|
PR VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 58294
|
| Min. Negotiated Rate |
$327.55 |
| Max. Negotiated Rate |
$1,816.03 |
| Rate for Payer: Aetna Commercial |
$1,567.37
|
| Rate for Payer: Aetna Medicare |
$1,216.47
|
| Rate for Payer: BCBS Complete |
$817.45
|
| Rate for Payer: BCBS MAPPO |
$1,169.68
|
| Rate for Payer: BCBS Trust/PPO |
$327.55
|
| Rate for Payer: BCN Commercial |
$1,784.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,169.68
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cofinity Commercial |
$1,684.34
|
| Rate for Payer: Cofinity Commercial |
$1,567.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,169.68
|
| Rate for Payer: Mclaren Medicaid |
$778.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,228.16
|
| Rate for Payer: Meridian Medicaid |
$817.45
|
| Rate for Payer: Nomi Health Commercial |
$1,403.62
|
| Rate for Payer: PACE SWMI |
$1,169.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,169.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,816.03
|
| Rate for Payer: Priority Health Medicare |
$1,181.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,816.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,169.68
|
| Rate for Payer: UHC Exchange |
$1,169.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,169.68
|
| Rate for Payer: UHCCP Medicaid |
$778.52
|
|
|
PR VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE
|
Professional
|
Both
|
$2,757.00
|
|
|
Service Code
|
HCPCS 58270
|
| Min. Negotiated Rate |
$233.51 |
| Max. Negotiated Rate |
$1,792.05 |
| Rate for Payer: Aetna Commercial |
$1,150.51
|
| Rate for Payer: Aetna Medicare |
$892.93
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$858.59
|
| Rate for Payer: BCBS Trust/PPO |
$233.51
|
| Rate for Payer: BCN Commercial |
$1,313.56
|
| Rate for Payer: BCN Medicare Advantage |
$858.59
|
| Rate for Payer: Cash Price |
$2,205.60
|
| Rate for Payer: Cash Price |
$2,205.60
|
| Rate for Payer: Cofinity Commercial |
$1,236.37
|
| Rate for Payer: Cofinity Commercial |
$1,150.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.59
|
| Rate for Payer: Mclaren Medicaid |
$573.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$901.52
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Nomi Health Commercial |
$1,030.31
|
| Rate for Payer: PACE SWMI |
$858.59
|
| Rate for Payer: PHP Medicare Advantage |
$858.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,336.85
|
| Rate for Payer: Priority Health Medicare |
$867.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,336.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$858.59
|
| Rate for Payer: UHC Exchange |
$858.59
|
| Rate for Payer: UHC Medicare Advantage |
$858.59
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
|
|
PR VAGINAL HYSTERECTOMY UTERUS > 250 GM
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 58290
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$1,896.05 |
| Rate for Payer: Aetna Commercial |
$1,482.36
|
| Rate for Payer: Aetna Medicare |
$1,150.49
|
| Rate for Payer: BCBS Complete |
$773.38
|
| Rate for Payer: BCBS MAPPO |
$1,106.24
|
| Rate for Payer: BCBS Trust/PPO |
$137.36
|
| Rate for Payer: BCN Commercial |
$1,687.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.24
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cofinity Commercial |
$1,592.99
|
| Rate for Payer: Cofinity Commercial |
$1,482.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.24
|
| Rate for Payer: Mclaren Medicaid |
$736.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,161.55
|
| Rate for Payer: Meridian Medicaid |
$773.38
|
| Rate for Payer: Nomi Health Commercial |
$1,327.49
|
| Rate for Payer: PACE SWMI |
$1,106.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,896.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,718.31
|
| Rate for Payer: Priority Health Medicare |
$1,117.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,718.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,106.24
|
| Rate for Payer: UHC Exchange |
$1,106.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.24
|
| Rate for Payer: UHCCP Medicaid |
$736.55
|
|
|
PR VAGINAL HYSTERECTOMY UTERUS 250 GM/<
|
Professional
|
Both
|
$2,684.00
|
|
|
Service Code
|
HCPCS 58260
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,744.60 |
| Rate for Payer: Aetna Commercial |
$1,078.59
|
| Rate for Payer: Aetna Medicare |
$837.12
|
| Rate for Payer: BCBS Complete |
$564.94
|
| Rate for Payer: BCBS MAPPO |
$804.92
|
| Rate for Payer: BCBS Trust/PPO |
$240.90
|
| Rate for Payer: BCN Commercial |
$1,231.47
|
| Rate for Payer: BCN Medicare Advantage |
$804.92
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cofinity Commercial |
$1,159.08
|
| Rate for Payer: Cofinity Commercial |
$1,078.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.92
|
| Rate for Payer: Mclaren Medicaid |
$538.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.17
|
| Rate for Payer: Meridian Medicaid |
$564.94
|
| Rate for Payer: Nomi Health Commercial |
$965.90
|
| Rate for Payer: PACE SWMI |
$804.92
|
| Rate for Payer: PHP Medicare Advantage |
$804.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,255.50
|
| Rate for Payer: Priority Health Medicare |
$812.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,255.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$804.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$804.92
|
| Rate for Payer: UHC Exchange |
$804.92
|
| Rate for Payer: UHC Medicare Advantage |
$804.92
|
| Rate for Payer: UHCCP Medicaid |
$538.04
|
|
|
PR VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 58275
|
| Min. Negotiated Rate |
$263.09 |
| Max. Negotiated Rate |
$1,570.40 |
| Rate for Payer: Aetna Commercial |
$1,277.02
|
| Rate for Payer: Aetna Medicare |
$991.12
|
| Rate for Payer: BCBS Complete |
$667.82
|
| Rate for Payer: BCBS MAPPO |
$953.00
|
| Rate for Payer: BCBS Trust/PPO |
$263.09
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$953.00
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,372.32
|
| Rate for Payer: Cofinity Commercial |
$1,277.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.00
|
| Rate for Payer: Mclaren Medicaid |
$636.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,000.65
|
| Rate for Payer: Meridian Medicaid |
$667.82
|
| Rate for Payer: Nomi Health Commercial |
$1,143.60
|
| Rate for Payer: PACE SWMI |
$953.00
|
| Rate for Payer: PHP Medicare Advantage |
$953.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$636.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,481.19
|
| Rate for Payer: Priority Health Medicare |
$962.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,481.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$953.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.00
|
| Rate for Payer: UHC Exchange |
$953.00
|
| Rate for Payer: UHC Medicare Advantage |
$953.00
|
| Rate for Payer: UHCCP Medicaid |
$636.02
|
|
|
PR VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 57110
|
| Min. Negotiated Rate |
$578.51 |
| Max. Negotiated Rate |
$2,148.07 |
| Rate for Payer: Aetna Commercial |
$1,160.33
|
| Rate for Payer: Aetna Medicare |
$900.56
|
| Rate for Payer: BCBS Complete |
$607.44
|
| Rate for Payer: BCBS MAPPO |
$865.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,148.07
|
| Rate for Payer: BCN Commercial |
$1,325.29
|
| Rate for Payer: BCN Medicare Advantage |
$865.92
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cofinity Commercial |
$1,246.92
|
| Rate for Payer: Cofinity Commercial |
$1,160.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$865.92
|
| Rate for Payer: Mclaren Medicaid |
$578.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.22
|
| Rate for Payer: Meridian Medicaid |
$607.44
|
| Rate for Payer: Nomi Health Commercial |
$1,039.10
|
| Rate for Payer: PACE SWMI |
$865.92
|
| Rate for Payer: PHP Medicare Advantage |
$865.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,350.25
|
| Rate for Payer: Priority Health Medicare |
$874.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,350.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$865.92
|
| Rate for Payer: UHC Exchange |
$865.92
|
| Rate for Payer: UHC Medicare Advantage |
$865.92
|
| Rate for Payer: UHCCP Medicaid |
$578.51
|
|
|
PR VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL
|
Professional
|
Both
|
$1,993.00
|
|
|
Service Code
|
HCPCS 57106
|
| Min. Negotiated Rate |
$345.70 |
| Max. Negotiated Rate |
$3,372.14 |
| Rate for Payer: Aetna Commercial |
$683.78
|
| Rate for Payer: Aetna Medicare |
$530.69
|
| Rate for Payer: BCBS Complete |
$362.98
|
| Rate for Payer: BCBS MAPPO |
$510.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,372.14
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$510.28
|
| Rate for Payer: Cash Price |
$1,594.40
|
| Rate for Payer: Cash Price |
$1,594.40
|
| Rate for Payer: Cofinity Commercial |
$734.80
|
| Rate for Payer: Cofinity Commercial |
$683.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.28
|
| Rate for Payer: Mclaren Medicaid |
$345.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.79
|
| Rate for Payer: Meridian Medicaid |
$362.98
|
| Rate for Payer: Nomi Health Commercial |
$612.34
|
| Rate for Payer: PACE SWMI |
$510.28
|
| Rate for Payer: PHP Medicare Advantage |
$510.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,295.45
|
| Rate for Payer: Priority Health HMO/PPO |
$807.56
|
| Rate for Payer: Priority Health Medicare |
$515.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$807.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.28
|
| Rate for Payer: UHC Exchange |
$510.28
|
| Rate for Payer: UHC Medicare Advantage |
$510.28
|
| Rate for Payer: UHCCP Medicaid |
$345.70
|
|
|
PR VAGINOPLASTY INTERSEX STATE
|
Professional
|
Both
|
$2,533.00
|
|
|
Service Code
|
HCPCS 57335
|
| Min. Negotiated Rate |
$753.17 |
| Max. Negotiated Rate |
$1,759.48 |
| Rate for Payer: Aetna Commercial |
$1,511.52
|
| Rate for Payer: Aetna Medicare |
$1,173.12
|
| Rate for Payer: BCBS Complete |
$790.83
|
| Rate for Payer: BCBS MAPPO |
$1,128.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,671.54
|
| Rate for Payer: BCN Commercial |
$1,727.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.00
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cash Price |
$2,026.40
|
| Rate for Payer: Cofinity Commercial |
$1,624.32
|
| Rate for Payer: Cofinity Commercial |
$1,511.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.00
|
| Rate for Payer: Mclaren Medicaid |
$753.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.40
|
| Rate for Payer: Meridian Medicaid |
$790.83
|
| Rate for Payer: Nomi Health Commercial |
$1,353.60
|
| Rate for Payer: PACE SWMI |
$1,128.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$753.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,759.48
|
| Rate for Payer: Priority Health Medicare |
$1,139.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,759.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,128.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.00
|
| Rate for Payer: UHC Exchange |
$1,128.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.00
|
| Rate for Payer: UHCCP Medicaid |
$753.17
|
|
|
PR VAGNC PRTL RMVL VAG WALL W/RMVL PARAVAGINAL TISS
|
Professional
|
Both
|
$2,571.00
|
|
|
Service Code
|
HCPCS 57107
|
| Min. Negotiated Rate |
$935.28 |
| Max. Negotiated Rate |
$3,758.85 |
| Rate for Payer: Aetna Commercial |
$1,874.71
|
| Rate for Payer: Aetna Medicare |
$1,455.00
|
| Rate for Payer: BCBS Complete |
$982.04
|
| Rate for Payer: BCBS MAPPO |
$1,399.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,758.85
|
| Rate for Payer: BCN Commercial |
$2,129.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,399.04
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cofinity Commercial |
$2,014.62
|
| Rate for Payer: Cofinity Commercial |
$1,874.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,399.04
|
| Rate for Payer: Mclaren Medicaid |
$935.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,468.99
|
| Rate for Payer: Meridian Medicaid |
$982.04
|
| Rate for Payer: Nomi Health Commercial |
$1,678.85
|
| Rate for Payer: PACE SWMI |
$1,399.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,399.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$935.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,180.62
|
| Rate for Payer: Priority Health Medicare |
$1,413.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,180.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,399.04
|
| Rate for Payer: UHC Exchange |
$1,399.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,399.04
|
| Rate for Payer: UHCCP Medicaid |
$935.28
|
|
|
PR VAGOTOMY PFRMD W/PRTL DSTL GSTRCT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 43635
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$806.71 |
| Rate for Payer: Aetna Commercial |
$146.53
|
| Rate for Payer: Aetna Medicare |
$113.72
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$109.35
|
| Rate for Payer: BCBS Trust/PPO |
$806.71
|
| Rate for Payer: BCN Commercial |
$163.22
|
| Rate for Payer: BCN Medicare Advantage |
$109.35
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$157.46
|
| Rate for Payer: Cofinity Commercial |
$146.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.35
|
| Rate for Payer: Mclaren Medicaid |
$71.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.82
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Nomi Health Commercial |
$131.22
|
| Rate for Payer: PACE SWMI |
$109.35
|
| Rate for Payer: PHP Medicare Advantage |
$109.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO |
$199.26
|
| Rate for Payer: Priority Health Medicare |
$110.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.35
|
| Rate for Payer: UHC Exchange |
$109.35
|
| Rate for Payer: UHC Medicare Advantage |
$109.35
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
|
|
PR VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,859.00
|
|
|
Service Code
|
HCPCS 33460
|
| Min. Negotiated Rate |
$1,500.37 |
| Max. Negotiated Rate |
$3,731.81 |
| Rate for Payer: Aetna Commercial |
$3,069.82
|
| Rate for Payer: Aetna Medicare |
$2,382.55
|
| Rate for Payer: BCBS Complete |
$1,575.39
|
| Rate for Payer: BCBS MAPPO |
$2,290.91
|
| Rate for Payer: BCN Commercial |
$3,425.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,290.91
|
| Rate for Payer: Cash Price |
$3,887.20
|
| Rate for Payer: Cash Price |
$3,887.20
|
| Rate for Payer: Cofinity Commercial |
$3,298.91
|
| Rate for Payer: Cofinity Commercial |
$3,069.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,290.91
|
| Rate for Payer: Mclaren Medicaid |
$1,500.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,405.46
|
| Rate for Payer: Meridian Medicaid |
$1,575.39
|
| Rate for Payer: Nomi Health Commercial |
$2,749.09
|
| Rate for Payer: PACE SWMI |
$2,290.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,290.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,500.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,158.35
|
| Rate for Payer: Priority Health HMO/PPO |
$3,731.81
|
| Rate for Payer: Priority Health Medicare |
$2,313.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,731.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,290.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,290.91
|
| Rate for Payer: UHC Exchange |
$2,290.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,290.91
|
| Rate for Payer: UHCCP Medicaid |
$1,500.37
|
|
|
PR VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS
|
Professional
|
Both
|
$8,923.00
|
|
|
Service Code
|
HCPCS 33422
|
| Min. Negotiated Rate |
$495.02 |
| Max. Negotiated Rate |
$5,799.95 |
| Rate for Payer: Aetna Commercial |
$2,131.89
|
| Rate for Payer: Aetna Medicare |
$1,654.60
|
| Rate for Payer: BCBS Complete |
$1,098.79
|
| Rate for Payer: BCBS MAPPO |
$1,590.96
|
| Rate for Payer: BCBS Trust/PPO |
$495.02
|
| Rate for Payer: BCN Commercial |
$2,382.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,590.96
|
| Rate for Payer: Cash Price |
$7,138.40
|
| Rate for Payer: Cash Price |
$7,138.40
|
| Rate for Payer: Cofinity Commercial |
$2,290.98
|
| Rate for Payer: Cofinity Commercial |
$2,131.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,590.96
|
| Rate for Payer: Mclaren Medicaid |
$1,046.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,670.51
|
| Rate for Payer: Meridian Medicaid |
$1,098.79
|
| Rate for Payer: Nomi Health Commercial |
$1,909.15
|
| Rate for Payer: PACE SWMI |
$1,590.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,590.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,799.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,597.96
|
| Rate for Payer: Priority Health Medicare |
$1,606.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,597.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,590.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,590.96
|
| Rate for Payer: UHC Exchange |
$1,590.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,590.96
|
| Rate for Payer: UHCCP Medicaid |
$1,046.47
|
|
|
PR VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS
|
Professional
|
Both
|
$8,513.00
|
|
|
Service Code
|
HCPCS 33425
|
| Min. Negotiated Rate |
$763.39 |
| Max. Negotiated Rate |
$5,533.45 |
| Rate for Payer: Aetna Commercial |
$3,500.62
|
| Rate for Payer: Aetna Medicare |
$2,716.90
|
| Rate for Payer: BCBS Complete |
$1,797.47
|
| Rate for Payer: BCBS MAPPO |
$2,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$763.39
|
| Rate for Payer: BCN Commercial |
$3,906.98
|
| Rate for Payer: BCN Medicare Advantage |
$2,612.40
|
| Rate for Payer: Cash Price |
$6,810.40
|
| Rate for Payer: Cash Price |
$6,810.40
|
| Rate for Payer: Cofinity Commercial |
$3,761.86
|
| Rate for Payer: Cofinity Commercial |
$3,500.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,711.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,743.02
|
| Rate for Payer: Meridian Medicaid |
$1,797.47
|
| Rate for Payer: Nomi Health Commercial |
$3,134.88
|
| Rate for Payer: PACE SWMI |
$2,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,711.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,533.45
|
| Rate for Payer: Priority Health HMO/PPO |
$4,266.83
|
| Rate for Payer: Priority Health Medicare |
$2,638.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,266.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,612.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,612.40
|
| Rate for Payer: UHC Exchange |
$2,612.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,711.88
|
|
|
PR VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION
|
Professional
|
Both
|
$7,544.00
|
|
|
Service Code
|
HCPCS 33463
|
| Min. Negotiated Rate |
$1,183.92 |
| Max. Negotiated Rate |
$4,903.60 |
| Rate for Payer: Aetna Commercial |
$3,943.97
|
| Rate for Payer: Aetna Medicare |
$3,060.99
|
| Rate for Payer: BCBS Complete |
$2,024.92
|
| Rate for Payer: BCBS MAPPO |
$2,943.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$4,392.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,943.26
|
| Rate for Payer: Cash Price |
$6,035.20
|
| Rate for Payer: Cash Price |
$6,035.20
|
| Rate for Payer: Cofinity Commercial |
$4,238.29
|
| Rate for Payer: Cofinity Commercial |
$3,943.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,943.26
|
| Rate for Payer: Mclaren Medicaid |
$1,928.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,090.42
|
| Rate for Payer: Meridian Medicaid |
$2,024.92
|
| Rate for Payer: Nomi Health Commercial |
$3,531.91
|
| Rate for Payer: PACE SWMI |
$2,943.26
|
| Rate for Payer: PHP Medicare Advantage |
$2,943.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,928.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,903.60
|
| Rate for Payer: Priority Health HMO/PPO |
$4,801.85
|
| Rate for Payer: Priority Health Medicare |
$2,972.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,801.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,943.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,943.26
|
| Rate for Payer: UHC Exchange |
$2,943.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,943.26
|
| Rate for Payer: UHCCP Medicaid |
$1,928.50
|
|
|
PR VALVULOPLASTY TRICUSPID VALVE W/RING INSERTION
|
Professional
|
Both
|
$5,116.00
|
|
|
Service Code
|
HCPCS 33464
|
| Min. Negotiated Rate |
$309.58 |
| Max. Negotiated Rate |
$3,809.45 |
| Rate for Payer: Aetna Commercial |
$3,125.93
|
| Rate for Payer: Aetna Medicare |
$2,426.09
|
| Rate for Payer: BCBS Complete |
$1,607.15
|
| Rate for Payer: BCBS MAPPO |
$2,332.78
|
| Rate for Payer: BCBS Trust/PPO |
$309.58
|
| Rate for Payer: BCN Commercial |
$3,487.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,332.78
|
| Rate for Payer: Cash Price |
$4,092.80
|
| Rate for Payer: Cash Price |
$4,092.80
|
| Rate for Payer: Cofinity Commercial |
$3,125.93
|
| Rate for Payer: Cofinity Commercial |
$3,359.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,332.78
|
| Rate for Payer: Mclaren Medicaid |
$1,530.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,449.42
|
| Rate for Payer: Meridian Medicaid |
$1,607.15
|
| Rate for Payer: Nomi Health Commercial |
$2,799.34
|
| Rate for Payer: PACE SWMI |
$2,332.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,332.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,530.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,325.40
|
| Rate for Payer: Priority Health HMO/PPO |
$3,809.45
|
| Rate for Payer: Priority Health Medicare |
$2,356.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,809.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,332.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,332.78
|
| Rate for Payer: UHC Exchange |
$2,332.78
|
| Rate for Payer: UHC Medicare Advantage |
$2,332.78
|
| Rate for Payer: UHCCP Medicaid |
$1,530.62
|
|
|
PR VANTAS IMPLANT
|
Professional
|
Both
|
$3,401.00
|
|
|
Service Code
|
HCPCS J9225
|
| Min. Negotiated Rate |
$1,360.40 |
| Max. Negotiated Rate |
$5,264.35 |
| Rate for Payer: Aetna Commercial |
$4,678.90
|
| Rate for Payer: Aetna Medicare |
$1,700.50
|
| Rate for Payer: BCBS Complete |
$1,360.40
|
| Rate for Payer: BCBS Trust/PPO |
$5,264.35
|
| Rate for Payer: BCN Commercial |
$5,264.35
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Cash Price |
$2,720.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,210.65
|
|
|
PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 90716
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$177.68 |
| Rate for Payer: Aetna Commercial |
$177.68
|
| Rate for Payer: Aetna Medicare |
$108.00
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS Trust/PPO |
$160.76
|
| Rate for Payer: BCN Commercial |
$157.78
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
|
|
PR VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX
|
Professional
|
Both
|
$1,335.00
|
|
|
Service Code
|
HCPCS 37500
|
| Min. Negotiated Rate |
$396.82 |
| Max. Negotiated Rate |
$1,413.20 |
| Rate for Payer: Aetna Commercial |
$813.25
|
| Rate for Payer: Aetna Medicare |
$631.18
|
| Rate for Payer: BCBS Complete |
$416.66
|
| Rate for Payer: BCBS MAPPO |
$606.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,413.20
|
| Rate for Payer: BCN Commercial |
$902.59
|
| Rate for Payer: BCN Medicare Advantage |
$606.90
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cash Price |
$1,068.00
|
| Rate for Payer: Cofinity Commercial |
$813.25
|
| Rate for Payer: Cofinity Commercial |
$873.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.90
|
| Rate for Payer: Mclaren Medicaid |
$396.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.24
|
| Rate for Payer: Meridian Medicaid |
$416.66
|
| Rate for Payer: Nomi Health Commercial |
$728.28
|
| Rate for Payer: PACE SWMI |
$606.90
|
| Rate for Payer: PHP Medicare Advantage |
$606.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$867.75
|
| Rate for Payer: Priority Health HMO/PPO |
$987.60
|
| Rate for Payer: Priority Health Medicare |
$612.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$987.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.90
|
| Rate for Payer: UHC Exchange |
$606.90
|
| Rate for Payer: UHC Medicare Advantage |
$606.90
|
| Rate for Payer: UHCCP Medicaid |
$396.82
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I
|
Professional
|
Both
|
$1,515.00
|
|
|
Service Code
|
HCPCS 37242
|
| Min. Negotiated Rate |
$295.86 |
| Max. Negotiated Rate |
$10,507.06 |
| Rate for Payer: Aetna Commercial |
$603.31
|
| Rate for Payer: Aetna Medicare |
$468.24
|
| Rate for Payer: BCBS Complete |
$310.65
|
| Rate for Payer: BCBS MAPPO |
$450.23
|
| Rate for Payer: BCBS Trust/PPO |
$658.79
|
| Rate for Payer: BCN Commercial |
$10,507.06
|
| Rate for Payer: BCN Medicare Advantage |
$450.23
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cofinity Commercial |
$648.33
|
| Rate for Payer: Cofinity Commercial |
$603.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.23
|
| Rate for Payer: Mclaren Medicaid |
$295.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.74
|
| Rate for Payer: Meridian Medicaid |
$310.65
|
| Rate for Payer: Nomi Health Commercial |
$540.28
|
| Rate for Payer: PACE SWMI |
$450.23
|
| Rate for Payer: PHP Medicare Advantage |
$450.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.75
|
| Rate for Payer: Priority Health HMO/PPO |
$736.05
|
| Rate for Payer: Priority Health Medicare |
$454.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$736.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$450.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$450.23
|
| Rate for Payer: UHC Exchange |
$450.23
|
| Rate for Payer: UHC Medicare Advantage |
$450.23
|
| Rate for Payer: UHCCP Medicaid |
$295.86
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE
|
Professional
|
Both
|
$9,702.00
|
|
|
Service Code
|
HCPCS 37244
|
| Min. Negotiated Rate |
$410.88 |
| Max. Negotiated Rate |
$9,737.39 |
| Rate for Payer: Aetna Commercial |
$831.43
|
| Rate for Payer: Aetna Medicare |
$645.29
|
| Rate for Payer: BCBS Complete |
$431.42
|
| Rate for Payer: BCBS MAPPO |
$620.47
|
| Rate for Payer: BCBS Trust/PPO |
$624.45
|
| Rate for Payer: BCN Commercial |
$9,737.39
|
| Rate for Payer: BCN Medicare Advantage |
$620.47
|
| Rate for Payer: Cash Price |
$7,761.60
|
| Rate for Payer: Cash Price |
$7,761.60
|
| Rate for Payer: Cofinity Commercial |
$893.48
|
| Rate for Payer: Cofinity Commercial |
$831.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.47
|
| Rate for Payer: Mclaren Medicaid |
$410.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.49
|
| Rate for Payer: Meridian Medicaid |
$431.42
|
| Rate for Payer: Nomi Health Commercial |
$744.56
|
| Rate for Payer: PACE SWMI |
$620.47
|
| Rate for Payer: PHP Medicare Advantage |
$620.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,306.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,019.51
|
| Rate for Payer: Priority Health Medicare |
$626.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.47
|
| Rate for Payer: UHC Exchange |
$620.47
|
| Rate for Payer: UHC Medicare Advantage |
$620.47
|
| Rate for Payer: UHCCP Medicaid |
$410.88
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 37241
|
| Min. Negotiated Rate |
$265.82 |
| Max. Negotiated Rate |
$6,882.05 |
| Rate for Payer: Aetna Commercial |
$540.85
|
| Rate for Payer: Aetna Medicare |
$419.76
|
| Rate for Payer: BCBS Complete |
$279.11
|
| Rate for Payer: BCBS MAPPO |
$403.62
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$6,882.05
|
| Rate for Payer: BCN Medicare Advantage |
$403.62
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$581.21
|
| Rate for Payer: Cofinity Commercial |
$540.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.62
|
| Rate for Payer: Mclaren Medicaid |
$265.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.80
|
| Rate for Payer: Meridian Medicaid |
$279.11
|
| Rate for Payer: Nomi Health Commercial |
$484.34
|
| Rate for Payer: PACE SWMI |
$403.62
|
| Rate for Payer: PHP Medicare Advantage |
$403.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health HMO/PPO |
$661.05
|
| Rate for Payer: Priority Health Medicare |
$407.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.62
|
| Rate for Payer: UHC Exchange |
$403.62
|
| Rate for Payer: UHC Medicare Advantage |
$403.62
|
| Rate for Payer: UHCCP Medicaid |
$265.82
|
|
|
PR VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 37243
|
| Min. Negotiated Rate |
$349.32 |
| Max. Negotiated Rate |
$12,761.33 |
| Rate for Payer: Aetna Commercial |
$706.96
|
| Rate for Payer: Aetna Medicare |
$548.68
|
| Rate for Payer: BCBS Complete |
$366.79
|
| Rate for Payer: BCBS MAPPO |
$527.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCN Commercial |
$12,761.33
|
| Rate for Payer: BCN Medicare Advantage |
$527.58
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cofinity Commercial |
$759.72
|
| Rate for Payer: Cofinity Commercial |
$706.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.58
|
| Rate for Payer: Mclaren Medicaid |
$349.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.96
|
| Rate for Payer: Meridian Medicaid |
$366.79
|
| Rate for Payer: Nomi Health Commercial |
$633.10
|
| Rate for Payer: PACE SWMI |
$527.58
|
| Rate for Payer: PHP Medicare Advantage |
$527.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.05
|
| Rate for Payer: Priority Health HMO/PPO |
$864.74
|
| Rate for Payer: Priority Health Medicare |
$532.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$864.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.58
|
| Rate for Payer: UHC Exchange |
$527.58
|
| Rate for Payer: UHC Medicare Advantage |
$527.58
|
| Rate for Payer: UHCCP Medicaid |
$349.32
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Professional
|
Both
|
$893.00
|
|
|
Service Code
|
HCPCS 55250
|
| Min. Negotiated Rate |
$148.89 |
| Max. Negotiated Rate |
$1,543.69 |
| Rate for Payer: Aetna Commercial |
$293.55
|
| Rate for Payer: Aetna Medicare |
$227.83
|
| Rate for Payer: BCBS Complete |
$156.33
|
| Rate for Payer: BCBS MAPPO |
$219.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,543.69
|
| Rate for Payer: BCN Commercial |
$393.05
|
| Rate for Payer: BCN Medicare Advantage |
$219.07
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$293.55
|
| Rate for Payer: Cofinity Commercial |
$315.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.07
|
| Rate for Payer: Mclaren Medicaid |
$148.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.02
|
| Rate for Payer: Meridian Medicaid |
$156.33
|
| Rate for Payer: Nomi Health Commercial |
$262.88
|
| Rate for Payer: PACE SWMI |
$219.07
|
| Rate for Payer: PHP Medicare Advantage |
$219.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.45
|
| Rate for Payer: Priority Health HMO/PPO |
$369.09
|
| Rate for Payer: Priority Health Medicare |
$221.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$369.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.07
|
| Rate for Payer: UHC Exchange |
$219.07
|
| Rate for Payer: UHC Medicare Advantage |
$219.07
|
| Rate for Payer: UHCCP Medicaid |
$148.89
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Facility
|
IP
|
$893.00
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
55250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$580.45 |
| Max. Negotiated Rate |
$803.70 |
| Rate for Payer: Aetna Commercial |
$759.05
|
| Rate for Payer: BCBS Trust/PPO |
$728.96
|
| Rate for Payer: BCN Commercial |
$690.11
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$767.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.40
|
| Rate for Payer: Healthscope Commercial |
$803.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$669.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$759.05
|
| Rate for Payer: Nomi Health Commercial |
$732.26
|
| Rate for Payer: PHP Commercial |
$759.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.45
|
| Rate for Payer: Priority Health HMO/PPO |
$776.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$598.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.84
|
| Rate for Payer: UHC Core |
$745.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$669.75
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Facility
|
OP
|
$893.00
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
55250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$212.09 |
| Max. Negotiated Rate |
$1,523.78 |
| Rate for Payer: Aetna Commercial |
$759.05
|
| Rate for Payer: Aetna Medicare |
$232.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$279.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$279.06
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$223.25
|
| Rate for Payer: BCBS Trust/PPO |
$734.14
|
| Rate for Payer: BCN Commercial |
$694.31
|
| Rate for Payer: BCN Medicare Advantage |
$223.25
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cash Price |
$714.40
|
| Rate for Payer: Cofinity Commercial |
$767.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.25
|
| Rate for Payer: Healthscope Commercial |
$803.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$669.75
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.41
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$759.05
|
| Rate for Payer: Nomi Health Commercial |
$732.26
|
| Rate for Payer: PACE Senior Care Partners |
$212.09
|
| Rate for Payer: PACE SWMI |
$223.25
|
| Rate for Payer: PHP Commercial |
$759.05
|
| Rate for Payer: PHP Medicare Advantage |
$223.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.45
|
| Rate for Payer: Priority Health HMO/PPO |
$776.91
|
| Rate for Payer: Priority Health Medicare |
$225.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$598.31
|
| Rate for Payer: Railroad Medicare Medicare |
$223.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.84
|
| Rate for Payer: UHC Core |
$745.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$223.25
|
| Rate for Payer: UHC Exchange |
$223.25
|
| Rate for Payer: UHC Medicare Advantage |
$223.25
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$223.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$669.75
|
|
