|
PR OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM
|
Professional
|
Both
|
$2,046.00
|
|
|
Service Code
|
HCPCS 27258
|
| Min. Negotiated Rate |
$649.86 |
| Max. Negotiated Rate |
$1,947.65 |
| Rate for Payer: Aetna Commercial |
$1,340.58
|
| Rate for Payer: Aetna Medicare |
$1,040.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,440.62
|
| Rate for Payer: BCBS Complete |
$682.35
|
| Rate for Payer: BCBS MAPPO |
$1,000.43
|
| Rate for Payer: BCN Commercial |
$1,684.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,000.43
|
| Rate for Payer: Cash Price |
$1,636.80
|
| Rate for Payer: Cash Price |
$1,636.80
|
| Rate for Payer: Cofinity Commercial |
$1,340.58
|
| Rate for Payer: Cofinity Commercial |
$1,440.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,000.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,050.45
|
| Rate for Payer: Meridian Medicaid |
$682.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,100.47
|
| Rate for Payer: Nomi Health Commercial |
$1,200.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,534.50
|
| Rate for Payer: PACE SWMI |
$1,000.43
|
| Rate for Payer: PHP Commercial |
$1,400.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,000.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,800.33
|
| Rate for Payer: Priority Health Medicare |
$1,000.43
|
| Rate for Payer: Priority Health SBD |
$1,800.33
|
| Rate for Payer: Priority Health Tiered Network |
$1,800.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,000.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,947.65
|
| Rate for Payer: UHC Core |
$1,947.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,000.43
|
| Rate for Payer: UHC Exchange |
$1,947.65
|
| Rate for Payer: UHC Medicaid |
$649.86
|
| Rate for Payer: UHCCP Medicaid |
$649.86
|
| Rate for Payer: UMR Bronson Commercial |
$941.16
|
|
|
PR OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF
|
Professional
|
Both
|
$2,202.00
|
|
|
Service Code
|
HCPCS 23532
|
| Min. Negotiated Rate |
$380.84 |
| Max. Negotiated Rate |
$1,651.50 |
| Rate for Payer: Aetna Commercial |
$778.22
|
| Rate for Payer: Aetna Medicare |
$603.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.29
|
| Rate for Payer: BCBS Complete |
$399.88
|
| Rate for Payer: BCBS MAPPO |
$580.76
|
| Rate for Payer: BCN Commercial |
$962.60
|
| Rate for Payer: BCN Medicare Advantage |
$580.76
|
| Rate for Payer: Cash Price |
$1,761.60
|
| Rate for Payer: Cash Price |
$1,761.60
|
| Rate for Payer: Cofinity Commercial |
$778.22
|
| Rate for Payer: Cofinity Commercial |
$836.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$580.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$609.80
|
| Rate for Payer: Meridian Medicaid |
$399.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$638.84
|
| Rate for Payer: Nomi Health Commercial |
$696.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,651.50
|
| Rate for Payer: PACE SWMI |
$580.76
|
| Rate for Payer: PHP Commercial |
$813.06
|
| Rate for Payer: PHP Medicare Advantage |
$580.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,028.99
|
| Rate for Payer: Priority Health Medicare |
$580.76
|
| Rate for Payer: Priority Health SBD |
$1,028.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,028.99
|
| Rate for Payer: Railroad Medicare Medicare |
$580.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,088.34
|
| Rate for Payer: UHC Core |
$1,088.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$580.76
|
| Rate for Payer: UHC Exchange |
$1,088.34
|
| Rate for Payer: UHC Medicaid |
$380.84
|
| Rate for Payer: UHCCP Medicaid |
$380.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,012.92
|
|
|
PR OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 27536
|
| Min. Negotiated Rate |
$695.66 |
| Max. Negotiated Rate |
$2,392.50 |
| Rate for Payer: Aetna Commercial |
$1,435.43
|
| Rate for Payer: Aetna Medicare |
$1,114.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,542.56
|
| Rate for Payer: BCBS Complete |
$730.44
|
| Rate for Payer: BCBS MAPPO |
$1,071.22
|
| Rate for Payer: BCN Commercial |
$1,799.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.22
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cofinity Commercial |
$1,435.43
|
| Rate for Payer: Cofinity Commercial |
$1,542.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,124.78
|
| Rate for Payer: Meridian Medicaid |
$730.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,178.34
|
| Rate for Payer: Nomi Health Commercial |
$1,285.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,392.50
|
| Rate for Payer: PACE SWMI |
$1,071.22
|
| Rate for Payer: PHP Commercial |
$1,499.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$695.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,923.30
|
| Rate for Payer: Priority Health Medicare |
$1,071.22
|
| Rate for Payer: Priority Health SBD |
$1,923.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,923.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,071.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,084.03
|
| Rate for Payer: UHC Core |
$2,084.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,071.22
|
| Rate for Payer: UHC Exchange |
$2,084.03
|
| Rate for Payer: UHC Medicaid |
$695.66
|
| Rate for Payer: UHCCP Medicaid |
$695.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,467.40
|
|
|
PR OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE
|
Professional
|
Both
|
$3,694.00
|
|
|
Service Code
|
HCPCS 27758
|
| Min. Negotiated Rate |
$531.44 |
| Max. Negotiated Rate |
$2,770.50 |
| Rate for Payer: Aetna Commercial |
$1,092.01
|
| Rate for Payer: Aetna Medicare |
$847.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,092.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,173.50
|
| Rate for Payer: BCBS Complete |
$558.01
|
| Rate for Payer: BCBS MAPPO |
$814.93
|
| Rate for Payer: BCN Commercial |
$1,363.47
|
| Rate for Payer: BCN Medicare Advantage |
$814.93
|
| Rate for Payer: Cash Price |
$2,955.20
|
| Rate for Payer: Cash Price |
$2,955.20
|
| Rate for Payer: Cofinity Commercial |
$1,092.01
|
| Rate for Payer: Cofinity Commercial |
$1,173.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$814.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$855.68
|
| Rate for Payer: Meridian Medicaid |
$558.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$896.42
|
| Rate for Payer: Nomi Health Commercial |
$977.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,770.50
|
| Rate for Payer: PACE SWMI |
$814.93
|
| Rate for Payer: PHP Commercial |
$1,140.90
|
| Rate for Payer: PHP Medicare Advantage |
$814.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,457.52
|
| Rate for Payer: Priority Health Medicare |
$814.93
|
| Rate for Payer: Priority Health SBD |
$1,457.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,457.52
|
| Rate for Payer: Railroad Medicare Medicare |
$814.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.05
|
| Rate for Payer: UHC Core |
$1,564.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$814.93
|
| Rate for Payer: UHC Exchange |
$1,564.05
|
| Rate for Payer: UHC Medicaid |
$531.44
|
| Rate for Payer: UHCCP Medicaid |
$531.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,699.24
|
|
|
PROPYLENE GLYCOL 1 %-GLYCERIN 0.3 % EYE DROPS
|
Facility
|
OP
|
$26.80
|
|
|
Service Code
|
NDC 10119002003
|
| Hospital Charge Code |
34235
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$24.12 |
| Rate for Payer: Aetna American Axle |
$17.42
|
| Rate for Payer: Aetna Commercial |
$22.78
|
| Rate for Payer: Aetna Medicare |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.42
|
| Rate for Payer: BCBS Complete |
$10.72
|
| Rate for Payer: Cash Price |
$21.44
|
| Rate for Payer: Cofinity Advantage |
$18.76
|
| Rate for Payer: Cofinity Commercial |
$23.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.44
|
| Rate for Payer: Healthscope Commercial |
$24.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.10
|
| Rate for Payer: PHP Commercial |
$22.78
|
| Rate for Payer: Priority Health SBD |
$16.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.42
|
| Rate for Payer: UHC Core |
$13.96
|
| Rate for Payer: UHC Exchange |
$10.53
|
| Rate for Payer: UMR Bronson Commercial |
$9.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.10
|
|
|
PROPYLENE GLYCOL 1 %-GLYCERIN 0.3 % EYE DROPS
|
Facility
|
IP
|
$26.80
|
|
|
Service Code
|
NDC 10119002003
|
| Hospital Charge Code |
34235
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$24.12 |
| Rate for Payer: Aetna American Axle |
$17.42
|
| Rate for Payer: Aetna Commercial |
$22.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.42
|
| Rate for Payer: Cash Price |
$21.44
|
| Rate for Payer: Cofinity Advantage |
$18.76
|
| Rate for Payer: Cofinity Commercial |
$23.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.44
|
| Rate for Payer: Healthscope Commercial |
$24.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.10
|
| Rate for Payer: PHP Commercial |
$22.78
|
| Rate for Payer: Priority Health SBD |
$16.88
|
| Rate for Payer: UMR Bronson Commercial |
$11.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.10
|
|
|
PROPYLPARABEN (BULK) CRYSTALS
|
Facility
|
OP
|
$237.60
|
|
|
Service Code
|
NDC 38779155105
|
| Hospital Charge Code |
13102
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.91 |
| Max. Negotiated Rate |
$213.84 |
| Rate for Payer: Aetna American Axle |
$154.44
|
| Rate for Payer: Aetna Commercial |
$201.96
|
| Rate for Payer: Aetna Medicare |
$118.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.44
|
| Rate for Payer: BCBS Complete |
$95.04
|
| Rate for Payer: Cash Price |
$190.08
|
| Rate for Payer: Cofinity Advantage |
$166.32
|
| Rate for Payer: Cofinity Commercial |
$204.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.08
|
| Rate for Payer: Healthscope Commercial |
$213.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.20
|
| Rate for Payer: PHP Commercial |
$201.96
|
| Rate for Payer: Priority Health SBD |
$149.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.44
|
| Rate for Payer: UHC Core |
$123.79
|
| Rate for Payer: UHC Exchange |
$93.38
|
| Rate for Payer: UMR Bronson Commercial |
$87.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.20
|
|
|
PROPYLPARABEN (BULK) CRYSTALS
|
Facility
|
IP
|
$237.60
|
|
|
Service Code
|
NDC 38779155105
|
| Hospital Charge Code |
13102
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$104.54 |
| Max. Negotiated Rate |
$213.84 |
| Rate for Payer: Aetna American Axle |
$154.44
|
| Rate for Payer: Aetna Commercial |
$201.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.44
|
| Rate for Payer: Cash Price |
$190.08
|
| Rate for Payer: Cofinity Advantage |
$166.32
|
| Rate for Payer: Cofinity Commercial |
$204.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.08
|
| Rate for Payer: Healthscope Commercial |
$213.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.20
|
| Rate for Payer: PHP Commercial |
$201.96
|
| Rate for Payer: Priority Health SBD |
$149.69
|
| Rate for Payer: UMR Bronson Commercial |
$104.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.20
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
IP
|
$252.48
|
|
|
Service Code
|
NDC 00228234810
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.09 |
| Max. Negotiated Rate |
$227.23 |
| Rate for Payer: Aetna American Axle |
$164.11
|
| Rate for Payer: Aetna Commercial |
$214.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.11
|
| Rate for Payer: Cash Price |
$201.98
|
| Rate for Payer: Cofinity Advantage |
$176.74
|
| Rate for Payer: Cofinity Commercial |
$217.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.98
|
| Rate for Payer: Healthscope Commercial |
$227.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.36
|
| Rate for Payer: PHP Commercial |
$214.61
|
| Rate for Payer: Priority Health SBD |
$159.06
|
| Rate for Payer: UMR Bronson Commercial |
$111.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.36
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
OP
|
$335.04
|
|
|
Service Code
|
NDC 67253065110
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$123.96 |
| Max. Negotiated Rate |
$301.54 |
| Rate for Payer: Aetna American Axle |
$217.78
|
| Rate for Payer: Aetna Commercial |
$284.78
|
| Rate for Payer: Aetna Medicare |
$167.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.78
|
| Rate for Payer: BCBS Complete |
$134.02
|
| Rate for Payer: Cash Price |
$268.03
|
| Rate for Payer: Cofinity Advantage |
$234.53
|
| Rate for Payer: Cofinity Commercial |
$288.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.03
|
| Rate for Payer: Healthscope Commercial |
$301.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$234.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.28
|
| Rate for Payer: PHP Commercial |
$284.78
|
| Rate for Payer: Priority Health SBD |
$211.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.78
|
| Rate for Payer: UHC Core |
$174.56
|
| Rate for Payer: UHC Exchange |
$131.67
|
| Rate for Payer: UMR Bronson Commercial |
$123.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.28
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
OP
|
$252.48
|
|
|
Service Code
|
NDC 00228234810
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.42 |
| Max. Negotiated Rate |
$227.23 |
| Rate for Payer: Aetna American Axle |
$164.11
|
| Rate for Payer: Aetna Commercial |
$214.61
|
| Rate for Payer: Aetna Medicare |
$126.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.11
|
| Rate for Payer: BCBS Complete |
$100.99
|
| Rate for Payer: Cash Price |
$201.98
|
| Rate for Payer: Cofinity Advantage |
$176.74
|
| Rate for Payer: Cofinity Commercial |
$217.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.98
|
| Rate for Payer: Healthscope Commercial |
$227.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.36
|
| Rate for Payer: PHP Commercial |
$214.61
|
| Rate for Payer: Priority Health SBD |
$159.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.11
|
| Rate for Payer: UHC Core |
$131.54
|
| Rate for Payer: UHC Exchange |
$99.22
|
| Rate for Payer: UMR Bronson Commercial |
$93.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.36
|
|
|
PROPYLTHIOURACIL 50 MG TABLET
|
Facility
|
IP
|
$335.04
|
|
|
Service Code
|
NDC 67253065110
|
| Hospital Charge Code |
6662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.42 |
| Max. Negotiated Rate |
$301.54 |
| Rate for Payer: Aetna American Axle |
$217.78
|
| Rate for Payer: Aetna Commercial |
$284.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.78
|
| Rate for Payer: Cash Price |
$268.03
|
| Rate for Payer: Cofinity Advantage |
$234.53
|
| Rate for Payer: Cofinity Commercial |
$288.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.03
|
| Rate for Payer: Healthscope Commercial |
$301.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$234.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.28
|
| Rate for Payer: PHP Commercial |
$284.78
|
| Rate for Payer: Priority Health SBD |
$211.08
|
| Rate for Payer: UMR Bronson Commercial |
$147.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.28
|
|
|
PR ORAL DEXAMETHASONE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J8540
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: Aetna Commercial |
$0.04
|
| Rate for Payer: Aetna Medicare |
$0.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.04
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS MAPPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.03
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.03
|
| Rate for Payer: Nomi Health Commercial |
$0.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.75
|
| Rate for Payer: PACE SWMI |
$0.03
|
| Rate for Payer: PHP Commercial |
$0.04
|
| Rate for Payer: PHP Medicare Advantage |
$0.03
|
| Rate for Payer: Priority Health Medicare |
$0.03
|
| Rate for Payer: Railroad Medicare Medicare |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
|
|
PR ORAL POLIOVIRUS IMMUNIZATN,LIVE,OPC
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 90712
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: UMR Bronson Commercial |
$13.34
|
|
|
PR ORAL PRESCRIP DRUG NON CHEMO
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS J8499
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
| Rate for Payer: UMR Bronson Commercial |
$1.84
|
|
|
PR ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 95933
|
| Min. Negotiated Rate |
$79.58 |
| Max. Negotiated Rate |
$129.75 |
| Rate for Payer: Aetna Commercial |
$107.25
|
| Rate for Payer: Aetna Medicare |
$83.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.26
|
| Rate for Payer: BCBS MAPPO |
$80.04
|
| Rate for Payer: BCN Commercial |
$119.51
|
| Rate for Payer: BCN Medicare Advantage |
$80.04
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$115.26
|
| Rate for Payer: Cofinity Commercial |
$107.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.04
|
| Rate for Payer: Nomi Health Commercial |
$96.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: PACE SWMI |
$80.04
|
| Rate for Payer: PHP Commercial |
$112.06
|
| Rate for Payer: PHP Medicare Advantage |
$80.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$110.22
|
| Rate for Payer: Priority Health Medicare |
$80.04
|
| Rate for Payer: Priority Health SBD |
$110.22
|
| Rate for Payer: Priority Health Tiered Network |
$110.22
|
| Rate for Payer: Railroad Medicare Medicare |
$80.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.98
|
| Rate for Payer: UHC Core |
$126.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.04
|
| Rate for Payer: UHC Exchange |
$126.98
|
| Rate for Payer: UMR Bronson Commercial |
$79.58
|
|
|
PR ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ
|
Professional
|
Both
|
$8,195.00
|
|
|
Service Code
|
HCPCS 61584
|
| Min. Negotiated Rate |
$1,805.60 |
| Max. Negotiated Rate |
$6,146.25 |
| Rate for Payer: Aetna Commercial |
$3,745.76
|
| Rate for Payer: Aetna Medicare |
$2,907.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,745.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,025.29
|
| Rate for Payer: BCBS Complete |
$1,895.88
|
| Rate for Payer: BCBS MAPPO |
$2,795.34
|
| Rate for Payer: BCN Commercial |
$6,003.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,795.34
|
| Rate for Payer: Cash Price |
$6,556.00
|
| Rate for Payer: Cash Price |
$6,556.00
|
| Rate for Payer: Cofinity Commercial |
$3,745.76
|
| Rate for Payer: Cofinity Commercial |
$4,025.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,795.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,935.11
|
| Rate for Payer: Meridian Medicaid |
$1,895.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,074.87
|
| Rate for Payer: Nomi Health Commercial |
$3,354.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,146.25
|
| Rate for Payer: PACE SWMI |
$2,795.34
|
| Rate for Payer: PHP Commercial |
$3,913.48
|
| Rate for Payer: PHP Medicare Advantage |
$2,795.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,805.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,047.66
|
| Rate for Payer: Priority Health Medicare |
$2,795.34
|
| Rate for Payer: Priority Health SBD |
$5,047.66
|
| Rate for Payer: Priority Health Tiered Network |
$5,047.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,795.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,033.00
|
| Rate for Payer: UHC Core |
$5,033.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,795.34
|
| Rate for Payer: UHC Exchange |
$5,033.00
|
| Rate for Payer: UHC Medicaid |
$1,805.60
|
| Rate for Payer: UHCCP Medicaid |
$1,805.60
|
| Rate for Payer: UMR Bronson Commercial |
$3,769.70
|
|
|
PR ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE
|
Professional
|
Both
|
$5,932.00
|
|
|
Service Code
|
HCPCS 61592
|
| Min. Negotiated Rate |
$1,934.47 |
| Max. Negotiated Rate |
$6,587.35 |
| Rate for Payer: Aetna Commercial |
$4,030.59
|
| Rate for Payer: Aetna Medicare |
$3,128.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,030.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,331.38
|
| Rate for Payer: BCBS Complete |
$2,031.19
|
| Rate for Payer: BCBS MAPPO |
$3,007.90
|
| Rate for Payer: BCN Commercial |
$6,587.35
|
| Rate for Payer: BCN Medicare Advantage |
$3,007.90
|
| Rate for Payer: Cash Price |
$4,745.60
|
| Rate for Payer: Cash Price |
$4,745.60
|
| Rate for Payer: Cofinity Commercial |
$4,030.59
|
| Rate for Payer: Cofinity Commercial |
$4,331.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,007.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,158.30
|
| Rate for Payer: Meridian Medicaid |
$2,031.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,308.69
|
| Rate for Payer: Nomi Health Commercial |
$3,609.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,449.00
|
| Rate for Payer: PACE SWMI |
$3,007.90
|
| Rate for Payer: PHP Commercial |
$4,211.06
|
| Rate for Payer: PHP Medicare Advantage |
$3,007.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,934.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,538.14
|
| Rate for Payer: Priority Health Medicare |
$3,007.90
|
| Rate for Payer: Priority Health SBD |
$5,538.14
|
| Rate for Payer: Priority Health Tiered Network |
$5,538.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,007.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,580.65
|
| Rate for Payer: UHC Core |
$5,580.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,007.90
|
| Rate for Payer: UHC Exchange |
$5,580.65
|
| Rate for Payer: UHC Medicaid |
$1,934.47
|
| Rate for Payer: UHCCP Medicaid |
$1,934.47
|
| Rate for Payer: UMR Bronson Commercial |
$2,728.72
|
|
|
PR ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN
|
Professional
|
Both
|
$3,696.00
|
|
|
Service Code
|
HCPCS 67445
|
| Min. Negotiated Rate |
$836.45 |
| Max. Negotiated Rate |
$2,772.00 |
| Rate for Payer: Aetna Commercial |
$1,692.55
|
| Rate for Payer: Aetna Medicare |
$1,313.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,692.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,818.86
|
| Rate for Payer: BCBS Complete |
$878.27
|
| Rate for Payer: BCBS MAPPO |
$1,263.10
|
| Rate for Payer: BCN Commercial |
$2,240.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,263.10
|
| Rate for Payer: Cash Price |
$2,956.80
|
| Rate for Payer: Cash Price |
$2,956.80
|
| Rate for Payer: Cofinity Commercial |
$1,692.55
|
| Rate for Payer: Cofinity Commercial |
$1,818.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,263.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,326.26
|
| Rate for Payer: Meridian Medicaid |
$878.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,389.41
|
| Rate for Payer: Nomi Health Commercial |
$1,515.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,772.00
|
| Rate for Payer: PACE SWMI |
$1,263.10
|
| Rate for Payer: PHP Commercial |
$1,768.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,263.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,624.87
|
| Rate for Payer: Priority Health Medicare |
$1,263.10
|
| Rate for Payer: Priority Health SBD |
$2,624.87
|
| Rate for Payer: Priority Health Tiered Network |
$2,624.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,263.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,505.10
|
| Rate for Payer: UHC Core |
$2,505.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,263.10
|
| Rate for Payer: UHC Exchange |
$2,505.10
|
| Rate for Payer: UHC Medicaid |
$836.45
|
| Rate for Payer: UHCCP Medicaid |
$836.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,700.16
|
|
|
PR ORBITOTOMY W/O BONE FLAP EXPL W/WO BIOPSY
|
Professional
|
Both
|
$1,712.00
|
|
|
Service Code
|
HCPCS 67400
|
| Min. Negotiated Rate |
$581.06 |
| Max. Negotiated Rate |
$1,780.84 |
| Rate for Payer: Aetna Commercial |
$1,165.88
|
| Rate for Payer: Aetna Medicare |
$904.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.89
|
| Rate for Payer: BCBS Complete |
$610.11
|
| Rate for Payer: BCBS MAPPO |
$870.06
|
| Rate for Payer: BCN Commercial |
$1,520.34
|
| Rate for Payer: BCN Medicare Advantage |
$870.06
|
| Rate for Payer: Cash Price |
$1,369.60
|
| Rate for Payer: Cash Price |
$1,369.60
|
| Rate for Payer: Cofinity Commercial |
$1,165.88
|
| Rate for Payer: Cofinity Commercial |
$1,252.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$913.56
|
| Rate for Payer: Meridian Medicaid |
$610.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$957.07
|
| Rate for Payer: Nomi Health Commercial |
$1,044.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,284.00
|
| Rate for Payer: PACE SWMI |
$870.06
|
| Rate for Payer: PHP Commercial |
$1,218.08
|
| Rate for Payer: PHP Medicare Advantage |
$870.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,780.84
|
| Rate for Payer: Priority Health Medicare |
$870.06
|
| Rate for Payer: Priority Health SBD |
$1,780.84
|
| Rate for Payer: Priority Health Tiered Network |
$1,780.84
|
| Rate for Payer: Railroad Medicare Medicare |
$870.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,665.63
|
| Rate for Payer: UHC Core |
$1,665.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$870.06
|
| Rate for Payer: UHC Exchange |
$1,665.63
|
| Rate for Payer: UHC Medicaid |
$581.06
|
| Rate for Payer: UHCCP Medicaid |
$581.06
|
| Rate for Payer: UMR Bronson Commercial |
$787.52
|
|
|
PR ORBITOTOMY W/O BONE FLAP W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$2,732.00
|
|
|
Service Code
|
HCPCS 67413
|
| Min. Negotiated Rate |
$540.17 |
| Max. Negotiated Rate |
$2,049.00 |
| Rate for Payer: Aetna Commercial |
$1,082.89
|
| Rate for Payer: Aetna Medicare |
$840.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,163.71
|
| Rate for Payer: BCBS Complete |
$567.18
|
| Rate for Payer: BCBS MAPPO |
$808.13
|
| Rate for Payer: BCN Commercial |
$1,412.27
|
| Rate for Payer: BCN Medicare Advantage |
$808.13
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,082.89
|
| Rate for Payer: Cofinity Commercial |
$1,163.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$808.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$848.54
|
| Rate for Payer: Meridian Medicaid |
$567.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$888.94
|
| Rate for Payer: Nomi Health Commercial |
$969.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,049.00
|
| Rate for Payer: PACE SWMI |
$808.13
|
| Rate for Payer: PHP Commercial |
$1,131.38
|
| Rate for Payer: PHP Medicare Advantage |
$808.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$540.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,654.26
|
| Rate for Payer: Priority Health Medicare |
$808.13
|
| Rate for Payer: Priority Health SBD |
$1,654.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,654.26
|
| Rate for Payer: Railroad Medicare Medicare |
$808.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,541.57
|
| Rate for Payer: UHC Core |
$1,541.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$808.13
|
| Rate for Payer: UHC Exchange |
$1,541.57
|
| Rate for Payer: UHC Medicaid |
$540.17
|
| Rate for Payer: UHCCP Medicaid |
$540.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,256.72
|
|
|
PR ORCHIECTOMY PARTIAL
|
Professional
|
Both
|
$1,136.00
|
|
|
Service Code
|
HCPCS 54522
|
| Min. Negotiated Rate |
$341.23 |
| Max. Negotiated Rate |
$1,038.24 |
| Rate for Payer: Aetna Commercial |
$706.01
|
| Rate for Payer: Aetna Medicare |
$547.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.69
|
| Rate for Payer: BCBS Complete |
$358.29
|
| Rate for Payer: BCBS MAPPO |
$526.87
|
| Rate for Payer: BCN Commercial |
$882.42
|
| Rate for Payer: BCN Medicare Advantage |
$526.87
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cofinity Commercial |
$706.01
|
| Rate for Payer: Cofinity Commercial |
$758.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.21
|
| Rate for Payer: Meridian Medicaid |
$358.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$579.56
|
| Rate for Payer: Nomi Health Commercial |
$632.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.00
|
| Rate for Payer: PACE SWMI |
$526.87
|
| Rate for Payer: PHP Commercial |
$737.62
|
| Rate for Payer: PHP Medicare Advantage |
$526.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$961.24
|
| Rate for Payer: Priority Health Medicare |
$526.87
|
| Rate for Payer: Priority Health SBD |
$961.24
|
| Rate for Payer: Priority Health Tiered Network |
$961.24
|
| Rate for Payer: Railroad Medicare Medicare |
$526.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.24
|
| Rate for Payer: UHC Core |
$1,038.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$526.87
|
| Rate for Payer: UHC Exchange |
$1,038.24
|
| Rate for Payer: UHC Medicaid |
$341.23
|
| Rate for Payer: UHCCP Medicaid |
$341.23
|
| Rate for Payer: UMR Bronson Commercial |
$522.56
|
|
|
PR ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 54530
|
| Min. Negotiated Rate |
$299.27 |
| Max. Negotiated Rate |
$891.05 |
| Rate for Payer: Aetna Commercial |
$616.99
|
| Rate for Payer: Aetna Medicare |
$478.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.03
|
| Rate for Payer: BCBS Complete |
$314.23
|
| Rate for Payer: BCBS MAPPO |
$460.44
|
| Rate for Payer: BCN Commercial |
$767.39
|
| Rate for Payer: BCN Medicare Advantage |
$460.44
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$616.99
|
| Rate for Payer: Cofinity Commercial |
$663.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.46
|
| Rate for Payer: Meridian Medicaid |
$314.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$506.48
|
| Rate for Payer: Nomi Health Commercial |
$552.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$748.50
|
| Rate for Payer: PACE SWMI |
$460.44
|
| Rate for Payer: PHP Commercial |
$644.62
|
| Rate for Payer: PHP Medicare Advantage |
$460.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$835.94
|
| Rate for Payer: Priority Health Medicare |
$460.44
|
| Rate for Payer: Priority Health SBD |
$835.94
|
| Rate for Payer: Priority Health Tiered Network |
$835.94
|
| Rate for Payer: Railroad Medicare Medicare |
$460.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$891.05
|
| Rate for Payer: UHC Core |
$891.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$460.44
|
| Rate for Payer: UHC Exchange |
$891.05
|
| Rate for Payer: UHC Medicaid |
$299.27
|
| Rate for Payer: UHCCP Medicaid |
$299.27
|
| Rate for Payer: UMR Bronson Commercial |
$459.08
|
|
|
PR ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL
|
Professional
|
Both
|
$1,443.00
|
|
|
Service Code
|
HCPCS 54535
|
| Min. Negotiated Rate |
$429.62 |
| Max. Negotiated Rate |
$1,313.09 |
| Rate for Payer: Aetna Commercial |
$890.24
|
| Rate for Payer: Aetna Medicare |
$690.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$890.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$956.68
|
| Rate for Payer: BCBS Complete |
$451.10
|
| Rate for Payer: BCBS MAPPO |
$664.36
|
| Rate for Payer: BCN Commercial |
$1,114.98
|
| Rate for Payer: BCN Medicare Advantage |
$664.36
|
| Rate for Payer: Cash Price |
$1,154.40
|
| Rate for Payer: Cash Price |
$1,154.40
|
| Rate for Payer: Cofinity Commercial |
$890.24
|
| Rate for Payer: Cofinity Commercial |
$956.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$664.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$697.58
|
| Rate for Payer: Meridian Medicaid |
$451.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$730.80
|
| Rate for Payer: Nomi Health Commercial |
$797.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,082.25
|
| Rate for Payer: PACE SWMI |
$664.36
|
| Rate for Payer: PHP Commercial |
$930.10
|
| Rate for Payer: PHP Medicare Advantage |
$664.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,214.58
|
| Rate for Payer: Priority Health Medicare |
$664.36
|
| Rate for Payer: Priority Health SBD |
$1,214.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,214.58
|
| Rate for Payer: Railroad Medicare Medicare |
$664.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.09
|
| Rate for Payer: UHC Core |
$1,313.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$664.36
|
| Rate for Payer: UHC Exchange |
$1,313.09
|
| Rate for Payer: UHC Medicaid |
$429.62
|
| Rate for Payer: UHCCP Medicaid |
$429.62
|
| Rate for Payer: UMR Bronson Commercial |
$663.78
|
|
|
PR ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH
|
Professional
|
Both
|
$633.00
|
|
|
Service Code
|
HCPCS 54520
|
| Min. Negotiated Rate |
$194.90 |
| Max. Negotiated Rate |
$571.83 |
| Rate for Payer: Aetna Commercial |
$401.09
|
| Rate for Payer: Aetna Medicare |
$311.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.02
|
| Rate for Payer: BCBS Complete |
$204.65
|
| Rate for Payer: BCBS MAPPO |
$299.32
|
| Rate for Payer: BCN Commercial |
$495.49
|
| Rate for Payer: BCN Medicare Advantage |
$299.32
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cofinity Commercial |
$401.09
|
| Rate for Payer: Cofinity Commercial |
$431.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.29
|
| Rate for Payer: Meridian Medicaid |
$204.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.25
|
| Rate for Payer: Nomi Health Commercial |
$359.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.75
|
| Rate for Payer: PACE SWMI |
$299.32
|
| Rate for Payer: PHP Commercial |
$419.05
|
| Rate for Payer: PHP Medicare Advantage |
$299.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$539.75
|
| Rate for Payer: Priority Health Medicare |
$299.32
|
| Rate for Payer: Priority Health SBD |
$539.75
|
| Rate for Payer: Priority Health Tiered Network |
$539.75
|
| Rate for Payer: Railroad Medicare Medicare |
$299.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.83
|
| Rate for Payer: UHC Core |
$571.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$299.32
|
| Rate for Payer: UHC Exchange |
$571.83
|
| Rate for Payer: UHC Medicaid |
$194.90
|
| Rate for Payer: UHCCP Medicaid |
$194.90
|
| Rate for Payer: UMR Bronson Commercial |
$291.18
|
|
