|
PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY
|
Professional
|
Both
|
$3,153.00
|
|
|
Service Code
|
HCPCS 58150
|
| Min. Negotiated Rate |
$652.21 |
| Max. Negotiated Rate |
$2,929.42 |
| Rate for Payer: Aetna Commercial |
$1,207.92
|
| Rate for Payer: BCBS Complete |
$684.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,929.42
|
| Rate for Payer: Cash Price |
$2,522.40
|
| Rate for Payer: Cash Price |
$2,522.40
|
| Rate for Payer: Meridian Medicaid |
$684.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$652.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,207.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,437.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,437.32
|
| Rate for Payer: Priority Health SBD |
$1,437.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,450.38
|
|
|
PR TOTAL DISC ARTHRP ANT 2ND LEVEL CERVICAL
|
Professional
|
Both
|
$1,055.00
|
|
|
Service Code
|
HCPCS 22858
|
| Min. Negotiated Rate |
$65.37 |
| Max. Negotiated Rate |
$769.04 |
| Rate for Payer: Aetna Commercial |
$683.01
|
| Rate for Payer: BCBS Complete |
$337.93
|
| Rate for Payer: BCBS Trust/PPO |
$65.37
|
| Rate for Payer: Cash Price |
$844.00
|
| Rate for Payer: Cash Price |
$844.00
|
| Rate for Payer: Meridian Medicaid |
$337.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$738.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.04
|
| Rate for Payer: Priority Health Narrow Network |
$769.04
|
| Rate for Payer: Priority Health SBD |
$769.04
|
| Rate for Payer: UMR Bronson Commercial |
$485.30
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$3,351.28
|
|
|
Service Code
|
HCPCS 22856
|
| Min. Negotiated Rate |
$132.08 |
| Max. Negotiated Rate |
$2,490.44 |
| Rate for Payer: Aetna Commercial |
$2,188.95
|
| Rate for Payer: BCBS Complete |
$1,098.57
|
| Rate for Payer: BCBS Trust/PPO |
$132.08
|
| Rate for Payer: Cash Price |
$2,681.02
|
| Rate for Payer: Cash Price |
$2,681.02
|
| Rate for Payer: Meridian Medicaid |
$1,098.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,345.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,490.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,490.44
|
| Rate for Payer: Priority Health SBD |
$2,490.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,541.59
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR
|
Professional
|
Both
|
$6,907.00
|
|
|
Service Code
|
HCPCS 22857
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$4,834.90 |
| Rate for Payer: Aetna Commercial |
$2,366.42
|
| Rate for Payer: BCBS Complete |
$1,172.38
|
| Rate for Payer: BCBS Trust/PPO |
$66.57
|
| Rate for Payer: Cash Price |
$5,525.60
|
| Rate for Payer: Cash Price |
$5,525.60
|
| Rate for Payer: Meridian Medicaid |
$1,172.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,116.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,834.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,692.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,692.65
|
| Rate for Payer: Priority Health SBD |
$2,692.65
|
| Rate for Payer: UMR Bronson Commercial |
$3,177.22
|
|
|
PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY
|
Professional
|
Both
|
$5,770.00
|
|
|
Service Code
|
HCPCS 43112
|
| Min. Negotiated Rate |
$109.36 |
| Max. Negotiated Rate |
$6,012.03 |
| Rate for Payer: Aetna Commercial |
$4,681.60
|
| Rate for Payer: BCBS Complete |
$2,284.81
|
| Rate for Payer: BCBS Trust/PPO |
$109.36
|
| Rate for Payer: Cash Price |
$4,616.00
|
| Rate for Payer: Cash Price |
$4,616.00
|
| Rate for Payer: Meridian Medicaid |
$2,284.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,176.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,039.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,012.03
|
| Rate for Payer: Priority Health Narrow Network |
$6,012.03
|
| Rate for Payer: Priority Health SBD |
$6,012.03
|
| Rate for Payer: UMR Bronson Commercial |
$2,654.20
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,495.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$453.90 |
| Max. Negotiated Rate |
$1,746.50 |
| Rate for Payer: Aetna Commercial |
$907.32
|
| Rate for Payer: BCBS Complete |
$476.60
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Meridian Medicaid |
$476.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.06
|
| Rate for Payer: Priority Health SBD |
$1,003.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,147.70
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
OP
|
$2,495.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$697.78 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna American Axle |
$1,621.75
|
| Rate for Payer: Aetna Commercial |
$2,120.75
|
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$5,780.16
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Cofinity Commercial |
$2,145.70
|
| Rate for Payer: Cofinity Commercial |
$1,746.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$2,245.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.25
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.75
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$2,120.75
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Priority Health SBD |
$1,571.85
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$767.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$697.78
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: UMR Bronson Commercial |
$923.15
|
| Rate for Payer: VA VA |
$5,128.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.25
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,495.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,097.80 |
| Max. Negotiated Rate |
$2,245.50 |
| Rate for Payer: Aetna American Axle |
$1,621.75
|
| Rate for Payer: Aetna Commercial |
$2,120.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.75
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Cofinity Commercial |
$1,746.50
|
| Rate for Payer: Cofinity Commercial |
$2,145.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.00
|
| Rate for Payer: Healthscope Commercial |
$2,245.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.75
|
| Rate for Payer: PHP Commercial |
$2,120.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
| Rate for Payer: Priority Health SBD |
$1,571.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,097.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.25
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,495.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$453.90 |
| Max. Negotiated Rate |
$1,746.50 |
| Rate for Payer: Aetna Commercial |
$907.32
|
| Rate for Payer: BCBS Complete |
$476.60
|
| Rate for Payer: BCBS Trust/PPO |
$484.45
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Cash Price |
$1,996.00
|
| Rate for Payer: Meridian Medicaid |
$476.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.06
|
| Rate for Payer: Priority Health SBD |
$1,003.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,147.70
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,409.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$566.87 |
| Max. Negotiated Rate |
$1,325.27 |
| Rate for Payer: Aetna Commercial |
$1,197.71
|
| Rate for Payer: BCBS Complete |
$632.04
|
| Rate for Payer: BCBS Trust/PPO |
$566.87
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Meridian Medicaid |
$632.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$601.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,325.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,325.27
|
| Rate for Payer: Priority Health SBD |
$1,325.27
|
| Rate for Payer: UMR Bronson Commercial |
$648.14
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,465.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$5,163.00 |
| Rate for Payer: Aetna Commercial |
$4,000.38
|
| Rate for Payer: BCBS Complete |
$1,971.92
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: Cash Price |
$4,372.00
|
| Rate for Payer: Cash Price |
$4,372.00
|
| Rate for Payer: Meridian Medicaid |
$1,971.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,878.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,163.00
|
| Rate for Payer: Priority Health Narrow Network |
$5,163.00
|
| Rate for Payer: Priority Health SBD |
$5,163.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,513.90
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,809.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$79.81 |
| Max. Negotiated Rate |
$6,577.06 |
| Rate for Payer: Aetna Commercial |
$5,120.17
|
| Rate for Payer: BCBS Complete |
$2,511.37
|
| Rate for Payer: BCBS Trust/PPO |
$79.81
|
| Rate for Payer: Cash Price |
$6,247.20
|
| Rate for Payer: Cash Price |
$6,247.20
|
| Rate for Payer: Meridian Medicaid |
$2,511.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,391.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,466.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,577.06
|
| Rate for Payer: Priority Health Narrow Network |
$6,577.06
|
| Rate for Payer: Priority Health SBD |
$6,577.06
|
| Rate for Payer: UMR Bronson Commercial |
$3,592.14
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,208.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$845.60 |
| Rate for Payer: Aetna Commercial |
$267.76
|
| Rate for Payer: BCBS Complete |
$136.21
|
| Rate for Payer: BCBS Trust/PPO |
$406.79
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Meridian Medicaid |
$136.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.60
|
| Rate for Payer: Priority Health Narrow Network |
$353.60
|
| Rate for Payer: Priority Health SBD |
$353.60
|
| Rate for Payer: UMR Bronson Commercial |
$555.68
|
|
|
PR TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$1,068.75 |
| Rate for Payer: Aetna Commercial |
$62.37
|
| Rate for Payer: BCBS Complete |
$31.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.75
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$31.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.15
|
| Rate for Payer: Priority Health Narrow Network |
$67.15
|
| Rate for Payer: Priority Health SBD |
$67.15
|
| Rate for Payer: UMR Bronson Commercial |
$80.04
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$241.97 |
| Max. Negotiated Rate |
$1,900.30 |
| Rate for Payer: Aetna Commercial |
$438.14
|
| Rate for Payer: BCBS Complete |
$254.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,900.30
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Meridian Medicaid |
$254.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.08
|
| Rate for Payer: Priority Health Narrow Network |
$533.08
|
| Rate for Payer: Priority Health SBD |
$533.08
|
| Rate for Payer: UMR Bronson Commercial |
$262.20
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$933.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$215.98 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$393.11
|
| Rate for Payer: BCBS Complete |
$226.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Meridian Medicaid |
$226.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.68
|
| Rate for Payer: Priority Health Narrow Network |
$477.68
|
| Rate for Payer: Priority Health SBD |
$477.68
|
| Rate for Payer: UMR Bronson Commercial |
$429.18
|
|
|
PR TRACHEOBRNCHSC THRU EST TRACHS INC
|
Professional
|
Both
|
$453.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$73.70 |
| Max. Negotiated Rate |
$1,672.60 |
| Rate for Payer: Aetna Commercial |
$145.81
|
| Rate for Payer: BCBS Complete |
$77.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,672.60
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Meridian Medicaid |
$77.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$317.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.36
|
| Rate for Payer: Priority Health Narrow Network |
$158.36
|
| Rate for Payer: Priority Health SBD |
$158.36
|
| Rate for Payer: UMR Bronson Commercial |
$208.38
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,319.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$864.35 |
| Max. Negotiated Rate |
$3,023.30 |
| Rate for Payer: Aetna Commercial |
$1,748.98
|
| Rate for Payer: BCBS Complete |
$907.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,349.28
|
| Rate for Payer: Cash Price |
$3,455.20
|
| Rate for Payer: Cash Price |
$3,455.20
|
| Rate for Payer: Meridian Medicaid |
$907.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$864.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,023.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,891.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,891.07
|
| Rate for Payer: Priority Health SBD |
$1,891.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,986.74
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,328.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$457.52 |
| Max. Negotiated Rate |
$1,319.17 |
| Rate for Payer: Aetna Commercial |
$924.68
|
| Rate for Payer: BCBS Complete |
$480.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.17
|
| Rate for Payer: Cash Price |
$1,062.40
|
| Rate for Payer: Cash Price |
$1,062.40
|
| Rate for Payer: Meridian Medicaid |
$480.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$929.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$996.93
|
| Rate for Payer: Priority Health Narrow Network |
$996.93
|
| Rate for Payer: Priority Health SBD |
$996.93
|
| Rate for Payer: UMR Bronson Commercial |
$610.88
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$894.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$272.64 |
| Max. Negotiated Rate |
$1,181.81 |
| Rate for Payer: Aetna Commercial |
$554.79
|
| Rate for Payer: BCBS Complete |
$286.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.81
|
| Rate for Payer: Cash Price |
$715.20
|
| Rate for Payer: Cash Price |
$715.20
|
| Rate for Payer: Meridian Medicaid |
$286.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$593.17
|
| Rate for Payer: Priority Health Narrow Network |
$593.17
|
| Rate for Payer: Priority Health SBD |
$593.17
|
| Rate for Payer: UMR Bronson Commercial |
$411.24
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$208.53 |
| Max. Negotiated Rate |
$555.10 |
| Rate for Payer: Aetna Commercial |
$432.01
|
| Rate for Payer: BCBS Complete |
$218.96
|
| Rate for Payer: BCBS Trust/PPO |
$424.08
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Meridian Medicaid |
$218.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.10
|
| Rate for Payer: Priority Health Narrow Network |
$456.10
|
| Rate for Payer: Priority Health SBD |
$456.10
|
| Rate for Payer: UMR Bronson Commercial |
$364.78
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,166.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$1,439.09 |
| Rate for Payer: Aetna Commercial |
$414.60
|
| Rate for Payer: BCBS Complete |
$212.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.09
|
| Rate for Payer: Cash Price |
$932.80
|
| Rate for Payer: Cash Price |
$932.80
|
| Rate for Payer: Meridian Medicaid |
$212.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.36
|
| Rate for Payer: Priority Health Narrow Network |
$440.36
|
| Rate for Payer: Priority Health SBD |
$440.36
|
| Rate for Payer: UMR Bronson Commercial |
$536.36
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$613.65 |
| Max. Negotiated Rate |
$1,336.81 |
| Rate for Payer: Aetna Commercial |
$1,228.30
|
| Rate for Payer: BCBS Complete |
$644.33
|
| Rate for Payer: BCBS Trust/PPO |
$825.73
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Meridian Medicaid |
$644.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$613.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,336.81
|
| Rate for Payer: Priority Health SBD |
$1,336.81
|
| Rate for Payer: UMR Bronson Commercial |
$698.74
|
|
|
PR TRACHEOSTOMY PLANNED SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 31600
|
| Min. Negotiated Rate |
$193.19 |
| Max. Negotiated Rate |
$753.88 |
| Rate for Payer: Aetna Commercial |
$396.30
|
| Rate for Payer: BCBS Complete |
$202.85
|
| Rate for Payer: BCBS Trust/PPO |
$753.88
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Meridian Medicaid |
$202.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$720.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.52
|
| Rate for Payer: Priority Health Narrow Network |
$419.52
|
| Rate for Payer: Priority Health SBD |
$419.52
|
| Rate for Payer: UMR Bronson Commercial |
$473.34
|
|
|
PR TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 31601
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$1,079.85 |
| Rate for Payer: Aetna Commercial |
$574.14
|
| Rate for Payer: BCBS Complete |
$299.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.85
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Meridian Medicaid |
$299.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.09
|
| Rate for Payer: Priority Health Narrow Network |
$619.09
|
| Rate for Payer: Priority Health SBD |
$619.09
|
| Rate for Payer: UMR Bronson Commercial |
$468.28
|
|
