|
PR EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 11450
|
| Min. Negotiated Rate |
$162.52 |
| Max. Negotiated Rate |
$566.25 |
| Rate for Payer: Aetna Commercial |
$330.98
|
| Rate for Payer: Aetna Medicare |
$247.00
|
| Rate for Payer: BCBS Complete |
$170.65
|
| Rate for Payer: BCBS MAPPO |
$247.00
|
| Rate for Payer: BCN Commercial |
$399.39
|
| Rate for Payer: BCN Medicare Advantage |
$247.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$355.68
|
| Rate for Payer: Cofinity Commercial |
$330.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.00
|
| Rate for Payer: Healthscope Commercial |
$296.40
|
| Rate for Payer: Healthscope Whirlpool |
$296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.35
|
| Rate for Payer: Meridian Medicaid |
$170.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.70
|
| Rate for Payer: Nomi Health Commercial |
$296.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$566.25
|
| Rate for Payer: PACE SWMI |
$247.00
|
| Rate for Payer: PHP Medicare Advantage |
$247.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$365.54
|
| Rate for Payer: Priority Health Medicare |
$247.00
|
| Rate for Payer: Priority Health Narrow Network |
$365.54
|
| Rate for Payer: Railroad Medicare Medicare |
$247.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$443.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$247.00
|
| Rate for Payer: UHC Exchange |
$443.77
|
| Rate for Payer: UHC Medicaid |
$162.52
|
| Rate for Payer: UHCCP DNSP |
$247.00
|
| Rate for Payer: UHCCP Medicaid |
$162.52
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 11463
|
| Min. Negotiated Rate |
$201.29 |
| Max. Negotiated Rate |
$573.78 |
| Rate for Payer: Aetna Commercial |
$411.49
|
| Rate for Payer: Aetna Medicare |
$307.08
|
| Rate for Payer: BCBS Complete |
$211.35
|
| Rate for Payer: BCBS MAPPO |
$307.08
|
| Rate for Payer: BCN Commercial |
$501.96
|
| Rate for Payer: BCN Medicare Advantage |
$307.08
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cofinity Commercial |
$442.20
|
| Rate for Payer: Cofinity Commercial |
$411.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.08
|
| Rate for Payer: Healthscope Commercial |
$368.50
|
| Rate for Payer: Healthscope Whirlpool |
$368.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.43
|
| Rate for Payer: Meridian Medicaid |
$211.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$337.79
|
| Rate for Payer: Nomi Health Commercial |
$368.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.50
|
| Rate for Payer: PACE SWMI |
$307.08
|
| Rate for Payer: PHP Medicare Advantage |
$307.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$459.42
|
| Rate for Payer: Priority Health Medicare |
$307.08
|
| Rate for Payer: Priority Health Narrow Network |
$459.42
|
| Rate for Payer: Railroad Medicare Medicare |
$307.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$573.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.08
|
| Rate for Payer: UHC Exchange |
$573.78
|
| Rate for Payer: UHC Medicaid |
$201.29
|
| Rate for Payer: UHCCP DNSP |
$307.08
|
| Rate for Payer: UHCCP Medicaid |
$201.29
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS 11462
|
| Min. Negotiated Rate |
$154.85 |
| Max. Negotiated Rate |
$422.12 |
| Rate for Payer: Aetna Commercial |
$314.67
|
| Rate for Payer: Aetna Medicare |
$234.83
|
| Rate for Payer: BCBS Complete |
$162.59
|
| Rate for Payer: BCBS MAPPO |
$234.83
|
| Rate for Payer: BCN Commercial |
$382.95
|
| Rate for Payer: BCN Medicare Advantage |
$234.83
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cofinity Commercial |
$338.16
|
| Rate for Payer: Cofinity Commercial |
$314.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.83
|
| Rate for Payer: Healthscope Commercial |
$281.80
|
| Rate for Payer: Healthscope Whirlpool |
$281.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.57
|
| Rate for Payer: Meridian Medicaid |
$162.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$258.31
|
| Rate for Payer: Nomi Health Commercial |
$281.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$365.25
|
| Rate for Payer: PACE SWMI |
$234.83
|
| Rate for Payer: PHP Medicare Advantage |
$234.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$350.49
|
| Rate for Payer: Priority Health Medicare |
$234.83
|
| Rate for Payer: Priority Health Narrow Network |
$350.49
|
| Rate for Payer: Railroad Medicare Medicare |
$234.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$422.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$234.83
|
| Rate for Payer: UHC Exchange |
$422.12
|
| Rate for Payer: UHC Medicaid |
$154.85
|
| Rate for Payer: UHCCP DNSP |
$234.83
|
| Rate for Payer: UHCCP Medicaid |
$154.85
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 11471
|
| Min. Negotiated Rate |
$211.51 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$433.24
|
| Rate for Payer: Aetna Medicare |
$323.31
|
| Rate for Payer: BCBS Complete |
$222.09
|
| Rate for Payer: BCBS MAPPO |
$323.31
|
| Rate for Payer: BCN Commercial |
$532.34
|
| Rate for Payer: BCN Medicare Advantage |
$323.31
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$465.57
|
| Rate for Payer: Cofinity Commercial |
$433.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.31
|
| Rate for Payer: Healthscope Commercial |
$387.97
|
| Rate for Payer: Healthscope Whirlpool |
$387.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.48
|
| Rate for Payer: Meridian Medicaid |
$222.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.64
|
| Rate for Payer: Nomi Health Commercial |
$387.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$762.00
|
| Rate for Payer: PACE SWMI |
$323.31
|
| Rate for Payer: PHP Medicare Advantage |
$323.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$487.22
|
| Rate for Payer: Priority Health Medicare |
$323.31
|
| Rate for Payer: Priority Health Narrow Network |
$487.22
|
| Rate for Payer: Railroad Medicare Medicare |
$323.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$606.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$323.31
|
| Rate for Payer: UHC Exchange |
$606.63
|
| Rate for Payer: UHC Medicaid |
$211.51
|
| Rate for Payer: UHCCP DNSP |
$323.31
|
| Rate for Payer: UHCCP Medicaid |
$211.51
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$937.00
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$179.13 |
| Max. Negotiated Rate |
$702.75 |
| Rate for Payer: Aetna Commercial |
$365.51
|
| Rate for Payer: Aetna Medicare |
$272.77
|
| Rate for Payer: BCBS Complete |
$188.09
|
| Rate for Payer: BCBS MAPPO |
$272.77
|
| Rate for Payer: BCN Commercial |
$436.23
|
| Rate for Payer: BCN Medicare Advantage |
$272.77
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cofinity Commercial |
$392.79
|
| Rate for Payer: Cofinity Commercial |
$365.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.77
|
| Rate for Payer: Healthscope Commercial |
$327.32
|
| Rate for Payer: Healthscope Whirlpool |
$327.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.41
|
| Rate for Payer: Meridian Medicaid |
$188.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.05
|
| Rate for Payer: Nomi Health Commercial |
$327.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.75
|
| Rate for Payer: PACE SWMI |
$272.77
|
| Rate for Payer: PHP Medicare Advantage |
$272.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$399.27
|
| Rate for Payer: Priority Health Medicare |
$272.77
|
| Rate for Payer: Priority Health Narrow Network |
$399.27
|
| Rate for Payer: Railroad Medicare Medicare |
$272.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$489.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$272.77
|
| Rate for Payer: UHC Exchange |
$489.79
|
| Rate for Payer: UHC Medicaid |
$179.13
|
| Rate for Payer: UHCCP DNSP |
$272.77
|
| Rate for Payer: UHCCP Medicaid |
$179.13
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,898.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$300.33 |
| Max. Negotiated Rate |
$1,423.50 |
| Rate for Payer: Aetna Commercial |
$619.24
|
| Rate for Payer: Aetna Medicare |
$462.12
|
| Rate for Payer: BCBS Complete |
$315.35
|
| Rate for Payer: BCBS MAPPO |
$462.12
|
| Rate for Payer: BCN Commercial |
$769.88
|
| Rate for Payer: BCN Medicare Advantage |
$462.12
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Cofinity Commercial |
$665.45
|
| Rate for Payer: Cofinity Commercial |
$619.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.12
|
| Rate for Payer: Healthscope Commercial |
$554.54
|
| Rate for Payer: Healthscope Whirlpool |
$554.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$485.23
|
| Rate for Payer: Meridian Medicaid |
$315.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$508.33
|
| Rate for Payer: Nomi Health Commercial |
$554.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.50
|
| Rate for Payer: PACE SWMI |
$462.12
|
| Rate for Payer: PHP Medicare Advantage |
$462.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$838.65
|
| Rate for Payer: Priority Health Medicare |
$462.12
|
| Rate for Payer: Priority Health Narrow Network |
$838.65
|
| Rate for Payer: Railroad Medicare Medicare |
$462.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$898.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$462.12
|
| Rate for Payer: UHC Exchange |
$898.47
|
| Rate for Payer: UHC Medicaid |
$300.33
|
| Rate for Payer: UHCCP DNSP |
$462.12
|
| Rate for Payer: UHCCP Medicaid |
$300.33
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
OP
|
$1,294.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$907.09 |
| Max. Negotiated Rate |
$4,459.41 |
| Rate for Payer: Aetna Commercial |
$1,164.60
|
| Rate for Payer: Aetna Medicare |
$3,567.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: ASR ASR |
$1,255.18
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,066.90
|
| Rate for Payer: BCN Commercial |
$1,066.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$1,216.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,255.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,294.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,567.53
|
| Rate for Payer: Mclaren Commercial |
$1,164.60
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$1,959.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,099.90
|
| Rate for Payer: Nomi Health Commercial |
$1,061.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,924.28
|
| Rate for Payer: PHP Medicaid |
$1,912.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,133.80
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$907.09
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP DNSP |
$3,567.53
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
55040
|
| Min. Negotiated Rate |
$200.86 |
| Max. Negotiated Rate |
$970.50 |
| Rate for Payer: Aetna Commercial |
$412.88
|
| Rate for Payer: Aetna Medicare |
$308.12
|
| Rate for Payer: BCBS Complete |
$210.90
|
| Rate for Payer: BCBS MAPPO |
$308.12
|
| Rate for Payer: BCN Commercial |
$511.43
|
| Rate for Payer: BCN Medicare Advantage |
$308.12
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$443.69
|
| Rate for Payer: Cofinity Commercial |
$412.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.12
|
| Rate for Payer: Healthscope Commercial |
$369.74
|
| Rate for Payer: Healthscope Whirlpool |
$369.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.53
|
| Rate for Payer: Meridian Medicaid |
$210.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.93
|
| Rate for Payer: Nomi Health Commercial |
$369.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PACE SWMI |
$308.12
|
| Rate for Payer: PHP Medicare Advantage |
$308.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$557.11
|
| Rate for Payer: Priority Health Medicare |
$308.12
|
| Rate for Payer: Priority Health Narrow Network |
$557.11
|
| Rate for Payer: Railroad Medicare Medicare |
$308.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$308.12
|
| Rate for Payer: UHC Exchange |
$590.96
|
| Rate for Payer: UHC Medicaid |
$200.86
|
| Rate for Payer: UHCCP DNSP |
$308.12
|
| Rate for Payer: UHCCP Medicaid |
$200.86
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$200.86 |
| Max. Negotiated Rate |
$970.50 |
| Rate for Payer: Aetna Commercial |
$412.88
|
| Rate for Payer: Aetna Medicare |
$308.12
|
| Rate for Payer: BCBS Complete |
$210.90
|
| Rate for Payer: BCBS MAPPO |
$308.12
|
| Rate for Payer: BCN Commercial |
$511.43
|
| Rate for Payer: BCN Medicare Advantage |
$308.12
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$443.69
|
| Rate for Payer: Cofinity Commercial |
$412.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.12
|
| Rate for Payer: Healthscope Commercial |
$369.74
|
| Rate for Payer: Healthscope Whirlpool |
$369.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.53
|
| Rate for Payer: Meridian Medicaid |
$210.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.93
|
| Rate for Payer: Nomi Health Commercial |
$369.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PACE SWMI |
$308.12
|
| Rate for Payer: PHP Medicare Advantage |
$308.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$557.11
|
| Rate for Payer: Priority Health Medicare |
$308.12
|
| Rate for Payer: Priority Health Narrow Network |
$557.11
|
| Rate for Payer: Railroad Medicare Medicare |
$308.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$308.12
|
| Rate for Payer: UHC Exchange |
$590.96
|
| Rate for Payer: UHC Medicaid |
$200.86
|
| Rate for Payer: UHCCP DNSP |
$308.12
|
| Rate for Payer: UHCCP Medicaid |
$200.86
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
IP
|
$1,294.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$970.50 |
| Max. Negotiated Rate |
$1,294.00 |
| Rate for Payer: Aetna Commercial |
$1,164.60
|
| Rate for Payer: ASR ASR |
$1,255.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.63
|
| Rate for Payer: BCN Commercial |
$1,062.63
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$1,216.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.20
|
| Rate for Payer: Healthscope Commercial |
$1,255.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,294.00
|
| Rate for Payer: Mclaren Commercial |
$1,164.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,099.90
|
| Rate for Payer: Nomi Health Commercial |
$1,061.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$4,164.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$1,098.87 |
| Max. Negotiated Rate |
$3,425.78 |
| Rate for Payer: Aetna Commercial |
$2,338.97
|
| Rate for Payer: Aetna Medicare |
$1,745.50
|
| Rate for Payer: BCBS Complete |
$1,153.81
|
| Rate for Payer: BCBS MAPPO |
$1,745.50
|
| Rate for Payer: BCN Commercial |
$2,791.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,745.50
|
| Rate for Payer: Cash Price |
$3,331.20
|
| Rate for Payer: Cash Price |
$3,331.20
|
| Rate for Payer: Cofinity Commercial |
$2,513.52
|
| Rate for Payer: Cofinity Commercial |
$2,338.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,745.50
|
| Rate for Payer: Healthscope Commercial |
$2,094.60
|
| Rate for Payer: Healthscope Whirlpool |
$2,094.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,832.78
|
| Rate for Payer: Meridian Medicaid |
$1,153.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,920.05
|
| Rate for Payer: Nomi Health Commercial |
$2,094.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,123.00
|
| Rate for Payer: PACE SWMI |
$1,745.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,745.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,098.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,002.09
|
| Rate for Payer: Priority Health Medicare |
$1,745.50
|
| Rate for Payer: Priority Health Narrow Network |
$3,002.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,745.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,425.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,745.50
|
| Rate for Payer: UHC Exchange |
$3,425.78
|
| Rate for Payer: UHC Medicaid |
$1,098.87
|
| Rate for Payer: UHCCP DNSP |
$1,745.50
|
| Rate for Payer: UHCCP Medicaid |
$1,098.87
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$2,065.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$330.36 |
| Max. Negotiated Rate |
$1,548.75 |
| Rate for Payer: Aetna Commercial |
$692.87
|
| Rate for Payer: Aetna Medicare |
$517.07
|
| Rate for Payer: BCBS Complete |
$346.88
|
| Rate for Payer: BCBS MAPPO |
$517.07
|
| Rate for Payer: BCN Commercial |
$826.65
|
| Rate for Payer: BCN Medicare Advantage |
$517.07
|
| Rate for Payer: Cash Price |
$1,652.00
|
| Rate for Payer: Cash Price |
$1,652.00
|
| Rate for Payer: Cofinity Commercial |
$744.58
|
| Rate for Payer: Cofinity Commercial |
$692.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.07
|
| Rate for Payer: Healthscope Commercial |
$620.48
|
| Rate for Payer: Healthscope Whirlpool |
$620.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$542.92
|
| Rate for Payer: Meridian Medicaid |
$346.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$568.78
|
| Rate for Payer: Nomi Health Commercial |
$620.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,548.75
|
| Rate for Payer: PACE SWMI |
$517.07
|
| Rate for Payer: PHP Medicare Advantage |
$517.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$888.95
|
| Rate for Payer: Priority Health Medicare |
$517.07
|
| Rate for Payer: Priority Health Narrow Network |
$888.95
|
| Rate for Payer: Railroad Medicare Medicare |
$517.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,005.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$517.07
|
| Rate for Payer: UHC Exchange |
$1,005.74
|
| Rate for Payer: UHC Medicaid |
$330.36
|
| Rate for Payer: UHCCP DNSP |
$517.07
|
| Rate for Payer: UHCCP Medicaid |
$330.36
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$829.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$250.70 |
| Max. Negotiated Rate |
$669.13 |
| Rate for Payer: Aetna Commercial |
$498.76
|
| Rate for Payer: Aetna Medicare |
$372.21
|
| Rate for Payer: BCBS Complete |
$263.24
|
| Rate for Payer: BCBS MAPPO |
$372.21
|
| Rate for Payer: BCN Commercial |
$623.48
|
| Rate for Payer: BCN Medicare Advantage |
$372.21
|
| Rate for Payer: Cash Price |
$663.20
|
| Rate for Payer: Cash Price |
$663.20
|
| Rate for Payer: Cofinity Commercial |
$535.98
|
| Rate for Payer: Cofinity Commercial |
$498.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.21
|
| Rate for Payer: Healthscope Commercial |
$446.65
|
| Rate for Payer: Healthscope Whirlpool |
$446.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.82
|
| Rate for Payer: Meridian Medicaid |
$263.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.43
|
| Rate for Payer: Nomi Health Commercial |
$446.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.75
|
| Rate for Payer: PACE SWMI |
$372.21
|
| Rate for Payer: PHP Medicare Advantage |
$372.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$587.13
|
| Rate for Payer: Priority Health Medicare |
$372.21
|
| Rate for Payer: Priority Health Narrow Network |
$587.13
|
| Rate for Payer: Railroad Medicare Medicare |
$372.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$669.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.21
|
| Rate for Payer: UHC Exchange |
$669.13
|
| Rate for Payer: UHC Medicaid |
$250.70
|
| Rate for Payer: UHCCP DNSP |
$372.21
|
| Rate for Payer: UHCCP Medicaid |
$250.70
|
|
|
PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 28080
|
| Min. Negotiated Rate |
$235.79 |
| Max. Negotiated Rate |
$684.75 |
| Rate for Payer: Aetna Commercial |
$476.13
|
| Rate for Payer: Aetna Medicare |
$355.32
|
| Rate for Payer: BCBS Complete |
$247.58
|
| Rate for Payer: BCBS MAPPO |
$355.32
|
| Rate for Payer: BCN Commercial |
$640.07
|
| Rate for Payer: BCN Medicare Advantage |
$355.32
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Cofinity Commercial |
$476.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.32
|
| Rate for Payer: Healthscope Commercial |
$426.38
|
| Rate for Payer: Healthscope Whirlpool |
$426.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.09
|
| Rate for Payer: Meridian Medicaid |
$247.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$390.85
|
| Rate for Payer: Nomi Health Commercial |
$426.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.75
|
| Rate for Payer: PACE SWMI |
$355.32
|
| Rate for Payer: PHP Medicare Advantage |
$355.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$622.82
|
| Rate for Payer: Priority Health Medicare |
$355.32
|
| Rate for Payer: Priority Health Narrow Network |
$622.82
|
| Rate for Payer: Railroad Medicare Medicare |
$355.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$638.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$355.32
|
| Rate for Payer: UHC Exchange |
$638.74
|
| Rate for Payer: UHC Medicaid |
$235.79
|
| Rate for Payer: UHCCP DNSP |
$355.32
|
| Rate for Payer: UHCCP Medicaid |
$235.79
|
|
|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$211.08 |
| Max. Negotiated Rate |
$613.50 |
| Rate for Payer: Aetna Commercial |
$429.16
|
| Rate for Payer: Aetna Medicare |
$320.27
|
| Rate for Payer: BCBS Complete |
$221.63
|
| Rate for Payer: BCBS MAPPO |
$320.27
|
| Rate for Payer: BCN Commercial |
$494.00
|
| Rate for Payer: BCN Medicare Advantage |
$320.27
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cofinity Commercial |
$461.19
|
| Rate for Payer: Cofinity Commercial |
$429.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.27
|
| Rate for Payer: Healthscope Commercial |
$384.32
|
| Rate for Payer: Healthscope Whirlpool |
$384.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.28
|
| Rate for Payer: Meridian Medicaid |
$221.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$352.30
|
| Rate for Payer: Nomi Health Commercial |
$384.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$613.50
|
| Rate for Payer: PACE SWMI |
$320.27
|
| Rate for Payer: PHP Medicare Advantage |
$320.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$452.14
|
| Rate for Payer: Priority Health Medicare |
$320.27
|
| Rate for Payer: Priority Health Narrow Network |
$452.14
|
| Rate for Payer: Railroad Medicare Medicare |
$320.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$320.27
|
| Rate for Payer: UHC Exchange |
$549.16
|
| Rate for Payer: UHC Medicaid |
$211.08
|
| Rate for Payer: UHCCP DNSP |
$320.27
|
| Rate for Payer: UHCCP Medicaid |
$211.08
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$454.50 |
| Rate for Payer: Aetna Commercial |
$259.46
|
| Rate for Payer: Aetna Medicare |
$193.63
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS MAPPO |
$193.63
|
| Rate for Payer: BCN Commercial |
$327.67
|
| Rate for Payer: BCN Medicare Advantage |
$193.63
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cofinity Commercial |
$278.83
|
| Rate for Payer: Cofinity Commercial |
$259.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.63
|
| Rate for Payer: Healthscope Commercial |
$232.36
|
| Rate for Payer: Healthscope Whirlpool |
$232.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.31
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$212.99
|
| Rate for Payer: Nomi Health Commercial |
$232.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$454.50
|
| Rate for Payer: PACE SWMI |
$193.63
|
| Rate for Payer: PHP Medicare Advantage |
$193.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$399.25
|
| Rate for Payer: Priority Health Medicare |
$193.63
|
| Rate for Payer: Priority Health Narrow Network |
$399.25
|
| Rate for Payer: Railroad Medicare Medicare |
$193.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$193.63
|
| Rate for Payer: UHC Exchange |
$370.19
|
| Rate for Payer: UHC Medicaid |
$128.44
|
| Rate for Payer: UHCCP DNSP |
$193.63
|
| Rate for Payer: UHCCP Medicaid |
$128.44
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,807.50 |
| Rate for Payer: Aetna Commercial |
$660.03
|
| Rate for Payer: Aetna Medicare |
$492.56
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$492.56
|
| Rate for Payer: BCN Commercial |
$811.71
|
| Rate for Payer: BCN Medicare Advantage |
$492.56
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$709.29
|
| Rate for Payer: Cofinity Commercial |
$660.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.56
|
| Rate for Payer: Healthscope Commercial |
$591.07
|
| Rate for Payer: Healthscope Whirlpool |
$591.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.19
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$541.82
|
| Rate for Payer: Nomi Health Commercial |
$591.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,807.50
|
| Rate for Payer: PACE SWMI |
$492.56
|
| Rate for Payer: PHP Medicare Advantage |
$492.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$867.70
|
| Rate for Payer: Priority Health Medicare |
$492.56
|
| Rate for Payer: Priority Health Narrow Network |
$867.70
|
| Rate for Payer: Railroad Medicare Medicare |
$492.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$915.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$492.56
|
| Rate for Payer: UHC Exchange |
$915.57
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP DNSP |
$492.56
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$1,564.83 |
| Rate for Payer: Aetna Commercial |
$1,075.64
|
| Rate for Payer: Aetna Medicare |
$802.72
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS MAPPO |
$802.72
|
| Rate for Payer: BCN Commercial |
$1,284.30
|
| Rate for Payer: BCN Medicare Advantage |
$802.72
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,155.92
|
| Rate for Payer: Cofinity Commercial |
$1,075.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.72
|
| Rate for Payer: Healthscope Commercial |
$963.26
|
| Rate for Payer: Healthscope Whirlpool |
$963.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.86
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$882.99
|
| Rate for Payer: Nomi Health Commercial |
$963.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,164.75
|
| Rate for Payer: PACE SWMI |
$802.72
|
| Rate for Payer: PHP Medicare Advantage |
$802.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,564.83
|
| Rate for Payer: Priority Health Medicare |
$802.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,564.83
|
| Rate for Payer: Railroad Medicare Medicare |
$802.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,485.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.72
|
| Rate for Payer: UHC Exchange |
$1,485.56
|
| Rate for Payer: UHC Medicaid |
$515.46
|
| Rate for Payer: UHCCP DNSP |
$802.72
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
|
|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$667.76 |
| Max. Negotiated Rate |
$2,039.92 |
| Rate for Payer: Aetna Commercial |
$1,397.37
|
| Rate for Payer: Aetna Medicare |
$1,042.81
|
| Rate for Payer: BCBS Complete |
$701.15
|
| Rate for Payer: BCBS MAPPO |
$1,042.81
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,042.81
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$1,501.65
|
| Rate for Payer: Cofinity Commercial |
$1,397.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,042.81
|
| Rate for Payer: Healthscope Commercial |
$1,251.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,251.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,094.95
|
| Rate for Payer: Meridian Medicaid |
$701.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,147.09
|
| Rate for Payer: Nomi Health Commercial |
$1,251.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,757.25
|
| Rate for Payer: PACE SWMI |
$1,042.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,042.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,039.92
|
| Rate for Payer: Priority Health Medicare |
$1,042.81
|
| Rate for Payer: Priority Health Narrow Network |
$2,039.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,042.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,970.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,042.81
|
| Rate for Payer: UHC Exchange |
$1,970.93
|
| Rate for Payer: UHC Medicaid |
$667.76
|
| Rate for Payer: UHCCP DNSP |
$1,042.81
|
| Rate for Payer: UHCCP Medicaid |
$667.76
|
|
|
PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 27630
|
| Min. Negotiated Rate |
$221.09 |
| Max. Negotiated Rate |
$1,038.00 |
| Rate for Payer: Aetna Commercial |
$449.89
|
| Rate for Payer: Aetna Medicare |
$335.74
|
| Rate for Payer: BCBS Complete |
$232.14
|
| Rate for Payer: BCBS MAPPO |
$335.74
|
| Rate for Payer: BCN Commercial |
$549.28
|
| Rate for Payer: BCN Medicare Advantage |
$335.74
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cofinity Commercial |
$483.47
|
| Rate for Payer: Cofinity Commercial |
$449.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.74
|
| Rate for Payer: Healthscope Commercial |
$402.89
|
| Rate for Payer: Healthscope Whirlpool |
$402.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.53
|
| Rate for Payer: Meridian Medicaid |
$232.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$369.31
|
| Rate for Payer: Nomi Health Commercial |
$402.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,038.00
|
| Rate for Payer: PACE SWMI |
$335.74
|
| Rate for Payer: PHP Medicare Advantage |
$335.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$587.15
|
| Rate for Payer: Priority Health Medicare |
$335.74
|
| Rate for Payer: Priority Health Narrow Network |
$587.15
|
| Rate for Payer: Railroad Medicare Medicare |
$335.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$335.74
|
| Rate for Payer: UHC Exchange |
$625.32
|
| Rate for Payer: UHC Medicaid |
$221.09
|
| Rate for Payer: UHCCP DNSP |
$335.74
|
| Rate for Payer: UHCCP Medicaid |
$221.09
|
|
|
PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 25110
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$892.50 |
| Rate for Payer: Aetna Commercial |
$436.01
|
| Rate for Payer: Aetna Medicare |
$325.38
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$325.38
|
| Rate for Payer: BCN Commercial |
$536.33
|
| Rate for Payer: BCN Medicare Advantage |
$325.38
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$468.55
|
| Rate for Payer: Cofinity Commercial |
$436.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.38
|
| Rate for Payer: Healthscope Commercial |
$390.46
|
| Rate for Payer: Healthscope Whirlpool |
$390.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.65
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$357.92
|
| Rate for Payer: Nomi Health Commercial |
$390.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE SWMI |
$325.38
|
| Rate for Payer: PHP Medicare Advantage |
$325.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$573.31
|
| Rate for Payer: Priority Health Medicare |
$325.38
|
| Rate for Payer: Priority Health Narrow Network |
$573.31
|
| Rate for Payer: Railroad Medicare Medicare |
$325.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$325.38
|
| Rate for Payer: UHC Exchange |
$590.96
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP DNSP |
$325.38
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
|
|
PR EXCISION LESION TONGUE W/O CLOSURE
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 41110
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna Commercial |
$153.42
|
| Rate for Payer: Aetna Medicare |
$114.49
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$114.49
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$114.49
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$164.87
|
| Rate for Payer: Cofinity Commercial |
$153.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.49
|
| Rate for Payer: Healthscope Commercial |
$137.39
|
| Rate for Payer: Healthscope Whirlpool |
$137.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.21
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.94
|
| Rate for Payer: Nomi Health Commercial |
$137.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.00
|
| Rate for Payer: PACE SWMI |
$114.49
|
| Rate for Payer: PHP Medicare Advantage |
$114.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$237.85
|
| Rate for Payer: Priority Health Medicare |
$114.49
|
| Rate for Payer: Priority Health Narrow Network |
$237.85
|
| Rate for Payer: Railroad Medicare Medicare |
$114.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$223.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.49
|
| Rate for Payer: UHC Exchange |
$223.75
|
| Rate for Payer: UHC Medicaid |
$75.83
|
| Rate for Payer: UHCCP DNSP |
$114.49
|
| Rate for Payer: UHCCP Medicaid |
$75.83
|
|
|
PR EXCISION LINGUAL FRENUM FRENECTOMY
|
Professional
|
Both
|
$460.00
|
|
|
Service Code
|
HCPCS 41115
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$172.27
|
| Rate for Payer: Aetna Medicare |
$128.56
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCBS MAPPO |
$128.56
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: BCN Medicare Advantage |
$128.56
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cofinity Commercial |
$185.13
|
| Rate for Payer: Cofinity Commercial |
$172.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.56
|
| Rate for Payer: Healthscope Commercial |
$154.27
|
| Rate for Payer: Healthscope Whirlpool |
$154.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.99
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.42
|
| Rate for Payer: Nomi Health Commercial |
$154.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.00
|
| Rate for Payer: PACE SWMI |
$128.56
|
| Rate for Payer: PHP Medicare Advantage |
$128.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$268.18
|
| Rate for Payer: Priority Health Medicare |
$128.56
|
| Rate for Payer: Priority Health Narrow Network |
$268.18
|
| Rate for Payer: Railroad Medicare Medicare |
$128.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.56
|
| Rate for Payer: UHC Exchange |
$249.90
|
| Rate for Payer: UHC Medicaid |
$84.99
|
| Rate for Payer: UHCCP DNSP |
$128.56
|
| Rate for Payer: UHCCP Medicaid |
$84.99
|
|
|
PR EXCISION LOCAL LESION EPIDIDYMIS
|
Professional
|
Both
|
$636.00
|
|
|
Service Code
|
HCPCS 54830
|
| Min. Negotiated Rate |
$221.73 |
| Max. Negotiated Rate |
$651.61 |
| Rate for Payer: Aetna Commercial |
$455.75
|
| Rate for Payer: Aetna Medicare |
$340.11
|
| Rate for Payer: BCBS Complete |
$232.82
|
| Rate for Payer: BCBS MAPPO |
$340.11
|
| Rate for Payer: BCN Commercial |
$562.72
|
| Rate for Payer: BCN Medicare Advantage |
$340.11
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cofinity Commercial |
$489.76
|
| Rate for Payer: Cofinity Commercial |
$455.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.11
|
| Rate for Payer: Healthscope Commercial |
$408.13
|
| Rate for Payer: Healthscope Whirlpool |
$408.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.12
|
| Rate for Payer: Meridian Medicaid |
$232.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.12
|
| Rate for Payer: Nomi Health Commercial |
$408.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.00
|
| Rate for Payer: PACE SWMI |
$340.11
|
| Rate for Payer: PHP Medicare Advantage |
$340.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$612.99
|
| Rate for Payer: Priority Health Medicare |
$340.11
|
| Rate for Payer: Priority Health Narrow Network |
$612.99
|
| Rate for Payer: Railroad Medicare Medicare |
$340.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$651.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.11
|
| Rate for Payer: UHC Exchange |
$651.61
|
| Rate for Payer: UHC Medicaid |
$221.73
|
| Rate for Payer: UHCCP DNSP |
$340.11
|
| Rate for Payer: UHCCP Medicaid |
$221.73
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
11640
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Aetna Commercial |
$143.94
|
| Rate for Payer: Aetna Medicare |
$107.42
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$107.42
|
| Rate for Payer: BCN Commercial |
$150.40
|
| Rate for Payer: BCN Medicare Advantage |
$107.42
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$154.68
|
| Rate for Payer: Cofinity Commercial |
$143.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.42
|
| Rate for Payer: Healthscope Commercial |
$128.90
|
| Rate for Payer: Healthscope Whirlpool |
$128.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.79
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.16
|
| Rate for Payer: Nomi Health Commercial |
$128.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE SWMI |
$107.42
|
| Rate for Payer: PHP Medicare Advantage |
$107.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$174.57
|
| Rate for Payer: Priority Health Medicare |
$107.42
|
| Rate for Payer: Priority Health Narrow Network |
$174.57
|
| Rate for Payer: Railroad Medicare Medicare |
$107.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.42
|
| Rate for Payer: UHC Exchange |
$216.30
|
| Rate for Payer: UHC Medicaid |
$70.72
|
| Rate for Payer: UHCCP DNSP |
$107.42
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
