|
PR INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 54405
|
| Min. Negotiated Rate |
$464.77 |
| Max. Negotiated Rate |
$1,429.11 |
| Rate for Payer: Aetna Commercial |
$964.37
|
| Rate for Payer: Aetna Medicare |
$719.68
|
| Rate for Payer: BCBS Complete |
$488.01
|
| Rate for Payer: BCBS MAPPO |
$719.68
|
| Rate for Payer: BCN Commercial |
$1,210.10
|
| Rate for Payer: BCN Medicare Advantage |
$719.68
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Cofinity Commercial |
$964.37
|
| Rate for Payer: Cofinity Commercial |
$1,036.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.68
|
| Rate for Payer: Healthscope Commercial |
$863.62
|
| Rate for Payer: Healthscope Whirlpool |
$863.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.66
|
| Rate for Payer: Meridian Medicaid |
$488.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$791.65
|
| Rate for Payer: Nomi Health Commercial |
$863.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,132.50
|
| Rate for Payer: PACE SWMI |
$719.68
|
| Rate for Payer: PHP Medicare Advantage |
$719.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,318.19
|
| Rate for Payer: Priority Health Medicare |
$719.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,318.19
|
| Rate for Payer: Railroad Medicare Medicare |
$719.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,429.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$719.68
|
| Rate for Payer: UHC Exchange |
$1,429.11
|
| Rate for Payer: UHC Medicaid |
$464.77
|
| Rate for Payer: UHCCP DNSP |
$719.68
|
| Rate for Payer: UHCCP Medicaid |
$464.77
|
|
|
PR INSJ NON-NDWELLG BLADDER CATHETER
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 51701
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$125.25 |
| Rate for Payer: Aetna Commercial |
$29.56
|
| Rate for Payer: Aetna Medicare |
$22.06
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCBS MAPPO |
$22.06
|
| Rate for Payer: BCN Commercial |
$29.45
|
| Rate for Payer: BCN Medicare Advantage |
$22.06
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$31.77
|
| Rate for Payer: Cofinity Commercial |
$29.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.06
|
| Rate for Payer: Healthscope Commercial |
$26.47
|
| Rate for Payer: Healthscope Whirlpool |
$26.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.16
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.27
|
| Rate for Payer: Nomi Health Commercial |
$26.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.25
|
| Rate for Payer: PACE SWMI |
$22.06
|
| Rate for Payer: PHP Medicare Advantage |
$22.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$40.68
|
| Rate for Payer: Priority Health Medicare |
$22.06
|
| Rate for Payer: Priority Health Narrow Network |
$40.68
|
| Rate for Payer: Railroad Medicare Medicare |
$22.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.06
|
| Rate for Payer: UHC Exchange |
$46.75
|
| Rate for Payer: UHC Medicaid |
$14.06
|
| Rate for Payer: UHCCP DNSP |
$22.06
|
| Rate for Payer: UHCCP Medicaid |
$14.06
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 36555
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$774.75 |
| Rate for Payer: Aetna Commercial |
$105.71
|
| Rate for Payer: Aetna Medicare |
$78.89
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$78.89
|
| Rate for Payer: BCN Commercial |
$124.00
|
| Rate for Payer: BCN Medicare Advantage |
$78.89
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cofinity Commercial |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$105.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.89
|
| Rate for Payer: Healthscope Commercial |
$94.67
|
| Rate for Payer: Healthscope Whirlpool |
$94.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.83
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.78
|
| Rate for Payer: Nomi Health Commercial |
$94.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$774.75
|
| Rate for Payer: PACE SWMI |
$78.89
|
| Rate for Payer: PHP Medicare Advantage |
$78.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$133.34
|
| Rate for Payer: Priority Health Medicare |
$78.89
|
| Rate for Payer: Priority Health Narrow Network |
$133.34
|
| Rate for Payer: Railroad Medicare Medicare |
$78.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.89
|
| Rate for Payer: UHC Exchange |
$151.29
|
| Rate for Payer: UHC Medicaid |
$50.48
|
| Rate for Payer: UHCCP DNSP |
$78.89
|
| Rate for Payer: UHCCP Medicaid |
$50.48
|
|
|
PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>
|
Professional
|
Both
|
$885.00
|
|
|
Service Code
|
HCPCS 36556
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$663.75 |
| Rate for Payer: Aetna Commercial |
$103.69
|
| Rate for Payer: Aetna Medicare |
$77.38
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS MAPPO |
$77.38
|
| Rate for Payer: BCN Commercial |
$124.00
|
| Rate for Payer: BCN Medicare Advantage |
$77.38
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cofinity Commercial |
$111.43
|
| Rate for Payer: Cofinity Commercial |
$103.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.38
|
| Rate for Payer: Healthscope Commercial |
$92.86
|
| Rate for Payer: Healthscope Whirlpool |
$92.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.25
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.12
|
| Rate for Payer: Nomi Health Commercial |
$92.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.75
|
| Rate for Payer: PACE SWMI |
$77.38
|
| Rate for Payer: PHP Medicare Advantage |
$77.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$133.34
|
| Rate for Payer: Priority Health Medicare |
$77.38
|
| Rate for Payer: Priority Health Narrow Network |
$133.34
|
| Rate for Payer: Railroad Medicare Medicare |
$77.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$77.38
|
| Rate for Payer: UHC Exchange |
$151.85
|
| Rate for Payer: UHC Medicaid |
$49.42
|
| Rate for Payer: UHCCP DNSP |
$77.38
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
|
|
PR INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 54400
|
| Min. Negotiated Rate |
$309.28 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$639.26
|
| Rate for Payer: Aetna Medicare |
$477.06
|
| Rate for Payer: BCBS Complete |
$324.74
|
| Rate for Payer: BCBS MAPPO |
$477.06
|
| Rate for Payer: BCN Commercial |
$799.76
|
| Rate for Payer: BCN Medicare Advantage |
$477.06
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cofinity Commercial |
$686.97
|
| Rate for Payer: Cofinity Commercial |
$639.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.06
|
| Rate for Payer: Healthscope Commercial |
$572.47
|
| Rate for Payer: Healthscope Whirlpool |
$572.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$500.91
|
| Rate for Payer: Meridian Medicaid |
$324.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$524.77
|
| Rate for Payer: Nomi Health Commercial |
$572.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,233.00
|
| Rate for Payer: PACE SWMI |
$477.06
|
| Rate for Payer: PHP Medicare Advantage |
$477.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$871.19
|
| Rate for Payer: Priority Health Medicare |
$477.06
|
| Rate for Payer: Priority Health Narrow Network |
$871.19
|
| Rate for Payer: Railroad Medicare Medicare |
$477.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$477.06
|
| Rate for Payer: UHC Exchange |
$935.84
|
| Rate for Payer: UHC Medicaid |
$309.28
|
| Rate for Payer: UHCCP DNSP |
$477.06
|
| Rate for Payer: UHCCP Medicaid |
$309.28
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 33990
|
| Min. Negotiated Rate |
$199.58 |
| Max. Negotiated Rate |
$759.18 |
| Rate for Payer: Aetna Commercial |
$423.31
|
| Rate for Payer: Aetna Medicare |
$315.90
|
| Rate for Payer: BCBS Complete |
$209.56
|
| Rate for Payer: BCBS MAPPO |
$315.90
|
| Rate for Payer: BCN Commercial |
$525.87
|
| Rate for Payer: BCN Medicare Advantage |
$315.90
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$454.90
|
| Rate for Payer: Cofinity Commercial |
$423.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.90
|
| Rate for Payer: Healthscope Commercial |
$379.08
|
| Rate for Payer: Healthscope Whirlpool |
$379.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.69
|
| Rate for Payer: Meridian Medicaid |
$209.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$347.49
|
| Rate for Payer: Nomi Health Commercial |
$379.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$693.00
|
| Rate for Payer: PACE SWMI |
$315.90
|
| Rate for Payer: PHP Medicare Advantage |
$315.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$565.51
|
| Rate for Payer: Priority Health Medicare |
$315.90
|
| Rate for Payer: Priority Health Narrow Network |
$565.51
|
| Rate for Payer: Railroad Medicare Medicare |
$315.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$759.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$315.90
|
| Rate for Payer: UHC Exchange |
$759.18
|
| Rate for Payer: UHC Medicaid |
$199.58
|
| Rate for Payer: UHCCP DNSP |
$315.90
|
| Rate for Payer: UHCCP Medicaid |
$199.58
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL&VEN ACCESS
|
Professional
|
Both
|
$3,481.00
|
|
|
Service Code
|
HCPCS 33991
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$2,610.75 |
| Rate for Payer: Aetna Commercial |
$562.22
|
| Rate for Payer: Aetna Medicare |
$419.57
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCBS MAPPO |
$419.57
|
| Rate for Payer: BCN Commercial |
$661.32
|
| Rate for Payer: BCN Medicare Advantage |
$419.57
|
| Rate for Payer: Cash Price |
$2,784.80
|
| Rate for Payer: Cash Price |
$2,784.80
|
| Rate for Payer: Cofinity Commercial |
$604.18
|
| Rate for Payer: Cofinity Commercial |
$562.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.57
|
| Rate for Payer: Healthscope Commercial |
$503.48
|
| Rate for Payer: Healthscope Whirlpool |
$503.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$440.55
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$461.53
|
| Rate for Payer: Nomi Health Commercial |
$503.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,610.75
|
| Rate for Payer: PACE SWMI |
$419.57
|
| Rate for Payer: PHP Medicare Advantage |
$419.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$711.16
|
| Rate for Payer: Priority Health Medicare |
$419.57
|
| Rate for Payer: Priority Health Narrow Network |
$711.16
|
| Rate for Payer: Railroad Medicare Medicare |
$419.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,114.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$419.57
|
| Rate for Payer: UHC Exchange |
$1,114.37
|
| Rate for Payer: UHC Medicaid |
$265.19
|
| Rate for Payer: UHCCP DNSP |
$419.57
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
36571
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$1,338.75 |
| Rate for Payer: Aetna Commercial |
$389.26
|
| Rate for Payer: Aetna Medicare |
$290.49
|
| Rate for Payer: BCBS Complete |
$196.81
|
| Rate for Payer: BCBS MAPPO |
$290.49
|
| Rate for Payer: BCN Commercial |
$464.12
|
| Rate for Payer: BCN Medicare Advantage |
$290.49
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$418.31
|
| Rate for Payer: Cofinity Commercial |
$389.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.49
|
| Rate for Payer: Healthscope Commercial |
$348.59
|
| Rate for Payer: Healthscope Whirlpool |
$348.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.01
|
| Rate for Payer: Meridian Medicaid |
$196.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$319.54
|
| Rate for Payer: Nomi Health Commercial |
$348.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,338.75
|
| Rate for Payer: PACE SWMI |
$290.49
|
| Rate for Payer: PHP Medicare Advantage |
$290.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$499.10
|
| Rate for Payer: Priority Health Medicare |
$290.49
|
| Rate for Payer: Priority Health Narrow Network |
$499.10
|
| Rate for Payer: Railroad Medicare Medicare |
$290.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$551.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$290.49
|
| Rate for Payer: UHC Exchange |
$551.13
|
| Rate for Payer: UHC Medicaid |
$187.44
|
| Rate for Payer: UHCCP DNSP |
$290.49
|
| Rate for Payer: UHCCP Medicaid |
$187.44
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$1,785.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,338.75 |
| Max. Negotiated Rate |
$1,785.00 |
| Rate for Payer: Aetna Commercial |
$1,606.50
|
| Rate for Payer: ASR ASR |
$1,731.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,465.84
|
| Rate for Payer: BCN Commercial |
$1,465.84
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$1,677.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,428.00
|
| Rate for Payer: Healthscope Commercial |
$1,731.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,785.00
|
| Rate for Payer: Mclaren Commercial |
$1,606.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,517.25
|
| Rate for Payer: Nomi Health Commercial |
$1,463.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,338.75
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 36571
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$1,338.75 |
| Rate for Payer: Aetna Commercial |
$389.26
|
| Rate for Payer: Aetna Medicare |
$290.49
|
| Rate for Payer: BCBS Complete |
$196.81
|
| Rate for Payer: BCBS MAPPO |
$290.49
|
| Rate for Payer: BCN Commercial |
$464.12
|
| Rate for Payer: BCN Medicare Advantage |
$290.49
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$418.31
|
| Rate for Payer: Cofinity Commercial |
$389.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.49
|
| Rate for Payer: Healthscope Commercial |
$348.59
|
| Rate for Payer: Healthscope Whirlpool |
$348.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.01
|
| Rate for Payer: Meridian Medicaid |
$196.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$319.54
|
| Rate for Payer: Nomi Health Commercial |
$348.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,338.75
|
| Rate for Payer: PACE SWMI |
$290.49
|
| Rate for Payer: PHP Medicare Advantage |
$290.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$499.10
|
| Rate for Payer: Priority Health Medicare |
$290.49
|
| Rate for Payer: Priority Health Narrow Network |
$499.10
|
| Rate for Payer: Railroad Medicare Medicare |
$290.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$551.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$290.49
|
| Rate for Payer: UHC Exchange |
$551.13
|
| Rate for Payer: UHC Medicaid |
$187.44
|
| Rate for Payer: UHCCP DNSP |
$290.49
|
| Rate for Payer: UHCCP Medicaid |
$187.44
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$1,785.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,251.29 |
| Max. Negotiated Rate |
$3,932.66 |
| Rate for Payer: Aetna Commercial |
$1,606.50
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$1,731.45
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.73
|
| Rate for Payer: BCN Commercial |
$1,471.73
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$1,677.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,428.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,731.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,785.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$1,606.50
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,517.25
|
| Rate for Payer: Nomi Health Commercial |
$1,463.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,338.75
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,564.02
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,251.29
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR
|
Professional
|
Both
|
$3,179.00
|
|
|
Service Code
|
HCPCS 36570
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$2,384.25 |
| Rate for Payer: Aetna Commercial |
$422.09
|
| Rate for Payer: Aetna Medicare |
$314.99
|
| Rate for Payer: BCBS Complete |
$213.36
|
| Rate for Payer: BCBS MAPPO |
$314.99
|
| Rate for Payer: BCN Commercial |
$498.98
|
| Rate for Payer: BCN Medicare Advantage |
$314.99
|
| Rate for Payer: Cash Price |
$2,543.20
|
| Rate for Payer: Cash Price |
$2,543.20
|
| Rate for Payer: Cofinity Commercial |
$453.59
|
| Rate for Payer: Cofinity Commercial |
$422.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.99
|
| Rate for Payer: Healthscope Commercial |
$377.99
|
| Rate for Payer: Healthscope Whirlpool |
$377.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.74
|
| Rate for Payer: Meridian Medicaid |
$213.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$346.49
|
| Rate for Payer: Nomi Health Commercial |
$377.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,384.25
|
| Rate for Payer: PACE SWMI |
$314.99
|
| Rate for Payer: PHP Medicare Advantage |
$314.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$536.58
|
| Rate for Payer: Priority Health Medicare |
$314.99
|
| Rate for Payer: Priority Health Narrow Network |
$536.58
|
| Rate for Payer: Railroad Medicare Medicare |
$314.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$314.99
|
| Rate for Payer: UHC Exchange |
$586.05
|
| Rate for Payer: UHC Medicaid |
$203.20
|
| Rate for Payer: UHCCP DNSP |
$314.99
|
| Rate for Payer: UHCCP Medicaid |
$203.20
|
|
|
PR INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY
|
Professional
|
Both
|
$1,727.00
|
|
|
Service Code
|
HCPCS 19342
|
| Min. Negotiated Rate |
$442.83 |
| Max. Negotiated Rate |
$1,617.85 |
| Rate for Payer: Aetna Commercial |
$907.81
|
| Rate for Payer: Aetna Medicare |
$677.47
|
| Rate for Payer: BCBS Complete |
$464.97
|
| Rate for Payer: BCBS MAPPO |
$677.47
|
| Rate for Payer: BCN Commercial |
$1,152.83
|
| Rate for Payer: BCN Medicare Advantage |
$677.47
|
| Rate for Payer: Cash Price |
$1,381.60
|
| Rate for Payer: Cash Price |
$1,381.60
|
| Rate for Payer: Cofinity Commercial |
$975.56
|
| Rate for Payer: Cofinity Commercial |
$907.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.47
|
| Rate for Payer: Healthscope Commercial |
$812.96
|
| Rate for Payer: Healthscope Whirlpool |
$812.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$711.34
|
| Rate for Payer: Meridian Medicaid |
$464.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$745.22
|
| Rate for Payer: Nomi Health Commercial |
$812.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,295.25
|
| Rate for Payer: PACE SWMI |
$677.47
|
| Rate for Payer: PHP Medicare Advantage |
$677.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,055.13
|
| Rate for Payer: Priority Health Medicare |
$677.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,055.13
|
| Rate for Payer: Railroad Medicare Medicare |
$677.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,617.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$677.47
|
| Rate for Payer: UHC Exchange |
$1,617.85
|
| Rate for Payer: UHC Medicaid |
$442.83
|
| Rate for Payer: UHCCP DNSP |
$677.47
|
| Rate for Payer: UHCCP Medicaid |
$442.83
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS
|
Professional
|
Both
|
$1,947.00
|
|
|
Service Code
|
HCPCS 61886
|
| Min. Negotiated Rate |
$593.84 |
| Max. Negotiated Rate |
$1,871.29 |
| Rate for Payer: Aetna Commercial |
$1,215.92
|
| Rate for Payer: Aetna Medicare |
$907.40
|
| Rate for Payer: BCBS Complete |
$623.53
|
| Rate for Payer: BCBS MAPPO |
$907.40
|
| Rate for Payer: BCN Commercial |
$1,871.29
|
| Rate for Payer: BCN Medicare Advantage |
$907.40
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cash Price |
$1,557.60
|
| Rate for Payer: Cofinity Commercial |
$1,306.66
|
| Rate for Payer: Cofinity Commercial |
$1,215.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$907.40
|
| Rate for Payer: Healthscope Commercial |
$1,088.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$952.77
|
| Rate for Payer: Meridian Medicaid |
$623.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$998.14
|
| Rate for Payer: Nomi Health Commercial |
$1,088.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,460.25
|
| Rate for Payer: PACE SWMI |
$907.40
|
| Rate for Payer: PHP Medicare Advantage |
$907.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,573.23
|
| Rate for Payer: Priority Health Medicare |
$907.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,573.23
|
| Rate for Payer: Railroad Medicare Medicare |
$907.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,490.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$907.40
|
| Rate for Payer: UHC Exchange |
$1,490.85
|
| Rate for Payer: UHC Medicaid |
$593.84
|
| Rate for Payer: UHCCP DNSP |
$907.40
|
| Rate for Payer: UHCCP Medicaid |
$593.84
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR
|
Professional
|
Both
|
$1,704.00
|
|
|
Service Code
|
HCPCS 61885
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$1,278.00 |
| Rate for Payer: Aetna Commercial |
$727.90
|
| Rate for Payer: Aetna Medicare |
$543.21
|
| Rate for Payer: BCBS Complete |
$373.27
|
| Rate for Payer: BCBS MAPPO |
$543.21
|
| Rate for Payer: BCN Commercial |
$1,122.08
|
| Rate for Payer: BCN Medicare Advantage |
$543.21
|
| Rate for Payer: Cash Price |
$1,363.20
|
| Rate for Payer: Cash Price |
$1,363.20
|
| Rate for Payer: Cofinity Commercial |
$782.22
|
| Rate for Payer: Cofinity Commercial |
$727.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.21
|
| Rate for Payer: Healthscope Commercial |
$651.85
|
| Rate for Payer: Healthscope Whirlpool |
$651.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.37
|
| Rate for Payer: Meridian Medicaid |
$373.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$597.53
|
| Rate for Payer: Nomi Health Commercial |
$651.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,278.00
|
| Rate for Payer: PACE SWMI |
$543.21
|
| Rate for Payer: PHP Medicare Advantage |
$543.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$943.36
|
| Rate for Payer: Priority Health Medicare |
$543.21
|
| Rate for Payer: Priority Health Narrow Network |
$943.36
|
| Rate for Payer: Railroad Medicare Medicare |
$543.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$901.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$543.21
|
| Rate for Payer: UHC Exchange |
$901.32
|
| Rate for Payer: UHC Medicaid |
$355.50
|
| Rate for Payer: UHCCP DNSP |
$543.21
|
| Rate for Payer: UHCCP Medicaid |
$355.50
|
|
|
PR INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 0571T
|
| Min. Negotiated Rate |
$368.00 |
| Max. Negotiated Rate |
$29,977.58 |
| Rate for Payer: Aetna Commercial |
$612.82
|
| Rate for Payer: BCBS Complete |
$368.00
|
| Rate for Payer: BCN Commercial |
$29,977.58
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,311.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,311.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,005.46
|
| Rate for Payer: UHC Exchange |
$1,005.46
|
|
|
PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR
|
Professional
|
Both
|
$1,954.00
|
|
|
Service Code
|
HCPCS 33249
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$1,626.53 |
| Rate for Payer: Aetna Commercial |
$1,066.04
|
| Rate for Payer: Aetna Medicare |
$795.55
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCBS MAPPO |
$795.55
|
| Rate for Payer: BCN Commercial |
$1,340.57
|
| Rate for Payer: BCN Medicare Advantage |
$795.55
|
| Rate for Payer: Cash Price |
$1,563.20
|
| Rate for Payer: Cash Price |
$1,563.20
|
| Rate for Payer: Cofinity Commercial |
$1,145.59
|
| Rate for Payer: Cofinity Commercial |
$1,066.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$795.55
|
| Rate for Payer: Healthscope Commercial |
$954.66
|
| Rate for Payer: Healthscope Whirlpool |
$954.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$835.33
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$875.11
|
| Rate for Payer: Nomi Health Commercial |
$954.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,465.50
|
| Rate for Payer: PACE SWMI |
$795.55
|
| Rate for Payer: PHP Medicare Advantage |
$795.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,441.61
|
| Rate for Payer: Priority Health Medicare |
$795.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,441.61
|
| Rate for Payer: Railroad Medicare Medicare |
$795.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,626.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$795.55
|
| Rate for Payer: UHC Exchange |
$1,626.53
|
| Rate for Payer: UHC Medicaid |
$508.86
|
| Rate for Payer: UHCCP DNSP |
$795.55
|
| Rate for Payer: UHCCP Medicaid |
$508.86
|
|
|
PR INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 63685
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$1,767.00 |
| Rate for Payer: Aetna Commercial |
$419.69
|
| Rate for Payer: Aetna Medicare |
$313.20
|
| Rate for Payer: BCBS Complete |
$213.36
|
| Rate for Payer: BCBS MAPPO |
$313.20
|
| Rate for Payer: BCN Commercial |
$511.92
|
| Rate for Payer: BCN Medicare Advantage |
$313.20
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cofinity Commercial |
$451.01
|
| Rate for Payer: Cofinity Commercial |
$419.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.20
|
| Rate for Payer: Healthscope Commercial |
$375.84
|
| Rate for Payer: Healthscope Whirlpool |
$375.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.86
|
| Rate for Payer: Meridian Medicaid |
$213.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.52
|
| Rate for Payer: Nomi Health Commercial |
$375.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,767.00
|
| Rate for Payer: PACE SWMI |
$313.20
|
| Rate for Payer: PHP Medicare Advantage |
$313.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$594.59
|
| Rate for Payer: Priority Health Medicare |
$313.20
|
| Rate for Payer: Priority Health Narrow Network |
$594.59
|
| Rate for Payer: Railroad Medicare Medicare |
$313.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$628.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$313.20
|
| Rate for Payer: UHC Exchange |
$628.98
|
| Rate for Payer: UHC Medicaid |
$203.20
|
| Rate for Payer: UHCCP DNSP |
$313.20
|
| Rate for Payer: UHCCP Medicaid |
$203.20
|
|
|
PR INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
HCPCS 33210
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$800.25 |
| Rate for Payer: Aetna Commercial |
$189.88
|
| Rate for Payer: Aetna Medicare |
$141.70
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$141.70
|
| Rate for Payer: BCN Commercial |
$236.04
|
| Rate for Payer: BCN Medicare Advantage |
$141.70
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cofinity Commercial |
$204.05
|
| Rate for Payer: Cofinity Commercial |
$189.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.70
|
| Rate for Payer: Healthscope Commercial |
$170.04
|
| Rate for Payer: Healthscope Whirlpool |
$170.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.78
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.87
|
| Rate for Payer: Nomi Health Commercial |
$170.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$800.25
|
| Rate for Payer: PACE SWMI |
$141.70
|
| Rate for Payer: PHP Medicare Advantage |
$141.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$253.83
|
| Rate for Payer: Priority Health Medicare |
$141.70
|
| Rate for Payer: Priority Health Narrow Network |
$253.83
|
| Rate for Payer: Railroad Medicare Medicare |
$141.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$141.70
|
| Rate for Payer: UHC Exchange |
$291.90
|
| Rate for Payer: UHC Medicaid |
$89.67
|
| Rate for Payer: UHCCP DNSP |
$141.70
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
|
|
PR INSJ SUBQ RSVR PUMP/CONT INFUSION SYS VENTR CATH
|
Professional
|
Both
|
$2,807.00
|
|
|
Service Code
|
HCPCS 61215
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$2,105.25 |
| Rate for Payer: Aetna Commercial |
$727.41
|
| Rate for Payer: Aetna Medicare |
$542.84
|
| Rate for Payer: BCBS Complete |
$373.27
|
| Rate for Payer: BCBS MAPPO |
$542.84
|
| Rate for Payer: BCN Commercial |
$1,102.82
|
| Rate for Payer: BCN Medicare Advantage |
$542.84
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cash Price |
$2,245.60
|
| Rate for Payer: Cofinity Commercial |
$781.69
|
| Rate for Payer: Cofinity Commercial |
$727.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.84
|
| Rate for Payer: Healthscope Commercial |
$651.41
|
| Rate for Payer: Healthscope Whirlpool |
$651.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.98
|
| Rate for Payer: Meridian Medicaid |
$373.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$597.12
|
| Rate for Payer: Nomi Health Commercial |
$651.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,105.25
|
| Rate for Payer: PACE SWMI |
$542.84
|
| Rate for Payer: PHP Medicare Advantage |
$542.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$927.16
|
| Rate for Payer: Priority Health Medicare |
$542.84
|
| Rate for Payer: Priority Health Narrow Network |
$927.16
|
| Rate for Payer: Railroad Medicare Medicare |
$542.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$880.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$542.84
|
| Rate for Payer: UHC Exchange |
$880.20
|
| Rate for Payer: UHC Medicaid |
$355.50
|
| Rate for Payer: UHCCP DNSP |
$542.84
|
| Rate for Payer: UHCCP Medicaid |
$355.50
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 51703
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$89.95
|
| Rate for Payer: Aetna Medicare |
$67.13
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$67.13
|
| Rate for Payer: BCN Commercial |
$113.04
|
| Rate for Payer: BCN Medicare Advantage |
$67.13
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$96.67
|
| Rate for Payer: Cofinity Commercial |
$89.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.13
|
| Rate for Payer: Healthscope Commercial |
$80.56
|
| Rate for Payer: Healthscope Whirlpool |
$80.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.49
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.84
|
| Rate for Payer: Nomi Health Commercial |
$80.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.00
|
| Rate for Payer: PACE SWMI |
$67.13
|
| Rate for Payer: PHP Medicare Advantage |
$67.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$123.14
|
| Rate for Payer: Priority Health Medicare |
$67.13
|
| Rate for Payer: Priority Health Narrow Network |
$123.14
|
| Rate for Payer: Railroad Medicare Medicare |
$67.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.13
|
| Rate for Payer: UHC Exchange |
$136.92
|
| Rate for Payer: UHC Medicaid |
$43.03
|
| Rate for Payer: UHCCP DNSP |
$67.13
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 51702
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$30.38
|
| Rate for Payer: Aetna Medicare |
$22.67
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$22.67
|
| Rate for Payer: BCN Commercial |
$36.85
|
| Rate for Payer: BCN Medicare Advantage |
$22.67
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$30.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.67
|
| Rate for Payer: Healthscope Commercial |
$27.20
|
| Rate for Payer: Healthscope Whirlpool |
$27.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.80
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.94
|
| Rate for Payer: Nomi Health Commercial |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.00
|
| Rate for Payer: PACE SWMI |
$22.67
|
| Rate for Payer: PHP Medicare Advantage |
$22.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$40.15
|
| Rate for Payer: Priority Health Medicare |
$22.67
|
| Rate for Payer: Priority Health Narrow Network |
$40.15
|
| Rate for Payer: Railroad Medicare Medicare |
$22.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.67
|
| Rate for Payer: UHC Exchange |
$45.50
|
| Rate for Payer: UHC Medicaid |
$14.48
|
| Rate for Payer: UHCCP DNSP |
$22.67
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
PR INSJ TESTICULAR PROSTH SEPARATE PROCEDURE
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 54660
|
| Min. Negotiated Rate |
$213.21 |
| Max. Negotiated Rate |
$625.25 |
| Rate for Payer: Aetna Commercial |
$437.71
|
| Rate for Payer: Aetna Medicare |
$326.65
|
| Rate for Payer: BCBS Complete |
$223.87
|
| Rate for Payer: BCBS MAPPO |
$326.65
|
| Rate for Payer: BCN Commercial |
$543.30
|
| Rate for Payer: BCN Medicare Advantage |
$326.65
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$470.38
|
| Rate for Payer: Cofinity Commercial |
$437.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.65
|
| Rate for Payer: Healthscope Commercial |
$391.98
|
| Rate for Payer: Healthscope Whirlpool |
$391.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$342.98
|
| Rate for Payer: Meridian Medicaid |
$223.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$359.31
|
| Rate for Payer: Nomi Health Commercial |
$391.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$563.25
|
| Rate for Payer: PACE SWMI |
$326.65
|
| Rate for Payer: PHP Medicare Advantage |
$326.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$591.83
|
| Rate for Payer: Priority Health Medicare |
$326.65
|
| Rate for Payer: Priority Health Narrow Network |
$591.83
|
| Rate for Payer: Railroad Medicare Medicare |
$326.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$326.65
|
| Rate for Payer: UHC Exchange |
$625.25
|
| Rate for Payer: UHC Medicaid |
$213.21
|
| Rate for Payer: UHCCP DNSP |
$326.65
|
| Rate for Payer: UHCCP Medicaid |
$213.21
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$3,549.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$3,932.66 |
| Rate for Payer: Aetna Commercial |
$3,194.10
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$3,442.53
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,926.15
|
| Rate for Payer: BCN Commercial |
$2,926.15
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,839.20
|
| Rate for Payer: Cash Price |
$2,839.20
|
| Rate for Payer: Cofinity Commercial |
$3,336.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,839.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,442.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,549.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$3,194.10
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,016.65
|
| Rate for Payer: Nomi Health Commercial |
$2,910.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,661.75
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,109.63
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,487.85
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,549.00
|
|
|
Service Code
|
HCPCS 36561
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$2,661.75 |
| Rate for Payer: Aetna Commercial |
$398.14
|
| Rate for Payer: Aetna Medicare |
$297.12
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS MAPPO |
$297.12
|
| Rate for Payer: BCN Commercial |
$490.01
|
| Rate for Payer: BCN Medicare Advantage |
$297.12
|
| Rate for Payer: Cash Price |
$2,839.20
|
| Rate for Payer: Cash Price |
$2,839.20
|
| Rate for Payer: Cofinity Commercial |
$427.85
|
| Rate for Payer: Cofinity Commercial |
$398.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.12
|
| Rate for Payer: Healthscope Commercial |
$356.54
|
| Rate for Payer: Healthscope Whirlpool |
$356.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.98
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.83
|
| Rate for Payer: Nomi Health Commercial |
$356.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,661.75
|
| Rate for Payer: PACE SWMI |
$297.12
|
| Rate for Payer: PHP Medicare Advantage |
$297.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$526.95
|
| Rate for Payer: Priority Health Medicare |
$297.12
|
| Rate for Payer: Priority Health Narrow Network |
$526.95
|
| Rate for Payer: Railroad Medicare Medicare |
$297.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.12
|
| Rate for Payer: UHC Exchange |
$595.45
|
| Rate for Payer: UHC Medicaid |
$191.27
|
| Rate for Payer: UHCCP DNSP |
$297.12
|
| Rate for Payer: UHCCP Medicaid |
$191.27
|
|
