|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 96170
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$113.38 |
| Rate for Payer: Aetna Commercial |
$84.24
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS Trust/PPO |
$66.04
|
| Rate for Payer: BCN Commercial |
$113.38
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.91
|
| Rate for Payer: Priority Health Narrow Network |
$97.91
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 96171
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$102.49 |
| Rate for Payer: Aetna Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$102.49
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.48
|
| Rate for Payer: Priority Health Narrow Network |
$35.48
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 96167
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$115.70 |
| Rate for Payer: Aetna Commercial |
$80.61
|
| Rate for Payer: Aetna Medicare |
$60.16
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$60.16
|
| Rate for Payer: BCBS Trust/PPO |
$115.70
|
| Rate for Payer: BCN Commercial |
$99.69
|
| Rate for Payer: BCN Medicare Advantage |
$60.16
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$86.63
|
| Rate for Payer: Cofinity Commercial |
$80.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.16
|
| Rate for Payer: Healthscope Commercial |
$72.19
|
| Rate for Payer: Healthscope Whirlpool |
$72.19
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.17
|
| Rate for Payer: PACE SWMI |
$60.16
|
| Rate for Payer: PHP Medicare Advantage |
$60.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.40
|
| Rate for Payer: Priority Health Medicare |
$60.16
|
| Rate for Payer: Priority Health Narrow Network |
$80.40
|
| Rate for Payer: UHC Medicare Advantage |
$61.96
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 96168
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$168.53 |
| Rate for Payer: Aetna Commercial |
$28.35
|
| Rate for Payer: Aetna Medicare |
$21.16
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCBS MAPPO |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$168.53
|
| Rate for Payer: BCN Commercial |
$35.19
|
| Rate for Payer: BCN Medicare Advantage |
$21.16
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$30.47
|
| Rate for Payer: Cofinity Commercial |
$28.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.16
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$25.39
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.22
|
| Rate for Payer: PACE SWMI |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$21.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.30
|
| Rate for Payer: Priority Health Medicare |
$21.16
|
| Rate for Payer: Priority Health Narrow Network |
$28.30
|
| Rate for Payer: UHC Medicare Advantage |
$21.79
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 96158
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$831.54 |
| Rate for Payer: Aetna Commercial |
$76.07
|
| Rate for Payer: Aetna Medicare |
$56.77
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$56.77
|
| Rate for Payer: BCBS Trust/PPO |
$831.54
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$56.77
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$76.07
|
| Rate for Payer: Cofinity Commercial |
$81.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.77
|
| Rate for Payer: Healthscope Commercial |
$68.12
|
| Rate for Payer: Healthscope Whirlpool |
$68.12
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.61
|
| Rate for Payer: PACE SWMI |
$56.77
|
| Rate for Payer: PHP Medicare Advantage |
$56.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.91
|
| Rate for Payer: Priority Health Medicare |
$56.77
|
| Rate for Payer: Priority Health Narrow Network |
$75.91
|
| Rate for Payer: UHC Medicare Advantage |
$58.47
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 96159
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$208.15 |
| Rate for Payer: Aetna Commercial |
$26.09
|
| Rate for Payer: Aetna Medicare |
$19.47
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$208.15
|
| Rate for Payer: BCN Commercial |
$32.25
|
| Rate for Payer: BCN Medicare Advantage |
$19.47
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$28.04
|
| Rate for Payer: Cofinity Commercial |
$26.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.47
|
| Rate for Payer: Healthscope Commercial |
$23.36
|
| Rate for Payer: Healthscope Whirlpool |
$23.36
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.44
|
| Rate for Payer: PACE SWMI |
$19.47
|
| Rate for Payer: PHP Medicare Advantage |
$19.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.04
|
| Rate for Payer: Priority Health Medicare |
$19.47
|
| Rate for Payer: Priority Health Narrow Network |
$26.04
|
| Rate for Payer: UHC Medicare Advantage |
$20.05
|
|
|
PR HEALTH RISK ASSESSMENT TEST
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 99420
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$35.00 |
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
|
|
PR HEARING AID CHECK BINAURAL
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 92593
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$392.83 |
| Rate for Payer: Aetna Commercial |
$39.35
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS Trust/PPO |
$392.83
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.41
|
| Rate for Payer: Priority Health Narrow Network |
$49.41
|
|
|
PR HEARING AID CHECK MONAURAL
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 92592
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$2,403.24 |
| Rate for Payer: Aetna Commercial |
$23.53
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.24
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.09
|
| Rate for Payer: Priority Health Narrow Network |
$30.09
|
|
|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$864.19 |
| Rate for Payer: Aetna Commercial |
$76.88
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$864.19
|
| Rate for Payer: BCN Commercial |
$98.85
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.12
|
| Rate for Payer: Priority Health Narrow Network |
$96.12
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$1,399.47 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,399.47
|
| Rate for Payer: BCN Commercial |
$98.85
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.46
|
| Rate for Payer: Priority Health Narrow Network |
$75.46
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,408.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$3,785.60 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: BCBS Complete |
$2,163.20
|
| Rate for Payer: Cash Price |
$4,326.40
|
| Rate for Payer: Cash Price |
$4,326.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,785.60
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$88.69 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS Complete |
$170.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.50
|
|
|
PR HEARING AID RESTOCKING FEE
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 00663
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,287.54
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$726.97 |
| Max. Negotiated Rate |
$1,730.08 |
| Rate for Payer: Aetna Commercial |
$1,493.58
|
| Rate for Payer: Aetna Medicare |
$1,114.61
|
| Rate for Payer: BCBS Complete |
$763.32
|
| Rate for Payer: BCBS MAPPO |
$1,114.61
|
| Rate for Payer: BCBS Trust/PPO |
$984.22
|
| Rate for Payer: BCN Commercial |
$1,655.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,114.61
|
| Rate for Payer: Cash Price |
$1,830.03
|
| Rate for Payer: Cash Price |
$1,830.03
|
| Rate for Payer: Cofinity Commercial |
$1,605.04
|
| Rate for Payer: Cofinity Commercial |
$1,493.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,114.61
|
| Rate for Payer: Healthscope Commercial |
$1,337.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,337.53
|
| Rate for Payer: Meridian Medicaid |
$763.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,170.34
|
| Rate for Payer: PACE SWMI |
$1,114.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,114.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$726.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,730.08
|
| Rate for Payer: Priority Health Medicare |
$1,114.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,730.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.05
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$683.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$172.53 |
| Max. Negotiated Rate |
$888.60 |
| Rate for Payer: Aetna Commercial |
$346.42
|
| Rate for Payer: Aetna Medicare |
$258.52
|
| Rate for Payer: BCBS Complete |
$181.16
|
| Rate for Payer: BCBS MAPPO |
$258.52
|
| Rate for Payer: BCBS Trust/PPO |
$888.60
|
| Rate for Payer: BCN Commercial |
$592.77
|
| Rate for Payer: BCN Medicare Advantage |
$258.52
|
| Rate for Payer: Cash Price |
$546.40
|
| Rate for Payer: Cash Price |
$546.40
|
| Rate for Payer: Cofinity Commercial |
$372.27
|
| Rate for Payer: Cofinity Commercial |
$346.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.52
|
| Rate for Payer: Healthscope Commercial |
$310.22
|
| Rate for Payer: Healthscope Whirlpool |
$310.22
|
| Rate for Payer: Meridian Medicaid |
$181.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.45
|
| Rate for Payer: PACE SWMI |
$258.52
|
| Rate for Payer: PHP Medicare Advantage |
$258.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.95
|
| Rate for Payer: Priority Health Medicare |
$258.52
|
| Rate for Payer: Priority Health Narrow Network |
$404.95
|
| Rate for Payer: UHC Medicare Advantage |
$266.28
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$293.73 |
| Rate for Payer: Aetna Commercial |
$94.01
|
| Rate for Payer: Aetna Medicare |
$70.16
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$70.16
|
| Rate for Payer: BCBS Trust/PPO |
$293.73
|
| Rate for Payer: BCN Commercial |
$103.11
|
| Rate for Payer: BCN Medicare Advantage |
$70.16
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$101.03
|
| Rate for Payer: Cofinity Commercial |
$94.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.16
|
| Rate for Payer: Healthscope Commercial |
$84.19
|
| Rate for Payer: Healthscope Whirlpool |
$84.19
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.67
|
| Rate for Payer: PACE SWMI |
$70.16
|
| Rate for Payer: PHP Medicare Advantage |
$70.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.77
|
| Rate for Payer: Priority Health Medicare |
$70.16
|
| Rate for Payer: Priority Health Narrow Network |
$94.77
|
| Rate for Payer: UHC Medicare Advantage |
$72.26
|
|
|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$584.00
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$408.80 |
| Rate for Payer: Aetna Commercial |
$133.53
|
| Rate for Payer: Aetna Medicare |
$99.65
|
| Rate for Payer: BCBS Complete |
$67.55
|
| Rate for Payer: BCBS MAPPO |
$99.65
|
| Rate for Payer: BCBS Trust/PPO |
$314.34
|
| Rate for Payer: BCN Commercial |
$146.60
|
| Rate for Payer: BCN Medicare Advantage |
$99.65
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Cofinity Commercial |
$133.53
|
| Rate for Payer: Cofinity Commercial |
$143.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.65
|
| Rate for Payer: Healthscope Commercial |
$119.58
|
| Rate for Payer: Healthscope Whirlpool |
$119.58
|
| Rate for Payer: Meridian Medicaid |
$67.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.63
|
| Rate for Payer: PACE SWMI |
$99.65
|
| Rate for Payer: PHP Medicare Advantage |
$99.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.74
|
| Rate for Payer: Priority Health Medicare |
$99.65
|
| Rate for Payer: Priority Health Narrow Network |
$134.74
|
| Rate for Payer: UHC Medicare Advantage |
$102.64
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
OP
|
$407.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$284.90 |
| Max. Negotiated Rate |
$1,015.50 |
| Rate for Payer: Aetna Commercial |
$366.30
|
| Rate for Payer: Aetna Medicare |
$812.40
|
| 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: ASR ASR |
$394.79
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$315.55
|
| Rate for Payer: BCN Commercial |
$315.55
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$382.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$407.00
|
| Rate for Payer: Healthscope Whirlpool |
$394.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$812.40
|
| Rate for Payer: Mclaren Commercial |
$366.30
|
| 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 |
$345.95
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$893.64
|
| Rate for Payer: PHP Medicaid |
$444.38
|
| 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 |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.70
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$680.56
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$358.16
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: VA VA |
$812.40
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$1,246.26 |
| Rate for Payer: Aetna Commercial |
$250.85
|
| Rate for Payer: Aetna Medicare |
$187.20
|
| Rate for Payer: BCBS Complete |
$129.72
|
| Rate for Payer: BCBS MAPPO |
$187.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,246.26
|
| Rate for Payer: BCN Commercial |
$335.33
|
| Rate for Payer: BCN Medicare Advantage |
$187.20
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$250.85
|
| Rate for Payer: Cofinity Commercial |
$269.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.20
|
| Rate for Payer: Healthscope Commercial |
$224.64
|
| Rate for Payer: Healthscope Whirlpool |
$224.64
|
| Rate for Payer: Meridian Medicaid |
$129.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$196.56
|
| Rate for Payer: PACE SWMI |
$187.20
|
| Rate for Payer: PHP Medicare Advantage |
$187.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.26
|
| Rate for Payer: Priority Health Medicare |
$187.20
|
| Rate for Payer: Priority Health Narrow Network |
$339.26
|
| Rate for Payer: UHC Medicare Advantage |
$192.82
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$1,246.26 |
| Rate for Payer: Aetna Commercial |
$250.85
|
| Rate for Payer: Aetna Medicare |
$187.20
|
| Rate for Payer: BCBS Complete |
$129.72
|
| Rate for Payer: BCBS MAPPO |
$187.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,246.26
|
| Rate for Payer: BCN Commercial |
$335.33
|
| Rate for Payer: BCN Medicare Advantage |
$187.20
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$250.85
|
| Rate for Payer: Cofinity Commercial |
$269.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.20
|
| Rate for Payer: Healthscope Commercial |
$224.64
|
| Rate for Payer: Healthscope Whirlpool |
$224.64
|
| Rate for Payer: Meridian Medicaid |
$129.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$196.56
|
| Rate for Payer: PACE SWMI |
$187.20
|
| Rate for Payer: PHP Medicare Advantage |
$187.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.26
|
| Rate for Payer: Priority Health Medicare |
$187.20
|
| Rate for Payer: Priority Health Narrow Network |
$339.26
|
| Rate for Payer: UHC Medicare Advantage |
$192.82
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
IP
|
$407.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$284.90 |
| Max. Negotiated Rate |
$407.00 |
| Rate for Payer: Aetna Commercial |
$366.30
|
| Rate for Payer: ASR ASR |
$394.79
|
| Rate for Payer: BCBS Trust/PPO |
$315.55
|
| Rate for Payer: BCN Commercial |
$315.55
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$382.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.60
|
| Rate for Payer: Healthscope Commercial |
$407.00
|
| Rate for Payer: Healthscope Whirlpool |
$394.79
|
| Rate for Payer: Mclaren Commercial |
$366.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$358.16
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,582.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,107.40 |
| Max. Negotiated Rate |
$1,582.00 |
| Rate for Payer: Aetna Commercial |
$1,423.80
|
| Rate for Payer: ASR ASR |
$1,534.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,226.52
|
| Rate for Payer: BCN Commercial |
$1,226.52
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$1,487.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,265.60
|
| Rate for Payer: Healthscope Commercial |
$1,582.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,534.54
|
| Rate for Payer: Mclaren Commercial |
$1,423.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,344.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,107.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,392.16
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$310.13 |
| Max. Negotiated Rate |
$2,501.50 |
| Rate for Payer: Aetna Commercial |
$635.94
|
| Rate for Payer: Aetna Medicare |
$474.58
|
| Rate for Payer: BCBS Complete |
$325.64
|
| Rate for Payer: BCBS MAPPO |
$474.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$474.58
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$683.40
|
| Rate for Payer: Cofinity Commercial |
$635.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.58
|
| Rate for Payer: Healthscope Commercial |
$569.50
|
| Rate for Payer: Healthscope Whirlpool |
$569.50
|
| Rate for Payer: Meridian Medicaid |
$325.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$498.31
|
| Rate for Payer: PACE SWMI |
$474.58
|
| Rate for Payer: PHP Medicare Advantage |
$474.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,107.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.39
|
| Rate for Payer: Priority Health Medicare |
$474.58
|
| Rate for Payer: Priority Health Narrow Network |
$851.39
|
| Rate for Payer: UHC Medicare Advantage |
$488.82
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$310.13 |
| Max. Negotiated Rate |
$2,501.50 |
| Rate for Payer: Aetna Commercial |
$635.94
|
| Rate for Payer: Aetna Medicare |
$474.58
|
| Rate for Payer: BCBS Complete |
$325.64
|
| Rate for Payer: BCBS MAPPO |
$474.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$474.58
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$683.40
|
| Rate for Payer: Cofinity Commercial |
$635.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.58
|
| Rate for Payer: Healthscope Commercial |
$569.50
|
| Rate for Payer: Healthscope Whirlpool |
$569.50
|
| Rate for Payer: Meridian Medicaid |
$325.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$498.31
|
| Rate for Payer: PACE SWMI |
$474.58
|
| Rate for Payer: PHP Medicare Advantage |
$474.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,107.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.39
|
| Rate for Payer: Priority Health Medicare |
$474.58
|
| Rate for Payer: Priority Health Narrow Network |
$851.39
|
| Rate for Payer: UHC Medicare Advantage |
$488.82
|
|
