|
PR SCROTAL EXPLORATION
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 55110
|
| Min. Negotiated Rate |
$251.55 |
| Max. Negotiated Rate |
$2,153.88 |
| Rate for Payer: Aetna Commercial |
$500.07
|
| Rate for Payer: Aetna Medicare |
$388.12
|
| Rate for Payer: BCBS Complete |
$264.13
|
| Rate for Payer: BCBS MAPPO |
$373.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,153.88
|
| Rate for Payer: BCN Commercial |
$562.96
|
| Rate for Payer: BCN Medicare Advantage |
$373.19
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$537.39
|
| Rate for Payer: Cofinity Commercial |
$500.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.19
|
| Rate for Payer: Mclaren Medicaid |
$251.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.85
|
| Rate for Payer: Meridian Medicaid |
$264.13
|
| Rate for Payer: Nomi Health Commercial |
$447.83
|
| Rate for Payer: PACE SWMI |
$373.19
|
| Rate for Payer: PHP Medicare Advantage |
$373.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$456.30
|
| Rate for Payer: Priority Health HMO/PPO |
$622.61
|
| Rate for Payer: Priority Health Medicare |
$376.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$622.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.19
|
| Rate for Payer: UHC Exchange |
$373.19
|
| Rate for Payer: UHC Medicare Advantage |
$373.19
|
| Rate for Payer: UHCCP Medicaid |
$251.55
|
|
|
PR SCROTOPLASTY COMPLICATED
|
Professional
|
Both
|
$1,414.00
|
|
|
Service Code
|
HCPCS 55180
|
| Min. Negotiated Rate |
$442.40 |
| Max. Negotiated Rate |
$1,956.82 |
| Rate for Payer: Aetna Commercial |
$882.27
|
| Rate for Payer: Aetna Medicare |
$684.75
|
| Rate for Payer: BCBS Complete |
$464.52
|
| Rate for Payer: BCBS MAPPO |
$658.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,956.82
|
| Rate for Payer: BCN Commercial |
$996.41
|
| Rate for Payer: BCN Medicare Advantage |
$658.41
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cofinity Commercial |
$948.11
|
| Rate for Payer: Cofinity Commercial |
$882.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.41
|
| Rate for Payer: Mclaren Medicaid |
$442.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.33
|
| Rate for Payer: Meridian Medicaid |
$464.52
|
| Rate for Payer: Nomi Health Commercial |
$790.09
|
| Rate for Payer: PACE SWMI |
$658.41
|
| Rate for Payer: PHP Medicare Advantage |
$658.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,099.28
|
| Rate for Payer: Priority Health Medicare |
$664.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,099.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.41
|
| Rate for Payer: UHC Exchange |
$658.41
|
| Rate for Payer: UHC Medicare Advantage |
$658.41
|
| Rate for Payer: UHCCP Medicaid |
$442.40
|
|
|
PR SCROTOPLASTY SIMPLE
|
Professional
|
Both
|
$684.00
|
|
|
Service Code
|
HCPCS 55175
|
| Min. Negotiated Rate |
$236.22 |
| Max. Negotiated Rate |
$1,287.47 |
| Rate for Payer: Aetna Commercial |
$468.73
|
| Rate for Payer: Aetna Medicare |
$363.79
|
| Rate for Payer: BCBS Complete |
$248.03
|
| Rate for Payer: BCBS MAPPO |
$349.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.47
|
| Rate for Payer: BCN Commercial |
$530.22
|
| Rate for Payer: BCN Medicare Advantage |
$349.80
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Cofinity Commercial |
$503.71
|
| Rate for Payer: Cofinity Commercial |
$468.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.80
|
| Rate for Payer: Mclaren Medicaid |
$236.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.29
|
| Rate for Payer: Meridian Medicaid |
$248.03
|
| Rate for Payer: Nomi Health Commercial |
$419.76
|
| Rate for Payer: PACE SWMI |
$349.80
|
| Rate for Payer: PHP Medicare Advantage |
$349.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.60
|
| Rate for Payer: Priority Health HMO/PPO |
$585.86
|
| Rate for Payer: Priority Health Medicare |
$353.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.80
|
| Rate for Payer: UHC Exchange |
$349.80
|
| Rate for Payer: UHC Medicare Advantage |
$349.80
|
| Rate for Payer: UHCCP Medicaid |
$236.22
|
|
|
PR SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN
|
Professional
|
Both
|
$2,346.00
|
|
|
Service Code
|
HCPCS 49900
|
| Min. Negotiated Rate |
$533.78 |
| Max. Negotiated Rate |
$4,854.55 |
| Rate for Payer: Aetna Commercial |
$1,070.57
|
| Rate for Payer: Aetna Medicare |
$830.89
|
| Rate for Payer: BCBS Complete |
$560.47
|
| Rate for Payer: BCBS MAPPO |
$798.93
|
| Rate for Payer: BCBS Trust/PPO |
$4,854.55
|
| Rate for Payer: BCN Commercial |
$1,200.68
|
| Rate for Payer: BCN Medicare Advantage |
$798.93
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$1,150.46
|
| Rate for Payer: Cofinity Commercial |
$1,070.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$798.93
|
| Rate for Payer: Mclaren Medicaid |
$533.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$838.88
|
| Rate for Payer: Meridian Medicaid |
$560.47
|
| Rate for Payer: Nomi Health Commercial |
$958.72
|
| Rate for Payer: PACE SWMI |
$798.93
|
| Rate for Payer: PHP Medicare Advantage |
$798.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$533.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,524.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,482.53
|
| Rate for Payer: Priority Health Medicare |
$806.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,482.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$798.93
|
| Rate for Payer: UHC Exchange |
$798.93
|
| Rate for Payer: UHC Medicare Advantage |
$798.93
|
| Rate for Payer: UHCCP Medicaid |
$533.78
|
|
|
PR SECONDARY CLOSURE SURG WOUND/DEHSN XTNSV/COMP
|
Professional
|
Both
|
$1,792.00
|
|
|
Service Code
|
HCPCS 13160
|
| Min. Negotiated Rate |
$349.63 |
| Max. Negotiated Rate |
$1,164.80 |
| Rate for Payer: Aetna Commercial |
$1,022.26
|
| Rate for Payer: Aetna Medicare |
$793.40
|
| Rate for Payer: BCBS Complete |
$539.45
|
| Rate for Payer: BCBS MAPPO |
$762.88
|
| Rate for Payer: BCBS Trust/PPO |
$349.63
|
| Rate for Payer: BCN Commercial |
$1,160.61
|
| Rate for Payer: BCN Medicare Advantage |
$762.88
|
| Rate for Payer: Cash Price |
$1,433.60
|
| Rate for Payer: Cash Price |
$1,433.60
|
| Rate for Payer: Cofinity Commercial |
$1,098.55
|
| Rate for Payer: Cofinity Commercial |
$1,022.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.88
|
| Rate for Payer: Mclaren Medicaid |
$513.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.02
|
| Rate for Payer: Meridian Medicaid |
$539.45
|
| Rate for Payer: Nomi Health Commercial |
$915.46
|
| Rate for Payer: PACE SWMI |
$762.88
|
| Rate for Payer: PHP Medicare Advantage |
$762.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$513.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,164.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,078.68
|
| Rate for Payer: Priority Health Medicare |
$770.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,078.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$762.88
|
| Rate for Payer: UHC Exchange |
$762.88
|
| Rate for Payer: UHC Medicare Advantage |
$762.88
|
| Rate for Payer: UHCCP Medicaid |
$513.76
|
|
|
PR SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ
|
Professional
|
Both
|
$4,570.00
|
|
|
Service Code
|
HCPCS 21275
|
| Min. Negotiated Rate |
$544.43 |
| Max. Negotiated Rate |
$3,205.12 |
| Rate for Payer: Aetna Commercial |
$1,078.94
|
| Rate for Payer: Aetna Medicare |
$837.39
|
| Rate for Payer: BCBS Complete |
$571.65
|
| Rate for Payer: BCBS MAPPO |
$805.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,205.12
|
| Rate for Payer: BCN Commercial |
$1,235.37
|
| Rate for Payer: BCN Medicare Advantage |
$805.18
|
| Rate for Payer: Cash Price |
$3,656.00
|
| Rate for Payer: Cash Price |
$3,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,159.46
|
| Rate for Payer: Cofinity Commercial |
$1,078.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.18
|
| Rate for Payer: Mclaren Medicaid |
$544.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.44
|
| Rate for Payer: Meridian Medicaid |
$571.65
|
| Rate for Payer: Nomi Health Commercial |
$966.22
|
| Rate for Payer: PACE SWMI |
$805.18
|
| Rate for Payer: PHP Medicare Advantage |
$805.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,970.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,290.97
|
| Rate for Payer: Priority Health Medicare |
$813.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,290.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$805.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.18
|
| Rate for Payer: UHC Exchange |
$805.18
|
| Rate for Payer: UHC Medicare Advantage |
$805.18
|
| Rate for Payer: UHCCP Medicaid |
$544.43
|
|
|
PR SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT
|
Professional
|
Both
|
$6,290.00
|
|
|
Service Code
|
HCPCS 61618
|
| Min. Negotiated Rate |
$44.38 |
| Max. Negotiated Rate |
$4,088.50 |
| Rate for Payer: Aetna Commercial |
$1,701.05
|
| Rate for Payer: Aetna Medicare |
$1,320.22
|
| Rate for Payer: BCBS Complete |
$882.30
|
| Rate for Payer: BCBS MAPPO |
$1,269.44
|
| Rate for Payer: BCBS Trust/PPO |
$44.38
|
| Rate for Payer: BCN Commercial |
$2,635.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,269.44
|
| Rate for Payer: Cash Price |
$5,032.00
|
| Rate for Payer: Cash Price |
$5,032.00
|
| Rate for Payer: Cofinity Commercial |
$1,827.99
|
| Rate for Payer: Cofinity Commercial |
$1,701.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,269.44
|
| Rate for Payer: Mclaren Medicaid |
$840.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,332.91
|
| Rate for Payer: Meridian Medicaid |
$882.30
|
| Rate for Payer: Nomi Health Commercial |
$1,523.33
|
| Rate for Payer: PACE SWMI |
$1,269.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,269.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,088.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,221.97
|
| Rate for Payer: Priority Health Medicare |
$1,282.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,221.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,269.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,269.44
|
| Rate for Payer: UHC Exchange |
$1,269.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,269.44
|
| Rate for Payer: UHCCP Medicaid |
$840.29
|
|
|
PR SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL
|
Professional
|
Both
|
$2,567.00
|
|
|
Service Code
|
HCPCS 37186
|
| Min. Negotiated Rate |
$152.51 |
| Max. Negotiated Rate |
$1,745.07 |
| Rate for Payer: Priority Health Cigna Priority Health |
$1,668.55
|
| Rate for Payer: Priority Health HMO/PPO |
$377.59
|
| Rate for Payer: Priority Health Medicare |
$236.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.80
|
| Rate for Payer: UHC Exchange |
$233.80
|
| Rate for Payer: UHC Medicare Advantage |
$233.80
|
| Rate for Payer: UHCCP Medicaid |
$152.51
|
| Rate for Payer: Aetna Commercial |
$313.29
|
| Rate for Payer: Aetna Medicare |
$243.15
|
| Rate for Payer: BCBS Complete |
$160.14
|
| Rate for Payer: BCBS MAPPO |
$233.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.73
|
| Rate for Payer: BCN Commercial |
$1,745.07
|
| Rate for Payer: BCN Medicare Advantage |
$233.80
|
| Rate for Payer: Cash Price |
$2,053.60
|
| Rate for Payer: Cash Price |
$2,053.60
|
| Rate for Payer: Cofinity Commercial |
$336.67
|
| Rate for Payer: Cofinity Commercial |
$313.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.80
|
| Rate for Payer: Mclaren Medicaid |
$152.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.49
|
| Rate for Payer: Meridian Medicaid |
$160.14
|
| Rate for Payer: Nomi Health Commercial |
$280.56
|
| Rate for Payer: PACE SWMI |
$233.80
|
| Rate for Payer: PHP Medicare Advantage |
$233.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.51
|
|
|
PR SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP
|
Professional
|
Both
|
$9,939.00
|
|
|
Service Code
|
HCPCS 61619
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$6,460.35 |
| Rate for Payer: Aetna Commercial |
$1,861.97
|
| Rate for Payer: Aetna Medicare |
$1,445.11
|
| Rate for Payer: BCBS Complete |
$968.18
|
| Rate for Payer: BCBS MAPPO |
$1,389.53
|
| Rate for Payer: BCBS Trust/PPO |
$18.49
|
| Rate for Payer: BCN Commercial |
$2,915.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.53
|
| Rate for Payer: Cash Price |
$7,951.20
|
| Rate for Payer: Cash Price |
$7,951.20
|
| Rate for Payer: Cofinity Commercial |
$1,861.97
|
| Rate for Payer: Cofinity Commercial |
$2,000.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.53
|
| Rate for Payer: Mclaren Medicaid |
$922.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,459.01
|
| Rate for Payer: Meridian Medicaid |
$968.18
|
| Rate for Payer: Nomi Health Commercial |
$1,667.44
|
| Rate for Payer: PACE SWMI |
$1,389.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$922.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,460.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,464.81
|
| Rate for Payer: Priority Health Medicare |
$1,403.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,464.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,389.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.53
|
| Rate for Payer: UHC Exchange |
$1,389.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,389.53
|
| Rate for Payer: UHCCP Medicaid |
$922.08
|
|
|
PR SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 97535
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$88.75 |
| Rate for Payer: Aetna Commercial |
$40.94
|
| Rate for Payer: Aetna Medicare |
$31.77
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$30.55
|
| Rate for Payer: BCBS Trust/PPO |
$88.75
|
| Rate for Payer: BCN Commercial |
$31.97
|
| Rate for Payer: BCN Medicare Advantage |
$30.55
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$43.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.08
|
| Rate for Payer: Nomi Health Commercial |
$36.66
|
| Rate for Payer: PACE SWMI |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.55
|
| Rate for Payer: UHC Exchange |
$30.55
|
| Rate for Payer: UHC Medicare Advantage |
$30.55
|
|
|
PR SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 92060
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$970.49 |
| Rate for Payer: Aetna Commercial |
$78.31
|
| Rate for Payer: Aetna Medicare |
$60.78
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS MAPPO |
$58.44
|
| Rate for Payer: BCBS Trust/PPO |
$970.49
|
| Rate for Payer: BCN Commercial |
$91.87
|
| Rate for Payer: BCN Medicare Advantage |
$58.44
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$84.15
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.44
|
| Rate for Payer: Mclaren Medicaid |
$23.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.36
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Nomi Health Commercial |
$70.13
|
| Rate for Payer: PACE SWMI |
$58.44
|
| Rate for Payer: PHP Medicare Advantage |
$58.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$59.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.44
|
| Rate for Payer: UHC Exchange |
$58.44
|
| Rate for Payer: UHC Medicare Advantage |
$58.44
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
|
|
PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 30520
|
| Min. Negotiated Rate |
$430.47 |
| Max. Negotiated Rate |
$2,055.30 |
| Rate for Payer: Aetna Commercial |
$836.66
|
| Rate for Payer: Aetna Commercial |
$836.66
|
| Rate for Payer: Aetna Medicare |
$649.34
|
| Rate for Payer: Aetna Medicare |
$649.34
|
| Rate for Payer: BCBS Complete |
$451.99
|
| Rate for Payer: BCBS Complete |
$451.99
|
| Rate for Payer: BCBS MAPPO |
$624.37
|
| Rate for Payer: BCBS MAPPO |
$624.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCN Commercial |
$999.83
|
| Rate for Payer: BCN Commercial |
$999.83
|
| Rate for Payer: BCN Medicare Advantage |
$624.37
|
| Rate for Payer: BCN Medicare Advantage |
$624.37
|
| Rate for Payer: Cash Price |
$1,456.00
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cash Price |
$1,456.00
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cofinity Commercial |
$899.09
|
| Rate for Payer: Cofinity Commercial |
$836.66
|
| Rate for Payer: Cofinity Commercial |
$899.09
|
| Rate for Payer: Cofinity Commercial |
$836.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.37
|
| Rate for Payer: Mclaren Medicaid |
$430.47
|
| Rate for Payer: Mclaren Medicaid |
$430.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.59
|
| Rate for Payer: Meridian Medicaid |
$451.99
|
| Rate for Payer: Meridian Medicaid |
$451.99
|
| Rate for Payer: Nomi Health Commercial |
$749.24
|
| Rate for Payer: Nomi Health Commercial |
$749.24
|
| Rate for Payer: PACE SWMI |
$624.37
|
| Rate for Payer: PACE SWMI |
$624.37
|
| Rate for Payer: PHP Medicare Advantage |
$624.37
|
| Rate for Payer: PHP Medicare Advantage |
$624.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.00
|
| Rate for Payer: Priority Health HMO/PPO |
$946.86
|
| Rate for Payer: Priority Health HMO/PPO |
$946.86
|
| Rate for Payer: Priority Health Medicare |
$630.61
|
| Rate for Payer: Priority Health Medicare |
$630.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.37
|
| Rate for Payer: UHC Exchange |
$624.37
|
| Rate for Payer: UHC Exchange |
$624.37
|
| Rate for Payer: UHC Medicare Advantage |
$624.37
|
| Rate for Payer: UHC Medicare Advantage |
$624.37
|
| Rate for Payer: UHCCP Medicaid |
$430.47
|
| Rate for Payer: UHCCP Medicaid |
$430.47
|
|
|
PR SEQUESTRECTOMY FOREARM &/WRIST
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
HCPCS 25145
|
| Min. Negotiated Rate |
$334.94 |
| Max. Negotiated Rate |
$1,467.05 |
| Rate for Payer: Aetna Commercial |
$677.88
|
| Rate for Payer: Aetna Medicare |
$526.12
|
| Rate for Payer: BCBS Complete |
$360.97
|
| Rate for Payer: BCBS MAPPO |
$505.88
|
| Rate for Payer: BCBS Trust/PPO |
$334.94
|
| Rate for Payer: BCN Commercial |
$772.60
|
| Rate for Payer: BCN Medicare Advantage |
$505.88
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cofinity Commercial |
$728.47
|
| Rate for Payer: Cofinity Commercial |
$677.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.88
|
| Rate for Payer: Mclaren Medicaid |
$343.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.17
|
| Rate for Payer: Meridian Medicaid |
$360.97
|
| Rate for Payer: Nomi Health Commercial |
$607.06
|
| Rate for Payer: PACE SWMI |
$505.88
|
| Rate for Payer: PHP Medicare Advantage |
$505.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.05
|
| Rate for Payer: Priority Health HMO/PPO |
$813.67
|
| Rate for Payer: Priority Health Medicare |
$510.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$813.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.88
|
| Rate for Payer: UHC Exchange |
$505.88
|
| Rate for Payer: UHC Medicare Advantage |
$505.88
|
| Rate for Payer: UHCCP Medicaid |
$343.78
|
|
|
PR SEQUESTRECTOMY SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 24134
|
| Min. Negotiated Rate |
$175.92 |
| Max. Negotiated Rate |
$1,443.00 |
| Rate for Payer: Aetna Commercial |
$970.40
|
| Rate for Payer: Aetna Medicare |
$753.15
|
| Rate for Payer: BCBS Complete |
$513.72
|
| Rate for Payer: BCBS MAPPO |
$724.18
|
| Rate for Payer: BCBS Trust/PPO |
$175.92
|
| Rate for Payer: BCN Commercial |
$1,101.97
|
| Rate for Payer: BCN Medicare Advantage |
$724.18
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$970.40
|
| Rate for Payer: Cofinity Commercial |
$1,042.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.18
|
| Rate for Payer: Mclaren Medicaid |
$489.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$760.39
|
| Rate for Payer: Meridian Medicaid |
$513.72
|
| Rate for Payer: Nomi Health Commercial |
$869.02
|
| Rate for Payer: PACE SWMI |
$724.18
|
| Rate for Payer: PHP Medicare Advantage |
$724.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,157.66
|
| Rate for Payer: Priority Health Medicare |
$731.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,157.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.18
|
| Rate for Payer: UHC Exchange |
$724.18
|
| Rate for Payer: UHC Medicare Advantage |
$724.18
|
| Rate for Payer: UHCCP Medicaid |
$489.26
|
|
|
PR SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 99050
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$608.60 |
| Rate for Payer: Aetna Commercial |
$23.50
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Trust/PPO |
$608.60
|
| Rate for Payer: BCN Commercial |
$20.16
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO |
$24.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.43
|
|
|
PR SESAMOIDECTOMY FIRST TOE SPX
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
HCPCS 28315
|
| Min. Negotiated Rate |
$212.57 |
| Max. Negotiated Rate |
$1,893.96 |
| Rate for Payer: Aetna Commercial |
$419.15
|
| Rate for Payer: Aetna Medicare |
$325.31
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS MAPPO |
$312.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.96
|
| Rate for Payer: BCN Commercial |
$697.34
|
| Rate for Payer: BCN Medicare Advantage |
$312.80
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cofinity Commercial |
$450.43
|
| Rate for Payer: Cofinity Commercial |
$419.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.80
|
| Rate for Payer: Mclaren Medicaid |
$212.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.44
|
| Rate for Payer: Meridian Medicaid |
$223.20
|
| Rate for Payer: Nomi Health Commercial |
$375.36
|
| Rate for Payer: PACE SWMI |
$312.80
|
| Rate for Payer: PHP Medicare Advantage |
$312.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.85
|
| Rate for Payer: Priority Health HMO/PPO |
$502.25
|
| Rate for Payer: Priority Health Medicare |
$315.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$502.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.80
|
| Rate for Payer: UHC Exchange |
$312.80
|
| Rate for Payer: UHC Medicare Advantage |
$312.80
|
| Rate for Payer: UHCCP Medicaid |
$212.57
|
|
|
PR SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,680.00
|
|
|
Service Code
|
HCPCS 26185
|
| Min. Negotiated Rate |
$369.13 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna Commercial |
$724.79
|
| Rate for Payer: Aetna Medicare |
$562.53
|
| Rate for Payer: BCBS Complete |
$387.59
|
| Rate for Payer: BCBS MAPPO |
$540.89
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$825.87
|
| Rate for Payer: BCN Medicare Advantage |
$540.89
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cofinity Commercial |
$778.88
|
| Rate for Payer: Cofinity Commercial |
$724.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.89
|
| Rate for Payer: Mclaren Medicaid |
$369.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$567.93
|
| Rate for Payer: Meridian Medicaid |
$387.59
|
| Rate for Payer: Nomi Health Commercial |
$649.07
|
| Rate for Payer: PACE SWMI |
$540.89
|
| Rate for Payer: PHP Medicare Advantage |
$540.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.00
|
| Rate for Payer: Priority Health HMO/PPO |
$871.67
|
| Rate for Payer: Priority Health Medicare |
$546.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$871.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$540.89
|
| Rate for Payer: UHC Exchange |
$540.89
|
| Rate for Payer: UHC Medicare Advantage |
$540.89
|
| Rate for Payer: UHCCP Medicaid |
$369.13
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$154.38 |
| Max. Negotiated Rate |
$678.18 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna Medicare |
$169.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$203.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$203.12
|
| Rate for Payer: BCBS Complete |
$678.18
|
| Rate for Payer: BCBS MAPPO |
$162.50
|
| Rate for Payer: BCBS Trust/PPO |
$534.36
|
| Rate for Payer: BCN Commercial |
$505.38
|
| Rate for Payer: BCN Medicare Advantage |
$162.50
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.50
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Mclaren Medicaid |
$645.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.62
|
| Rate for Payer: Meridian Medicaid |
$678.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.50
|
| Rate for Payer: Nomi Health Commercial |
$533.00
|
| Rate for Payer: PACE Senior Care Partners |
$154.38
|
| Rate for Payer: PACE SWMI |
$162.50
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: PHP Medicare Advantage |
$162.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO |
$565.50
|
| Rate for Payer: Priority Health Medicare |
$164.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.50
|
| Rate for Payer: Railroad Medicare Medicare |
$162.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.00
|
| Rate for Payer: UHC Core |
$542.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.50
|
| Rate for Payer: UHC Exchange |
$162.50
|
| Rate for Payer: UHC Medicare Advantage |
$162.50
|
| Rate for Payer: UHCCP Medicaid |
$645.84
|
| Rate for Payer: VA VA |
$162.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$430.03 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$430.03
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Nomi Health Commercial |
$76.64
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO |
$118.72
|
| Rate for Payer: Priority Health Medicare |
$64.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Exchange |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$422.50 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: BCBS Trust/PPO |
$530.60
|
| Rate for Payer: BCN Commercial |
$502.32
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.50
|
| Rate for Payer: Nomi Health Commercial |
$533.00
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO |
$565.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.00
|
| Rate for Payer: UHC Core |
$542.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 45335
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$430.03 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$430.03
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Nomi Health Commercial |
$76.64
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO |
$118.72
|
| Rate for Payer: Priority Health Medicare |
$64.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Exchange |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45338
|
| Min. Negotiated Rate |
$76.08 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$118.23
|
| Rate for Payer: BCBS Complete |
$80.06
|
| Rate for Payer: BCBS MAPPO |
$113.68
|
| Rate for Payer: BCBS Trust/PPO |
$76.08
|
| Rate for Payer: BCN Commercial |
$439.81
|
| Rate for Payer: BCN Medicare Advantage |
$113.68
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$152.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.68
|
| Rate for Payer: Mclaren Medicaid |
$76.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.36
|
| Rate for Payer: Meridian Medicaid |
$80.06
|
| Rate for Payer: Nomi Health Commercial |
$136.42
|
| Rate for Payer: PACE SWMI |
$113.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$212.38
|
| Rate for Payer: Priority Health Medicare |
$114.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.68
|
| Rate for Payer: UHC Exchange |
$113.68
|
| Rate for Payer: UHC Medicare Advantage |
$113.68
|
| Rate for Payer: UHCCP Medicaid |
$76.25
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$488.15 |
| Max. Negotiated Rate |
$675.90 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: BCBS Trust/PPO |
$613.04
|
| Rate for Payer: BCN Commercial |
$580.37
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$615.82
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$653.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.88
|
| Rate for Payer: UHC Core |
$627.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.25
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$178.36 |
| Max. Negotiated Rate |
$877.06 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna Medicare |
$195.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$234.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$234.69
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$187.75
|
| Rate for Payer: BCBS Trust/PPO |
$617.40
|
| Rate for Payer: BCN Commercial |
$583.90
|
| Rate for Payer: BCN Medicare Advantage |
$187.75
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.75
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.25
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.14
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$615.82
|
| Rate for Payer: PACE Senior Care Partners |
$178.36
|
| Rate for Payer: PACE SWMI |
$187.75
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: PHP Medicare Advantage |
$187.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$653.37
|
| Rate for Payer: Priority Health Medicare |
$189.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.17
|
| Rate for Payer: Railroad Medicare Medicare |
$187.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.88
|
| Rate for Payer: UHC Core |
$627.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.75
|
| Rate for Payer: UHC Exchange |
$187.75
|
| Rate for Payer: UHC Medicare Advantage |
$187.75
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$187.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.25
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$76.08 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$118.23
|
| Rate for Payer: BCBS Complete |
$80.06
|
| Rate for Payer: BCBS MAPPO |
$113.68
|
| Rate for Payer: BCBS Trust/PPO |
$76.08
|
| Rate for Payer: BCN Commercial |
$439.81
|
| Rate for Payer: BCN Medicare Advantage |
$113.68
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$152.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.68
|
| Rate for Payer: Mclaren Medicaid |
$76.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.36
|
| Rate for Payer: Meridian Medicaid |
$80.06
|
| Rate for Payer: Nomi Health Commercial |
$136.42
|
| Rate for Payer: PACE SWMI |
$113.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$212.38
|
| Rate for Payer: Priority Health Medicare |
$114.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.68
|
| Rate for Payer: UHC Exchange |
$113.68
|
| Rate for Payer: UHC Medicare Advantage |
$113.68
|
| Rate for Payer: UHCCP Medicaid |
$76.25
|
|
