PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Facility
|
IP
|
$1,817.00
|
|
Service Code
|
CPT 24359
|
Hospital Charge Code |
24359
|
Min. Negotiated Rate |
$1,271.90 |
Max. Negotiated Rate |
$1,817.00 |
Rate for Payer: Aetna Commercial |
$1,635.30
|
Rate for Payer: ASR ASR |
$1,762.49
|
Rate for Payer: BCBS Trust/PPO |
$1,408.72
|
Rate for Payer: BCN Commercial |
$1,408.72
|
Rate for Payer: Cash Price |
$1,453.60
|
Rate for Payer: Cofinity Commercial |
$1,707.98
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,453.60
|
Rate for Payer: Healthscope Commercial |
$1,817.00
|
Rate for Payer: Healthscope Whirlpool |
$1,762.49
|
Rate for Payer: Mclaren Commercial |
$1,635.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,544.45
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,271.90
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,598.96
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$1,817.00
|
|
Service Code
|
HCPCS 24359
|
Hospital Charge Code |
24359
|
Min. Negotiated Rate |
$191.45 |
Max. Negotiated Rate |
$1,271.90 |
Rate for Payer: Aetna Commercial |
$877.70
|
Rate for Payer: Aetna Medicare |
$655.00
|
Rate for Payer: BCBS Complete |
$452.67
|
Rate for Payer: BCBS MAPPO |
$655.00
|
Rate for Payer: BCBS Trust/PPO |
$191.45
|
Rate for Payer: BCN Commercial |
$978.82
|
Rate for Payer: BCN Medicare Advantage |
$655.00
|
Rate for Payer: Cash Price |
$1,453.60
|
Rate for Payer: Cash Price |
$1,453.60
|
Rate for Payer: Cofinity Commercial |
$877.70
|
Rate for Payer: Cofinity Commercial |
$943.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.00
|
Rate for Payer: Healthscope Commercial |
$786.00
|
Rate for Payer: Healthscope Whirlpool |
$786.00
|
Rate for Payer: Meridian Medicaid |
$452.67
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$687.75
|
Rate for Payer: PACE SWMI |
$655.00
|
Rate for Payer: PHP Medicare Advantage |
$655.00
|
Rate for Payer: Priority Health Choice Medicaid |
$431.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,271.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,022.83
|
Rate for Payer: Priority Health Medicare |
$655.00
|
Rate for Payer: Priority Health Narrow Network |
$1,022.83
|
Rate for Payer: UHC Medicare Advantage |
$674.65
|
|
PR TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,251.00
|
|
Service Code
|
HCPCS 25290
|
Min. Negotiated Rate |
$285.42 |
Max. Negotiated Rate |
$1,061.88 |
Rate for Payer: Aetna Commercial |
$576.58
|
Rate for Payer: Aetna Medicare |
$430.28
|
Rate for Payer: BCBS Complete |
$299.69
|
Rate for Payer: BCBS MAPPO |
$430.28
|
Rate for Payer: BCBS Trust/PPO |
$1,061.88
|
Rate for Payer: BCN Commercial |
$646.52
|
Rate for Payer: BCN Medicare Advantage |
$430.28
|
Rate for Payer: Cash Price |
$1,000.80
|
Rate for Payer: Cash Price |
$1,000.80
|
Rate for Payer: Cofinity Commercial |
$619.60
|
Rate for Payer: Cofinity Commercial |
$576.58
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.28
|
Rate for Payer: Healthscope Commercial |
$516.34
|
Rate for Payer: Healthscope Whirlpool |
$516.34
|
Rate for Payer: Meridian Medicaid |
$299.69
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$451.79
|
Rate for Payer: PACE SWMI |
$430.28
|
Rate for Payer: PHP Medicare Advantage |
$430.28
|
Rate for Payer: Priority Health Choice Medicaid |
$285.42
|
Rate for Payer: Priority Health Cigna Priority Health |
$875.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$675.59
|
Rate for Payer: Priority Health Medicare |
$430.28
|
Rate for Payer: Priority Health Narrow Network |
$675.59
|
Rate for Payer: UHC Medicare Advantage |
$443.19
|
|
PR TOBACCO USE CESSATION INTENSIVE >10 MINUTES
|
Professional
|
Both
|
$41.00
|
|
Service Code
|
HCPCS 99407
|
Min. Negotiated Rate |
$15.76 |
Max. Negotiated Rate |
$1,526.79 |
Rate for Payer: Aetna Commercial |
$32.94
|
Rate for Payer: Aetna Medicare |
$24.58
|
Rate for Payer: BCBS Complete |
$16.55
|
Rate for Payer: BCBS MAPPO |
$24.58
|
Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
Rate for Payer: BCN Commercial |
$29.38
|
Rate for Payer: BCN Medicare Advantage |
$24.58
|
Rate for Payer: Cash Price |
$32.80
|
Rate for Payer: Cash Price |
$32.80
|
Rate for Payer: Cofinity Commercial |
$35.40
|
Rate for Payer: Cofinity Commercial |
$32.94
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.58
|
Rate for Payer: Healthscope Commercial |
$27.04
|
Rate for Payer: Healthscope Whirlpool |
$27.04
|
Rate for Payer: Meridian Medicaid |
$16.55
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.81
|
Rate for Payer: PACE SWMI |
$24.58
|
Rate for Payer: PHP Medicare Advantage |
$24.58
|
Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
Rate for Payer: Priority Health Cigna Priority Health |
$28.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.70
|
Rate for Payer: Priority Health Medicare |
$24.58
|
Rate for Payer: Priority Health Narrow Network |
$31.70
|
Rate for Payer: UHC Medicare Advantage |
$25.32
|
|
PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Professional
|
Both
|
$30.00
|
|
Service Code
|
HCPCS 99406
|
Min. Negotiated Rate |
$7.46 |
Max. Negotiated Rate |
$1,290.64 |
Rate for Payer: Aetna Commercial |
$15.60
|
Rate for Payer: Aetna Medicare |
$11.64
|
Rate for Payer: BCBS Complete |
$7.83
|
Rate for Payer: BCBS MAPPO |
$11.64
|
Rate for Payer: BCBS Trust/PPO |
$1,290.64
|
Rate for Payer: BCN Commercial |
$15.76
|
Rate for Payer: BCN Medicare Advantage |
$11.64
|
Rate for Payer: Cash Price |
$24.00
|
Rate for Payer: Cash Price |
$24.00
|
Rate for Payer: Cofinity Commercial |
$16.76
|
Rate for Payer: Cofinity Commercial |
$15.60
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.64
|
Rate for Payer: Healthscope Commercial |
$12.80
|
Rate for Payer: Healthscope Whirlpool |
$12.80
|
Rate for Payer: Meridian Medicaid |
$7.83
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.22
|
Rate for Payer: PACE SWMI |
$11.64
|
Rate for Payer: PHP Medicare Advantage |
$11.64
|
Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.99
|
Rate for Payer: Priority Health Medicare |
$11.64
|
Rate for Payer: Priority Health Narrow Network |
$14.99
|
Rate for Payer: UHC Medicare Advantage |
$11.99
|
|
PR TOBACCO-USE COUNSEL>10MIN
|
Professional
|
Both
|
$47.00
|
|
Service Code
|
HCPCS G0437
|
Min. Negotiated Rate |
$18.80 |
Max. Negotiated Rate |
$32.90 |
Rate for Payer: BCBS Complete |
$18.80
|
Rate for Payer: Cash Price |
$37.60
|
Rate for Payer: Cash Price |
$37.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.16
|
Rate for Payer: Priority Health Narrow Network |
$32.16
|
|
PR TOBACCO-USE COUNSEL 3-10 MIN
|
Professional
|
Both
|
$24.00
|
|
Service Code
|
HCPCS G0436
|
Min. Negotiated Rate |
$9.60 |
Max. Negotiated Rate |
$16.80 |
Rate for Payer: BCBS Complete |
$9.60
|
Rate for Payer: Cash Price |
$19.20
|
Rate for Payer: Cash Price |
$19.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.42
|
Rate for Payer: Priority Health Narrow Network |
$15.42
|
|
PR TONE DECAY TEST
|
Professional
|
Both
|
$56.00
|
|
Service Code
|
HCPCS 92563
|
Min. Negotiated Rate |
$22.40 |
Max. Negotiated Rate |
$1,190.79 |
Rate for Payer: Aetna Commercial |
$41.03
|
Rate for Payer: Aetna Medicare |
$30.62
|
Rate for Payer: BCBS Complete |
$22.40
|
Rate for Payer: BCBS MAPPO |
$30.62
|
Rate for Payer: BCBS Trust/PPO |
$1,190.79
|
Rate for Payer: BCN Commercial |
$48.38
|
Rate for Payer: BCN Medicare Advantage |
$30.62
|
Rate for Payer: Cash Price |
$44.80
|
Rate for Payer: Cash Price |
$44.80
|
Rate for Payer: Cofinity Commercial |
$41.03
|
Rate for Payer: Cofinity Commercial |
$44.09
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.62
|
Rate for Payer: Healthscope Commercial |
$36.74
|
Rate for Payer: Healthscope Whirlpool |
$36.74
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.15
|
Rate for Payer: PACE SWMI |
$30.62
|
Rate for Payer: PHP Medicare Advantage |
$30.62
|
Rate for Payer: Priority Health Cigna Priority Health |
$39.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.47
|
Rate for Payer: Priority Health Medicare |
$30.62
|
Rate for Payer: Priority Health Narrow Network |
$44.47
|
Rate for Payer: UHC Medicare Advantage |
$31.54
|
|
PR TONSILLECTOMY & ADENOIDECTOMY <AGE 12
|
Professional
|
Both
|
$891.00
|
|
Service Code
|
HCPCS 42820
|
Min. Negotiated Rate |
$188.51 |
Max. Negotiated Rate |
$652.98 |
Rate for Payer: Aetna Commercial |
$383.86
|
Rate for Payer: Aetna Medicare |
$286.46
|
Rate for Payer: BCBS Complete |
$197.94
|
Rate for Payer: BCBS MAPPO |
$286.46
|
Rate for Payer: BCBS Trust/PPO |
$652.98
|
Rate for Payer: BCN Commercial |
$428.08
|
Rate for Payer: BCN Medicare Advantage |
$286.46
|
Rate for Payer: Cash Price |
$712.80
|
Rate for Payer: Cash Price |
$712.80
|
Rate for Payer: Cofinity Commercial |
$383.86
|
Rate for Payer: Cofinity Commercial |
$412.50
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.46
|
Rate for Payer: Healthscope Commercial |
$343.75
|
Rate for Payer: Healthscope Whirlpool |
$343.75
|
Rate for Payer: Meridian Medicaid |
$197.94
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$300.78
|
Rate for Payer: PACE SWMI |
$286.46
|
Rate for Payer: PHP Medicare Advantage |
$286.46
|
Rate for Payer: Priority Health Choice Medicaid |
$188.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$623.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.06
|
Rate for Payer: Priority Health Medicare |
$286.46
|
Rate for Payer: Priority Health Narrow Network |
$515.06
|
Rate for Payer: UHC Medicare Advantage |
$295.05
|
|
PR TONSILLECTOMY & ADENOIDECTOMY AGE 12/>
|
Professional
|
Both
|
$568.00
|
|
Service Code
|
HCPCS 42821
|
Min. Negotiated Rate |
$196.81 |
Max. Negotiated Rate |
$1,924.07 |
Rate for Payer: Aetna Commercial |
$402.17
|
Rate for Payer: Aetna Medicare |
$300.13
|
Rate for Payer: BCBS Complete |
$206.65
|
Rate for Payer: BCBS MAPPO |
$300.13
|
Rate for Payer: BCBS Trust/PPO |
$1,924.07
|
Rate for Payer: BCN Commercial |
$448.61
|
Rate for Payer: BCN Medicare Advantage |
$300.13
|
Rate for Payer: Cash Price |
$454.40
|
Rate for Payer: Cash Price |
$454.40
|
Rate for Payer: Cofinity Commercial |
$402.17
|
Rate for Payer: Cofinity Commercial |
$432.19
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.13
|
Rate for Payer: Healthscope Commercial |
$360.16
|
Rate for Payer: Healthscope Whirlpool |
$360.16
|
Rate for Payer: Meridian Medicaid |
$206.65
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$315.14
|
Rate for Payer: PACE SWMI |
$300.13
|
Rate for Payer: PHP Medicare Advantage |
$300.13
|
Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
Rate for Payer: Priority Health Cigna Priority Health |
$397.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.75
|
Rate for Payer: Priority Health Medicare |
$300.13
|
Rate for Payer: Priority Health Narrow Network |
$539.75
|
Rate for Payer: UHC Medicare Advantage |
$309.13
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY <AGE 12
|
Professional
|
Both
|
$475.00
|
|
Service Code
|
HCPCS 42825
|
Min. Negotiated Rate |
$174.02 |
Max. Negotiated Rate |
$1,488.22 |
Rate for Payer: Aetna Commercial |
$353.01
|
Rate for Payer: Aetna Medicare |
$263.44
|
Rate for Payer: BCBS Complete |
$182.72
|
Rate for Payer: BCBS MAPPO |
$263.44
|
Rate for Payer: BCBS Trust/PPO |
$1,488.22
|
Rate for Payer: BCN Commercial |
$395.83
|
Rate for Payer: BCN Medicare Advantage |
$263.44
|
Rate for Payer: Cash Price |
$380.00
|
Rate for Payer: Cash Price |
$380.00
|
Rate for Payer: Cofinity Commercial |
$353.01
|
Rate for Payer: Cofinity Commercial |
$379.35
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.44
|
Rate for Payer: Healthscope Commercial |
$316.13
|
Rate for Payer: Healthscope Whirlpool |
$316.13
|
Rate for Payer: Meridian Medicaid |
$182.72
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.61
|
Rate for Payer: PACE SWMI |
$263.44
|
Rate for Payer: PHP Medicare Advantage |
$263.44
|
Rate for Payer: Priority Health Choice Medicaid |
$174.02
|
Rate for Payer: Priority Health Cigna Priority Health |
$332.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$476.26
|
Rate for Payer: Priority Health Medicare |
$263.44
|
Rate for Payer: Priority Health Narrow Network |
$476.26
|
Rate for Payer: UHC Medicare Advantage |
$271.34
|
|
PR TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>
|
Professional
|
Both
|
$464.00
|
|
Service Code
|
HCPCS 42826
|
Min. Negotiated Rate |
$165.71 |
Max. Negotiated Rate |
$1,230.94 |
Rate for Payer: Aetna Commercial |
$336.63
|
Rate for Payer: Aetna Medicare |
$251.22
|
Rate for Payer: BCBS Complete |
$174.00
|
Rate for Payer: BCBS MAPPO |
$251.22
|
Rate for Payer: BCBS Trust/PPO |
$1,230.94
|
Rate for Payer: BCN Commercial |
$376.77
|
Rate for Payer: BCN Medicare Advantage |
$251.22
|
Rate for Payer: Cash Price |
$371.20
|
Rate for Payer: Cash Price |
$371.20
|
Rate for Payer: Cofinity Commercial |
$361.76
|
Rate for Payer: Cofinity Commercial |
$336.63
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.22
|
Rate for Payer: Healthscope Commercial |
$301.46
|
Rate for Payer: Healthscope Whirlpool |
$301.46
|
Rate for Payer: Meridian Medicaid |
$174.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$263.78
|
Rate for Payer: PACE SWMI |
$251.22
|
Rate for Payer: PHP Medicare Advantage |
$251.22
|
Rate for Payer: Priority Health Choice Medicaid |
$165.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$324.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.33
|
Rate for Payer: Priority Health Medicare |
$251.22
|
Rate for Payer: Priority Health Narrow Network |
$453.33
|
Rate for Payer: UHC Medicare Advantage |
$258.76
|
|
PR TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM
|
Professional
|
Both
|
$2,363.00
|
|
Service Code
|
HCPCS 58200
|
Min. Negotiated Rate |
$82.02 |
Max. Negotiated Rate |
$1,964.97 |
Rate for Payer: Aetna Commercial |
$1,785.13
|
Rate for Payer: Aetna Medicare |
$1,332.19
|
Rate for Payer: BCBS Complete |
$908.02
|
Rate for Payer: BCBS MAPPO |
$1,332.19
|
Rate for Payer: BCBS Trust/PPO |
$82.02
|
Rate for Payer: BCN Commercial |
$1,964.97
|
Rate for Payer: BCN Medicare Advantage |
$1,332.19
|
Rate for Payer: Cash Price |
$1,890.40
|
Rate for Payer: Cash Price |
$1,890.40
|
Rate for Payer: Cofinity Commercial |
$1,785.13
|
Rate for Payer: Cofinity Commercial |
$1,918.35
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,332.19
|
Rate for Payer: Healthscope Commercial |
$1,598.63
|
Rate for Payer: Healthscope Whirlpool |
$1,598.63
|
Rate for Payer: Meridian Medicaid |
$908.02
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,398.80
|
Rate for Payer: PACE SWMI |
$1,332.19
|
Rate for Payer: PHP Medicare Advantage |
$1,332.19
|
Rate for Payer: Priority Health Choice Medicaid |
$864.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,654.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,903.63
|
Rate for Payer: Priority Health Medicare |
$1,332.19
|
Rate for Payer: Priority Health Narrow Network |
$1,903.63
|
Rate for Payer: UHC Medicare Advantage |
$1,372.16
|
|
PR TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY
|
Professional
|
Both
|
$3,291.00
|
|
Service Code
|
HCPCS 58152
|
Min. Negotiated Rate |
$11.46 |
Max. Negotiated Rate |
$2,303.70 |
Rate for Payer: Aetna Commercial |
$1,650.05
|
Rate for Payer: Aetna Medicare |
$1,231.38
|
Rate for Payer: BCBS Complete |
$832.87
|
Rate for Payer: BCBS MAPPO |
$1,231.38
|
Rate for Payer: BCBS Trust/PPO |
$11.46
|
Rate for Payer: BCN Commercial |
$1,812.99
|
Rate for Payer: BCN Medicare Advantage |
$1,231.38
|
Rate for Payer: Cash Price |
$2,632.80
|
Rate for Payer: Cash Price |
$2,632.80
|
Rate for Payer: Cofinity Commercial |
$1,650.05
|
Rate for Payer: Cofinity Commercial |
$1,773.19
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.38
|
Rate for Payer: Healthscope Commercial |
$1,477.66
|
Rate for Payer: Healthscope Whirlpool |
$1,477.66
|
Rate for Payer: Meridian Medicaid |
$832.87
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,292.95
|
Rate for Payer: PACE SWMI |
$1,231.38
|
Rate for Payer: PHP Medicare Advantage |
$1,231.38
|
Rate for Payer: Priority Health Choice Medicaid |
$793.21
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,303.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,756.41
|
Rate for Payer: Priority Health Medicare |
$1,231.38
|
Rate for Payer: Priority Health Narrow Network |
$1,756.41
|
Rate for Payer: UHC Medicare Advantage |
$1,268.32
|
|
PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY
|
Professional
|
Both
|
$3,153.00
|
|
Service Code
|
HCPCS 58150
|
Min. Negotiated Rate |
$652.21 |
Max. Negotiated Rate |
$2,929.42 |
Rate for Payer: Aetna Commercial |
$1,347.30
|
Rate for Payer: Aetna Medicare |
$1,005.45
|
Rate for Payer: BCBS Complete |
$684.82
|
Rate for Payer: BCBS MAPPO |
$1,005.45
|
Rate for Payer: BCBS Trust/PPO |
$2,929.42
|
Rate for Payer: BCN Commercial |
$1,483.63
|
Rate for Payer: BCN Medicare Advantage |
$1,005.45
|
Rate for Payer: Cash Price |
$2,522.40
|
Rate for Payer: Cash Price |
$2,522.40
|
Rate for Payer: Cofinity Commercial |
$1,347.30
|
Rate for Payer: Cofinity Commercial |
$1,447.85
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.45
|
Rate for Payer: Healthscope Commercial |
$1,206.54
|
Rate for Payer: Healthscope Whirlpool |
$1,206.54
|
Rate for Payer: Meridian Medicaid |
$684.82
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,055.72
|
Rate for Payer: PACE SWMI |
$1,005.45
|
Rate for Payer: PHP Medicare Advantage |
$1,005.45
|
Rate for Payer: Priority Health Choice Medicaid |
$652.21
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,207.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,437.32
|
Rate for Payer: Priority Health Medicare |
$1,005.45
|
Rate for Payer: Priority Health Narrow Network |
$1,437.32
|
Rate for Payer: UHC Medicare Advantage |
$1,035.61
|
|
PR TOTAL DISC ARTHRP ANT 2ND LEVEL CERVICAL
|
Professional
|
Both
|
$1,055.00
|
|
Service Code
|
HCPCS 22858
|
Min. Negotiated Rate |
$65.37 |
Max. Negotiated Rate |
$769.04 |
Rate for Payer: Aetna Commercial |
$675.37
|
Rate for Payer: Aetna Medicare |
$504.01
|
Rate for Payer: BCBS Complete |
$337.93
|
Rate for Payer: BCBS MAPPO |
$504.01
|
Rate for Payer: BCBS Trust/PPO |
$65.37
|
Rate for Payer: BCN Commercial |
$735.95
|
Rate for Payer: BCN Medicare Advantage |
$504.01
|
Rate for Payer: Cash Price |
$844.00
|
Rate for Payer: Cash Price |
$844.00
|
Rate for Payer: Cofinity Commercial |
$725.77
|
Rate for Payer: Cofinity Commercial |
$675.37
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$504.01
|
Rate for Payer: Healthscope Commercial |
$604.81
|
Rate for Payer: Healthscope Whirlpool |
$604.81
|
Rate for Payer: Meridian Medicaid |
$337.93
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$529.21
|
Rate for Payer: PACE SWMI |
$504.01
|
Rate for Payer: PHP Medicare Advantage |
$504.01
|
Rate for Payer: Priority Health Choice Medicaid |
$321.84
|
Rate for Payer: Priority Health Cigna Priority Health |
$738.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.04
|
Rate for Payer: Priority Health Medicare |
$504.01
|
Rate for Payer: Priority Health Narrow Network |
$769.04
|
Rate for Payer: UHC Medicare Advantage |
$519.13
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$3,351.28
|
|
Service Code
|
HCPCS 22856
|
Min. Negotiated Rate |
$132.08 |
Max. Negotiated Rate |
$2,490.44 |
Rate for Payer: Aetna Commercial |
$2,169.67
|
Rate for Payer: Aetna Medicare |
$1,619.16
|
Rate for Payer: BCBS Complete |
$1,098.57
|
Rate for Payer: BCBS MAPPO |
$1,619.16
|
Rate for Payer: BCBS Trust/PPO |
$132.08
|
Rate for Payer: BCN Commercial |
$2,383.28
|
Rate for Payer: BCN Medicare Advantage |
$1,619.16
|
Rate for Payer: Cash Price |
$2,681.02
|
Rate for Payer: Cash Price |
$2,681.02
|
Rate for Payer: Cofinity Commercial |
$2,331.59
|
Rate for Payer: Cofinity Commercial |
$2,169.67
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,619.16
|
Rate for Payer: Healthscope Commercial |
$1,942.99
|
Rate for Payer: Healthscope Whirlpool |
$1,942.99
|
Rate for Payer: Meridian Medicaid |
$1,098.57
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,700.12
|
Rate for Payer: PACE SWMI |
$1,619.16
|
Rate for Payer: PHP Medicare Advantage |
$1,619.16
|
Rate for Payer: Priority Health Choice Medicaid |
$1,046.26
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,345.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,490.44
|
Rate for Payer: Priority Health Medicare |
$1,619.16
|
Rate for Payer: Priority Health Narrow Network |
$2,490.44
|
Rate for Payer: UHC Medicare Advantage |
$1,667.73
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR
|
Professional
|
Both
|
$6,907.00
|
|
Service Code
|
HCPCS 22857
|
Min. Negotiated Rate |
$66.57 |
Max. Negotiated Rate |
$4,834.90 |
Rate for Payer: Aetna Commercial |
$2,331.85
|
Rate for Payer: Aetna Medicare |
$1,740.19
|
Rate for Payer: BCBS Complete |
$1,172.38
|
Rate for Payer: BCBS MAPPO |
$1,740.19
|
Rate for Payer: BCBS Trust/PPO |
$66.57
|
Rate for Payer: BCN Commercial |
$2,576.80
|
Rate for Payer: BCN Medicare Advantage |
$1,740.19
|
Rate for Payer: Cash Price |
$5,525.60
|
Rate for Payer: Cash Price |
$5,525.60
|
Rate for Payer: Cofinity Commercial |
$2,505.87
|
Rate for Payer: Cofinity Commercial |
$2,331.85
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,740.19
|
Rate for Payer: Healthscope Commercial |
$2,088.23
|
Rate for Payer: Healthscope Whirlpool |
$2,088.23
|
Rate for Payer: Meridian Medicaid |
$1,172.38
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,827.20
|
Rate for Payer: PACE SWMI |
$1,740.19
|
Rate for Payer: PHP Medicare Advantage |
$1,740.19
|
Rate for Payer: Priority Health Choice Medicaid |
$1,116.55
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,834.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,692.65
|
Rate for Payer: Priority Health Medicare |
$1,740.19
|
Rate for Payer: Priority Health Narrow Network |
$2,692.65
|
Rate for Payer: UHC Medicare Advantage |
$1,792.40
|
|
PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY
|
Professional
|
Both
|
$5,770.00
|
|
Service Code
|
HCPCS 43112
|
Min. Negotiated Rate |
$109.36 |
Max. Negotiated Rate |
$6,012.03 |
Rate for Payer: Aetna Commercial |
$4,592.47
|
Rate for Payer: Aetna Medicare |
$3,427.22
|
Rate for Payer: BCBS Complete |
$2,284.81
|
Rate for Payer: BCBS MAPPO |
$3,427.22
|
Rate for Payer: BCBS Trust/PPO |
$109.36
|
Rate for Payer: BCN Commercial |
$4,996.73
|
Rate for Payer: BCN Medicare Advantage |
$3,427.22
|
Rate for Payer: Cash Price |
$4,616.00
|
Rate for Payer: Cash Price |
$4,616.00
|
Rate for Payer: Cofinity Commercial |
$4,935.20
|
Rate for Payer: Cofinity Commercial |
$4,592.47
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,427.22
|
Rate for Payer: Healthscope Commercial |
$4,112.66
|
Rate for Payer: Healthscope Whirlpool |
$4,112.66
|
Rate for Payer: Meridian Medicaid |
$2,284.81
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,598.58
|
Rate for Payer: PACE SWMI |
$3,427.22
|
Rate for Payer: PHP Medicare Advantage |
$3,427.22
|
Rate for Payer: Priority Health Choice Medicaid |
$2,176.01
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,039.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,012.03
|
Rate for Payer: Priority Health Medicare |
$3,427.22
|
Rate for Payer: Priority Health Narrow Network |
$6,012.03
|
Rate for Payer: UHC Medicare Advantage |
$3,530.04
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
OP
|
$2,495.00
|
|
Service Code
|
CPT 60220
|
Hospital Charge Code |
60220
|
Hospital Revenue Code
|
960
|
Min. Negotiated Rate |
$1,746.50 |
Max. Negotiated Rate |
$6,411.01 |
Rate for Payer: Aetna Commercial |
$2,245.50
|
Rate for Payer: Aetna Medicare |
$5,128.81
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
Rate for Payer: ASR ASR |
$2,420.15
|
Rate for Payer: BCBS Complete |
$2,945.99
|
Rate for Payer: BCBS MAPPO |
$5,128.81
|
Rate for Payer: BCBS Trust/PPO |
$1,934.37
|
Rate for Payer: BCN Commercial |
$1,934.37
|
Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
Rate for Payer: Cash Price |
$1,996.00
|
Rate for Payer: Cash Price |
$1,996.00
|
Rate for Payer: Cofinity Commercial |
$2,345.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
Rate for Payer: Healthscope Commercial |
$2,495.00
|
Rate for Payer: Healthscope Whirlpool |
$2,420.15
|
Rate for Payer: Humana Choice PPO Medicare |
$5,128.81
|
Rate for Payer: Mclaren Commercial |
$2,245.50
|
Rate for Payer: Mclaren Medicaid |
$2,805.46
|
Rate for Payer: Mclaren Medicare |
$5,128.81
|
Rate for Payer: Meridian Medicaid |
$2,945.99
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.75
|
Rate for Payer: PACE Medicare |
$4,872.37
|
Rate for Payer: PACE SWMI |
$5,128.81
|
Rate for Payer: PHP Commercial |
$5,641.69
|
Rate for Payer: PHP Medicaid |
$2,805.46
|
Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,270.45
|
Rate for Payer: Priority Health Medicare |
$5,128.81
|
Rate for Payer: Priority Health Narrow Network |
$1,771.45
|
Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,195.60
|
Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
Rate for Payer: VA VA |
$5,128.81
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,495.00
|
|
Service Code
|
HCPCS 60220
|
Min. Negotiated Rate |
$453.90 |
Max. Negotiated Rate |
$1,746.50 |
Rate for Payer: Aetna Commercial |
$937.87
|
Rate for Payer: Aetna Medicare |
$699.90
|
Rate for Payer: BCBS Complete |
$476.60
|
Rate for Payer: BCBS MAPPO |
$699.90
|
Rate for Payer: BCBS Trust/PPO |
$484.45
|
Rate for Payer: BCN Commercial |
$1,036.00
|
Rate for Payer: BCN Medicare Advantage |
$699.90
|
Rate for Payer: Cash Price |
$1,996.00
|
Rate for Payer: Cash Price |
$1,996.00
|
Rate for Payer: Cofinity Commercial |
$937.87
|
Rate for Payer: Cofinity Commercial |
$1,007.86
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.90
|
Rate for Payer: Healthscope Commercial |
$839.88
|
Rate for Payer: Healthscope Whirlpool |
$839.88
|
Rate for Payer: Meridian Medicaid |
$476.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$734.90
|
Rate for Payer: PACE SWMI |
$699.90
|
Rate for Payer: PHP Medicare Advantage |
$699.90
|
Rate for Payer: Priority Health Choice Medicaid |
$453.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.06
|
Rate for Payer: Priority Health Medicare |
$699.90
|
Rate for Payer: Priority Health Narrow Network |
$1,003.06
|
Rate for Payer: UHC Medicare Advantage |
$720.90
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,495.00
|
|
Service Code
|
CPT 60220
|
Hospital Charge Code |
60220
|
Hospital Revenue Code
|
960
|
Min. Negotiated Rate |
$1,746.50 |
Max. Negotiated Rate |
$2,495.00 |
Rate for Payer: Aetna Commercial |
$2,245.50
|
Rate for Payer: ASR ASR |
$2,420.15
|
Rate for Payer: BCBS Trust/PPO |
$1,934.37
|
Rate for Payer: BCN Commercial |
$1,934.37
|
Rate for Payer: Cash Price |
$1,996.00
|
Rate for Payer: Cofinity Commercial |
$2,345.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.00
|
Rate for Payer: Healthscope Commercial |
$2,495.00
|
Rate for Payer: Healthscope Whirlpool |
$2,420.15
|
Rate for Payer: Mclaren Commercial |
$2,245.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,195.60
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,495.00
|
|
Service Code
|
HCPCS 60220
|
Hospital Charge Code |
60220
|
Min. Negotiated Rate |
$453.90 |
Max. Negotiated Rate |
$1,746.50 |
Rate for Payer: Aetna Commercial |
$937.87
|
Rate for Payer: Aetna Medicare |
$699.90
|
Rate for Payer: BCBS Complete |
$476.60
|
Rate for Payer: BCBS MAPPO |
$699.90
|
Rate for Payer: BCBS Trust/PPO |
$484.45
|
Rate for Payer: BCN Commercial |
$1,036.00
|
Rate for Payer: BCN Medicare Advantage |
$699.90
|
Rate for Payer: Cash Price |
$1,996.00
|
Rate for Payer: Cash Price |
$1,996.00
|
Rate for Payer: Cofinity Commercial |
$937.87
|
Rate for Payer: Cofinity Commercial |
$1,007.86
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.90
|
Rate for Payer: Healthscope Commercial |
$839.88
|
Rate for Payer: Healthscope Whirlpool |
$839.88
|
Rate for Payer: Meridian Medicaid |
$476.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$734.90
|
Rate for Payer: PACE SWMI |
$699.90
|
Rate for Payer: PHP Medicare Advantage |
$699.90
|
Rate for Payer: Priority Health Choice Medicaid |
$453.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,746.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.06
|
Rate for Payer: Priority Health Medicare |
$699.90
|
Rate for Payer: Priority Health Narrow Network |
$1,003.06
|
Rate for Payer: UHC Medicare Advantage |
$720.90
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,409.00
|
|
Service Code
|
HCPCS 60225
|
Min. Negotiated Rate |
$566.87 |
Max. Negotiated Rate |
$1,368.79 |
Rate for Payer: Aetna Commercial |
$1,239.15
|
Rate for Payer: Aetna Medicare |
$924.74
|
Rate for Payer: BCBS Complete |
$632.04
|
Rate for Payer: BCBS MAPPO |
$924.74
|
Rate for Payer: BCBS Trust/PPO |
$566.87
|
Rate for Payer: BCN Commercial |
$1,368.79
|
Rate for Payer: BCN Medicare Advantage |
$924.74
|
Rate for Payer: Cash Price |
$1,127.20
|
Rate for Payer: Cash Price |
$1,127.20
|
Rate for Payer: Cofinity Commercial |
$1,239.15
|
Rate for Payer: Cofinity Commercial |
$1,331.63
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$924.74
|
Rate for Payer: Healthscope Commercial |
$1,109.69
|
Rate for Payer: Healthscope Whirlpool |
$1,109.69
|
Rate for Payer: Meridian Medicaid |
$632.04
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$970.98
|
Rate for Payer: PACE SWMI |
$924.74
|
Rate for Payer: PHP Medicare Advantage |
$924.74
|
Rate for Payer: Priority Health Choice Medicaid |
$601.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$986.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,325.27
|
Rate for Payer: Priority Health Medicare |
$924.74
|
Rate for Payer: Priority Health Narrow Network |
$1,325.27
|
Rate for Payer: UHC Medicare Advantage |
$952.48
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,465.00
|
|
Service Code
|
HCPCS 43107
|
Min. Negotiated Rate |
$295.85 |
Max. Negotiated Rate |
$5,163.00 |
Rate for Payer: Aetna Commercial |
$3,935.66
|
Rate for Payer: Aetna Medicare |
$2,937.06
|
Rate for Payer: BCBS Complete |
$1,971.92
|
Rate for Payer: BCBS MAPPO |
$2,937.06
|
Rate for Payer: BCBS Trust/PPO |
$295.85
|
Rate for Payer: BCN Commercial |
$4,291.08
|
Rate for Payer: BCN Medicare Advantage |
$2,937.06
|
Rate for Payer: Cash Price |
$4,372.00
|
Rate for Payer: Cash Price |
$4,372.00
|
Rate for Payer: Cofinity Commercial |
$3,935.66
|
Rate for Payer: Cofinity Commercial |
$4,229.37
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,937.06
|
Rate for Payer: Healthscope Commercial |
$3,524.47
|
Rate for Payer: Healthscope Whirlpool |
$3,524.47
|
Rate for Payer: Meridian Medicaid |
$1,971.92
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,083.91
|
Rate for Payer: PACE SWMI |
$2,937.06
|
Rate for Payer: PHP Medicare Advantage |
$2,937.06
|
Rate for Payer: Priority Health Choice Medicaid |
$1,878.02
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,825.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,163.00
|
Rate for Payer: Priority Health Medicare |
$2,937.06
|
Rate for Payer: Priority Health Narrow Network |
$5,163.00
|
Rate for Payer: UHC Medicare Advantage |
$3,025.17
|
|