|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,131.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$223.65 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$456.71
|
| Rate for Payer: Aetna Medicare |
$340.83
|
| Rate for Payer: BCBS Complete |
$234.83
|
| Rate for Payer: BCBS MAPPO |
$340.83
|
| Rate for Payer: BCN Commercial |
$537.33
|
| Rate for Payer: BCN Medicare Advantage |
$340.83
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$490.80
|
| Rate for Payer: Cofinity Commercial |
$456.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.83
|
| Rate for Payer: Healthscope Commercial |
$409.00
|
| Rate for Payer: Healthscope Whirlpool |
$409.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.87
|
| Rate for Payer: Meridian Medicaid |
$234.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.91
|
| Rate for Payer: Nomi Health Commercial |
$409.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PACE SWMI |
$340.83
|
| Rate for Payer: PHP Medicare Advantage |
$340.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$654.69
|
| Rate for Payer: Priority Health Medicare |
$340.83
|
| Rate for Payer: Priority Health Narrow Network |
$654.69
|
| Rate for Payer: Railroad Medicare Medicare |
$340.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$623.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.83
|
| Rate for Payer: UHC Exchange |
$623.20
|
| Rate for Payer: UHC Medicaid |
$223.65
|
| Rate for Payer: UHCCP DNSP |
$340.83
|
| Rate for Payer: UHCCP Medicaid |
$223.65
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,131.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$223.65 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$456.71
|
| Rate for Payer: Aetna Medicare |
$340.83
|
| Rate for Payer: BCBS Complete |
$234.83
|
| Rate for Payer: BCBS MAPPO |
$340.83
|
| Rate for Payer: BCN Commercial |
$537.33
|
| Rate for Payer: BCN Medicare Advantage |
$340.83
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$490.80
|
| Rate for Payer: Cofinity Commercial |
$456.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.83
|
| Rate for Payer: Healthscope Commercial |
$409.00
|
| Rate for Payer: Healthscope Whirlpool |
$409.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.87
|
| Rate for Payer: Meridian Medicaid |
$234.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.91
|
| Rate for Payer: Nomi Health Commercial |
$409.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| Rate for Payer: PACE SWMI |
$340.83
|
| Rate for Payer: PHP Medicare Advantage |
$340.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$654.69
|
| Rate for Payer: Priority Health Medicare |
$340.83
|
| Rate for Payer: Priority Health Narrow Network |
$654.69
|
| Rate for Payer: Railroad Medicare Medicare |
$340.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$623.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.83
|
| Rate for Payer: UHC Exchange |
$623.20
|
| Rate for Payer: UHC Medicaid |
$223.65
|
| Rate for Payer: UHCCP DNSP |
$340.83
|
| Rate for Payer: UHCCP Medicaid |
$223.65
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,131.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$792.83 |
| Max. Negotiated Rate |
$3,457.10 |
| Rate for Payer: Aetna Commercial |
$1,017.90
|
| 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 |
$1,097.07
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$932.51
|
| Rate for Payer: BCN Commercial |
$932.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$1,063.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$904.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$1,097.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,131.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,765.68
|
| Rate for Payer: Mclaren Commercial |
$1,017.90
|
| 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 |
$961.35
|
| Rate for Payer: Nomi Health Commercial |
$927.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
| 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 |
$990.98
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Narrow Network |
$792.83
|
| 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 NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,131.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$848.25 |
| Max. Negotiated Rate |
$1,131.00 |
| Rate for Payer: Aetna Commercial |
$1,017.90
|
| Rate for Payer: ASR ASR |
$1,097.07
|
| Rate for Payer: BCBS Trust/PPO |
$928.78
|
| Rate for Payer: BCN Commercial |
$928.78
|
| Rate for Payer: Cash Price |
$904.80
|
| Rate for Payer: Cofinity Commercial |
$1,063.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$904.80
|
| Rate for Payer: Healthscope Commercial |
$1,097.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,131.00
|
| Rate for Payer: Mclaren Commercial |
$1,017.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$961.35
|
| Rate for Payer: Nomi Health Commercial |
$927.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$848.25
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,163.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$872.25 |
| Rate for Payer: Aetna Commercial |
$414.07
|
| Rate for Payer: Aetna Medicare |
$309.01
|
| Rate for Payer: BCBS Complete |
$213.36
|
| Rate for Payer: BCBS MAPPO |
$309.01
|
| Rate for Payer: BCN Commercial |
$486.03
|
| Rate for Payer: BCN Medicare Advantage |
$309.01
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$444.97
|
| Rate for Payer: Cofinity Commercial |
$414.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.01
|
| Rate for Payer: Healthscope Commercial |
$370.81
|
| Rate for Payer: Healthscope Whirlpool |
$370.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.46
|
| Rate for Payer: Meridian Medicaid |
$213.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.91
|
| Rate for Payer: Nomi Health Commercial |
$370.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE SWMI |
$309.01
|
| Rate for Payer: PHP Medicare Advantage |
$309.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$592.19
|
| Rate for Payer: Priority Health Medicare |
$309.01
|
| Rate for Payer: Priority Health Narrow Network |
$592.19
|
| Rate for Payer: Railroad Medicare Medicare |
$309.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$554.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.01
|
| Rate for Payer: UHC Exchange |
$554.89
|
| Rate for Payer: UHC Medicaid |
$203.20
|
| Rate for Payer: UHCCP DNSP |
$309.01
|
| Rate for Payer: UHCCP Medicaid |
$203.20
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
IP
|
$1,163.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$872.25 |
| Max. Negotiated Rate |
$1,163.00 |
| Rate for Payer: Aetna Commercial |
$1,046.70
|
| Rate for Payer: ASR ASR |
$1,128.11
|
| Rate for Payer: BCBS Trust/PPO |
$955.06
|
| Rate for Payer: BCN Commercial |
$955.06
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$1,093.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$930.40
|
| Rate for Payer: Healthscope Commercial |
$1,128.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,163.00
|
| Rate for Payer: Mclaren Commercial |
$1,046.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.55
|
| Rate for Payer: Nomi Health Commercial |
$953.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,163.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$872.25 |
| Rate for Payer: Aetna Commercial |
$414.07
|
| Rate for Payer: Aetna Medicare |
$309.01
|
| Rate for Payer: BCBS Complete |
$213.36
|
| Rate for Payer: BCBS MAPPO |
$309.01
|
| Rate for Payer: BCN Commercial |
$486.03
|
| Rate for Payer: BCN Medicare Advantage |
$309.01
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$444.97
|
| Rate for Payer: Cofinity Commercial |
$414.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.01
|
| Rate for Payer: Healthscope Commercial |
$370.81
|
| Rate for Payer: Healthscope Whirlpool |
$370.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.46
|
| Rate for Payer: Meridian Medicaid |
$213.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.91
|
| Rate for Payer: Nomi Health Commercial |
$370.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| Rate for Payer: PACE SWMI |
$309.01
|
| Rate for Payer: PHP Medicare Advantage |
$309.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$592.19
|
| Rate for Payer: Priority Health Medicare |
$309.01
|
| Rate for Payer: Priority Health Narrow Network |
$592.19
|
| Rate for Payer: Railroad Medicare Medicare |
$309.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$554.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.01
|
| Rate for Payer: UHC Exchange |
$554.89
|
| Rate for Payer: UHC Medicaid |
$203.20
|
| Rate for Payer: UHCCP DNSP |
$309.01
|
| Rate for Payer: UHCCP Medicaid |
$203.20
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
OP
|
$1,163.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$815.26 |
| Max. Negotiated Rate |
$3,457.10 |
| Rate for Payer: Aetna Commercial |
$1,046.70
|
| 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 |
$1,128.11
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$958.89
|
| Rate for Payer: BCN Commercial |
$958.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cash Price |
$930.40
|
| Rate for Payer: Cofinity Commercial |
$1,093.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$930.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$1,128.11
|
| Rate for Payer: Healthscope Whirlpool |
$1,163.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,765.68
|
| Rate for Payer: Mclaren Commercial |
$1,046.70
|
| 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 |
$988.55
|
| Rate for Payer: Nomi Health Commercial |
$953.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.25
|
| 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 |
$1,019.02
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Narrow Network |
$815.26
|
| 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 HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 46257
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$770.58 |
| Rate for Payer: Aetna Commercial |
$538.47
|
| Rate for Payer: Aetna Medicare |
$401.84
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCBS MAPPO |
$401.84
|
| Rate for Payer: BCN Commercial |
$632.43
|
| Rate for Payer: BCN Medicare Advantage |
$401.84
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$578.65
|
| Rate for Payer: Cofinity Commercial |
$538.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.84
|
| Rate for Payer: Healthscope Commercial |
$482.21
|
| Rate for Payer: Healthscope Whirlpool |
$482.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.93
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$442.02
|
| Rate for Payer: Nomi Health Commercial |
$482.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$573.75
|
| Rate for Payer: PACE SWMI |
$401.84
|
| Rate for Payer: PHP Medicare Advantage |
$401.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$770.58
|
| Rate for Payer: Priority Health Medicare |
$401.84
|
| Rate for Payer: Priority Health Narrow Network |
$770.58
|
| Rate for Payer: Railroad Medicare Medicare |
$401.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$745.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$401.84
|
| Rate for Payer: UHC Exchange |
$745.99
|
| Rate for Payer: UHC Medicaid |
$265.19
|
| Rate for Payer: UHCCP DNSP |
$401.84
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
|
|
PR HEMORRHOIDOPEXY STAPLING
|
Professional
|
Both
|
$665.00
|
|
|
Service Code
|
HCPCS 46947
|
| Min. Negotiated Rate |
$241.97 |
| Max. Negotiated Rate |
$717.20 |
| Rate for Payer: Aetna Commercial |
$497.14
|
| Rate for Payer: Aetna Medicare |
$371.00
|
| Rate for Payer: BCBS Complete |
$254.07
|
| Rate for Payer: BCBS MAPPO |
$371.00
|
| Rate for Payer: BCN Commercial |
$588.61
|
| Rate for Payer: BCN Medicare Advantage |
$371.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$534.24
|
| Rate for Payer: Cofinity Commercial |
$497.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.00
|
| Rate for Payer: Healthscope Commercial |
$445.20
|
| Rate for Payer: Healthscope Whirlpool |
$445.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.55
|
| Rate for Payer: Meridian Medicaid |
$254.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$408.10
|
| Rate for Payer: Nomi Health Commercial |
$445.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$498.75
|
| Rate for Payer: PACE SWMI |
$371.00
|
| Rate for Payer: PHP Medicare Advantage |
$371.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$717.20
|
| Rate for Payer: Priority Health Medicare |
$371.00
|
| Rate for Payer: Priority Health Narrow Network |
$717.20
|
| Rate for Payer: Railroad Medicare Medicare |
$371.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$676.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.00
|
| Rate for Payer: UHC Exchange |
$676.51
|
| Rate for Payer: UHC Medicaid |
$241.97
|
| Rate for Payer: UHCCP DNSP |
$371.00
|
| Rate for Payer: UHCCP Medicaid |
$241.97
|
|
|
PR HEPATECTOMY RESCJ PARTIAL LOBECTOMY
|
Professional
|
Both
|
$4,772.00
|
|
|
Service Code
|
HCPCS 47120
|
| Min. Negotiated Rate |
$1,381.73 |
| Max. Negotiated Rate |
$4,259.43 |
| Rate for Payer: Aetna Commercial |
$2,891.02
|
| Rate for Payer: Aetna Medicare |
$2,157.48
|
| Rate for Payer: BCBS Complete |
$1,450.82
|
| Rate for Payer: BCBS MAPPO |
$2,157.48
|
| Rate for Payer: BCN Commercial |
$3,495.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,157.48
|
| Rate for Payer: Cash Price |
$3,817.60
|
| Rate for Payer: Cash Price |
$3,817.60
|
| Rate for Payer: Cofinity Commercial |
$3,106.77
|
| Rate for Payer: Cofinity Commercial |
$2,891.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,157.48
|
| Rate for Payer: Healthscope Commercial |
$2,588.98
|
| Rate for Payer: Healthscope Whirlpool |
$2,588.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,265.35
|
| Rate for Payer: Meridian Medicaid |
$1,450.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,373.23
|
| Rate for Payer: Nomi Health Commercial |
$2,588.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,579.00
|
| Rate for Payer: PACE SWMI |
$2,157.48
|
| Rate for Payer: PHP Medicare Advantage |
$2,157.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,259.43
|
| Rate for Payer: Priority Health Medicare |
$2,157.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,259.43
|
| Rate for Payer: Railroad Medicare Medicare |
$2,157.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,164.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,157.48
|
| Rate for Payer: UHC Exchange |
$4,164.38
|
| Rate for Payer: UHC Medicaid |
$1,381.73
|
| Rate for Payer: UHCCP DNSP |
$2,157.48
|
| Rate for Payer: UHCCP Medicaid |
$1,381.73
|
|
|
PR HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY
|
Professional
|
Both
|
$6,344.00
|
|
|
Service Code
|
HCPCS 47130
|
| Min. Negotiated Rate |
$1,927.86 |
| Max. Negotiated Rate |
$6,008.11 |
| Rate for Payer: Aetna Commercial |
$4,052.84
|
| Rate for Payer: Aetna Medicare |
$3,024.51
|
| Rate for Payer: BCBS Complete |
$2,024.25
|
| Rate for Payer: BCBS MAPPO |
$3,024.51
|
| Rate for Payer: BCN Commercial |
$4,931.01
|
| Rate for Payer: BCN Medicare Advantage |
$3,024.51
|
| Rate for Payer: Cash Price |
$5,075.20
|
| Rate for Payer: Cash Price |
$5,075.20
|
| Rate for Payer: Cofinity Commercial |
$4,052.84
|
| Rate for Payer: Cofinity Commercial |
$4,355.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,024.51
|
| Rate for Payer: Healthscope Commercial |
$3,629.41
|
| Rate for Payer: Healthscope Whirlpool |
$3,629.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,175.74
|
| Rate for Payer: Meridian Medicaid |
$2,024.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,326.96
|
| Rate for Payer: Nomi Health Commercial |
$3,629.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,758.00
|
| Rate for Payer: PACE SWMI |
$3,024.51
|
| Rate for Payer: PHP Medicare Advantage |
$3,024.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,927.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,008.11
|
| Rate for Payer: Priority Health Medicare |
$3,024.51
|
| Rate for Payer: Priority Health Narrow Network |
$6,008.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3,024.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,919.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,024.51
|
| Rate for Payer: UHC Exchange |
$5,919.01
|
| Rate for Payer: UHC Medicaid |
$1,927.86
|
| Rate for Payer: UHCCP DNSP |
$3,024.51
|
| Rate for Payer: UHCCP Medicaid |
$1,927.86
|
|
|
PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 90636
|
| Min. Negotiated Rate |
$118.50 |
| Max. Negotiated Rate |
$132.43 |
| Rate for Payer: Aetna Commercial |
$123.57
|
| Rate for Payer: BCBS Trust/PPO |
$132.43
|
| Rate for Payer: BCN Commercial |
$130.06
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.43
|
| Rate for Payer: UHC Exchange |
$132.43
|
|
|
PR HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 90371
|
| Min. Negotiated Rate |
$137.83 |
| Max. Negotiated Rate |
$201.90 |
| Rate for Payer: Aetna Commercial |
$187.88
|
| Rate for Payer: Aetna Medicare |
$140.21
|
| Rate for Payer: BCBS MAPPO |
$140.21
|
| Rate for Payer: BCBS Trust/PPO |
$158.07
|
| Rate for Payer: BCN Commercial |
$174.06
|
| Rate for Payer: BCN Medicare Advantage |
$140.21
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$187.88
|
| Rate for Payer: Cofinity Commercial |
$201.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.21
|
| Rate for Payer: Healthscope Commercial |
$168.25
|
| Rate for Payer: Healthscope Whirlpool |
$168.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.23
|
| Rate for Payer: Nomi Health Commercial |
$168.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: PACE SWMI |
$140.21
|
| Rate for Payer: PHP Medicare Advantage |
$140.21
|
| Rate for Payer: Priority Health Medicare |
$140.21
|
| Rate for Payer: Railroad Medicare Medicare |
$140.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.21
|
| Rate for Payer: UHC Exchange |
$137.83
|
| Rate for Payer: UHCCP DNSP |
$140.21
|
|
|
PR HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES
|
Professional
|
Both
|
$2,310.00
|
|
|
Service Code
|
HCPCS 47010
|
| Min. Negotiated Rate |
$728.89 |
| Max. Negotiated Rate |
$2,223.17 |
| Rate for Payer: Aetna Commercial |
$1,519.00
|
| Rate for Payer: Aetna Medicare |
$1,133.58
|
| Rate for Payer: BCBS Complete |
$765.33
|
| Rate for Payer: BCBS MAPPO |
$1,133.58
|
| Rate for Payer: BCN Commercial |
$1,824.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,133.58
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cash Price |
$1,848.00
|
| Rate for Payer: Cofinity Commercial |
$1,632.36
|
| Rate for Payer: Cofinity Commercial |
$1,519.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,133.58
|
| Rate for Payer: Healthscope Commercial |
$1,360.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,360.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,190.26
|
| Rate for Payer: Meridian Medicaid |
$765.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,246.94
|
| Rate for Payer: Nomi Health Commercial |
$1,360.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,732.50
|
| Rate for Payer: PACE SWMI |
$1,133.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,133.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$728.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,223.17
|
| Rate for Payer: Priority Health Medicare |
$1,133.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,223.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,133.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,152.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,133.58
|
| Rate for Payer: UHC Exchange |
$2,152.07
|
| Rate for Payer: UHC Medicaid |
$728.89
|
| Rate for Payer: UHCCP DNSP |
$1,133.58
|
| Rate for Payer: UHCCP Medicaid |
$728.89
|
|
|
PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 90633
|
| Min. Negotiated Rate |
$38.37 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Commercial |
$38.42
|
| Rate for Payer: BCBS Trust/PPO |
$39.13
|
| Rate for Payer: BCN Commercial |
$38.37
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.56
|
| Rate for Payer: UHC Exchange |
$39.56
|
|
|
PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
HCPCS 90632
|
| Min. Negotiated Rate |
$69.75 |
| Max. Negotiated Rate |
$106.17 |
| Rate for Payer: Aetna Commercial |
$98.80
|
| Rate for Payer: Aetna Medicare |
$73.73
|
| Rate for Payer: BCBS MAPPO |
$73.73
|
| Rate for Payer: BCBS Trust/PPO |
$83.73
|
| Rate for Payer: BCN Commercial |
$84.64
|
| Rate for Payer: BCN Medicare Advantage |
$73.73
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cofinity Commercial |
$98.80
|
| Rate for Payer: Cofinity Commercial |
$106.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.73
|
| Rate for Payer: Healthscope Commercial |
$88.48
|
| Rate for Payer: Healthscope Whirlpool |
$88.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.10
|
| Rate for Payer: Nomi Health Commercial |
$88.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.75
|
| Rate for Payer: PACE SWMI |
$73.73
|
| Rate for Payer: PHP Medicare Advantage |
$73.73
|
| Rate for Payer: Priority Health Medicare |
$73.73
|
| Rate for Payer: Railroad Medicare Medicare |
$73.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.73
|
| Rate for Payer: UHC Exchange |
$84.94
|
| Rate for Payer: UHCCP DNSP |
$73.73
|
|
|
PR HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 90743
|
| Min. Negotiated Rate |
$67.58 |
| Max. Negotiated Rate |
$108.22 |
| Rate for Payer: Aetna Commercial |
$100.70
|
| Rate for Payer: Aetna Medicare |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$75.15
|
| Rate for Payer: BCBS Trust/PPO |
$72.21
|
| Rate for Payer: BCN Commercial |
$67.58
|
| Rate for Payer: BCN Medicare Advantage |
$75.15
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$108.22
|
| Rate for Payer: Cofinity Commercial |
$100.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.15
|
| Rate for Payer: Healthscope Commercial |
$90.18
|
| Rate for Payer: Healthscope Whirlpool |
$90.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.67
|
| Rate for Payer: Nomi Health Commercial |
$90.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$75.15
|
| Rate for Payer: PHP Medicare Advantage |
$75.15
|
| Rate for Payer: Priority Health Medicare |
$75.15
|
| Rate for Payer: Railroad Medicare Medicare |
$75.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.15
|
| Rate for Payer: UHC Exchange |
$72.21
|
| Rate for Payer: UHCCP DNSP |
$75.15
|
|
|
PR HEPB VACCINE ADULT 2/4 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 90739
|
| Min. Negotiated Rate |
$153.25 |
| Max. Negotiated Rate |
$255.69 |
| Rate for Payer: Aetna Commercial |
$237.93
|
| Rate for Payer: Aetna Medicare |
$177.56
|
| Rate for Payer: BCBS MAPPO |
$177.56
|
| Rate for Payer: BCBS Trust/PPO |
$155.75
|
| Rate for Payer: BCN Commercial |
$153.25
|
| Rate for Payer: BCN Medicare Advantage |
$177.56
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$255.69
|
| Rate for Payer: Cofinity Commercial |
$237.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.56
|
| Rate for Payer: Healthscope Commercial |
$213.07
|
| Rate for Payer: Healthscope Whirlpool |
$213.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.32
|
| Rate for Payer: Nomi Health Commercial |
$213.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.00
|
| Rate for Payer: PACE SWMI |
$177.56
|
| Rate for Payer: PHP Medicare Advantage |
$177.56
|
| Rate for Payer: Priority Health Medicare |
$177.56
|
| Rate for Payer: Railroad Medicare Medicare |
$177.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.56
|
| Rate for Payer: UHC Exchange |
$155.75
|
| Rate for Payer: UHCCP DNSP |
$177.56
|
|
|
PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 90746
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$108.22 |
| Rate for Payer: Aetna Commercial |
$100.70
|
| Rate for Payer: Aetna Medicare |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$75.15
|
| Rate for Payer: BCBS Trust/PPO |
$72.21
|
| Rate for Payer: BCN Commercial |
$70.96
|
| Rate for Payer: BCN Medicare Advantage |
$75.15
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$108.22
|
| Rate for Payer: Cofinity Commercial |
$100.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.15
|
| Rate for Payer: Healthscope Commercial |
$90.18
|
| Rate for Payer: Healthscope Whirlpool |
$90.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.67
|
| Rate for Payer: Nomi Health Commercial |
$90.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.75
|
| Rate for Payer: PACE SWMI |
$75.15
|
| Rate for Payer: PHP Medicare Advantage |
$75.15
|
| Rate for Payer: Priority Health Medicare |
$75.15
|
| Rate for Payer: Railroad Medicare Medicare |
$75.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.15
|
| Rate for Payer: UHC Exchange |
$72.23
|
| Rate for Payer: UHCCP DNSP |
$75.15
|
|
|
PR HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 90744
|
| Min. Negotiated Rate |
$27.75 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare |
$33.20
|
| Rate for Payer: BCBS MAPPO |
$33.20
|
| Rate for Payer: BCBS Trust/PPO |
$29.25
|
| Rate for Payer: BCN Commercial |
$28.65
|
| Rate for Payer: BCN Medicare Advantage |
$33.20
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$47.81
|
| Rate for Payer: Cofinity Commercial |
$44.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.20
|
| Rate for Payer: Healthscope Commercial |
$39.84
|
| Rate for Payer: Healthscope Whirlpool |
$39.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.52
|
| Rate for Payer: Nomi Health Commercial |
$39.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: PACE SWMI |
$33.20
|
| Rate for Payer: PHP Medicare Advantage |
$33.20
|
| Rate for Payer: Priority Health Medicare |
$33.20
|
| Rate for Payer: Railroad Medicare Medicare |
$33.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.20
|
| Rate for Payer: UHC Exchange |
$29.26
|
| Rate for Payer: UHCCP DNSP |
$33.20
|
|
|
PR HFO FLEXION GLOVE PRE OTS
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS L3912
|
| Min. Negotiated Rate |
$38.42 |
| Max. Negotiated Rate |
$169.69 |
| Rate for Payer: Aetna Commercial |
$157.91
|
| Rate for Payer: Aetna Medicare |
$117.84
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$117.84
|
| Rate for Payer: BCN Commercial |
$112.82
|
| Rate for Payer: BCN Medicare Advantage |
$117.84
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$169.69
|
| Rate for Payer: Cofinity Commercial |
$157.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.84
|
| Rate for Payer: Healthscope Commercial |
$141.41
|
| Rate for Payer: Healthscope Whirlpool |
$141.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.62
|
| Rate for Payer: Nomi Health Commercial |
$141.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.50
|
| Rate for Payer: PACE SWMI |
$117.84
|
| Rate for Payer: PHP Medicare Advantage |
$117.84
|
| Rate for Payer: Priority Health Medicare |
$117.84
|
| Rate for Payer: Railroad Medicare Medicare |
$117.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$117.84
|
| Rate for Payer: UHC Exchange |
$38.42
|
| Rate for Payer: UHCCP DNSP |
$117.84
|
|
|
PR HFO NONTORSION JNTS PRE CST
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS L3929
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$147.11 |
| Rate for Payer: Aetna Commercial |
$136.89
|
| Rate for Payer: Aetna Medicare |
$102.16
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCBS MAPPO |
$102.16
|
| Rate for Payer: BCN Commercial |
$97.81
|
| Rate for Payer: BCN Medicare Advantage |
$102.16
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$147.11
|
| Rate for Payer: Cofinity Commercial |
$136.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.16
|
| Rate for Payer: Healthscope Commercial |
$122.59
|
| Rate for Payer: Healthscope Whirlpool |
$122.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$112.38
|
| Rate for Payer: Nomi Health Commercial |
$122.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.75
|
| Rate for Payer: PACE SWMI |
$102.16
|
| Rate for Payer: PHP Medicare Advantage |
$102.16
|
| Rate for Payer: Priority Health Medicare |
$102.16
|
| Rate for Payer: Railroad Medicare Medicare |
$102.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$102.16
|
| Rate for Payer: UHC Exchange |
$33.31
|
| Rate for Payer: UHCCP DNSP |
$102.16
|
|
|
PR HFO W/JOINT(S) CF
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS L3921
|
| Min. Negotiated Rate |
$117.15 |
| Max. Negotiated Rate |
$517.36 |
| Rate for Payer: Aetna Commercial |
$481.44
|
| Rate for Payer: Aetna Medicare |
$359.28
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: BCBS MAPPO |
$359.28
|
| Rate for Payer: BCN Commercial |
$343.98
|
| Rate for Payer: BCN Medicare Advantage |
$359.28
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$517.36
|
| Rate for Payer: Cofinity Commercial |
$481.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.28
|
| Rate for Payer: Healthscope Commercial |
$431.14
|
| Rate for Payer: Healthscope Whirlpool |
$431.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.21
|
| Rate for Payer: Nomi Health Commercial |
$431.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.75
|
| Rate for Payer: PACE SWMI |
$359.28
|
| Rate for Payer: PHP Medicare Advantage |
$359.28
|
| Rate for Payer: Priority Health Medicare |
$359.28
|
| Rate for Payer: Railroad Medicare Medicare |
$359.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$359.28
|
| Rate for Payer: UHC Exchange |
$117.15
|
| Rate for Payer: UHCCP DNSP |
$359.28
|
|
|
PR HFO W/O JOINTS CF
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS L3913
|
| Min. Negotiated Rate |
$98.77 |
| Max. Negotiated Rate |
$436.18 |
| Rate for Payer: Aetna Commercial |
$405.89
|
| Rate for Payer: Aetna Medicare |
$302.90
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: BCBS MAPPO |
$302.90
|
| Rate for Payer: BCN Commercial |
$290.00
|
| Rate for Payer: BCN Medicare Advantage |
$302.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$436.18
|
| Rate for Payer: Cofinity Commercial |
$405.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.90
|
| Rate for Payer: Healthscope Commercial |
$363.48
|
| Rate for Payer: Healthscope Whirlpool |
$363.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.19
|
| Rate for Payer: Nomi Health Commercial |
$363.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.75
|
| Rate for Payer: PACE SWMI |
$302.90
|
| Rate for Payer: PHP Medicare Advantage |
$302.90
|
| Rate for Payer: Priority Health Medicare |
$302.90
|
| Rate for Payer: Railroad Medicare Medicare |
$302.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$302.90
|
| Rate for Payer: UHC Exchange |
$98.77
|
| Rate for Payer: UHCCP DNSP |
$302.90
|
|
