|
PR HEALTH RISK ASSESSMENT TEST
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 99420
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
|
|
PR HEARING AID CHECK BINAURAL
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 92593
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$48.51 |
| Rate for Payer: Aetna Commercial |
$39.35
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCN Commercial |
$48.51
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR HEARING AID CHECK MONAURAL
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 92592
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$48.51 |
| Rate for Payer: Aetna Commercial |
$23.53
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCN Commercial |
$48.51
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
|
|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Commercial |
$76.88
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCN Commercial |
$99.92
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCN Commercial |
$99.92
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
|
|
PR HEARING AID FITTING SERVICES 1ST 60 MINUTES
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 92634
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR HEARING AID FITTING SERVICES EA ADDL 15 MINUTES
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 92635
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR HEARING AID MEAS VERIF W/PROBE MICROPHONE
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 92639
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 92636
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 92637
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,681.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$4,260.75 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: BCBS Complete |
$2,272.40
|
| Rate for Payer: Cash Price |
$4,544.80
|
| Rate for Payer: Cash Price |
$4,544.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,260.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,500.00
|
| Rate for Payer: UHC Exchange |
$2,500.00
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$148.33 |
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: BCBS Complete |
$178.80
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.33
|
| Rate for Payer: UHC Exchange |
$148.33
|
| Rate for Payer: UHC Exchange |
$148.33
|
| Rate for Payer: UHC Exchange |
$148.33
|
|
|
PR HEARING AID SELECTION SERVICES 1ST 30 MINUTES
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 92631
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
|
|
PR HEARING AID SELECTION SERVICES EA ADDL 15 MIN
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 92632
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
|
|
PR HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 92642
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
|
|
PR HEARING DEVICE VERIFICATION ELECTROACOUSTIC ALYS
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 92641
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,403.00
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$660.51 |
| Max. Negotiated Rate |
$1,986.05 |
| Rate for Payer: Aetna Commercial |
$1,363.49
|
| Rate for Payer: Aetna Medicare |
$1,017.53
|
| Rate for Payer: BCBS Complete |
$693.54
|
| Rate for Payer: BCBS MAPPO |
$1,017.53
|
| Rate for Payer: BCN Commercial |
$1,713.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,017.53
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cash Price |
$1,922.40
|
| Rate for Payer: Cofinity Commercial |
$1,363.49
|
| Rate for Payer: Cofinity Commercial |
$1,465.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,017.53
|
| Rate for Payer: Healthscope Commercial |
$1,221.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,221.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,068.41
|
| Rate for Payer: Meridian Medicaid |
$693.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,119.28
|
| Rate for Payer: Nomi Health Commercial |
$1,221.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,802.25
|
| Rate for Payer: PACE SWMI |
$1,017.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,017.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,831.73
|
| Rate for Payer: Priority Health Medicare |
$1,017.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,831.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,017.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,986.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,017.53
|
| Rate for Payer: UHC Exchange |
$1,986.05
|
| Rate for Payer: UHC Medicaid |
$660.51
|
| Rate for Payer: UHCCP DNSP |
$1,017.53
|
| Rate for Payer: UHCCP Medicaid |
$660.51
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$718.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$538.50 |
| Rate for Payer: Aetna Commercial |
$331.09
|
| Rate for Payer: Aetna Medicare |
$247.08
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS MAPPO |
$247.08
|
| Rate for Payer: BCN Commercial |
$407.35
|
| Rate for Payer: BCN Medicare Advantage |
$247.08
|
| Rate for Payer: Cash Price |
$574.40
|
| Rate for Payer: Cash Price |
$574.40
|
| Rate for Payer: Cofinity Commercial |
$355.80
|
| Rate for Payer: Cofinity Commercial |
$331.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.08
|
| Rate for Payer: Healthscope Commercial |
$296.50
|
| Rate for Payer: Healthscope Whirlpool |
$296.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.43
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.79
|
| Rate for Payer: Nomi Health Commercial |
$296.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$538.50
|
| Rate for Payer: PACE SWMI |
$247.08
|
| Rate for Payer: PHP Medicare Advantage |
$247.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$435.44
|
| Rate for Payer: Priority Health Medicare |
$247.08
|
| Rate for Payer: Priority Health Narrow Network |
$435.44
|
| Rate for Payer: Railroad Medicare Medicare |
$247.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$464.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$247.08
|
| Rate for Payer: UHC Exchange |
$464.51
|
| Rate for Payer: UHC Medicaid |
$162.95
|
| Rate for Payer: UHCCP DNSP |
$247.08
|
| Rate for Payer: UHCCP Medicaid |
$162.95
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$118.34 |
| Rate for Payer: Aetna Commercial |
$81.57
|
| Rate for Payer: Aetna Medicare |
$60.87
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$60.87
|
| Rate for Payer: BCN Commercial |
$104.58
|
| Rate for Payer: BCN Medicare Advantage |
$60.87
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Cofinity Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.87
|
| Rate for Payer: Healthscope Commercial |
$73.04
|
| Rate for Payer: Healthscope Whirlpool |
$73.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.96
|
| Rate for Payer: Nomi Health Commercial |
$73.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$60.87
|
| Rate for Payer: PHP Medicare Advantage |
$60.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$96.44
|
| Rate for Payer: Priority Health Medicare |
$60.87
|
| Rate for Payer: Priority Health Narrow Network |
$96.44
|
| Rate for Payer: Railroad Medicare Medicare |
$60.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.87
|
| Rate for Payer: UHC Exchange |
$118.34
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP DNSP |
$60.87
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$56.45 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$117.57
|
| Rate for Payer: Aetna Medicare |
$87.74
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS MAPPO |
$87.74
|
| Rate for Payer: BCN Commercial |
$151.39
|
| Rate for Payer: BCN Medicare Advantage |
$87.74
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$126.35
|
| Rate for Payer: Cofinity Commercial |
$117.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.74
|
| Rate for Payer: Healthscope Commercial |
$105.29
|
| Rate for Payer: Healthscope Whirlpool |
$105.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.13
|
| Rate for Payer: Meridian Medicaid |
$59.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.51
|
| Rate for Payer: Nomi Health Commercial |
$105.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PACE SWMI |
$87.74
|
| Rate for Payer: PHP Medicare Advantage |
$87.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$139.61
|
| Rate for Payer: Priority Health Medicare |
$87.74
|
| Rate for Payer: Priority Health Narrow Network |
$139.61
|
| Rate for Payer: Railroad Medicare Medicare |
$87.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$87.74
|
| Rate for Payer: UHC Exchange |
$168.91
|
| Rate for Payer: UHC Medicaid |
$56.45
|
| Rate for Payer: UHCCP DNSP |
$87.74
|
| Rate for Payer: UHCCP Medicaid |
$56.45
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$427.00
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$125.67 |
| Max. Negotiated Rate |
$357.38 |
| Rate for Payer: Aetna Commercial |
$253.53
|
| Rate for Payer: Aetna Medicare |
$189.20
|
| Rate for Payer: BCBS Complete |
$131.95
|
| Rate for Payer: BCBS MAPPO |
$189.20
|
| Rate for Payer: BCN Commercial |
$231.30
|
| Rate for Payer: BCN Medicare Advantage |
$189.20
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Cofinity Commercial |
$272.45
|
| Rate for Payer: Cofinity Commercial |
$253.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.20
|
| Rate for Payer: Healthscope Commercial |
$227.04
|
| Rate for Payer: Healthscope Whirlpool |
$227.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.66
|
| Rate for Payer: Meridian Medicaid |
$131.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$208.12
|
| Rate for Payer: Nomi Health Commercial |
$227.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$320.25
|
| Rate for Payer: PACE SWMI |
$189.20
|
| Rate for Payer: PHP Medicare Advantage |
$189.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$357.38
|
| Rate for Payer: Priority Health Medicare |
$189.20
|
| Rate for Payer: Priority Health Narrow Network |
$357.38
|
| Rate for Payer: Railroad Medicare Medicare |
$189.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$331.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$189.20
|
| Rate for Payer: UHC Exchange |
$331.45
|
| Rate for Payer: UHC Medicaid |
$125.67
|
| Rate for Payer: UHCCP DNSP |
$189.20
|
| Rate for Payer: UHCCP Medicaid |
$125.67
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,662.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$305.87 |
| Max. Negotiated Rate |
$1,246.50 |
| Rate for Payer: Aetna Commercial |
$625.30
|
| Rate for Payer: Aetna Medicare |
$466.64
|
| Rate for Payer: BCBS Complete |
$321.16
|
| Rate for Payer: BCBS MAPPO |
$466.64
|
| Rate for Payer: BCN Commercial |
$731.04
|
| Rate for Payer: BCN Medicare Advantage |
$466.64
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Commercial |
$671.96
|
| Rate for Payer: Cofinity Commercial |
$625.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.64
|
| Rate for Payer: Healthscope Commercial |
$559.97
|
| Rate for Payer: Healthscope Whirlpool |
$559.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.97
|
| Rate for Payer: Meridian Medicaid |
$321.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$513.30
|
| Rate for Payer: Nomi Health Commercial |
$559.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.50
|
| Rate for Payer: PACE SWMI |
$466.64
|
| Rate for Payer: PHP Medicare Advantage |
$466.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$890.73
|
| Rate for Payer: Priority Health Medicare |
$466.64
|
| Rate for Payer: Priority Health Narrow Network |
$890.73
|
| Rate for Payer: Railroad Medicare Medicare |
$466.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$839.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$466.64
|
| Rate for Payer: UHC Exchange |
$839.62
|
| Rate for Payer: UHC Medicaid |
$305.87
|
| Rate for Payer: UHCCP DNSP |
$466.64
|
| Rate for Payer: UHCCP Medicaid |
$305.87
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
OP
|
$1,662.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,165.06 |
| Max. Negotiated Rate |
$3,457.10 |
| Rate for Payer: Aetna Commercial |
$1,495.80
|
| Rate for Payer: Aetna Medicare |
$2,765.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: ASR ASR |
$1,612.14
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,370.32
|
| Rate for Payer: BCN Commercial |
$1,370.32
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Commercial |
$1,562.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,329.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$1,612.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,662.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,765.68
|
| Rate for Payer: Mclaren Commercial |
$1,495.80
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$1,518.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,412.70
|
| Rate for Payer: Nomi Health Commercial |
$1,362.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.50
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$3,042.25
|
| Rate for Payer: PHP Medicaid |
$1,482.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,456.24
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,165.06
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP DNSP |
$2,765.68
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,662.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$305.87 |
| Max. Negotiated Rate |
$1,246.50 |
| Rate for Payer: Aetna Commercial |
$625.30
|
| Rate for Payer: Aetna Medicare |
$466.64
|
| Rate for Payer: BCBS Complete |
$321.16
|
| Rate for Payer: BCBS MAPPO |
$466.64
|
| Rate for Payer: BCN Commercial |
$731.04
|
| Rate for Payer: BCN Medicare Advantage |
$466.64
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Commercial |
$671.96
|
| Rate for Payer: Cofinity Commercial |
$625.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.64
|
| Rate for Payer: Healthscope Commercial |
$559.97
|
| Rate for Payer: Healthscope Whirlpool |
$559.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.97
|
| Rate for Payer: Meridian Medicaid |
$321.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$513.30
|
| Rate for Payer: Nomi Health Commercial |
$559.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.50
|
| Rate for Payer: PACE SWMI |
$466.64
|
| Rate for Payer: PHP Medicare Advantage |
$466.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$890.73
|
| Rate for Payer: Priority Health Medicare |
$466.64
|
| Rate for Payer: Priority Health Narrow Network |
$890.73
|
| Rate for Payer: Railroad Medicare Medicare |
$466.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$839.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$466.64
|
| Rate for Payer: UHC Exchange |
$839.62
|
| Rate for Payer: UHC Medicaid |
$305.87
|
| Rate for Payer: UHCCP DNSP |
$466.64
|
| Rate for Payer: UHCCP Medicaid |
$305.87
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,662.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,246.50 |
| Max. Negotiated Rate |
$1,662.00 |
| Rate for Payer: Aetna Commercial |
$1,495.80
|
| Rate for Payer: ASR ASR |
$1,612.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,364.83
|
| Rate for Payer: BCN Commercial |
$1,364.83
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cofinity Commercial |
$1,562.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,329.60
|
| Rate for Payer: Healthscope Commercial |
$1,612.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,662.00
|
| Rate for Payer: Mclaren Commercial |
$1,495.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,412.70
|
| Rate for Payer: Nomi Health Commercial |
$1,362.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,246.50
|
|
