|
PR OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM
|
Professional
|
Both
|
$2,585.00
|
|
|
Service Code
|
HCPCS 22216
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$1,809.50 |
| Rate for Payer: Aetna Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$241.76
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: Cash Price |
$2,068.00
|
| Rate for Payer: Cash Price |
$2,068.00
|
| Rate for Payer: Meridian Medicaid |
$241.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,809.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.47
|
| Rate for Payer: Priority Health Narrow Network |
$550.47
|
| Rate for Payer: Priority Health SBD |
$550.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,189.10
|
|
|
PR OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 28305
|
| Min. Negotiated Rate |
$434.52 |
| Max. Negotiated Rate |
$1,202.94 |
| Rate for Payer: Aetna Commercial |
$901.63
|
| Rate for Payer: BCBS Complete |
$456.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.94
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Meridian Medicaid |
$456.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,181.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,023.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,023.34
|
| Rate for Payer: Priority Health SBD |
$1,023.34
|
| Rate for Payer: UMR Bronson Commercial |
$776.48
|
|
|
PR OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT
|
Professional
|
Both
|
$3,884.00
|
|
|
Service Code
|
HCPCS 28309
|
| Min. Negotiated Rate |
$582.34 |
| Max. Negotiated Rate |
$2,718.80 |
| Rate for Payer: Aetna Commercial |
$1,184.22
|
| Rate for Payer: BCBS Complete |
$611.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,728.07
|
| Rate for Payer: Cash Price |
$3,107.20
|
| Rate for Payer: Cash Price |
$3,107.20
|
| Rate for Payer: Meridian Medicaid |
$611.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,718.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,374.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,374.15
|
| Rate for Payer: Priority Health SBD |
$1,374.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,786.64
|
|
|
PR OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR
|
Professional
|
Both
|
$1,389.00
|
|
|
Service Code
|
HCPCS 28306
|
| Min. Negotiated Rate |
$263.27 |
| Max. Negotiated Rate |
$1,500.90 |
| Rate for Payer: Aetna Commercial |
$529.18
|
| Rate for Payer: BCBS Complete |
$276.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.90
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Meridian Medicaid |
$276.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.90
|
| Rate for Payer: Priority Health Narrow Network |
$618.90
|
| Rate for Payer: Priority Health SBD |
$618.90
|
| Rate for Payer: UMR Bronson Commercial |
$638.94
|
|
|
PR OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 28308
|
| Min. Negotiated Rate |
$250.91 |
| Max. Negotiated Rate |
$1,566.94 |
| Rate for Payer: Aetna Commercial |
$506.51
|
| Rate for Payer: BCBS Complete |
$263.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.94
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Meridian Medicaid |
$263.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.29
|
| Rate for Payer: Priority Health Narrow Network |
$589.29
|
| Rate for Payer: Priority Health SBD |
$589.29
|
| Rate for Payer: UMR Bronson Commercial |
$490.36
|
|
|
PR OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 63295
|
| Min. Negotiated Rate |
$210.44 |
| Max. Negotiated Rate |
$871.50 |
| Rate for Payer: Aetna Commercial |
$425.26
|
| Rate for Payer: BCBS Complete |
$220.96
|
| Rate for Payer: BCBS Trust/PPO |
$256.75
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Meridian Medicaid |
$220.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.99
|
| Rate for Payer: Priority Health Narrow Network |
$559.99
|
| Rate for Payer: Priority Health SBD |
$559.99
|
| Rate for Payer: UMR Bronson Commercial |
$572.70
|
|
|
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$135.40
|
|
|
Service Code
|
HCPCS J2720
|
| Hospital Charge Code |
6677
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.58 |
| Max. Negotiated Rate |
$121.86 |
| Rate for Payer: Aetna American Axle |
$88.01
|
| Rate for Payer: Aetna American Axle |
$29.30
|
| Rate for Payer: Aetna Commercial |
$115.09
|
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.01
|
| Rate for Payer: Cash Price |
$36.06
|
| Rate for Payer: Cash Price |
$108.32
|
| Rate for Payer: Cofinity Commercial |
$38.77
|
| Rate for Payer: Cofinity Commercial |
$94.78
|
| Rate for Payer: Cofinity Commercial |
$116.44
|
| Rate for Payer: Cofinity Commercial |
$31.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.06
|
| Rate for Payer: Healthscope Commercial |
$40.57
|
| Rate for Payer: Healthscope Commercial |
$121.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.09
|
| Rate for Payer: PHP Commercial |
$38.32
|
| Rate for Payer: PHP Commercial |
$115.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.78
|
| Rate for Payer: Priority Health SBD |
$28.40
|
| Rate for Payer: Priority Health SBD |
$85.30
|
| Rate for Payer: UMR Bronson Commercial |
$59.58
|
| Rate for Payer: UMR Bronson Commercial |
$19.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.81
|
|
|
PROTEIN SUPPLEMENT ORAL
|
Facility
|
IP
|
$3.43
|
|
|
Service Code
|
NDC 4390028430
|
| Hospital Charge Code |
150950
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.51 |
| Max. Negotiated Rate |
$3.09 |
| Rate for Payer: Aetna American Axle |
$2.23
|
| Rate for Payer: Aetna Commercial |
$2.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.23
|
| Rate for Payer: Cash Price |
$2.74
|
| Rate for Payer: Cofinity Commercial |
$2.40
|
| Rate for Payer: Cofinity Commercial |
$2.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.74
|
| Rate for Payer: Healthscope Commercial |
$3.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.92
|
| Rate for Payer: PHP Commercial |
$2.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.40
|
| Rate for Payer: Priority Health SBD |
$2.16
|
| Rate for Payer: UMR Bronson Commercial |
$1.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.57
|
|
|
PR OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA
|
Professional
|
Both
|
$4,394.00
|
|
|
Service Code
|
HCPCS 61345
|
| Min. Negotiated Rate |
$660.90 |
| Max. Negotiated Rate |
$3,492.46 |
| Rate for Payer: Aetna Commercial |
$2,639.58
|
| Rate for Payer: BCBS Complete |
$1,391.55
|
| Rate for Payer: BCBS Trust/PPO |
$660.90
|
| Rate for Payer: Cash Price |
$3,515.20
|
| Rate for Payer: Cash Price |
$3,515.20
|
| Rate for Payer: Meridian Medicaid |
$1,391.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,325.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,075.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,492.46
|
| Rate for Payer: Priority Health Narrow Network |
$3,492.46
|
| Rate for Payer: Priority Health SBD |
$3,492.46
|
| Rate for Payer: UMR Bronson Commercial |
$2,021.24
|
|
|
PR OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 92502
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$1,298.03 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,298.03
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.21
|
| Rate for Payer: Priority Health Narrow Network |
$126.21
|
| Rate for Payer: Priority Health SBD |
$126.21
|
| Rate for Payer: UMR Bronson Commercial |
$149.96
|
|
|
PR OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 69300
|
| Min. Negotiated Rate |
$302.89 |
| Max. Negotiated Rate |
$1,934.63 |
| Rate for Payer: Aetna Commercial |
$518.23
|
| Rate for Payer: BCBS Complete |
$318.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,934.63
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Meridian Medicaid |
$318.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.34
|
| Rate for Payer: Priority Health Narrow Network |
$663.34
|
| Rate for Payer: Priority Health SBD |
$663.34
|
| Rate for Payer: UMR Bronson Commercial |
$713.00
|
|
|
PR OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 93797
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$118.87 |
| Rate for Payer: Aetna Commercial |
$10.29
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.29
|
| Rate for Payer: Priority Health Narrow Network |
$12.29
|
| Rate for Payer: Priority Health SBD |
$12.29
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
PR OVARIAN CYSTECTOMY UNI/BI
|
Professional
|
Both
|
$2,338.00
|
|
|
Service Code
|
HCPCS 58925
|
| Min. Negotiated Rate |
$164.83 |
| Max. Negotiated Rate |
$1,636.60 |
| Rate for Payer: Aetna Commercial |
$912.21
|
| Rate for Payer: BCBS Complete |
$517.98
|
| Rate for Payer: BCBS Trust/PPO |
$164.83
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Meridian Medicaid |
$517.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,091.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,091.72
|
| Rate for Payer: Priority Health SBD |
$1,091.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,075.48
|
|
|
PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$149.10
|
|
|
Service Code
|
NDC 0085-1132-04
|
| Hospital Charge Code |
17934
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.60 |
| Max. Negotiated Rate |
$134.19 |
| Rate for Payer: Aetna American Axle |
$96.92
|
| Rate for Payer: Aetna Commercial |
$126.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.92
|
| Rate for Payer: Cash Price |
$119.28
|
| Rate for Payer: Cofinity Commercial |
$104.37
|
| Rate for Payer: Cofinity Commercial |
$128.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.28
|
| Rate for Payer: Healthscope Commercial |
$134.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$126.74
|
| Rate for Payer: PHP Commercial |
$126.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.37
|
| Rate for Payer: Priority Health SBD |
$93.93
|
| Rate for Payer: UMR Bronson Commercial |
$65.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.82
|
|
|
PROVENTIL HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$116.90
|
|
|
Service Code
|
NDC 0254-1007-52
|
| Hospital Charge Code |
17934
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.44 |
| Max. Negotiated Rate |
$105.21 |
| Rate for Payer: Aetna American Axle |
$75.98
|
| Rate for Payer: Aetna Commercial |
$99.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.98
|
| Rate for Payer: Cash Price |
$93.52
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Cofinity Commercial |
$81.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.52
|
| Rate for Payer: Healthscope Commercial |
$105.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.36
|
| Rate for Payer: PHP Commercial |
$99.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.83
|
| Rate for Payer: Priority Health SBD |
$73.65
|
| Rate for Payer: UMR Bronson Commercial |
$51.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.68
|
|
|
PR OVINE, UP TO 999 USP UNITS
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J3471
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Aetna Commercial |
$0.51
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS Trust/PPO |
$0.50
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.40
|
| Rate for Payer: UMR Bronson Commercial |
$0.92
|
|
|
PR PACKING STRIPS, NON-IMPREG
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS A6407
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$4.20 |
| Rate for Payer: Aetna Commercial |
$1.74
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
| Rate for Payer: UMR Bronson Commercial |
$2.76
|
|
|
PR PALATOPHARYNGOPLASTY
|
Professional
|
Both
|
$2,424.00
|
|
|
Service Code
|
HCPCS 42145
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$1,696.80 |
| Rate for Payer: Aetna Commercial |
$914.29
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.94
|
| Rate for Payer: Cash Price |
$1,939.20
|
| Rate for Payer: Cash Price |
$1,939.20
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,696.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,216.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,216.52
|
| Rate for Payer: Priority Health SBD |
$1,216.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,115.04
|
|
|
PR PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS
|
Professional
|
Both
|
$7,449.00
|
|
|
Service Code
|
HCPCS 48160
|
| Min. Negotiated Rate |
$809.36 |
| Max. Negotiated Rate |
$5,468.15 |
| Rate for Payer: Aetna Commercial |
$4,176.69
|
| Rate for Payer: BCBS Complete |
$2,979.60
|
| Rate for Payer: BCBS Trust/PPO |
$809.36
|
| Rate for Payer: Cash Price |
$5,959.20
|
| Rate for Payer: Cash Price |
$5,959.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,214.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,468.15
|
| Rate for Payer: Priority Health Narrow Network |
$5,468.15
|
| Rate for Payer: Priority Health SBD |
$5,468.15
|
| Rate for Payer: UMR Bronson Commercial |
$3,426.54
|
|
|
PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST
|
Professional
|
Both
|
$3,379.00
|
|
|
Service Code
|
HCPCS 48548
|
| Min. Negotiated Rate |
$484.98 |
| Max. Negotiated Rate |
$2,932.80 |
| Rate for Payer: Aetna Commercial |
$2,265.27
|
| Rate for Payer: BCBS Complete |
$1,120.49
|
| Rate for Payer: BCBS Trust/PPO |
$484.98
|
| Rate for Payer: Cash Price |
$2,703.20
|
| Rate for Payer: Cash Price |
$2,703.20
|
| Rate for Payer: Meridian Medicaid |
$1,120.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,067.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,365.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,932.80
|
| Rate for Payer: Priority Health Narrow Network |
$2,932.80
|
| Rate for Payer: Priority Health SBD |
$2,932.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,554.34
|
|
|
PR PANCREATORRHAPHY INJURY
|
Professional
|
Both
|
$3,208.00
|
|
|
Service Code
|
HCPCS 48545
|
| Min. Negotiated Rate |
$525.66 |
| Max. Negotiated Rate |
$2,366.00 |
| Rate for Payer: Aetna Commercial |
$1,824.64
|
| Rate for Payer: BCBS Complete |
$904.22
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: Cash Price |
$2,566.40
|
| Rate for Payer: Cash Price |
$2,566.40
|
| Rate for Payer: Meridian Medicaid |
$904.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$861.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,366.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,366.00
|
| Rate for Payer: Priority Health SBD |
$2,366.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,475.68
|
|
|
PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC
|
Professional
|
Both
|
$2,485.00
|
|
|
Service Code
|
HCPCS 60505
|
| Min. Negotiated Rate |
$576.38 |
| Max. Negotiated Rate |
$1,977.27 |
| Rate for Payer: Aetna Commercial |
$1,795.96
|
| Rate for Payer: BCBS Complete |
$941.57
|
| Rate for Payer: BCBS Trust/PPO |
$576.38
|
| Rate for Payer: Cash Price |
$1,988.00
|
| Rate for Payer: Cash Price |
$1,988.00
|
| Rate for Payer: Meridian Medicaid |
$941.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$896.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,739.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,977.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,977.27
|
| Rate for Payer: Priority Health SBD |
$1,977.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,143.10
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$153.15 |
| Max. Negotiated Rate |
$663.02 |
| Rate for Payer: Aetna Commercial |
$313.69
|
| Rate for Payer: BCBS Complete |
$160.81
|
| Rate for Payer: BCBS Trust/PPO |
$663.02
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Meridian Medicaid |
$160.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.72
|
| Rate for Payer: Priority Health Narrow Network |
$339.72
|
| Rate for Payer: Priority Health SBD |
$339.72
|
| Rate for Payer: UMR Bronson Commercial |
$218.50
|
|
|
PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS
|
Professional
|
Both
|
$3,438.00
|
|
|
Service Code
|
HCPCS 60500
|
| Min. Negotiated Rate |
$621.96 |
| Max. Negotiated Rate |
$3,645.80 |
| Rate for Payer: Aetna Commercial |
$1,250.32
|
| Rate for Payer: BCBS Complete |
$653.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,645.80
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Cash Price |
$2,750.40
|
| Rate for Payer: Meridian Medicaid |
$653.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,406.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,374.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,374.00
|
| Rate for Payer: Priority Health SBD |
$1,374.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,581.48
|
|
|
PR PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR
|
Professional
|
Both
|
$3,803.00
|
|
|
Service Code
|
HCPCS 60502
|
| Min. Negotiated Rate |
$834.96 |
| Max. Negotiated Rate |
$2,662.10 |
| Rate for Payer: Aetna Commercial |
$1,675.74
|
| Rate for Payer: BCBS Complete |
$876.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.71
|
| Rate for Payer: Cash Price |
$3,042.40
|
| Rate for Payer: Cash Price |
$3,042.40
|
| Rate for Payer: Meridian Medicaid |
$876.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,662.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,841.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,841.95
|
| Rate for Payer: Priority Health SBD |
$1,841.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,749.38
|
|
