|
PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 99406
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$14.97
|
| Rate for Payer: Aetna Medicare |
$11.62
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$11.17
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.73
|
| 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 Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$11.28
|
| 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
|
|
|
PR TOBACCO-USE COUNSEL>10MIN
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS G0437
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
|
|
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: Priority Health Cigna Priority Health |
$15.60
|
|
|
PR TONE DECAY TEST
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 92563
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$45.53 |
| 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: 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 Medicare |
$31.94
|
| 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 |
$279.29 |
| Max. Negotiated Rate |
$590.85 |
| Rate for Payer: Aetna Commercial |
$374.25
|
| Rate for Payer: Aetna Medicare |
$290.46
|
| Rate for Payer: BCBS Complete |
$363.60
|
| Rate for Payer: BCBS MAPPO |
$279.29
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.25
|
| 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 Cigna Priority Health |
$590.85
|
| Rate for Payer: Priority Health Medicare |
$282.08
|
| 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
|
|
|
PR TONSILLECTOMY & ADENOIDECTOMY AGE 12/>
|
Professional
|
Both
|
$579.00
|
|
|
Service Code
|
HCPCS 42821
|
| Min. Negotiated Rate |
$231.60 |
| Max. Negotiated Rate |
$419.13 |
| Rate for Payer: Aetna Commercial |
$390.02
|
| Rate for Payer: Aetna Medicare |
$302.70
|
| Rate for Payer: BCBS Complete |
$231.60
|
| Rate for Payer: BCBS MAPPO |
$291.06
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.61
|
| 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 Cigna Priority Health |
$376.35
|
| Rate for Payer: Priority Health Medicare |
$293.97
|
| 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
|
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY <AGE 12
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 42825
|
| Min. Negotiated Rate |
$194.00 |
| Max. Negotiated Rate |
$370.01 |
| Rate for Payer: Aetna Commercial |
$344.31
|
| Rate for Payer: Aetna Medicare |
$267.23
|
| Rate for Payer: BCBS Complete |
$194.00
|
| Rate for Payer: BCBS MAPPO |
$256.95
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.80
|
| 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 Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health Medicare |
$259.52
|
| 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
|
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 42826
|
| Min. Negotiated Rate |
$189.20 |
| Max. Negotiated Rate |
$352.24 |
| Rate for Payer: Aetna Commercial |
$327.78
|
| Rate for Payer: Aetna Medicare |
$254.39
|
| Rate for Payer: BCBS Complete |
$189.20
|
| Rate for Payer: BCBS MAPPO |
$244.61
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.84
|
| 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 Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health Medicare |
$247.06
|
| 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
|
|
|
PR TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 58200
|
| Min. Negotiated Rate |
$964.00 |
| Max. Negotiated Rate |
$1,871.18 |
| Rate for Payer: Aetna Commercial |
$1,741.24
|
| Rate for Payer: Aetna Medicare |
$1,351.41
|
| Rate for Payer: BCBS Complete |
$964.00
|
| Rate for Payer: BCBS MAPPO |
$1,299.43
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,364.40
|
| 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 Cigna Priority Health |
$1,566.50
|
| Rate for Payer: Priority Health Medicare |
$1,312.42
|
| 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
|
|
|
PR TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY
|
Professional
|
Both
|
$3,357.00
|
|
|
Service Code
|
HCPCS 58152
|
| Min. Negotiated Rate |
$1,189.85 |
| 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 |
$1,342.80
|
| Rate for Payer: BCBS MAPPO |
$1,189.85
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,249.34
|
| 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 Cigna Priority Health |
$2,182.05
|
| Rate for Payer: Priority Health Medicare |
$1,201.75
|
| 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
|
|
|
PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY
|
Professional
|
Both
|
$3,216.00
|
|
|
Service Code
|
HCPCS 58150
|
| Min. Negotiated Rate |
$979.07 |
| Max. Negotiated Rate |
$2,090.40 |
| Rate for Payer: Aetna Commercial |
$1,311.95
|
| Rate for Payer: Aetna Medicare |
$1,018.23
|
| Rate for Payer: BCBS Complete |
$1,286.40
|
| Rate for Payer: BCBS MAPPO |
$979.07
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.02
|
| 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 Cigna Priority Health |
$2,090.40
|
| Rate for Payer: Priority Health Medicare |
$988.86
|
| 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
|
|
|
PR TOTAL DISC ARTHRP ANT 2ND LEVEL CERVICAL
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 22858
|
| Min. Negotiated Rate |
$430.40 |
| Max. Negotiated Rate |
$712.32 |
| Rate for Payer: Aetna Commercial |
$662.86
|
| Rate for Payer: Aetna Medicare |
$514.46
|
| Rate for Payer: BCBS Complete |
$430.40
|
| Rate for Payer: BCBS MAPPO |
$494.67
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.40
|
| 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 Cigna Priority Health |
$699.40
|
| Rate for Payer: Priority Health Medicare |
$499.62
|
| 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
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 22856
|
| Min. Negotiated Rate |
$1,367.20 |
| Max. Negotiated Rate |
$2,284.46 |
| Rate for Payer: Aetna Commercial |
$2,125.82
|
| Rate for Payer: Aetna Medicare |
$1,649.89
|
| Rate for Payer: BCBS Complete |
$1,367.20
|
| Rate for Payer: BCBS MAPPO |
$1,586.43
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,665.75
|
| 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 Cigna Priority Health |
$2,221.70
|
| Rate for Payer: Priority Health Medicare |
$1,602.29
|
| 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
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR
|
Professional
|
Both
|
$7,045.00
|
|
|
Service Code
|
HCPCS 22857
|
| Min. Negotiated Rate |
$1,682.29 |
| 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 |
$2,818.00
|
| Rate for Payer: BCBS MAPPO |
$1,682.29
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,766.40
|
| 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 Cigna Priority Health |
$4,579.25
|
| Rate for Payer: Priority Health Medicare |
$1,699.11
|
| 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
|
|
|
PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY
|
Professional
|
Both
|
$5,885.00
|
|
|
Service Code
|
HCPCS 43112
|
| Min. Negotiated Rate |
$2,354.00 |
| Max. Negotiated Rate |
$4,734.72 |
| Rate for Payer: Aetna Commercial |
$4,405.92
|
| Rate for Payer: Aetna Medicare |
$3,419.52
|
| Rate for Payer: BCBS Complete |
$2,354.00
|
| Rate for Payer: BCBS MAPPO |
$3,288.00
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,452.40
|
| 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 Cigna Priority Health |
$3,825.25
|
| Rate for Payer: Priority Health Medicare |
$3,320.88
|
| 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
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$680.87 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$708.10
|
| Rate for Payer: BCBS Complete |
$1,018.00
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health Medicare |
$687.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Exchange |
$680.87
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,654.25 |
| Max. Negotiated Rate |
$2,290.50 |
| Rate for Payer: Aetna Commercial |
$2,163.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.48
|
| Rate for Payer: BCN Commercial |
$1,966.78
|
| 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: Healthscope Commercial |
$2,290.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: Nomi Health Commercial |
$2,086.90
|
| Rate for Payer: PHP Commercial |
$2,163.25
|
| 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 Narrow/Tiered Network |
$1,705.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,239.60
|
| Rate for Payer: UHC Core |
$2,125.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.75
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$680.87 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$708.10
|
| Rate for Payer: BCBS Complete |
$1,018.00
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health Medicare |
$687.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Exchange |
$680.87
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
|
|
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 |
$4,429.45 |
| 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 |
$4,429.45
|
| 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 |
$4,218.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.06
|
| Rate for Payer: Meridian Medicaid |
$4,429.45
|
| 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 |
$4,218.24
|
| 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 |
$2,125.07
|
| 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 |
$4,218.24
|
| Rate for Payer: VA VA |
$636.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.75
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,437.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$574.80 |
| Max. Negotiated Rate |
$1,302.48 |
| Rate for Payer: Aetna Commercial |
$1,212.03
|
| Rate for Payer: Aetna Medicare |
$940.68
|
| Rate for Payer: BCBS Complete |
$574.80
|
| Rate for Payer: BCBS MAPPO |
$904.50
|
| Rate for Payer: BCN Medicare Advantage |
$904.50
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cofinity Commercial |
$1,302.48
|
| Rate for Payer: Cofinity Commercial |
$1,212.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.73
|
| Rate for Payer: Nomi Health Commercial |
$1,085.40
|
| Rate for Payer: PACE SWMI |
$904.50
|
| Rate for Payer: PHP Medicare Advantage |
$904.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.05
|
| Rate for Payer: Priority Health Medicare |
$913.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$904.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.50
|
| Rate for Payer: UHC Exchange |
$904.50
|
| Rate for Payer: UHC Medicare Advantage |
$904.50
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$2,229.60 |
| Max. Negotiated Rate |
$4,117.75 |
| Rate for Payer: Aetna Commercial |
$3,831.80
|
| Rate for Payer: Aetna Medicare |
$2,973.93
|
| Rate for Payer: BCBS Complete |
$2,229.60
|
| Rate for Payer: BCBS MAPPO |
$2,859.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,859.55
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cofinity Commercial |
$4,117.75
|
| Rate for Payer: Cofinity Commercial |
$3,831.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,859.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,002.53
|
| Rate for Payer: Nomi Health Commercial |
$3,431.46
|
| Rate for Payer: PACE SWMI |
$2,859.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,859.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health Medicare |
$2,888.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,859.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,859.55
|
| Rate for Payer: UHC Exchange |
$2,859.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,859.55
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,965.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$3,186.00 |
| Max. Negotiated Rate |
$5,269.26 |
| Rate for Payer: Aetna Commercial |
$4,903.34
|
| Rate for Payer: Aetna Medicare |
$3,805.58
|
| Rate for Payer: BCBS Complete |
$3,186.00
|
| Rate for Payer: BCBS MAPPO |
$3,659.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,659.21
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cofinity Commercial |
$5,269.26
|
| Rate for Payer: Cofinity Commercial |
$4,903.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,659.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,842.17
|
| Rate for Payer: Nomi Health Commercial |
$4,391.05
|
| Rate for Payer: PACE SWMI |
$3,659.21
|
| Rate for Payer: PHP Medicare Advantage |
$3,659.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,177.25
|
| Rate for Payer: Priority Health Medicare |
$3,695.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,659.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,659.21
|
| Rate for Payer: UHC Exchange |
$3,659.21
|
| Rate for Payer: UHC Medicare Advantage |
$3,659.21
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,232.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$190.04 |
| Max. Negotiated Rate |
$800.80 |
| Rate for Payer: Aetna Commercial |
$254.65
|
| Rate for Payer: Aetna Medicare |
$197.64
|
| Rate for Payer: BCBS Complete |
$492.80
|
| Rate for Payer: BCBS MAPPO |
$190.04
|
| Rate for Payer: BCN Medicare Advantage |
$190.04
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cofinity Commercial |
$273.66
|
| Rate for Payer: Cofinity Commercial |
$254.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.54
|
| Rate for Payer: Nomi Health Commercial |
$228.05
|
| Rate for Payer: PACE SWMI |
$190.04
|
| Rate for Payer: PHP Medicare Advantage |
$190.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.80
|
| Rate for Payer: Priority Health Medicare |
$191.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.04
|
| Rate for Payer: UHC Exchange |
$190.04
|
| Rate for Payer: UHC Medicare Advantage |
$190.04
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$46.62 |
| Max. Negotiated Rate |
$115.05 |
| Rate for Payer: Aetna Commercial |
$62.47
|
| Rate for Payer: Aetna Medicare |
$48.48
|
| Rate for Payer: BCBS Complete |
$70.80
|
| Rate for Payer: BCBS MAPPO |
$46.62
|
| Rate for Payer: BCN Medicare Advantage |
$46.62
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$67.13
|
| Rate for Payer: Cofinity Commercial |
$62.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.95
|
| Rate for Payer: Nomi Health Commercial |
$55.94
|
| Rate for Payer: PACE SWMI |
$46.62
|
| Rate for Payer: PHP Medicare Advantage |
$46.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health Medicare |
$47.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.62
|
| Rate for Payer: UHC Exchange |
$46.62
|
| Rate for Payer: UHC Medicare Advantage |
$46.62
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$232.40 |
| Max. Negotiated Rate |
$513.23 |
| Rate for Payer: Aetna Commercial |
$477.59
|
| Rate for Payer: Aetna Medicare |
$370.67
|
| Rate for Payer: BCBS Complete |
$232.40
|
| Rate for Payer: BCBS MAPPO |
$356.41
|
| Rate for Payer: BCN Medicare Advantage |
$356.41
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cofinity Commercial |
$513.23
|
| Rate for Payer: Cofinity Commercial |
$477.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.23
|
| Rate for Payer: Nomi Health Commercial |
$427.69
|
| Rate for Payer: PACE SWMI |
$356.41
|
| Rate for Payer: PHP Medicare Advantage |
$356.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.65
|
| Rate for Payer: Priority Health Medicare |
$359.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.41
|
| Rate for Payer: UHC Exchange |
$356.41
|
| Rate for Payer: UHC Medicare Advantage |
$356.41
|
|
