|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
10120
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$194.25 |
| Max. Negotiated Rate |
$259.00 |
| Rate for Payer: Aetna Commercial |
$233.10
|
| Rate for Payer: ASR ASR |
$251.23
|
| Rate for Payer: BCBS Trust/PPO |
$212.69
|
| Rate for Payer: BCN Commercial |
$212.69
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$243.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Healthscope Commercial |
$251.23
|
| Rate for Payer: Healthscope Whirlpool |
$259.00
|
| Rate for Payer: Mclaren Commercial |
$233.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Nomi Health Commercial |
$212.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 10120
|
| Min. Negotiated Rate |
$65.18 |
| Max. Negotiated Rate |
$194.25 |
| Rate for Payer: Aetna Commercial |
$131.03
|
| Rate for Payer: Aetna Medicare |
$97.78
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$97.78
|
| Rate for Payer: BCN Commercial |
$159.35
|
| Rate for Payer: BCN Medicare Advantage |
$97.78
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$131.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.78
|
| Rate for Payer: Healthscope Commercial |
$117.34
|
| Rate for Payer: Healthscope Whirlpool |
$117.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.67
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.56
|
| Rate for Payer: Nomi Health Commercial |
$117.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
| Rate for Payer: PACE SWMI |
$97.78
|
| Rate for Payer: PHP Medicare Advantage |
$97.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$145.85
|
| Rate for Payer: Priority Health Medicare |
$97.78
|
| Rate for Payer: Priority Health Narrow Network |
$145.85
|
| Rate for Payer: Railroad Medicare Medicare |
$97.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.78
|
| Rate for Payer: UHC Exchange |
$176.12
|
| Rate for Payer: UHC Medicaid |
$65.18
|
| Rate for Payer: UHCCP DNSP |
$97.78
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
10120
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$194.25 |
| Max. Negotiated Rate |
$506.31 |
| Rate for Payer: Aetna Commercial |
$233.10
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$251.23
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$213.55
|
| Rate for Payer: BCN Commercial |
$213.55
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$243.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$251.23
|
| Rate for Payer: Healthscope Whirlpool |
$259.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$233.10
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Nomi Health Commercial |
$212.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$455.16
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$364.13
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 10120
|
| Hospital Charge Code |
10120
|
| Min. Negotiated Rate |
$65.18 |
| Max. Negotiated Rate |
$194.25 |
| Rate for Payer: Aetna Commercial |
$131.03
|
| Rate for Payer: Aetna Medicare |
$97.78
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$97.78
|
| Rate for Payer: BCN Commercial |
$159.35
|
| Rate for Payer: BCN Medicare Advantage |
$97.78
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$131.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.78
|
| Rate for Payer: Healthscope Commercial |
$117.34
|
| Rate for Payer: Healthscope Whirlpool |
$117.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.67
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.56
|
| Rate for Payer: Nomi Health Commercial |
$117.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
| Rate for Payer: PACE SWMI |
$97.78
|
| Rate for Payer: PHP Medicare Advantage |
$97.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$145.85
|
| Rate for Payer: Priority Health Medicare |
$97.78
|
| Rate for Payer: Priority Health Narrow Network |
$145.85
|
| Rate for Payer: Railroad Medicare Medicare |
$97.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.78
|
| Rate for Payer: UHC Exchange |
$176.12
|
| Rate for Payer: UHC Medicaid |
$65.18
|
| Rate for Payer: UHCCP DNSP |
$97.78
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR INCISION&SUBCUTANEOUS PLMT CRANIAL BONE GRAFT
|
Professional
|
Both
|
$1,641.00
|
|
|
Service Code
|
HCPCS 61316
|
| Min. Negotiated Rate |
$50.91 |
| Max. Negotiated Rate |
$1,230.75 |
| Rate for Payer: Aetna Commercial |
$108.38
|
| Rate for Payer: Aetna Medicare |
$80.88
|
| Rate for Payer: BCBS Complete |
$53.46
|
| Rate for Payer: BCBS MAPPO |
$80.88
|
| Rate for Payer: BCN Commercial |
$182.32
|
| Rate for Payer: BCN Medicare Advantage |
$80.88
|
| Rate for Payer: Cash Price |
$1,312.80
|
| Rate for Payer: Cash Price |
$1,312.80
|
| Rate for Payer: Cofinity Commercial |
$116.47
|
| Rate for Payer: Cofinity Commercial |
$108.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.88
|
| Rate for Payer: Healthscope Commercial |
$97.06
|
| Rate for Payer: Healthscope Whirlpool |
$97.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.92
|
| Rate for Payer: Meridian Medicaid |
$53.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.97
|
| Rate for Payer: Nomi Health Commercial |
$97.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,230.75
|
| Rate for Payer: PACE SWMI |
$80.88
|
| Rate for Payer: PHP Medicare Advantage |
$80.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$153.28
|
| Rate for Payer: Priority Health Medicare |
$80.88
|
| Rate for Payer: Priority Health Narrow Network |
$153.28
|
| Rate for Payer: Railroad Medicare Medicare |
$80.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.88
|
| Rate for Payer: UHC Exchange |
$156.06
|
| Rate for Payer: UHC Medicaid |
$50.91
|
| Rate for Payer: UHCCP DNSP |
$80.88
|
| Rate for Payer: UHCCP Medicaid |
$50.91
|
|
|
PR INCISION THROMBOSED HEMORRHOID EXTERNAL
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 46083
|
| Min. Negotiated Rate |
$68.59 |
| Max. Negotiated Rate |
$277.50 |
| Rate for Payer: Aetna Commercial |
$139.78
|
| Rate for Payer: Aetna Medicare |
$104.31
|
| Rate for Payer: BCBS Complete |
$72.02
|
| Rate for Payer: BCBS MAPPO |
$104.31
|
| Rate for Payer: BCN Commercial |
$167.32
|
| Rate for Payer: BCN Medicare Advantage |
$104.31
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$150.21
|
| Rate for Payer: Cofinity Commercial |
$139.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.31
|
| Rate for Payer: Healthscope Commercial |
$125.17
|
| Rate for Payer: Healthscope Whirlpool |
$125.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.53
|
| Rate for Payer: Meridian Medicaid |
$72.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.74
|
| Rate for Payer: Nomi Health Commercial |
$125.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.50
|
| Rate for Payer: PACE SWMI |
$104.31
|
| Rate for Payer: PHP Medicare Advantage |
$104.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.86
|
| Rate for Payer: Priority Health Medicare |
$104.31
|
| Rate for Payer: Priority Health Narrow Network |
$203.86
|
| Rate for Payer: Railroad Medicare Medicare |
$104.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$189.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.31
|
| Rate for Payer: UHC Exchange |
$189.02
|
| Rate for Payer: UHC Medicaid |
$68.59
|
| Rate for Payer: UHCCP DNSP |
$104.31
|
| Rate for Payer: UHCCP Medicaid |
$68.59
|
|
|
PR INCOBOTULINUMTOXIN A
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS J0588
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$7.62 |
| Rate for Payer: Aetna Commercial |
$7.09
|
| Rate for Payer: Aetna Medicare |
$5.29
|
| Rate for Payer: BCBS MAPPO |
$5.29
|
| Rate for Payer: BCBS Trust/PPO |
$5.26
|
| Rate for Payer: BCN Commercial |
$5.34
|
| Rate for Payer: BCN Medicare Advantage |
$5.29
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$7.62
|
| Rate for Payer: Cofinity Commercial |
$7.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.29
|
| Rate for Payer: Healthscope Commercial |
$6.35
|
| Rate for Payer: Healthscope Whirlpool |
$6.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.82
|
| Rate for Payer: Nomi Health Commercial |
$6.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: PACE SWMI |
$5.29
|
| Rate for Payer: PHP Medicare Advantage |
$5.29
|
| Rate for Payer: Priority Health Medicare |
$5.29
|
| Rate for Payer: Railroad Medicare Medicare |
$5.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.29
|
| Rate for Payer: UHC Exchange |
$5.25
|
| Rate for Payer: UHCCP DNSP |
$5.29
|
|
|
PR INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 99340
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$168.75 |
| Rate for Payer: BCBS Complete |
$90.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
|
|
PR INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 59856
|
| Min. Negotiated Rate |
$286.27 |
| Max. Negotiated Rate |
$878.07 |
| Rate for Payer: Aetna Commercial |
$602.29
|
| Rate for Payer: Aetna Medicare |
$449.47
|
| Rate for Payer: BCBS Complete |
$300.58
|
| Rate for Payer: BCBS MAPPO |
$449.47
|
| Rate for Payer: BCN Commercial |
$750.46
|
| Rate for Payer: BCN Medicare Advantage |
$449.47
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$602.29
|
| Rate for Payer: Cofinity Commercial |
$647.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.47
|
| Rate for Payer: Healthscope Commercial |
$539.36
|
| Rate for Payer: Healthscope Whirlpool |
$539.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.94
|
| Rate for Payer: Meridian Medicaid |
$300.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$494.42
|
| Rate for Payer: Nomi Health Commercial |
$539.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$449.47
|
| Rate for Payer: PHP Medicare Advantage |
$449.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$708.43
|
| Rate for Payer: Priority Health Medicare |
$449.47
|
| Rate for Payer: Priority Health Narrow Network |
$708.43
|
| Rate for Payer: Railroad Medicare Medicare |
$449.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$878.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$449.47
|
| Rate for Payer: UHC Exchange |
$878.07
|
| Rate for Payer: UHC Medicaid |
$286.27
|
| Rate for Payer: UHCCP DNSP |
$449.47
|
| Rate for Payer: UHCCP Medicaid |
$286.27
|
|
|
PR INDUCED ABORT 1/> VAG SUPPOS DLVR FETUS HYSTOT
|
Professional
|
Both
|
$1,884.00
|
|
|
Service Code
|
HCPCS 59857
|
| Min. Negotiated Rate |
$332.92 |
| Max. Negotiated Rate |
$1,413.00 |
| Rate for Payer: Aetna Commercial |
$702.36
|
| Rate for Payer: Aetna Medicare |
$524.15
|
| Rate for Payer: BCBS Complete |
$349.57
|
| Rate for Payer: BCBS MAPPO |
$524.15
|
| Rate for Payer: BCN Commercial |
$873.95
|
| Rate for Payer: BCN Medicare Advantage |
$524.15
|
| Rate for Payer: Cash Price |
$1,507.20
|
| Rate for Payer: Cash Price |
$1,507.20
|
| Rate for Payer: Cofinity Commercial |
$754.78
|
| Rate for Payer: Cofinity Commercial |
$702.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.15
|
| Rate for Payer: Healthscope Commercial |
$628.98
|
| Rate for Payer: Healthscope Whirlpool |
$628.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$550.36
|
| Rate for Payer: Meridian Medicaid |
$349.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$576.57
|
| Rate for Payer: Nomi Health Commercial |
$628.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,413.00
|
| Rate for Payer: PACE SWMI |
$524.15
|
| Rate for Payer: PHP Medicare Advantage |
$524.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$825.02
|
| Rate for Payer: Priority Health Medicare |
$524.15
|
| Rate for Payer: Priority Health Narrow Network |
$825.02
|
| Rate for Payer: Railroad Medicare Medicare |
$524.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,029.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$524.15
|
| Rate for Payer: UHC Exchange |
$1,029.28
|
| Rate for Payer: UHC Medicaid |
$332.92
|
| Rate for Payer: UHCCP DNSP |
$524.15
|
| Rate for Payer: UHCCP Medicaid |
$332.92
|
|
|
PR INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 59855
|
| Min. Negotiated Rate |
$246.02 |
| Max. Negotiated Rate |
$746.43 |
| Rate for Payer: Aetna Commercial |
$515.82
|
| Rate for Payer: Aetna Medicare |
$384.94
|
| Rate for Payer: BCBS Complete |
$258.32
|
| Rate for Payer: BCBS MAPPO |
$384.94
|
| Rate for Payer: BCN Commercial |
$640.91
|
| Rate for Payer: BCN Medicare Advantage |
$384.94
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$554.31
|
| Rate for Payer: Cofinity Commercial |
$515.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.94
|
| Rate for Payer: Healthscope Commercial |
$461.93
|
| Rate for Payer: Healthscope Whirlpool |
$461.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$404.19
|
| Rate for Payer: Meridian Medicaid |
$258.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$423.43
|
| Rate for Payer: Nomi Health Commercial |
$461.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE SWMI |
$384.94
|
| Rate for Payer: PHP Medicare Advantage |
$384.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$605.01
|
| Rate for Payer: Priority Health Medicare |
$384.94
|
| Rate for Payer: Priority Health Narrow Network |
$605.01
|
| Rate for Payer: Railroad Medicare Medicare |
$384.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$746.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$384.94
|
| Rate for Payer: UHC Exchange |
$746.43
|
| Rate for Payer: UHC Medicaid |
$246.02
|
| Rate for Payer: UHCCP DNSP |
$384.94
|
| Rate for Payer: UHCCP Medicaid |
$246.02
|
|
|
PR INDUCED ABORTION DILATION AND CURETTAGE
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 59840
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$622.50 |
| Rate for Payer: Aetna Commercial |
$266.81
|
| Rate for Payer: Aetna Medicare |
$199.11
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS MAPPO |
$199.11
|
| Rate for Payer: BCN Commercial |
$333.65
|
| Rate for Payer: BCN Medicare Advantage |
$199.11
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$286.72
|
| Rate for Payer: Cofinity Commercial |
$266.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.11
|
| Rate for Payer: Healthscope Commercial |
$238.93
|
| Rate for Payer: Healthscope Whirlpool |
$238.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.07
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.02
|
| Rate for Payer: Nomi Health Commercial |
$238.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PACE SWMI |
$199.11
|
| Rate for Payer: PHP Medicare Advantage |
$199.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$314.96
|
| Rate for Payer: Priority Health Medicare |
$199.11
|
| Rate for Payer: Priority Health Narrow Network |
$314.96
|
| Rate for Payer: Railroad Medicare Medicare |
$199.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$380.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.11
|
| Rate for Payer: UHC Exchange |
$380.76
|
| Rate for Payer: UHC Medicaid |
$128.44
|
| Rate for Payer: UHCCP DNSP |
$199.11
|
| Rate for Payer: UHCCP Medicaid |
$128.44
|
|
|
PR INDUCED ABORTION DILATION & EVACUATION
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 59841
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$654.00 |
| Rate for Payer: Aetna Commercial |
$449.96
|
| Rate for Payer: Aetna Medicare |
$335.79
|
| Rate for Payer: BCBS Complete |
$225.21
|
| Rate for Payer: BCBS MAPPO |
$335.79
|
| Rate for Payer: BCN Commercial |
$562.72
|
| Rate for Payer: BCN Medicare Advantage |
$335.79
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$483.54
|
| Rate for Payer: Cofinity Commercial |
$449.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.79
|
| Rate for Payer: Healthscope Commercial |
$402.95
|
| Rate for Payer: Healthscope Whirlpool |
$402.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.58
|
| Rate for Payer: Meridian Medicaid |
$225.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$369.37
|
| Rate for Payer: Nomi Health Commercial |
$402.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.00
|
| Rate for Payer: PACE SWMI |
$335.79
|
| Rate for Payer: PHP Medicare Advantage |
$335.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$531.21
|
| Rate for Payer: Priority Health Medicare |
$335.79
|
| Rate for Payer: Priority Health Narrow Network |
$531.21
|
| Rate for Payer: Railroad Medicare Medicare |
$335.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$652.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$335.79
|
| Rate for Payer: UHC Exchange |
$652.05
|
| Rate for Payer: UHC Medicaid |
$214.49
|
| Rate for Payer: UHCCP DNSP |
$335.79
|
| Rate for Payer: UHCCP Medicaid |
$214.49
|
|
|
PR INDWELLING CATHETER SPECIAL
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS A4340
|
| Min. Negotiated Rate |
$12.54 |
| Max. Negotiated Rate |
$55.38 |
| Rate for Payer: Aetna Commercial |
$51.54
|
| Rate for Payer: Aetna Medicare |
$38.46
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCN Commercial |
$36.82
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$55.38
|
| Rate for Payer: Cofinity Commercial |
$51.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$46.15
|
| Rate for Payer: Healthscope Whirlpool |
$46.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.31
|
| Rate for Payer: Nomi Health Commercial |
$46.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.46
|
| Rate for Payer: UHC Exchange |
$12.54
|
| Rate for Payer: UHCCP DNSP |
$38.46
|
|
|
PR INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI
|
Professional
|
Both
|
$11,294.00
|
|
|
Service Code
|
HCPCS 61591
|
| Min. Negotiated Rate |
$1,772.37 |
| Max. Negotiated Rate |
$8,470.50 |
| Rate for Payer: Aetna Commercial |
$3,687.49
|
| Rate for Payer: Aetna Medicare |
$2,751.86
|
| Rate for Payer: BCBS Complete |
$1,860.99
|
| Rate for Payer: BCBS MAPPO |
$2,751.86
|
| Rate for Payer: BCN Commercial |
$4,617.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,751.86
|
| Rate for Payer: Cash Price |
$9,035.20
|
| Rate for Payer: Cash Price |
$9,035.20
|
| Rate for Payer: Cofinity Commercial |
$3,962.68
|
| Rate for Payer: Cofinity Commercial |
$3,687.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,751.86
|
| Rate for Payer: Healthscope Commercial |
$3,302.23
|
| Rate for Payer: Healthscope Whirlpool |
$3,302.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,889.45
|
| Rate for Payer: Meridian Medicaid |
$1,860.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,027.05
|
| Rate for Payer: Nomi Health Commercial |
$3,302.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,470.50
|
| Rate for Payer: PACE SWMI |
$2,751.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,751.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,772.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,363.46
|
| Rate for Payer: Priority Health Medicare |
$2,751.86
|
| Rate for Payer: Priority Health Narrow Network |
$5,363.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,751.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,395.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,751.86
|
| Rate for Payer: UHC Exchange |
$5,395.55
|
| Rate for Payer: UHC Medicaid |
$1,772.37
|
| Rate for Payer: UHCCP DNSP |
$2,751.86
|
| Rate for Payer: UHCCP Medicaid |
$1,772.37
|
|
|
PR INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN
|
Professional
|
Both
|
$6,769.00
|
|
|
Service Code
|
HCPCS 61590
|
| Min. Negotiated Rate |
$1,699.95 |
| Max. Negotiated Rate |
$5,335.01 |
| Rate for Payer: Aetna Commercial |
$3,528.53
|
| Rate for Payer: Aetna Medicare |
$2,633.23
|
| Rate for Payer: BCBS Complete |
$1,784.95
|
| Rate for Payer: BCBS MAPPO |
$2,633.23
|
| Rate for Payer: BCN Commercial |
$4,504.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,633.23
|
| Rate for Payer: Cash Price |
$5,415.20
|
| Rate for Payer: Cash Price |
$5,415.20
|
| Rate for Payer: Cofinity Commercial |
$3,791.85
|
| Rate for Payer: Cofinity Commercial |
$3,528.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,633.23
|
| Rate for Payer: Healthscope Commercial |
$3,159.88
|
| Rate for Payer: Healthscope Whirlpool |
$3,159.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,764.89
|
| Rate for Payer: Meridian Medicaid |
$1,784.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,896.55
|
| Rate for Payer: Nomi Health Commercial |
$3,159.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,076.75
|
| Rate for Payer: PACE SWMI |
$2,633.23
|
| Rate for Payer: PHP Medicare Advantage |
$2,633.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,699.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,231.59
|
| Rate for Payer: Priority Health Medicare |
$2,633.23
|
| Rate for Payer: Priority Health Narrow Network |
$5,231.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,633.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,335.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,633.23
|
| Rate for Payer: UHC Exchange |
$5,335.01
|
| Rate for Payer: UHC Medicaid |
$1,699.95
|
| Rate for Payer: UHCCP DNSP |
$2,633.23
|
| Rate for Payer: UHCCP Medicaid |
$1,699.95
|
|
|
PR INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 95079
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: Aetna Medicare |
$56.82
|
| Rate for Payer: BCBS Complete |
$38.47
|
| Rate for Payer: BCBS MAPPO |
$56.82
|
| Rate for Payer: BCN Commercial |
$100.60
|
| Rate for Payer: BCN Medicare Advantage |
$56.82
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$81.82
|
| Rate for Payer: Cofinity Commercial |
$76.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.82
|
| Rate for Payer: Healthscope Commercial |
$68.18
|
| Rate for Payer: Healthscope Whirlpool |
$68.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.66
|
| Rate for Payer: Meridian Medicaid |
$38.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.50
|
| Rate for Payer: Nomi Health Commercial |
$68.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.25
|
| Rate for Payer: PACE SWMI |
$56.82
|
| Rate for Payer: PHP Medicare Advantage |
$56.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.68
|
| Rate for Payer: Priority Health Medicare |
$56.82
|
| Rate for Payer: Priority Health Narrow Network |
$94.68
|
| Rate for Payer: Railroad Medicare Medicare |
$56.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.82
|
| Rate for Payer: UHC Exchange |
$111.27
|
| Rate for Payer: UHC Medicaid |
$36.64
|
| Rate for Payer: UHCCP DNSP |
$56.82
|
| Rate for Payer: UHCCP Medicaid |
$36.64
|
|
|
PR INGESTION CHALLENGE TEST INITIAL 120 MINUTES
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 95076
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$82.84
|
| Rate for Payer: Aetna Medicare |
$61.82
|
| Rate for Payer: BCBS Complete |
$41.82
|
| Rate for Payer: BCBS MAPPO |
$61.82
|
| Rate for Payer: BCN Commercial |
$109.06
|
| Rate for Payer: BCN Medicare Advantage |
$61.82
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cofinity Commercial |
$89.02
|
| Rate for Payer: Cofinity Commercial |
$82.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.82
|
| Rate for Payer: Healthscope Commercial |
$74.18
|
| Rate for Payer: Healthscope Whirlpool |
$74.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.91
|
| Rate for Payer: Meridian Medicaid |
$41.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.00
|
| Rate for Payer: Nomi Health Commercial |
$74.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: PACE SWMI |
$61.82
|
| Rate for Payer: PHP Medicare Advantage |
$61.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$102.65
|
| Rate for Payer: Priority Health Medicare |
$61.82
|
| Rate for Payer: Priority Health Narrow Network |
$102.65
|
| Rate for Payer: Railroad Medicare Medicare |
$61.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$120.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.82
|
| Rate for Payer: UHC Exchange |
$120.94
|
| Rate for Payer: UHC Medicaid |
$39.83
|
| Rate for Payer: UHCCP DNSP |
$61.82
|
| Rate for Payer: UHCCP Medicaid |
$39.83
|
|
|
PR INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX
|
Professional
|
Both
|
$2,708.00
|
|
|
Service Code
|
HCPCS 38760
|
| Min. Negotiated Rate |
$497.78 |
| Max. Negotiated Rate |
$2,031.00 |
| Rate for Payer: Aetna Commercial |
$1,035.02
|
| Rate for Payer: Aetna Medicare |
$772.40
|
| Rate for Payer: BCBS Complete |
$522.67
|
| Rate for Payer: BCBS MAPPO |
$772.40
|
| Rate for Payer: BCN Commercial |
$1,260.39
|
| Rate for Payer: BCN Medicare Advantage |
$772.40
|
| Rate for Payer: Cash Price |
$2,166.40
|
| Rate for Payer: Cash Price |
$2,166.40
|
| Rate for Payer: Cofinity Commercial |
$1,112.26
|
| Rate for Payer: Cofinity Commercial |
$1,035.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.40
|
| Rate for Payer: Healthscope Commercial |
$926.88
|
| Rate for Payer: Healthscope Whirlpool |
$926.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.02
|
| Rate for Payer: Meridian Medicaid |
$522.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$849.64
|
| Rate for Payer: Nomi Health Commercial |
$926.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,031.00
|
| Rate for Payer: PACE SWMI |
$772.40
|
| Rate for Payer: PHP Medicare Advantage |
$772.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,677.05
|
| Rate for Payer: Priority Health Medicare |
$772.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,677.05
|
| Rate for Payer: Railroad Medicare Medicare |
$772.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,483.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$772.40
|
| Rate for Payer: UHC Exchange |
$1,483.23
|
| Rate for Payer: UHC Medicaid |
$497.78
|
| Rate for Payer: UHCCP DNSP |
$772.40
|
| Rate for Payer: UHCCP Medicaid |
$497.78
|
|
|
PR INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC
|
Professional
|
Both
|
$2,788.00
|
|
|
Service Code
|
HCPCS 38765
|
| Min. Negotiated Rate |
$781.50 |
| Max. Negotiated Rate |
$2,620.59 |
| Rate for Payer: Aetna Commercial |
$1,629.15
|
| Rate for Payer: Aetna Medicare |
$1,215.78
|
| Rate for Payer: BCBS Complete |
$820.58
|
| Rate for Payer: BCBS MAPPO |
$1,215.78
|
| Rate for Payer: BCN Commercial |
$1,969.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,215.78
|
| Rate for Payer: Cash Price |
$2,230.40
|
| Rate for Payer: Cash Price |
$2,230.40
|
| Rate for Payer: Cofinity Commercial |
$1,750.72
|
| Rate for Payer: Cofinity Commercial |
$1,629.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,215.78
|
| Rate for Payer: Healthscope Commercial |
$1,458.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,458.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,276.57
|
| Rate for Payer: Meridian Medicaid |
$820.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,337.36
|
| Rate for Payer: Nomi Health Commercial |
$1,458.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,091.00
|
| Rate for Payer: PACE SWMI |
$1,215.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,215.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,620.59
|
| Rate for Payer: Priority Health Medicare |
$1,215.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,620.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,215.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,307.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,215.78
|
| Rate for Payer: UHC Exchange |
$2,307.64
|
| Rate for Payer: UHC Medicaid |
$781.50
|
| Rate for Payer: UHCCP DNSP |
$1,215.78
|
| Rate for Payer: UHCCP Medicaid |
$781.50
|
|
|
PR INHLJ BRNCL CHALLENGE TSTG W/HISTAMINE/METHACHOL
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 95070
|
| Min. Negotiated Rate |
$36.51 |
| Max. Negotiated Rate |
$192.00 |
| Rate for Payer: Aetna Commercial |
$48.92
|
| Rate for Payer: Aetna Medicare |
$36.51
|
| Rate for Payer: BCBS MAPPO |
$36.51
|
| Rate for Payer: BCN Commercial |
$52.79
|
| Rate for Payer: BCN Medicare Advantage |
$36.51
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$48.92
|
| Rate for Payer: Cofinity Commercial |
$52.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.51
|
| Rate for Payer: Healthscope Commercial |
$43.81
|
| Rate for Payer: Healthscope Whirlpool |
$43.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.16
|
| Rate for Payer: Nomi Health Commercial |
$43.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE SWMI |
$36.51
|
| Rate for Payer: PHP Medicare Advantage |
$36.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.69
|
| Rate for Payer: Priority Health Medicare |
$36.51
|
| Rate for Payer: Priority Health Narrow Network |
$49.69
|
| Rate for Payer: Railroad Medicare Medicare |
$36.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.51
|
| Rate for Payer: UHC Exchange |
$49.54
|
| Rate for Payer: UHCCP DNSP |
$36.51
|
|
|
PR INITIAL FOOT EXAM PT LOPS
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS G0245
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: Aetna Commercial |
$46.23
|
| Rate for Payer: Aetna Medicare |
$34.50
|
| Rate for Payer: BCBS Complete |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$34.50
|
| Rate for Payer: BCN Commercial |
$58.26
|
| Rate for Payer: BCN Medicare Advantage |
$34.50
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$49.68
|
| Rate for Payer: Cofinity Commercial |
$46.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.50
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Healthscope Whirlpool |
$41.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.95
|
| Rate for Payer: Nomi Health Commercial |
$41.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.75
|
| Rate for Payer: PACE SWMI |
$34.50
|
| Rate for Payer: PHP Medicare Advantage |
$34.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$44.36
|
| Rate for Payer: Priority Health Medicare |
$34.50
|
| Rate for Payer: Priority Health Narrow Network |
$44.36
|
| Rate for Payer: Railroad Medicare Medicare |
$34.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.50
|
| Rate for Payer: UHC Exchange |
$60.79
|
| Rate for Payer: UHCCP DNSP |
$34.50
|
|
|
PR INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL
|
Professional
|
Both
|
$1,097.00
|
|
|
Service Code
|
HCPCS 99477
|
| Min. Negotiated Rate |
$293.02 |
| Max. Negotiated Rate |
$822.75 |
| Rate for Payer: Aetna Commercial |
$392.65
|
| Rate for Payer: Aetna Medicare |
$293.02
|
| Rate for Payer: BCBS Complete |
$307.67
|
| Rate for Payer: BCBS MAPPO |
$293.02
|
| Rate for Payer: BCN Commercial |
$498.48
|
| Rate for Payer: BCN Medicare Advantage |
$293.02
|
| Rate for Payer: Cash Price |
$877.60
|
| Rate for Payer: Cash Price |
$877.60
|
| Rate for Payer: Cofinity Commercial |
$421.95
|
| Rate for Payer: Cofinity Commercial |
$392.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.02
|
| Rate for Payer: Healthscope Commercial |
$322.32
|
| Rate for Payer: Healthscope Whirlpool |
$322.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.67
|
| Rate for Payer: Meridian Medicaid |
$307.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$322.32
|
| Rate for Payer: Nomi Health Commercial |
$351.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$822.75
|
| Rate for Payer: PACE SWMI |
$293.02
|
| Rate for Payer: PHP Medicare Advantage |
$293.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$448.38
|
| Rate for Payer: Priority Health Medicare |
$293.02
|
| Rate for Payer: Priority Health Narrow Network |
$448.38
|
| Rate for Payer: Railroad Medicare Medicare |
$293.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$495.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$293.02
|
| Rate for Payer: UHC Exchange |
$495.28
|
| Rate for Payer: UHC Medicaid |
$293.02
|
| Rate for Payer: UHCCP DNSP |
$293.02
|
| Rate for Payer: UHCCP Medicaid |
$293.02
|
|
|
PR INITIAL INPATIENT CONSULT NEW/ESTAB PT 20 MIN
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 99251
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.50
|
|
|
PR INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 99306
|
| Min. Negotiated Rate |
$143.73 |
| Max. Negotiated Rate |
$269.91 |
| Rate for Payer: Aetna Commercial |
$215.67
|
| Rate for Payer: Aetna Medicare |
$160.95
|
| Rate for Payer: BCBS Complete |
$150.92
|
| Rate for Payer: BCBS MAPPO |
$160.95
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: BCN Medicare Advantage |
$160.95
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$215.67
|
| Rate for Payer: Cofinity Commercial |
$231.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.95
|
| Rate for Payer: Healthscope Commercial |
$177.04
|
| Rate for Payer: Healthscope Whirlpool |
$177.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.00
|
| Rate for Payer: Meridian Medicaid |
$150.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$177.04
|
| Rate for Payer: Nomi Health Commercial |
$193.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
| Rate for Payer: PACE SWMI |
$160.95
|
| Rate for Payer: PHP Medicare Advantage |
$160.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$242.78
|
| Rate for Payer: Priority Health Medicare |
$160.95
|
| Rate for Payer: Priority Health Narrow Network |
$242.78
|
| Rate for Payer: Railroad Medicare Medicare |
$160.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$235.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$160.95
|
| Rate for Payer: UHC Exchange |
$235.01
|
| Rate for Payer: UHC Medicaid |
$143.73
|
| Rate for Payer: UHCCP DNSP |
$160.95
|
| Rate for Payer: UHCCP Medicaid |
$143.73
|
|
