|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,474.00
|
|
|
Service Code
|
HCPCS 25295
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$958.10 |
| Rate for Payer: Aetna Commercial |
$684.38
|
| Rate for Payer: Aetna Medicare |
$531.16
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCBS MAPPO |
$510.73
|
| Rate for Payer: BCBS Trust/PPO |
$803.02
|
| Rate for Payer: BCN Commercial |
$781.39
|
| Rate for Payer: BCN Medicare Advantage |
$510.73
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$735.45
|
| Rate for Payer: Cofinity Commercial |
$684.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.73
|
| Rate for Payer: Mclaren Medicaid |
$347.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.27
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Nomi Health Commercial |
$612.88
|
| Rate for Payer: PACE SWMI |
$510.73
|
| Rate for Payer: PHP Medicare Advantage |
$510.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.10
|
| Rate for Payer: Priority Health HMO/PPO |
$821.30
|
| Rate for Payer: Priority Health Medicare |
$515.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.73
|
| Rate for Payer: UHC Exchange |
$510.73
|
| Rate for Payer: UHC Medicare Advantage |
$510.73
|
| Rate for Payer: UHCCP Medicaid |
$347.40
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Facility
|
OP
|
$1,474.00
|
|
|
Service Code
|
CPT 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$350.08 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$1,252.90
|
| Rate for Payer: Aetna Medicare |
$383.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$460.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$460.62
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$368.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,211.78
|
| Rate for Payer: BCN Commercial |
$1,146.04
|
| Rate for Payer: BCN Medicare Advantage |
$368.50
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$1,267.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.50
|
| Rate for Payer: Healthscope Commercial |
$1,326.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,105.50
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.92
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$423.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,252.90
|
| Rate for Payer: Nomi Health Commercial |
$1,208.68
|
| Rate for Payer: PACE Senior Care Partners |
$350.08
|
| Rate for Payer: PACE SWMI |
$368.50
|
| Rate for Payer: PHP Commercial |
$1,252.90
|
| Rate for Payer: PHP Medicare Advantage |
$368.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,282.38
|
| Rate for Payer: Priority Health Medicare |
$372.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$987.58
|
| Rate for Payer: Railroad Medicare Medicare |
$368.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,297.12
|
| Rate for Payer: UHC Core |
$1,230.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$368.50
|
| Rate for Payer: UHC Exchange |
$368.50
|
| Rate for Payer: UHC Medicare Advantage |
$368.50
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$368.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,105.50
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24358
|
| Min. Negotiated Rate |
$222.41 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$688.60
|
| Rate for Payer: Aetna Medicare |
$534.44
|
| Rate for Payer: BCBS Complete |
$367.24
|
| Rate for Payer: BCBS MAPPO |
$513.88
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCN Commercial |
$783.35
|
| Rate for Payer: BCN Medicare Advantage |
$513.88
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$739.99
|
| Rate for Payer: Cofinity Commercial |
$688.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.88
|
| Rate for Payer: Mclaren Medicaid |
$349.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$539.57
|
| Rate for Payer: Meridian Medicaid |
$367.24
|
| Rate for Payer: Nomi Health Commercial |
$616.66
|
| Rate for Payer: PACE SWMI |
$513.88
|
| Rate for Payer: PHP Medicare Advantage |
$513.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO |
$825.89
|
| Rate for Payer: Priority Health Medicare |
$519.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$825.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$513.88
|
| Rate for Payer: UHC Exchange |
$513.88
|
| Rate for Payer: UHC Medicare Advantage |
$513.88
|
| Rate for Payer: UHCCP Medicaid |
$349.75
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Facility
|
IP
|
$1,853.00
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
24359
|
| Min. Negotiated Rate |
$1,204.45 |
| Max. Negotiated Rate |
$1,667.70 |
| Rate for Payer: Aetna Commercial |
$1,575.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,512.60
|
| Rate for Payer: BCN Commercial |
$1,432.00
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$1,593.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,482.40
|
| Rate for Payer: Healthscope Commercial |
$1,667.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,389.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,575.05
|
| Rate for Payer: Nomi Health Commercial |
$1,519.46
|
| Rate for Payer: PHP Commercial |
$1,575.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,612.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,241.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,630.64
|
| Rate for Payer: UHC Core |
$1,547.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,389.75
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 24359
|
| Hospital Charge Code |
24359
|
| Min. Negotiated Rate |
$191.45 |
| Max. Negotiated Rate |
$1,204.45 |
| Rate for Payer: Aetna Commercial |
$860.21
|
| Rate for Payer: Aetna Medicare |
$667.63
|
| Rate for Payer: BCBS Complete |
$456.47
|
| Rate for Payer: BCBS MAPPO |
$641.95
|
| Rate for Payer: BCBS Trust/PPO |
$191.45
|
| Rate for Payer: BCN Commercial |
$978.82
|
| Rate for Payer: BCN Medicare Advantage |
$641.95
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$924.41
|
| Rate for Payer: Cofinity Commercial |
$860.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.95
|
| Rate for Payer: Mclaren Medicaid |
$434.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$674.05
|
| Rate for Payer: Meridian Medicaid |
$456.47
|
| Rate for Payer: Nomi Health Commercial |
$770.34
|
| Rate for Payer: PACE SWMI |
$641.95
|
| Rate for Payer: PHP Medicare Advantage |
$641.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,029.94
|
| Rate for Payer: Priority Health Medicare |
$648.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,029.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.95
|
| Rate for Payer: UHC Exchange |
$641.95
|
| Rate for Payer: UHC Medicare Advantage |
$641.95
|
| Rate for Payer: UHCCP Medicaid |
$434.73
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 24359
|
| Min. Negotiated Rate |
$191.45 |
| Max. Negotiated Rate |
$1,204.45 |
| Rate for Payer: Aetna Commercial |
$860.21
|
| Rate for Payer: Aetna Medicare |
$667.63
|
| Rate for Payer: BCBS Complete |
$456.47
|
| Rate for Payer: BCBS MAPPO |
$641.95
|
| Rate for Payer: BCBS Trust/PPO |
$191.45
|
| Rate for Payer: BCN Commercial |
$978.82
|
| Rate for Payer: BCN Medicare Advantage |
$641.95
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$924.41
|
| Rate for Payer: Cofinity Commercial |
$860.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.95
|
| Rate for Payer: Mclaren Medicaid |
$434.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$674.05
|
| Rate for Payer: Meridian Medicaid |
$456.47
|
| Rate for Payer: Nomi Health Commercial |
$770.34
|
| Rate for Payer: PACE SWMI |
$641.95
|
| Rate for Payer: PHP Medicare Advantage |
$641.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,029.94
|
| Rate for Payer: Priority Health Medicare |
$648.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,029.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.95
|
| Rate for Payer: UHC Exchange |
$641.95
|
| Rate for Payer: UHC Medicare Advantage |
$641.95
|
| Rate for Payer: UHCCP Medicaid |
$434.73
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Facility
|
OP
|
$1,853.00
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
24359
|
| Min. Negotiated Rate |
$440.09 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$1,575.05
|
| Rate for Payer: Aetna Medicare |
$481.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$579.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$579.06
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$463.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.35
|
| Rate for Payer: BCN Commercial |
$1,440.71
|
| Rate for Payer: BCN Medicare Advantage |
$463.25
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$1,593.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,482.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.25
|
| Rate for Payer: Healthscope Commercial |
$1,667.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,389.75
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.41
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$532.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,575.05
|
| Rate for Payer: Nomi Health Commercial |
$1,519.46
|
| Rate for Payer: PACE Senior Care Partners |
$440.09
|
| Rate for Payer: PACE SWMI |
$463.25
|
| Rate for Payer: PHP Commercial |
$1,575.05
|
| Rate for Payer: PHP Medicare Advantage |
$463.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,612.11
|
| Rate for Payer: Priority Health Medicare |
$467.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,241.51
|
| Rate for Payer: Railroad Medicare Medicare |
$463.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,630.64
|
| Rate for Payer: UHC Core |
$1,547.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$463.25
|
| Rate for Payer: UHC Exchange |
$463.25
|
| Rate for Payer: UHC Medicare Advantage |
$463.25
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$463.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,389.75
|
|
|
PR TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,276.00
|
|
|
Service Code
|
HCPCS 25290
|
| Min. Negotiated Rate |
$288.62 |
| Max. Negotiated Rate |
$1,061.88 |
| Rate for Payer: Aetna Commercial |
$567.46
|
| Rate for Payer: Aetna Medicare |
$440.42
|
| Rate for Payer: BCBS Complete |
$303.05
|
| Rate for Payer: BCBS MAPPO |
$423.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.88
|
| Rate for Payer: BCN Commercial |
$646.52
|
| Rate for Payer: BCN Medicare Advantage |
$423.48
|
| Rate for Payer: Cash Price |
$1,020.80
|
| Rate for Payer: Cash Price |
$1,020.80
|
| Rate for Payer: Cofinity Commercial |
$609.81
|
| Rate for Payer: Cofinity Commercial |
$567.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.48
|
| Rate for Payer: Mclaren Medicaid |
$288.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.65
|
| Rate for Payer: Meridian Medicaid |
$303.05
|
| Rate for Payer: Nomi Health Commercial |
$508.18
|
| Rate for Payer: PACE SWMI |
$423.48
|
| Rate for Payer: PHP Medicare Advantage |
$423.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.40
|
| Rate for Payer: Priority Health HMO/PPO |
$681.87
|
| Rate for Payer: Priority Health Medicare |
$427.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$681.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$423.48
|
| Rate for Payer: UHC Exchange |
$423.48
|
| Rate for Payer: UHC Medicare Advantage |
$423.48
|
| Rate for Payer: UHCCP Medicaid |
$288.62
|
|
|
PR TOBACCO USE CESSATION INTENSIVE >10 MINUTES
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 99407
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$1,526.79 |
| Rate for Payer: Aetna Commercial |
$31.60
|
| Rate for Payer: Aetna Medicare |
$24.52
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS MAPPO |
$23.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$23.58
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$31.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.58
|
| Rate for Payer: Mclaren Medicaid |
$15.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.76
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: Nomi Health Commercial |
$28.30
|
| Rate for Payer: PACE SWMI |
$23.58
|
| Rate for Payer: PHP Medicare Advantage |
$23.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO |
$33.20
|
| Rate for Payer: Priority Health Medicare |
$23.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.58
|
| Rate for Payer: UHC Exchange |
$23.58
|
| Rate for Payer: UHC Medicare Advantage |
$23.58
|
| Rate for Payer: UHCCP Medicaid |
$15.76
|
|
|
PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 99406
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$1,290.64 |
| Rate for Payer: Aetna Commercial |
$14.97
|
| Rate for Payer: Aetna Medicare |
$11.62
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$11.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.64
|
| Rate for Payer: BCN Commercial |
$15.76
|
| Rate for Payer: BCN Medicare Advantage |
$11.17
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$16.08
|
| Rate for Payer: Cofinity Commercial |
$14.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.17
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.73
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Nomi Health Commercial |
$13.40
|
| Rate for Payer: PACE SWMI |
$11.17
|
| Rate for Payer: PHP Medicare Advantage |
$11.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO |
$15.71
|
| Rate for Payer: Priority Health Medicare |
$11.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.17
|
| Rate for Payer: UHC Exchange |
$11.17
|
| Rate for Payer: UHC Medicare Advantage |
$11.17
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
|
|
PR TOBACCO-USE COUNSEL>10MIN
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS G0437
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$32.16 |
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO |
$32.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.16
|
|
|
PR TOBACCO-USE COUNSEL 3-10 MIN
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS G0436
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health HMO/PPO |
$15.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.42
|
|
|
PR TONE DECAY TEST
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 92563
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$1,190.79 |
| Rate for Payer: Aetna Commercial |
$42.37
|
| Rate for Payer: Aetna Medicare |
$32.88
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS MAPPO |
$31.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.79
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$31.62
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$42.37
|
| Rate for Payer: Cofinity Commercial |
$45.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.20
|
| Rate for Payer: Nomi Health Commercial |
$37.94
|
| Rate for Payer: PACE SWMI |
$31.62
|
| Rate for Payer: PHP Medicare Advantage |
$31.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO |
$47.04
|
| Rate for Payer: Priority Health Medicare |
$31.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.62
|
| Rate for Payer: UHC Exchange |
$31.62
|
| Rate for Payer: UHC Medicare Advantage |
$31.62
|
|
|
PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12
|
Professional
|
Both
|
$909.00
|
|
|
Service Code
|
HCPCS 42820
|
| Min. Negotiated Rate |
$189.36 |
| Max. Negotiated Rate |
$652.98 |
| Rate for Payer: Aetna Commercial |
$374.25
|
| Rate for Payer: Aetna Medicare |
$290.46
|
| Rate for Payer: BCBS Complete |
$198.83
|
| Rate for Payer: BCBS MAPPO |
$279.29
|
| Rate for Payer: BCBS Trust/PPO |
$652.98
|
| Rate for Payer: BCN Commercial |
$428.08
|
| Rate for Payer: BCN Medicare Advantage |
$279.29
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cofinity Commercial |
$402.18
|
| Rate for Payer: Cofinity Commercial |
$374.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.29
|
| Rate for Payer: Mclaren Medicaid |
$189.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.25
|
| Rate for Payer: Meridian Medicaid |
$198.83
|
| Rate for Payer: Nomi Health Commercial |
$335.15
|
| Rate for Payer: PACE SWMI |
$279.29
|
| Rate for Payer: PHP Medicare Advantage |
$279.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.85
|
| Rate for Payer: Priority Health HMO/PPO |
$527.98
|
| Rate for Payer: Priority Health Medicare |
$282.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$527.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.29
|
| Rate for Payer: UHC Exchange |
$279.29
|
| Rate for Payer: UHC Medicare Advantage |
$279.29
|
| Rate for Payer: UHCCP Medicaid |
$189.36
|
|
|
PR TONSILLECTOMY & ADENOIDECTOMY AGE 12/>
|
Professional
|
Both
|
$579.00
|
|
|
Service Code
|
HCPCS 42821
|
| Min. Negotiated Rate |
$197.45 |
| Max. Negotiated Rate |
$1,924.07 |
| Rate for Payer: Aetna Commercial |
$390.02
|
| Rate for Payer: Aetna Medicare |
$302.70
|
| Rate for Payer: BCBS Complete |
$207.32
|
| Rate for Payer: BCBS MAPPO |
$291.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,924.07
|
| Rate for Payer: BCN Commercial |
$448.61
|
| Rate for Payer: BCN Medicare Advantage |
$291.06
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cofinity Commercial |
$419.13
|
| Rate for Payer: Cofinity Commercial |
$390.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.06
|
| Rate for Payer: Mclaren Medicaid |
$197.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.61
|
| Rate for Payer: Meridian Medicaid |
$207.32
|
| Rate for Payer: Nomi Health Commercial |
$349.27
|
| Rate for Payer: PACE SWMI |
$291.06
|
| Rate for Payer: PHP Medicare Advantage |
$291.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$376.35
|
| Rate for Payer: Priority Health HMO/PPO |
$551.26
|
| Rate for Payer: Priority Health Medicare |
$293.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$551.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.06
|
| Rate for Payer: UHC Exchange |
$291.06
|
| Rate for Payer: UHC Medicare Advantage |
$291.06
|
| Rate for Payer: UHCCP Medicaid |
$197.45
|
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY <AGE 12
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 42825
|
| Min. Negotiated Rate |
$175.30 |
| Max. Negotiated Rate |
$1,488.22 |
| Rate for Payer: Aetna Commercial |
$344.31
|
| Rate for Payer: Aetna Medicare |
$267.23
|
| Rate for Payer: BCBS Complete |
$184.06
|
| Rate for Payer: BCBS MAPPO |
$256.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,488.22
|
| Rate for Payer: BCN Commercial |
$395.83
|
| Rate for Payer: BCN Medicare Advantage |
$256.95
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$370.01
|
| Rate for Payer: Cofinity Commercial |
$344.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.95
|
| Rate for Payer: Mclaren Medicaid |
$175.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.80
|
| Rate for Payer: Meridian Medicaid |
$184.06
|
| Rate for Payer: Nomi Health Commercial |
$308.34
|
| Rate for Payer: PACE SWMI |
$256.95
|
| Rate for Payer: PHP Medicare Advantage |
$256.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health HMO/PPO |
$487.42
|
| Rate for Payer: Priority Health Medicare |
$259.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$487.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.95
|
| Rate for Payer: UHC Exchange |
$256.95
|
| Rate for Payer: UHC Medicare Advantage |
$256.95
|
| Rate for Payer: UHCCP Medicaid |
$175.30
|
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 42826
|
| Min. Negotiated Rate |
$166.57 |
| Max. Negotiated Rate |
$1,230.94 |
| Rate for Payer: Aetna Commercial |
$327.78
|
| Rate for Payer: Aetna Medicare |
$254.39
|
| Rate for Payer: BCBS Complete |
$174.90
|
| Rate for Payer: BCBS MAPPO |
$244.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.94
|
| Rate for Payer: BCN Commercial |
$376.77
|
| Rate for Payer: BCN Medicare Advantage |
$244.61
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$352.24
|
| Rate for Payer: Cofinity Commercial |
$327.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.61
|
| Rate for Payer: Mclaren Medicaid |
$166.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.84
|
| Rate for Payer: Meridian Medicaid |
$174.90
|
| Rate for Payer: Nomi Health Commercial |
$293.53
|
| Rate for Payer: PACE SWMI |
$244.61
|
| Rate for Payer: PHP Medicare Advantage |
$244.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO |
$464.16
|
| Rate for Payer: Priority Health Medicare |
$247.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$464.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$244.61
|
| Rate for Payer: UHC Exchange |
$244.61
|
| Rate for Payer: UHC Medicare Advantage |
$244.61
|
| Rate for Payer: UHCCP Medicaid |
$166.57
|
|
|
PR TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 58200
|
| Min. Negotiated Rate |
$82.02 |
| Max. Negotiated Rate |
$2,013.95 |
| Rate for Payer: Aetna Commercial |
$1,741.24
|
| Rate for Payer: Aetna Medicare |
$1,351.41
|
| Rate for Payer: BCBS Complete |
$910.93
|
| Rate for Payer: BCBS MAPPO |
$1,299.43
|
| Rate for Payer: BCBS Trust/PPO |
$82.02
|
| Rate for Payer: BCN Commercial |
$1,964.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,299.43
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$1,871.18
|
| Rate for Payer: Cofinity Commercial |
$1,741.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,299.43
|
| Rate for Payer: Mclaren Medicaid |
$867.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,364.40
|
| Rate for Payer: Meridian Medicaid |
$910.93
|
| Rate for Payer: Nomi Health Commercial |
$1,559.32
|
| Rate for Payer: PACE SWMI |
$1,299.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,299.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$867.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,013.95
|
| Rate for Payer: Priority Health Medicare |
$1,312.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,013.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,299.43
|
| Rate for Payer: UHC Exchange |
$1,299.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,299.43
|
| Rate for Payer: UHCCP Medicaid |
$867.55
|
|
|
PR TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY
|
Professional
|
Both
|
$3,357.00
|
|
|
Service Code
|
HCPCS 58152
|
| Min. Negotiated Rate |
$11.46 |
| Max. Negotiated Rate |
$2,182.05 |
| Rate for Payer: Aetna Commercial |
$1,594.40
|
| Rate for Payer: Aetna Medicare |
$1,237.44
|
| Rate for Payer: BCBS Complete |
$831.76
|
| Rate for Payer: BCBS MAPPO |
$1,189.85
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| Rate for Payer: BCN Commercial |
$1,812.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,189.85
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,713.38
|
| Rate for Payer: Cofinity Commercial |
$1,594.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,189.85
|
| Rate for Payer: Mclaren Medicaid |
$792.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,249.34
|
| Rate for Payer: Meridian Medicaid |
$831.76
|
| Rate for Payer: Nomi Health Commercial |
$1,427.82
|
| Rate for Payer: PACE SWMI |
$1,189.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,189.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$792.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,847.28
|
| Rate for Payer: Priority Health Medicare |
$1,201.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,847.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,189.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,189.85
|
| Rate for Payer: UHC Exchange |
$1,189.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,189.85
|
| Rate for Payer: UHCCP Medicaid |
$792.15
|
|
|
PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY
|
Professional
|
Both
|
$3,216.00
|
|
|
Service Code
|
HCPCS 58150
|
| Min. Negotiated Rate |
$653.91 |
| Max. Negotiated Rate |
$2,929.42 |
| Rate for Payer: Aetna Commercial |
$1,311.95
|
| Rate for Payer: Aetna Medicare |
$1,018.23
|
| Rate for Payer: BCBS Complete |
$686.61
|
| Rate for Payer: BCBS MAPPO |
$979.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,929.42
|
| Rate for Payer: BCN Commercial |
$1,483.63
|
| Rate for Payer: BCN Medicare Advantage |
$979.07
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cofinity Commercial |
$1,409.86
|
| Rate for Payer: Cofinity Commercial |
$1,311.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.07
|
| Rate for Payer: Mclaren Medicaid |
$653.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.02
|
| Rate for Payer: Meridian Medicaid |
$686.61
|
| Rate for Payer: Nomi Health Commercial |
$1,174.88
|
| Rate for Payer: PACE SWMI |
$979.07
|
| Rate for Payer: PHP Medicare Advantage |
$979.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,090.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,518.89
|
| Rate for Payer: Priority Health Medicare |
$988.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,518.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$979.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$979.07
|
| Rate for Payer: UHC Exchange |
$979.07
|
| Rate for Payer: UHC Medicare Advantage |
$979.07
|
| Rate for Payer: UHCCP Medicaid |
$653.91
|
|
|
PR TOTAL DISC ARTHRP ANT 2ND LEVEL CERVICAL
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 22858
|
| Min. Negotiated Rate |
$65.37 |
| Max. Negotiated Rate |
$768.88 |
| Rate for Payer: Aetna Commercial |
$662.86
|
| Rate for Payer: Aetna Medicare |
$514.46
|
| Rate for Payer: BCBS Complete |
$340.62
|
| Rate for Payer: BCBS MAPPO |
$494.67
|
| Rate for Payer: BCBS Trust/PPO |
$65.37
|
| Rate for Payer: BCN Commercial |
$735.95
|
| Rate for Payer: BCN Medicare Advantage |
$494.67
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$712.32
|
| Rate for Payer: Cofinity Commercial |
$662.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.67
|
| Rate for Payer: Mclaren Medicaid |
$324.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.40
|
| Rate for Payer: Meridian Medicaid |
$340.62
|
| Rate for Payer: Nomi Health Commercial |
$593.60
|
| Rate for Payer: PACE SWMI |
$494.67
|
| Rate for Payer: PHP Medicare Advantage |
$494.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$699.40
|
| Rate for Payer: Priority Health HMO/PPO |
$768.88
|
| Rate for Payer: Priority Health Medicare |
$499.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$768.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$494.67
|
| Rate for Payer: UHC Exchange |
$494.67
|
| Rate for Payer: UHC Medicare Advantage |
$494.67
|
| Rate for Payer: UHCCP Medicaid |
$324.40
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 22856
|
| Min. Negotiated Rate |
$132.08 |
| Max. Negotiated Rate |
$2,499.52 |
| Rate for Payer: Aetna Commercial |
$2,125.82
|
| Rate for Payer: Aetna Medicare |
$1,649.89
|
| Rate for Payer: BCBS Complete |
$1,104.16
|
| Rate for Payer: BCBS MAPPO |
$1,586.43
|
| Rate for Payer: BCBS Trust/PPO |
$132.08
|
| Rate for Payer: BCN Commercial |
$2,383.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,586.43
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cofinity Commercial |
$2,284.46
|
| Rate for Payer: Cofinity Commercial |
$2,125.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,586.43
|
| Rate for Payer: Mclaren Medicaid |
$1,051.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,665.75
|
| Rate for Payer: Meridian Medicaid |
$1,104.16
|
| Rate for Payer: Nomi Health Commercial |
$1,903.72
|
| Rate for Payer: PACE SWMI |
$1,586.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,586.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,051.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.70
|
| Rate for Payer: Priority Health HMO/PPO |
$2,499.52
|
| Rate for Payer: Priority Health Medicare |
$1,602.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,499.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,586.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,586.43
|
| Rate for Payer: UHC Exchange |
$1,586.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,586.43
|
| Rate for Payer: UHCCP Medicaid |
$1,051.58
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR
|
Professional
|
Both
|
$7,045.00
|
|
|
Service Code
|
HCPCS 22857
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$4,579.25 |
| Rate for Payer: Aetna Commercial |
$2,254.27
|
| Rate for Payer: Aetna Medicare |
$1,749.58
|
| Rate for Payer: BCBS Complete |
$1,181.76
|
| Rate for Payer: BCBS MAPPO |
$1,682.29
|
| Rate for Payer: BCBS Trust/PPO |
$66.57
|
| Rate for Payer: BCN Commercial |
$2,576.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,682.29
|
| Rate for Payer: Cash Price |
$5,636.00
|
| Rate for Payer: Cash Price |
$5,636.00
|
| Rate for Payer: Cofinity Commercial |
$2,422.50
|
| Rate for Payer: Cofinity Commercial |
$2,254.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,682.29
|
| Rate for Payer: Mclaren Medicaid |
$1,125.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,766.40
|
| Rate for Payer: Meridian Medicaid |
$1,181.76
|
| Rate for Payer: Nomi Health Commercial |
$2,018.75
|
| Rate for Payer: PACE SWMI |
$1,682.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,682.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,125.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,579.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,667.45
|
| Rate for Payer: Priority Health Medicare |
$1,699.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,667.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,682.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,682.29
|
| Rate for Payer: UHC Exchange |
$1,682.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,682.29
|
| Rate for Payer: UHCCP Medicaid |
$1,125.49
|
|
|
PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY
|
Professional
|
Both
|
$5,885.00
|
|
|
Service Code
|
HCPCS 43112
|
| Min. Negotiated Rate |
$109.36 |
| Max. Negotiated Rate |
$6,094.80 |
| Rate for Payer: Aetna Commercial |
$4,405.92
|
| Rate for Payer: Aetna Medicare |
$3,419.52
|
| Rate for Payer: BCBS Complete |
$2,262.45
|
| Rate for Payer: BCBS MAPPO |
$3,288.00
|
| Rate for Payer: BCBS Trust/PPO |
$109.36
|
| Rate for Payer: BCN Commercial |
$4,996.73
|
| Rate for Payer: BCN Medicare Advantage |
$3,288.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cofinity Commercial |
$4,734.72
|
| Rate for Payer: Cofinity Commercial |
$4,405.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,288.00
|
| Rate for Payer: Mclaren Medicaid |
$2,154.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,452.40
|
| Rate for Payer: Meridian Medicaid |
$2,262.45
|
| Rate for Payer: Nomi Health Commercial |
$3,945.60
|
| Rate for Payer: PACE SWMI |
$3,288.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,288.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,154.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.25
|
| Rate for Payer: Priority Health HMO/PPO |
$6,094.80
|
| Rate for Payer: Priority Health Medicare |
$3,320.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,094.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,288.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,288.00
|
| Rate for Payer: UHC Exchange |
$3,288.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,288.00
|
| Rate for Payer: UHCCP Medicaid |
$2,154.71
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
OP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$604.44 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$2,163.25
|
| Rate for Payer: Aetna Medicare |
$661.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$795.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$795.31
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$636.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.24
|
| Rate for Payer: BCN Commercial |
$1,978.74
|
| Rate for Payer: BCN Medicare Advantage |
$636.25
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$2,188.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.25
|
| Rate for Payer: Healthscope Commercial |
$2,290.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.75
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.06
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$731.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: Nomi Health Commercial |
$2,086.90
|
| Rate for Payer: PACE Senior Care Partners |
$604.44
|
| Rate for Payer: PACE SWMI |
$636.25
|
| Rate for Payer: PHP Commercial |
$2,163.25
|
| Rate for Payer: PHP Medicare Advantage |
$636.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,214.15
|
| Rate for Payer: Priority Health Medicare |
$642.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.15
|
| Rate for Payer: Railroad Medicare Medicare |
$636.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,239.60
|
| Rate for Payer: UHC Core |
$2,125.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$636.25
|
| Rate for Payer: UHC Exchange |
$636.25
|
| Rate for Payer: UHC Medicare Advantage |
$636.25
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$636.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.75
|
|
