|
PR DRUG-ELUTING STENTS, SINGLE
|
Professional
|
Both
|
$2,525.00
|
|
|
Service Code
|
HCPCS G0290
|
| Min. Negotiated Rate |
$1,010.00 |
| Max. Negotiated Rate |
$1,641.25 |
| Rate for Payer: Aetna Medicare |
$1,262.50
|
| Rate for Payer: BCBS Complete |
$1,010.00
|
| Rate for Payer: Cash Price |
$2,020.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,641.25
|
|
|
PR DRUG SCREEN MULTI DRUG CLASS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS G0434
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
|
|
PR DRUG SCREEN MULTIP CLASS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS G0431
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$40.30 |
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
|
|
PR DRUG SCREEN PANEL 10 WITH BATH SALTS
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 00124
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$50.05 |
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
|
|
PR DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS
|
Professional
|
Both
|
$2,434.00
|
|
|
Service Code
|
HCPCS 36838
|
| Min. Negotiated Rate |
$713.55 |
| Max. Negotiated Rate |
$1,776.29 |
| Rate for Payer: Aetna Commercial |
$1,535.31
|
| Rate for Payer: Aetna Medicare |
$1,217.00
|
| Rate for Payer: BCBS Complete |
$749.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.13
|
| Rate for Payer: BCN Commercial |
$1,629.74
|
| Rate for Payer: Cash Price |
$1,947.20
|
| Rate for Payer: Cash Price |
$1,947.20
|
| Rate for Payer: Meridian Medicaid |
$749.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,582.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,776.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,776.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,542.73
|
| Rate for Payer: UHC Exchange |
$1,542.73
|
| Rate for Payer: UHCCP Medicaid |
$713.55
|
|
|
PR DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 17107
|
| Min. Negotiated Rate |
$233.02 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Aetna Commercial |
$379.73
|
| Rate for Payer: Aetna Medicare |
$409.00
|
| Rate for Payer: BCBS Complete |
$244.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,712.50
|
| Rate for Payer: BCN Commercial |
$523.42
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Meridian Medicaid |
$244.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.09
|
| Rate for Payer: Priority Health Narrow Network |
$488.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$379.15
|
| Rate for Payer: UHC Exchange |
$379.15
|
| Rate for Payer: UHCCP Medicaid |
$233.02
|
|
|
PR DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 17108
|
| Min. Negotiated Rate |
$340.59 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$559.13
|
| Rate for Payer: Aetna Medicare |
$585.00
|
| Rate for Payer: BCBS Complete |
$357.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.00
|
| Rate for Payer: BCN Commercial |
$742.53
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Meridian Medicaid |
$357.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$340.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.11
|
| Rate for Payer: Priority Health Narrow Network |
$716.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$556.67
|
| Rate for Payer: UHC Exchange |
$556.67
|
| Rate for Payer: UHCCP Medicaid |
$340.59
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 46924
|
| Min. Negotiated Rate |
$118.00 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$239.74
|
| Rate for Payer: Aetna Medicare |
$432.50
|
| Rate for Payer: BCBS Complete |
$123.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$809.25
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Meridian Medicaid |
$123.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.74
|
| Rate for Payer: Priority Health Narrow Network |
$325.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.70
|
| Rate for Payer: UHC Exchange |
$218.70
|
| Rate for Payer: UHCCP Medicaid |
$118.00
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 46924
|
| Hospital Charge Code |
46924
|
| Min. Negotiated Rate |
$118.00 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$239.74
|
| Rate for Payer: Aetna Medicare |
$432.50
|
| Rate for Payer: BCBS Complete |
$123.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$809.25
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Meridian Medicaid |
$123.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.74
|
| Rate for Payer: Priority Health Narrow Network |
$325.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.70
|
| Rate for Payer: UHC Exchange |
$218.70
|
| Rate for Payer: UHCCP Medicaid |
$118.00
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
IP
|
$865.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$562.25 |
| Max. Negotiated Rate |
$865.00 |
| Rate for Payer: Aetna Commercial |
$778.50
|
| Rate for Payer: ASR ASR |
$839.05
|
| Rate for Payer: ASR Commercial |
$839.05
|
| Rate for Payer: BCBS Trust/PPO |
$704.89
|
| Rate for Payer: BCN Commercial |
$670.63
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$813.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.00
|
| Rate for Payer: Healthscope Commercial |
$865.00
|
| Rate for Payer: Healthscope Whirlpool |
$839.05
|
| Rate for Payer: Mclaren Commercial |
$778.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.25
|
| Rate for Payer: Nomi Health Commercial |
$709.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$761.20
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
OP
|
$865.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$562.25 |
| Max. Negotiated Rate |
$4,164.76 |
| Rate for Payer: Aetna Commercial |
$778.50
|
| Rate for Payer: Aetna Medicare |
$2,686.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: ASR ASR |
$839.05
|
| Rate for Payer: ASR Commercial |
$839.05
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$708.35
|
| Rate for Payer: BCN Commercial |
$670.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$813.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$865.00
|
| Rate for Payer: Healthscope Whirlpool |
$839.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,686.94
|
| Rate for Payer: Mclaren Commercial |
$778.50
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.25
|
| Rate for Payer: Nomi Health Commercial |
$709.30
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$2,955.63
|
| Rate for Payer: PHP Medicaid |
$1,440.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$757.91
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$606.36
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$761.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$4,164.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP DNSP |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 46900
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$179.17
|
| Rate for Payer: Aetna Medicare |
$191.50
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.58
|
| Rate for Payer: Priority Health Narrow Network |
$247.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.98
|
| Rate for Payer: UHC Exchange |
$161.98
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
IP
|
$383.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$248.95 |
| Max. Negotiated Rate |
$383.00 |
| Rate for Payer: Aetna Commercial |
$344.70
|
| Rate for Payer: ASR ASR |
$371.51
|
| Rate for Payer: ASR Commercial |
$371.51
|
| Rate for Payer: BCBS Trust/PPO |
$312.11
|
| Rate for Payer: BCN Commercial |
$296.94
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$360.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.40
|
| Rate for Payer: Healthscope Commercial |
$383.00
|
| Rate for Payer: Healthscope Whirlpool |
$371.51
|
| Rate for Payer: Mclaren Commercial |
$344.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.55
|
| Rate for Payer: Nomi Health Commercial |
$314.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.04
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
OP
|
$383.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$209.82 |
| Max. Negotiated Rate |
$606.75 |
| Rate for Payer: Aetna Commercial |
$344.70
|
| Rate for Payer: Aetna Medicare |
$391.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: ASR ASR |
$371.51
|
| Rate for Payer: ASR Commercial |
$371.51
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$313.64
|
| Rate for Payer: BCN Commercial |
$296.94
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$360.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$383.00
|
| Rate for Payer: Healthscope Whirlpool |
$371.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.45
|
| Rate for Payer: Mclaren Commercial |
$344.70
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.55
|
| Rate for Payer: Nomi Health Commercial |
$314.06
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$430.60
|
| Rate for Payer: PHP Medicaid |
$209.82
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$335.58
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$268.48
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$337.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$606.75
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP DNSP |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$179.17
|
| Rate for Payer: Aetna Medicare |
$191.50
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.58
|
| Rate for Payer: Priority Health Narrow Network |
$247.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.98
|
| Rate for Payer: UHC Exchange |
$161.98
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
|
|
PR DSTRJ LESION ANUS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 46916
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$1,647.77 |
| Rate for Payer: Aetna Commercial |
$184.99
|
| Rate for Payer: Aetna Medicare |
$206.00
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.77
|
| Rate for Payer: BCN Commercial |
$383.13
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.34
|
| Rate for Payer: Priority Health Narrow Network |
$255.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.18
|
| Rate for Payer: UHC Exchange |
$171.18
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
|
|
PR DSTRJ LESION ANUS SIMPLE LASER SURG
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 46917
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$1,832.14 |
| Rate for Payer: Aetna Commercial |
$169.46
|
| Rate for Payer: Aetna Medicare |
$357.00
|
| Rate for Payer: BCBS Complete |
$87.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.14
|
| Rate for Payer: BCN Commercial |
$659.72
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Meridian Medicaid |
$87.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.67
|
| Rate for Payer: Priority Health Narrow Network |
$232.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.21
|
| Rate for Payer: UHC Exchange |
$157.21
|
| Rate for Payer: UHCCP Medicaid |
$83.50
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
OP
|
$517.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$336.05 |
| Max. Negotiated Rate |
$4,164.76 |
| Rate for Payer: Aetna Commercial |
$465.30
|
| Rate for Payer: Aetna Medicare |
$2,686.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: ASR ASR |
$501.49
|
| Rate for Payer: ASR Commercial |
$501.49
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$423.37
|
| Rate for Payer: BCN Commercial |
$400.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$485.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$517.00
|
| Rate for Payer: Healthscope Whirlpool |
$501.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,686.94
|
| Rate for Payer: Mclaren Commercial |
$465.30
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.45
|
| Rate for Payer: Nomi Health Commercial |
$423.94
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$2,955.63
|
| Rate for Payer: PHP Medicaid |
$1,440.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.00
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$362.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$454.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$4,164.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP DNSP |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 46922
|
| Hospital Charge Code |
46922
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$181.18
|
| Rate for Payer: Aetna Medicare |
$258.50
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.78
|
| Rate for Payer: Priority Health Narrow Network |
$248.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.33
|
| Rate for Payer: UHC Exchange |
$157.33
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
IP
|
$517.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$336.05 |
| Max. Negotiated Rate |
$517.00 |
| Rate for Payer: Aetna Commercial |
$465.30
|
| Rate for Payer: ASR ASR |
$501.49
|
| Rate for Payer: ASR Commercial |
$501.49
|
| Rate for Payer: BCBS Trust/PPO |
$421.30
|
| Rate for Payer: BCN Commercial |
$400.83
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$485.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.60
|
| Rate for Payer: Healthscope Commercial |
$517.00
|
| Rate for Payer: Healthscope Whirlpool |
$501.49
|
| Rate for Payer: Mclaren Commercial |
$465.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.45
|
| Rate for Payer: Nomi Health Commercial |
$423.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$454.96
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 46922
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$181.18
|
| Rate for Payer: Aetna Medicare |
$258.50
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.78
|
| Rate for Payer: Priority Health Narrow Network |
$248.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.33
|
| Rate for Payer: UHC Exchange |
$157.33
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
|
|
PR DSTRJ LESION ANUS SMPL ELTRDSICCATION
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46910
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$2,583.92 |
| Rate for Payer: Aetna Commercial |
$178.48
|
| Rate for Payer: Aetna Medicare |
$207.50
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,583.92
|
| Rate for Payer: BCN Commercial |
$387.03
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.01
|
| Rate for Payer: Priority Health Narrow Network |
$244.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.71
|
| Rate for Payer: UHC Exchange |
$157.71
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM
|
Professional
|
Both
|
$430.00
|
|
|
Service Code
|
HCPCS 42160
|
| Min. Negotiated Rate |
$90.31 |
| Max. Negotiated Rate |
$342.56 |
| Rate for Payer: Aetna Commercial |
$189.22
|
| Rate for Payer: Aetna Medicare |
$215.00
|
| Rate for Payer: BCBS Complete |
$94.83
|
| Rate for Payer: BCBS Trust/PPO |
$264.46
|
| Rate for Payer: BCN Commercial |
$342.56
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Meridian Medicaid |
$94.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.55
|
| Rate for Payer: Priority Health Narrow Network |
$253.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.28
|
| Rate for Payer: UHC Exchange |
$180.28
|
| Rate for Payer: UHCCP Medicaid |
$90.31
|
|
|
PR DSTRJ LESION PENIS EXTENSIVE
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
HCPCS 54065
|
| Min. Negotiated Rate |
$112.25 |
| Max. Negotiated Rate |
$1,527.84 |
| Rate for Payer: Aetna Commercial |
$215.30
|
| Rate for Payer: Aetna Medicare |
$232.50
|
| Rate for Payer: BCBS Complete |
$117.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.84
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Meridian Medicaid |
$117.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.36
|
| Rate for Payer: Priority Health Narrow Network |
$275.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$192.81
|
| Rate for Payer: UHC Exchange |
$192.81
|
| Rate for Payer: UHCCP Medicaid |
$112.25
|
|
|
PR DSTRJ LESION PENIS SIMPLE CHEMICAL
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 54050
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$1,664.67 |
| Rate for Payer: Aetna Commercial |
$132.50
|
| Rate for Payer: Aetna Medicare |
$112.00
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.67
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.69
|
| Rate for Payer: UHC Exchange |
$115.69
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
|
