|
PR DSTRJ CUTANEOUS VASCULAR PRLF LES 10.0-50.0SQCM
|
Professional
|
Both
|
$843.00
|
|
|
Service Code
|
HCPCS 17107
|
| Min. Negotiated Rate |
$197.03 |
| Max. Negotiated Rate |
$632.25 |
| Rate for Payer: Aetna Commercial |
$400.90
|
| Rate for Payer: Aetna Medicare |
$299.18
|
| Rate for Payer: BCBS Complete |
$206.88
|
| Rate for Payer: BCBS MAPPO |
$299.18
|
| Rate for Payer: BCN Commercial |
$429.61
|
| Rate for Payer: BCN Medicare Advantage |
$299.18
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cofinity Commercial |
$430.82
|
| Rate for Payer: Cofinity Commercial |
$400.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.18
|
| Rate for Payer: Healthscope Commercial |
$359.02
|
| Rate for Payer: Healthscope Whirlpool |
$359.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.14
|
| Rate for Payer: Meridian Medicaid |
$206.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.10
|
| Rate for Payer: Nomi Health Commercial |
$359.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.25
|
| Rate for Payer: PACE SWMI |
$299.18
|
| Rate for Payer: PHP Medicare Advantage |
$299.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$498.62
|
| Rate for Payer: Priority Health Medicare |
$299.18
|
| Rate for Payer: Priority Health Narrow Network |
$498.62
|
| Rate for Payer: Railroad Medicare Medicare |
$299.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$613.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$299.18
|
| Rate for Payer: UHC Exchange |
$613.09
|
| Rate for Payer: UHC Medicaid |
$197.03
|
| Rate for Payer: UHCCP DNSP |
$299.18
|
| Rate for Payer: UHCCP Medicaid |
$197.03
|
|
|
PR DSTRJ CUTANEOUS VASCULAR PRLF LESIONS>50.0 SQ CM
|
Professional
|
Both
|
$1,205.00
|
|
|
Service Code
|
HCPCS 17108
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$906.96 |
| Rate for Payer: Aetna Commercial |
$592.15
|
| Rate for Payer: Aetna Medicare |
$441.90
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$441.90
|
| Rate for Payer: BCN Commercial |
$627.93
|
| Rate for Payer: BCN Medicare Advantage |
$441.90
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Commercial |
$636.34
|
| Rate for Payer: Cofinity Commercial |
$592.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.90
|
| Rate for Payer: Healthscope Commercial |
$530.28
|
| Rate for Payer: Healthscope Whirlpool |
$530.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$464.00
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$486.09
|
| Rate for Payer: Nomi Health Commercial |
$530.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$903.75
|
| Rate for Payer: PACE SWMI |
$441.90
|
| Rate for Payer: PHP Medicare Advantage |
$441.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$728.79
|
| Rate for Payer: Priority Health Medicare |
$441.90
|
| Rate for Payer: Priority Health Narrow Network |
$728.79
|
| Rate for Payer: Railroad Medicare Medicare |
$441.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$906.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$441.90
|
| Rate for Payer: UHC Exchange |
$906.96
|
| Rate for Payer: UHC Medicaid |
$289.25
|
| Rate for Payer: UHCCP DNSP |
$441.90
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
IP
|
$891.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$668.25 |
| Max. Negotiated Rate |
$891.00 |
| Rate for Payer: Aetna Commercial |
$801.90
|
| Rate for Payer: ASR ASR |
$864.27
|
| Rate for Payer: BCBS Trust/PPO |
$731.69
|
| Rate for Payer: BCN Commercial |
$731.69
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$837.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.80
|
| Rate for Payer: Healthscope Commercial |
$864.27
|
| Rate for Payer: Healthscope Whirlpool |
$891.00
|
| Rate for Payer: Mclaren Commercial |
$801.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.35
|
| Rate for Payer: Nomi Health Commercial |
$730.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
OP
|
$891.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$624.59 |
| Max. Negotiated Rate |
$3,457.10 |
| Rate for Payer: Aetna Commercial |
$801.90
|
| Rate for Payer: Aetna Medicare |
$2,765.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: ASR ASR |
$864.27
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$734.63
|
| Rate for Payer: BCN Commercial |
$734.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$837.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$864.27
|
| Rate for Payer: Healthscope Whirlpool |
$891.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,765.68
|
| Rate for Payer: Mclaren Commercial |
$801.90
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$1,518.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.35
|
| Rate for Payer: Nomi Health Commercial |
$730.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$3,042.25
|
| Rate for Payer: PHP Medicaid |
$1,482.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$780.69
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Narrow Network |
$624.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP DNSP |
$2,765.68
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 46924
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Aetna Commercial |
$225.27
|
| Rate for Payer: Aetna Medicare |
$168.11
|
| Rate for Payer: BCBS Complete |
$115.19
|
| Rate for Payer: BCBS MAPPO |
$168.11
|
| Rate for Payer: BCN Commercial |
$275.88
|
| Rate for Payer: BCN Medicare Advantage |
$168.11
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$242.08
|
| Rate for Payer: Cofinity Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.11
|
| Rate for Payer: Healthscope Commercial |
$201.73
|
| Rate for Payer: Healthscope Whirlpool |
$201.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.52
|
| Rate for Payer: Meridian Medicaid |
$115.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$201.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE SWMI |
$168.11
|
| Rate for Payer: PHP Medicare Advantage |
$168.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$336.14
|
| Rate for Payer: Priority Health Medicare |
$168.11
|
| Rate for Payer: Priority Health Narrow Network |
$336.14
|
| Rate for Payer: Railroad Medicare Medicare |
$168.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.11
|
| Rate for Payer: UHC Exchange |
$316.00
|
| Rate for Payer: UHC Medicaid |
$109.70
|
| Rate for Payer: UHCCP DNSP |
$168.11
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 46924
|
| Hospital Charge Code |
46924
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Aetna Commercial |
$225.27
|
| Rate for Payer: Aetna Medicare |
$168.11
|
| Rate for Payer: BCBS Complete |
$115.19
|
| Rate for Payer: BCBS MAPPO |
$168.11
|
| Rate for Payer: BCN Commercial |
$275.88
|
| Rate for Payer: BCN Medicare Advantage |
$168.11
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$242.08
|
| Rate for Payer: Cofinity Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.11
|
| Rate for Payer: Healthscope Commercial |
$201.73
|
| Rate for Payer: Healthscope Whirlpool |
$201.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.52
|
| Rate for Payer: Meridian Medicaid |
$115.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$201.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE SWMI |
$168.11
|
| Rate for Payer: PHP Medicare Advantage |
$168.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$336.14
|
| Rate for Payer: Priority Health Medicare |
$168.11
|
| Rate for Payer: Priority Health Narrow Network |
$336.14
|
| Rate for Payer: Railroad Medicare Medicare |
$168.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.11
|
| Rate for Payer: UHC Exchange |
$316.00
|
| Rate for Payer: UHC Medicaid |
$109.70
|
| Rate for Payer: UHCCP DNSP |
$168.11
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 46900
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$295.50 |
| Rate for Payer: Aetna Commercial |
$171.57
|
| Rate for Payer: Aetna Medicare |
$128.04
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$128.04
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$128.04
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$184.38
|
| Rate for Payer: Cofinity Commercial |
$171.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.04
|
| Rate for Payer: Healthscope Commercial |
$153.65
|
| Rate for Payer: Healthscope Whirlpool |
$153.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.44
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.84
|
| Rate for Payer: Nomi Health Commercial |
$153.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.50
|
| Rate for Payer: PACE SWMI |
$128.04
|
| Rate for Payer: PHP Medicare Advantage |
$128.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$254.85
|
| Rate for Payer: Priority Health Medicare |
$128.04
|
| Rate for Payer: Priority Health Narrow Network |
$254.85
|
| Rate for Payer: Railroad Medicare Medicare |
$128.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.04
|
| Rate for Payer: UHC Exchange |
$236.85
|
| Rate for Payer: UHC Medicaid |
$84.35
|
| Rate for Payer: UHCCP DNSP |
$128.04
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
|
|
PR DSTRJ LESION ANUS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 46916
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$318.00 |
| Rate for Payer: Aetna Commercial |
$158.74
|
| Rate for Payer: Aetna Medicare |
$118.46
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$118.46
|
| Rate for Payer: BCN Commercial |
$214.13
|
| Rate for Payer: BCN Medicare Advantage |
$118.46
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$170.58
|
| Rate for Payer: Cofinity Commercial |
$158.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.46
|
| Rate for Payer: Healthscope Commercial |
$142.15
|
| Rate for Payer: Healthscope Whirlpool |
$142.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.38
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.31
|
| Rate for Payer: Nomi Health Commercial |
$142.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$118.46
|
| Rate for Payer: PHP Medicare Advantage |
$118.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$260.91
|
| Rate for Payer: Priority Health Medicare |
$118.46
|
| Rate for Payer: Priority Health Narrow Network |
$260.91
|
| Rate for Payer: Railroad Medicare Medicare |
$118.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.46
|
| Rate for Payer: UHC Exchange |
$244.42
|
| Rate for Payer: UHC Medicaid |
$77.96
|
| Rate for Payer: UHCCP DNSP |
$118.46
|
| Rate for Payer: UHCCP Medicaid |
$77.96
|
|
|
PR DSTRJ LESION ANUS SIMPLE LASER SURG
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 46917
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$551.25 |
| Rate for Payer: Aetna Commercial |
$157.97
|
| Rate for Payer: Aetna Medicare |
$117.89
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS MAPPO |
$117.89
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$117.89
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$169.76
|
| Rate for Payer: Cofinity Commercial |
$157.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.89
|
| Rate for Payer: Healthscope Commercial |
$141.47
|
| Rate for Payer: Healthscope Whirlpool |
$141.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.78
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.68
|
| Rate for Payer: Nomi Health Commercial |
$141.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE SWMI |
$117.89
|
| Rate for Payer: PHP Medicare Advantage |
$117.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$237.85
|
| Rate for Payer: Priority Health Medicare |
$117.89
|
| Rate for Payer: Priority Health Narrow Network |
$237.85
|
| Rate for Payer: Railroad Medicare Medicare |
$117.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$117.89
|
| Rate for Payer: UHC Exchange |
$223.22
|
| Rate for Payer: UHC Medicaid |
$77.11
|
| Rate for Payer: UHCCP DNSP |
$117.89
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 46922
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Aetna Commercial |
$174.99
|
| Rate for Payer: Aetna Medicare |
$130.59
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$130.59
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$130.59
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$188.05
|
| Rate for Payer: Cofinity Commercial |
$174.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.59
|
| Rate for Payer: Healthscope Commercial |
$156.71
|
| Rate for Payer: Healthscope Whirlpool |
$156.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.12
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.65
|
| Rate for Payer: Nomi Health Commercial |
$156.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE SWMI |
$130.59
|
| Rate for Payer: PHP Medicare Advantage |
$130.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$254.85
|
| Rate for Payer: Priority Health Medicare |
$130.59
|
| Rate for Payer: Priority Health Narrow Network |
$254.85
|
| Rate for Payer: Railroad Medicare Medicare |
$130.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.59
|
| Rate for Payer: UHC Exchange |
$237.86
|
| Rate for Payer: UHC Medicaid |
$85.63
|
| Rate for Payer: UHCCP DNSP |
$130.59
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 46922
|
| Hospital Charge Code |
46922
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Aetna Commercial |
$174.99
|
| Rate for Payer: Aetna Medicare |
$130.59
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$130.59
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$130.59
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$188.05
|
| Rate for Payer: Cofinity Commercial |
$174.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.59
|
| Rate for Payer: Healthscope Commercial |
$156.71
|
| Rate for Payer: Healthscope Whirlpool |
$156.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.12
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.65
|
| Rate for Payer: Nomi Health Commercial |
$156.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE SWMI |
$130.59
|
| Rate for Payer: PHP Medicare Advantage |
$130.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$254.85
|
| Rate for Payer: Priority Health Medicare |
$130.59
|
| Rate for Payer: Priority Health Narrow Network |
$254.85
|
| Rate for Payer: Railroad Medicare Medicare |
$130.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.59
|
| Rate for Payer: UHC Exchange |
$237.86
|
| Rate for Payer: UHC Medicaid |
$85.63
|
| Rate for Payer: UHCCP DNSP |
$130.59
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
IP
|
$533.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$399.75 |
| Max. Negotiated Rate |
$533.00 |
| Rate for Payer: Aetna Commercial |
$479.70
|
| Rate for Payer: ASR ASR |
$517.01
|
| Rate for Payer: BCBS Trust/PPO |
$437.70
|
| Rate for Payer: BCN Commercial |
$437.70
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$501.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.40
|
| Rate for Payer: Healthscope Commercial |
$517.01
|
| Rate for Payer: Healthscope Whirlpool |
$533.00
|
| Rate for Payer: Mclaren Commercial |
$479.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$453.05
|
| Rate for Payer: Nomi Health Commercial |
$437.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
OP
|
$533.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$373.63 |
| Max. Negotiated Rate |
$3,457.10 |
| Rate for Payer: Aetna Commercial |
$479.70
|
| Rate for Payer: Aetna Medicare |
$2,765.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: ASR ASR |
$517.01
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$439.46
|
| Rate for Payer: BCN Commercial |
$439.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$501.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$517.01
|
| Rate for Payer: Healthscope Whirlpool |
$533.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,765.68
|
| Rate for Payer: Mclaren Commercial |
$479.70
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$1,518.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$453.05
|
| Rate for Payer: Nomi Health Commercial |
$437.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$3,042.25
|
| Rate for Payer: PHP Medicaid |
$1,482.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$467.01
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Narrow Network |
$373.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP DNSP |
$2,765.68
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
PR DSTRJ LESION ANUS SMPL ELTRDSICCATION
|
Professional
|
Both
|
$427.00
|
|
|
Service Code
|
HCPCS 46910
|
| Min. Negotiated Rate |
$82.86 |
| Max. Negotiated Rate |
$320.25 |
| Rate for Payer: Aetna Commercial |
$169.09
|
| Rate for Payer: Aetna Medicare |
$126.19
|
| Rate for Payer: BCBS Complete |
$87.00
|
| Rate for Payer: BCBS MAPPO |
$126.19
|
| Rate for Payer: BCN Commercial |
$203.67
|
| Rate for Payer: BCN Medicare Advantage |
$126.19
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Cofinity Commercial |
$181.71
|
| Rate for Payer: Cofinity Commercial |
$169.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.19
|
| Rate for Payer: Healthscope Commercial |
$151.43
|
| Rate for Payer: Healthscope Whirlpool |
$151.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.50
|
| Rate for Payer: Meridian Medicaid |
$87.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$138.81
|
| Rate for Payer: Nomi Health Commercial |
$151.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$320.25
|
| Rate for Payer: PACE SWMI |
$126.19
|
| Rate for Payer: PHP Medicare Advantage |
$126.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.17
|
| Rate for Payer: Priority Health Medicare |
$126.19
|
| Rate for Payer: Priority Health Narrow Network |
$248.17
|
| Rate for Payer: Railroad Medicare Medicare |
$126.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.19
|
| Rate for Payer: UHC Exchange |
$232.41
|
| Rate for Payer: UHC Medicaid |
$82.86
|
| Rate for Payer: UHCCP DNSP |
$126.19
|
| Rate for Payer: UHCCP Medicaid |
$82.86
|
|
|
PR DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 42160
|
| Min. Negotiated Rate |
$82.22 |
| Max. Negotiated Rate |
$332.25 |
| Rate for Payer: Aetna Commercial |
$166.87
|
| Rate for Payer: Aetna Medicare |
$124.53
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS MAPPO |
$124.53
|
| Rate for Payer: BCN Commercial |
$211.14
|
| Rate for Payer: BCN Medicare Advantage |
$124.53
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cofinity Commercial |
$179.32
|
| Rate for Payer: Cofinity Commercial |
$166.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.53
|
| Rate for Payer: Healthscope Commercial |
$149.44
|
| Rate for Payer: Healthscope Whirlpool |
$149.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.76
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.98
|
| Rate for Payer: Nomi Health Commercial |
$149.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$332.25
|
| Rate for Payer: PACE SWMI |
$124.53
|
| Rate for Payer: PHP Medicare Advantage |
$124.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.27
|
| Rate for Payer: Priority Health Medicare |
$124.53
|
| Rate for Payer: Priority Health Narrow Network |
$257.27
|
| Rate for Payer: Railroad Medicare Medicare |
$124.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.53
|
| Rate for Payer: UHC Exchange |
$249.59
|
| Rate for Payer: UHC Medicaid |
$82.22
|
| Rate for Payer: UHCCP DNSP |
$124.53
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
|
|
PR DSTRJ LESION PENIS EXTENSIVE
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 54065
|
| Min. Negotiated Rate |
$96.06 |
| Max. Negotiated Rate |
$359.25 |
| Rate for Payer: Aetna Commercial |
$196.10
|
| Rate for Payer: Aetna Medicare |
$146.34
|
| Rate for Payer: BCBS Complete |
$100.86
|
| Rate for Payer: BCBS MAPPO |
$146.34
|
| Rate for Payer: BCN Commercial |
$262.44
|
| Rate for Payer: BCN Medicare Advantage |
$146.34
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$210.73
|
| Rate for Payer: Cofinity Commercial |
$196.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.34
|
| Rate for Payer: Healthscope Commercial |
$175.61
|
| Rate for Payer: Healthscope Whirlpool |
$175.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.66
|
| Rate for Payer: Meridian Medicaid |
$100.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$160.97
|
| Rate for Payer: Nomi Health Commercial |
$175.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.25
|
| Rate for Payer: PACE SWMI |
$146.34
|
| Rate for Payer: PHP Medicare Advantage |
$146.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$285.88
|
| Rate for Payer: Priority Health Medicare |
$146.34
|
| Rate for Payer: Priority Health Narrow Network |
$285.88
|
| Rate for Payer: Railroad Medicare Medicare |
$146.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$146.34
|
| Rate for Payer: UHC Exchange |
$296.10
|
| Rate for Payer: UHC Medicaid |
$96.06
|
| Rate for Payer: UHCCP DNSP |
$146.34
|
| Rate for Payer: UHCCP Medicaid |
$96.06
|
|
|
PR DSTRJ LESION PENIS SIMPLE CHEMICAL
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 54050
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$179.38 |
| Rate for Payer: Aetna Commercial |
$124.77
|
| Rate for Payer: Aetna Medicare |
$93.11
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$93.11
|
| Rate for Payer: BCN Commercial |
$162.84
|
| Rate for Payer: BCN Medicare Advantage |
$93.11
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$134.08
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.11
|
| Rate for Payer: Healthscope Commercial |
$111.73
|
| Rate for Payer: Healthscope Whirlpool |
$111.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.77
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.42
|
| Rate for Payer: Nomi Health Commercial |
$111.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
| Rate for Payer: PACE SWMI |
$93.11
|
| Rate for Payer: PHP Medicare Advantage |
$93.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$177.38
|
| Rate for Payer: Priority Health Medicare |
$93.11
|
| Rate for Payer: Priority Health Narrow Network |
$177.38
|
| Rate for Payer: Railroad Medicare Medicare |
$93.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.11
|
| Rate for Payer: UHC Exchange |
$179.38
|
| Rate for Payer: UHC Medicaid |
$61.77
|
| Rate for Payer: UHCCP DNSP |
$93.11
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR DSTRJ LESION PENIS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 54056
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Aetna Commercial |
$127.53
|
| Rate for Payer: Aetna Medicare |
$95.17
|
| Rate for Payer: BCBS Complete |
$66.42
|
| Rate for Payer: BCBS MAPPO |
$95.17
|
| Rate for Payer: BCN Commercial |
$135.09
|
| Rate for Payer: BCN Medicare Advantage |
$95.17
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$137.04
|
| Rate for Payer: Cofinity Commercial |
$127.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.17
|
| Rate for Payer: Healthscope Commercial |
$114.20
|
| Rate for Payer: Healthscope Whirlpool |
$114.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.93
|
| Rate for Payer: Meridian Medicaid |
$66.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.69
|
| Rate for Payer: Nomi Health Commercial |
$114.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.50
|
| Rate for Payer: PACE SWMI |
$95.17
|
| Rate for Payer: PHP Medicare Advantage |
$95.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$186.60
|
| Rate for Payer: Priority Health Medicare |
$95.17
|
| Rate for Payer: Priority Health Narrow Network |
$186.60
|
| Rate for Payer: Railroad Medicare Medicare |
$95.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.17
|
| Rate for Payer: UHC Exchange |
$186.79
|
| Rate for Payer: UHC Medicaid |
$63.26
|
| Rate for Payer: UHCCP DNSP |
$95.17
|
| Rate for Payer: UHCCP Medicaid |
$63.26
|
|
|
PR DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 54055
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$162.75 |
| Rate for Payer: Aetna Commercial |
$112.35
|
| Rate for Payer: Aetna Medicare |
$83.84
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$83.84
|
| Rate for Payer: BCN Commercial |
$146.91
|
| Rate for Payer: BCN Medicare Advantage |
$83.84
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$120.73
|
| Rate for Payer: Cofinity Commercial |
$112.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.84
|
| Rate for Payer: Healthscope Commercial |
$100.61
|
| Rate for Payer: Healthscope Whirlpool |
$100.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.03
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.22
|
| Rate for Payer: Nomi Health Commercial |
$100.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.75
|
| Rate for Payer: PACE SWMI |
$83.84
|
| Rate for Payer: PHP Medicare Advantage |
$83.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$160.02
|
| Rate for Payer: Priority Health Medicare |
$83.84
|
| Rate for Payer: Priority Health Narrow Network |
$160.02
|
| Rate for Payer: Railroad Medicare Medicare |
$83.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$83.84
|
| Rate for Payer: UHC Exchange |
$160.78
|
| Rate for Payer: UHC Medicaid |
$55.38
|
| Rate for Payer: UHCCP DNSP |
$83.84
|
| Rate for Payer: UHCCP Medicaid |
$55.38
|
|
|
PR DSTRJ LESION PENIS SIMPLE LASER
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 54057
|
| Min. Negotiated Rate |
$58.15 |
| Max. Negotiated Rate |
$192.00 |
| Rate for Payer: Aetna Commercial |
$118.01
|
| Rate for Payer: Aetna Medicare |
$88.07
|
| Rate for Payer: BCBS Complete |
$61.06
|
| Rate for Payer: BCBS MAPPO |
$88.07
|
| Rate for Payer: BCN Commercial |
$145.91
|
| Rate for Payer: BCN Medicare Advantage |
$88.07
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$126.82
|
| Rate for Payer: Cofinity Commercial |
$118.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.07
|
| Rate for Payer: Healthscope Commercial |
$105.68
|
| Rate for Payer: Healthscope Whirlpool |
$105.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.47
|
| Rate for Payer: Meridian Medicaid |
$61.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.88
|
| Rate for Payer: Nomi Health Commercial |
$105.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE SWMI |
$88.07
|
| Rate for Payer: PHP Medicare Advantage |
$88.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$158.95
|
| Rate for Payer: Priority Health Medicare |
$88.07
|
| Rate for Payer: Priority Health Narrow Network |
$158.95
|
| Rate for Payer: Railroad Medicare Medicare |
$88.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$88.07
|
| Rate for Payer: UHC Exchange |
$163.86
|
| Rate for Payer: UHC Medicaid |
$58.15
|
| Rate for Payer: UHCCP DNSP |
$88.07
|
| Rate for Payer: UHCCP Medicaid |
$58.15
|
|
|
PR DSTRJ LESION PENIS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 54060
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Aetna Commercial |
$159.81
|
| Rate for Payer: Aetna Medicare |
$119.26
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$119.26
|
| Rate for Payer: BCN Commercial |
$199.69
|
| Rate for Payer: BCN Medicare Advantage |
$119.26
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$171.73
|
| Rate for Payer: Cofinity Commercial |
$159.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.26
|
| Rate for Payer: Healthscope Commercial |
$143.11
|
| Rate for Payer: Healthscope Whirlpool |
$143.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.22
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.19
|
| Rate for Payer: Nomi Health Commercial |
$143.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.50
|
| Rate for Payer: PACE SWMI |
$119.26
|
| Rate for Payer: PHP Medicare Advantage |
$119.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$217.53
|
| Rate for Payer: Priority Health Medicare |
$119.26
|
| Rate for Payer: Priority Health Narrow Network |
$217.53
|
| Rate for Payer: Railroad Medicare Medicare |
$119.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$226.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.26
|
| Rate for Payer: UHC Exchange |
$226.72
|
| Rate for Payer: UHC Medicaid |
$78.17
|
| Rate for Payer: UHCCP DNSP |
$119.26
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
|
|
PR DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 40820
|
| Min. Negotiated Rate |
$97.77 |
| Max. Negotiated Rate |
$362.25 |
| Rate for Payer: Aetna Commercial |
$194.11
|
| Rate for Payer: Aetna Medicare |
$144.86
|
| Rate for Payer: BCBS Complete |
$102.66
|
| Rate for Payer: BCBS MAPPO |
$144.86
|
| Rate for Payer: BCN Commercial |
$247.49
|
| Rate for Payer: BCN Medicare Advantage |
$144.86
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cofinity Commercial |
$208.60
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.86
|
| Rate for Payer: Healthscope Commercial |
$173.83
|
| Rate for Payer: Healthscope Whirlpool |
$173.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.10
|
| Rate for Payer: Meridian Medicaid |
$102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.35
|
| Rate for Payer: Nomi Health Commercial |
$173.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$362.25
|
| Rate for Payer: PACE SWMI |
$144.86
|
| Rate for Payer: PHP Medicare Advantage |
$144.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$301.55
|
| Rate for Payer: Priority Health Medicare |
$144.86
|
| Rate for Payer: Priority Health Narrow Network |
$301.55
|
| Rate for Payer: Railroad Medicare Medicare |
$144.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$282.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.86
|
| Rate for Payer: UHC Exchange |
$282.49
|
| Rate for Payer: UHC Medicaid |
$97.77
|
| Rate for Payer: UHCCP DNSP |
$144.86
|
| Rate for Payer: UHCCP Medicaid |
$97.77
|
|
|
PR DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM
|
Professional
|
Both
|
$585.00
|
|
|
Service Code
|
HCPCS 17276
|
| Min. Negotiated Rate |
$106.93 |
| Max. Negotiated Rate |
$438.75 |
| Rate for Payer: Aetna Commercial |
$220.76
|
| Rate for Payer: Aetna Medicare |
$164.75
|
| Rate for Payer: BCBS Complete |
$112.28
|
| Rate for Payer: BCBS MAPPO |
$164.75
|
| Rate for Payer: BCN Commercial |
$239.15
|
| Rate for Payer: BCN Medicare Advantage |
$164.75
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cofinity Commercial |
$237.24
|
| Rate for Payer: Cofinity Commercial |
$220.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.75
|
| Rate for Payer: Healthscope Commercial |
$197.70
|
| Rate for Payer: Healthscope Whirlpool |
$197.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.99
|
| Rate for Payer: Meridian Medicaid |
$112.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$181.22
|
| Rate for Payer: Nomi Health Commercial |
$197.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.75
|
| Rate for Payer: PACE SWMI |
$164.75
|
| Rate for Payer: PHP Medicare Advantage |
$164.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$277.57
|
| Rate for Payer: Priority Health Medicare |
$164.75
|
| Rate for Payer: Priority Health Narrow Network |
$277.57
|
| Rate for Payer: Railroad Medicare Medicare |
$164.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$355.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$164.75
|
| Rate for Payer: UHC Exchange |
$355.69
|
| Rate for Payer: UHC Medicaid |
$106.93
|
| Rate for Payer: UHCCP DNSP |
$164.75
|
| Rate for Payer: UHCCP Medicaid |
$106.93
|
|
|
PR DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR
|
Professional
|
Both
|
$1,248.00
|
|
|
Service Code
|
HCPCS 64610
|
| Min. Negotiated Rate |
$286.49 |
| Max. Negotiated Rate |
$936.00 |
| Rate for Payer: Aetna Commercial |
$598.22
|
| Rate for Payer: Aetna Medicare |
$446.43
|
| Rate for Payer: BCBS Complete |
$300.81
|
| Rate for Payer: BCBS MAPPO |
$446.43
|
| Rate for Payer: BCN Commercial |
$726.55
|
| Rate for Payer: BCN Medicare Advantage |
$446.43
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cofinity Commercial |
$642.86
|
| Rate for Payer: Cofinity Commercial |
$598.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.43
|
| Rate for Payer: Healthscope Commercial |
$535.72
|
| Rate for Payer: Healthscope Whirlpool |
$535.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$468.75
|
| Rate for Payer: Meridian Medicaid |
$300.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.07
|
| Rate for Payer: Nomi Health Commercial |
$535.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$936.00
|
| Rate for Payer: PACE SWMI |
$446.43
|
| Rate for Payer: PHP Medicare Advantage |
$446.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$843.89
|
| Rate for Payer: Priority Health Medicare |
$446.43
|
| Rate for Payer: Priority Health Narrow Network |
$843.89
|
| Rate for Payer: Railroad Medicare Medicare |
$446.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$853.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$446.43
|
| Rate for Payer: UHC Exchange |
$853.71
|
| Rate for Payer: UHC Medicaid |
$286.49
|
| Rate for Payer: UHCCP DNSP |
$446.43
|
| Rate for Payer: UHCCP Medicaid |
$286.49
|
|
|
PR DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE
|
Professional
|
Both
|
$795.00
|
|
|
Service Code
|
HCPCS 64620
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$596.25 |
| Rate for Payer: Aetna Commercial |
$219.18
|
| Rate for Payer: Aetna Medicare |
$163.57
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS MAPPO |
$163.57
|
| Rate for Payer: BCN Commercial |
$267.91
|
| Rate for Payer: BCN Medicare Advantage |
$163.57
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Cash Price |
$636.00
|
| Rate for Payer: Cofinity Commercial |
$235.54
|
| Rate for Payer: Cofinity Commercial |
$219.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.57
|
| Rate for Payer: Healthscope Commercial |
$196.28
|
| Rate for Payer: Healthscope Whirlpool |
$196.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.75
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.93
|
| Rate for Payer: Nomi Health Commercial |
$196.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$596.25
|
| Rate for Payer: PACE SWMI |
$163.57
|
| Rate for Payer: PHP Medicare Advantage |
$163.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$311.17
|
| Rate for Payer: Priority Health Medicare |
$163.57
|
| Rate for Payer: Priority Health Narrow Network |
$311.17
|
| Rate for Payer: Railroad Medicare Medicare |
$163.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.57
|
| Rate for Payer: UHC Exchange |
$305.91
|
| Rate for Payer: UHC Medicaid |
$106.71
|
| Rate for Payer: UHCCP DNSP |
$163.57
|
| Rate for Payer: UHCCP Medicaid |
$106.71
|
|
