|
PR CLOSURE GASTROCOLIC FISTULA
|
Professional
|
Both
|
$4,010.00
|
|
|
Service Code
|
HCPCS 43880
|
| Min. Negotiated Rate |
$954.45 |
| Max. Negotiated Rate |
$3,007.50 |
| Rate for Payer: Aetna Commercial |
$2,002.82
|
| Rate for Payer: Aetna Medicare |
$1,494.64
|
| Rate for Payer: BCBS Complete |
$1,002.17
|
| Rate for Payer: BCBS MAPPO |
$1,494.64
|
| Rate for Payer: BCN Commercial |
$2,411.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,494.64
|
| Rate for Payer: Cash Price |
$3,208.00
|
| Rate for Payer: Cash Price |
$3,208.00
|
| Rate for Payer: Cofinity Commercial |
$2,152.28
|
| Rate for Payer: Cofinity Commercial |
$2,002.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,494.64
|
| Rate for Payer: Healthscope Commercial |
$1,793.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,793.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,569.37
|
| Rate for Payer: Meridian Medicaid |
$1,002.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,644.10
|
| Rate for Payer: Nomi Health Commercial |
$1,793.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,007.50
|
| Rate for Payer: PACE SWMI |
$1,494.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,494.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$954.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,938.52
|
| Rate for Payer: Priority Health Medicare |
$1,494.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,938.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,494.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,844.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,494.64
|
| Rate for Payer: UHC Exchange |
$2,844.57
|
| Rate for Payer: UHC Medicaid |
$954.45
|
| Rate for Payer: UHCCP DNSP |
$1,494.64
|
| Rate for Payer: UHCCP Medicaid |
$954.45
|
|
|
PR CLOSURE GASTROSTOMY SURGICAL
|
Professional
|
Both
|
$2,014.00
|
|
|
Service Code
|
HCPCS 43870
|
| Min. Negotiated Rate |
$429.62 |
| Max. Negotiated Rate |
$1,510.50 |
| Rate for Payer: Aetna Commercial |
$893.93
|
| Rate for Payer: Aetna Medicare |
$667.11
|
| Rate for Payer: BCBS Complete |
$451.10
|
| Rate for Payer: BCBS MAPPO |
$667.11
|
| Rate for Payer: BCN Commercial |
$1,067.67
|
| Rate for Payer: BCN Medicare Advantage |
$667.11
|
| Rate for Payer: Cash Price |
$1,611.20
|
| Rate for Payer: Cash Price |
$1,611.20
|
| Rate for Payer: Cofinity Commercial |
$960.64
|
| Rate for Payer: Cofinity Commercial |
$893.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.11
|
| Rate for Payer: Healthscope Commercial |
$800.53
|
| Rate for Payer: Healthscope Whirlpool |
$800.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.47
|
| Rate for Payer: Meridian Medicaid |
$451.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$733.82
|
| Rate for Payer: Nomi Health Commercial |
$800.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,510.50
|
| Rate for Payer: PACE SWMI |
$667.11
|
| Rate for Payer: PHP Medicare Advantage |
$667.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,300.89
|
| Rate for Payer: Priority Health Medicare |
$667.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.89
|
| Rate for Payer: Railroad Medicare Medicare |
$667.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,262.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$667.11
|
| Rate for Payer: UHC Exchange |
$1,262.91
|
| Rate for Payer: UHC Medicaid |
$429.62
|
| Rate for Payer: UHCCP DNSP |
$667.11
|
| Rate for Payer: UHCCP Medicaid |
$429.62
|
|
|
PR CLOSURE INTESTINAL CUTANEOUS FISTULA
|
Professional
|
Both
|
$2,622.00
|
|
|
Service Code
|
HCPCS 44640
|
| Min. Negotiated Rate |
$818.77 |
| Max. Negotiated Rate |
$2,538.06 |
| Rate for Payer: Aetna Commercial |
$1,715.17
|
| Rate for Payer: Aetna Medicare |
$1,279.98
|
| Rate for Payer: BCBS Complete |
$859.71
|
| Rate for Payer: BCBS MAPPO |
$1,279.98
|
| Rate for Payer: BCN Commercial |
$2,083.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.98
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Cofinity Commercial |
$1,843.17
|
| Rate for Payer: Cofinity Commercial |
$1,715.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.98
|
| Rate for Payer: Healthscope Commercial |
$1,535.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,535.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,343.98
|
| Rate for Payer: Meridian Medicaid |
$859.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,407.98
|
| Rate for Payer: Nomi Health Commercial |
$1,535.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,966.50
|
| Rate for Payer: PACE SWMI |
$1,279.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,279.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,538.06
|
| Rate for Payer: Priority Health Medicare |
$1,279.98
|
| Rate for Payer: Priority Health Narrow Network |
$2,538.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,279.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,494.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,279.98
|
| Rate for Payer: UHC Exchange |
$2,494.69
|
| Rate for Payer: UHC Medicaid |
$818.77
|
| Rate for Payer: UHCCP DNSP |
$1,279.98
|
| Rate for Payer: UHCCP Medicaid |
$818.77
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 40830
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$414.75 |
| Rate for Payer: Aetna Commercial |
$178.70
|
| Rate for Payer: Aetna Medicare |
$133.36
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$133.36
|
| Rate for Payer: BCN Commercial |
$221.60
|
| Rate for Payer: BCN Medicare Advantage |
$133.36
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cofinity Commercial |
$192.04
|
| Rate for Payer: Cofinity Commercial |
$178.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.36
|
| Rate for Payer: Healthscope Commercial |
$160.03
|
| Rate for Payer: Healthscope Whirlpool |
$160.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.03
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.70
|
| Rate for Payer: Nomi Health Commercial |
$160.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.75
|
| Rate for Payer: PACE SWMI |
$133.36
|
| Rate for Payer: PHP Medicare Advantage |
$133.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$270.00
|
| Rate for Payer: Priority Health Medicare |
$133.36
|
| Rate for Payer: Priority Health Narrow Network |
$270.00
|
| Rate for Payer: Railroad Medicare Medicare |
$133.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.36
|
| Rate for Payer: UHC Exchange |
$289.50
|
| Rate for Payer: UHC Medicaid |
$88.40
|
| Rate for Payer: UHCCP DNSP |
$133.36
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL
|
Professional
|
Both
|
$712.00
|
|
|
Service Code
|
HCPCS 40831
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$534.00 |
| Rate for Payer: Aetna Commercial |
$249.66
|
| Rate for Payer: Aetna Medicare |
$186.31
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$186.31
|
| Rate for Payer: BCN Commercial |
$306.26
|
| Rate for Payer: BCN Medicare Advantage |
$186.31
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cofinity Commercial |
$268.29
|
| Rate for Payer: Cofinity Commercial |
$249.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.31
|
| Rate for Payer: Healthscope Commercial |
$223.57
|
| Rate for Payer: Healthscope Whirlpool |
$223.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.63
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$204.94
|
| Rate for Payer: Nomi Health Commercial |
$223.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$534.00
|
| Rate for Payer: PACE SWMI |
$186.31
|
| Rate for Payer: PHP Medicare Advantage |
$186.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$373.15
|
| Rate for Payer: Priority Health Medicare |
$186.31
|
| Rate for Payer: Priority Health Narrow Network |
$373.15
|
| Rate for Payer: Railroad Medicare Medicare |
$186.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$397.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$186.31
|
| Rate for Payer: UHC Exchange |
$397.50
|
| Rate for Payer: UHC Medicaid |
$123.33
|
| Rate for Payer: UHCCP DNSP |
$186.31
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
|
|
PR CLOSURE RECTOURETHRAL FISTULA
|
Professional
|
Both
|
$3,381.00
|
|
|
Service Code
|
HCPCS 45820
|
| Min. Negotiated Rate |
$772.98 |
| Max. Negotiated Rate |
$2,535.75 |
| Rate for Payer: Aetna Commercial |
$1,611.50
|
| Rate for Payer: Aetna Medicare |
$1,202.61
|
| Rate for Payer: BCBS Complete |
$811.63
|
| Rate for Payer: BCBS MAPPO |
$1,202.61
|
| Rate for Payer: BCN Commercial |
$1,917.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,202.61
|
| Rate for Payer: Cash Price |
$2,704.80
|
| Rate for Payer: Cash Price |
$2,704.80
|
| Rate for Payer: Cofinity Commercial |
$1,731.76
|
| Rate for Payer: Cofinity Commercial |
$1,611.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,202.61
|
| Rate for Payer: Healthscope Commercial |
$1,443.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,443.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,262.74
|
| Rate for Payer: Meridian Medicaid |
$811.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,322.87
|
| Rate for Payer: Nomi Health Commercial |
$1,443.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,535.75
|
| Rate for Payer: PACE SWMI |
$1,202.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,202.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$772.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,336.62
|
| Rate for Payer: Priority Health Medicare |
$1,202.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,336.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,202.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,263.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,202.61
|
| Rate for Payer: UHC Exchange |
$2,263.62
|
| Rate for Payer: UHC Medicaid |
$772.98
|
| Rate for Payer: UHCCP DNSP |
$1,202.61
|
| Rate for Payer: UHCCP Medicaid |
$772.98
|
|
|
PR CLOSURE RECTOVESICAL FISTULA
|
Professional
|
Both
|
$2,945.00
|
|
|
Service Code
|
HCPCS 45800
|
| Min. Negotiated Rate |
$771.27 |
| Max. Negotiated Rate |
$2,331.16 |
| Rate for Payer: Aetna Commercial |
$1,607.91
|
| Rate for Payer: Aetna Medicare |
$1,199.93
|
| Rate for Payer: BCBS Complete |
$809.83
|
| Rate for Payer: BCBS MAPPO |
$1,199.93
|
| Rate for Payer: BCN Commercial |
$1,913.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,199.93
|
| Rate for Payer: Cash Price |
$2,356.00
|
| Rate for Payer: Cash Price |
$2,356.00
|
| Rate for Payer: Cofinity Commercial |
$1,727.90
|
| Rate for Payer: Cofinity Commercial |
$1,607.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,199.93
|
| Rate for Payer: Healthscope Commercial |
$1,439.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,439.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,259.93
|
| Rate for Payer: Meridian Medicaid |
$809.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,319.92
|
| Rate for Payer: Nomi Health Commercial |
$1,439.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,208.75
|
| Rate for Payer: PACE SWMI |
$1,199.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,199.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$771.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,331.16
|
| Rate for Payer: Priority Health Medicare |
$1,199.93
|
| Rate for Payer: Priority Health Narrow Network |
$2,331.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,199.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,257.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,199.93
|
| Rate for Payer: UHC Exchange |
$2,257.44
|
| Rate for Payer: UHC Medicaid |
$771.27
|
| Rate for Payer: UHCCP DNSP |
$1,199.93
|
| Rate for Payer: UHCCP Medicaid |
$771.27
|
|
|
PR CLOSURE SALIVARY FISTULA
|
Professional
|
Both
|
$843.00
|
|
|
Service Code
|
HCPCS 42600
|
| Min. Negotiated Rate |
$203.63 |
| Max. Negotiated Rate |
$658.33 |
| Rate for Payer: Aetna Commercial |
$416.19
|
| Rate for Payer: Aetna Medicare |
$310.59
|
| Rate for Payer: BCBS Complete |
$213.81
|
| Rate for Payer: BCBS MAPPO |
$310.59
|
| Rate for Payer: BCN Commercial |
$540.31
|
| Rate for Payer: BCN Medicare Advantage |
$310.59
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cofinity Commercial |
$447.25
|
| Rate for Payer: Cofinity Commercial |
$416.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.59
|
| Rate for Payer: Healthscope Commercial |
$372.71
|
| Rate for Payer: Healthscope Whirlpool |
$372.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.12
|
| Rate for Payer: Meridian Medicaid |
$213.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$341.65
|
| Rate for Payer: Nomi Health Commercial |
$372.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.25
|
| Rate for Payer: PACE SWMI |
$310.59
|
| Rate for Payer: PHP Medicare Advantage |
$310.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$658.33
|
| Rate for Payer: Priority Health Medicare |
$310.59
|
| Rate for Payer: Priority Health Narrow Network |
$658.33
|
| Rate for Payer: Railroad Medicare Medicare |
$310.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$603.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$310.59
|
| Rate for Payer: UHC Exchange |
$603.80
|
| Rate for Payer: UHC Medicaid |
$203.63
|
| Rate for Payer: UHCCP DNSP |
$310.59
|
| Rate for Payer: UHCCP Medicaid |
$203.63
|
|
|
PR CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH
|
Professional
|
Both
|
$992.00
|
|
|
Service Code
|
HCPCS 57320
|
| Min. Negotiated Rate |
$319.93 |
| Max. Negotiated Rate |
$964.24 |
| Rate for Payer: Aetna Commercial |
$661.99
|
| Rate for Payer: Aetna Medicare |
$494.02
|
| Rate for Payer: BCBS Complete |
$335.93
|
| Rate for Payer: BCBS MAPPO |
$494.02
|
| Rate for Payer: BCN Commercial |
$847.06
|
| Rate for Payer: BCN Medicare Advantage |
$494.02
|
| Rate for Payer: Cash Price |
$793.60
|
| Rate for Payer: Cash Price |
$793.60
|
| Rate for Payer: Cofinity Commercial |
$711.39
|
| Rate for Payer: Cofinity Commercial |
$661.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.02
|
| Rate for Payer: Healthscope Commercial |
$592.82
|
| Rate for Payer: Healthscope Whirlpool |
$592.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.72
|
| Rate for Payer: Meridian Medicaid |
$335.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$543.42
|
| Rate for Payer: Nomi Health Commercial |
$592.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$744.00
|
| Rate for Payer: PACE SWMI |
$494.02
|
| Rate for Payer: PHP Medicare Advantage |
$494.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$857.89
|
| Rate for Payer: Priority Health Medicare |
$494.02
|
| Rate for Payer: Priority Health Narrow Network |
$857.89
|
| Rate for Payer: Railroad Medicare Medicare |
$494.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$494.02
|
| Rate for Payer: UHC Exchange |
$964.24
|
| Rate for Payer: UHC Medicaid |
$319.93
|
| Rate for Payer: UHCCP DNSP |
$494.02
|
| Rate for Payer: UHCCP Medicaid |
$319.93
|
|
|
PR CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 23540
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$327.94
|
| Rate for Payer: Aetna Medicare |
$244.73
|
| Rate for Payer: BCBS Complete |
$171.99
|
| Rate for Payer: BCBS MAPPO |
$244.73
|
| Rate for Payer: BCN Commercial |
$372.99
|
| Rate for Payer: BCN Medicare Advantage |
$244.73
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$352.41
|
| Rate for Payer: Cofinity Commercial |
$327.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.73
|
| Rate for Payer: Healthscope Commercial |
$293.68
|
| Rate for Payer: Healthscope Whirlpool |
$293.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.97
|
| Rate for Payer: Meridian Medicaid |
$171.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$269.20
|
| Rate for Payer: Nomi Health Commercial |
$293.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$462.00
|
| Rate for Payer: PACE SWMI |
$244.73
|
| Rate for Payer: PHP Medicare Advantage |
$244.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$398.72
|
| Rate for Payer: Priority Health Medicare |
$244.73
|
| Rate for Payer: Priority Health Narrow Network |
$398.72
|
| Rate for Payer: Railroad Medicare Medicare |
$244.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$396.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$244.73
|
| Rate for Payer: UHC Exchange |
$396.55
|
| Rate for Payer: UHC Medicaid |
$163.80
|
| Rate for Payer: UHCCP DNSP |
$244.73
|
| Rate for Payer: UHCCP Medicaid |
$163.80
|
|
|
PR CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$531.00
|
|
|
Service Code
|
HCPCS 23500
|
| Min. Negotiated Rate |
$156.34 |
| Max. Negotiated Rate |
$398.25 |
| Rate for Payer: Aetna Commercial |
$312.66
|
| Rate for Payer: Aetna Medicare |
$233.33
|
| Rate for Payer: BCBS Complete |
$164.16
|
| Rate for Payer: BCBS MAPPO |
$233.33
|
| Rate for Payer: BCN Commercial |
$363.53
|
| Rate for Payer: BCN Medicare Advantage |
$233.33
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$336.00
|
| Rate for Payer: Cofinity Commercial |
$312.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.33
|
| Rate for Payer: Healthscope Commercial |
$280.00
|
| Rate for Payer: Healthscope Whirlpool |
$280.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.00
|
| Rate for Payer: Meridian Medicaid |
$164.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$256.66
|
| Rate for Payer: Nomi Health Commercial |
$280.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$398.25
|
| Rate for Payer: PACE SWMI |
$233.33
|
| Rate for Payer: PHP Medicare Advantage |
$233.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$388.60
|
| Rate for Payer: Priority Health Medicare |
$233.33
|
| Rate for Payer: Priority Health Narrow Network |
$388.60
|
| Rate for Payer: Railroad Medicare Medicare |
$233.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$233.33
|
| Rate for Payer: UHC Exchange |
$384.66
|
| Rate for Payer: UHC Medicaid |
$156.34
|
| Rate for Payer: UHCCP DNSP |
$233.33
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
|
|
PR CLSD TX PELVIC RING FX W/MANIPULATION W/ANES
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 27198
|
| Min. Negotiated Rate |
$181.26 |
| Max. Negotiated Rate |
$537.45 |
| Rate for Payer: Aetna Commercial |
$375.35
|
| Rate for Payer: Aetna Medicare |
$280.11
|
| Rate for Payer: BCBS Complete |
$190.32
|
| Rate for Payer: BCBS MAPPO |
$280.11
|
| Rate for Payer: BCN Commercial |
$478.07
|
| Rate for Payer: BCN Medicare Advantage |
$280.11
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$403.36
|
| Rate for Payer: Cofinity Commercial |
$375.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.11
|
| Rate for Payer: Healthscope Commercial |
$336.13
|
| Rate for Payer: Healthscope Whirlpool |
$336.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.12
|
| Rate for Payer: Meridian Medicaid |
$190.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.12
|
| Rate for Payer: Nomi Health Commercial |
$336.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.75
|
| Rate for Payer: PACE SWMI |
$280.11
|
| Rate for Payer: PHP Medicare Advantage |
$280.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$511.04
|
| Rate for Payer: Priority Health Medicare |
$280.11
|
| Rate for Payer: Priority Health Narrow Network |
$511.04
|
| Rate for Payer: Railroad Medicare Medicare |
$280.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$537.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$280.11
|
| Rate for Payer: UHC Exchange |
$537.45
|
| Rate for Payer: UHC Medicaid |
$181.26
|
| Rate for Payer: UHCCP DNSP |
$280.11
|
| Rate for Payer: UHCCP Medicaid |
$181.26
|
|
|
PR CLSD TX PELVIC RING FX W/O MANIPULATION
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 27197
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$221.19 |
| Rate for Payer: Aetna Commercial |
$159.90
|
| Rate for Payer: Aetna Medicare |
$119.33
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$119.33
|
| Rate for Payer: BCN Commercial |
$200.69
|
| Rate for Payer: BCN Medicare Advantage |
$119.33
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$171.84
|
| Rate for Payer: Cofinity Commercial |
$159.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.33
|
| Rate for Payer: Healthscope Commercial |
$143.20
|
| Rate for Payer: Healthscope Whirlpool |
$143.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.30
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.26
|
| Rate for Payer: Nomi Health Commercial |
$143.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.25
|
| Rate for Payer: PACE SWMI |
$119.33
|
| Rate for Payer: PHP Medicare Advantage |
$119.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$214.53
|
| Rate for Payer: Priority Health Medicare |
$119.33
|
| Rate for Payer: Priority Health Narrow Network |
$214.53
|
| Rate for Payer: Railroad Medicare Medicare |
$119.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.33
|
| Rate for Payer: UHC Exchange |
$221.19
|
| Rate for Payer: UHC Medicaid |
$78.81
|
| Rate for Payer: UHCCP DNSP |
$119.33
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES
|
Professional
|
Both
|
$1,062.00
|
|
|
Service Code
|
HCPCS 23655
|
| Min. Negotiated Rate |
$267.10 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$540.36
|
| Rate for Payer: Aetna Medicare |
$403.25
|
| Rate for Payer: BCBS Complete |
$280.45
|
| Rate for Payer: BCBS MAPPO |
$403.25
|
| Rate for Payer: BCN Commercial |
$631.94
|
| Rate for Payer: BCN Medicare Advantage |
$403.25
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cofinity Commercial |
$580.68
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.25
|
| Rate for Payer: Healthscope Commercial |
$483.90
|
| Rate for Payer: Healthscope Whirlpool |
$483.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.41
|
| Rate for Payer: Meridian Medicaid |
$280.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.57
|
| Rate for Payer: Nomi Health Commercial |
$483.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.50
|
| Rate for Payer: PACE SWMI |
$403.25
|
| Rate for Payer: PHP Medicare Advantage |
$403.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$675.53
|
| Rate for Payer: Priority Health Medicare |
$403.25
|
| Rate for Payer: Priority Health Narrow Network |
$675.53
|
| Rate for Payer: Railroad Medicare Medicare |
$403.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$699.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$403.25
|
| Rate for Payer: UHC Exchange |
$699.03
|
| Rate for Payer: UHC Medicaid |
$267.10
|
| Rate for Payer: UHCCP DNSP |
$403.25
|
| Rate for Payer: UHCCP Medicaid |
$267.10
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 23650
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$536.25 |
| Rate for Payer: Aetna Commercial |
$471.22
|
| Rate for Payer: Aetna Medicare |
$351.66
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$351.66
|
| Rate for Payer: BCN Commercial |
$473.58
|
| Rate for Payer: BCN Medicare Advantage |
$351.66
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$506.39
|
| Rate for Payer: Cofinity Commercial |
$471.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.66
|
| Rate for Payer: Healthscope Commercial |
$421.99
|
| Rate for Payer: Healthscope Whirlpool |
$421.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.24
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$386.83
|
| Rate for Payer: Nomi Health Commercial |
$421.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$536.25
|
| Rate for Payer: PACE SWMI |
$351.66
|
| Rate for Payer: PHP Medicare Advantage |
$351.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$506.25
|
| Rate for Payer: Priority Health Medicare |
$351.66
|
| Rate for Payer: Priority Health Narrow Network |
$506.25
|
| Rate for Payer: Railroad Medicare Medicare |
$351.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$502.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$351.66
|
| Rate for Payer: UHC Exchange |
$502.72
|
| Rate for Payer: UHC Medicaid |
$234.51
|
| Rate for Payer: UHCCP DNSP |
$351.66
|
| Rate for Payer: UHCCP Medicaid |
$234.51
|
|
|
PR CLSR ANAL FSTL W/RCT ADVMNT FLAP
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 46288
|
| Min. Negotiated Rate |
$352.30 |
| Max. Negotiated Rate |
$1,296.00 |
| Rate for Payer: Aetna Commercial |
$719.34
|
| Rate for Payer: Aetna Medicare |
$536.82
|
| Rate for Payer: BCBS Complete |
$369.92
|
| Rate for Payer: BCBS MAPPO |
$536.82
|
| Rate for Payer: BCN Commercial |
$847.57
|
| Rate for Payer: BCN Medicare Advantage |
$536.82
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cofinity Commercial |
$773.02
|
| Rate for Payer: Cofinity Commercial |
$719.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.82
|
| Rate for Payer: Healthscope Commercial |
$644.18
|
| Rate for Payer: Healthscope Whirlpool |
$644.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.66
|
| Rate for Payer: Meridian Medicaid |
$369.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$590.50
|
| Rate for Payer: Nomi Health Commercial |
$644.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,296.00
|
| Rate for Payer: PACE SWMI |
$536.82
|
| Rate for Payer: PHP Medicare Advantage |
$536.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,032.71
|
| Rate for Payer: Priority Health Medicare |
$536.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,032.71
|
| Rate for Payer: Railroad Medicare Medicare |
$536.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$536.82
|
| Rate for Payer: UHC Exchange |
$964.22
|
| Rate for Payer: UHC Medicaid |
$352.30
|
| Rate for Payer: UHCCP DNSP |
$536.82
|
| Rate for Payer: UHCCP Medicaid |
$352.30
|
|
|
PR CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA
|
Professional
|
Both
|
$1,928.00
|
|
|
Service Code
|
HCPCS 32810
|
| Min. Negotiated Rate |
$557.21 |
| Max. Negotiated Rate |
$1,590.55 |
| Rate for Payer: Aetna Commercial |
$1,161.14
|
| Rate for Payer: Aetna Medicare |
$866.52
|
| Rate for Payer: BCBS Complete |
$585.07
|
| Rate for Payer: BCBS MAPPO |
$866.52
|
| Rate for Payer: BCN Commercial |
$1,340.07
|
| Rate for Payer: BCN Medicare Advantage |
$866.52
|
| Rate for Payer: Cash Price |
$1,542.40
|
| Rate for Payer: Cash Price |
$1,542.40
|
| Rate for Payer: Cofinity Commercial |
$1,247.79
|
| Rate for Payer: Cofinity Commercial |
$1,161.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.52
|
| Rate for Payer: Healthscope Commercial |
$1,039.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,039.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.85
|
| Rate for Payer: Meridian Medicaid |
$585.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$953.17
|
| Rate for Payer: Nomi Health Commercial |
$1,039.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,446.00
|
| Rate for Payer: PACE SWMI |
$866.52
|
| Rate for Payer: PHP Medicare Advantage |
$866.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,261.94
|
| Rate for Payer: Priority Health Medicare |
$866.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,261.94
|
| Rate for Payer: Railroad Medicare Medicare |
$866.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,590.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$866.52
|
| Rate for Payer: UHC Exchange |
$1,590.55
|
| Rate for Payer: UHC Medicaid |
$557.21
|
| Rate for Payer: UHCCP DNSP |
$866.52
|
| Rate for Payer: UHCCP Medicaid |
$557.21
|
|
|
PR CLSR ENTEROENTERIC/ENTEROCOLIC FSTL
|
Professional
|
Both
|
$2,656.00
|
|
|
Service Code
|
HCPCS 44650
|
| Min. Negotiated Rate |
$843.91 |
| Max. Negotiated Rate |
$2,611.48 |
| Rate for Payer: Aetna Commercial |
$1,767.54
|
| Rate for Payer: Aetna Medicare |
$1,319.06
|
| Rate for Payer: BCBS Complete |
$886.11
|
| Rate for Payer: BCBS MAPPO |
$1,319.06
|
| Rate for Payer: BCN Commercial |
$2,143.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,319.06
|
| Rate for Payer: Cash Price |
$2,124.80
|
| Rate for Payer: Cash Price |
$2,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,899.45
|
| Rate for Payer: Cofinity Commercial |
$1,767.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,319.06
|
| Rate for Payer: Healthscope Commercial |
$1,582.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,582.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,385.01
|
| Rate for Payer: Meridian Medicaid |
$886.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,450.97
|
| Rate for Payer: Nomi Health Commercial |
$1,582.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,992.00
|
| Rate for Payer: PACE SWMI |
$1,319.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,319.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$843.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,611.48
|
| Rate for Payer: Priority Health Medicare |
$1,319.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,611.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,319.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,578.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,319.06
|
| Rate for Payer: UHC Exchange |
$2,578.73
|
| Rate for Payer: UHC Medicaid |
$843.91
|
| Rate for Payer: UHCCP DNSP |
$1,319.06
|
| Rate for Payer: UHCCP Medicaid |
$843.91
|
|
|
PR CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ
|
Professional
|
Both
|
$3,683.00
|
|
|
Service Code
|
HCPCS 44661
|
| Min. Negotiated Rate |
$901.84 |
| Max. Negotiated Rate |
$2,805.64 |
| Rate for Payer: Aetna Commercial |
$1,890.27
|
| Rate for Payer: Aetna Medicare |
$1,410.65
|
| Rate for Payer: BCBS Complete |
$946.93
|
| Rate for Payer: BCBS MAPPO |
$1,410.65
|
| Rate for Payer: BCN Commercial |
$2,302.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,410.65
|
| Rate for Payer: Cash Price |
$2,946.40
|
| Rate for Payer: Cash Price |
$2,946.40
|
| Rate for Payer: Cofinity Commercial |
$2,031.34
|
| Rate for Payer: Cofinity Commercial |
$1,890.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,410.65
|
| Rate for Payer: Healthscope Commercial |
$1,692.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,692.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,481.18
|
| Rate for Payer: Meridian Medicaid |
$946.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,551.71
|
| Rate for Payer: Nomi Health Commercial |
$1,692.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,762.25
|
| Rate for Payer: PACE SWMI |
$1,410.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,410.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$901.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,805.64
|
| Rate for Payer: Priority Health Medicare |
$1,410.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,805.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,410.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,764.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,410.65
|
| Rate for Payer: UHC Exchange |
$2,764.84
|
| Rate for Payer: UHC Medicaid |
$901.84
|
| Rate for Payer: UHCCP DNSP |
$1,410.65
|
| Rate for Payer: UHCCP Medicaid |
$901.84
|
|
|
PR CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ
|
Professional
|
Both
|
$2,742.00
|
|
|
Service Code
|
HCPCS 44660
|
| Min. Negotiated Rate |
$775.75 |
| Max. Negotiated Rate |
$2,435.53 |
| Rate for Payer: Aetna Commercial |
$1,621.16
|
| Rate for Payer: Aetna Medicare |
$1,209.82
|
| Rate for Payer: BCBS Complete |
$814.54
|
| Rate for Payer: BCBS MAPPO |
$1,209.82
|
| Rate for Payer: BCN Commercial |
$1,998.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,209.82
|
| Rate for Payer: Cash Price |
$2,193.60
|
| Rate for Payer: Cash Price |
$2,193.60
|
| Rate for Payer: Cofinity Commercial |
$1,742.14
|
| Rate for Payer: Cofinity Commercial |
$1,621.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,209.82
|
| Rate for Payer: Healthscope Commercial |
$1,451.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,451.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,270.31
|
| Rate for Payer: Meridian Medicaid |
$814.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,330.80
|
| Rate for Payer: Nomi Health Commercial |
$1,451.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,056.50
|
| Rate for Payer: PACE SWMI |
$1,209.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,209.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,435.53
|
| Rate for Payer: Priority Health Medicare |
$1,209.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,435.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,209.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,374.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,209.82
|
| Rate for Payer: UHC Exchange |
$2,374.14
|
| Rate for Payer: UHC Medicaid |
$775.75
|
| Rate for Payer: UHCCP DNSP |
$1,209.82
|
| Rate for Payer: UHCCP Medicaid |
$775.75
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL CRV APPR
|
Professional
|
Both
|
$2,774.00
|
|
|
Service Code
|
HCPCS 43420
|
| Min. Negotiated Rate |
$560.40 |
| Max. Negotiated Rate |
$2,080.50 |
| Rate for Payer: Aetna Commercial |
$1,161.93
|
| Rate for Payer: Aetna Medicare |
$867.11
|
| Rate for Payer: BCBS Complete |
$588.42
|
| Rate for Payer: BCBS MAPPO |
$867.11
|
| Rate for Payer: BCN Commercial |
$1,529.30
|
| Rate for Payer: BCN Medicare Advantage |
$867.11
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cofinity Commercial |
$1,248.64
|
| Rate for Payer: Cofinity Commercial |
$1,161.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$867.11
|
| Rate for Payer: Healthscope Commercial |
$1,040.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,040.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$910.47
|
| Rate for Payer: Meridian Medicaid |
$588.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$953.82
|
| Rate for Payer: Nomi Health Commercial |
$1,040.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,080.50
|
| Rate for Payer: PACE SWMI |
$867.11
|
| Rate for Payer: PHP Medicare Advantage |
$867.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,863.35
|
| Rate for Payer: Priority Health Medicare |
$867.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,863.35
|
| Rate for Payer: Railroad Medicare Medicare |
$867.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,773.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$867.11
|
| Rate for Payer: UHC Exchange |
$1,773.69
|
| Rate for Payer: UHC Medicaid |
$560.40
|
| Rate for Payer: UHCCP DNSP |
$867.11
|
| Rate for Payer: UHCCP Medicaid |
$560.40
|
|
|
PR CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR
|
Professional
|
Both
|
$4,302.00
|
|
|
Service Code
|
HCPCS 43425
|
| Min. Negotiated Rate |
$877.35 |
| Max. Negotiated Rate |
$3,226.50 |
| Rate for Payer: Aetna Commercial |
$1,837.76
|
| Rate for Payer: Aetna Medicare |
$1,371.46
|
| Rate for Payer: BCBS Complete |
$921.22
|
| Rate for Payer: BCBS MAPPO |
$1,371.46
|
| Rate for Payer: BCN Commercial |
$2,138.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,371.46
|
| Rate for Payer: Cash Price |
$3,441.60
|
| Rate for Payer: Cash Price |
$3,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,974.90
|
| Rate for Payer: Cofinity Commercial |
$1,837.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,371.46
|
| Rate for Payer: Healthscope Commercial |
$1,645.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,645.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,440.03
|
| Rate for Payer: Meridian Medicaid |
$921.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,508.61
|
| Rate for Payer: Nomi Health Commercial |
$1,645.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,226.50
|
| Rate for Payer: PACE SWMI |
$1,371.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,371.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$877.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,606.02
|
| Rate for Payer: Priority Health Medicare |
$1,371.46
|
| Rate for Payer: Priority Health Narrow Network |
$2,606.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,371.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,562.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,371.46
|
| Rate for Payer: UHC Exchange |
$2,562.03
|
| Rate for Payer: UHC Medicaid |
$877.35
|
| Rate for Payer: UHCCP DNSP |
$1,371.46
|
| Rate for Payer: UHCCP Medicaid |
$877.35
|
|
|
PR CLSR LACRIMAL PUNCTUM PLUG EACH
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 68761
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: Aetna Medicare |
$99.02
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$99.02
|
| Rate for Payer: BCN Commercial |
$137.05
|
| Rate for Payer: BCN Medicare Advantage |
$99.02
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Cofinity Commercial |
$132.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.02
|
| Rate for Payer: Healthscope Commercial |
$118.82
|
| Rate for Payer: Healthscope Whirlpool |
$118.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.97
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.92
|
| Rate for Payer: Nomi Health Commercial |
$118.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$99.02
|
| Rate for Payer: PHP Medicare Advantage |
$99.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.58
|
| Rate for Payer: Priority Health Medicare |
$99.02
|
| Rate for Payer: Priority Health Narrow Network |
$203.58
|
| Rate for Payer: Railroad Medicare Medicare |
$99.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.02
|
| Rate for Payer: UHC Exchange |
$198.76
|
| Rate for Payer: UHC Medicaid |
$66.03
|
| Rate for Payer: UHCCP DNSP |
$99.02
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT
|
Professional
|
Both
|
$3,000.00
|
|
|
Service Code
|
HCPCS 44625
|
| Min. Negotiated Rate |
$595.34 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$1,241.39
|
| Rate for Payer: Aetna Medicare |
$926.41
|
| Rate for Payer: BCBS Complete |
$625.11
|
| Rate for Payer: BCBS MAPPO |
$926.41
|
| Rate for Payer: BCN Commercial |
$1,508.39
|
| Rate for Payer: BCN Medicare Advantage |
$926.41
|
| Rate for Payer: Cash Price |
$2,400.00
|
| Rate for Payer: Cash Price |
$2,400.00
|
| Rate for Payer: Cofinity Commercial |
$1,334.03
|
| Rate for Payer: Cofinity Commercial |
$1,241.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.41
|
| Rate for Payer: Healthscope Commercial |
$1,111.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,111.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.73
|
| Rate for Payer: Meridian Medicaid |
$625.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.05
|
| Rate for Payer: Nomi Health Commercial |
$1,111.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,250.00
|
| Rate for Payer: PACE SWMI |
$926.41
|
| Rate for Payer: PHP Medicare Advantage |
$926.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,837.88
|
| Rate for Payer: Priority Health Medicare |
$926.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,837.88
|
| Rate for Payer: Railroad Medicare Medicare |
$926.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,797.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$926.41
|
| Rate for Payer: UHC Exchange |
$1,797.92
|
| Rate for Payer: UHC Medicaid |
$595.34
|
| Rate for Payer: UHCCP DNSP |
$926.41
|
| Rate for Payer: UHCCP Medicaid |
$595.34
|
|
|
PR CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS
|
Professional
|
Both
|
$3,061.00
|
|
|
Service Code
|
HCPCS 44626
|
| Min. Negotiated Rate |
$928.68 |
| Max. Negotiated Rate |
$2,886.96 |
| Rate for Payer: Aetna Commercial |
$1,947.69
|
| Rate for Payer: Aetna Medicare |
$1,453.50
|
| Rate for Payer: BCBS Complete |
$975.11
|
| Rate for Payer: BCBS MAPPO |
$1,453.50
|
| Rate for Payer: BCN Commercial |
$2,369.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,453.50
|
| Rate for Payer: Cash Price |
$2,448.80
|
| Rate for Payer: Cash Price |
$2,448.80
|
| Rate for Payer: Cofinity Commercial |
$2,093.04
|
| Rate for Payer: Cofinity Commercial |
$1,947.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,453.50
|
| Rate for Payer: Healthscope Commercial |
$1,744.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,744.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,526.17
|
| Rate for Payer: Meridian Medicaid |
$975.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,598.85
|
| Rate for Payer: Nomi Health Commercial |
$1,744.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,295.75
|
| Rate for Payer: PACE SWMI |
$1,453.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,453.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$928.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,886.96
|
| Rate for Payer: Priority Health Medicare |
$1,453.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,886.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,453.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,854.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,453.50
|
| Rate for Payer: UHC Exchange |
$2,854.31
|
| Rate for Payer: UHC Medicaid |
$928.68
|
| Rate for Payer: UHCCP DNSP |
$1,453.50
|
| Rate for Payer: UHCCP Medicaid |
$928.68
|
|
