|
PR EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART
|
Professional
|
Both
|
$2,812.00
|
|
|
Service Code
|
HCPCS 34151
|
| Min. Negotiated Rate |
$805.57 |
| Max. Negotiated Rate |
$2,496.73 |
| Rate for Payer: Aetna Commercial |
$1,709.57
|
| Rate for Payer: Aetna Medicare |
$1,275.80
|
| Rate for Payer: BCBS Complete |
$845.85
|
| Rate for Payer: BCBS MAPPO |
$1,275.80
|
| Rate for Payer: BCN Commercial |
$2,034.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.80
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cash Price |
$2,249.60
|
| Rate for Payer: Cofinity Commercial |
$1,837.15
|
| Rate for Payer: Cofinity Commercial |
$1,709.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.80
|
| Rate for Payer: Healthscope Commercial |
$1,530.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,530.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.59
|
| Rate for Payer: Meridian Medicaid |
$845.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,403.38
|
| Rate for Payer: Nomi Health Commercial |
$1,530.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,109.00
|
| Rate for Payer: PACE SWMI |
$1,275.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$805.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,187.57
|
| Rate for Payer: Priority Health Medicare |
$1,275.80
|
| Rate for Payer: Priority Health Narrow Network |
$2,187.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,275.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,496.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,275.80
|
| Rate for Payer: UHC Exchange |
$2,496.73
|
| Rate for Payer: UHC Medicaid |
$805.57
|
| Rate for Payer: UHCCP DNSP |
$1,275.80
|
| Rate for Payer: UHCCP Medicaid |
$805.57
|
|
|
PR EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC
|
Professional
|
Both
|
$1,296.00
|
|
|
Service Code
|
HCPCS 34111
|
| Min. Negotiated Rate |
$346.98 |
| Max. Negotiated Rate |
$1,075.63 |
| Rate for Payer: Aetna Commercial |
$733.27
|
| Rate for Payer: Aetna Medicare |
$547.22
|
| Rate for Payer: BCBS Complete |
$364.33
|
| Rate for Payer: BCBS MAPPO |
$547.22
|
| Rate for Payer: BCN Commercial |
$872.96
|
| Rate for Payer: BCN Medicare Advantage |
$547.22
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cofinity Commercial |
$788.00
|
| Rate for Payer: Cofinity Commercial |
$733.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.22
|
| Rate for Payer: Healthscope Commercial |
$656.66
|
| Rate for Payer: Healthscope Whirlpool |
$656.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.58
|
| Rate for Payer: Meridian Medicaid |
$364.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$601.94
|
| Rate for Payer: Nomi Health Commercial |
$656.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.00
|
| Rate for Payer: PACE SWMI |
$547.22
|
| Rate for Payer: PHP Medicare Advantage |
$547.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$938.75
|
| Rate for Payer: Priority Health Medicare |
$547.22
|
| Rate for Payer: Priority Health Narrow Network |
$938.75
|
| Rate for Payer: Railroad Medicare Medicare |
$547.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,075.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$547.22
|
| Rate for Payer: UHC Exchange |
$1,075.63
|
| Rate for Payer: UHC Medicaid |
$346.98
|
| Rate for Payer: UHCCP DNSP |
$547.22
|
| Rate for Payer: UHCCP Medicaid |
$346.98
|
|
|
PR EMERGENCY DEPARTMENT VISIT HIGH MDM
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
HCPCS 99285
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$299.15 |
| Rate for Payer: Aetna Commercial |
$229.85
|
| Rate for Payer: Aetna Medicare |
$171.53
|
| Rate for Payer: BCBS Complete |
$114.73
|
| Rate for Payer: BCBS MAPPO |
$171.53
|
| Rate for Payer: BCN Commercial |
$259.95
|
| Rate for Payer: BCN Medicare Advantage |
$171.53
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cofinity Commercial |
$247.00
|
| Rate for Payer: Cofinity Commercial |
$229.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.53
|
| Rate for Payer: Healthscope Commercial |
$188.68
|
| Rate for Payer: Healthscope Whirlpool |
$188.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.11
|
| Rate for Payer: Meridian Medicaid |
$114.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.68
|
| Rate for Payer: Nomi Health Commercial |
$205.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.50
|
| Rate for Payer: PACE SWMI |
$171.53
|
| Rate for Payer: PHP Medicare Advantage |
$171.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$299.15
|
| Rate for Payer: Priority Health Medicare |
$171.53
|
| Rate for Payer: Priority Health Narrow Network |
$299.15
|
| Rate for Payer: Railroad Medicare Medicare |
$171.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$171.53
|
| Rate for Payer: UHC Exchange |
$248.51
|
| Rate for Payer: UHC Medicaid |
$109.27
|
| Rate for Payer: UHCCP DNSP |
$171.53
|
| Rate for Payer: UHCCP Medicaid |
$109.27
|
|
|
PR EMERGENCY DEPARTMENT VISIT LOW MDM
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 99283
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$133.50 |
| Rate for Payer: Aetna Commercial |
$93.16
|
| Rate for Payer: Aetna Medicare |
$69.52
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$69.52
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: BCN Medicare Advantage |
$69.52
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cofinity Commercial |
$93.16
|
| Rate for Payer: Cofinity Commercial |
$100.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.52
|
| Rate for Payer: Healthscope Commercial |
$76.47
|
| Rate for Payer: Healthscope Whirlpool |
$76.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.00
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.47
|
| Rate for Payer: Nomi Health Commercial |
$83.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.50
|
| Rate for Payer: PACE SWMI |
$69.52
|
| Rate for Payer: PHP Medicare Advantage |
$69.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$114.00
|
| Rate for Payer: Priority Health Medicare |
$69.52
|
| Rate for Payer: Priority Health Narrow Network |
$114.00
|
| Rate for Payer: Railroad Medicare Medicare |
$69.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.52
|
| Rate for Payer: UHC Exchange |
$93.02
|
| Rate for Payer: UHC Medicaid |
$44.30
|
| Rate for Payer: UHCCP DNSP |
$69.52
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 99281
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: Aetna Medicare |
$11.01
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$11.01
|
| Rate for Payer: BCN Commercial |
$16.93
|
| Rate for Payer: BCN Medicare Advantage |
$11.01
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Cofinity Commercial |
$14.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.01
|
| Rate for Payer: Healthscope Commercial |
$12.11
|
| Rate for Payer: Healthscope Whirlpool |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.56
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.11
|
| Rate for Payer: Nomi Health Commercial |
$13.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.00
|
| Rate for Payer: PACE SWMI |
$11.01
|
| Rate for Payer: PHP Medicare Advantage |
$11.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36.89
|
| Rate for Payer: Priority Health Medicare |
$11.01
|
| Rate for Payer: Priority Health Narrow Network |
$36.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.01
|
| Rate for Payer: UHC Exchange |
$32.32
|
| Rate for Payer: UHC Medicaid |
$7.03
|
| Rate for Payer: UHCCP DNSP |
$11.01
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
|
|
PR EMERGENCY DEPARTMENT VISIT MODERATE MDM
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 99284
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$203.10 |
| Rate for Payer: Aetna Commercial |
$158.71
|
| Rate for Payer: Aetna Medicare |
$118.44
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCBS MAPPO |
$118.44
|
| Rate for Payer: BCN Commercial |
$179.28
|
| Rate for Payer: BCN Medicare Advantage |
$118.44
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$170.55
|
| Rate for Payer: Cofinity Commercial |
$158.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.44
|
| Rate for Payer: Healthscope Commercial |
$130.28
|
| Rate for Payer: Healthscope Whirlpool |
$130.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.36
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.28
|
| Rate for Payer: Nomi Health Commercial |
$142.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE SWMI |
$118.44
|
| Rate for Payer: PHP Medicare Advantage |
$118.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.10
|
| Rate for Payer: Priority Health Medicare |
$118.44
|
| Rate for Payer: Priority Health Narrow Network |
$203.10
|
| Rate for Payer: Railroad Medicare Medicare |
$118.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.44
|
| Rate for Payer: UHC Exchange |
$170.98
|
| Rate for Payer: UHC Medicaid |
$75.40
|
| Rate for Payer: UHCCP DNSP |
$118.44
|
| Rate for Payer: UHCCP Medicaid |
$75.40
|
|
|
PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 99282
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Aetna Commercial |
$54.14
|
| Rate for Payer: Aetna Medicare |
$40.40
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$40.40
|
| Rate for Payer: BCN Commercial |
$62.25
|
| Rate for Payer: BCN Medicare Advantage |
$40.40
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$58.18
|
| Rate for Payer: Cofinity Commercial |
$54.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.40
|
| Rate for Payer: Healthscope Commercial |
$44.44
|
| Rate for Payer: Healthscope Whirlpool |
$44.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.42
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.44
|
| Rate for Payer: Nomi Health Commercial |
$48.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.50
|
| Rate for Payer: PACE SWMI |
$40.40
|
| Rate for Payer: PHP Medicare Advantage |
$40.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$71.81
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow Network |
$71.81
|
| Rate for Payer: Railroad Medicare Medicare |
$40.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.40
|
| Rate for Payer: UHC Exchange |
$62.11
|
| Rate for Payer: UHC Medicaid |
$25.77
|
| Rate for Payer: UHCCP DNSP |
$40.40
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 51784
|
| Min. Negotiated Rate |
$63.38 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$84.93
|
| Rate for Payer: Aetna Medicare |
$63.38
|
| Rate for Payer: BCBS MAPPO |
$63.38
|
| Rate for Payer: BCN Commercial |
$95.61
|
| Rate for Payer: BCN Medicare Advantage |
$63.38
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$84.93
|
| Rate for Payer: Cofinity Commercial |
$91.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.38
|
| Rate for Payer: Healthscope Commercial |
$76.06
|
| Rate for Payer: Healthscope Whirlpool |
$76.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.72
|
| Rate for Payer: Nomi Health Commercial |
$76.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.75
|
| Rate for Payer: PACE SWMI |
$63.38
|
| Rate for Payer: PHP Medicare Advantage |
$63.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$104.16
|
| Rate for Payer: Priority Health Medicare |
$63.38
|
| Rate for Payer: Priority Health Narrow Network |
$104.16
|
| Rate for Payer: Railroad Medicare Medicare |
$63.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.38
|
| Rate for Payer: UHC Exchange |
$114.81
|
| Rate for Payer: UHCCP DNSP |
$63.38
|
|
|
PR ENDOBRONCHIAL U/S ADD-ON
|
Professional
|
Both
|
$478.00
|
|
|
Service Code
|
HCPCS 31620
|
| Min. Negotiated Rate |
$191.20 |
| Max. Negotiated Rate |
$358.50 |
| Rate for Payer: BCBS Complete |
$191.20
|
| Rate for Payer: Cash Price |
$382.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.50
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Facility
|
OP
|
$321.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
57505
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$1,147.17 |
| Rate for Payer: Aetna Commercial |
$288.90
|
| Rate for Payer: Aetna Medicare |
$917.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: ASR ASR |
$311.37
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$264.66
|
| Rate for Payer: BCCCP Commercial |
$145.60
|
| Rate for Payer: BCN Commercial |
$264.66
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$301.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$311.37
|
| Rate for Payer: Healthscope Whirlpool |
$321.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$917.74
|
| Rate for Payer: Mclaren Commercial |
$288.90
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$504.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.85
|
| Rate for Payer: Nomi Health Commercial |
$263.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$1,009.51
|
| Rate for Payer: PHP Medicaid |
$491.91
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$281.26
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Narrow Network |
$225.02
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP DNSP |
$917.74
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 57505
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$240.75 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$95.76
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$95.76
|
| Rate for Payer: BCN Commercial |
$129.59
|
| Rate for Payer: BCN Medicare Advantage |
$95.76
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$137.89
|
| Rate for Payer: Cofinity Commercial |
$128.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.76
|
| Rate for Payer: Healthscope Commercial |
$114.91
|
| Rate for Payer: Healthscope Whirlpool |
$114.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.55
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.34
|
| Rate for Payer: Nomi Health Commercial |
$114.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PACE SWMI |
$95.76
|
| Rate for Payer: PHP Medicare Advantage |
$95.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$166.43
|
| Rate for Payer: Priority Health Medicare |
$95.76
|
| Rate for Payer: Priority Health Narrow Network |
$166.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.76
|
| Rate for Payer: UHC Exchange |
$173.93
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP DNSP |
$95.76
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 57505
|
| Hospital Charge Code |
57505
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$240.75 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$95.76
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$95.76
|
| Rate for Payer: BCN Commercial |
$129.59
|
| Rate for Payer: BCN Medicare Advantage |
$95.76
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$137.89
|
| Rate for Payer: Cofinity Commercial |
$128.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.76
|
| Rate for Payer: Healthscope Commercial |
$114.91
|
| Rate for Payer: Healthscope Whirlpool |
$114.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.55
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.34
|
| Rate for Payer: Nomi Health Commercial |
$114.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PACE SWMI |
$95.76
|
| Rate for Payer: PHP Medicare Advantage |
$95.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$166.43
|
| Rate for Payer: Priority Health Medicare |
$95.76
|
| Rate for Payer: Priority Health Narrow Network |
$166.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.76
|
| Rate for Payer: UHC Exchange |
$173.93
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP DNSP |
$95.76
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Facility
|
IP
|
$321.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
57505
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$240.75 |
| Max. Negotiated Rate |
$321.00 |
| Rate for Payer: Aetna Commercial |
$288.90
|
| Rate for Payer: ASR ASR |
$311.37
|
| Rate for Payer: BCBS Trust/PPO |
$263.61
|
| Rate for Payer: BCN Commercial |
$263.61
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$301.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.80
|
| Rate for Payer: Healthscope Commercial |
$311.37
|
| Rate for Payer: Healthscope Whirlpool |
$321.00
|
| Rate for Payer: Mclaren Commercial |
$288.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.85
|
| Rate for Payer: Nomi Health Commercial |
$263.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
|
|
PR END OF LIFE COUNSELING
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS S0257
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$47.64 |
| Rate for Payer: Aetna Commercial |
$3.85
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCN Commercial |
$29.04
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.64
|
| Rate for Payer: Priority Health Narrow Network |
$47.64
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 92979
|
| Min. Negotiated Rate |
$110.06 |
| Max. Negotiated Rate |
$284.12 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: BCN Commercial |
$110.06
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$227.18
|
| Rate for Payer: Priority Health Narrow Network |
$227.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.12
|
| Rate for Payer: UHC Exchange |
$284.12
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 92978
|
| Min. Negotiated Rate |
$137.95 |
| Max. Negotiated Rate |
$463.55 |
| Rate for Payer: Aetna Commercial |
$348.91
|
| Rate for Payer: BCN Commercial |
$137.95
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$374.38
|
| Rate for Payer: Priority Health Narrow Network |
$374.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$463.55
|
| Rate for Payer: UHC Exchange |
$463.55
|
|
|
PR ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID
|
Professional
|
Both
|
$2,104.00
|
|
|
Service Code
|
HCPCS 58353
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$1,578.00 |
| Rate for Payer: Aetna Commercial |
$268.83
|
| Rate for Payer: Aetna Medicare |
$200.62
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS MAPPO |
$200.62
|
| Rate for Payer: BCN Commercial |
$346.10
|
| Rate for Payer: BCN Medicare Advantage |
$200.62
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cofinity Commercial |
$288.89
|
| Rate for Payer: Cofinity Commercial |
$268.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.62
|
| Rate for Payer: Healthscope Commercial |
$240.74
|
| Rate for Payer: Healthscope Whirlpool |
$240.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.65
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.68
|
| Rate for Payer: Nomi Health Commercial |
$240.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.00
|
| Rate for Payer: PACE SWMI |
$200.62
|
| Rate for Payer: PHP Medicare Advantage |
$200.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$350.52
|
| Rate for Payer: Priority Health Medicare |
$200.62
|
| Rate for Payer: Priority Health Narrow Network |
$350.52
|
| Rate for Payer: Railroad Medicare Medicare |
$200.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$397.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$200.62
|
| Rate for Payer: UHC Exchange |
$397.94
|
| Rate for Payer: UHC Medicaid |
$129.93
|
| Rate for Payer: UHCCP DNSP |
$200.62
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
|
|
PR ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 58110
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Commercial |
$47.58
|
| Rate for Payer: Aetna Medicare |
$35.51
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$35.51
|
| Rate for Payer: BCN Commercial |
$60.25
|
| Rate for Payer: BCN Medicare Advantage |
$35.51
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$51.13
|
| Rate for Payer: Cofinity Commercial |
$47.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.51
|
| Rate for Payer: Healthscope Commercial |
$42.61
|
| Rate for Payer: Healthscope Whirlpool |
$42.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.29
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.06
|
| Rate for Payer: Nomi Health Commercial |
$42.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$35.51
|
| Rate for Payer: PHP Medicare Advantage |
$35.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.03
|
| Rate for Payer: Priority Health Medicare |
$35.51
|
| Rate for Payer: Priority Health Narrow Network |
$61.03
|
| Rate for Payer: Railroad Medicare Medicare |
$35.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.51
|
| Rate for Payer: UHC Exchange |
$73.11
|
| Rate for Payer: UHC Medicaid |
$22.58
|
| Rate for Payer: UHCCP DNSP |
$35.51
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
58100
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Commercial |
$74.05
|
| Rate for Payer: Aetna Medicare |
$55.26
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$55.26
|
| Rate for Payer: BCN Commercial |
$74.22
|
| Rate for Payer: BCN Medicare Advantage |
$55.26
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$79.57
|
| Rate for Payer: Cofinity Commercial |
$74.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.26
|
| Rate for Payer: Healthscope Commercial |
$66.31
|
| Rate for Payer: Healthscope Whirlpool |
$66.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.02
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.79
|
| Rate for Payer: Nomi Health Commercial |
$66.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE SWMI |
$55.26
|
| Rate for Payer: PHP Medicare Advantage |
$55.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.31
|
| Rate for Payer: Priority Health Medicare |
$55.26
|
| Rate for Payer: Priority Health Narrow Network |
$95.31
|
| Rate for Payer: Railroad Medicare Medicare |
$55.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.26
|
| Rate for Payer: UHC Exchange |
$114.34
|
| Rate for Payer: UHC Medicaid |
$35.15
|
| Rate for Payer: UHCCP DNSP |
$55.26
|
| Rate for Payer: UHCCP Medicaid |
$35.15
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
58100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$97.15 |
| Max. Negotiated Rate |
$251.80 |
| Rate for Payer: Aetna Commercial |
$198.90
|
| Rate for Payer: Aetna Medicare |
$201.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: ASR ASR |
$214.37
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$182.21
|
| Rate for Payer: BCCCP Commercial |
$97.15
|
| Rate for Payer: BCN Commercial |
$182.21
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$207.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$214.37
|
| Rate for Payer: Healthscope Whirlpool |
$221.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$201.44
|
| Rate for Payer: Mclaren Commercial |
$198.90
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$110.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.85
|
| Rate for Payer: Nomi Health Commercial |
$181.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$221.58
|
| Rate for Payer: PHP Medicaid |
$107.97
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$193.64
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health Narrow Network |
$154.92
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP DNSP |
$201.44
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
58100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: Aetna Commercial |
$198.90
|
| Rate for Payer: ASR ASR |
$214.37
|
| Rate for Payer: BCBS Trust/PPO |
$181.49
|
| Rate for Payer: BCN Commercial |
$181.49
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$207.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.80
|
| Rate for Payer: Healthscope Commercial |
$214.37
|
| Rate for Payer: Healthscope Whirlpool |
$221.00
|
| Rate for Payer: Mclaren Commercial |
$198.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.85
|
| Rate for Payer: Nomi Health Commercial |
$181.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 58100
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Commercial |
$74.05
|
| Rate for Payer: Aetna Medicare |
$55.26
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$55.26
|
| Rate for Payer: BCN Commercial |
$74.22
|
| Rate for Payer: BCN Medicare Advantage |
$55.26
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$79.57
|
| Rate for Payer: Cofinity Commercial |
$74.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.26
|
| Rate for Payer: Healthscope Commercial |
$66.31
|
| Rate for Payer: Healthscope Whirlpool |
$66.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.02
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.79
|
| Rate for Payer: Nomi Health Commercial |
$66.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE SWMI |
$55.26
|
| Rate for Payer: PHP Medicare Advantage |
$55.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.31
|
| Rate for Payer: Priority Health Medicare |
$55.26
|
| Rate for Payer: Priority Health Narrow Network |
$95.31
|
| Rate for Payer: Railroad Medicare Medicare |
$55.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.26
|
| Rate for Payer: UHC Exchange |
$114.34
|
| Rate for Payer: UHC Medicaid |
$35.15
|
| Rate for Payer: UHCCP DNSP |
$55.26
|
| Rate for Payer: UHCCP Medicaid |
$35.15
|
|
|
PR ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR
|
Professional
|
Both
|
$2,897.00
|
|
|
Service Code
|
HCPCS 58356
|
| Min. Negotiated Rate |
$194.90 |
| Max. Negotiated Rate |
$2,172.75 |
| Rate for Payer: Aetna Commercial |
$408.87
|
| Rate for Payer: Aetna Medicare |
$305.13
|
| Rate for Payer: BCBS Complete |
$204.65
|
| Rate for Payer: BCBS MAPPO |
$305.13
|
| Rate for Payer: BCN Commercial |
$526.37
|
| Rate for Payer: BCN Medicare Advantage |
$305.13
|
| Rate for Payer: Cash Price |
$2,317.60
|
| Rate for Payer: Cash Price |
$2,317.60
|
| Rate for Payer: Cofinity Commercial |
$439.39
|
| Rate for Payer: Cofinity Commercial |
$408.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.13
|
| Rate for Payer: Healthscope Commercial |
$366.16
|
| Rate for Payer: Healthscope Whirlpool |
$366.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.39
|
| Rate for Payer: Meridian Medicaid |
$204.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.64
|
| Rate for Payer: Nomi Health Commercial |
$366.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,172.75
|
| Rate for Payer: PACE SWMI |
$305.13
|
| Rate for Payer: PHP Medicare Advantage |
$305.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$533.09
|
| Rate for Payer: Priority Health Medicare |
$305.13
|
| Rate for Payer: Priority Health Narrow Network |
$533.09
|
| Rate for Payer: Railroad Medicare Medicare |
$305.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$628.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.13
|
| Rate for Payer: UHC Exchange |
$628.49
|
| Rate for Payer: UHC Medicaid |
$194.90
|
| Rate for Payer: UHCCP DNSP |
$305.13
|
| Rate for Payer: UHCCP Medicaid |
$194.90
|
|
|
PR ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 43273
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$361.50 |
| Rate for Payer: Aetna Commercial |
$135.34
|
| Rate for Payer: Aetna Medicare |
$101.00
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$101.00
|
| Rate for Payer: BCN Commercial |
$174.79
|
| Rate for Payer: BCN Medicare Advantage |
$101.00
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Cofinity Commercial |
$135.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.00
|
| Rate for Payer: Healthscope Commercial |
$121.20
|
| Rate for Payer: Healthscope Whirlpool |
$121.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.05
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.10
|
| Rate for Payer: Nomi Health Commercial |
$121.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.50
|
| Rate for Payer: PACE SWMI |
$101.00
|
| Rate for Payer: PHP Medicare Advantage |
$101.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$212.98
|
| Rate for Payer: Priority Health Medicare |
$101.00
|
| Rate for Payer: Priority Health Narrow Network |
$212.98
|
| Rate for Payer: Railroad Medicare Medicare |
$101.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$212.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.00
|
| Rate for Payer: UHC Exchange |
$212.66
|
| Rate for Payer: UHC Medicaid |
$64.97
|
| Rate for Payer: UHCCP DNSP |
$101.00
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
PR ENDOSCOPY UPPER SMALL INTESTINE
|
Professional
|
Both
|
$963.00
|
|
|
Service Code
|
HCPCS 44360
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$722.25 |
| Rate for Payer: Aetna Commercial |
$168.08
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: BCBS Complete |
$85.44
|
| Rate for Payer: BCBS MAPPO |
$125.43
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$125.43
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cash Price |
$770.40
|
| Rate for Payer: Cofinity Commercial |
$180.62
|
| Rate for Payer: Cofinity Commercial |
$168.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.43
|
| Rate for Payer: Healthscope Commercial |
$150.52
|
| Rate for Payer: Healthscope Whirlpool |
$150.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.70
|
| Rate for Payer: Meridian Medicaid |
$85.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.97
|
| Rate for Payer: Nomi Health Commercial |
$150.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.25
|
| Rate for Payer: PACE SWMI |
$125.43
|
| Rate for Payer: PHP Medicare Advantage |
$125.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.87
|
| Rate for Payer: Priority Health Medicare |
$125.43
|
| Rate for Payer: Priority Health Narrow Network |
$257.87
|
| Rate for Payer: Railroad Medicare Medicare |
$125.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$125.43
|
| Rate for Payer: UHC Exchange |
$252.60
|
| Rate for Payer: UHC Medicaid |
$81.37
|
| Rate for Payer: UHCCP DNSP |
$125.43
|
| Rate for Payer: UHCCP Medicaid |
$81.37
|
|
