|
PR ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 99170
|
| Min. Negotiated Rate |
$80.10 |
| Max. Negotiated Rate |
$174.20 |
| Rate for Payer: Aetna Commercial |
$107.33
|
| Rate for Payer: Aetna Medicare |
$80.10
|
| Rate for Payer: BCBS Complete |
$107.20
|
| Rate for Payer: BCBS MAPPO |
$80.10
|
| Rate for Payer: BCN Medicare Advantage |
$80.10
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cofinity Commercial |
$115.34
|
| Rate for Payer: Cofinity Commercial |
$107.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.10
|
| Rate for Payer: Healthscope Commercial |
$96.12
|
| Rate for Payer: Healthscope Whirlpool |
$96.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.11
|
| Rate for Payer: Nomi Health Commercial |
$96.12
|
| Rate for Payer: PACE SWMI |
$80.10
|
| Rate for Payer: PHP Medicare Advantage |
$80.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.20
|
| Rate for Payer: Priority Health Medicare |
$80.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.10
|
| Rate for Payer: UHC Medicare Advantage |
$80.10
|
| Rate for Payer: UHCCP DNSP |
$80.10
|
|
|
PR ANOPLASTY PLASTIC OPERATION STRICTURE ADULT
|
Professional
|
Both
|
$1,349.00
|
|
|
Service Code
|
HCPCS 46700
|
| Min. Negotiated Rate |
$539.60 |
| Max. Negotiated Rate |
$902.85 |
| Rate for Payer: Aetna Commercial |
$840.15
|
| Rate for Payer: Aetna Medicare |
$626.98
|
| Rate for Payer: BCBS Complete |
$539.60
|
| Rate for Payer: BCBS MAPPO |
$626.98
|
| Rate for Payer: BCN Medicare Advantage |
$626.98
|
| Rate for Payer: Cash Price |
$1,079.20
|
| Rate for Payer: Cash Price |
$1,079.20
|
| Rate for Payer: Cofinity Commercial |
$902.85
|
| Rate for Payer: Cofinity Commercial |
$840.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.98
|
| Rate for Payer: Healthscope Commercial |
$752.38
|
| Rate for Payer: Healthscope Whirlpool |
$752.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.33
|
| Rate for Payer: Nomi Health Commercial |
$752.38
|
| Rate for Payer: PACE SWMI |
$626.98
|
| Rate for Payer: PHP Medicare Advantage |
$626.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.85
|
| Rate for Payer: Priority Health Medicare |
$626.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.98
|
| Rate for Payer: UHC Medicare Advantage |
$626.98
|
| Rate for Payer: UHCCP DNSP |
$626.98
|
|
|
PR ANOPLASTY PLASTIC OPERATION STRICTURE INFANT
|
Professional
|
Both
|
$1,425.00
|
|
|
Service Code
|
HCPCS 46705
|
| Min. Negotiated Rate |
$552.88 |
| Max. Negotiated Rate |
$926.25 |
| Rate for Payer: Aetna Commercial |
$740.86
|
| Rate for Payer: Aetna Medicare |
$552.88
|
| Rate for Payer: BCBS Complete |
$570.00
|
| Rate for Payer: BCBS MAPPO |
$552.88
|
| Rate for Payer: BCN Medicare Advantage |
$552.88
|
| Rate for Payer: Cash Price |
$1,140.00
|
| Rate for Payer: Cash Price |
$1,140.00
|
| Rate for Payer: Cofinity Commercial |
$796.15
|
| Rate for Payer: Cofinity Commercial |
$740.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.88
|
| Rate for Payer: Healthscope Commercial |
$663.46
|
| Rate for Payer: Healthscope Whirlpool |
$663.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.52
|
| Rate for Payer: Nomi Health Commercial |
$663.46
|
| Rate for Payer: PACE SWMI |
$552.88
|
| Rate for Payer: PHP Medicare Advantage |
$552.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$926.25
|
| Rate for Payer: Priority Health Medicare |
$552.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.88
|
| Rate for Payer: UHC Medicare Advantage |
$552.88
|
| Rate for Payer: UHCCP DNSP |
$552.88
|
|
|
PR ANORECTAL MANOMETRY
|
Professional
|
Both
|
$393.00
|
|
|
Service Code
|
HCPCS 91122
|
| Min. Negotiated Rate |
$157.20 |
| Max. Negotiated Rate |
$355.36 |
| Rate for Payer: Aetna Commercial |
$330.69
|
| Rate for Payer: Aetna Medicare |
$246.78
|
| Rate for Payer: BCBS Complete |
$157.20
|
| Rate for Payer: BCBS MAPPO |
$246.78
|
| Rate for Payer: BCN Medicare Advantage |
$246.78
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cofinity Commercial |
$355.36
|
| Rate for Payer: Cofinity Commercial |
$330.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.78
|
| Rate for Payer: Healthscope Commercial |
$296.14
|
| Rate for Payer: Healthscope Whirlpool |
$296.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.12
|
| Rate for Payer: Nomi Health Commercial |
$296.14
|
| Rate for Payer: PACE SWMI |
$246.78
|
| Rate for Payer: PHP Medicare Advantage |
$246.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.45
|
| Rate for Payer: Priority Health Medicare |
$246.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.78
|
| Rate for Payer: UHC Medicare Advantage |
$246.78
|
| Rate for Payer: UHCCP DNSP |
$246.78
|
|
|
PR ANORECTAL MYOMECTOMY
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 45108
|
| Min. Negotiated Rate |
$363.16 |
| Max. Negotiated Rate |
$1,082.25 |
| Rate for Payer: Aetna Commercial |
$486.63
|
| Rate for Payer: Aetna Medicare |
$363.16
|
| Rate for Payer: BCBS Complete |
$666.00
|
| Rate for Payer: BCBS MAPPO |
$363.16
|
| Rate for Payer: BCN Medicare Advantage |
$363.16
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$522.95
|
| Rate for Payer: Cofinity Commercial |
$486.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.16
|
| Rate for Payer: Healthscope Commercial |
$435.79
|
| Rate for Payer: Healthscope Whirlpool |
$435.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.32
|
| Rate for Payer: Nomi Health Commercial |
$435.79
|
| Rate for Payer: PACE SWMI |
$363.16
|
| Rate for Payer: PHP Medicare Advantage |
$363.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health Medicare |
$363.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.16
|
| Rate for Payer: UHC Medicare Advantage |
$363.16
|
| Rate for Payer: UHCCP DNSP |
$363.16
|
|
|
PR ANOSCOPY ABLATION LESION
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 46615
|
| Min. Negotiated Rate |
$86.25 |
| Max. Negotiated Rate |
$435.50 |
| Rate for Payer: Aetna Commercial |
$115.58
|
| Rate for Payer: Aetna Medicare |
$86.25
|
| Rate for Payer: BCBS Complete |
$268.00
|
| Rate for Payer: BCBS MAPPO |
$86.25
|
| Rate for Payer: BCN Medicare Advantage |
$86.25
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cofinity Commercial |
$124.20
|
| Rate for Payer: Cofinity Commercial |
$115.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.25
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Healthscope Whirlpool |
$103.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.56
|
| Rate for Payer: Nomi Health Commercial |
$103.50
|
| Rate for Payer: PACE SWMI |
$86.25
|
| Rate for Payer: PHP Medicare Advantage |
$86.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.50
|
| Rate for Payer: Priority Health Medicare |
$86.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.25
|
| Rate for Payer: UHC Medicare Advantage |
$86.25
|
| Rate for Payer: UHCCP DNSP |
$86.25
|
|
|
PR ANOSCOPY CONTROL BLEEDING
|
Professional
|
Both
|
$639.00
|
|
|
Service Code
|
HCPCS 46614
|
| Min. Negotiated Rate |
$61.70 |
| Max. Negotiated Rate |
$415.35 |
| Rate for Payer: Aetna Commercial |
$82.68
|
| Rate for Payer: Aetna Medicare |
$61.70
|
| Rate for Payer: BCBS Complete |
$255.60
|
| Rate for Payer: BCBS MAPPO |
$61.70
|
| Rate for Payer: BCN Medicare Advantage |
$61.70
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cofinity Commercial |
$88.85
|
| Rate for Payer: Cofinity Commercial |
$82.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.70
|
| Rate for Payer: Healthscope Commercial |
$74.04
|
| Rate for Payer: Healthscope Whirlpool |
$74.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.78
|
| Rate for Payer: Nomi Health Commercial |
$74.04
|
| Rate for Payer: PACE SWMI |
$61.70
|
| Rate for Payer: PHP Medicare Advantage |
$61.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$415.35
|
| Rate for Payer: Priority Health Medicare |
$61.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.70
|
| Rate for Payer: UHC Medicare Advantage |
$61.70
|
| Rate for Payer: UHCCP DNSP |
$61.70
|
|
|
PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 46600
|
| Min. Negotiated Rate |
$39.10 |
| Max. Negotiated Rate |
$159.25 |
| Rate for Payer: Aetna Commercial |
$52.39
|
| Rate for Payer: Aetna Medicare |
$39.10
|
| Rate for Payer: BCBS Complete |
$98.00
|
| Rate for Payer: BCBS MAPPO |
$39.10
|
| Rate for Payer: BCN Medicare Advantage |
$39.10
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$52.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.10
|
| Rate for Payer: Healthscope Commercial |
$46.92
|
| Rate for Payer: Healthscope Whirlpool |
$46.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.05
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PACE SWMI |
$39.10
|
| Rate for Payer: PHP Medicare Advantage |
$39.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.25
|
| Rate for Payer: Priority Health Medicare |
$39.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.10
|
| Rate for Payer: UHC Medicare Advantage |
$39.10
|
| Rate for Payer: UHCCP DNSP |
$39.10
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 46601
|
| Min. Negotiated Rate |
$89.19 |
| Max. Negotiated Rate |
$176.80 |
| Rate for Payer: Aetna Commercial |
$119.51
|
| Rate for Payer: Aetna Medicare |
$89.19
|
| Rate for Payer: BCBS Complete |
$108.80
|
| Rate for Payer: BCBS MAPPO |
$89.19
|
| Rate for Payer: BCN Medicare Advantage |
$89.19
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$128.43
|
| Rate for Payer: Cofinity Commercial |
$119.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.19
|
| Rate for Payer: Healthscope Commercial |
$107.03
|
| Rate for Payer: Healthscope Whirlpool |
$107.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.65
|
| Rate for Payer: Nomi Health Commercial |
$107.03
|
| Rate for Payer: PACE SWMI |
$89.19
|
| Rate for Payer: PHP Medicare Advantage |
$89.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health Medicare |
$89.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.19
|
| Rate for Payer: UHC Medicare Advantage |
$89.19
|
| Rate for Payer: UHCCP DNSP |
$89.19
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX
|
Professional
|
Both
|
$288.00
|
|
|
Service Code
|
HCPCS 46607
|
| Min. Negotiated Rate |
$115.20 |
| Max. Negotiated Rate |
$187.20 |
| Rate for Payer: Aetna Commercial |
$158.28
|
| Rate for Payer: Aetna Medicare |
$118.12
|
| Rate for Payer: BCBS Complete |
$115.20
|
| Rate for Payer: BCBS MAPPO |
$118.12
|
| Rate for Payer: BCN Medicare Advantage |
$118.12
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cofinity Commercial |
$170.09
|
| Rate for Payer: Cofinity Commercial |
$158.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.12
|
| Rate for Payer: Healthscope Commercial |
$141.74
|
| Rate for Payer: Healthscope Whirlpool |
$141.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$141.74
|
| Rate for Payer: PACE SWMI |
$118.12
|
| Rate for Payer: PHP Medicare Advantage |
$118.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.20
|
| Rate for Payer: Priority Health Medicare |
$118.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.12
|
| Rate for Payer: UHC Medicare Advantage |
$118.12
|
| Rate for Payer: UHCCP DNSP |
$118.12
|
|
|
PR ANOSCOPY W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 46606
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$238.55 |
| Rate for Payer: Aetna Commercial |
$97.04
|
| Rate for Payer: Aetna Medicare |
$72.42
|
| Rate for Payer: BCBS Complete |
$146.80
|
| Rate for Payer: BCBS MAPPO |
$72.42
|
| Rate for Payer: BCN Medicare Advantage |
$72.42
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$97.04
|
| Rate for Payer: Cofinity Commercial |
$104.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.42
|
| Rate for Payer: Healthscope Commercial |
$86.90
|
| Rate for Payer: Healthscope Whirlpool |
$86.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.04
|
| Rate for Payer: Nomi Health Commercial |
$86.90
|
| Rate for Payer: PACE SWMI |
$72.42
|
| Rate for Payer: PHP Medicare Advantage |
$72.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health Medicare |
$72.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.42
|
| Rate for Payer: UHC Medicare Advantage |
$72.42
|
| Rate for Payer: UHCCP DNSP |
$72.42
|
|
|
PR ANOSCOPY W/DILATION
|
Professional
|
Both
|
$1,006.00
|
|
|
Service Code
|
HCPCS 46604
|
| Min. Negotiated Rate |
$62.67 |
| Max. Negotiated Rate |
$653.90 |
| Rate for Payer: Aetna Commercial |
$83.98
|
| Rate for Payer: Aetna Medicare |
$62.67
|
| Rate for Payer: BCBS Complete |
$402.40
|
| Rate for Payer: BCBS MAPPO |
$62.67
|
| Rate for Payer: BCN Medicare Advantage |
$62.67
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Cash Price |
$804.80
|
| Rate for Payer: Cofinity Commercial |
$90.24
|
| Rate for Payer: Cofinity Commercial |
$83.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.67
|
| Rate for Payer: Healthscope Commercial |
$75.20
|
| Rate for Payer: Healthscope Whirlpool |
$75.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.80
|
| Rate for Payer: Nomi Health Commercial |
$75.20
|
| Rate for Payer: PACE SWMI |
$62.67
|
| Rate for Payer: PHP Medicare Advantage |
$62.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.90
|
| Rate for Payer: Priority Health Medicare |
$62.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.67
|
| Rate for Payer: UHC Medicare Advantage |
$62.67
|
| Rate for Payer: UHCCP DNSP |
$62.67
|
|
|
PR ANOSCOPY W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 46608
|
| Min. Negotiated Rate |
$82.06 |
| Max. Negotiated Rate |
$231.40 |
| Rate for Payer: Aetna Commercial |
$109.96
|
| Rate for Payer: Aetna Medicare |
$82.06
|
| Rate for Payer: BCBS Complete |
$142.40
|
| Rate for Payer: BCBS MAPPO |
$82.06
|
| Rate for Payer: BCN Medicare Advantage |
$82.06
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cofinity Commercial |
$118.17
|
| Rate for Payer: Cofinity Commercial |
$109.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.06
|
| Rate for Payer: Healthscope Commercial |
$98.47
|
| Rate for Payer: Healthscope Whirlpool |
$98.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.16
|
| Rate for Payer: Nomi Health Commercial |
$98.47
|
| Rate for Payer: PACE SWMI |
$82.06
|
| Rate for Payer: PHP Medicare Advantage |
$82.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.40
|
| Rate for Payer: Priority Health Medicare |
$82.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.06
|
| Rate for Payer: UHC Medicare Advantage |
$82.06
|
| Rate for Payer: UHCCP DNSP |
$82.06
|
|
|
PR ANOSCOPY W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 46610
|
| Min. Negotiated Rate |
$76.95 |
| Max. Negotiated Rate |
$373.10 |
| Rate for Payer: Aetna Commercial |
$103.11
|
| Rate for Payer: Aetna Medicare |
$76.95
|
| Rate for Payer: BCBS Complete |
$229.60
|
| Rate for Payer: BCBS MAPPO |
$76.95
|
| Rate for Payer: BCN Medicare Advantage |
$76.95
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$110.81
|
| Rate for Payer: Cofinity Commercial |
$103.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.95
|
| Rate for Payer: Healthscope Commercial |
$92.34
|
| Rate for Payer: Healthscope Whirlpool |
$92.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.80
|
| Rate for Payer: Nomi Health Commercial |
$92.34
|
| Rate for Payer: PACE SWMI |
$76.95
|
| Rate for Payer: PHP Medicare Advantage |
$76.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health Medicare |
$76.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.95
|
| Rate for Payer: UHC Medicare Advantage |
$76.95
|
| Rate for Payer: UHCCP DNSP |
$76.95
|
|
|
PR ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 46611
|
| Min. Negotiated Rate |
$76.83 |
| Max. Negotiated Rate |
$373.10 |
| Rate for Payer: Aetna Commercial |
$102.95
|
| Rate for Payer: Aetna Medicare |
$76.83
|
| Rate for Payer: BCBS Complete |
$229.60
|
| Rate for Payer: BCBS MAPPO |
$76.83
|
| Rate for Payer: BCN Medicare Advantage |
$76.83
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$110.64
|
| Rate for Payer: Cofinity Commercial |
$102.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.83
|
| Rate for Payer: Healthscope Commercial |
$92.20
|
| Rate for Payer: Healthscope Whirlpool |
$92.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.67
|
| Rate for Payer: Nomi Health Commercial |
$92.20
|
| Rate for Payer: PACE SWMI |
$76.83
|
| Rate for Payer: PHP Medicare Advantage |
$76.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health Medicare |
$76.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.83
|
| Rate for Payer: UHC Medicare Advantage |
$76.83
|
| Rate for Payer: UHCCP DNSP |
$76.83
|
|
|
PR ANOSC RMVL MULT TUMORS CAUTERY/SNARE
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 46612
|
| Min. Negotiated Rate |
$92.78 |
| Max. Negotiated Rate |
$435.50 |
| Rate for Payer: Aetna Commercial |
$124.33
|
| Rate for Payer: Aetna Medicare |
$92.78
|
| Rate for Payer: BCBS Complete |
$268.00
|
| Rate for Payer: BCBS MAPPO |
$92.78
|
| Rate for Payer: BCN Medicare Advantage |
$92.78
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cofinity Commercial |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$124.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.78
|
| Rate for Payer: Healthscope Commercial |
$111.34
|
| Rate for Payer: Healthscope Whirlpool |
$111.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.42
|
| Rate for Payer: Nomi Health Commercial |
$111.34
|
| Rate for Payer: PACE SWMI |
$92.78
|
| Rate for Payer: PHP Medicare Advantage |
$92.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.50
|
| Rate for Payer: Priority Health Medicare |
$92.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.78
|
| Rate for Payer: UHC Medicare Advantage |
$92.78
|
| Rate for Payer: UHCCP DNSP |
$92.78
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$102.28 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$137.06
|
| Rate for Payer: Aetna Medicare |
$102.28
|
| Rate for Payer: BCBS Complete |
$128.80
|
| Rate for Payer: BCBS MAPPO |
$102.28
|
| Rate for Payer: BCN Medicare Advantage |
$102.28
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$147.28
|
| Rate for Payer: Cofinity Commercial |
$137.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.28
|
| Rate for Payer: Healthscope Commercial |
$122.74
|
| Rate for Payer: Healthscope Whirlpool |
$122.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.39
|
| Rate for Payer: Nomi Health Commercial |
$122.74
|
| Rate for Payer: PACE SWMI |
$102.28
|
| Rate for Payer: PHP Medicare Advantage |
$102.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health Medicare |
$102.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.28
|
| Rate for Payer: UHC Medicare Advantage |
$102.28
|
| Rate for Payer: UHCCP DNSP |
$102.28
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 45990
|
| Min. Negotiated Rate |
$102.28 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$137.06
|
| Rate for Payer: Aetna Medicare |
$102.28
|
| Rate for Payer: BCBS Complete |
$128.80
|
| Rate for Payer: BCBS MAPPO |
$102.28
|
| Rate for Payer: BCN Medicare Advantage |
$102.28
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$147.28
|
| Rate for Payer: Cofinity Commercial |
$137.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.28
|
| Rate for Payer: Healthscope Commercial |
$122.74
|
| Rate for Payer: Healthscope Whirlpool |
$122.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.39
|
| Rate for Payer: Nomi Health Commercial |
$122.74
|
| Rate for Payer: PACE SWMI |
$102.28
|
| Rate for Payer: PHP Medicare Advantage |
$102.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health Medicare |
$102.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.28
|
| Rate for Payer: UHC Medicare Advantage |
$102.28
|
| Rate for Payer: UHCCP DNSP |
$102.28
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Facility
|
OP
|
$322.00
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$209.30 |
| Max. Negotiated Rate |
$4,145.63 |
| Rate for Payer: Aetna Commercial |
$289.80
|
| Rate for Payer: Aetna Medicare |
$2,674.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: ASR ASR |
$312.34
|
| Rate for Payer: ASR Commercial |
$312.34
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCBS Trust/PPO |
$263.69
|
| Rate for Payer: BCN Commercial |
$249.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$302.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$322.00
|
| Rate for Payer: Healthscope Whirlpool |
$312.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,674.60
|
| Rate for Payer: Mclaren Commercial |
$289.80
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.70
|
| Rate for Payer: Nomi Health Commercial |
$264.04
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$2,942.06
|
| Rate for Payer: PHP Medicaid |
$1,433.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.14
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health Narrow Network |
$225.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Exchange |
$4,145.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP DNSP |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,433.59
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Facility
|
IP
|
$322.00
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
45990
|
| Min. Negotiated Rate |
$209.30 |
| Max. Negotiated Rate |
$322.00 |
| Rate for Payer: Aetna Commercial |
$289.80
|
| Rate for Payer: ASR ASR |
$312.34
|
| Rate for Payer: ASR Commercial |
$312.34
|
| Rate for Payer: BCBS Trust/PPO |
$262.40
|
| Rate for Payer: BCN Commercial |
$249.65
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$302.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Healthscope Commercial |
$322.00
|
| Rate for Payer: Healthscope Whirlpool |
$312.34
|
| Rate for Payer: Mclaren Commercial |
$289.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.70
|
| Rate for Payer: Nomi Health Commercial |
$264.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.36
|
|
|
PR ANTEPARTUM CARE ONLY 4-6 VISITS
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 59425
|
| Min. Negotiated Rate |
$424.09 |
| Max. Negotiated Rate |
$751.40 |
| Rate for Payer: Aetna Commercial |
$568.28
|
| Rate for Payer: Aetna Medicare |
$424.09
|
| Rate for Payer: BCBS Complete |
$462.40
|
| Rate for Payer: BCBS MAPPO |
$424.09
|
| Rate for Payer: BCN Medicare Advantage |
$424.09
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cofinity Commercial |
$610.69
|
| Rate for Payer: Cofinity Commercial |
$568.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.09
|
| Rate for Payer: Healthscope Commercial |
$508.91
|
| Rate for Payer: Healthscope Whirlpool |
$508.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$445.29
|
| Rate for Payer: Nomi Health Commercial |
$508.91
|
| Rate for Payer: PACE SWMI |
$424.09
|
| Rate for Payer: PHP Medicare Advantage |
$424.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.40
|
| Rate for Payer: Priority Health Medicare |
$424.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$424.09
|
| Rate for Payer: UHC Medicare Advantage |
$424.09
|
| Rate for Payer: UHCCP DNSP |
$424.09
|
|
|
PR ANTEPARTUM CARE ONLY 7/> VISITS
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 59426
|
| Min. Negotiated Rate |
$635.60 |
| Max. Negotiated Rate |
$1,122.31 |
| Rate for Payer: Aetna Commercial |
$1,044.37
|
| Rate for Payer: Aetna Medicare |
$779.38
|
| Rate for Payer: BCBS Complete |
$635.60
|
| Rate for Payer: BCBS MAPPO |
$779.38
|
| Rate for Payer: BCN Medicare Advantage |
$779.38
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$1,122.31
|
| Rate for Payer: Cofinity Commercial |
$1,044.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.38
|
| Rate for Payer: Healthscope Commercial |
$935.26
|
| Rate for Payer: Healthscope Whirlpool |
$935.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$818.35
|
| Rate for Payer: Nomi Health Commercial |
$935.26
|
| Rate for Payer: PACE SWMI |
$779.38
|
| Rate for Payer: PHP Medicare Advantage |
$779.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health Medicare |
$779.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.38
|
| Rate for Payer: UHC Medicare Advantage |
$779.38
|
| Rate for Payer: UHCCP DNSP |
$779.38
|
|
|
PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 57240
|
| Min. Negotiated Rate |
$587.39 |
| Max. Negotiated Rate |
$1,009.45 |
| Rate for Payer: Aetna Commercial |
$787.10
|
| Rate for Payer: Aetna Medicare |
$587.39
|
| Rate for Payer: BCBS Complete |
$621.20
|
| Rate for Payer: BCBS MAPPO |
$587.39
|
| Rate for Payer: BCN Medicare Advantage |
$587.39
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$845.84
|
| Rate for Payer: Cofinity Commercial |
$787.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.39
|
| Rate for Payer: Healthscope Commercial |
$704.87
|
| Rate for Payer: Healthscope Whirlpool |
$704.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$616.76
|
| Rate for Payer: Nomi Health Commercial |
$704.87
|
| Rate for Payer: PACE SWMI |
$587.39
|
| Rate for Payer: PHP Medicare Advantage |
$587.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,009.45
|
| Rate for Payer: Priority Health Medicare |
$587.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.39
|
| Rate for Payer: UHC Medicare Advantage |
$587.39
|
| Rate for Payer: UHCCP DNSP |
$587.39
|
|
|
PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,881.00
|
|
|
Service Code
|
HCPCS 22845
|
| Min. Negotiated Rate |
$709.23 |
| Max. Negotiated Rate |
$2,522.65 |
| Rate for Payer: Aetna Commercial |
$950.37
|
| Rate for Payer: Aetna Medicare |
$709.23
|
| Rate for Payer: BCBS Complete |
$1,552.40
|
| Rate for Payer: BCBS MAPPO |
$709.23
|
| Rate for Payer: BCN Medicare Advantage |
$709.23
|
| Rate for Payer: Cash Price |
$3,104.80
|
| Rate for Payer: Cash Price |
$3,104.80
|
| Rate for Payer: Cofinity Commercial |
$950.37
|
| Rate for Payer: Cofinity Commercial |
$1,021.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.23
|
| Rate for Payer: Healthscope Commercial |
$851.08
|
| Rate for Payer: Healthscope Whirlpool |
$851.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$744.69
|
| Rate for Payer: Nomi Health Commercial |
$851.08
|
| Rate for Payer: PACE SWMI |
$709.23
|
| Rate for Payer: PHP Medicare Advantage |
$709.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,522.65
|
| Rate for Payer: Priority Health Medicare |
$709.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.23
|
| Rate for Payer: UHC Medicare Advantage |
$709.23
|
| Rate for Payer: UHCCP DNSP |
$709.23
|
|
|
PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$4,270.00
|
|
|
Service Code
|
HCPCS 22846
|
| Min. Negotiated Rate |
$739.06 |
| Max. Negotiated Rate |
$2,775.50 |
| Rate for Payer: Aetna Commercial |
$990.34
|
| Rate for Payer: Aetna Medicare |
$739.06
|
| Rate for Payer: BCBS Complete |
$1,708.00
|
| Rate for Payer: BCBS MAPPO |
$739.06
|
| Rate for Payer: BCN Medicare Advantage |
$739.06
|
| Rate for Payer: Cash Price |
$3,416.00
|
| Rate for Payer: Cash Price |
$3,416.00
|
| Rate for Payer: Cofinity Commercial |
$990.34
|
| Rate for Payer: Cofinity Commercial |
$1,064.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.06
|
| Rate for Payer: Healthscope Commercial |
$886.87
|
| Rate for Payer: Healthscope Whirlpool |
$886.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.01
|
| Rate for Payer: Nomi Health Commercial |
$886.87
|
| Rate for Payer: PACE SWMI |
$739.06
|
| Rate for Payer: PHP Medicare Advantage |
$739.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,775.50
|
| Rate for Payer: Priority Health Medicare |
$739.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$739.06
|
| Rate for Payer: UHC Medicare Advantage |
$739.06
|
| Rate for Payer: UHCCP DNSP |
$739.06
|
|
