|
PR HEARING AID CHECK BINAURAL
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 92593
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
|
|
PR HEARING AID CHECK MONAURAL
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 92592
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
|
|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,516.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$2,206.40 |
| Max. Negotiated Rate |
$3,585.40 |
| Rate for Payer: Aetna Medicare |
$2,758.00
|
| Rate for Payer: BCBS Complete |
$2,206.40
|
| Rate for Payer: Cash Price |
$4,412.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,585.40
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: Aetna Medicare |
$217.00
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$173.60
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$933.20 |
| Max. Negotiated Rate |
$1,570.36 |
| Rate for Payer: Aetna Commercial |
$1,461.31
|
| Rate for Payer: Aetna Medicare |
$1,090.53
|
| Rate for Payer: BCBS Complete |
$933.20
|
| Rate for Payer: BCBS MAPPO |
$1,090.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.53
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,570.36
|
| Rate for Payer: Cofinity Commercial |
$1,461.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.53
|
| Rate for Payer: Healthscope Commercial |
$1,308.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.06
|
| Rate for Payer: Nomi Health Commercial |
$1,308.64
|
| Rate for Payer: PACE SWMI |
$1,090.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health Medicare |
$1,090.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,090.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,090.53
|
| Rate for Payer: UHCCP DNSP |
$1,090.53
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$697.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$255.44 |
| Max. Negotiated Rate |
$453.05 |
| Rate for Payer: Aetna Commercial |
$342.29
|
| Rate for Payer: Aetna Medicare |
$255.44
|
| Rate for Payer: BCBS Complete |
$278.80
|
| Rate for Payer: BCBS MAPPO |
$255.44
|
| Rate for Payer: BCN Medicare Advantage |
$255.44
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cofinity Commercial |
$367.83
|
| Rate for Payer: Cofinity Commercial |
$342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.44
|
| Rate for Payer: Healthscope Commercial |
$306.53
|
| Rate for Payer: Healthscope Whirlpool |
$306.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.21
|
| Rate for Payer: Nomi Health Commercial |
$306.53
|
| Rate for Payer: PACE SWMI |
$255.44
|
| Rate for Payer: PHP Medicare Advantage |
$255.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$453.05
|
| Rate for Payer: Priority Health Medicare |
$255.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.44
|
| Rate for Payer: UHC Medicare Advantage |
$255.44
|
| Rate for Payer: UHCCP DNSP |
$255.44
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$96.22 |
| Rate for Payer: Aetna Commercial |
$89.54
|
| Rate for Payer: Aetna Medicare |
$66.82
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$66.82
|
| Rate for Payer: BCN Medicare Advantage |
$66.82
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$96.22
|
| Rate for Payer: Cofinity Commercial |
$89.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.82
|
| Rate for Payer: Healthscope Commercial |
$80.18
|
| Rate for Payer: Healthscope Whirlpool |
$80.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.16
|
| Rate for Payer: Nomi Health Commercial |
$80.18
|
| Rate for Payer: PACE SWMI |
$66.82
|
| Rate for Payer: PHP Medicare Advantage |
$66.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health Medicare |
$66.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.82
|
| Rate for Payer: UHC Medicare Advantage |
$66.82
|
| Rate for Payer: UHCCP DNSP |
$66.82
|
|
|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$129.66
|
| Rate for Payer: Aetna Medicare |
$96.76
|
| Rate for Payer: BCBS Complete |
$238.40
|
| Rate for Payer: BCBS MAPPO |
$96.76
|
| Rate for Payer: BCN Medicare Advantage |
$96.76
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$139.33
|
| Rate for Payer: Cofinity Commercial |
$129.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.76
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Healthscope Whirlpool |
$116.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.60
|
| Rate for Payer: Nomi Health Commercial |
$116.11
|
| Rate for Payer: PACE SWMI |
$96.76
|
| Rate for Payer: PHP Medicare Advantage |
$96.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health Medicare |
$96.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.76
|
| Rate for Payer: UHC Medicare Advantage |
$96.76
|
| Rate for Payer: UHCCP DNSP |
$96.76
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$269.75 |
| Max. Negotiated Rate |
$1,378.21 |
| Rate for Payer: Aetna Commercial |
$373.50
|
| Rate for Payer: Aetna Medicare |
$889.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: ASR ASR |
$402.55
|
| Rate for Payer: ASR Commercial |
$402.55
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCBS Trust/PPO |
$339.84
|
| Rate for Payer: BCN Commercial |
$321.75
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$390.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$415.00
|
| Rate for Payer: Healthscope Whirlpool |
$402.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$889.17
|
| Rate for Payer: Mclaren Commercial |
$373.50
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: Nomi Health Commercial |
$340.30
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$978.09
|
| Rate for Payer: PHP Medicaid |
$476.60
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$363.62
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health Narrow Network |
$290.92
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$365.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,378.21
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP DNSP |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$166.00 |
| Max. Negotiated Rate |
$269.75 |
| Rate for Payer: Aetna Commercial |
$245.77
|
| Rate for Payer: Aetna Medicare |
$183.41
|
| Rate for Payer: BCBS Complete |
$166.00
|
| Rate for Payer: BCBS MAPPO |
$183.41
|
| Rate for Payer: BCN Medicare Advantage |
$183.41
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$264.11
|
| Rate for Payer: Cofinity Commercial |
$245.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.41
|
| Rate for Payer: Healthscope Commercial |
$220.09
|
| Rate for Payer: Healthscope Whirlpool |
$220.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.58
|
| Rate for Payer: Nomi Health Commercial |
$220.09
|
| Rate for Payer: PACE SWMI |
$183.41
|
| Rate for Payer: PHP Medicare Advantage |
$183.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health Medicare |
$183.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.41
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
| Rate for Payer: UHCCP DNSP |
$183.41
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$166.00 |
| Max. Negotiated Rate |
$269.75 |
| Rate for Payer: Aetna Commercial |
$245.77
|
| Rate for Payer: Aetna Medicare |
$183.41
|
| Rate for Payer: BCBS Complete |
$166.00
|
| Rate for Payer: BCBS MAPPO |
$183.41
|
| Rate for Payer: BCN Medicare Advantage |
$183.41
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$264.11
|
| Rate for Payer: Cofinity Commercial |
$245.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.41
|
| Rate for Payer: Healthscope Commercial |
$220.09
|
| Rate for Payer: Healthscope Whirlpool |
$220.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.58
|
| Rate for Payer: Nomi Health Commercial |
$220.09
|
| Rate for Payer: PACE SWMI |
$183.41
|
| Rate for Payer: PHP Medicare Advantage |
$183.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health Medicare |
$183.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.41
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
| Rate for Payer: UHCCP DNSP |
$183.41
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$269.75 |
| Max. Negotiated Rate |
$415.00 |
| Rate for Payer: Aetna Commercial |
$373.50
|
| Rate for Payer: ASR ASR |
$402.55
|
| Rate for Payer: ASR Commercial |
$402.55
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$321.75
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$390.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Healthscope Commercial |
$415.00
|
| Rate for Payer: Healthscope Whirlpool |
$402.55
|
| Rate for Payer: Mclaren Commercial |
$373.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: Nomi Health Commercial |
$340.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$365.20
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,049.10 |
| Max. Negotiated Rate |
$1,614.00 |
| Rate for Payer: Aetna Commercial |
$1,452.60
|
| Rate for Payer: ASR ASR |
$1,565.58
|
| Rate for Payer: ASR Commercial |
$1,565.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.25
|
| Rate for Payer: BCN Commercial |
$1,251.33
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,517.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Healthscope Commercial |
$1,614.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,565.58
|
| Rate for Payer: Mclaren Commercial |
$1,452.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: Nomi Health Commercial |
$1,323.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,420.32
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$462.98 |
| Max. Negotiated Rate |
$1,049.10 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$462.98
|
| Rate for Payer: BCBS Complete |
$645.60
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Healthscope Commercial |
$555.58
|
| Rate for Payer: Healthscope Whirlpool |
$555.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health Medicare |
$462.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
| Rate for Payer: UHCCP DNSP |
$462.98
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$462.98 |
| Max. Negotiated Rate |
$1,049.10 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$462.98
|
| Rate for Payer: BCBS Complete |
$645.60
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Healthscope Commercial |
$555.58
|
| Rate for Payer: Healthscope Whirlpool |
$555.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health Medicare |
$462.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
| Rate for Payer: UHCCP DNSP |
$462.98
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
OP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,049.10 |
| Max. Negotiated Rate |
$4,145.63 |
| Rate for Payer: Aetna Commercial |
$1,452.60
|
| Rate for Payer: Aetna Medicare |
$2,674.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: ASR ASR |
$1,565.58
|
| Rate for Payer: ASR Commercial |
$1,565.58
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.70
|
| Rate for Payer: BCN Commercial |
$1,251.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,517.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$1,614.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,565.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,674.60
|
| Rate for Payer: Mclaren Commercial |
$1,452.60
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: Nomi Health Commercial |
$1,323.48
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$2,942.06
|
| Rate for Payer: PHP Medicaid |
$1,433.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,414.19
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,131.41
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,420.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Exchange |
$4,145.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP DNSP |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,433.59
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$339.69 |
| Max. Negotiated Rate |
$713.70 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$339.69
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Healthscope Commercial |
$407.63
|
| Rate for Payer: Healthscope Whirlpool |
$407.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$339.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
| Rate for Payer: UHCCP DNSP |
$339.69
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$713.70 |
| Max. Negotiated Rate |
$4,145.63 |
| Rate for Payer: Aetna Commercial |
$988.20
|
| Rate for Payer: Aetna Medicare |
$2,674.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: ASR ASR |
$1,065.06
|
| Rate for Payer: ASR Commercial |
$1,065.06
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCBS Trust/PPO |
$899.15
|
| Rate for Payer: BCN Commercial |
$851.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$1,032.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$1,098.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,065.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,674.60
|
| Rate for Payer: Mclaren Commercial |
$988.20
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: Nomi Health Commercial |
$900.36
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$2,942.06
|
| Rate for Payer: PHP Medicaid |
$1,433.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$962.07
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health Narrow Network |
$769.70
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$966.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Exchange |
$4,145.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP DNSP |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,433.59
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$713.70 |
| Max. Negotiated Rate |
$1,098.00 |
| Rate for Payer: Aetna Commercial |
$988.20
|
| Rate for Payer: ASR ASR |
$1,065.06
|
| Rate for Payer: ASR Commercial |
$1,065.06
|
| Rate for Payer: BCBS Trust/PPO |
$894.76
|
| Rate for Payer: BCN Commercial |
$851.28
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$1,032.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Healthscope Commercial |
$1,098.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,065.06
|
| Rate for Payer: Mclaren Commercial |
$988.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: Nomi Health Commercial |
$900.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$966.24
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$339.69 |
| Max. Negotiated Rate |
$713.70 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$339.69
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Healthscope Commercial |
$407.63
|
| Rate for Payer: Healthscope Whirlpool |
$407.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$339.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
| Rate for Payer: UHCCP DNSP |
$339.69
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$306.79 |
| Max. Negotiated Rate |
$733.85 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$306.79
|
| Rate for Payer: BCBS Complete |
$451.60
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Healthscope Commercial |
$368.15
|
| Rate for Payer: Healthscope Whirlpool |
$368.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health Medicare |
$306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
| Rate for Payer: UHCCP DNSP |
$306.79
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$306.79 |
| Max. Negotiated Rate |
$733.85 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$306.79
|
| Rate for Payer: BCBS Complete |
$451.60
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Healthscope Commercial |
$368.15
|
| Rate for Payer: Healthscope Whirlpool |
$368.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health Medicare |
$306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
| Rate for Payer: UHCCP DNSP |
$306.79
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
IP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$733.85 |
| Max. Negotiated Rate |
$1,129.00 |
| Rate for Payer: Aetna Commercial |
$1,016.10
|
| Rate for Payer: ASR ASR |
$1,095.13
|
| Rate for Payer: ASR Commercial |
$1,095.13
|
| Rate for Payer: BCBS Trust/PPO |
$920.02
|
| Rate for Payer: BCN Commercial |
$875.31
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$1,061.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Healthscope Commercial |
$1,129.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,095.13
|
| Rate for Payer: Mclaren Commercial |
$1,016.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: Nomi Health Commercial |
$925.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$993.52
|
|
