|
PR I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 42700
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$492.38 |
| Rate for Payer: Aetna Commercial |
$176.88
|
| Rate for Payer: Aetna Medicare |
$154.00
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS Trust/PPO |
$492.38
|
| Rate for Payer: BCN Commercial |
$284.90
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.79
|
| Rate for Payer: Priority Health Narrow Network |
$245.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.50
|
| Rate for Payer: UHC Exchange |
$163.50
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 42720
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$692.06 |
| Rate for Payer: Aetna Commercial |
$511.86
|
| Rate for Payer: Aetna Medicare |
$413.50
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: BCN Commercial |
$657.27
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$692.06
|
| Rate for Payer: Priority Health Narrow Network |
$692.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$485.34
|
| Rate for Payer: UHC Exchange |
$485.34
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 42725
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$1,436.59 |
| Rate for Payer: Aetna Commercial |
$1,060.45
|
| Rate for Payer: Aetna Medicare |
$739.00
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.83
|
| Rate for Payer: BCN Commercial |
$1,165.98
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$960.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,436.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,436.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$991.76
|
| Rate for Payer: UHC Exchange |
$991.76
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
|
|
PR I&D BELOW FASCIA FOOT 1 BURSAL SPACE
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 28002
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$564.20 |
| Rate for Payer: Aetna Commercial |
$419.78
|
| Rate for Payer: Aetna Medicare |
$434.00
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$359.18
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.21
|
| Rate for Payer: Priority Health Narrow Network |
$213.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$445.07
|
| Rate for Payer: UHC Exchange |
$445.07
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
|
|
PR I&D BELOW FASCIA FOOT MULTIPLE AREAS
|
Professional
|
Both
|
$1,243.00
|
|
|
Service Code
|
HCPCS 28003
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$3,691.76 |
| Rate for Payer: Aetna Commercial |
$745.46
|
| Rate for Payer: Aetna Medicare |
$621.50
|
| Rate for Payer: BCBS Complete |
$172.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,691.76
|
| Rate for Payer: BCN Commercial |
$554.65
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Meridian Medicaid |
$172.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.34
|
| Rate for Payer: Priority Health Narrow Network |
$392.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$645.13
|
| Rate for Payer: UHC Exchange |
$645.13
|
| Rate for Payer: UHCCP Medicaid |
$164.22
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
|
OP
|
$1,665.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$1,082.25 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,498.50
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$1,615.05
|
| Rate for Payer: ASR Commercial |
$1,615.05
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.47
|
| Rate for Payer: BCN Commercial |
$1,290.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,565.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,665.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,615.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,498.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: Nomi Health Commercial |
$1,365.30
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,055.76
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,444.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,465.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$332.71 |
| Max. Negotiated Rate |
$3,899.38 |
| Rate for Payer: Aetna Commercial |
$675.38
|
| Rate for Payer: Aetna Medicare |
$832.50
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.38
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.22
|
| Rate for Payer: Priority Health Narrow Network |
$788.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.19
|
| Rate for Payer: UHC Exchange |
$567.19
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 27301
|
| Min. Negotiated Rate |
$332.71 |
| Max. Negotiated Rate |
$3,899.38 |
| Rate for Payer: Aetna Commercial |
$675.38
|
| Rate for Payer: Aetna Medicare |
$832.50
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.38
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.22
|
| Rate for Payer: Priority Health Narrow Network |
$788.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.19
|
| Rate for Payer: UHC Exchange |
$567.19
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
|
IP
|
$1,665.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$1,082.25 |
| Max. Negotiated Rate |
$1,665.00 |
| Rate for Payer: Aetna Commercial |
$1,498.50
|
| Rate for Payer: ASR ASR |
$1,615.05
|
| Rate for Payer: ASR Commercial |
$1,615.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,356.81
|
| Rate for Payer: BCN Commercial |
$1,290.87
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,565.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Healthscope Commercial |
$1,665.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,615.05
|
| Rate for Payer: Mclaren Commercial |
$1,498.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: Nomi Health Commercial |
$1,365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,465.20
|
|
|
PR I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR
|
Professional
|
Both
|
$2,460.00
|
|
|
Service Code
|
HCPCS 22010
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,599.00 |
| Rate for Payer: Aetna Commercial |
$1,291.27
|
| Rate for Payer: Aetna Medicare |
$1,230.00
|
| Rate for Payer: BCBS Complete |
$667.60
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$1,424.01
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Meridian Medicaid |
$667.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$635.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,599.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,503.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,503.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,069.60
|
| Rate for Payer: UHC Exchange |
$1,069.60
|
| Rate for Payer: UHCCP Medicaid |
$635.81
|
|
|
PR I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC
|
Professional
|
Both
|
$1,725.00
|
|
|
Service Code
|
HCPCS 22015
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,467.05 |
| Rate for Payer: Aetna Commercial |
$1,265.29
|
| Rate for Payer: Aetna Medicare |
$862.50
|
| Rate for Payer: BCBS Complete |
$650.37
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$1,399.57
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Meridian Medicaid |
$650.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,121.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,467.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,057.49
|
| Rate for Payer: UHC Exchange |
$1,057.49
|
| Rate for Payer: UHCCP Medicaid |
$619.40
|
|
|
PR I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$1,168.00
|
|
|
Service Code
|
HCPCS 21501
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$759.20 |
| Rate for Payer: Aetna Commercial |
$434.09
|
| Rate for Payer: Aetna Medicare |
$584.00
|
| Rate for Payer: BCBS Complete |
$231.70
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$718.85
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Meridian Medicaid |
$231.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.59
|
| Rate for Payer: Priority Health Narrow Network |
$521.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.21
|
| Rate for Payer: UHC Exchange |
$364.21
|
| Rate for Payer: UHCCP Medicaid |
$220.67
|
|
|
PR I&D DP ABSC/HMTMA SFT TIS NCK/THRX PRTL RIB OSTC
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 21502
|
| Min. Negotiated Rate |
$328.23 |
| Max. Negotiated Rate |
$779.06 |
| Rate for Payer: Aetna Commercial |
$681.32
|
| Rate for Payer: Aetna Medicare |
$478.50
|
| Rate for Payer: BCBS Complete |
$344.64
|
| Rate for Payer: BCBS Trust/PPO |
$483.43
|
| Rate for Payer: BCN Commercial |
$742.79
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Meridian Medicaid |
$344.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$779.06
|
| Rate for Payer: Priority Health Narrow Network |
$779.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$610.68
|
| Rate for Payer: UHC Exchange |
$610.68
|
| Rate for Payer: UHCCP Medicaid |
$328.23
|
|
|
PR I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC
|
Professional
|
Both
|
$1,637.00
|
|
|
Service Code
|
HCPCS 45020
|
| Min. Negotiated Rate |
$371.26 |
| Max. Negotiated Rate |
$1,064.05 |
| Rate for Payer: Aetna Commercial |
$768.90
|
| Rate for Payer: Aetna Medicare |
$818.50
|
| Rate for Payer: BCBS Complete |
$389.82
|
| Rate for Payer: BCBS Trust/PPO |
$489.21
|
| Rate for Payer: BCN Commercial |
$841.99
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Meridian Medicaid |
$389.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,064.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$663.23
|
| Rate for Payer: UHC Exchange |
$663.23
|
| Rate for Payer: UHCCP Medicaid |
$371.26
|
|
|
PR I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 54700
|
| Min. Negotiated Rate |
$138.02 |
| Max. Negotiated Rate |
$2,037.12 |
| Rate for Payer: Aetna Commercial |
$273.26
|
| Rate for Payer: Aetna Medicare |
$202.50
|
| Rate for Payer: BCBS Complete |
$144.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,037.12
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Meridian Medicaid |
$144.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.39
|
| Rate for Payer: Priority Health Narrow Network |
$341.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.87
|
| Rate for Payer: UHC Exchange |
$253.87
|
| Rate for Payer: UHCCP Medicaid |
$138.02
|
|
|
PR I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$931.00
|
|
|
Service Code
|
HCPCS 25028
|
| Min. Negotiated Rate |
$209.74 |
| Max. Negotiated Rate |
$1,068.61 |
| Rate for Payer: Aetna Commercial |
$870.43
|
| Rate for Payer: Aetna Medicare |
$465.50
|
| Rate for Payer: BCBS Complete |
$464.74
|
| Rate for Payer: BCBS Trust/PPO |
$209.74
|
| Rate for Payer: BCN Commercial |
$1,026.22
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Meridian Medicaid |
$464.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$573.73
|
| Rate for Payer: UHC Exchange |
$573.73
|
| Rate for Payer: UHCCP Medicaid |
$442.61
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$199.08 |
| Rate for Payer: Aetna Commercial |
$126.93
|
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.20
|
| Rate for Payer: Priority Health Narrow Network |
$161.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.57
|
| Rate for Payer: UHC Exchange |
$122.57
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$242.10
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$260.93
|
| Rate for Payer: ASR Commercial |
$260.93
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$220.28
|
| Rate for Payer: BCN Commercial |
$208.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$252.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$269.00
|
| Rate for Payer: Healthscope Whirlpool |
$260.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$242.10
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.65
|
| Rate for Payer: Nomi Health Commercial |
$220.58
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.74
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,574.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$269.00 |
| Rate for Payer: Aetna Commercial |
$242.10
|
| Rate for Payer: ASR ASR |
$260.93
|
| Rate for Payer: ASR Commercial |
$260.93
|
| Rate for Payer: BCBS Trust/PPO |
$219.21
|
| Rate for Payer: BCN Commercial |
$208.56
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$252.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Healthscope Commercial |
$269.00
|
| Rate for Payer: Healthscope Whirlpool |
$260.93
|
| Rate for Payer: Mclaren Commercial |
$242.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.65
|
| Rate for Payer: Nomi Health Commercial |
$220.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.72
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$199.08 |
| Rate for Payer: Aetna Commercial |
$126.93
|
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.20
|
| Rate for Payer: Priority Health Narrow Network |
$161.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.57
|
| Rate for Payer: UHC Exchange |
$122.57
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 46045
|
| Min. Negotiated Rate |
$285.42 |
| Max. Negotiated Rate |
$2,294.94 |
| Rate for Payer: Aetna Commercial |
$588.31
|
| Rate for Payer: Aetna Medicare |
$368.00
|
| Rate for Payer: BCBS Complete |
$299.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.94
|
| Rate for Payer: BCN Commercial |
$644.08
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Meridian Medicaid |
$299.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$794.07
|
| Rate for Payer: Priority Health Narrow Network |
$794.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$493.50
|
| Rate for Payer: UHC Exchange |
$493.50
|
| Rate for Payer: UHCCP Medicaid |
$285.42
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$478.40 |
| Max. Negotiated Rate |
$4,164.76 |
| Rate for Payer: Aetna Commercial |
$662.40
|
| Rate for Payer: Aetna Medicare |
$2,686.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: ASR ASR |
$713.92
|
| Rate for Payer: ASR Commercial |
$713.92
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$602.71
|
| Rate for Payer: BCN Commercial |
$570.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$691.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$736.00
|
| Rate for Payer: Healthscope Whirlpool |
$713.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,686.94
|
| Rate for Payer: Mclaren Commercial |
$662.40
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.60
|
| Rate for Payer: Nomi Health Commercial |
$603.52
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$2,955.63
|
| Rate for Payer: PHP Medicaid |
$1,440.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$644.88
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$515.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$4,164.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP DNSP |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$478.40 |
| Max. Negotiated Rate |
$736.00 |
| Rate for Payer: Aetna Commercial |
$662.40
|
| Rate for Payer: ASR ASR |
$713.92
|
| Rate for Payer: ASR Commercial |
$713.92
|
| Rate for Payer: BCBS Trust/PPO |
$599.77
|
| Rate for Payer: BCN Commercial |
$570.62
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$691.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Healthscope Commercial |
$736.00
|
| Rate for Payer: Healthscope Whirlpool |
$713.92
|
| Rate for Payer: Mclaren Commercial |
$662.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.60
|
| Rate for Payer: Nomi Health Commercial |
$603.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.68
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$285.42 |
| Max. Negotiated Rate |
$2,294.94 |
| Rate for Payer: Aetna Commercial |
$588.31
|
| Rate for Payer: Aetna Medicare |
$368.00
|
| Rate for Payer: BCBS Complete |
$299.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.94
|
| Rate for Payer: BCN Commercial |
$644.08
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Meridian Medicaid |
$299.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$794.07
|
| Rate for Payer: Priority Health Narrow Network |
$794.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$493.50
|
| Rate for Payer: UHC Exchange |
$493.50
|
| Rate for Payer: UHCCP Medicaid |
$285.42
|
|
|
PR I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$2,127.00
|
|
|
Service Code
|
HCPCS 46060
|
| Min. Negotiated Rate |
$316.73 |
| Max. Negotiated Rate |
$1,438.03 |
| Rate for Payer: Aetna Commercial |
$645.77
|
| Rate for Payer: Aetna Medicare |
$1,063.50
|
| Rate for Payer: BCBS Complete |
$332.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,438.03
|
| Rate for Payer: BCN Commercial |
$715.42
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Meridian Medicaid |
$332.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.18
|
| Rate for Payer: Priority Health Narrow Network |
$878.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$539.66
|
| Rate for Payer: UHC Exchange |
$539.66
|
| Rate for Payer: UHCCP Medicaid |
$316.73
|
|
