|
PR EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS
|
Professional
|
Both
|
$1,452.00
|
|
|
Service Code
|
HCPCS 23150
|
| Min. Negotiated Rate |
$403.42 |
| Max. Negotiated Rate |
$1,162.39 |
| Rate for Payer: Aetna Commercial |
$825.67
|
| Rate for Payer: Aetna Medicare |
$616.17
|
| Rate for Payer: BCBS Complete |
$423.59
|
| Rate for Payer: BCBS MAPPO |
$616.17
|
| Rate for Payer: BCN Commercial |
$1,022.36
|
| Rate for Payer: BCN Medicare Advantage |
$616.17
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cofinity Commercial |
$887.28
|
| Rate for Payer: Cofinity Commercial |
$825.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.17
|
| Rate for Payer: Healthscope Commercial |
$739.40
|
| Rate for Payer: Healthscope Whirlpool |
$739.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.98
|
| Rate for Payer: Meridian Medicaid |
$423.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.79
|
| Rate for Payer: Nomi Health Commercial |
$739.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.00
|
| Rate for Payer: PACE SWMI |
$616.17
|
| Rate for Payer: PHP Medicare Advantage |
$616.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,092.86
|
| Rate for Payer: Priority Health Medicare |
$616.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,092.86
|
| Rate for Payer: Railroad Medicare Medicare |
$616.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,162.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$616.17
|
| Rate for Payer: UHC Exchange |
$1,162.39
|
| Rate for Payer: UHC Medicaid |
$403.42
|
| Rate for Payer: UHCCP DNSP |
$616.17
|
| Rate for Payer: UHCCP Medicaid |
$403.42
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 23155
|
| Min. Negotiated Rate |
$477.33 |
| Max. Negotiated Rate |
$1,389.18 |
| Rate for Payer: Aetna Commercial |
$978.74
|
| Rate for Payer: Aetna Medicare |
$730.40
|
| Rate for Payer: BCBS Complete |
$501.20
|
| Rate for Payer: BCBS MAPPO |
$730.40
|
| Rate for Payer: BCN Commercial |
$1,219.05
|
| Rate for Payer: BCN Medicare Advantage |
$730.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$978.74
|
| Rate for Payer: Cofinity Commercial |
$1,051.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$730.40
|
| Rate for Payer: Healthscope Commercial |
$876.48
|
| Rate for Payer: Healthscope Whirlpool |
$876.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$766.92
|
| Rate for Payer: Meridian Medicaid |
$501.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$803.44
|
| Rate for Payer: Nomi Health Commercial |
$876.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.75
|
| Rate for Payer: PACE SWMI |
$730.40
|
| Rate for Payer: PHP Medicare Advantage |
$730.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,303.13
|
| Rate for Payer: Priority Health Medicare |
$730.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,303.13
|
| Rate for Payer: Railroad Medicare Medicare |
$730.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,389.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$730.40
|
| Rate for Payer: UHC Exchange |
$1,389.18
|
| Rate for Payer: UHC Medicaid |
$477.33
|
| Rate for Payer: UHCCP DNSP |
$730.40
|
| Rate for Payer: UHCCP Medicaid |
$477.33
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT
|
Professional
|
Both
|
$1,338.00
|
|
|
Service Code
|
HCPCS 23156
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$1,182.57 |
| Rate for Payer: Aetna Commercial |
$839.16
|
| Rate for Payer: Aetna Medicare |
$626.24
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCBS MAPPO |
$626.24
|
| Rate for Payer: BCN Commercial |
$1,041.78
|
| Rate for Payer: BCN Medicare Advantage |
$626.24
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cofinity Commercial |
$901.79
|
| Rate for Payer: Cofinity Commercial |
$839.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.24
|
| Rate for Payer: Healthscope Commercial |
$751.49
|
| Rate for Payer: Healthscope Whirlpool |
$751.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.55
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.86
|
| Rate for Payer: Nomi Health Commercial |
$751.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,003.50
|
| Rate for Payer: PACE SWMI |
$626.24
|
| Rate for Payer: PHP Medicare Advantage |
$626.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,113.63
|
| Rate for Payer: Priority Health Medicare |
$626.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,113.63
|
| Rate for Payer: Railroad Medicare Medicare |
$626.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,182.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$626.24
|
| Rate for Payer: UHC Exchange |
$1,182.57
|
| Rate for Payer: UHC Medicaid |
$409.81
|
| Rate for Payer: UHCCP DNSP |
$626.24
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
|
|
PR EXC/CURTG CST/B9 TUM PHALANGES FOOT
|
Professional
|
Both
|
$548.00
|
|
|
Service Code
|
HCPCS 28108
|
| Min. Negotiated Rate |
$174.87 |
| Max. Negotiated Rate |
$501.40 |
| Rate for Payer: Aetna Commercial |
$355.86
|
| Rate for Payer: Aetna Medicare |
$265.57
|
| Rate for Payer: BCBS Complete |
$183.61
|
| Rate for Payer: BCBS MAPPO |
$265.57
|
| Rate for Payer: BCN Commercial |
$440.71
|
| Rate for Payer: BCN Medicare Advantage |
$265.57
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cofinity Commercial |
$382.42
|
| Rate for Payer: Cofinity Commercial |
$355.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.57
|
| Rate for Payer: Healthscope Commercial |
$318.68
|
| Rate for Payer: Healthscope Whirlpool |
$318.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.85
|
| Rate for Payer: Meridian Medicaid |
$183.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$292.13
|
| Rate for Payer: Nomi Health Commercial |
$318.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.00
|
| Rate for Payer: PACE SWMI |
$265.57
|
| Rate for Payer: PHP Medicare Advantage |
$265.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$471.12
|
| Rate for Payer: Priority Health Medicare |
$265.57
|
| Rate for Payer: Priority Health Narrow Network |
$471.12
|
| Rate for Payer: Railroad Medicare Medicare |
$265.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$501.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$265.57
|
| Rate for Payer: UHC Exchange |
$501.40
|
| Rate for Payer: UHC Medicaid |
$174.87
|
| Rate for Payer: UHCCP DNSP |
$265.57
|
| Rate for Payer: UHCCP Medicaid |
$174.87
|
|
|
PR EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT
|
Professional
|
Both
|
$990.00
|
|
|
Service Code
|
HCPCS 28106
|
| Min. Negotiated Rate |
$253.04 |
| Max. Negotiated Rate |
$751.23 |
| Rate for Payer: Aetna Commercial |
$519.17
|
| Rate for Payer: Aetna Medicare |
$387.44
|
| Rate for Payer: BCBS Complete |
$265.69
|
| Rate for Payer: BCBS MAPPO |
$387.44
|
| Rate for Payer: BCN Commercial |
$645.38
|
| Rate for Payer: BCN Medicare Advantage |
$387.44
|
| Rate for Payer: Cash Price |
$792.00
|
| Rate for Payer: Cash Price |
$792.00
|
| Rate for Payer: Cofinity Commercial |
$557.91
|
| Rate for Payer: Cofinity Commercial |
$519.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.44
|
| Rate for Payer: Healthscope Commercial |
$464.93
|
| Rate for Payer: Healthscope Whirlpool |
$464.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.81
|
| Rate for Payer: Meridian Medicaid |
$265.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$426.18
|
| Rate for Payer: Nomi Health Commercial |
$464.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.50
|
| Rate for Payer: PACE SWMI |
$387.44
|
| Rate for Payer: PHP Medicare Advantage |
$387.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$689.90
|
| Rate for Payer: Priority Health Medicare |
$387.44
|
| Rate for Payer: Priority Health Narrow Network |
$689.90
|
| Rate for Payer: Railroad Medicare Medicare |
$387.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$387.44
|
| Rate for Payer: UHC Exchange |
$751.23
|
| Rate for Payer: UHC Medicaid |
$253.04
|
| Rate for Payer: UHCCP DNSP |
$387.44
|
| Rate for Payer: UHCCP Medicaid |
$253.04
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 25136
|
| Min. Negotiated Rate |
$308.21 |
| Max. Negotiated Rate |
$860.97 |
| Rate for Payer: Aetna Commercial |
$626.99
|
| Rate for Payer: Aetna Medicare |
$467.90
|
| Rate for Payer: BCBS Complete |
$323.62
|
| Rate for Payer: BCBS MAPPO |
$467.90
|
| Rate for Payer: BCN Commercial |
$768.38
|
| Rate for Payer: BCN Medicare Advantage |
$467.90
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cofinity Commercial |
$673.78
|
| Rate for Payer: Cofinity Commercial |
$626.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.90
|
| Rate for Payer: Healthscope Commercial |
$561.48
|
| Rate for Payer: Healthscope Whirlpool |
$561.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.30
|
| Rate for Payer: Meridian Medicaid |
$323.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$514.69
|
| Rate for Payer: Nomi Health Commercial |
$561.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$774.75
|
| Rate for Payer: PACE SWMI |
$467.90
|
| Rate for Payer: PHP Medicare Advantage |
$467.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$821.39
|
| Rate for Payer: Priority Health Medicare |
$467.90
|
| Rate for Payer: Priority Health Narrow Network |
$821.39
|
| Rate for Payer: Railroad Medicare Medicare |
$467.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$860.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$467.90
|
| Rate for Payer: UHC Exchange |
$860.97
|
| Rate for Payer: UHC Medicaid |
$308.21
|
| Rate for Payer: UHCCP DNSP |
$467.90
|
| Rate for Payer: UHCCP Medicaid |
$308.21
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT
|
Professional
|
Both
|
$1,041.00
|
|
|
Service Code
|
HCPCS 25135
|
| Min. Negotiated Rate |
$345.06 |
| Max. Negotiated Rate |
$971.46 |
| Rate for Payer: Aetna Commercial |
$703.07
|
| Rate for Payer: Aetna Medicare |
$524.68
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCBS MAPPO |
$524.68
|
| Rate for Payer: BCN Commercial |
$865.49
|
| Rate for Payer: BCN Medicare Advantage |
$524.68
|
| Rate for Payer: Cash Price |
$832.80
|
| Rate for Payer: Cash Price |
$832.80
|
| Rate for Payer: Cofinity Commercial |
$755.54
|
| Rate for Payer: Cofinity Commercial |
$703.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.68
|
| Rate for Payer: Healthscope Commercial |
$629.62
|
| Rate for Payer: Healthscope Whirlpool |
$629.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$550.91
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$577.15
|
| Rate for Payer: Nomi Health Commercial |
$629.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.75
|
| Rate for Payer: PACE SWMI |
$524.68
|
| Rate for Payer: PHP Medicare Advantage |
$524.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$925.18
|
| Rate for Payer: Priority Health Medicare |
$524.68
|
| Rate for Payer: Priority Health Narrow Network |
$925.18
|
| Rate for Payer: Railroad Medicare Medicare |
$524.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$971.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$524.68
|
| Rate for Payer: UHC Exchange |
$971.46
|
| Rate for Payer: UHC Medicaid |
$345.06
|
| Rate for Payer: UHCCP DNSP |
$524.68
|
| Rate for Payer: UHCCP Medicaid |
$345.06
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT
|
Professional
|
Both
|
$1,252.00
|
|
|
Service Code
|
HCPCS 25126
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$1,039.96 |
| Rate for Payer: Aetna Commercial |
$747.81
|
| Rate for Payer: Aetna Medicare |
$558.07
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCBS MAPPO |
$558.07
|
| Rate for Payer: BCN Commercial |
$922.27
|
| Rate for Payer: BCN Medicare Advantage |
$558.07
|
| Rate for Payer: Cash Price |
$1,001.60
|
| Rate for Payer: Cash Price |
$1,001.60
|
| Rate for Payer: Cofinity Commercial |
$803.62
|
| Rate for Payer: Cofinity Commercial |
$747.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.07
|
| Rate for Payer: Healthscope Commercial |
$669.68
|
| Rate for Payer: Healthscope Whirlpool |
$669.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.97
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$613.88
|
| Rate for Payer: Nomi Health Commercial |
$669.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$939.00
|
| Rate for Payer: PACE SWMI |
$558.07
|
| Rate for Payer: PHP Medicare Advantage |
$558.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$985.88
|
| Rate for Payer: Priority Health Medicare |
$558.07
|
| Rate for Payer: Priority Health Narrow Network |
$985.88
|
| Rate for Payer: Railroad Medicare Medicare |
$558.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,039.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$558.07
|
| Rate for Payer: UHC Exchange |
$1,039.96
|
| Rate for Payer: UHC Medicaid |
$366.36
|
| Rate for Payer: UHCCP DNSP |
$558.07
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$2,389.00
|
|
|
Service Code
|
HCPCS 25125
|
| Min. Negotiated Rate |
$364.02 |
| Max. Negotiated Rate |
$1,791.75 |
| Rate for Payer: Aetna Commercial |
$742.86
|
| Rate for Payer: Aetna Medicare |
$554.37
|
| Rate for Payer: BCBS Complete |
$382.22
|
| Rate for Payer: BCBS MAPPO |
$554.37
|
| Rate for Payer: BCN Commercial |
$916.28
|
| Rate for Payer: BCN Medicare Advantage |
$554.37
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cofinity Commercial |
$798.29
|
| Rate for Payer: Cofinity Commercial |
$742.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.37
|
| Rate for Payer: Healthscope Commercial |
$665.24
|
| Rate for Payer: Healthscope Whirlpool |
$665.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.09
|
| Rate for Payer: Meridian Medicaid |
$382.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$609.81
|
| Rate for Payer: Nomi Health Commercial |
$665.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,791.75
|
| Rate for Payer: PACE SWMI |
$554.37
|
| Rate for Payer: PHP Medicare Advantage |
$554.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$979.49
|
| Rate for Payer: Priority Health Medicare |
$554.37
|
| Rate for Payer: Priority Health Narrow Network |
$979.49
|
| Rate for Payer: Railroad Medicare Medicare |
$554.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,032.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$554.37
|
| Rate for Payer: UHC Exchange |
$1,032.01
|
| Rate for Payer: UHC Medicaid |
$364.02
|
| Rate for Payer: UHCCP DNSP |
$554.37
|
| Rate for Payer: UHCCP Medicaid |
$364.02
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
IP
|
$1,084.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$813.00 |
| Max. Negotiated Rate |
$1,084.00 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: ASR ASR |
$1,051.48
|
| Rate for Payer: BCBS Trust/PPO |
$890.18
|
| Rate for Payer: BCN Commercial |
$890.18
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$1,018.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Healthscope Commercial |
$1,051.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,084.00
|
| Rate for Payer: Mclaren Commercial |
$975.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$888.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$515.37 |
| Max. Negotiated Rate |
$4,876.69 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Medicare |
$3,901.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: ASR ASR |
$1,051.48
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$893.76
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$893.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$1,018.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$1,051.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,084.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,901.35
|
| Rate for Payer: Mclaren Commercial |
$975.60
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$2,142.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$888.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$4,291.48
|
| Rate for Payer: PHP Medicaid |
$2,091.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,267.20
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Narrow Network |
$3,413.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP DNSP |
$3,901.35
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 19120
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$813.00 |
| Rate for Payer: Aetna Commercial |
$535.42
|
| Rate for Payer: Aetna Medicare |
$399.57
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCBS MAPPO |
$399.57
|
| Rate for Payer: BCN Commercial |
$635.43
|
| Rate for Payer: BCN Medicare Advantage |
$399.57
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$575.38
|
| Rate for Payer: Cofinity Commercial |
$535.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.57
|
| Rate for Payer: Healthscope Commercial |
$479.48
|
| Rate for Payer: Healthscope Whirlpool |
$479.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.55
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.53
|
| Rate for Payer: Nomi Health Commercial |
$479.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PACE SWMI |
$399.57
|
| Rate for Payer: PHP Medicare Advantage |
$399.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$581.58
|
| Rate for Payer: Priority Health Medicare |
$399.57
|
| Rate for Payer: Priority Health Narrow Network |
$581.58
|
| Rate for Payer: Railroad Medicare Medicare |
$399.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$728.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$399.57
|
| Rate for Payer: UHC Exchange |
$728.43
|
| Rate for Payer: UHC Medicaid |
$260.07
|
| Rate for Payer: UHCCP DNSP |
$399.57
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 19120
|
| Hospital Charge Code |
19120
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$813.00 |
| Rate for Payer: Aetna Commercial |
$535.42
|
| Rate for Payer: Aetna Medicare |
$399.57
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCBS MAPPO |
$399.57
|
| Rate for Payer: BCN Commercial |
$635.43
|
| Rate for Payer: BCN Medicare Advantage |
$399.57
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$575.38
|
| Rate for Payer: Cofinity Commercial |
$535.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.57
|
| Rate for Payer: Healthscope Commercial |
$479.48
|
| Rate for Payer: Healthscope Whirlpool |
$479.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.55
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.53
|
| Rate for Payer: Nomi Health Commercial |
$479.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PACE SWMI |
$399.57
|
| Rate for Payer: PHP Medicare Advantage |
$399.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$581.58
|
| Rate for Payer: Priority Health Medicare |
$399.57
|
| Rate for Payer: Priority Health Narrow Network |
$581.58
|
| Rate for Payer: Railroad Medicare Medicare |
$399.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$728.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$399.57
|
| Rate for Payer: UHC Exchange |
$728.43
|
| Rate for Payer: UHC Medicaid |
$260.07
|
| Rate for Payer: UHCCP DNSP |
$399.57
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
|
|
PR EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 60200
|
| Min. Negotiated Rate |
$396.39 |
| Max. Negotiated Rate |
$1,163.26 |
| Rate for Payer: Aetna Commercial |
$818.23
|
| Rate for Payer: Aetna Medicare |
$610.62
|
| Rate for Payer: BCBS Complete |
$416.21
|
| Rate for Payer: BCBS MAPPO |
$610.62
|
| Rate for Payer: BCN Commercial |
$1,009.90
|
| Rate for Payer: BCN Medicare Advantage |
$610.62
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$879.29
|
| Rate for Payer: Cofinity Commercial |
$818.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.62
|
| Rate for Payer: Healthscope Commercial |
$732.74
|
| Rate for Payer: Healthscope Whirlpool |
$732.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.15
|
| Rate for Payer: Meridian Medicaid |
$416.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$671.68
|
| Rate for Payer: Nomi Health Commercial |
$732.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.75
|
| Rate for Payer: PACE SWMI |
$610.62
|
| Rate for Payer: PHP Medicare Advantage |
$610.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,095.09
|
| Rate for Payer: Priority Health Medicare |
$610.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,095.09
|
| Rate for Payer: Railroad Medicare Medicare |
$610.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,163.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$610.62
|
| Rate for Payer: UHC Exchange |
$1,163.26
|
| Rate for Payer: UHC Medicaid |
$396.39
|
| Rate for Payer: UHCCP DNSP |
$610.62
|
| Rate for Payer: UHCCP Medicaid |
$396.39
|
|
|
PR EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM
|
Professional
|
Both
|
$4,089.00
|
|
|
Service Code
|
HCPCS 49204
|
| Min. Negotiated Rate |
$1,635.60 |
| Max. Negotiated Rate |
$3,066.75 |
| Rate for Payer: Aetna Commercial |
$2,046.13
|
| Rate for Payer: BCBS Complete |
$1,635.60
|
| Rate for Payer: BCN Commercial |
$2,249.95
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,066.75
|
|
|
PR EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM
|
Professional
|
Both
|
$3,304.00
|
|
|
Service Code
|
HCPCS 49205
|
| Min. Negotiated Rate |
$1,321.60 |
| Max. Negotiated Rate |
$2,581.02 |
| Rate for Payer: Aetna Commercial |
$2,348.49
|
| Rate for Payer: BCBS Complete |
$1,321.60
|
| Rate for Payer: BCN Commercial |
$2,581.02
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,478.00
|
|
|
PR EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX
|
Professional
|
Both
|
$1,083.00
|
|
|
Service Code
|
HCPCS 42870
|
| Min. Negotiated Rate |
$349.75 |
| Max. Negotiated Rate |
$1,073.95 |
| Rate for Payer: Aetna Commercial |
$699.56
|
| Rate for Payer: Aetna Medicare |
$522.06
|
| Rate for Payer: BCBS Complete |
$367.24
|
| Rate for Payer: BCBS MAPPO |
$522.06
|
| Rate for Payer: BCN Commercial |
$881.42
|
| Rate for Payer: BCN Medicare Advantage |
$522.06
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cofinity Commercial |
$699.56
|
| Rate for Payer: Cofinity Commercial |
$751.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.06
|
| Rate for Payer: Healthscope Commercial |
$626.47
|
| Rate for Payer: Healthscope Whirlpool |
$626.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.16
|
| Rate for Payer: Meridian Medicaid |
$367.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$574.27
|
| Rate for Payer: Nomi Health Commercial |
$626.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$812.25
|
| Rate for Payer: PACE SWMI |
$522.06
|
| Rate for Payer: PHP Medicare Advantage |
$522.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,073.95
|
| Rate for Payer: Priority Health Medicare |
$522.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,073.95
|
| Rate for Payer: Railroad Medicare Medicare |
$522.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$997.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$522.06
|
| Rate for Payer: UHC Exchange |
$997.68
|
| Rate for Payer: UHC Medicaid |
$349.75
|
| Rate for Payer: UHCCP DNSP |
$522.06
|
| Rate for Payer: UHCCP Medicaid |
$349.75
|
|
|
PR EXC EXCSV SKN ABD INFRAUMBILICAL PANNICULECTOMY
|
Professional
|
Both
|
$2,732.00
|
|
|
Service Code
|
HCPCS 15830
|
| Min. Negotiated Rate |
$680.54 |
| Max. Negotiated Rate |
$2,060.91 |
| Rate for Payer: Aetna Commercial |
$1,402.91
|
| Rate for Payer: Aetna Medicare |
$1,046.95
|
| Rate for Payer: BCBS Complete |
$714.57
|
| Rate for Payer: BCBS MAPPO |
$1,046.95
|
| Rate for Payer: BCN Commercial |
$1,772.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,046.95
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,507.61
|
| Rate for Payer: Cofinity Commercial |
$1,402.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,046.95
|
| Rate for Payer: Healthscope Commercial |
$1,256.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,256.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,099.30
|
| Rate for Payer: Meridian Medicaid |
$714.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,151.64
|
| Rate for Payer: Nomi Health Commercial |
$1,256.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,049.00
|
| Rate for Payer: PACE SWMI |
$1,046.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,046.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,622.12
|
| Rate for Payer: Priority Health Medicare |
$1,046.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,622.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,046.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,060.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,046.95
|
| Rate for Payer: UHC Exchange |
$2,060.91
|
| Rate for Payer: UHC Medicaid |
$680.54
|
| Rate for Payer: UHCCP DNSP |
$1,046.95
|
| Rate for Payer: UHCCP Medicaid |
$680.54
|
|
|
PR EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F
|
Professional
|
Both
|
$2,731.00
|
|
|
Service Code
|
HCPCS 26390
|
| Min. Negotiated Rate |
$542.94 |
| Max. Negotiated Rate |
$2,048.25 |
| Rate for Payer: Aetna Commercial |
$1,096.33
|
| Rate for Payer: Aetna Medicare |
$818.16
|
| Rate for Payer: BCBS Complete |
$570.09
|
| Rate for Payer: BCBS MAPPO |
$818.16
|
| Rate for Payer: BCN Commercial |
$1,322.64
|
| Rate for Payer: BCN Medicare Advantage |
$818.16
|
| Rate for Payer: Cash Price |
$2,184.80
|
| Rate for Payer: Cash Price |
$2,184.80
|
| Rate for Payer: Cofinity Commercial |
$1,178.15
|
| Rate for Payer: Cofinity Commercial |
$1,096.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$818.16
|
| Rate for Payer: Healthscope Commercial |
$981.79
|
| Rate for Payer: Healthscope Whirlpool |
$981.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$859.07
|
| Rate for Payer: Meridian Medicaid |
$570.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$899.98
|
| Rate for Payer: Nomi Health Commercial |
$981.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,048.25
|
| Rate for Payer: PACE SWMI |
$818.16
|
| Rate for Payer: PHP Medicare Advantage |
$818.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,413.86
|
| Rate for Payer: Priority Health Medicare |
$818.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,413.86
|
| Rate for Payer: Railroad Medicare Medicare |
$818.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,466.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$818.16
|
| Rate for Payer: UHC Exchange |
$1,466.84
|
| Rate for Payer: UHC Medicaid |
$542.94
|
| Rate for Payer: UHCCP DNSP |
$818.16
|
| Rate for Payer: UHCCP Medicaid |
$542.94
|
|
|
PR EXC FRENUM LABIAL/BUCCAL
|
Professional
|
Both
|
$525.00
|
|
|
Service Code
|
HCPCS 40819
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna Commercial |
$243.02
|
| Rate for Payer: Aetna Medicare |
$181.36
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCBS MAPPO |
$181.36
|
| Rate for Payer: BCN Commercial |
$305.26
|
| Rate for Payer: BCN Medicare Advantage |
$181.36
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Cofinity Commercial |
$243.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.36
|
| Rate for Payer: Healthscope Commercial |
$217.63
|
| Rate for Payer: Healthscope Whirlpool |
$217.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.43
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$199.50
|
| Rate for Payer: Nomi Health Commercial |
$217.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
| Rate for Payer: PACE SWMI |
$181.36
|
| Rate for Payer: PHP Medicare Advantage |
$181.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$371.93
|
| Rate for Payer: Priority Health Medicare |
$181.36
|
| Rate for Payer: Priority Health Narrow Network |
$371.93
|
| Rate for Payer: Railroad Medicare Medicare |
$181.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$363.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.36
|
| Rate for Payer: UHC Exchange |
$363.33
|
| Rate for Payer: UHC Medicaid |
$120.35
|
| Rate for Payer: UHCCP DNSP |
$181.36
|
| Rate for Payer: UHCCP Medicaid |
$120.35
|
|
|
PR EXC/FULGURATION URETHRAL CARUNCLE
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 53265
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$330.51 |
| Rate for Payer: Aetna Commercial |
$224.88
|
| Rate for Payer: Aetna Medicare |
$167.82
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$167.82
|
| Rate for Payer: BCN Commercial |
$285.34
|
| Rate for Payer: BCN Medicare Advantage |
$167.82
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$241.66
|
| Rate for Payer: Cofinity Commercial |
$224.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.82
|
| Rate for Payer: Healthscope Commercial |
$201.38
|
| Rate for Payer: Healthscope Whirlpool |
$201.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.21
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.60
|
| Rate for Payer: Nomi Health Commercial |
$201.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$167.82
|
| Rate for Payer: PHP Medicare Advantage |
$167.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$310.84
|
| Rate for Payer: Priority Health Medicare |
$167.82
|
| Rate for Payer: Priority Health Narrow Network |
$310.84
|
| Rate for Payer: Railroad Medicare Medicare |
$167.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.82
|
| Rate for Payer: UHC Exchange |
$330.51
|
| Rate for Payer: UHC Medicaid |
$108.63
|
| Rate for Payer: UHCCP DNSP |
$167.82
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
|
|
PR EXC/FULGURATION URETHRAL POLYP DSTL URETHRA
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 53260
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$318.16 |
| Rate for Payer: Aetna Commercial |
$218.33
|
| Rate for Payer: Aetna Medicare |
$162.93
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$162.93
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$162.93
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$234.62
|
| Rate for Payer: Cofinity Commercial |
$218.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.93
|
| Rate for Payer: Healthscope Commercial |
$195.52
|
| Rate for Payer: Healthscope Whirlpool |
$195.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.08
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.22
|
| Rate for Payer: Nomi Health Commercial |
$195.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.25
|
| Rate for Payer: PACE SWMI |
$162.93
|
| Rate for Payer: PHP Medicare Advantage |
$162.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$297.81
|
| Rate for Payer: Priority Health Medicare |
$162.93
|
| Rate for Payer: Priority Health Narrow Network |
$297.81
|
| Rate for Payer: Railroad Medicare Medicare |
$162.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$318.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.93
|
| Rate for Payer: UHC Exchange |
$318.16
|
| Rate for Payer: UHC Medicaid |
$105.65
|
| Rate for Payer: UHCCP DNSP |
$162.93
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
|
|
PR EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 50435
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$116.30
|
| Rate for Payer: Aetna Medicare |
$86.79
|
| Rate for Payer: BCBS Complete |
$58.82
|
| Rate for Payer: BCBS MAPPO |
$86.79
|
| Rate for Payer: BCN Commercial |
$146.40
|
| Rate for Payer: BCN Medicare Advantage |
$86.79
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$124.98
|
| Rate for Payer: Cofinity Commercial |
$116.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.79
|
| Rate for Payer: Healthscope Commercial |
$104.15
|
| Rate for Payer: Healthscope Whirlpool |
$104.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.13
|
| Rate for Payer: Meridian Medicaid |
$58.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.47
|
| Rate for Payer: Nomi Health Commercial |
$104.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: PACE SWMI |
$86.79
|
| Rate for Payer: PHP Medicare Advantage |
$86.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$159.49
|
| Rate for Payer: Priority Health Medicare |
$86.79
|
| Rate for Payer: Priority Health Narrow Network |
$159.49
|
| Rate for Payer: Railroad Medicare Medicare |
$86.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.79
|
| Rate for Payer: UHC Exchange |
$175.98
|
| Rate for Payer: UHC Medicaid |
$56.02
|
| Rate for Payer: UHCCP DNSP |
$86.79
|
| Rate for Payer: UHCCP Medicaid |
$56.02
|
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 49423
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$984.00 |
| Rate for Payer: Aetna Commercial |
$81.45
|
| Rate for Payer: Aetna Medicare |
$60.78
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCBS MAPPO |
$60.78
|
| Rate for Payer: BCN Commercial |
$103.08
|
| Rate for Payer: BCN Medicare Advantage |
$60.78
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$87.52
|
| Rate for Payer: Cofinity Commercial |
$81.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.78
|
| Rate for Payer: Healthscope Commercial |
$72.94
|
| Rate for Payer: Healthscope Whirlpool |
$72.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.82
|
| Rate for Payer: Meridian Medicaid |
$40.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.86
|
| Rate for Payer: Nomi Health Commercial |
$72.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.00
|
| Rate for Payer: PACE SWMI |
$60.78
|
| Rate for Payer: PHP Medicare Advantage |
$60.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$125.60
|
| Rate for Payer: Priority Health Medicare |
$60.78
|
| Rate for Payer: Priority Health Narrow Network |
$125.60
|
| Rate for Payer: Railroad Medicare Medicare |
$60.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.78
|
| Rate for Payer: UHC Exchange |
$126.22
|
| Rate for Payer: UHC Medicaid |
$38.77
|
| Rate for Payer: UHCCP DNSP |
$60.78
|
| Rate for Payer: UHCCP Medicaid |
$38.77
|
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 55500
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$690.10 |
| Rate for Payer: Aetna Commercial |
$482.49
|
| Rate for Payer: Aetna Medicare |
$360.07
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$360.07
|
| Rate for Payer: BCN Commercial |
$591.11
|
| Rate for Payer: BCN Medicare Advantage |
$360.07
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cofinity Commercial |
$518.50
|
| Rate for Payer: Cofinity Commercial |
$482.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.07
|
| Rate for Payer: Healthscope Commercial |
$432.08
|
| Rate for Payer: Healthscope Whirlpool |
$432.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.07
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.08
|
| Rate for Payer: Nomi Health Commercial |
$432.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$560.25
|
| Rate for Payer: PACE SWMI |
$360.07
|
| Rate for Payer: PHP Medicare Advantage |
$360.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$643.90
|
| Rate for Payer: Priority Health Medicare |
$360.07
|
| Rate for Payer: Priority Health Narrow Network |
$643.90
|
| Rate for Payer: Railroad Medicare Medicare |
$360.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$690.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$360.07
|
| Rate for Payer: UHC Exchange |
$690.10
|
| Rate for Payer: UHC Medicaid |
$234.51
|
| Rate for Payer: UHCCP DNSP |
$360.07
|
| Rate for Payer: UHCCP Medicaid |
$234.51
|
|
