|
PR BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC
|
Professional
|
Both
|
$2,503.00
|
|
|
Service Code
|
HCPCS 58956
|
| Min. Negotiated Rate |
$803.86 |
| Max. Negotiated Rate |
$2,390.34 |
| Rate for Payer: Aetna Commercial |
$1,674.76
|
| Rate for Payer: Aetna Medicare |
$1,249.82
|
| Rate for Payer: BCBS Complete |
$844.05
|
| Rate for Payer: BCBS MAPPO |
$1,249.82
|
| Rate for Payer: BCN Commercial |
$2,044.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,249.82
|
| Rate for Payer: Cash Price |
$2,002.40
|
| Rate for Payer: Cash Price |
$2,002.40
|
| Rate for Payer: Cofinity Commercial |
$1,799.74
|
| Rate for Payer: Cofinity Commercial |
$1,674.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,249.82
|
| Rate for Payer: Healthscope Commercial |
$1,499.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,312.31
|
| Rate for Payer: Meridian Medicaid |
$844.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,374.80
|
| Rate for Payer: Nomi Health Commercial |
$1,499.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,877.25
|
| Rate for Payer: PACE SWMI |
$1,249.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,249.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,070.85
|
| Rate for Payer: Priority Health Medicare |
$1,249.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,070.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,249.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,390.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,249.82
|
| Rate for Payer: UHC Exchange |
$2,390.34
|
| Rate for Payer: UHC Medicaid |
$803.86
|
| Rate for Payer: UHCCP DNSP |
$1,249.82
|
| Rate for Payer: UHCCP Medicaid |
$803.86
|
|
|
PR BUDESONIDE NON-COMP UNIT
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS J7626
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Aetna Commercial |
$1.47
|
| Rate for Payer: Aetna Medicare |
$1.10
|
| Rate for Payer: BCBS Complete |
$3.60
|
| Rate for Payer: BCBS MAPPO |
$1.10
|
| Rate for Payer: BCN Commercial |
$0.08
|
| Rate for Payer: BCN Medicare Advantage |
$1.10
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$1.58
|
| Rate for Payer: Cofinity Commercial |
$1.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.10
|
| Rate for Payer: Healthscope Commercial |
$1.32
|
| Rate for Payer: Healthscope Whirlpool |
$1.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.21
|
| Rate for Payer: Nomi Health Commercial |
$1.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.75
|
| Rate for Payer: PACE SWMI |
$1.10
|
| Rate for Payer: PHP Medicare Advantage |
$1.10
|
| Rate for Payer: Priority Health Medicare |
$1.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.10
|
| Rate for Payer: UHC Exchange |
$1.05
|
| Rate for Payer: UHCCP DNSP |
$1.10
|
|
|
PR BURR HOLE FOR VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$1,927.00
|
|
|
Service Code
|
HCPCS 61120
|
| Min. Negotiated Rate |
$493.31 |
| Max. Negotiated Rate |
$1,445.25 |
| Rate for Payer: Aetna Commercial |
$1,020.84
|
| Rate for Payer: Aetna Medicare |
$761.82
|
| Rate for Payer: BCBS Complete |
$517.98
|
| Rate for Payer: BCBS MAPPO |
$761.82
|
| Rate for Payer: BCN Commercial |
$1,154.32
|
| Rate for Payer: BCN Medicare Advantage |
$761.82
|
| Rate for Payer: Cash Price |
$1,541.60
|
| Rate for Payer: Cash Price |
$1,541.60
|
| Rate for Payer: Cofinity Commercial |
$1,097.02
|
| Rate for Payer: Cofinity Commercial |
$1,020.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.82
|
| Rate for Payer: Healthscope Commercial |
$914.18
|
| Rate for Payer: Healthscope Whirlpool |
$914.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.91
|
| Rate for Payer: Meridian Medicaid |
$517.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$838.00
|
| Rate for Payer: Nomi Health Commercial |
$914.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,445.25
|
| Rate for Payer: PACE SWMI |
$761.82
|
| Rate for Payer: PHP Medicare Advantage |
$761.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,340.72
|
| Rate for Payer: Priority Health Medicare |
$761.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,340.72
|
| Rate for Payer: Railroad Medicare Medicare |
$761.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,306.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$761.82
|
| Rate for Payer: UHC Exchange |
$1,306.36
|
| Rate for Payer: UHC Medicaid |
$493.31
|
| Rate for Payer: UHCCP DNSP |
$761.82
|
| Rate for Payer: UHCCP Medicaid |
$493.31
|
|
|
PR BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE
|
Professional
|
Both
|
$2,631.00
|
|
|
Service Code
|
HCPCS 61210
|
| Min. Negotiated Rate |
$214.07 |
| Max. Negotiated Rate |
$1,973.25 |
| Rate for Payer: Aetna Commercial |
$455.80
|
| Rate for Payer: Aetna Medicare |
$340.15
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$340.15
|
| Rate for Payer: BCN Commercial |
$761.59
|
| Rate for Payer: BCN Medicare Advantage |
$340.15
|
| Rate for Payer: Cash Price |
$2,104.80
|
| Rate for Payer: Cash Price |
$2,104.80
|
| Rate for Payer: Cofinity Commercial |
$489.82
|
| Rate for Payer: Cofinity Commercial |
$455.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.15
|
| Rate for Payer: Healthscope Commercial |
$408.18
|
| Rate for Payer: Healthscope Whirlpool |
$408.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.16
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.17
|
| Rate for Payer: Nomi Health Commercial |
$408.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,973.25
|
| Rate for Payer: PACE SWMI |
$340.15
|
| Rate for Payer: PHP Medicare Advantage |
$340.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$640.29
|
| Rate for Payer: Priority Health Medicare |
$340.15
|
| Rate for Payer: Priority Health Narrow Network |
$640.29
|
| Rate for Payer: Railroad Medicare Medicare |
$340.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$654.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.15
|
| Rate for Payer: UHC Exchange |
$654.29
|
| Rate for Payer: UHC Medicaid |
$214.07
|
| Rate for Payer: UHCCP DNSP |
$340.15
|
| Rate for Payer: UHCCP Medicaid |
$214.07
|
|
|
PR BURR HOLE/TREPHINE STTL EXPL N/FLWD OTH SURG
|
Professional
|
Both
|
$2,807.00
|
|
|
Service Code
|
HCPCS 61250
|
| Min. Negotiated Rate |
$563.17 |
| Max. Negotiated Rate |
$2,105.25 |
| Rate for Payer: Aetna Commercial |
$1,169.77
|
| Rate for Payer: Aetna Medicare |
$872.96
|
| Rate for Payer: BCBS Complete |
$591.33
|
| Rate for Payer: BCBS MAPPO |
$872.96
|
| Rate for Payer: BCN Commercial |
$1,333.59
|
| Rate for Payer: BCN Medicare Advantage |
$872.96
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,257.06
|
| Rate for Payer: Cofinity Commercial |
$1,169.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.96
|
| Rate for Payer: Healthscope Commercial |
$1,047.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,047.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$916.61
|
| Rate for Payer: Meridian Medicaid |
$591.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$960.26
|
| Rate for Payer: Nomi Health Commercial |
$1,047.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,105.25
|
| Rate for Payer: PACE SWMI |
$872.96
|
| Rate for Payer: PHP Medicare Advantage |
$872.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$563.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,548.94
|
| Rate for Payer: Priority Health Medicare |
$872.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.94
|
| Rate for Payer: Railroad Medicare Medicare |
$872.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,519.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$872.96
|
| Rate for Payer: UHC Exchange |
$1,519.58
|
| Rate for Payer: UHC Medicaid |
$563.17
|
| Rate for Payer: UHCCP DNSP |
$872.96
|
| Rate for Payer: UHCCP Medicaid |
$563.17
|
|
|
PR BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION
|
Professional
|
Both
|
$4,751.00
|
|
|
Service Code
|
HCPCS 61140
|
| Min. Negotiated Rate |
$808.55 |
| Max. Negotiated Rate |
$3,563.25 |
| Rate for Payer: Aetna Commercial |
$1,684.46
|
| Rate for Payer: Aetna Medicare |
$1,257.06
|
| Rate for Payer: BCBS Complete |
$848.98
|
| Rate for Payer: BCBS MAPPO |
$1,257.06
|
| Rate for Payer: BCN Commercial |
$2,689.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.06
|
| Rate for Payer: Cash Price |
$3,800.80
|
| Rate for Payer: Cash Price |
$3,800.80
|
| Rate for Payer: Cofinity Commercial |
$1,810.17
|
| Rate for Payer: Cofinity Commercial |
$1,684.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.06
|
| Rate for Payer: Healthscope Commercial |
$1,508.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,508.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.91
|
| Rate for Payer: Meridian Medicaid |
$848.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,382.77
|
| Rate for Payer: Nomi Health Commercial |
$1,508.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,563.25
|
| Rate for Payer: PACE SWMI |
$1,257.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,261.53
|
| Rate for Payer: Priority Health Medicare |
$1,257.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,261.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,257.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,224.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,257.06
|
| Rate for Payer: UHC Exchange |
$2,224.89
|
| Rate for Payer: UHC Medicaid |
$808.55
|
| Rate for Payer: UHCCP DNSP |
$1,257.06
|
| Rate for Payer: UHCCP Medicaid |
$808.55
|
|
|
PR BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST
|
Professional
|
Both
|
$4,245.00
|
|
|
Service Code
|
HCPCS 61150
|
| Min. Negotiated Rate |
$852.21 |
| Max. Negotiated Rate |
$3,183.75 |
| Rate for Payer: Aetna Commercial |
$1,781.73
|
| Rate for Payer: Aetna Medicare |
$1,329.65
|
| Rate for Payer: BCBS Complete |
$894.82
|
| Rate for Payer: BCBS MAPPO |
$1,329.65
|
| Rate for Payer: BCN Commercial |
$2,852.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,329.65
|
| Rate for Payer: Cash Price |
$3,396.00
|
| Rate for Payer: Cash Price |
$3,396.00
|
| Rate for Payer: Cofinity Commercial |
$1,914.70
|
| Rate for Payer: Cofinity Commercial |
$1,781.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,329.65
|
| Rate for Payer: Healthscope Commercial |
$1,595.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,595.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,396.13
|
| Rate for Payer: Meridian Medicaid |
$894.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,462.62
|
| Rate for Payer: Nomi Health Commercial |
$1,595.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,183.75
|
| Rate for Payer: PACE SWMI |
$1,329.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,329.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,398.04
|
| Rate for Payer: Priority Health Medicare |
$1,329.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,398.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,329.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,379.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,329.65
|
| Rate for Payer: UHC Exchange |
$2,379.10
|
| Rate for Payer: UHC Medicaid |
$852.21
|
| Rate for Payer: UHCCP DNSP |
$1,329.65
|
| Rate for Payer: UHCCP Medicaid |
$852.21
|
|
|
PR BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL
|
Professional
|
Both
|
$3,796.00
|
|
|
Service Code
|
HCPCS 61156
|
| Min. Negotiated Rate |
$780.65 |
| Max. Negotiated Rate |
$2,847.00 |
| Rate for Payer: Aetna Commercial |
$1,632.71
|
| Rate for Payer: Aetna Medicare |
$1,218.44
|
| Rate for Payer: BCBS Complete |
$819.68
|
| Rate for Payer: BCBS MAPPO |
$1,218.44
|
| Rate for Payer: BCN Commercial |
$2,620.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.44
|
| Rate for Payer: Cash Price |
$3,036.80
|
| Rate for Payer: Cash Price |
$3,036.80
|
| Rate for Payer: Cofinity Commercial |
$1,754.55
|
| Rate for Payer: Cofinity Commercial |
$1,632.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.44
|
| Rate for Payer: Healthscope Commercial |
$1,462.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,462.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.36
|
| Rate for Payer: Meridian Medicaid |
$819.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,340.28
|
| Rate for Payer: Nomi Health Commercial |
$1,462.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,847.00
|
| Rate for Payer: PACE SWMI |
$1,218.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,203.11
|
| Rate for Payer: Priority Health Medicare |
$1,218.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,203.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,218.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,186.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,218.44
|
| Rate for Payer: UHC Exchange |
$2,186.26
|
| Rate for Payer: UHC Medicaid |
$780.65
|
| Rate for Payer: UHCCP DNSP |
$1,218.44
|
| Rate for Payer: UHCCP Medicaid |
$780.65
|
|
|
PR BURR HOLE W/EVAC&/DRG HEMATOMA EXTRADURAL/SDRL
|
Professional
|
Both
|
$4,314.00
|
|
|
Service Code
|
HCPCS 61154
|
| Min. Negotiated Rate |
$820.48 |
| Max. Negotiated Rate |
$3,235.50 |
| Rate for Payer: Aetna Commercial |
$1,706.42
|
| Rate for Payer: Aetna Medicare |
$1,273.45
|
| Rate for Payer: BCBS Complete |
$861.50
|
| Rate for Payer: BCBS MAPPO |
$1,273.45
|
| Rate for Payer: BCN Commercial |
$2,704.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,273.45
|
| Rate for Payer: Cash Price |
$3,451.20
|
| Rate for Payer: Cash Price |
$3,451.20
|
| Rate for Payer: Cofinity Commercial |
$1,833.77
|
| Rate for Payer: Cofinity Commercial |
$1,706.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,273.45
|
| Rate for Payer: Healthscope Commercial |
$1,528.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,528.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,337.12
|
| Rate for Payer: Meridian Medicaid |
$861.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,400.80
|
| Rate for Payer: Nomi Health Commercial |
$1,528.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,235.50
|
| Rate for Payer: PACE SWMI |
$1,273.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,273.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,273.67
|
| Rate for Payer: Priority Health Medicare |
$1,273.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,273.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,273.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,231.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,273.45
|
| Rate for Payer: UHC Exchange |
$2,231.60
|
| Rate for Payer: UHC Medicaid |
$820.48
|
| Rate for Payer: UHCCP DNSP |
$1,273.45
|
| Rate for Payer: UHCCP Medicaid |
$820.48
|
|
|
PR BUTORPHANOL TARTRATE 1 MG
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS J0595
|
| Min. Negotiated Rate |
$3.02 |
| Max. Negotiated Rate |
$8.86 |
| Rate for Payer: Aetna Commercial |
$8.24
|
| Rate for Payer: Aetna Medicare |
$6.15
|
| Rate for Payer: BCBS MAPPO |
$6.15
|
| Rate for Payer: BCBS Trust/PPO |
$3.57
|
| Rate for Payer: BCN Commercial |
$3.02
|
| Rate for Payer: BCN Medicare Advantage |
$6.15
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$8.86
|
| Rate for Payer: Cofinity Commercial |
$8.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.15
|
| Rate for Payer: Healthscope Commercial |
$7.38
|
| Rate for Payer: Healthscope Whirlpool |
$7.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.76
|
| Rate for Payer: Nomi Health Commercial |
$7.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
| Rate for Payer: PACE SWMI |
$6.15
|
| Rate for Payer: PHP Medicare Advantage |
$6.15
|
| Rate for Payer: Priority Health Medicare |
$6.15
|
| Rate for Payer: Railroad Medicare Medicare |
$6.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.15
|
| Rate for Payer: UHC Exchange |
$5.54
|
| Rate for Payer: UHCCP DNSP |
$6.15
|
|
|
PR BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 49180
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$95.35
|
| Rate for Payer: Aetna Medicare |
$71.16
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$71.16
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$71.16
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$95.35
|
| Rate for Payer: Cofinity Commercial |
$102.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.16
|
| Rate for Payer: Healthscope Commercial |
$85.39
|
| Rate for Payer: Healthscope Whirlpool |
$85.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.72
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.28
|
| Rate for Payer: Nomi Health Commercial |
$85.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.50
|
| Rate for Payer: PACE SWMI |
$71.16
|
| Rate for Payer: PHP Medicare Advantage |
$71.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$148.06
|
| Rate for Payer: Priority Health Medicare |
$71.16
|
| Rate for Payer: Priority Health Narrow Network |
$148.06
|
| Rate for Payer: Railroad Medicare Medicare |
$71.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.16
|
| Rate for Payer: UHC Exchange |
$149.54
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP DNSP |
$71.16
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR BX ANORECTAL WALL ANAL APPROACH
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 45100
|
| Min. Negotiated Rate |
$192.77 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$392.70
|
| Rate for Payer: Aetna Medicare |
$293.06
|
| Rate for Payer: BCBS Complete |
$202.41
|
| Rate for Payer: BCBS MAPPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$460.13
|
| Rate for Payer: BCN Medicare Advantage |
$293.06
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$422.01
|
| Rate for Payer: Cofinity Commercial |
$392.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.06
|
| Rate for Payer: Healthscope Commercial |
$351.67
|
| Rate for Payer: Healthscope Whirlpool |
$351.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.71
|
| Rate for Payer: Meridian Medicaid |
$202.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$322.37
|
| Rate for Payer: Nomi Health Commercial |
$351.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.00
|
| Rate for Payer: PACE SWMI |
$293.06
|
| Rate for Payer: PHP Medicare Advantage |
$293.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$560.64
|
| Rate for Payer: Priority Health Medicare |
$293.06
|
| Rate for Payer: Priority Health Narrow Network |
$560.64
|
| Rate for Payer: Railroad Medicare Medicare |
$293.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$522.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$293.06
|
| Rate for Payer: UHC Exchange |
$522.44
|
| Rate for Payer: UHC Medicaid |
$192.77
|
| Rate for Payer: UHCCP DNSP |
$293.06
|
| Rate for Payer: UHCCP Medicaid |
$192.77
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 19100
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$83.32
|
| Rate for Payer: Aetna Medicare |
$62.18
|
| Rate for Payer: BCBS Complete |
$41.38
|
| Rate for Payer: BCBS MAPPO |
$62.18
|
| Rate for Payer: BCN Commercial |
$102.08
|
| Rate for Payer: BCN Medicare Advantage |
$62.18
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$89.54
|
| Rate for Payer: Cofinity Commercial |
$83.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.18
|
| Rate for Payer: Healthscope Commercial |
$74.62
|
| Rate for Payer: Healthscope Whirlpool |
$74.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.29
|
| Rate for Payer: Meridian Medicaid |
$41.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.40
|
| Rate for Payer: Nomi Health Commercial |
$74.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.00
|
| Rate for Payer: PACE SWMI |
$62.18
|
| Rate for Payer: PHP Medicare Advantage |
$62.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.43
|
| Rate for Payer: Priority Health Medicare |
$62.18
|
| Rate for Payer: Priority Health Narrow Network |
$93.43
|
| Rate for Payer: Railroad Medicare Medicare |
$62.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.18
|
| Rate for Payer: UHC Exchange |
$125.58
|
| Rate for Payer: UHC Medicaid |
$39.41
|
| Rate for Payer: UHCCP DNSP |
$62.18
|
| Rate for Payer: UHCCP Medicaid |
$39.41
|
|
|
PR BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 19081
|
| Min. Negotiated Rate |
$88.18 |
| Max. Negotiated Rate |
$597.00 |
| Rate for Payer: Aetna Commercial |
$185.05
|
| Rate for Payer: Aetna Medicare |
$138.10
|
| Rate for Payer: BCBS Complete |
$92.59
|
| Rate for Payer: BCBS MAPPO |
$138.10
|
| Rate for Payer: BCN Commercial |
$240.02
|
| Rate for Payer: BCN Medicare Advantage |
$138.10
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$198.86
|
| Rate for Payer: Cofinity Commercial |
$185.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.10
|
| Rate for Payer: Healthscope Commercial |
$165.72
|
| Rate for Payer: Healthscope Whirlpool |
$165.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.00
|
| Rate for Payer: Meridian Medicaid |
$92.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.91
|
| Rate for Payer: Nomi Health Commercial |
$165.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$597.00
|
| Rate for Payer: PACE SWMI |
$138.10
|
| Rate for Payer: PHP Medicare Advantage |
$138.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$219.69
|
| Rate for Payer: Priority Health Medicare |
$138.10
|
| Rate for Payer: Priority Health Narrow Network |
$219.69
|
| Rate for Payer: Railroad Medicare Medicare |
$138.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.10
|
| Rate for Payer: UHC Exchange |
$296.20
|
| Rate for Payer: UHC Medicaid |
$88.18
|
| Rate for Payer: UHCCP DNSP |
$138.10
|
| Rate for Payer: UHCCP Medicaid |
$88.18
|
|
|
PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 19083
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$340.50 |
| Rate for Payer: Aetna Commercial |
$174.82
|
| Rate for Payer: Aetna Medicare |
$130.46
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$130.46
|
| Rate for Payer: BCN Commercial |
$225.59
|
| Rate for Payer: BCN Medicare Advantage |
$130.46
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cofinity Commercial |
$187.86
|
| Rate for Payer: Cofinity Commercial |
$174.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.46
|
| Rate for Payer: Healthscope Commercial |
$156.55
|
| Rate for Payer: Healthscope Whirlpool |
$156.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.98
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.51
|
| Rate for Payer: Nomi Health Commercial |
$156.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$340.50
|
| Rate for Payer: PACE SWMI |
$130.46
|
| Rate for Payer: PHP Medicare Advantage |
$130.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$206.47
|
| Rate for Payer: Priority Health Medicare |
$130.46
|
| Rate for Payer: Priority Health Narrow Network |
$206.47
|
| Rate for Payer: Railroad Medicare Medicare |
$130.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.46
|
| Rate for Payer: UHC Exchange |
$280.24
|
| Rate for Payer: UHC Medicaid |
$83.28
|
| Rate for Payer: UHCCP DNSP |
$130.46
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
|
PR BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID
|
Professional
|
Both
|
$817.00
|
|
|
Service Code
|
HCPCS 19084
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$612.75 |
| Rate for Payer: Aetna Commercial |
$87.11
|
| Rate for Payer: Aetna Medicare |
$65.01
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$65.01
|
| Rate for Payer: BCN Commercial |
$113.54
|
| Rate for Payer: BCN Medicare Advantage |
$65.01
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$93.61
|
| Rate for Payer: Cofinity Commercial |
$87.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.01
|
| Rate for Payer: Healthscope Commercial |
$78.01
|
| Rate for Payer: Healthscope Whirlpool |
$78.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.26
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.51
|
| Rate for Payer: Nomi Health Commercial |
$78.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.75
|
| Rate for Payer: PACE SWMI |
$65.01
|
| Rate for Payer: PHP Medicare Advantage |
$65.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$103.92
|
| Rate for Payer: Priority Health Medicare |
$65.01
|
| Rate for Payer: Priority Health Narrow Network |
$103.92
|
| Rate for Payer: Railroad Medicare Medicare |
$65.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.01
|
| Rate for Payer: UHC Exchange |
$138.24
|
| Rate for Payer: UHC Medicaid |
$41.54
|
| Rate for Payer: UHCCP DNSP |
$65.01
|
| Rate for Payer: UHCCP Medicaid |
$41.54
|
|
|
PR BX/EXC LYMPH NODE NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 38505
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Aetna Commercial |
$99.21
|
| Rate for Payer: Aetna Medicare |
$74.04
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$74.04
|
| Rate for Payer: BCN Commercial |
$126.98
|
| Rate for Payer: BCN Medicare Advantage |
$74.04
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$99.21
|
| Rate for Payer: Cofinity Commercial |
$106.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.04
|
| Rate for Payer: Healthscope Commercial |
$88.85
|
| Rate for Payer: Healthscope Whirlpool |
$88.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.74
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.44
|
| Rate for Payer: Nomi Health Commercial |
$88.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.25
|
| Rate for Payer: PACE SWMI |
$74.04
|
| Rate for Payer: PHP Medicare Advantage |
$74.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$168.96
|
| Rate for Payer: Priority Health Medicare |
$74.04
|
| Rate for Payer: Priority Health Narrow Network |
$168.96
|
| Rate for Payer: Railroad Medicare Medicare |
$74.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.04
|
| Rate for Payer: UHC Exchange |
$122.72
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHCCP DNSP |
$74.04
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Facility
|
OP
|
$1,624.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
38525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,138.42 |
| Max. Negotiated Rate |
$4,876.69 |
| Rate for Payer: Aetna Commercial |
$1,461.60
|
| Rate for Payer: Aetna Medicare |
$3,901.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: ASR ASR |
$1,575.28
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.99
|
| Rate for Payer: BCN Commercial |
$1,338.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$1,526.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$1,575.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,624.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,901.35
|
| Rate for Payer: Mclaren Commercial |
$1,461.60
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$2,142.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.40
|
| Rate for Payer: Nomi Health Commercial |
$1,331.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$4,291.48
|
| Rate for Payer: PHP Medicaid |
$2,091.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,422.95
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,138.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP DNSP |
$3,901.35
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,624.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
38525
|
| Min. Negotiated Rate |
$274.56 |
| Max. Negotiated Rate |
$1,218.00 |
| Rate for Payer: Aetna Commercial |
$566.71
|
| Rate for Payer: Aetna Medicare |
$422.92
|
| Rate for Payer: BCBS Complete |
$288.29
|
| Rate for Payer: BCBS MAPPO |
$422.92
|
| Rate for Payer: BCN Commercial |
$668.79
|
| Rate for Payer: BCN Medicare Advantage |
$422.92
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$609.00
|
| Rate for Payer: Cofinity Commercial |
$566.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.92
|
| Rate for Payer: Healthscope Commercial |
$507.50
|
| Rate for Payer: Healthscope Whirlpool |
$507.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.07
|
| Rate for Payer: Meridian Medicaid |
$288.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$465.21
|
| Rate for Payer: Nomi Health Commercial |
$507.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
| Rate for Payer: PACE SWMI |
$422.92
|
| Rate for Payer: PHP Medicare Advantage |
$422.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$889.87
|
| Rate for Payer: Priority Health Medicare |
$422.92
|
| Rate for Payer: Priority Health Narrow Network |
$889.87
|
| Rate for Payer: Railroad Medicare Medicare |
$422.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$772.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$422.92
|
| Rate for Payer: UHC Exchange |
$772.06
|
| Rate for Payer: UHC Medicaid |
$274.56
|
| Rate for Payer: UHCCP DNSP |
$422.92
|
| Rate for Payer: UHCCP Medicaid |
$274.56
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Facility
|
IP
|
$1,624.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
38525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,218.00 |
| Max. Negotiated Rate |
$1,624.00 |
| Rate for Payer: Aetna Commercial |
$1,461.60
|
| Rate for Payer: ASR ASR |
$1,575.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,333.63
|
| Rate for Payer: BCN Commercial |
$1,333.63
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$1,526.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.20
|
| Rate for Payer: Healthscope Commercial |
$1,575.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,624.00
|
| Rate for Payer: Mclaren Commercial |
$1,461.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.40
|
| Rate for Payer: Nomi Health Commercial |
$1,331.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,624.00
|
|
|
Service Code
|
HCPCS 38525
|
| Min. Negotiated Rate |
$274.56 |
| Max. Negotiated Rate |
$1,218.00 |
| Rate for Payer: Aetna Commercial |
$566.71
|
| Rate for Payer: Aetna Medicare |
$422.92
|
| Rate for Payer: BCBS Complete |
$288.29
|
| Rate for Payer: BCBS MAPPO |
$422.92
|
| Rate for Payer: BCN Commercial |
$668.79
|
| Rate for Payer: BCN Medicare Advantage |
$422.92
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$609.00
|
| Rate for Payer: Cofinity Commercial |
$566.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.92
|
| Rate for Payer: Healthscope Commercial |
$507.50
|
| Rate for Payer: Healthscope Whirlpool |
$507.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.07
|
| Rate for Payer: Meridian Medicaid |
$288.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$465.21
|
| Rate for Payer: Nomi Health Commercial |
$507.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
| Rate for Payer: PACE SWMI |
$422.92
|
| Rate for Payer: PHP Medicare Advantage |
$422.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$889.87
|
| Rate for Payer: Priority Health Medicare |
$422.92
|
| Rate for Payer: Priority Health Narrow Network |
$889.87
|
| Rate for Payer: Railroad Medicare Medicare |
$422.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$772.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$422.92
|
| Rate for Payer: UHC Exchange |
$772.06
|
| Rate for Payer: UHC Medicaid |
$274.56
|
| Rate for Payer: UHCCP DNSP |
$422.92
|
| Rate for Payer: UHCCP Medicaid |
$274.56
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Facility
|
IP
|
$1,624.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
38510
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,218.00 |
| Max. Negotiated Rate |
$1,624.00 |
| Rate for Payer: Aetna Commercial |
$1,461.60
|
| Rate for Payer: ASR ASR |
$1,575.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,333.63
|
| Rate for Payer: BCN Commercial |
$1,333.63
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$1,526.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.20
|
| Rate for Payer: Healthscope Commercial |
$1,575.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,624.00
|
| Rate for Payer: Mclaren Commercial |
$1,461.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.40
|
| Rate for Payer: Nomi Health Commercial |
$1,331.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,624.00
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
38510
|
| Min. Negotiated Rate |
$241.12 |
| Max. Negotiated Rate |
$1,218.00 |
| Rate for Payer: Aetna Commercial |
$500.44
|
| Rate for Payer: Aetna Medicare |
$373.46
|
| Rate for Payer: BCBS Complete |
$253.18
|
| Rate for Payer: BCBS MAPPO |
$373.46
|
| Rate for Payer: BCN Commercial |
$629.95
|
| Rate for Payer: BCN Medicare Advantage |
$373.46
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$537.78
|
| Rate for Payer: Cofinity Commercial |
$500.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.46
|
| Rate for Payer: Healthscope Commercial |
$448.15
|
| Rate for Payer: Healthscope Whirlpool |
$448.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.13
|
| Rate for Payer: Meridian Medicaid |
$253.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.81
|
| Rate for Payer: Nomi Health Commercial |
$448.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
| Rate for Payer: PACE SWMI |
$373.46
|
| Rate for Payer: PHP Medicare Advantage |
$373.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$838.19
|
| Rate for Payer: Priority Health Medicare |
$373.46
|
| Rate for Payer: Priority Health Narrow Network |
$838.19
|
| Rate for Payer: Railroad Medicare Medicare |
$373.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$737.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.46
|
| Rate for Payer: UHC Exchange |
$737.24
|
| Rate for Payer: UHC Medicaid |
$241.12
|
| Rate for Payer: UHCCP DNSP |
$373.46
|
| Rate for Payer: UHCCP Medicaid |
$241.12
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Facility
|
OP
|
$1,624.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
38510
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,138.42 |
| Max. Negotiated Rate |
$4,876.69 |
| Rate for Payer: Aetna Commercial |
$1,461.60
|
| Rate for Payer: Aetna Medicare |
$3,901.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: ASR ASR |
$1,575.28
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.99
|
| Rate for Payer: BCN Commercial |
$1,338.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$1,526.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$1,575.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,624.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,901.35
|
| Rate for Payer: Mclaren Commercial |
$1,461.60
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$2,142.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.40
|
| Rate for Payer: Nomi Health Commercial |
$1,331.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$4,291.48
|
| Rate for Payer: PHP Medicaid |
$2,091.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,422.95
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,138.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP DNSP |
$3,901.35
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,624.00
|
|
|
Service Code
|
HCPCS 38510
|
| Min. Negotiated Rate |
$241.12 |
| Max. Negotiated Rate |
$1,218.00 |
| Rate for Payer: Aetna Commercial |
$500.44
|
| Rate for Payer: Aetna Medicare |
$373.46
|
| Rate for Payer: BCBS Complete |
$253.18
|
| Rate for Payer: BCBS MAPPO |
$373.46
|
| Rate for Payer: BCN Commercial |
$629.95
|
| Rate for Payer: BCN Medicare Advantage |
$373.46
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Cofinity Commercial |
$537.78
|
| Rate for Payer: Cofinity Commercial |
$500.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.46
|
| Rate for Payer: Healthscope Commercial |
$448.15
|
| Rate for Payer: Healthscope Whirlpool |
$448.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.13
|
| Rate for Payer: Meridian Medicaid |
$253.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.81
|
| Rate for Payer: Nomi Health Commercial |
$448.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.00
|
| Rate for Payer: PACE SWMI |
$373.46
|
| Rate for Payer: PHP Medicare Advantage |
$373.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$838.19
|
| Rate for Payer: Priority Health Medicare |
$373.46
|
| Rate for Payer: Priority Health Narrow Network |
$838.19
|
| Rate for Payer: Railroad Medicare Medicare |
$373.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$737.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.46
|
| Rate for Payer: UHC Exchange |
$737.24
|
| Rate for Payer: UHC Medicaid |
$241.12
|
| Rate for Payer: UHCCP DNSP |
$373.46
|
| Rate for Payer: UHCCP Medicaid |
$241.12
|
|
