PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$736.00
|
|
Service Code
|
HCPCS 45338
|
Min. Negotiated Rate |
$75.83 |
Max. Negotiated Rate |
$515.20 |
Rate for Payer: Aetna Commercial |
$156.26
|
Rate for Payer: Aetna Medicare |
$116.61
|
Rate for Payer: BCBS Complete |
$79.62
|
Rate for Payer: BCBS MAPPO |
$116.61
|
Rate for Payer: BCBS Trust/PPO |
$76.08
|
Rate for Payer: BCN Commercial |
$439.81
|
Rate for Payer: BCN Medicare Advantage |
$116.61
|
Rate for Payer: Cash Price |
$588.80
|
Rate for Payer: Cash Price |
$588.80
|
Rate for Payer: Cofinity Commercial |
$167.92
|
Rate for Payer: Cofinity Commercial |
$156.26
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.61
|
Rate for Payer: Healthscope Commercial |
$139.93
|
Rate for Payer: Healthscope Whirlpool |
$139.93
|
Rate for Payer: Meridian Medicaid |
$79.62
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.44
|
Rate for Payer: PACE SWMI |
$116.61
|
Rate for Payer: PHP Medicare Advantage |
$116.61
|
Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.55
|
Rate for Payer: Priority Health Medicare |
$116.61
|
Rate for Payer: Priority Health Narrow Network |
$207.55
|
Rate for Payer: UHC Medicare Advantage |
$120.11
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
IP
|
$736.00
|
|
Service Code
|
CPT 45338
|
Hospital Charge Code |
45338
|
Min. Negotiated Rate |
$515.20 |
Max. Negotiated Rate |
$736.00 |
Rate for Payer: Aetna Commercial |
$662.40
|
Rate for Payer: ASR ASR |
$713.92
|
Rate for Payer: BCBS Trust/PPO |
$570.62
|
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 Multiplan/Beech St/PHCS |
$625.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.68
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
OP
|
$736.00
|
|
Service Code
|
CPT 45338
|
Hospital Charge Code |
45338
|
Min. Negotiated Rate |
$515.20 |
Max. Negotiated Rate |
$1,311.18 |
Rate for Payer: Aetna Commercial |
$662.40
|
Rate for Payer: Aetna Medicare |
$1,048.94
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
Rate for Payer: ASR ASR |
$713.92
|
Rate for Payer: BCBS Complete |
$602.51
|
Rate for Payer: BCBS MAPPO |
$1,048.94
|
Rate for Payer: BCBS Trust/PPO |
$570.62
|
Rate for Payer: BCN Commercial |
$570.62
|
Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
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 |
$1,048.94
|
Rate for Payer: Healthscope Commercial |
$736.00
|
Rate for Payer: Healthscope Whirlpool |
$713.92
|
Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
Rate for Payer: Mclaren Commercial |
$662.40
|
Rate for Payer: Mclaren Medicaid |
$573.77
|
Rate for Payer: Mclaren Medicare |
$1,048.94
|
Rate for Payer: Meridian Medicaid |
$602.51
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.60
|
Rate for Payer: PACE Medicare |
$996.49
|
Rate for Payer: PACE SWMI |
$1,048.94
|
Rate for Payer: PHP Commercial |
$1,153.83
|
Rate for Payer: PHP Medicaid |
$573.77
|
Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$669.76
|
Rate for Payer: Priority Health Medicare |
$1,048.94
|
Rate for Payer: Priority Health Narrow Network |
$522.56
|
Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.68
|
Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
Rate for Payer: VA VA |
$1,048.94
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$736.00
|
|
Service Code
|
HCPCS 45338
|
Hospital Charge Code |
45338
|
Min. Negotiated Rate |
$75.83 |
Max. Negotiated Rate |
$515.20 |
Rate for Payer: Aetna Commercial |
$156.26
|
Rate for Payer: Aetna Medicare |
$116.61
|
Rate for Payer: BCBS Complete |
$79.62
|
Rate for Payer: BCBS MAPPO |
$116.61
|
Rate for Payer: BCBS Trust/PPO |
$76.08
|
Rate for Payer: BCN Commercial |
$439.81
|
Rate for Payer: BCN Medicare Advantage |
$116.61
|
Rate for Payer: Cash Price |
$588.80
|
Rate for Payer: Cash Price |
$588.80
|
Rate for Payer: Cofinity Commercial |
$156.26
|
Rate for Payer: Cofinity Commercial |
$167.92
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.61
|
Rate for Payer: Healthscope Commercial |
$139.93
|
Rate for Payer: Healthscope Whirlpool |
$139.93
|
Rate for Payer: Meridian Medicaid |
$79.62
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.44
|
Rate for Payer: PACE SWMI |
$116.61
|
Rate for Payer: PHP Medicare Advantage |
$116.61
|
Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.55
|
Rate for Payer: Priority Health Medicare |
$116.61
|
Rate for Payer: Priority Health Narrow Network |
$207.55
|
Rate for Payer: UHC Medicare Advantage |
$120.11
|
|
PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE
|
Professional
|
Both
|
$594.00
|
|
Service Code
|
HCPCS 45337
|
Min. Negotiated Rate |
$71.99 |
Max. Negotiated Rate |
$415.80 |
Rate for Payer: Aetna Commercial |
$149.50
|
Rate for Payer: Aetna Medicare |
$111.57
|
Rate for Payer: BCBS Complete |
$75.59
|
Rate for Payer: BCBS MAPPO |
$111.57
|
Rate for Payer: BCBS Trust/PPO |
$349.73
|
Rate for Payer: BCN Commercial |
$164.20
|
Rate for Payer: BCN Medicare Advantage |
$111.57
|
Rate for Payer: Cash Price |
$475.20
|
Rate for Payer: Cash Price |
$475.20
|
Rate for Payer: Cofinity Commercial |
$149.50
|
Rate for Payer: Cofinity Commercial |
$160.66
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.57
|
Rate for Payer: Healthscope Commercial |
$133.88
|
Rate for Payer: Healthscope Whirlpool |
$133.88
|
Rate for Payer: Meridian Medicaid |
$75.59
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$117.15
|
Rate for Payer: PACE SWMI |
$111.57
|
Rate for Payer: PHP Medicare Advantage |
$111.57
|
Rate for Payer: Priority Health Choice Medicaid |
$71.99
|
Rate for Payer: Priority Health Cigna Priority Health |
$415.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.56
|
Rate for Payer: Priority Health Medicare |
$111.57
|
Rate for Payer: Priority Health Narrow Network |
$197.56
|
Rate for Payer: UHC Medicare Advantage |
$114.92
|
|
PR SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$358.00
|
|
Service Code
|
HCPCS 45349
|
Min. Negotiated Rate |
$124.39 |
Max. Negotiated Rate |
$380.90 |
Rate for Payer: Aetna Commercial |
$258.14
|
Rate for Payer: Aetna Medicare |
$192.64
|
Rate for Payer: BCBS Complete |
$130.61
|
Rate for Payer: BCBS MAPPO |
$192.64
|
Rate for Payer: BCBS Trust/PPO |
$380.90
|
Rate for Payer: BCN Commercial |
$284.41
|
Rate for Payer: BCN Medicare Advantage |
$192.64
|
Rate for Payer: Cash Price |
$286.40
|
Rate for Payer: Cash Price |
$286.40
|
Rate for Payer: Cofinity Commercial |
$258.14
|
Rate for Payer: Cofinity Commercial |
$277.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.64
|
Rate for Payer: Healthscope Commercial |
$231.17
|
Rate for Payer: Healthscope Whirlpool |
$231.17
|
Rate for Payer: Meridian Medicaid |
$130.61
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.27
|
Rate for Payer: PACE SWMI |
$192.64
|
Rate for Payer: PHP Medicare Advantage |
$192.64
|
Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$250.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$342.19
|
Rate for Payer: Priority Health Medicare |
$192.64
|
Rate for Payer: Priority Health Narrow Network |
$342.19
|
Rate for Payer: UHC Medicare Advantage |
$198.42
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<
|
Professional
|
Both
|
$184.00
|
|
Service Code
|
HCPCS 11310
|
Min. Negotiated Rate |
$28.76 |
Max. Negotiated Rate |
$137.83 |
Rate for Payer: Aetna Commercial |
$60.25
|
Rate for Payer: Aetna Medicare |
$44.96
|
Rate for Payer: BCBS Complete |
$30.20
|
Rate for Payer: BCBS MAPPO |
$44.96
|
Rate for Payer: BCBS Trust/PPO |
$28.95
|
Rate for Payer: BCN Commercial |
$137.83
|
Rate for Payer: BCN Medicare Advantage |
$44.96
|
Rate for Payer: Cash Price |
$147.20
|
Rate for Payer: Cash Price |
$147.20
|
Rate for Payer: Cofinity Commercial |
$64.74
|
Rate for Payer: Cofinity Commercial |
$60.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.96
|
Rate for Payer: Healthscope Commercial |
$53.95
|
Rate for Payer: Healthscope Whirlpool |
$53.95
|
Rate for Payer: Meridian Medicaid |
$30.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.21
|
Rate for Payer: PACE SWMI |
$44.96
|
Rate for Payer: PHP Medicare Advantage |
$44.96
|
Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.91
|
Rate for Payer: Priority Health Medicare |
$44.96
|
Rate for Payer: Priority Health Narrow Network |
$55.91
|
Rate for Payer: UHC Medicare Advantage |
$46.31
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$301.00
|
|
Service Code
|
HCPCS 11313
|
Min. Negotiated Rate |
$60.71 |
Max. Negotiated Rate |
$338.18 |
Rate for Payer: Aetna Commercial |
$125.28
|
Rate for Payer: Aetna Medicare |
$93.49
|
Rate for Payer: BCBS Complete |
$63.75
|
Rate for Payer: BCBS MAPPO |
$93.49
|
Rate for Payer: BCBS Trust/PPO |
$338.18
|
Rate for Payer: BCN Commercial |
$214.00
|
Rate for Payer: BCN Medicare Advantage |
$93.49
|
Rate for Payer: Cash Price |
$240.80
|
Rate for Payer: Cash Price |
$240.80
|
Rate for Payer: Cofinity Commercial |
$134.63
|
Rate for Payer: Cofinity Commercial |
$125.28
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.49
|
Rate for Payer: Healthscope Commercial |
$112.19
|
Rate for Payer: Healthscope Whirlpool |
$112.19
|
Rate for Payer: Meridian Medicaid |
$63.75
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.16
|
Rate for Payer: PACE SWMI |
$93.49
|
Rate for Payer: PHP Medicare Advantage |
$93.49
|
Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$210.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.32
|
Rate for Payer: Priority Health Medicare |
$93.49
|
Rate for Payer: Priority Health Narrow Network |
$116.32
|
Rate for Payer: UHC Medicare Advantage |
$96.29
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$158.00
|
|
Service Code
|
HCPCS 11305
|
Min. Negotiated Rate |
$23.64 |
Max. Negotiated Rate |
$450.00 |
Rate for Payer: Aetna Commercial |
$49.67
|
Rate for Payer: Aetna Medicare |
$37.07
|
Rate for Payer: BCBS Complete |
$24.82
|
Rate for Payer: BCBS MAPPO |
$37.07
|
Rate for Payer: BCBS Trust/PPO |
$450.00
|
Rate for Payer: BCN Commercial |
$124.87
|
Rate for Payer: BCN Medicare Advantage |
$37.07
|
Rate for Payer: Cash Price |
$126.40
|
Rate for Payer: Cash Price |
$126.40
|
Rate for Payer: Cofinity Commercial |
$53.38
|
Rate for Payer: Cofinity Commercial |
$49.67
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.07
|
Rate for Payer: Healthscope Commercial |
$44.48
|
Rate for Payer: Healthscope Whirlpool |
$44.48
|
Rate for Payer: Meridian Medicaid |
$24.82
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.92
|
Rate for Payer: PACE SWMI |
$37.07
|
Rate for Payer: PHP Medicare Advantage |
$37.07
|
Rate for Payer: Priority Health Choice Medicaid |
$23.64
|
Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.62
|
Rate for Payer: Priority Health Medicare |
$37.07
|
Rate for Payer: Priority Health Narrow Network |
$45.62
|
Rate for Payer: UHC Medicare Advantage |
$38.18
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$196.00
|
|
Service Code
|
HCPCS 11306
|
Min. Negotiated Rate |
$28.95 |
Max. Negotiated Rate |
$145.29 |
Rate for Payer: Aetna Commercial |
$65.03
|
Rate for Payer: Aetna Medicare |
$48.53
|
Rate for Payer: BCBS Complete |
$32.43
|
Rate for Payer: BCBS MAPPO |
$48.53
|
Rate for Payer: BCBS Trust/PPO |
$28.95
|
Rate for Payer: BCN Commercial |
$145.29
|
Rate for Payer: BCN Medicare Advantage |
$48.53
|
Rate for Payer: Cash Price |
$156.80
|
Rate for Payer: Cash Price |
$156.80
|
Rate for Payer: Cofinity Commercial |
$69.88
|
Rate for Payer: Cofinity Commercial |
$65.03
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.53
|
Rate for Payer: Healthscope Commercial |
$58.24
|
Rate for Payer: Healthscope Whirlpool |
$58.24
|
Rate for Payer: Meridian Medicaid |
$32.43
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.96
|
Rate for Payer: PACE SWMI |
$48.53
|
Rate for Payer: PHP Medicare Advantage |
$48.53
|
Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
Rate for Payer: Priority Health Cigna Priority Health |
$137.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.02
|
Rate for Payer: Priority Health Medicare |
$48.53
|
Rate for Payer: Priority Health Narrow Network |
$60.02
|
Rate for Payer: UHC Medicare Advantage |
$49.99
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$232.00
|
|
Service Code
|
HCPCS 11307
|
Min. Negotiated Rate |
$39.41 |
Max. Negotiated Rate |
$2,827.44 |
Rate for Payer: Aetna Commercial |
$82.69
|
Rate for Payer: Aetna Medicare |
$61.71
|
Rate for Payer: BCBS Complete |
$41.38
|
Rate for Payer: BCBS MAPPO |
$61.71
|
Rate for Payer: BCBS Trust/PPO |
$2,827.44
|
Rate for Payer: BCN Commercial |
$164.53
|
Rate for Payer: BCN Medicare Advantage |
$61.71
|
Rate for Payer: Cash Price |
$185.60
|
Rate for Payer: Cash Price |
$185.60
|
Rate for Payer: Cofinity Commercial |
$82.69
|
Rate for Payer: Cofinity Commercial |
$88.86
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.71
|
Rate for Payer: Healthscope Commercial |
$74.05
|
Rate for Payer: Healthscope Whirlpool |
$74.05
|
Rate for Payer: Meridian Medicaid |
$41.38
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.80
|
Rate for Payer: PACE SWMI |
$61.71
|
Rate for Payer: PHP Medicare Advantage |
$61.71
|
Rate for Payer: Priority Health Choice Medicaid |
$39.41
|
Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.45
|
Rate for Payer: Priority Health Medicare |
$61.71
|
Rate for Payer: Priority Health Narrow Network |
$76.45
|
Rate for Payer: UHC Medicare Advantage |
$63.56
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$246.00
|
|
Service Code
|
HCPCS 11308
|
Min. Negotiated Rate |
$44.09 |
Max. Negotiated Rate |
$338.18 |
Rate for Payer: Aetna Commercial |
$92.43
|
Rate for Payer: Aetna Medicare |
$68.98
|
Rate for Payer: BCBS Complete |
$46.29
|
Rate for Payer: BCBS MAPPO |
$68.98
|
Rate for Payer: BCBS Trust/PPO |
$338.18
|
Rate for Payer: BCN Commercial |
$173.16
|
Rate for Payer: BCN Medicare Advantage |
$68.98
|
Rate for Payer: Cash Price |
$196.80
|
Rate for Payer: Cash Price |
$196.80
|
Rate for Payer: Cofinity Commercial |
$92.43
|
Rate for Payer: Cofinity Commercial |
$99.33
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.98
|
Rate for Payer: Healthscope Commercial |
$82.78
|
Rate for Payer: Healthscope Whirlpool |
$82.78
|
Rate for Payer: Meridian Medicaid |
$46.29
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.43
|
Rate for Payer: PACE SWMI |
$68.98
|
Rate for Payer: PHP Medicare Advantage |
$68.98
|
Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.09
|
Rate for Payer: Priority Health Medicare |
$68.98
|
Rate for Payer: Priority Health Narrow Network |
$85.09
|
Rate for Payer: UHC Medicare Advantage |
$71.05
|
|
PR SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<
|
Professional
|
Both
|
$158.00
|
|
Service Code
|
HCPCS 11300
|
Min. Negotiated Rate |
$21.51 |
Max. Negotiated Rate |
$285.00 |
Rate for Payer: Aetna Commercial |
$44.73
|
Rate for Payer: Aetna Medicare |
$33.38
|
Rate for Payer: BCBS Complete |
$22.59
|
Rate for Payer: BCBS MAPPO |
$33.38
|
Rate for Payer: BCBS Trust/PPO |
$285.00
|
Rate for Payer: BCN Commercial |
$119.76
|
Rate for Payer: BCN Medicare Advantage |
$33.38
|
Rate for Payer: Cash Price |
$126.40
|
Rate for Payer: Cash Price |
$126.40
|
Rate for Payer: Cofinity Commercial |
$44.73
|
Rate for Payer: Cofinity Commercial |
$48.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.38
|
Rate for Payer: Healthscope Commercial |
$40.06
|
Rate for Payer: Healthscope Whirlpool |
$40.06
|
Rate for Payer: Meridian Medicaid |
$22.59
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.05
|
Rate for Payer: PACE SWMI |
$33.38
|
Rate for Payer: PHP Medicare Advantage |
$33.38
|
Rate for Payer: Priority Health Choice Medicaid |
$21.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.52
|
Rate for Payer: Priority Health Medicare |
$33.38
|
Rate for Payer: Priority Health Narrow Network |
$41.52
|
Rate for Payer: UHC Medicare Advantage |
$34.38
|
|
PR SHOE LIFTS ELEVATION HEEL /I
|
Professional
|
Both
|
$64.00
|
|
Service Code
|
HCPCS L3334
|
Min. Negotiated Rate |
$22.97 |
Max. Negotiated Rate |
$44.80 |
Rate for Payer: Aetna Commercial |
$22.97
|
Rate for Payer: BCBS Complete |
$25.60
|
Rate for Payer: BCN Commercial |
$36.21
|
Rate for Payer: Cash Price |
$51.20
|
Rate for Payer: Cash Price |
$51.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$44.80
|
|
PR SHORTENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,184.00
|
|
Service Code
|
HCPCS 26477
|
Min. Negotiated Rate |
$408.32 |
Max. Negotiated Rate |
$974.84 |
Rate for Payer: Aetna Commercial |
$818.47
|
Rate for Payer: Aetna Medicare |
$610.80
|
Rate for Payer: BCBS Complete |
$428.74
|
Rate for Payer: BCBS MAPPO |
$610.80
|
Rate for Payer: BCBS Trust/PPO |
$974.19
|
Rate for Payer: BCN Commercial |
$932.88
|
Rate for Payer: BCN Medicare Advantage |
$610.80
|
Rate for Payer: Cash Price |
$947.20
|
Rate for Payer: Cash Price |
$947.20
|
Rate for Payer: Cofinity Commercial |
$818.47
|
Rate for Payer: Cofinity Commercial |
$879.55
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.80
|
Rate for Payer: Healthscope Commercial |
$732.96
|
Rate for Payer: Healthscope Whirlpool |
$732.96
|
Rate for Payer: Meridian Medicaid |
$428.74
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$641.34
|
Rate for Payer: PACE SWMI |
$610.80
|
Rate for Payer: PHP Medicare Advantage |
$610.80
|
Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$828.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.84
|
Rate for Payer: Priority Health Medicare |
$610.80
|
Rate for Payer: Priority Health Narrow Network |
$974.84
|
Rate for Payer: UHC Medicare Advantage |
$629.12
|
|
PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS
|
Professional
|
Both
|
$311.00
|
|
Service Code
|
HCPCS 95926
|
Min. Negotiated Rate |
$124.40 |
Max. Negotiated Rate |
$873.81 |
Rate for Payer: Aetna Commercial |
$194.58
|
Rate for Payer: Aetna Medicare |
$145.21
|
Rate for Payer: BCBS Complete |
$124.40
|
Rate for Payer: BCBS MAPPO |
$145.21
|
Rate for Payer: BCBS Trust/PPO |
$873.81
|
Rate for Payer: BCN Commercial |
$226.75
|
Rate for Payer: BCN Medicare Advantage |
$145.21
|
Rate for Payer: Cash Price |
$248.80
|
Rate for Payer: Cash Price |
$248.80
|
Rate for Payer: Cofinity Commercial |
$209.10
|
Rate for Payer: Cofinity Commercial |
$194.58
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.21
|
Rate for Payer: Healthscope Commercial |
$174.25
|
Rate for Payer: Healthscope Whirlpool |
$174.25
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.47
|
Rate for Payer: PACE SWMI |
$145.21
|
Rate for Payer: PHP Medicare Advantage |
$145.21
|
Rate for Payer: Priority Health Cigna Priority Health |
$217.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.41
|
Rate for Payer: Priority Health Medicare |
$145.21
|
Rate for Payer: Priority Health Narrow Network |
$208.41
|
Rate for Payer: UHC Medicare Advantage |
$149.57
|
|
PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD
|
Professional
|
Both
|
$282.00
|
|
Service Code
|
HCPCS 95927
|
Min. Negotiated Rate |
$99.85 |
Max. Negotiated Rate |
$242.39 |
Rate for Payer: Aetna Commercial |
$207.82
|
Rate for Payer: Aetna Commercial |
$207.82
|
Rate for Payer: Aetna Medicare |
$155.09
|
Rate for Payer: Aetna Medicare |
$155.09
|
Rate for Payer: BCBS Complete |
$112.80
|
Rate for Payer: BCBS Complete |
$78.80
|
Rate for Payer: BCBS MAPPO |
$155.09
|
Rate for Payer: BCBS MAPPO |
$155.09
|
Rate for Payer: BCBS Trust/PPO |
$99.85
|
Rate for Payer: BCBS Trust/PPO |
$99.85
|
Rate for Payer: BCN Commercial |
$242.39
|
Rate for Payer: BCN Commercial |
$242.39
|
Rate for Payer: BCN Medicare Advantage |
$155.09
|
Rate for Payer: BCN Medicare Advantage |
$155.09
|
Rate for Payer: Cash Price |
$225.60
|
Rate for Payer: Cash Price |
$225.60
|
Rate for Payer: Cash Price |
$157.60
|
Rate for Payer: Cash Price |
$157.60
|
Rate for Payer: Cofinity Commercial |
$207.82
|
Rate for Payer: Cofinity Commercial |
$223.33
|
Rate for Payer: Cofinity Commercial |
$207.82
|
Rate for Payer: Cofinity Commercial |
$223.33
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.09
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.09
|
Rate for Payer: Healthscope Commercial |
$186.11
|
Rate for Payer: Healthscope Commercial |
$186.11
|
Rate for Payer: Healthscope Whirlpool |
$186.11
|
Rate for Payer: Healthscope Whirlpool |
$186.11
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$162.84
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$162.84
|
Rate for Payer: PACE SWMI |
$155.09
|
Rate for Payer: PACE SWMI |
$155.09
|
Rate for Payer: PHP Medicare Advantage |
$155.09
|
Rate for Payer: PHP Medicare Advantage |
$155.09
|
Rate for Payer: Priority Health Cigna Priority Health |
$197.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$137.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.77
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.77
|
Rate for Payer: Priority Health Medicare |
$155.09
|
Rate for Payer: Priority Health Medicare |
$155.09
|
Rate for Payer: Priority Health Narrow Network |
$222.77
|
Rate for Payer: Priority Health Narrow Network |
$222.77
|
Rate for Payer: UHC Medicare Advantage |
$159.74
|
Rate for Payer: UHC Medicare Advantage |
$159.74
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS
|
Professional
|
Both
|
$321.00
|
|
Service Code
|
HCPCS 95925
|
Min. Negotiated Rate |
$128.40 |
Max. Negotiated Rate |
$1,239.39 |
Rate for Payer: Aetna Commercial |
$222.86
|
Rate for Payer: Aetna Medicare |
$166.31
|
Rate for Payer: BCBS Complete |
$128.40
|
Rate for Payer: BCBS MAPPO |
$166.31
|
Rate for Payer: BCBS Trust/PPO |
$1,239.39
|
Rate for Payer: BCN Commercial |
$259.98
|
Rate for Payer: BCN Medicare Advantage |
$166.31
|
Rate for Payer: Cash Price |
$256.80
|
Rate for Payer: Cash Price |
$256.80
|
Rate for Payer: Cofinity Commercial |
$239.49
|
Rate for Payer: Cofinity Commercial |
$222.86
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.31
|
Rate for Payer: Healthscope Commercial |
$199.57
|
Rate for Payer: Healthscope Whirlpool |
$199.57
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.63
|
Rate for Payer: PACE SWMI |
$166.31
|
Rate for Payer: PHP Medicare Advantage |
$166.31
|
Rate for Payer: Priority Health Cigna Priority Health |
$224.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.94
|
Rate for Payer: Priority Health Medicare |
$166.31
|
Rate for Payer: Priority Health Narrow Network |
$238.94
|
Rate for Payer: UHC Medicare Advantage |
$171.30
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB
|
Professional
|
Both
|
$120.00
|
|
Service Code
|
HCPCS 95938
|
Min. Negotiated Rate |
$48.00 |
Max. Negotiated Rate |
$556.30 |
Rate for Payer: Aetna Commercial |
$454.15
|
Rate for Payer: Aetna Medicare |
$338.92
|
Rate for Payer: BCBS Complete |
$48.00
|
Rate for Payer: BCBS MAPPO |
$338.92
|
Rate for Payer: BCBS Trust/PPO |
$556.30
|
Rate for Payer: BCN Commercial |
$531.68
|
Rate for Payer: BCN Medicare Advantage |
$338.92
|
Rate for Payer: Cash Price |
$96.00
|
Rate for Payer: Cash Price |
$96.00
|
Rate for Payer: Cofinity Commercial |
$454.15
|
Rate for Payer: Cofinity Commercial |
$488.04
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.92
|
Rate for Payer: Healthscope Commercial |
$406.70
|
Rate for Payer: Healthscope Whirlpool |
$406.70
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$355.87
|
Rate for Payer: PACE SWMI |
$338.92
|
Rate for Payer: PHP Medicare Advantage |
$338.92
|
Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.66
|
Rate for Payer: Priority Health Medicare |
$338.92
|
Rate for Payer: Priority Health Narrow Network |
$488.66
|
Rate for Payer: UHC Medicare Advantage |
$349.09
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$181.00
|
|
Service Code
|
HCPCS 11311
|
Min. Negotiated Rate |
$39.62 |
Max. Negotiated Rate |
$338.18 |
Rate for Payer: Aetna Commercial |
$82.29
|
Rate for Payer: Aetna Medicare |
$61.41
|
Rate for Payer: BCBS Complete |
$41.60
|
Rate for Payer: BCBS MAPPO |
$61.41
|
Rate for Payer: BCBS Trust/PPO |
$338.18
|
Rate for Payer: BCN Commercial |
$161.77
|
Rate for Payer: BCN Medicare Advantage |
$61.41
|
Rate for Payer: Cash Price |
$144.80
|
Rate for Payer: Cash Price |
$144.80
|
Rate for Payer: Cofinity Commercial |
$88.43
|
Rate for Payer: Cofinity Commercial |
$82.29
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.41
|
Rate for Payer: Healthscope Commercial |
$73.69
|
Rate for Payer: Healthscope Whirlpool |
$73.69
|
Rate for Payer: Meridian Medicaid |
$41.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.48
|
Rate for Payer: PACE SWMI |
$61.41
|
Rate for Payer: PHP Medicare Advantage |
$61.41
|
Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
Rate for Payer: Priority Health Cigna Priority Health |
$126.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.45
|
Rate for Payer: Priority Health Medicare |
$61.41
|
Rate for Payer: Priority Health Narrow Network |
$76.45
|
Rate for Payer: UHC Medicare Advantage |
$63.25
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$261.00
|
|
Service Code
|
HCPCS 11312
|
Min. Negotiated Rate |
$28.95 |
Max. Negotiated Rate |
$184.94 |
Rate for Payer: Aetna Commercial |
$98.77
|
Rate for Payer: Aetna Medicare |
$73.71
|
Rate for Payer: BCBS Complete |
$49.20
|
Rate for Payer: BCBS MAPPO |
$73.71
|
Rate for Payer: BCBS Trust/PPO |
$28.95
|
Rate for Payer: BCN Commercial |
$184.94
|
Rate for Payer: BCN Medicare Advantage |
$73.71
|
Rate for Payer: Cash Price |
$208.80
|
Rate for Payer: Cash Price |
$208.80
|
Rate for Payer: Cofinity Commercial |
$98.77
|
Rate for Payer: Cofinity Commercial |
$106.14
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.71
|
Rate for Payer: Healthscope Commercial |
$88.45
|
Rate for Payer: Healthscope Whirlpool |
$88.45
|
Rate for Payer: Meridian Medicaid |
$49.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.40
|
Rate for Payer: PACE SWMI |
$73.71
|
Rate for Payer: PHP Medicare Advantage |
$73.71
|
Rate for Payer: Priority Health Choice Medicaid |
$46.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$182.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.66
|
Rate for Payer: Priority Health Medicare |
$73.71
|
Rate for Payer: Priority Health Narrow Network |
$91.66
|
Rate for Payer: UHC Medicare Advantage |
$75.92
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$194.00
|
|
Service Code
|
CPT 11301
|
Hospital Charge Code |
11301
|
Hospital Revenue Code
|
521
|
Min. Negotiated Rate |
$97.34 |
Max. Negotiated Rate |
$222.44 |
Rate for Payer: Aetna Commercial |
$174.60
|
Rate for Payer: Aetna Medicare |
$177.95
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
Rate for Payer: ASR ASR |
$188.18
|
Rate for Payer: BCBS Complete |
$102.21
|
Rate for Payer: BCBS MAPPO |
$177.95
|
Rate for Payer: BCBS Trust/PPO |
$150.41
|
Rate for Payer: BCN Commercial |
$150.41
|
Rate for Payer: BCN Medicare Advantage |
$177.95
|
Rate for Payer: Cash Price |
$155.20
|
Rate for Payer: Cash Price |
$155.20
|
Rate for Payer: Cofinity Commercial |
$182.36
|
Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
Rate for Payer: Healthscope Commercial |
$194.00
|
Rate for Payer: Healthscope Whirlpool |
$188.18
|
Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
Rate for Payer: Mclaren Commercial |
$174.60
|
Rate for Payer: Mclaren Medicaid |
$97.34
|
Rate for Payer: Mclaren Medicare |
$177.95
|
Rate for Payer: Meridian Medicaid |
$102.21
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.90
|
Rate for Payer: PACE Medicare |
$169.05
|
Rate for Payer: PACE SWMI |
$177.95
|
Rate for Payer: PHP Commercial |
$195.74
|
Rate for Payer: PHP Medicaid |
$97.34
|
Rate for Payer: PHP Medicare Advantage |
$177.95
|
Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.54
|
Rate for Payer: Priority Health Medicare |
$177.95
|
Rate for Payer: Priority Health Narrow Network |
$137.74
|
Rate for Payer: Railroad Medicare Medicare |
$177.95
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.72
|
Rate for Payer: UHC Medicare Advantage |
$183.29
|
Rate for Payer: VA VA |
$177.95
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$194.00
|
|
Service Code
|
HCPCS 11301
|
Min. Negotiated Rate |
$32.38 |
Max. Negotiated Rate |
$507.28 |
Rate for Payer: Aetna Commercial |
$67.27
|
Rate for Payer: Aetna Medicare |
$50.20
|
Rate for Payer: BCBS Complete |
$34.00
|
Rate for Payer: BCBS MAPPO |
$50.20
|
Rate for Payer: BCBS Trust/PPO |
$507.28
|
Rate for Payer: BCN Commercial |
$144.11
|
Rate for Payer: BCN Medicare Advantage |
$50.20
|
Rate for Payer: Cash Price |
$155.20
|
Rate for Payer: Cash Price |
$155.20
|
Rate for Payer: Cofinity Commercial |
$72.29
|
Rate for Payer: Cofinity Commercial |
$67.27
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.20
|
Rate for Payer: Healthscope Commercial |
$60.24
|
Rate for Payer: Healthscope Whirlpool |
$60.24
|
Rate for Payer: Meridian Medicaid |
$34.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.71
|
Rate for Payer: PACE SWMI |
$50.20
|
Rate for Payer: PHP Medicare Advantage |
$50.20
|
Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.48
|
Rate for Payer: Priority Health Medicare |
$50.20
|
Rate for Payer: Priority Health Narrow Network |
$62.48
|
Rate for Payer: UHC Medicare Advantage |
$51.71
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$194.00
|
|
Service Code
|
CPT 11301
|
Hospital Charge Code |
11301
|
Hospital Revenue Code
|
521
|
Min. Negotiated Rate |
$135.80 |
Max. Negotiated Rate |
$194.00 |
Rate for Payer: Aetna Commercial |
$174.60
|
Rate for Payer: ASR ASR |
$188.18
|
Rate for Payer: BCBS Trust/PPO |
$150.41
|
Rate for Payer: BCN Commercial |
$150.41
|
Rate for Payer: Cash Price |
$155.20
|
Rate for Payer: Cofinity Commercial |
$182.36
|
Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
Rate for Payer: Healthscope Commercial |
$194.00
|
Rate for Payer: Healthscope Whirlpool |
$188.18
|
Rate for Payer: Mclaren Commercial |
$174.60
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.72
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$194.00
|
|
Service Code
|
HCPCS 11301
|
Hospital Charge Code |
11301
|
Min. Negotiated Rate |
$32.38 |
Max. Negotiated Rate |
$507.28 |
Rate for Payer: Aetna Commercial |
$67.27
|
Rate for Payer: Aetna Medicare |
$50.20
|
Rate for Payer: BCBS Complete |
$34.00
|
Rate for Payer: BCBS MAPPO |
$50.20
|
Rate for Payer: BCBS Trust/PPO |
$507.28
|
Rate for Payer: BCN Commercial |
$144.11
|
Rate for Payer: BCN Medicare Advantage |
$50.20
|
Rate for Payer: Cash Price |
$155.20
|
Rate for Payer: Cash Price |
$155.20
|
Rate for Payer: Cofinity Commercial |
$67.27
|
Rate for Payer: Cofinity Commercial |
$72.29
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.20
|
Rate for Payer: Healthscope Commercial |
$60.24
|
Rate for Payer: Healthscope Whirlpool |
$60.24
|
Rate for Payer: Meridian Medicaid |
$34.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.71
|
Rate for Payer: PACE SWMI |
$50.20
|
Rate for Payer: PHP Medicare Advantage |
$50.20
|
Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.48
|
Rate for Payer: Priority Health Medicare |
$50.20
|
Rate for Payer: Priority Health Narrow Network |
$62.48
|
Rate for Payer: UHC Medicare Advantage |
$51.71
|
|