|
PR PROBE NASOLACRIMAL DUCT W/WO IRRIGATION
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 68810
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$4,968.66 |
| Rate for Payer: Aetna Commercial |
$165.22
|
| Rate for Payer: BCBS Complete |
$85.21
|
| Rate for Payer: BCBS Trust/PPO |
$4,968.66
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Meridian Medicaid |
$85.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.70
|
| Rate for Payer: Priority Health Narrow Network |
$220.70
|
| Rate for Payer: Priority Health SBD |
$220.70
|
| Rate for Payer: UMR Bronson Commercial |
$127.88
|
|
|
PR PROCHLORPERAZINE INJECTION
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS J0780
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Aetna Commercial |
$3.53
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$1.73
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
|
|
PR PROCTOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$3,022.00
|
|
|
Service Code
|
HCPCS 45540
|
| Min. Negotiated Rate |
$667.33 |
| Max. Negotiated Rate |
$2,115.40 |
| Rate for Payer: Aetna Commercial |
$1,412.95
|
| Rate for Payer: BCBS Complete |
$700.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,895.01
|
| Rate for Payer: Cash Price |
$2,417.60
|
| Rate for Payer: Cash Price |
$2,417.60
|
| Rate for Payer: Meridian Medicaid |
$700.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,115.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,838.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,838.59
|
| Rate for Payer: Priority Health SBD |
$1,838.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,390.12
|
|
|
PR PROCTOPEXY PERINEAL APPROACH
|
Professional
|
Both
|
$1,625.00
|
|
|
Service Code
|
HCPCS 45541
|
| Min. Negotiated Rate |
$598.74 |
| Max. Negotiated Rate |
$2,270.63 |
| Rate for Payer: Aetna Commercial |
$1,266.92
|
| Rate for Payer: BCBS Complete |
$628.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,270.63
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Meridian Medicaid |
$628.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,646.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,646.32
|
| Rate for Payer: Priority Health SBD |
$1,646.32
|
| Rate for Payer: UMR Bronson Commercial |
$747.50
|
|
|
PR PROCTOPEXY W/SIGMOID RESCJ ABDL APPR
|
Professional
|
Both
|
$3,618.00
|
|
|
Service Code
|
HCPCS 45550
|
| Min. Negotiated Rate |
$921.86 |
| Max. Negotiated Rate |
$2,546.50 |
| Rate for Payer: Aetna Commercial |
$1,961.26
|
| Rate for Payer: BCBS Complete |
$967.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.43
|
| Rate for Payer: Cash Price |
$2,894.40
|
| Rate for Payer: Cash Price |
$2,894.40
|
| Rate for Payer: Meridian Medicaid |
$967.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,532.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,546.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,546.50
|
| Rate for Payer: Priority Health SBD |
$2,546.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,664.28
|
|
|
PR PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE
|
Professional
|
Both
|
$1,654.00
|
|
|
Service Code
|
HCPCS 45505
|
| Min. Negotiated Rate |
$386.60 |
| Max. Negotiated Rate |
$2,064.60 |
| Rate for Payer: Aetna Commercial |
$801.01
|
| Rate for Payer: BCBS Complete |
$405.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.60
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Cash Price |
$1,323.20
|
| Rate for Payer: Meridian Medicaid |
$405.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,061.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,061.87
|
| Rate for Payer: Priority Health SBD |
$1,061.87
|
| Rate for Payer: UMR Bronson Commercial |
$760.84
|
|
|
PR PROCTOPLASTY STENOSIS
|
Professional
|
Both
|
$1,118.00
|
|
|
Service Code
|
HCPCS 45500
|
| Min. Negotiated Rate |
$366.79 |
| Max. Negotiated Rate |
$2,757.73 |
| Rate for Payer: Aetna Commercial |
$764.12
|
| Rate for Payer: BCBS Complete |
$385.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,757.73
|
| Rate for Payer: Cash Price |
$894.40
|
| Rate for Payer: Cash Price |
$894.40
|
| Rate for Payer: Meridian Medicaid |
$385.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,006.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,006.61
|
| Rate for Payer: Priority Health SBD |
$1,006.61
|
| Rate for Payer: UMR Bronson Commercial |
$514.28
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
HCPCS 45300
|
| Hospital Charge Code |
45300
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$502.41 |
| Rate for Payer: Aetna Commercial |
$64.28
|
| Rate for Payer: BCBS Complete |
$32.20
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Meridian Medicaid |
$32.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.08
|
| Rate for Payer: Priority Health Narrow Network |
$84.08
|
| Rate for Payer: Priority Health SBD |
$84.08
|
| Rate for Payer: UMR Bronson Commercial |
$88.78
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
IP
|
$193.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$84.92 |
| Max. Negotiated Rate |
$173.70 |
| Rate for Payer: Aetna American Axle |
$125.45
|
| Rate for Payer: Aetna Commercial |
$164.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.45
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$135.10
|
| Rate for Payer: Cofinity Commercial |
$165.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.40
|
| Rate for Payer: Healthscope Commercial |
$173.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.05
|
| Rate for Payer: PHP Commercial |
$164.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: Priority Health SBD |
$121.59
|
| Rate for Payer: UMR Bronson Commercial |
$84.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.75
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
HCPCS 45300
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$502.41 |
| Rate for Payer: Aetna Commercial |
$64.28
|
| Rate for Payer: BCBS Complete |
$32.20
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Meridian Medicaid |
$32.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.08
|
| Rate for Payer: Priority Health Narrow Network |
$84.08
|
| Rate for Payer: Priority Health SBD |
$84.08
|
| Rate for Payer: UMR Bronson Commercial |
$88.78
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
OP
|
$193.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$47.15 |
| Max. Negotiated Rate |
$2,557.47 |
| Rate for Payer: Aetna American Axle |
$125.45
|
| Rate for Payer: Aetna Commercial |
$164.05
|
| Rate for Payer: Aetna Medicare |
$844.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$116.80
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$135.10
|
| Rate for Payer: Cofinity Commercial |
$165.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$173.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.75
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.05
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$164.05
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,557.47
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,045.98
|
| Rate for Payer: Priority Health SBD |
$121.59
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.40
|
| Rate for Payer: UHC Exchange |
$47.15
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: UMR Bronson Commercial |
$71.41
|
| Rate for Payer: VA VA |
$812.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.75
|
|
|
PR PROCTOSGMDSC RIGID ABLATION LESION
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 45320
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$331.10 |
| Rate for Payer: Aetna Commercial |
$140.99
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: BCBS Trust/PPO |
$223.95
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Meridian Medicaid |
$70.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.86
|
| Rate for Payer: Priority Health Narrow Network |
$182.86
|
| Rate for Payer: Priority Health SBD |
$182.86
|
| Rate for Payer: UMR Bronson Commercial |
$217.58
|
|
|
PR PROCTOSGMDSC RIGID CONTROL BLEEDING
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 45317
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$310.10 |
| Rate for Payer: Aetna Commercial |
$146.55
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS Trust/PPO |
$180.68
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.68
|
| Rate for Payer: Priority Health Narrow Network |
$191.68
|
| Rate for Payer: Priority Health SBD |
$191.68
|
| Rate for Payer: UMR Bronson Commercial |
$203.78
|
|
|
PR PROCTOSGMDSC RIGID DCMPRN VOLVULUS
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
HCPCS 45321
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$268.80 |
| Rate for Payer: Aetna Commercial |
$139.15
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.50
|
| Rate for Payer: Priority Health Narrow Network |
$180.50
|
| Rate for Payer: Priority Health SBD |
$180.50
|
| Rate for Payer: UMR Bronson Commercial |
$176.64
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 45308
|
| Min. Negotiated Rate |
$54.10 |
| Max. Negotiated Rate |
$213.50 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Meridian Medicaid |
$56.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.18
|
| Rate for Payer: Priority Health Narrow Network |
$148.18
|
| Rate for Payer: Priority Health SBD |
$148.18
|
| Rate for Payer: UMR Bronson Commercial |
$140.30
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 45309
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$676.75 |
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS Trust/PPO |
$676.75
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.99
|
| Rate for Payer: Priority Health Narrow Network |
$156.99
|
| Rate for Payer: Priority Health SBD |
$156.99
|
| Rate for Payer: UMR Bronson Commercial |
$170.20
|
|
|
PR PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 45315
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$1,137.43 |
| Rate for Payer: Aetna Commercial |
$142.82
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.43
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.20
|
| Rate for Payer: Priority Health Narrow Network |
$185.20
|
| Rate for Payer: Priority Health SBD |
$185.20
|
| Rate for Payer: UMR Bronson Commercial |
$217.58
|
|
|
PR PROCTOSGMDSC RIGID TNDSC STENT PLMT
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 45327
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$206.57 |
| Rate for Payer: Aetna Commercial |
$156.63
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.03
|
| Rate for Payer: Priority Health Narrow Network |
$204.03
|
| Rate for Payer: Priority Health SBD |
$204.03
|
| Rate for Payer: UMR Bronson Commercial |
$101.20
|
|
|
PR PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 45305
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$1,525.20 |
| Rate for Payer: Aetna Commercial |
$96.87
|
| Rate for Payer: BCBS Complete |
$48.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,525.20
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Meridian Medicaid |
$48.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.01
|
| Rate for Payer: Priority Health Narrow Network |
$127.01
|
| Rate for Payer: Priority Health SBD |
$127.01
|
| Rate for Payer: UMR Bronson Commercial |
$133.86
|
|
|
PR PROCTOSGMDSC RIGID W/DILATION
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 45303
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$520.38 |
| Rate for Payer: Aetna Commercial |
$112.11
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS Trust/PPO |
$520.38
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.75
|
| Rate for Payer: Priority Health Narrow Network |
$148.75
|
| Rate for Payer: Priority Health SBD |
$148.75
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 45307
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$854.26 |
| Rate for Payer: Aetna Commercial |
$127.11
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCBS Trust/PPO |
$854.26
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Meridian Medicaid |
$67.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.21
|
| Rate for Payer: Priority Health Narrow Network |
$175.21
|
| Rate for Payer: Priority Health SBD |
$175.21
|
| Rate for Payer: UMR Bronson Commercial |
$152.72
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 95115
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$432.68 |
| Rate for Payer: Aetna Commercial |
$9.04
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS Trust/PPO |
$432.68
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.72
|
| Rate for Payer: Priority Health Narrow Network |
$13.72
|
| Rate for Payer: Priority Health SBD |
$13.72
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 95117
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$446.94 |
| Rate for Payer: Aetna Commercial |
$11.04
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Trust/PPO |
$446.94
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.65
|
| Rate for Payer: Priority Health Narrow Network |
$16.65
|
| Rate for Payer: Priority Health SBD |
$16.65
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
PR PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 0389T
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: UMR Bronson Commercial |
$41.40
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 93280
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$707.92 |
| Rate for Payer: Aetna Commercial |
$101.66
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS Trust/PPO |
$707.92
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.55
|
| Rate for Payer: Priority Health Narrow Network |
$51.55
|
| Rate for Payer: Priority Health SBD |
$112.54
|
| Rate for Payer: UMR Bronson Commercial |
$99.36
|
|
