.95
|
| Rate for Payer: UHCCP Medicaid |
$1,427.95
|
|
