|
PR BUTORPHANOL TARTRATE 1 MG
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS J0595
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$7.27 |
| Rate for Payer: Aetna Commercial |
$6.77
|
| Rate for Payer: Aetna Medicare |
$5.05
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$5.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.72
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: BCN Medicare Advantage |
$5.05
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$7.27
|
| Rate for Payer: Cofinity Commercial |
$6.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.05
|
| Rate for Payer: Healthscope Commercial |
$6.06
|
| Rate for Payer: Healthscope Whirlpool |
$6.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.30
|
| Rate for Payer: PACE SWMI |
$5.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.90
|
| Rate for Payer: Priority Health Medicare |
$5.05
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
|
|
PR BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 49180
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$553.66 |
| Rate for Payer: Aetna Commercial |
$109.69
|
| Rate for Payer: Aetna Medicare |
$81.86
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS MAPPO |
$81.86
|
| Rate for Payer: BCBS Trust/PPO |
$553.66
|
| Rate for Payer: BCN Commercial |
$256.56
|
| Rate for Payer: BCN Medicare Advantage |
$81.86
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$109.69
|
| Rate for Payer: Cofinity Commercial |
$117.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.86
|
| Rate for Payer: Healthscope Commercial |
$98.23
|
| Rate for Payer: Healthscope Whirlpool |
$98.23
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.95
|
| Rate for Payer: PACE SWMI |
$81.86
|
| Rate for Payer: PHP Medicare Advantage |
$81.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.05
|
| Rate for Payer: Priority Health Medicare |
$81.86
|
| Rate for Payer: Priority Health Narrow Network |
$144.05
|
| Rate for Payer: UHC Medicare Advantage |
$84.32
|
|
|
PR BX ANORECTAL WALL ANAL APPROACH
|
Professional
|
Both
|
$754.00
|
|
|
Service Code
|
HCPCS 45100
|
| Min. Negotiated Rate |
$195.53 |
| Max. Negotiated Rate |
$534.64 |
| Rate for Payer: Aetna Commercial |
$397.48
|
| Rate for Payer: Aetna Medicare |
$296.63
|
| Rate for Payer: BCBS Complete |
$205.31
|
| Rate for Payer: BCBS MAPPO |
$296.63
|
| Rate for Payer: BCBS Trust/PPO |
$534.64
|
| Rate for Payer: BCN Commercial |
$443.72
|
| Rate for Payer: BCN Medicare Advantage |
$296.63
|
| Rate for Payer: Cash Price |
$603.20
|
| Rate for Payer: Cash Price |
$603.20
|
| Rate for Payer: Cofinity Commercial |
$427.15
|
| Rate for Payer: Cofinity Commercial |
$397.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.63
|
| Rate for Payer: Healthscope Commercial |
$355.96
|
| Rate for Payer: Healthscope Whirlpool |
$355.96
|
| Rate for Payer: Meridian Medicaid |
$205.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$311.46
|
| Rate for Payer: PACE SWMI |
$296.63
|
| Rate for Payer: PHP Medicare Advantage |
$296.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.89
|
| Rate for Payer: Priority Health Medicare |
$296.63
|
| Rate for Payer: Priority Health Narrow Network |
$533.89
|
| Rate for Payer: UHC Medicare Advantage |
$305.53
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Facility
|
IP
|
$293.00
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
19100
|
| Min. Negotiated Rate |
$205.10 |
| Max. Negotiated Rate |
$293.00 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: ASR ASR |
$284.21
|
| Rate for Payer: BCBS Trust/PPO |
$227.16
|
| Rate for Payer: BCN Commercial |
$227.16
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.40
|
| Rate for Payer: Healthscope Commercial |
$293.00
|
| Rate for Payer: Healthscope Whirlpool |
$284.21
|
| Rate for Payer: Mclaren Commercial |
$263.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.84
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 19100
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$92.18
|
| Rate for Payer: Aetna Medicare |
$68.79
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$68.79
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: BCN Medicare Advantage |
$68.79
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$99.06
|
| Rate for Payer: Cofinity Commercial |
$92.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.79
|
| Rate for Payer: Healthscope Commercial |
$82.55
|
| Rate for Payer: Healthscope Whirlpool |
$82.55
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.23
|
| Rate for Payer: PACE SWMI |
$68.79
|
| Rate for Payer: PHP Medicare Advantage |
$68.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.26
|
| Rate for Payer: Priority Health Medicare |
$68.79
|
| Rate for Payer: Priority Health Narrow Network |
$84.26
|
| Rate for Payer: UHC Medicare Advantage |
$70.85
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 19100
|
| Hospital Charge Code |
19100
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$92.18
|
| Rate for Payer: Aetna Medicare |
$68.79
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$68.79
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: BCN Medicare Advantage |
$68.79
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$92.18
|
| Rate for Payer: Cofinity Commercial |
$99.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.79
|
| Rate for Payer: Healthscope Commercial |
$82.55
|
| Rate for Payer: Healthscope Whirlpool |
$82.55
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.23
|
| Rate for Payer: PACE SWMI |
$68.79
|
| Rate for Payer: PHP Medicare Advantage |
$68.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.26
|
| Rate for Payer: Priority Health Medicare |
$68.79
|
| Rate for Payer: Priority Health Narrow Network |
$84.26
|
| Rate for Payer: UHC Medicare Advantage |
$70.85
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
19100
|
| Min. Negotiated Rate |
$159.85 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$263.70
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$284.21
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$227.16
|
| Rate for Payer: BCCCP Commercial |
$159.85
|
| Rate for Payer: BCN Commercial |
$227.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$293.00
|
| Rate for Payer: Healthscope Whirlpool |
$284.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$263.70
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.05
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$656.76
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$525.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
PR BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID
|
Professional
|
Both
|
$758.00
|
|
|
Service Code
|
HCPCS 19081
|
| Min. Negotiated Rate |
$102.03 |
| Max. Negotiated Rate |
$1,836.42 |
| Rate for Payer: Aetna Commercial |
$215.23
|
| Rate for Payer: Aetna Medicare |
$160.62
|
| Rate for Payer: BCBS Complete |
$107.13
|
| Rate for Payer: BCBS MAPPO |
$160.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,836.42
|
| Rate for Payer: BCN Commercial |
$741.81
|
| Rate for Payer: BCN Medicare Advantage |
$160.62
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cofinity Commercial |
$231.29
|
| Rate for Payer: Cofinity Commercial |
$215.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.62
|
| Rate for Payer: Healthscope Commercial |
$192.74
|
| Rate for Payer: Healthscope Whirlpool |
$192.74
|
| Rate for Payer: Meridian Medicaid |
$107.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$168.65
|
| Rate for Payer: PACE SWMI |
$160.62
|
| Rate for Payer: PHP Medicare Advantage |
$160.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.13
|
| Rate for Payer: Priority Health Medicare |
$160.62
|
| Rate for Payer: Priority Health Narrow Network |
$198.13
|
| Rate for Payer: UHC Medicare Advantage |
$165.44
|
|
|
PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
HCPCS 19083
|
| Min. Negotiated Rate |
$96.49 |
| Max. Negotiated Rate |
$741.81 |
| Rate for Payer: Aetna Commercial |
$202.25
|
| Rate for Payer: Aetna Medicare |
$150.93
|
| Rate for Payer: BCBS Complete |
$101.31
|
| Rate for Payer: BCBS MAPPO |
$150.93
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$741.81
|
| Rate for Payer: BCN Medicare Advantage |
$150.93
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cofinity Commercial |
$202.25
|
| Rate for Payer: Cofinity Commercial |
$217.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.93
|
| Rate for Payer: Healthscope Commercial |
$181.12
|
| Rate for Payer: Healthscope Whirlpool |
$181.12
|
| Rate for Payer: Meridian Medicaid |
$101.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.48
|
| Rate for Payer: PACE SWMI |
$150.93
|
| Rate for Payer: PHP Medicare Advantage |
$150.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.20
|
| Rate for Payer: Priority Health Medicare |
$150.93
|
| Rate for Payer: Priority Health Narrow Network |
$186.20
|
| Rate for Payer: UHC Medicare Advantage |
$155.46
|
|
|
PR BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID
|
Professional
|
Both
|
$777.00
|
|
|
Service Code
|
HCPCS 19084
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$566.87 |
| Rate for Payer: Aetna Commercial |
$102.27
|
| Rate for Payer: Aetna Medicare |
$76.32
|
| Rate for Payer: BCBS Complete |
$50.55
|
| Rate for Payer: BCBS MAPPO |
$76.32
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$566.87
|
| Rate for Payer: BCN Medicare Advantage |
$76.32
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cash Price |
$621.60
|
| Rate for Payer: Cofinity Commercial |
$109.90
|
| Rate for Payer: Cofinity Commercial |
$102.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.32
|
| Rate for Payer: Healthscope Commercial |
$91.58
|
| Rate for Payer: Healthscope Whirlpool |
$91.58
|
| Rate for Payer: Meridian Medicaid |
$50.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$80.14
|
| Rate for Payer: PACE SWMI |
$76.32
|
| Rate for Payer: PHP Medicare Advantage |
$76.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.13
|
| Rate for Payer: Priority Health Medicare |
$76.32
|
| Rate for Payer: Priority Health Narrow Network |
$94.13
|
| Rate for Payer: UHC Medicare Advantage |
$78.61
|
|
|
PR BX/EXC LYMPH NODE NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 38505
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$656.16 |
| Rate for Payer: Aetna Commercial |
$112.77
|
| Rate for Payer: Aetna Medicare |
$84.16
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$84.16
|
| Rate for Payer: BCBS Trust/PPO |
$656.16
|
| Rate for Payer: BCN Commercial |
$259.00
|
| Rate for Payer: BCN Medicare Advantage |
$84.16
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$121.19
|
| Rate for Payer: Cofinity Commercial |
$112.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.16
|
| Rate for Payer: Healthscope Commercial |
$100.99
|
| Rate for Payer: Healthscope Whirlpool |
$100.99
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$88.37
|
| Rate for Payer: PACE SWMI |
$84.16
|
| Rate for Payer: PHP Medicare Advantage |
$84.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.98
|
| Rate for Payer: Priority Health Medicare |
$84.16
|
| Rate for Payer: Priority Health Narrow Network |
$183.98
|
| Rate for Payer: UHC Medicare Advantage |
$86.68
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
38525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,082.20 |
| Max. Negotiated Rate |
$1,546.00 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: ASR ASR |
$1,499.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.61
|
| Rate for Payer: BCN Commercial |
$1,198.61
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$1,453.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.80
|
| Rate for Payer: Healthscope Commercial |
$1,546.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.62
|
| Rate for Payer: Mclaren Commercial |
$1,391.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.48
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
38525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,082.20 |
| Max. Negotiated Rate |
$4,235.21 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Medicare |
$3,388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,235.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,235.21
|
| Rate for Payer: ASR ASR |
$1,499.62
|
| Rate for Payer: BCBS Complete |
$1,946.16
|
| Rate for Payer: BCBS MAPPO |
$3,388.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.61
|
| Rate for Payer: BCN Commercial |
$1,198.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,388.17
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$1,453.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,388.17
|
| Rate for Payer: Healthscope Commercial |
$1,546.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,388.17
|
| Rate for Payer: Mclaren Commercial |
$1,391.40
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,388.17
|
| Rate for Payer: Meridian Medicaid |
$1,946.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,557.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,896.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.10
|
| Rate for Payer: PACE Medicare |
$3,218.76
|
| Rate for Payer: PACE SWMI |
$3,388.17
|
| Rate for Payer: PHP Commercial |
$3,726.99
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,388.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,406.86
|
| Rate for Payer: Priority Health Medicare |
$3,388.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,097.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,388.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,489.82
|
| Rate for Payer: VA VA |
$3,388.17
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,546.00
|
|
|
Service Code
|
HCPCS 38525
|
| Min. Negotiated Rate |
$284.14 |
| Max. Negotiated Rate |
$1,082.20 |
| Rate for Payer: Aetna Commercial |
$584.63
|
| Rate for Payer: Aetna Medicare |
$436.29
|
| Rate for Payer: BCBS Complete |
$298.35
|
| Rate for Payer: BCBS MAPPO |
$436.29
|
| Rate for Payer: BCBS Trust/PPO |
$486.04
|
| Rate for Payer: BCN Commercial |
$646.03
|
| Rate for Payer: BCN Medicare Advantage |
$436.29
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$584.63
|
| Rate for Payer: Cofinity Commercial |
$628.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.29
|
| Rate for Payer: Healthscope Commercial |
$523.55
|
| Rate for Payer: Healthscope Whirlpool |
$523.55
|
| Rate for Payer: Meridian Medicaid |
$298.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$458.10
|
| Rate for Payer: PACE SWMI |
$436.29
|
| Rate for Payer: PHP Medicare Advantage |
$436.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.58
|
| Rate for Payer: Priority Health Medicare |
$436.29
|
| Rate for Payer: Priority Health Narrow Network |
$957.58
|
| Rate for Payer: UHC Medicare Advantage |
$449.38
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,546.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
38525
|
| Min. Negotiated Rate |
$284.14 |
| Max. Negotiated Rate |
$1,082.20 |
| Rate for Payer: Aetna Commercial |
$584.63
|
| Rate for Payer: Aetna Medicare |
$436.29
|
| Rate for Payer: BCBS Complete |
$298.35
|
| Rate for Payer: BCBS MAPPO |
$436.29
|
| Rate for Payer: BCBS Trust/PPO |
$486.04
|
| Rate for Payer: BCN Commercial |
$646.03
|
| Rate for Payer: BCN Medicare Advantage |
$436.29
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$584.63
|
| Rate for Payer: Cofinity Commercial |
$628.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.29
|
| Rate for Payer: Healthscope Commercial |
$523.55
|
| Rate for Payer: Healthscope Whirlpool |
$523.55
|
| Rate for Payer: Meridian Medicaid |
$298.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$458.10
|
| Rate for Payer: PACE SWMI |
$436.29
|
| Rate for Payer: PHP Medicare Advantage |
$436.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.58
|
| Rate for Payer: Priority Health Medicare |
$436.29
|
| Rate for Payer: Priority Health Narrow Network |
$957.58
|
| Rate for Payer: UHC Medicare Advantage |
$449.38
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,546.00
|
|
|
Service Code
|
HCPCS 38510
|
| Min. Negotiated Rate |
$267.95 |
| Max. Negotiated Rate |
$1,082.20 |
| Rate for Payer: Aetna Commercial |
$555.58
|
| Rate for Payer: Aetna Medicare |
$414.61
|
| Rate for Payer: BCBS Complete |
$281.35
|
| Rate for Payer: BCBS MAPPO |
$414.61
|
| Rate for Payer: BCBS Trust/PPO |
$559.47
|
| Rate for Payer: BCN Commercial |
$777.00
|
| Rate for Payer: BCN Medicare Advantage |
$414.61
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$597.04
|
| Rate for Payer: Cofinity Commercial |
$555.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.61
|
| Rate for Payer: Healthscope Commercial |
$497.53
|
| Rate for Payer: Healthscope Whirlpool |
$497.53
|
| Rate for Payer: Meridian Medicaid |
$281.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$435.34
|
| Rate for Payer: PACE SWMI |
$414.61
|
| Rate for Payer: PHP Medicare Advantage |
$414.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.33
|
| Rate for Payer: Priority Health Medicare |
$414.61
|
| Rate for Payer: Priority Health Narrow Network |
$908.33
|
| Rate for Payer: UHC Medicare Advantage |
$427.05
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,546.00
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
38510
|
| Min. Negotiated Rate |
$267.95 |
| Max. Negotiated Rate |
$1,082.20 |
| Rate for Payer: Aetna Commercial |
$555.58
|
| Rate for Payer: Aetna Medicare |
$414.61
|
| Rate for Payer: BCBS Complete |
$281.35
|
| Rate for Payer: BCBS MAPPO |
$414.61
|
| Rate for Payer: BCBS Trust/PPO |
$559.47
|
| Rate for Payer: BCN Commercial |
$777.00
|
| Rate for Payer: BCN Medicare Advantage |
$414.61
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$597.04
|
| Rate for Payer: Cofinity Commercial |
$555.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.61
|
| Rate for Payer: Healthscope Commercial |
$497.53
|
| Rate for Payer: Healthscope Whirlpool |
$497.53
|
| Rate for Payer: Meridian Medicaid |
$281.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$435.34
|
| Rate for Payer: PACE SWMI |
$414.61
|
| Rate for Payer: PHP Medicare Advantage |
$414.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.33
|
| Rate for Payer: Priority Health Medicare |
$414.61
|
| Rate for Payer: Priority Health Narrow Network |
$908.33
|
| Rate for Payer: UHC Medicare Advantage |
$427.05
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Facility
|
IP
|
$1,546.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
38510
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,082.20 |
| Max. Negotiated Rate |
$1,546.00 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: ASR ASR |
$1,499.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.61
|
| Rate for Payer: BCN Commercial |
$1,198.61
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$1,453.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.80
|
| Rate for Payer: Healthscope Commercial |
$1,546.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.62
|
| Rate for Payer: Mclaren Commercial |
$1,391.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.48
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Facility
|
OP
|
$1,546.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
38510
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,082.20 |
| Max. Negotiated Rate |
$4,235.21 |
| Rate for Payer: Aetna Commercial |
$1,391.40
|
| Rate for Payer: Aetna Medicare |
$3,388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,235.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,235.21
|
| Rate for Payer: ASR ASR |
$1,499.62
|
| Rate for Payer: BCBS Complete |
$1,946.16
|
| Rate for Payer: BCBS MAPPO |
$3,388.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.61
|
| Rate for Payer: BCN Commercial |
$1,198.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,388.17
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cofinity Commercial |
$1,453.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,388.17
|
| Rate for Payer: Healthscope Commercial |
$1,546.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,388.17
|
| Rate for Payer: Mclaren Commercial |
$1,391.40
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,388.17
|
| Rate for Payer: Meridian Medicaid |
$1,946.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,557.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,896.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.10
|
| Rate for Payer: PACE Medicare |
$3,218.76
|
| Rate for Payer: PACE SWMI |
$3,388.17
|
| Rate for Payer: PHP Commercial |
$3,726.99
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,388.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,406.86
|
| Rate for Payer: Priority Health Medicare |
$3,388.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,097.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,388.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,489.82
|
| Rate for Payer: VA VA |
$3,388.17
|
|
|
PR BX/EXC LYMPH NODE OPEN INT MAMMARY NODE
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 38530
|
| Min. Negotiated Rate |
$363.59 |
| Max. Negotiated Rate |
$1,223.40 |
| Rate for Payer: Aetna Commercial |
$745.07
|
| Rate for Payer: Aetna Medicare |
$556.02
|
| Rate for Payer: BCBS Complete |
$381.77
|
| Rate for Payer: BCBS MAPPO |
$556.02
|
| Rate for Payer: BCBS Trust/PPO |
$427.39
|
| Rate for Payer: BCN Commercial |
$825.38
|
| Rate for Payer: BCN Medicare Advantage |
$556.02
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cofinity Commercial |
$745.07
|
| Rate for Payer: Cofinity Commercial |
$800.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$556.02
|
| Rate for Payer: Healthscope Commercial |
$667.22
|
| Rate for Payer: Healthscope Whirlpool |
$667.22
|
| Rate for Payer: Meridian Medicaid |
$381.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$583.82
|
| Rate for Payer: PACE SWMI |
$556.02
|
| Rate for Payer: PHP Medicare Advantage |
$556.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,223.40
|
| Rate for Payer: Priority Health Medicare |
$556.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.40
|
| Rate for Payer: UHC Medicare Advantage |
$572.70
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Facility
|
IP
|
$928.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
38500
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$649.60 |
| Max. Negotiated Rate |
$928.00 |
| Rate for Payer: Aetna Commercial |
$835.20
|
| Rate for Payer: ASR ASR |
$900.16
|
| Rate for Payer: BCBS Trust/PPO |
$719.48
|
| Rate for Payer: BCN Commercial |
$719.48
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cofinity Commercial |
$872.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$742.40
|
| Rate for Payer: Healthscope Commercial |
$928.00
|
| Rate for Payer: Healthscope Whirlpool |
$900.16
|
| Rate for Payer: Mclaren Commercial |
$835.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$788.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$816.64
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 38500
|
| Min. Negotiated Rate |
$164.01 |
| Max. Negotiated Rate |
$649.60 |
| Rate for Payer: Aetna Commercial |
$338.44
|
| Rate for Payer: Aetna Medicare |
$252.57
|
| Rate for Payer: BCBS Complete |
$172.21
|
| Rate for Payer: BCBS MAPPO |
$252.57
|
| Rate for Payer: BCBS Trust/PPO |
$512.45
|
| Rate for Payer: BCN Commercial |
$495.52
|
| Rate for Payer: BCN Medicare Advantage |
$252.57
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cofinity Commercial |
$363.70
|
| Rate for Payer: Cofinity Commercial |
$338.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.57
|
| Rate for Payer: Healthscope Commercial |
$303.08
|
| Rate for Payer: Healthscope Whirlpool |
$303.08
|
| Rate for Payer: Meridian Medicaid |
$172.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$265.20
|
| Rate for Payer: PACE SWMI |
$252.57
|
| Rate for Payer: PHP Medicare Advantage |
$252.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.13
|
| Rate for Payer: Priority Health Medicare |
$252.57
|
| Rate for Payer: Priority Health Narrow Network |
$554.13
|
| Rate for Payer: UHC Medicare Advantage |
$260.15
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
38500
|
| Min. Negotiated Rate |
$164.01 |
| Max. Negotiated Rate |
$649.60 |
| Rate for Payer: Aetna Commercial |
$338.44
|
| Rate for Payer: Aetna Medicare |
$252.57
|
| Rate for Payer: BCBS Complete |
$172.21
|
| Rate for Payer: BCBS MAPPO |
$252.57
|
| Rate for Payer: BCBS Trust/PPO |
$512.45
|
| Rate for Payer: BCN Commercial |
$495.52
|
| Rate for Payer: BCN Medicare Advantage |
$252.57
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cofinity Commercial |
$363.70
|
| Rate for Payer: Cofinity Commercial |
$338.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.57
|
| Rate for Payer: Healthscope Commercial |
$303.08
|
| Rate for Payer: Healthscope Whirlpool |
$303.08
|
| Rate for Payer: Meridian Medicaid |
$172.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$265.20
|
| Rate for Payer: PACE SWMI |
$252.57
|
| Rate for Payer: PHP Medicare Advantage |
$252.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.13
|
| Rate for Payer: Priority Health Medicare |
$252.57
|
| Rate for Payer: Priority Health Narrow Network |
$554.13
|
| Rate for Payer: UHC Medicare Advantage |
$260.15
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Facility
|
OP
|
$928.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
38500
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$649.60 |
| Max. Negotiated Rate |
$4,235.21 |
| Rate for Payer: Aetna Commercial |
$835.20
|
| Rate for Payer: Aetna Medicare |
$3,388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,235.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,235.21
|
| Rate for Payer: ASR ASR |
$900.16
|
| Rate for Payer: BCBS Complete |
$1,946.16
|
| Rate for Payer: BCBS MAPPO |
$3,388.17
|
| Rate for Payer: BCBS Trust/PPO |
$719.48
|
| Rate for Payer: BCN Commercial |
$719.48
|
| Rate for Payer: BCN Medicare Advantage |
$3,388.17
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cofinity Commercial |
$872.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$742.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,388.17
|
| Rate for Payer: Healthscope Commercial |
$928.00
|
| Rate for Payer: Healthscope Whirlpool |
$900.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,388.17
|
| Rate for Payer: Mclaren Commercial |
$835.20
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,388.17
|
| Rate for Payer: Meridian Medicaid |
$1,946.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,557.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,896.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$788.80
|
| Rate for Payer: PACE Medicare |
$3,218.76
|
| Rate for Payer: PACE SWMI |
$3,388.17
|
| Rate for Payer: PHP Commercial |
$3,726.99
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,388.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,542.36
|
| Rate for Payer: Priority Health Medicare |
$3,388.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,833.89
|
| Rate for Payer: Railroad Medicare Medicare |
$3,388.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$816.64
|
| Rate for Payer: UHC Medicare Advantage |
$3,489.82
|
| Rate for Payer: VA VA |
$3,388.17
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Facility
|
IP
|
$1,811.00
|
|
|
Service Code
|
CPT 38520
|
| Hospital Charge Code |
38520
|
| Min. Negotiated Rate |
$1,267.70 |
| Max. Negotiated Rate |
$1,811.00 |
| Rate for Payer: Aetna Commercial |
$1,629.90
|
| Rate for Payer: ASR ASR |
$1,756.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.07
|
| Rate for Payer: BCN Commercial |
$1,404.07
|
| Rate for Payer: Cash Price |
$1,448.80
|
| Rate for Payer: Cofinity Commercial |
$1,702.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.80
|
| Rate for Payer: Healthscope Commercial |
$1,811.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,756.67
|
| Rate for Payer: Mclaren Commercial |
$1,629.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,539.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,267.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,593.68
|
|
