|
PR RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER
|
Professional
|
Both
|
$3,367.00
|
|
|
Service Code
|
HCPCS 27488
|
| Min. Negotiated Rate |
$777.45 |
| Max. Negotiated Rate |
$2,188.55 |
| Rate for Payer: Aetna Commercial |
$1,549.70
|
| Rate for Payer: Aetna Medicare |
$1,202.75
|
| Rate for Payer: BCBS Complete |
$816.32
|
| Rate for Payer: BCBS MAPPO |
$1,156.49
|
| Rate for Payer: BCBS Trust/PPO |
$995.85
|
| Rate for Payer: BCN Commercial |
$1,756.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,156.49
|
| Rate for Payer: Cash Price |
$2,693.60
|
| Rate for Payer: Cash Price |
$2,693.60
|
| Rate for Payer: Cofinity Commercial |
$1,665.35
|
| Rate for Payer: Cofinity Commercial |
$1,549.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,156.49
|
| Rate for Payer: Mclaren Medicaid |
$777.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,214.31
|
| Rate for Payer: Meridian Medicaid |
$816.32
|
| Rate for Payer: Nomi Health Commercial |
$1,387.79
|
| Rate for Payer: PACE SWMI |
$1,156.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,156.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,188.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,842.58
|
| Rate for Payer: Priority Health Medicare |
$1,168.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,842.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,156.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,156.49
|
| Rate for Payer: UHC Exchange |
$1,156.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,156.49
|
| Rate for Payer: UHCCP Medicaid |
$777.45
|
|
|
PR RMVL/REVJ SLING MALE URINARY INCONTINENCE
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 53442
|
| Min. Negotiated Rate |
$505.02 |
| Max. Negotiated Rate |
$1,276.37 |
| Rate for Payer: Aetna Commercial |
$1,006.89
|
| Rate for Payer: Aetna Medicare |
$781.47
|
| Rate for Payer: BCBS Complete |
$530.27
|
| Rate for Payer: BCBS MAPPO |
$751.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,276.37
|
| Rate for Payer: BCN Commercial |
$1,134.22
|
| Rate for Payer: BCN Medicare Advantage |
$751.41
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,082.03
|
| Rate for Payer: Cofinity Commercial |
$1,006.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.41
|
| Rate for Payer: Mclaren Medicaid |
$505.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.98
|
| Rate for Payer: Meridian Medicaid |
$530.27
|
| Rate for Payer: Nomi Health Commercial |
$901.69
|
| Rate for Payer: PACE SWMI |
$751.41
|
| Rate for Payer: PHP Medicare Advantage |
$751.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,253.20
|
| Rate for Payer: Priority Health Medicare |
$758.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,253.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$751.41
|
| Rate for Payer: UHC Exchange |
$751.41
|
| Rate for Payer: UHC Medicare Advantage |
$751.41
|
| Rate for Payer: UHCCP Medicaid |
$505.02
|
|
|
PR RMVL/REVJ SLING STRESS INCONTINENCE
|
Professional
|
Both
|
$1,234.00
|
|
|
Service Code
|
HCPCS 57287
|
| Min. Negotiated Rate |
$475.84 |
| Max. Negotiated Rate |
$2,457.12 |
| Rate for Payer: Aetna Commercial |
$944.11
|
| Rate for Payer: Aetna Medicare |
$732.74
|
| Rate for Payer: BCBS Complete |
$499.63
|
| Rate for Payer: BCBS MAPPO |
$704.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,457.12
|
| Rate for Payer: BCN Commercial |
$1,509.08
|
| Rate for Payer: BCN Medicare Advantage |
$704.56
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cofinity Commercial |
$944.11
|
| Rate for Payer: Cofinity Commercial |
$1,014.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$704.56
|
| Rate for Payer: Mclaren Medicaid |
$475.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$739.79
|
| Rate for Payer: Meridian Medicaid |
$499.63
|
| Rate for Payer: Nomi Health Commercial |
$845.47
|
| Rate for Payer: PACE SWMI |
$704.56
|
| Rate for Payer: PHP Medicare Advantage |
$704.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,111.64
|
| Rate for Payer: Priority Health Medicare |
$711.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,111.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$704.56
|
| Rate for Payer: UHC Exchange |
$704.56
|
| Rate for Payer: UHC Medicare Advantage |
$704.56
|
| Rate for Payer: UHCCP Medicaid |
$475.84
|
|
|
PR RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS
|
Professional
|
Both
|
$1,673.00
|
|
|
Service Code
|
HCPCS 54410
|
| Min. Negotiated Rate |
$553.37 |
| Max. Negotiated Rate |
$2,612.13 |
| Rate for Payer: Aetna Commercial |
$1,105.31
|
| Rate for Payer: Aetna Medicare |
$857.85
|
| Rate for Payer: BCBS Complete |
$581.04
|
| Rate for Payer: BCBS MAPPO |
$824.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,612.13
|
| Rate for Payer: BCN Commercial |
$1,244.66
|
| Rate for Payer: BCN Medicare Advantage |
$824.86
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cofinity Commercial |
$1,187.80
|
| Rate for Payer: Cofinity Commercial |
$1,105.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$824.86
|
| Rate for Payer: Mclaren Medicaid |
$553.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$866.10
|
| Rate for Payer: Meridian Medicaid |
$581.04
|
| Rate for Payer: Nomi Health Commercial |
$989.83
|
| Rate for Payer: PACE SWMI |
$824.86
|
| Rate for Payer: PHP Medicare Advantage |
$824.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,374.64
|
| Rate for Payer: Priority Health Medicare |
$833.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,374.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$824.86
|
| Rate for Payer: UHC Exchange |
$824.86
|
| Rate for Payer: UHC Medicare Advantage |
$824.86
|
| Rate for Payer: UHCCP Medicaid |
$553.37
|
|
|
PR RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 50382
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$4,259.15 |
| Rate for Payer: Aetna Commercial |
$318.02
|
| Rate for Payer: Aetna Medicare |
$246.82
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$237.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,259.15
|
| Rate for Payer: BCN Commercial |
$1,487.05
|
| Rate for Payer: BCN Medicare Advantage |
$237.33
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$341.76
|
| Rate for Payer: Cofinity Commercial |
$318.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.33
|
| Rate for Payer: Mclaren Medicaid |
$157.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.20
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Nomi Health Commercial |
$284.80
|
| Rate for Payer: PACE SWMI |
$237.33
|
| Rate for Payer: PHP Medicare Advantage |
$237.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health HMO/PPO |
$389.86
|
| Rate for Payer: Priority Health Medicare |
$239.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.33
|
| Rate for Payer: UHC Exchange |
$237.33
|
| Rate for Payer: UHC Medicare Advantage |
$237.33
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
|
|
PR RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 53448
|
| Min. Negotiated Rate |
$807.77 |
| Max. Negotiated Rate |
$2,020.14 |
| Rate for Payer: Aetna Commercial |
$1,629.65
|
| Rate for Payer: Aetna Medicare |
$1,264.81
|
| Rate for Payer: BCBS Complete |
$853.67
|
| Rate for Payer: BCBS MAPPO |
$1,216.16
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: BCN Commercial |
$1,834.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,216.16
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cofinity Commercial |
$1,751.27
|
| Rate for Payer: Cofinity Commercial |
$1,629.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,216.16
|
| Rate for Payer: Mclaren Medicaid |
$813.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,276.97
|
| Rate for Payer: Meridian Medicaid |
$853.67
|
| Rate for Payer: Nomi Health Commercial |
$1,459.39
|
| Rate for Payer: PACE SWMI |
$1,216.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,216.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$813.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,020.14
|
| Rate for Payer: Priority Health Medicare |
$1,228.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,020.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,216.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,216.16
|
| Rate for Payer: UHC Exchange |
$1,216.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,216.16
|
| Rate for Payer: UHCCP Medicaid |
$813.02
|
|
|
PR RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL
|
Professional
|
Both
|
$2,131.00
|
|
|
Service Code
|
HCPCS 54411
|
| Min. Negotiated Rate |
$658.38 |
| Max. Negotiated Rate |
$3,265.16 |
| Rate for Payer: Aetna Commercial |
$1,316.54
|
| Rate for Payer: Aetna Medicare |
$1,021.79
|
| Rate for Payer: BCBS Complete |
$691.30
|
| Rate for Payer: BCBS MAPPO |
$982.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,265.16
|
| Rate for Payer: BCN Commercial |
$1,484.61
|
| Rate for Payer: BCN Medicare Advantage |
$982.49
|
| Rate for Payer: Cash Price |
$1,704.80
|
| Rate for Payer: Cash Price |
$1,704.80
|
| Rate for Payer: Cofinity Commercial |
$1,414.79
|
| Rate for Payer: Cofinity Commercial |
$1,316.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$982.49
|
| Rate for Payer: Mclaren Medicaid |
$658.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,031.61
|
| Rate for Payer: Meridian Medicaid |
$691.30
|
| Rate for Payer: Nomi Health Commercial |
$1,178.99
|
| Rate for Payer: PACE SWMI |
$982.49
|
| Rate for Payer: PHP Medicare Advantage |
$982.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,385.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,635.09
|
| Rate for Payer: Priority Health Medicare |
$992.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,635.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$982.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$982.49
|
| Rate for Payer: UHC Exchange |
$982.49
|
| Rate for Payer: UHC Medicare Advantage |
$982.49
|
| Rate for Payer: UHCCP Medicaid |
$658.38
|
|
|
PR RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC
|
Professional
|
Both
|
$2,515.00
|
|
|
Service Code
|
HCPCS 53447
|
| Min. Negotiated Rate |
$516.10 |
| Max. Negotiated Rate |
$1,634.75 |
| Rate for Payer: Aetna Commercial |
$1,031.38
|
| Rate for Payer: Aetna Medicare |
$800.48
|
| Rate for Payer: BCBS Complete |
$541.90
|
| Rate for Payer: BCBS MAPPO |
$769.69
|
| Rate for Payer: BCBS Trust/PPO |
$790.34
|
| Rate for Payer: BCN Commercial |
$1,162.57
|
| Rate for Payer: BCN Medicare Advantage |
$769.69
|
| Rate for Payer: Cash Price |
$2,012.00
|
| Rate for Payer: Cash Price |
$2,012.00
|
| Rate for Payer: Cofinity Commercial |
$1,108.35
|
| Rate for Payer: Cofinity Commercial |
$1,031.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$769.69
|
| Rate for Payer: Mclaren Medicaid |
$516.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$808.17
|
| Rate for Payer: Meridian Medicaid |
$541.90
|
| Rate for Payer: Nomi Health Commercial |
$923.63
|
| Rate for Payer: PACE SWMI |
$769.69
|
| Rate for Payer: PHP Medicare Advantage |
$769.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,634.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,282.50
|
| Rate for Payer: Priority Health Medicare |
$777.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,282.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$769.69
|
| Rate for Payer: UHC Exchange |
$769.69
|
| Rate for Payer: UHC Medicare Advantage |
$769.69
|
| Rate for Payer: UHCCP Medicaid |
$516.10
|
|
|
PR RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD
|
Professional
|
Both
|
$2,290.00
|
|
|
Service Code
|
HCPCS 54417
|
| Min. Negotiated Rate |
$575.74 |
| Max. Negotiated Rate |
$2,176.77 |
| Rate for Payer: Aetna Commercial |
$1,151.58
|
| Rate for Payer: Aetna Medicare |
$893.77
|
| Rate for Payer: BCBS Complete |
$604.53
|
| Rate for Payer: BCBS MAPPO |
$859.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,176.77
|
| Rate for Payer: BCN Commercial |
$1,295.97
|
| Rate for Payer: BCN Medicare Advantage |
$859.39
|
| Rate for Payer: Cash Price |
$1,832.00
|
| Rate for Payer: Cash Price |
$1,832.00
|
| Rate for Payer: Cofinity Commercial |
$1,237.52
|
| Rate for Payer: Cofinity Commercial |
$1,151.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.39
|
| Rate for Payer: Mclaren Medicaid |
$575.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$902.36
|
| Rate for Payer: Meridian Medicaid |
$604.53
|
| Rate for Payer: Nomi Health Commercial |
$1,031.27
|
| Rate for Payer: PACE SWMI |
$859.39
|
| Rate for Payer: PHP Medicare Advantage |
$859.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,488.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,429.50
|
| Rate for Payer: Priority Health Medicare |
$867.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$859.39
|
| Rate for Payer: UHC Exchange |
$859.39
|
| Rate for Payer: UHC Medicare Advantage |
$859.39
|
| Rate for Payer: UHCCP Medicaid |
$575.74
|
|
|
PR RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 50387
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$3,379.54 |
| Rate for Payer: Aetna Commercial |
$105.14
|
| Rate for Payer: Aetna Medicare |
$81.60
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$78.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,379.54
|
| Rate for Payer: BCN Commercial |
$822.45
|
| Rate for Payer: BCN Medicare Advantage |
$78.46
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$112.98
|
| Rate for Payer: Cofinity Commercial |
$105.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.46
|
| Rate for Payer: Mclaren Medicaid |
$51.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.38
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Nomi Health Commercial |
$94.15
|
| Rate for Payer: PACE SWMI |
$78.46
|
| Rate for Payer: PHP Medicare Advantage |
$78.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.35
|
| Rate for Payer: Priority Health HMO/PPO |
$128.90
|
| Rate for Payer: Priority Health Medicare |
$79.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.46
|
| Rate for Payer: UHC Exchange |
$78.46
|
| Rate for Payer: UHC Medicare Advantage |
$78.46
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE
|
Professional
|
Both
|
$1,698.00
|
|
|
Service Code
|
HCPCS 69711
|
| Min. Negotiated Rate |
$535.48 |
| Max. Negotiated Rate |
$3,026.10 |
| Rate for Payer: Aetna Commercial |
$1,051.15
|
| Rate for Payer: Aetna Medicare |
$815.82
|
| Rate for Payer: BCBS Complete |
$562.25
|
| Rate for Payer: BCBS MAPPO |
$784.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,026.10
|
| Rate for Payer: BCN Commercial |
$1,238.80
|
| Rate for Payer: BCN Medicare Advantage |
$784.44
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Cofinity Commercial |
$1,129.59
|
| Rate for Payer: Cofinity Commercial |
$1,051.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$784.44
|
| Rate for Payer: Mclaren Medicaid |
$535.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$823.66
|
| Rate for Payer: Meridian Medicaid |
$562.25
|
| Rate for Payer: Nomi Health Commercial |
$941.33
|
| Rate for Payer: PACE SWMI |
$784.44
|
| Rate for Payer: PHP Medicare Advantage |
$784.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,231.02
|
| Rate for Payer: Priority Health Medicare |
$792.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,231.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$784.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$784.44
|
| Rate for Payer: UHC Exchange |
$784.44
|
| Rate for Payer: UHC Medicare Advantage |
$784.44
|
| Rate for Payer: UHCCP Medicaid |
$535.48
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Facility
|
OP
|
$1,145.00
|
|
|
Service Code
|
CPT 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$271.94 |
| Max. Negotiated Rate |
$2,848.40 |
| Rate for Payer: Aetna Commercial |
$973.25
|
| Rate for Payer: Aetna Medicare |
$297.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.81
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$286.25
|
| Rate for Payer: BCBS Trust/PPO |
$941.30
|
| Rate for Payer: BCN Commercial |
$890.24
|
| Rate for Payer: BCN Medicare Advantage |
$286.25
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$984.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.25
|
| Rate for Payer: Healthscope Commercial |
$1,030.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.75
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.56
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.25
|
| Rate for Payer: Nomi Health Commercial |
$938.90
|
| Rate for Payer: PACE Senior Care Partners |
$271.94
|
| Rate for Payer: PACE SWMI |
$286.25
|
| Rate for Payer: PHP Commercial |
$973.25
|
| Rate for Payer: PHP Medicare Advantage |
$286.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO |
$996.15
|
| Rate for Payer: Priority Health Medicare |
$289.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$767.15
|
| Rate for Payer: Railroad Medicare Medicare |
$286.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.60
|
| Rate for Payer: UHC Core |
$956.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.25
|
| Rate for Payer: UHC Exchange |
$286.25
|
| Rate for Payer: UHC Medicare Advantage |
$286.25
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$286.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.75
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$418.55 |
| Max. Negotiated Rate |
$947.54 |
| Rate for Payer: Aetna Commercial |
$829.94
|
| Rate for Payer: Aetna Medicare |
$644.13
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$619.36
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$947.54
|
| Rate for Payer: BCN Medicare Advantage |
$619.36
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$891.88
|
| Rate for Payer: Cofinity Commercial |
$829.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.36
|
| Rate for Payer: Mclaren Medicaid |
$418.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.33
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Nomi Health Commercial |
$743.23
|
| Rate for Payer: PACE SWMI |
$619.36
|
| Rate for Payer: PHP Medicare Advantage |
$619.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO |
$878.65
|
| Rate for Payer: Priority Health Medicare |
$625.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$878.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.36
|
| Rate for Payer: UHC Exchange |
$619.36
|
| Rate for Payer: UHC Medicare Advantage |
$619.36
|
| Rate for Payer: UHCCP Medicaid |
$418.55
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 19330
|
| Min. Negotiated Rate |
$418.55 |
| Max. Negotiated Rate |
$947.54 |
| Rate for Payer: Aetna Commercial |
$829.94
|
| Rate for Payer: Aetna Medicare |
$644.13
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$619.36
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$947.54
|
| Rate for Payer: BCN Medicare Advantage |
$619.36
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$891.88
|
| Rate for Payer: Cofinity Commercial |
$829.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.36
|
| Rate for Payer: Mclaren Medicaid |
$418.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.33
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Nomi Health Commercial |
$743.23
|
| Rate for Payer: PACE SWMI |
$619.36
|
| Rate for Payer: PHP Medicare Advantage |
$619.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO |
$878.65
|
| Rate for Payer: Priority Health Medicare |
$625.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$878.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.36
|
| Rate for Payer: UHC Exchange |
$619.36
|
| Rate for Payer: UHC Medicare Advantage |
$619.36
|
| Rate for Payer: UHCCP Medicaid |
$418.55
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Facility
|
IP
|
$1,145.00
|
|
|
Service Code
|
CPT 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$744.25 |
| Max. Negotiated Rate |
$1,030.50 |
| Rate for Payer: Aetna Commercial |
$973.25
|
| Rate for Payer: BCBS Trust/PPO |
$934.66
|
| Rate for Payer: BCN Commercial |
$884.86
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$984.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.00
|
| Rate for Payer: Healthscope Commercial |
$1,030.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.25
|
| Rate for Payer: Nomi Health Commercial |
$938.90
|
| Rate for Payer: PHP Commercial |
$973.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO |
$996.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$767.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.60
|
| Rate for Payer: UHC Core |
$956.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.75
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY EA ADDL 10
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 11201
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$106.97 |
| Rate for Payer: Aetna Commercial |
$20.41
|
| Rate for Payer: Aetna Medicare |
$15.84
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: BCBS MAPPO |
$15.23
|
| Rate for Payer: BCBS Trust/PPO |
$106.97
|
| Rate for Payer: BCN Commercial |
$21.60
|
| Rate for Payer: BCN Medicare Advantage |
$15.23
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.23
|
| Rate for Payer: Mclaren Medicaid |
$10.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.99
|
| Rate for Payer: Meridian Medicaid |
$10.73
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: PACE SWMI |
$15.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO |
$21.68
|
| Rate for Payer: Priority Health Medicare |
$15.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.23
|
| Rate for Payer: UHC Exchange |
$15.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.23
|
| Rate for Payer: UHCCP Medicaid |
$10.22
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$41.56 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$148.75
|
| Rate for Payer: Aetna Medicare |
$45.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.69
|
| Rate for Payer: BCBS Complete |
$147.80
|
| Rate for Payer: BCBS MAPPO |
$43.75
|
| Rate for Payer: BCBS Trust/PPO |
$143.87
|
| Rate for Payer: BCN Commercial |
$136.06
|
| Rate for Payer: BCN Medicare Advantage |
$43.75
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.75
|
| Rate for Payer: Healthscope Commercial |
$157.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.25
|
| Rate for Payer: Mclaren Medicaid |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.94
|
| Rate for Payer: Meridian Medicaid |
$147.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.75
|
| Rate for Payer: Nomi Health Commercial |
$143.50
|
| Rate for Payer: PACE Senior Care Partners |
$41.56
|
| Rate for Payer: PACE SWMI |
$43.75
|
| Rate for Payer: PHP Commercial |
$148.75
|
| Rate for Payer: PHP Medicare Advantage |
$43.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO |
$152.25
|
| Rate for Payer: Priority Health Medicare |
$44.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.25
|
| Rate for Payer: Railroad Medicare Medicare |
$43.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.00
|
| Rate for Payer: UHC Core |
$146.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.75
|
| Rate for Payer: UHC Exchange |
$43.75
|
| Rate for Payer: UHC Medicare Advantage |
$43.75
|
| Rate for Payer: UHCCP Medicaid |
$140.75
|
| Rate for Payer: VA VA |
$43.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.25
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 11200
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$1,422.75 |
| Rate for Payer: Aetna Commercial |
$96.08
|
| Rate for Payer: Aetna Medicare |
$74.57
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS MAPPO |
$71.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.75
|
| Rate for Payer: BCN Commercial |
$107.59
|
| Rate for Payer: BCN Medicare Advantage |
$71.70
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$96.08
|
| Rate for Payer: Cofinity Commercial |
$103.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.70
|
| Rate for Payer: Mclaren Medicaid |
$49.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.28
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Nomi Health Commercial |
$86.04
|
| Rate for Payer: PACE SWMI |
$71.70
|
| Rate for Payer: PHP Medicare Advantage |
$71.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO |
$104.29
|
| Rate for Payer: Priority Health Medicare |
$72.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.70
|
| Rate for Payer: UHC Exchange |
$71.70
|
| Rate for Payer: UHC Medicare Advantage |
$71.70
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 11200
|
| Hospital Charge Code |
11200
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$1,422.75 |
| Rate for Payer: Aetna Commercial |
$96.08
|
| Rate for Payer: Aetna Medicare |
$74.57
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS MAPPO |
$71.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.75
|
| Rate for Payer: BCN Commercial |
$107.59
|
| Rate for Payer: BCN Medicare Advantage |
$71.70
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$96.08
|
| Rate for Payer: Cofinity Commercial |
$103.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.70
|
| Rate for Payer: Mclaren Medicaid |
$49.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.28
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Nomi Health Commercial |
$86.04
|
| Rate for Payer: PACE SWMI |
$71.70
|
| Rate for Payer: PHP Medicare Advantage |
$71.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO |
$104.29
|
| Rate for Payer: Priority Health Medicare |
$72.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.70
|
| Rate for Payer: UHC Exchange |
$71.70
|
| Rate for Payer: UHC Medicare Advantage |
$71.70
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$113.75 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$148.75
|
| Rate for Payer: BCBS Trust/PPO |
$142.85
|
| Rate for Payer: BCN Commercial |
$135.24
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.00
|
| Rate for Payer: Healthscope Commercial |
$157.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.75
|
| Rate for Payer: Nomi Health Commercial |
$143.50
|
| Rate for Payer: PHP Commercial |
$148.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO |
$152.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.00
|
| Rate for Payer: UHC Core |
$146.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.25
|
|
|
PR RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR
|
Professional
|
Both
|
$3,942.00
|
|
|
Service Code
|
HCPCS 63662
|
| Min. Negotiated Rate |
$556.57 |
| Max. Negotiated Rate |
$2,562.30 |
| Rate for Payer: Aetna Commercial |
$1,118.06
|
| Rate for Payer: Aetna Medicare |
$867.74
|
| Rate for Payer: BCBS Complete |
$584.40
|
| Rate for Payer: BCBS MAPPO |
$834.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.15
|
| Rate for Payer: BCN Commercial |
$1,251.99
|
| Rate for Payer: BCN Medicare Advantage |
$834.37
|
| Rate for Payer: Cash Price |
$3,153.60
|
| Rate for Payer: Cash Price |
$3,153.60
|
| Rate for Payer: Cofinity Commercial |
$1,201.49
|
| Rate for Payer: Cofinity Commercial |
$1,118.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$834.37
|
| Rate for Payer: Mclaren Medicaid |
$556.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.09
|
| Rate for Payer: Meridian Medicaid |
$584.40
|
| Rate for Payer: Nomi Health Commercial |
$1,001.24
|
| Rate for Payer: PACE SWMI |
$834.37
|
| Rate for Payer: PHP Medicare Advantage |
$834.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,562.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,478.09
|
| Rate for Payer: Priority Health Medicare |
$842.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,478.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$834.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$834.37
|
| Rate for Payer: UHC Exchange |
$834.37
|
| Rate for Payer: UHC Medicare Advantage |
$834.37
|
| Rate for Payer: UHCCP Medicaid |
$556.57
|
|
|
PR RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR
|
Professional
|
Both
|
$1,821.00
|
|
|
Service Code
|
HCPCS 63661
|
| Min. Negotiated Rate |
$213.21 |
| Max. Negotiated Rate |
$1,183.65 |
| Rate for Payer: Aetna Commercial |
$426.33
|
| Rate for Payer: Aetna Medicare |
$330.89
|
| Rate for Payer: BCBS Complete |
$223.87
|
| Rate for Payer: BCBS MAPPO |
$318.16
|
| Rate for Payer: BCBS Trust/PPO |
$409.43
|
| Rate for Payer: BCN Commercial |
$1,003.26
|
| Rate for Payer: BCN Medicare Advantage |
$318.16
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cofinity Commercial |
$458.15
|
| Rate for Payer: Cofinity Commercial |
$426.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.16
|
| Rate for Payer: Mclaren Medicaid |
$213.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.07
|
| Rate for Payer: Meridian Medicaid |
$223.87
|
| Rate for Payer: Nomi Health Commercial |
$381.79
|
| Rate for Payer: PACE SWMI |
$318.16
|
| Rate for Payer: PHP Medicare Advantage |
$318.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.65
|
| Rate for Payer: Priority Health HMO/PPO |
$565.87
|
| Rate for Payer: Priority Health Medicare |
$321.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$565.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.16
|
| Rate for Payer: UHC Exchange |
$318.16
|
| Rate for Payer: UHC Medicare Advantage |
$318.16
|
| Rate for Payer: UHCCP Medicaid |
$213.21
|
|
|
PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 62365
|
| Min. Negotiated Rate |
$178.57 |
| Max. Negotiated Rate |
$985.40 |
| Rate for Payer: Aetna Commercial |
$386.01
|
| Rate for Payer: Aetna Medicare |
$299.59
|
| Rate for Payer: BCBS Complete |
$203.74
|
| Rate for Payer: BCBS MAPPO |
$288.07
|
| Rate for Payer: BCBS Trust/PPO |
$178.57
|
| Rate for Payer: BCN Commercial |
$434.93
|
| Rate for Payer: BCN Medicare Advantage |
$288.07
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cofinity Commercial |
$414.82
|
| Rate for Payer: Cofinity Commercial |
$386.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.07
|
| Rate for Payer: Mclaren Medicaid |
$194.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.47
|
| Rate for Payer: Meridian Medicaid |
$203.74
|
| Rate for Payer: Nomi Health Commercial |
$345.68
|
| Rate for Payer: PACE SWMI |
$288.07
|
| Rate for Payer: PHP Medicare Advantage |
$288.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health HMO/PPO |
$515.25
|
| Rate for Payer: Priority Health Medicare |
$290.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$515.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.07
|
| Rate for Payer: UHC Exchange |
$288.07
|
| Rate for Payer: UHC Medicare Advantage |
$288.07
|
| Rate for Payer: UHCCP Medicaid |
$194.04
|
|
|
PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 26392
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$1,544.90 |
| Rate for Payer: Aetna Commercial |
$1,258.10
|
| Rate for Payer: Aetna Medicare |
$976.44
|
| Rate for Payer: BCBS Complete |
$675.87
|
| Rate for Payer: BCBS MAPPO |
$938.88
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$1,485.09
|
| Rate for Payer: BCN Medicare Advantage |
$938.88
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,351.99
|
| Rate for Payer: Cofinity Commercial |
$1,258.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.88
|
| Rate for Payer: Mclaren Medicaid |
$643.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.82
|
| Rate for Payer: Meridian Medicaid |
$675.87
|
| Rate for Payer: Nomi Health Commercial |
$1,126.66
|
| Rate for Payer: PACE SWMI |
$938.88
|
| Rate for Payer: PHP Medicare Advantage |
$938.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,544.90
|
| Rate for Payer: Priority Health Medicare |
$948.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,544.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$938.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$938.88
|
| Rate for Payer: UHC Exchange |
$938.88
|
| Rate for Payer: UHC Medicare Advantage |
$938.88
|
| Rate for Payer: UHCCP Medicaid |
$643.69
|
|
|
PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 46754
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$512.14 |
| Rate for Payer: Aetna Commercial |
$307.57
|
| Rate for Payer: Aetna Medicare |
$238.71
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$229.53
|
| Rate for Payer: BCBS Trust/PPO |
$396.75
|
| Rate for Payer: BCN Commercial |
$512.14
|
| Rate for Payer: BCN Medicare Advantage |
$229.53
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$330.52
|
| Rate for Payer: Cofinity Commercial |
$307.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.53
|
| Rate for Payer: Mclaren Medicaid |
$157.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.01
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Nomi Health Commercial |
$275.44
|
| Rate for Payer: PACE SWMI |
$229.53
|
| Rate for Payer: PHP Medicare Advantage |
$229.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.80
|
| Rate for Payer: Priority Health HMO/PPO |
$437.31
|
| Rate for Payer: Priority Health Medicare |
$231.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$437.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.53
|
| Rate for Payer: UHC Exchange |
$229.53
|
| Rate for Payer: UHC Medicare Advantage |
$229.53
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
|
