|
PR CERCLAGE CERVIX PREGNANCY VAGINAL
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 59320
|
| Min. Negotiated Rate |
$87.54 |
| Max. Negotiated Rate |
$567.00 |
| Rate for Payer: Aetna Commercial |
$185.01
|
| Rate for Payer: Aetna Medicare |
$138.07
|
| Rate for Payer: BCBS Complete |
$91.92
|
| Rate for Payer: BCBS MAPPO |
$138.07
|
| Rate for Payer: BCN Commercial |
$228.07
|
| Rate for Payer: BCN Medicare Advantage |
$138.07
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$198.82
|
| Rate for Payer: Cofinity Commercial |
$185.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.07
|
| Rate for Payer: Healthscope Commercial |
$165.68
|
| Rate for Payer: Healthscope Whirlpool |
$165.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.97
|
| Rate for Payer: Meridian Medicaid |
$91.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.88
|
| Rate for Payer: Nomi Health Commercial |
$165.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$567.00
|
| Rate for Payer: PACE SWMI |
$138.07
|
| Rate for Payer: PHP Medicare Advantage |
$138.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$215.31
|
| Rate for Payer: Priority Health Medicare |
$138.07
|
| Rate for Payer: Priority Health Narrow Network |
$215.31
|
| Rate for Payer: Railroad Medicare Medicare |
$138.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.07
|
| Rate for Payer: UHC Exchange |
$268.38
|
| Rate for Payer: UHC Medicaid |
$87.54
|
| Rate for Payer: UHCCP DNSP |
$138.07
|
| Rate for Payer: UHCCP Medicaid |
$87.54
|
|
|
PR CERCLAGE UTERINE CERVIX NONOBSTETRICAL
|
Professional
|
Both
|
$852.00
|
|
|
Service Code
|
HCPCS 57700
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$639.00 |
| Rate for Payer: Aetna Commercial |
$413.59
|
| Rate for Payer: Aetna Medicare |
$308.65
|
| Rate for Payer: BCBS Complete |
$213.36
|
| Rate for Payer: BCBS MAPPO |
$308.65
|
| Rate for Payer: BCN Commercial |
$534.33
|
| Rate for Payer: BCN Medicare Advantage |
$308.65
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cofinity Commercial |
$444.46
|
| Rate for Payer: Cofinity Commercial |
$413.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.65
|
| Rate for Payer: Healthscope Commercial |
$370.38
|
| Rate for Payer: Healthscope Whirlpool |
$370.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.08
|
| Rate for Payer: Meridian Medicaid |
$213.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.51
|
| Rate for Payer: Nomi Health Commercial |
$370.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$639.00
|
| Rate for Payer: PACE SWMI |
$308.65
|
| Rate for Payer: PHP Medicare Advantage |
$308.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$541.17
|
| Rate for Payer: Priority Health Medicare |
$308.65
|
| Rate for Payer: Priority Health Narrow Network |
$541.17
|
| Rate for Payer: Railroad Medicare Medicare |
$308.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$308.65
|
| Rate for Payer: UHC Exchange |
$582.90
|
| Rate for Payer: UHC Medicaid |
$203.20
|
| Rate for Payer: UHCCP DNSP |
$308.65
|
| Rate for Payer: UHCCP Medicaid |
$203.20
|
|
|
PR CERTOLIZUMAB PEGOL INJ 1MG
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J0717
|
| Min. Negotiated Rate |
$3.79 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$5.08
|
| Rate for Payer: Aetna Medicare |
$3.79
|
| Rate for Payer: BCBS MAPPO |
$3.79
|
| Rate for Payer: BCBS Trust/PPO |
$3.93
|
| Rate for Payer: BCN Commercial |
$4.05
|
| Rate for Payer: BCN Medicare Advantage |
$3.79
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$5.46
|
| Rate for Payer: Cofinity Commercial |
$5.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.79
|
| Rate for Payer: Healthscope Commercial |
$4.55
|
| Rate for Payer: Healthscope Whirlpool |
$4.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.17
|
| Rate for Payer: Nomi Health Commercial |
$4.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$3.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.79
|
| Rate for Payer: Priority Health Medicare |
$3.79
|
| Rate for Payer: Railroad Medicare Medicare |
$3.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.79
|
| Rate for Payer: UHC Exchange |
$3.87
|
| Rate for Payer: UHCCP DNSP |
$3.79
|
|
|
PR CERV FLEX N/ADJ FOAM PRE OTS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS L0120
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$46.81 |
| Rate for Payer: Aetna Commercial |
$43.56
|
| Rate for Payer: Aetna Medicare |
$32.51
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCN Commercial |
$31.12
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$46.81
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Healthscope Commercial |
$39.01
|
| Rate for Payer: Healthscope Whirlpool |
$39.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.76
|
| Rate for Payer: Nomi Health Commercial |
$39.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: Priority Health Medicare |
$32.51
|
| Rate for Payer: Railroad Medicare Medicare |
$32.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.51
|
| Rate for Payer: UHC Exchange |
$10.60
|
| Rate for Payer: UHCCP DNSP |
$32.51
|
|
|
PR CERVICAL CAP CONTRACEPTIVE
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS A4261
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$78.84 |
| Rate for Payer: Aetna Commercial |
$26.50
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCN Commercial |
$78.84
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
|
|
PR CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ
|
Professional
|
Both
|
$4,115.00
|
|
|
Service Code
|
HCPCS 38724
|
| Min. Negotiated Rate |
$805.14 |
| Max. Negotiated Rate |
$3,086.25 |
| Rate for Payer: Aetna Commercial |
$1,671.23
|
| Rate for Payer: Aetna Medicare |
$1,247.19
|
| Rate for Payer: BCBS Complete |
$845.40
|
| Rate for Payer: BCBS MAPPO |
$1,247.19
|
| Rate for Payer: BCN Commercial |
$2,178.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,247.19
|
| Rate for Payer: Cash Price |
$3,292.00
|
| Rate for Payer: Cash Price |
$3,292.00
|
| Rate for Payer: Cofinity Commercial |
$1,795.95
|
| Rate for Payer: Cofinity Commercial |
$1,671.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,247.19
|
| Rate for Payer: Healthscope Commercial |
$1,496.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,496.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,309.55
|
| Rate for Payer: Meridian Medicaid |
$845.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,371.91
|
| Rate for Payer: Nomi Health Commercial |
$1,496.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,086.25
|
| Rate for Payer: PACE SWMI |
$1,247.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,247.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$805.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,898.89
|
| Rate for Payer: Priority Health Medicare |
$1,247.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,898.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,247.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,533.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,247.19
|
| Rate for Payer: UHC Exchange |
$2,533.42
|
| Rate for Payer: UHC Medicaid |
$805.14
|
| Rate for Payer: UHCCP DNSP |
$1,247.19
|
| Rate for Payer: UHCCP Medicaid |
$805.14
|
|
|
PR CERVICAL LYMPHADENECTOMY
|
Professional
|
Both
|
$2,517.00
|
|
|
Service Code
|
HCPCS 38720
|
| Min. Negotiated Rate |
$762.11 |
| Max. Negotiated Rate |
$2,688.19 |
| Rate for Payer: Aetna Commercial |
$1,582.26
|
| Rate for Payer: Aetna Medicare |
$1,180.79
|
| Rate for Payer: BCBS Complete |
$800.22
|
| Rate for Payer: BCBS MAPPO |
$1,180.79
|
| Rate for Payer: BCN Commercial |
$2,020.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,180.79
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cash Price |
$2,013.60
|
| Rate for Payer: Cofinity Commercial |
$1,700.34
|
| Rate for Payer: Cofinity Commercial |
$1,582.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,180.79
|
| Rate for Payer: Healthscope Commercial |
$1,416.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,416.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,239.83
|
| Rate for Payer: Meridian Medicaid |
$800.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,298.87
|
| Rate for Payer: Nomi Health Commercial |
$1,416.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,887.75
|
| Rate for Payer: PACE SWMI |
$1,180.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,180.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$762.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,688.19
|
| Rate for Payer: Priority Health Medicare |
$1,180.79
|
| Rate for Payer: Priority Health Narrow Network |
$2,688.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1,180.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,349.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,180.79
|
| Rate for Payer: UHC Exchange |
$2,349.59
|
| Rate for Payer: UHC Medicaid |
$762.11
|
| Rate for Payer: UHCCP DNSP |
$1,180.79
|
| Rate for Payer: UHCCP Medicaid |
$762.11
|
|
|
PR CESAREAN DELIVERY ATTEMPTED VBAC
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 59620
|
| Min. Negotiated Rate |
$821.48 |
| Max. Negotiated Rate |
$1,930.50 |
| Rate for Payer: Aetna Commercial |
$1,159.23
|
| Rate for Payer: Aetna Medicare |
$865.10
|
| Rate for Payer: BCBS Complete |
$862.55
|
| Rate for Payer: BCBS MAPPO |
$865.10
|
| Rate for Payer: BCN Commercial |
$1,674.98
|
| Rate for Payer: BCN Medicare Advantage |
$865.10
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$1,245.74
|
| Rate for Payer: Cofinity Commercial |
$1,159.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$865.10
|
| Rate for Payer: Healthscope Commercial |
$1,038.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,038.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$908.36
|
| Rate for Payer: Meridian Medicaid |
$862.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$951.61
|
| Rate for Payer: Nomi Health Commercial |
$1,038.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,930.50
|
| Rate for Payer: PACE SWMI |
$865.10
|
| Rate for Payer: PHP Medicare Advantage |
$865.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,323.31
|
| Rate for Payer: Priority Health Medicare |
$865.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.31
|
| Rate for Payer: Railroad Medicare Medicare |
$865.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,208.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$865.10
|
| Rate for Payer: UHC Exchange |
$1,208.80
|
| Rate for Payer: UHC Medicaid |
$821.48
|
| Rate for Payer: UHCCP DNSP |
$865.10
|
| Rate for Payer: UHCCP Medicaid |
$821.48
|
|
|
PR CESAREAN DELIVERY ONLY
|
Professional
|
Both
|
$2,391.00
|
|
|
Service Code
|
HCPCS 59514
|
| Min. Negotiated Rate |
$792.56 |
| Max. Negotiated Rate |
$1,793.25 |
| Rate for Payer: Aetna Commercial |
$1,118.93
|
| Rate for Payer: Aetna Medicare |
$835.02
|
| Rate for Payer: BCBS Complete |
$832.19
|
| Rate for Payer: BCBS MAPPO |
$835.02
|
| Rate for Payer: BCN Commercial |
$1,595.20
|
| Rate for Payer: BCN Medicare Advantage |
$835.02
|
| Rate for Payer: Cash Price |
$1,912.80
|
| Rate for Payer: Cash Price |
$1,912.80
|
| Rate for Payer: Cofinity Commercial |
$1,202.43
|
| Rate for Payer: Cofinity Commercial |
$1,118.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.02
|
| Rate for Payer: Healthscope Commercial |
$1,002.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.77
|
| Rate for Payer: Meridian Medicaid |
$832.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$918.52
|
| Rate for Payer: Nomi Health Commercial |
$1,002.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,793.25
|
| Rate for Payer: PACE SWMI |
$835.02
|
| Rate for Payer: PHP Medicare Advantage |
$835.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$792.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,279.13
|
| Rate for Payer: Priority Health Medicare |
$835.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,279.13
|
| Rate for Payer: Railroad Medicare Medicare |
$835.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,166.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$835.02
|
| Rate for Payer: UHC Exchange |
$1,166.31
|
| Rate for Payer: UHC Medicaid |
$792.56
|
| Rate for Payer: UHCCP DNSP |
$835.02
|
| Rate for Payer: UHCCP Medicaid |
$792.56
|
|
|
PR CESAREAN DELIVERY ONLY W/POSTPARTUM CARE
|
Professional
|
Both
|
$2,671.00
|
|
|
Service Code
|
HCPCS 59515
|
| Min. Negotiated Rate |
$1,175.02 |
| Max. Negotiated Rate |
$2,003.25 |
| Rate for Payer: Aetna Commercial |
$1,657.39
|
| Rate for Payer: Aetna Medicare |
$1,236.86
|
| Rate for Payer: BCBS Complete |
$1,233.77
|
| Rate for Payer: BCBS MAPPO |
$1,236.86
|
| Rate for Payer: BCN Commercial |
$1,851.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,236.86
|
| Rate for Payer: Cash Price |
$2,136.80
|
| Rate for Payer: Cash Price |
$2,136.80
|
| Rate for Payer: Cofinity Commercial |
$1,781.08
|
| Rate for Payer: Cofinity Commercial |
$1,657.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,236.86
|
| Rate for Payer: Healthscope Commercial |
$1,484.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,484.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,298.70
|
| Rate for Payer: Meridian Medicaid |
$1,233.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,360.55
|
| Rate for Payer: Nomi Health Commercial |
$1,484.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,003.25
|
| Rate for Payer: PACE SWMI |
$1,236.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,236.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,175.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,894.48
|
| Rate for Payer: Priority Health Medicare |
$1,236.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,894.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,236.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,614.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,236.86
|
| Rate for Payer: UHC Exchange |
$1,614.17
|
| Rate for Payer: UHC Medicaid |
$1,175.02
|
| Rate for Payer: UHCCP DNSP |
$1,236.86
|
| Rate for Payer: UHCCP Medicaid |
$1,175.02
|
|
|
PR CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA
|
Professional
|
Both
|
$2,854.00
|
|
|
Service Code
|
HCPCS 59622
|
| Min. Negotiated Rate |
$1,211.94 |
| Max. Negotiated Rate |
$2,140.50 |
| Rate for Payer: Aetna Commercial |
$1,708.47
|
| Rate for Payer: Aetna Medicare |
$1,274.98
|
| Rate for Payer: BCBS Complete |
$1,272.54
|
| Rate for Payer: BCBS MAPPO |
$1,274.98
|
| Rate for Payer: BCN Commercial |
$1,944.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,274.98
|
| Rate for Payer: Cash Price |
$2,283.20
|
| Rate for Payer: Cash Price |
$2,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,835.97
|
| Rate for Payer: Cofinity Commercial |
$1,708.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,274.98
|
| Rate for Payer: Healthscope Commercial |
$1,529.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,529.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,338.73
|
| Rate for Payer: Meridian Medicaid |
$1,272.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,402.48
|
| Rate for Payer: Nomi Health Commercial |
$1,529.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,140.50
|
| Rate for Payer: PACE SWMI |
$1,274.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,274.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,211.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,960.30
|
| Rate for Payer: Priority Health Medicare |
$1,274.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,960.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,274.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,667.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,274.98
|
| Rate for Payer: UHC Exchange |
$1,667.42
|
| Rate for Payer: UHC Medicaid |
$1,211.94
|
| Rate for Payer: UHCCP DNSP |
$1,274.98
|
| Rate for Payer: UHCCP Medicaid |
$1,211.94
|
|
|
PR CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 37214
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$220.53 |
| Rate for Payer: Aetna Commercial |
$145.18
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$108.34
|
| Rate for Payer: BCN Commercial |
$178.77
|
| Rate for Payer: BCN Medicare Advantage |
$108.34
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$156.01
|
| Rate for Payer: Cofinity Commercial |
$145.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.34
|
| Rate for Payer: Healthscope Commercial |
$130.01
|
| Rate for Payer: Healthscope Whirlpool |
$130.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.76
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$119.17
|
| Rate for Payer: Nomi Health Commercial |
$130.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE SWMI |
$108.34
|
| Rate for Payer: PHP Medicare Advantage |
$108.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$192.24
|
| Rate for Payer: Priority Health Medicare |
$108.34
|
| Rate for Payer: Priority Health Narrow Network |
$192.24
|
| Rate for Payer: Railroad Medicare Medicare |
$108.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$220.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$108.34
|
| Rate for Payer: UHC Exchange |
$220.53
|
| Rate for Payer: UHC Medicaid |
$68.37
|
| Rate for Payer: UHCCP DNSP |
$108.34
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
|
|
PR CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 51710
|
| Min. Negotiated Rate |
$46.65 |
| Max. Negotiated Rate |
$263.25 |
| Rate for Payer: Aetna Commercial |
$96.28
|
| Rate for Payer: Aetna Medicare |
$71.85
|
| Rate for Payer: BCBS Complete |
$48.98
|
| Rate for Payer: BCBS MAPPO |
$71.85
|
| Rate for Payer: BCN Commercial |
$119.51
|
| Rate for Payer: BCN Medicare Advantage |
$71.85
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Cofinity Commercial |
$103.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.85
|
| Rate for Payer: Healthscope Commercial |
$86.22
|
| Rate for Payer: Healthscope Whirlpool |
$86.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.44
|
| Rate for Payer: Meridian Medicaid |
$48.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.03
|
| Rate for Payer: Nomi Health Commercial |
$86.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$263.25
|
| Rate for Payer: PACE SWMI |
$71.85
|
| Rate for Payer: PHP Medicare Advantage |
$71.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$130.19
|
| Rate for Payer: Priority Health Medicare |
$71.85
|
| Rate for Payer: Priority Health Narrow Network |
$130.19
|
| Rate for Payer: Railroad Medicare Medicare |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.85
|
| Rate for Payer: UHC Exchange |
$139.01
|
| Rate for Payer: UHC Medicaid |
$46.65
|
| Rate for Payer: UHCCP DNSP |
$71.85
|
| Rate for Payer: UHCCP Medicaid |
$46.65
|
|
|
PR CHANGE CYSTOSTOMY TUBE SIMPLE
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 51705
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$62.20
|
| Rate for Payer: Aetna Medicare |
$46.42
|
| Rate for Payer: BCBS Complete |
$31.53
|
| Rate for Payer: BCBS MAPPO |
$46.42
|
| Rate for Payer: BCN Commercial |
$78.18
|
| Rate for Payer: BCN Medicare Advantage |
$46.42
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$62.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.42
|
| Rate for Payer: Healthscope Commercial |
$55.70
|
| Rate for Payer: Healthscope Whirlpool |
$55.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.74
|
| Rate for Payer: Meridian Medicaid |
$31.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.06
|
| Rate for Payer: Nomi Health Commercial |
$55.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
| Rate for Payer: PACE SWMI |
$46.42
|
| Rate for Payer: PHP Medicare Advantage |
$46.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$85.16
|
| Rate for Payer: Priority Health Medicare |
$46.42
|
| Rate for Payer: Priority Health Narrow Network |
$85.16
|
| Rate for Payer: Railroad Medicare Medicare |
$46.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.42
|
| Rate for Payer: UHC Exchange |
$91.58
|
| Rate for Payer: UHC Medicaid |
$30.03
|
| Rate for Payer: UHCCP DNSP |
$46.42
|
| Rate for Payer: UHCCP Medicaid |
$30.03
|
|
|
PR CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE
|
Facility
|
IP
|
$860.00
|
|
|
Service Code
|
CPT 43760
|
| Hospital Charge Code |
43760
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$645.00 |
| Max. Negotiated Rate |
$860.00 |
| Rate for Payer: Aetna Commercial |
$774.00
|
| Rate for Payer: ASR ASR |
$834.20
|
| Rate for Payer: BCBS Trust/PPO |
$706.23
|
| Rate for Payer: BCN Commercial |
$706.23
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cofinity Commercial |
$808.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.00
|
| Rate for Payer: Healthscope Commercial |
$834.20
|
| Rate for Payer: Healthscope Whirlpool |
$860.00
|
| Rate for Payer: Mclaren Commercial |
$774.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.00
|
| Rate for Payer: Nomi Health Commercial |
$705.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.00
|
|
|
PR CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 43760
|
| Hospital Charge Code |
43760
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$645.00 |
| Rate for Payer: BCBS Complete |
$344.00
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.00
|
|
|
PR CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 43760
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$645.00 |
| Rate for Payer: BCBS Complete |
$344.00
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.00
|
|
|
PR CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE
|
Facility
|
OP
|
$860.00
|
|
|
Service Code
|
CPT 43760
|
| Hospital Charge Code |
43760
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$318.20 |
| Max. Negotiated Rate |
$860.00 |
| Rate for Payer: Aetna Commercial |
$774.00
|
| Rate for Payer: Aetna Medicare |
$318.20
|
| Rate for Payer: ASR ASR |
$834.20
|
| Rate for Payer: BCBS Complete |
$344.00
|
| Rate for Payer: BCBS Trust/PPO |
$709.07
|
| Rate for Payer: BCN Commercial |
$709.07
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cofinity Commercial |
$808.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.00
|
| Rate for Payer: Healthscope Commercial |
$834.20
|
| Rate for Payer: Healthscope Whirlpool |
$860.00
|
| Rate for Payer: Mclaren Commercial |
$774.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$688.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.00
|
| Rate for Payer: Nomi Health Commercial |
$705.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$753.53
|
| Rate for Payer: Priority Health Narrow Network |
$602.86
|
|
|
PR CHEMICAL CAUTERIZATION OF GRANULATION TISSUE
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 17250
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$111.75 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$34.25
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$34.25
|
| Rate for Payer: BCN Commercial |
$56.27
|
| Rate for Payer: BCN Medicare Advantage |
$34.25
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cofinity Commercial |
$45.90
|
| Rate for Payer: Cofinity Commercial |
$49.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.25
|
| Rate for Payer: Healthscope Commercial |
$41.10
|
| Rate for Payer: Healthscope Whirlpool |
$41.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.96
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.67
|
| Rate for Payer: Nomi Health Commercial |
$41.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
| Rate for Payer: PACE SWMI |
$34.25
|
| Rate for Payer: PHP Medicare Advantage |
$34.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$51.50
|
| Rate for Payer: Priority Health Medicare |
$34.25
|
| Rate for Payer: Priority Health Narrow Network |
$51.50
|
| Rate for Payer: Railroad Medicare Medicare |
$34.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.25
|
| Rate for Payer: UHC Exchange |
$64.62
|
| Rate for Payer: UHC Medicaid |
$22.58
|
| Rate for Payer: UHCCP DNSP |
$34.25
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
|
|
PR CHEMICAL PEEL FACIAL EPIDERMAL
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 15788
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$249.53
|
| Rate for Payer: Aetna Medicare |
$186.22
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$186.22
|
| Rate for Payer: BCN Commercial |
$258.79
|
| Rate for Payer: BCN Medicare Advantage |
$186.22
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cofinity Commercial |
$268.16
|
| Rate for Payer: Cofinity Commercial |
$249.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.22
|
| Rate for Payer: Healthscope Commercial |
$223.46
|
| Rate for Payer: Healthscope Whirlpool |
$223.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.53
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$204.84
|
| Rate for Payer: Nomi Health Commercial |
$223.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$688.50
|
| Rate for Payer: PACE SWMI |
$186.22
|
| Rate for Payer: PHP Medicare Advantage |
$186.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$300.36
|
| Rate for Payer: Priority Health Medicare |
$186.22
|
| Rate for Payer: Priority Health Narrow Network |
$300.36
|
| Rate for Payer: Railroad Medicare Medicare |
$186.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$388.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$186.22
|
| Rate for Payer: UHC Exchange |
$388.92
|
| Rate for Payer: UHC Medicaid |
$124.82
|
| Rate for Payer: UHCCP DNSP |
$186.22
|
| Rate for Payer: UHCCP Medicaid |
$124.82
|
|
|
PR CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 64644
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$137.43
|
| Rate for Payer: Aetna Medicare |
$102.56
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$102.56
|
| Rate for Payer: BCN Commercial |
$174.29
|
| Rate for Payer: BCN Medicare Advantage |
$102.56
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$147.69
|
| Rate for Payer: Cofinity Commercial |
$137.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.56
|
| Rate for Payer: Healthscope Commercial |
$123.07
|
| Rate for Payer: Healthscope Whirlpool |
$123.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.69
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$112.82
|
| Rate for Payer: Nomi Health Commercial |
$123.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$102.56
|
| Rate for Payer: PHP Medicare Advantage |
$102.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$202.43
|
| Rate for Payer: Priority Health Medicare |
$102.56
|
| Rate for Payer: Priority Health Narrow Network |
$202.43
|
| Rate for Payer: Railroad Medicare Medicare |
$102.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$205.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$102.56
|
| Rate for Payer: UHC Exchange |
$205.30
|
| Rate for Payer: UHC Medicaid |
$66.03
|
| Rate for Payer: UHCCP DNSP |
$102.56
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
|
|
PR CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 64643
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Aetna Commercial |
$80.00
|
| Rate for Payer: Aetna Medicare |
$59.70
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$59.70
|
| Rate for Payer: BCN Commercial |
$103.58
|
| Rate for Payer: BCN Medicare Advantage |
$59.70
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.70
|
| Rate for Payer: Healthscope Commercial |
$71.64
|
| Rate for Payer: Healthscope Whirlpool |
$71.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.69
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.67
|
| Rate for Payer: Nomi Health Commercial |
$71.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE SWMI |
$59.70
|
| Rate for Payer: PHP Medicare Advantage |
$59.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$120.30
|
| Rate for Payer: Priority Health Medicare |
$59.70
|
| Rate for Payer: Priority Health Narrow Network |
$120.30
|
| Rate for Payer: Railroad Medicare Medicare |
$59.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.70
|
| Rate for Payer: UHC Exchange |
$126.03
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP DNSP |
$59.70
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
PR CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64645
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$94.81
|
| Rate for Payer: Aetna Medicare |
$70.75
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS MAPPO |
$70.75
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$70.75
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$94.81
|
| Rate for Payer: Cofinity Commercial |
$101.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.75
|
| Rate for Payer: Healthscope Commercial |
$84.90
|
| Rate for Payer: Healthscope Whirlpool |
$84.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.29
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$84.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$70.75
|
| Rate for Payer: PHP Medicare Advantage |
$70.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$141.14
|
| Rate for Payer: Priority Health Medicare |
$70.75
|
| Rate for Payer: Priority Health Narrow Network |
$141.14
|
| Rate for Payer: Railroad Medicare Medicare |
$70.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.75
|
| Rate for Payer: UHC Exchange |
$145.06
|
| Rate for Payer: UHC Medicaid |
$44.94
|
| Rate for Payer: UHCCP DNSP |
$70.75
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
|
|
PR CHEMODENERVATION EXTREMITY&/TRUNK MUSCLE
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 64614
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$362.25 |
| Rate for Payer: BCBS Complete |
$193.20
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$362.25
|
|
|
PR CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 46505
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$318.96
|
| Rate for Payer: Aetna Medicare |
$238.03
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$238.03
|
| Rate for Payer: BCN Commercial |
$375.48
|
| Rate for Payer: BCN Medicare Advantage |
$238.03
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$318.96
|
| Rate for Payer: Cofinity Commercial |
$342.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.03
|
| Rate for Payer: Healthscope Commercial |
$285.64
|
| Rate for Payer: Healthscope Whirlpool |
$285.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.93
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.83
|
| Rate for Payer: Nomi Health Commercial |
$285.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE SWMI |
$238.03
|
| Rate for Payer: PHP Medicare Advantage |
$238.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$457.49
|
| Rate for Payer: Priority Health Medicare |
$238.03
|
| Rate for Payer: Priority Health Narrow Network |
$457.49
|
| Rate for Payer: Railroad Medicare Medicare |
$238.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$421.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$238.03
|
| Rate for Payer: UHC Exchange |
$421.98
|
| Rate for Payer: UHC Medicaid |
$157.19
|
| Rate for Payer: UHCCP DNSP |
$238.03
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
|
