|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$12,969.81
|
|
|
Service Code
|
APR-DRG 4033
|
| Min. Negotiated Rate |
$11,726.26 |
| Max. Negotiated Rate |
$12,969.81 |
| Rate for Payer: BCBS Complete |
$12,969.81
|
| Rate for Payer: Mclaren Medicaid |
$12,352.20
|
| Rate for Payer: Meridian Medicaid |
$12,969.81
|
| Rate for Payer: PHP Medicaid |
$11,726.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,352.20
|
| Rate for Payer: UHC Medicaid |
$12,352.20
|
| Rate for Payer: UHCCP Medicaid |
$12,352.20
|
|
|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$5,543.78
|
|
|
Service Code
|
APR-DRG 4031
|
| Min. Negotiated Rate |
$5,012.24 |
| Max. Negotiated Rate |
$5,543.78 |
| Rate for Payer: BCBS Complete |
$5,543.78
|
| Rate for Payer: Mclaren Medicaid |
$5,279.79
|
| Rate for Payer: Meridian Medicaid |
$5,543.78
|
| Rate for Payer: PHP Medicaid |
$5,012.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,279.79
|
| Rate for Payer: UHC Medicaid |
$5,279.79
|
| Rate for Payer: UHCCP Medicaid |
$5,279.79
|
|
|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$24,566.35
|
|
|
Service Code
|
APR-DRG 4034
|
| Min. Negotiated Rate |
$22,210.92 |
| Max. Negotiated Rate |
$24,566.35 |
| Rate for Payer: BCBS Complete |
$24,566.35
|
| Rate for Payer: Mclaren Medicaid |
$23,396.52
|
| Rate for Payer: Meridian Medicaid |
$24,566.35
|
| Rate for Payer: PHP Medicaid |
$22,210.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,396.52
|
| Rate for Payer: UHC Medicaid |
$23,396.52
|
| Rate for Payer: UHCCP Medicaid |
$23,396.52
|
|
|
PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SE
|
Facility
|
IP
|
$57,327.11
|
|
|
Service Code
|
APR-DRG 8504
|
| Min. Negotiated Rate |
$51,830.56 |
| Max. Negotiated Rate |
$57,327.11 |
| Rate for Payer: BCBS Complete |
$57,327.11
|
| Rate for Payer: Mclaren Medicaid |
$54,597.24
|
| Rate for Payer: Meridian Medicaid |
$57,327.11
|
| Rate for Payer: PHP Medicaid |
$51,830.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$54,597.24
|
| Rate for Payer: UHC Medicaid |
$54,597.24
|
| Rate for Payer: UHCCP Medicaid |
$54,597.24
|
|
|
PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SE
|
Facility
|
IP
|
$7,961.17
|
|
|
Service Code
|
APR-DRG 8501
|
| Min. Negotiated Rate |
$7,197.85 |
| Max. Negotiated Rate |
$7,961.17 |
| Rate for Payer: BCBS Complete |
$7,961.17
|
| Rate for Payer: Mclaren Medicaid |
$7,582.07
|
| Rate for Payer: Meridian Medicaid |
$7,961.17
|
| Rate for Payer: PHP Medicaid |
$7,197.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,582.07
|
| Rate for Payer: UHC Medicaid |
$7,582.07
|
| Rate for Payer: UHCCP Medicaid |
$7,582.07
|
|
|
PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SE
|
Facility
|
IP
|
$25,114.57
|
|
|
Service Code
|
APR-DRG 8503
|
| Min. Negotiated Rate |
$22,706.57 |
| Max. Negotiated Rate |
$25,114.57 |
| Rate for Payer: BCBS Complete |
$25,114.57
|
| Rate for Payer: Mclaren Medicaid |
$23,918.63
|
| Rate for Payer: Meridian Medicaid |
$25,114.57
|
| Rate for Payer: PHP Medicaid |
$22,706.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,918.63
|
| Rate for Payer: UHC Medicaid |
$23,918.63
|
| Rate for Payer: UHCCP Medicaid |
$23,918.63
|
|
|
PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SE
|
Facility
|
IP
|
$15,169.23
|
|
|
Service Code
|
APR-DRG 8502
|
| Min. Negotiated Rate |
$13,714.80 |
| Max. Negotiated Rate |
$15,169.23 |
| Rate for Payer: BCBS Complete |
$15,169.23
|
| Rate for Payer: Mclaren Medicaid |
$14,446.88
|
| Rate for Payer: Meridian Medicaid |
$15,169.23
|
| Rate for Payer: PHP Medicaid |
$13,714.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,446.88
|
| Rate for Payer: UHC Medicaid |
$14,446.88
|
| Rate for Payer: UHCCP Medicaid |
$14,446.88
|
|
|
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$29.98
|
|
|
Service Code
|
NDC 713013506
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$22.49 |
| Max. Negotiated Rate |
$29.98 |
| Rate for Payer: Aetna Commercial |
$26.98
|
| Rate for Payer: ASR ASR |
$29.08
|
| Rate for Payer: BCBS Trust/PPO |
$24.62
|
| Rate for Payer: BCN Commercial |
$24.62
|
| Rate for Payer: Cash Price |
$23.99
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$29.08
|
| Rate for Payer: Healthscope Whirlpool |
$29.98
|
| Rate for Payer: Mclaren Commercial |
$26.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.48
|
| Rate for Payer: Nomi Health Commercial |
$24.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.38
|
|
|
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$29.98
|
|
|
Service Code
|
NDC 713013506
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.09 |
| Max. Negotiated Rate |
$29.98 |
| Rate for Payer: Aetna Commercial |
$26.98
|
| Rate for Payer: Aetna Medicare |
$11.09
|
| Rate for Payer: ASR ASR |
$29.08
|
| Rate for Payer: BCBS Complete |
$11.99
|
| Rate for Payer: BCBS Trust/PPO |
$24.72
|
| Rate for Payer: BCN Commercial |
$24.72
|
| Rate for Payer: Cash Price |
$23.99
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$29.08
|
| Rate for Payer: Healthscope Whirlpool |
$29.98
|
| Rate for Payer: Mclaren Commercial |
$26.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.48
|
| Rate for Payer: Nomi Health Commercial |
$24.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26.27
|
| Rate for Payer: Priority Health Narrow Network |
$21.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.38
|
|
|
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$359.77
|
|
|
Service Code
|
NDC 713013512
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$133.12 |
| Max. Negotiated Rate |
$359.77 |
| Rate for Payer: Aetna Commercial |
$323.80
|
| Rate for Payer: Aetna Medicare |
$133.12
|
| Rate for Payer: ASR ASR |
$348.98
|
| Rate for Payer: BCBS Complete |
$143.91
|
| Rate for Payer: BCBS Trust/PPO |
$296.63
|
| Rate for Payer: BCN Commercial |
$296.63
|
| Rate for Payer: Cash Price |
$287.82
|
| Rate for Payer: Cofinity Commercial |
$338.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.82
|
| Rate for Payer: Healthscope Commercial |
$348.98
|
| Rate for Payer: Healthscope Whirlpool |
$359.77
|
| Rate for Payer: Mclaren Commercial |
$323.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$287.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.81
|
| Rate for Payer: Nomi Health Commercial |
$295.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$315.23
|
| Rate for Payer: Priority Health Narrow Network |
$252.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.60
|
|
|
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$359.77
|
|
|
Service Code
|
NDC 713013512
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$269.83 |
| Max. Negotiated Rate |
$359.77 |
| Rate for Payer: Aetna Commercial |
$323.80
|
| Rate for Payer: ASR ASR |
$348.98
|
| Rate for Payer: BCBS Trust/PPO |
$295.45
|
| Rate for Payer: BCN Commercial |
$295.45
|
| Rate for Payer: Cash Price |
$287.82
|
| Rate for Payer: Cofinity Commercial |
$338.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.82
|
| Rate for Payer: Healthscope Commercial |
$348.98
|
| Rate for Payer: Healthscope Whirlpool |
$359.77
|
| Rate for Payer: Mclaren Commercial |
$323.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.81
|
| Rate for Payer: Nomi Health Commercial |
$295.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.60
|
|
|
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION
|
Facility
|
OP
|
$22.79
|
|
|
Service Code
|
HCPCS J0780
|
| Hospital Charge Code |
155387
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.10 |
| Max. Negotiated Rate |
$22.79 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Commercial |
$29.49
|
| Rate for Payer: Aetna Commercial |
$28.65
|
| Rate for Payer: Aetna Commercial |
$34.95
|
| Rate for Payer: Aetna Commercial |
$29.69
|
| Rate for Payer: Aetna Commercial |
$31.24
|
| Rate for Payer: Aetna Commercial |
$37.48
|
| Rate for Payer: Aetna Commercial |
$40.14
|
| Rate for Payer: Aetna Commercial |
$48.65
|
| Rate for Payer: Aetna Commercial |
$26.83
|
| Rate for Payer: Aetna Medicare |
$12.84
|
| Rate for Payer: Aetna Medicare |
$14.37
|
| Rate for Payer: Aetna Medicare |
$11.78
|
| Rate for Payer: Aetna Medicare |
$8.43
|
| Rate for Payer: Aetna Medicare |
$12.12
|
| Rate for Payer: Aetna Medicare |
$12.21
|
| Rate for Payer: Aetna Medicare |
$15.41
|
| Rate for Payer: Aetna Medicare |
$11.03
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: ASR ASR |
$32.00
|
| Rate for Payer: ASR ASR |
$31.79
|
| Rate for Payer: ASR ASR |
$28.92
|
| Rate for Payer: ASR ASR |
$22.11
|
| Rate for Payer: ASR ASR |
$30.88
|
| Rate for Payer: ASR ASR |
$52.43
|
| Rate for Payer: ASR ASR |
$43.26
|
| Rate for Payer: ASR ASR |
$40.39
|
| Rate for Payer: ASR ASR |
$37.67
|
| Rate for Payer: ASR ASR |
$33.66
|
| Rate for Payer: BCBS Complete |
$17.84
|
| Rate for Payer: BCBS Complete |
$16.66
|
| Rate for Payer: BCBS Complete |
$11.92
|
| Rate for Payer: BCBS Complete |
$9.12
|
| Rate for Payer: BCBS Complete |
$12.73
|
| Rate for Payer: BCBS Complete |
$15.53
|
| Rate for Payer: BCBS Complete |
$13.88
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS Complete |
$21.62
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS Trust/PPO |
$27.02
|
| Rate for Payer: BCBS Trust/PPO |
$24.58
|
| Rate for Payer: BCBS Trust/PPO |
$36.77
|
| Rate for Payer: BCBS Trust/PPO |
$18.79
|
| Rate for Payer: BCBS Trust/PPO |
$26.25
|
| Rate for Payer: BCBS Trust/PPO |
$34.34
|
| Rate for Payer: BCBS Trust/PPO |
$32.02
|
| Rate for Payer: BCBS Trust/PPO |
$27.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.62
|
| Rate for Payer: BCBS Trust/PPO |
$44.57
|
| Rate for Payer: BCN Commercial |
$34.34
|
| Rate for Payer: BCN Commercial |
$28.62
|
| Rate for Payer: BCN Commercial |
$26.25
|
| Rate for Payer: BCN Commercial |
$27.02
|
| Rate for Payer: BCN Commercial |
$36.77
|
| Rate for Payer: BCN Commercial |
$24.58
|
| Rate for Payer: BCN Commercial |
$18.79
|
| Rate for Payer: BCN Commercial |
$32.02
|
| Rate for Payer: BCN Commercial |
$44.57
|
| Rate for Payer: BCN Commercial |
$27.20
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cash Price |
$18.24
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$18.24
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cash Price |
$26.39
|
| Rate for Payer: Cash Price |
$26.39
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cash Price |
$31.06
|
| Rate for Payer: Cash Price |
$31.06
|
| Rate for Payer: Cash Price |
$33.32
|
| Rate for Payer: Cash Price |
$33.32
|
| Rate for Payer: Cash Price |
$35.68
|
| Rate for Payer: Cash Price |
$35.68
|
| Rate for Payer: Cash Price |
$43.24
|
| Rate for Payer: Cash Price |
$43.24
|
| Rate for Payer: Cofinity Commercial |
$50.81
|
| Rate for Payer: Cofinity Commercial |
$41.93
|
| Rate for Payer: Cofinity Commercial |
$30.80
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Cofinity Commercial |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Cofinity Commercial |
$31.01
|
| Rate for Payer: Cofinity Commercial |
$39.15
|
| Rate for Payer: Cofinity Commercial |
$28.02
|
| Rate for Payer: Cofinity Commercial |
$32.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.85
|
| Rate for Payer: Healthscope Commercial |
$22.11
|
| Rate for Payer: Healthscope Commercial |
$37.67
|
| Rate for Payer: Healthscope Commercial |
$31.79
|
| Rate for Payer: Healthscope Commercial |
$32.00
|
| Rate for Payer: Healthscope Commercial |
$43.26
|
| Rate for Payer: Healthscope Commercial |
$30.88
|
| Rate for Payer: Healthscope Commercial |
$28.92
|
| Rate for Payer: Healthscope Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Healthscope Commercial |
$52.43
|
| Rate for Payer: Healthscope Whirlpool |
$31.84
|
| Rate for Payer: Healthscope Whirlpool |
$34.71
|
| Rate for Payer: Healthscope Whirlpool |
$32.77
|
| Rate for Payer: Healthscope Whirlpool |
$41.64
|
| Rate for Payer: Healthscope Whirlpool |
$38.83
|
| Rate for Payer: Healthscope Whirlpool |
$54.06
|
| Rate for Payer: Healthscope Whirlpool |
$32.99
|
| Rate for Payer: Healthscope Whirlpool |
$29.81
|
| Rate for Payer: Healthscope Whirlpool |
$22.79
|
| Rate for Payer: Healthscope Whirlpool |
$44.60
|
| Rate for Payer: Mclaren Commercial |
$20.51
|
| Rate for Payer: Mclaren Commercial |
$40.14
|
| Rate for Payer: Mclaren Commercial |
$34.95
|
| Rate for Payer: Mclaren Commercial |
$29.69
|
| Rate for Payer: Mclaren Commercial |
$31.24
|
| Rate for Payer: Mclaren Commercial |
$48.65
|
| Rate for Payer: Mclaren Commercial |
$29.49
|
| Rate for Payer: Mclaren Commercial |
$37.48
|
| Rate for Payer: Mclaren Commercial |
$26.83
|
| Rate for Payer: Mclaren Commercial |
$28.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.01
|
| Rate for Payer: Nomi Health Commercial |
$34.15
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: Nomi Health Commercial |
$36.57
|
| Rate for Payer: Nomi Health Commercial |
$27.05
|
| Rate for Payer: Nomi Health Commercial |
$31.84
|
| Rate for Payer: Nomi Health Commercial |
$28.46
|
| Rate for Payer: Nomi Health Commercial |
$18.69
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Nomi Health Commercial |
$26.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.62
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: Priority Health Narrow Network |
$2.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.17
|
|
|
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION
|
Facility
|
IP
|
$44.60
|
|
|
Service Code
|
HCPCS J0780
|
| Hospital Charge Code |
155387
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.45 |
| Max. Negotiated Rate |
$44.60 |
| Rate for Payer: Aetna Commercial |
$40.14
|
| Rate for Payer: Aetna Commercial |
$48.65
|
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Commercial |
$26.83
|
| Rate for Payer: Aetna Commercial |
$29.69
|
| Rate for Payer: Aetna Commercial |
$28.65
|
| Rate for Payer: Aetna Commercial |
$29.49
|
| Rate for Payer: Aetna Commercial |
$31.24
|
| Rate for Payer: Aetna Commercial |
$37.48
|
| Rate for Payer: Aetna Commercial |
$34.95
|
| Rate for Payer: ASR ASR |
$37.67
|
| Rate for Payer: ASR ASR |
$33.66
|
| Rate for Payer: ASR ASR |
$30.88
|
| Rate for Payer: ASR ASR |
$22.11
|
| Rate for Payer: ASR ASR |
$32.00
|
| Rate for Payer: ASR ASR |
$28.92
|
| Rate for Payer: ASR ASR |
$31.79
|
| Rate for Payer: ASR ASR |
$52.43
|
| Rate for Payer: ASR ASR |
$43.26
|
| Rate for Payer: ASR ASR |
$40.39
|
| Rate for Payer: BCBS Trust/PPO |
$44.39
|
| Rate for Payer: BCBS Trust/PPO |
$31.89
|
| Rate for Payer: BCBS Trust/PPO |
$24.48
|
| Rate for Payer: BCBS Trust/PPO |
$36.63
|
| Rate for Payer: BCBS Trust/PPO |
$28.50
|
| Rate for Payer: BCBS Trust/PPO |
$27.09
|
| Rate for Payer: BCBS Trust/PPO |
$34.20
|
| Rate for Payer: BCBS Trust/PPO |
$26.14
|
| Rate for Payer: BCBS Trust/PPO |
$26.91
|
| Rate for Payer: BCBS Trust/PPO |
$18.72
|
| Rate for Payer: BCN Commercial |
$26.91
|
| Rate for Payer: BCN Commercial |
$26.14
|
| Rate for Payer: BCN Commercial |
$24.48
|
| Rate for Payer: BCN Commercial |
$27.09
|
| Rate for Payer: BCN Commercial |
$18.72
|
| Rate for Payer: BCN Commercial |
$28.50
|
| Rate for Payer: BCN Commercial |
$31.89
|
| Rate for Payer: BCN Commercial |
$34.20
|
| Rate for Payer: BCN Commercial |
$36.63
|
| Rate for Payer: BCN Commercial |
$44.39
|
| Rate for Payer: Cash Price |
$18.24
|
| Rate for Payer: Cash Price |
$31.06
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cash Price |
$35.68
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$26.39
|
| Rate for Payer: Cash Price |
$43.24
|
| Rate for Payer: Cash Price |
$33.32
|
| Rate for Payer: Cofinity Commercial |
$30.80
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Cofinity Commercial |
$31.01
|
| Rate for Payer: Cofinity Commercial |
$28.02
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Cofinity Commercial |
$50.81
|
| Rate for Payer: Cofinity Commercial |
$32.62
|
| Rate for Payer: Cofinity Commercial |
$39.15
|
| Rate for Payer: Cofinity Commercial |
$41.93
|
| Rate for Payer: Cofinity Commercial |
$36.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.39
|
| Rate for Payer: Healthscope Commercial |
$32.00
|
| Rate for Payer: Healthscope Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$37.67
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Healthscope Commercial |
$43.26
|
| Rate for Payer: Healthscope Commercial |
$52.43
|
| Rate for Payer: Healthscope Commercial |
$30.88
|
| Rate for Payer: Healthscope Commercial |
$28.92
|
| Rate for Payer: Healthscope Commercial |
$31.79
|
| Rate for Payer: Healthscope Commercial |
$22.11
|
| Rate for Payer: Healthscope Whirlpool |
$22.79
|
| Rate for Payer: Healthscope Whirlpool |
$29.81
|
| Rate for Payer: Healthscope Whirlpool |
$38.83
|
| Rate for Payer: Healthscope Whirlpool |
$31.84
|
| Rate for Payer: Healthscope Whirlpool |
$44.60
|
| Rate for Payer: Healthscope Whirlpool |
$54.06
|
| Rate for Payer: Healthscope Whirlpool |
$34.71
|
| Rate for Payer: Healthscope Whirlpool |
$41.64
|
| Rate for Payer: Healthscope Whirlpool |
$32.77
|
| Rate for Payer: Healthscope Whirlpool |
$32.99
|
| Rate for Payer: Mclaren Commercial |
$31.24
|
| Rate for Payer: Mclaren Commercial |
$26.83
|
| Rate for Payer: Mclaren Commercial |
$29.49
|
| Rate for Payer: Mclaren Commercial |
$48.65
|
| Rate for Payer: Mclaren Commercial |
$34.95
|
| Rate for Payer: Mclaren Commercial |
$28.65
|
| Rate for Payer: Mclaren Commercial |
$20.51
|
| Rate for Payer: Mclaren Commercial |
$40.14
|
| Rate for Payer: Mclaren Commercial |
$29.69
|
| Rate for Payer: Mclaren Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: Nomi Health Commercial |
$28.46
|
| Rate for Payer: Nomi Health Commercial |
$31.84
|
| Rate for Payer: Nomi Health Commercial |
$18.69
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: Nomi Health Commercial |
$26.87
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Nomi Health Commercial |
$34.15
|
| Rate for Payer: Nomi Health Commercial |
$36.57
|
| Rate for Payer: Nomi Health Commercial |
$27.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.57
|
|
|
PROCHLORPERAZINE MALEATE 10 MG TABLET
|
Facility
|
IP
|
$3.03
|
|
|
Service Code
|
NDC 51079054201
|
| Hospital Charge Code |
6582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.27 |
| Max. Negotiated Rate |
$3.03 |
| Rate for Payer: Aetna Commercial |
$2.73
|
| Rate for Payer: ASR ASR |
$2.94
|
| Rate for Payer: BCBS Trust/PPO |
$2.49
|
| Rate for Payer: BCN Commercial |
$2.49
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Cofinity Commercial |
$2.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.42
|
| Rate for Payer: Healthscope Commercial |
$2.94
|
| Rate for Payer: Healthscope Whirlpool |
$3.03
|
| Rate for Payer: Mclaren Commercial |
$2.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.57
|
| Rate for Payer: Nomi Health Commercial |
$2.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.67
|
|
|
PROCHLORPERAZINE MALEATE 10 MG TABLET
|
Facility
|
IP
|
$293.52
|
|
|
Service Code
|
NDC 904738206
|
| Hospital Charge Code |
6582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$220.14 |
| Max. Negotiated Rate |
$293.52 |
| Rate for Payer: Aetna Commercial |
$264.17
|
| Rate for Payer: ASR ASR |
$284.71
|
| Rate for Payer: BCBS Trust/PPO |
$241.04
|
| Rate for Payer: BCN Commercial |
$241.04
|
| Rate for Payer: Cash Price |
$234.82
|
| Rate for Payer: Cofinity Commercial |
$275.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.82
|
| Rate for Payer: Healthscope Commercial |
$284.71
|
| Rate for Payer: Healthscope Whirlpool |
$293.52
|
| Rate for Payer: Mclaren Commercial |
$264.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.49
|
| Rate for Payer: Nomi Health Commercial |
$240.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.30
|
|
|
PROCHLORPERAZINE MALEATE 10 MG TABLET
|
Facility
|
OP
|
$293.52
|
|
|
Service Code
|
NDC 904738206
|
| Hospital Charge Code |
6582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$108.60 |
| Max. Negotiated Rate |
$293.52 |
| Rate for Payer: Aetna Commercial |
$264.17
|
| Rate for Payer: Aetna Medicare |
$108.60
|
| Rate for Payer: ASR ASR |
$284.71
|
| Rate for Payer: BCBS Complete |
$117.41
|
| Rate for Payer: BCBS Trust/PPO |
$242.01
|
| Rate for Payer: BCN Commercial |
$242.01
|
| Rate for Payer: Cash Price |
$234.82
|
| Rate for Payer: Cofinity Commercial |
$275.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.82
|
| Rate for Payer: Healthscope Commercial |
$284.71
|
| Rate for Payer: Healthscope Whirlpool |
$293.52
|
| Rate for Payer: Mclaren Commercial |
$264.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.49
|
| Rate for Payer: Nomi Health Commercial |
$240.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.18
|
| Rate for Payer: Priority Health Narrow Network |
$205.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.30
|
|
|
PROCHLORPERAZINE MALEATE 10 MG TABLET
|
Facility
|
OP
|
$462.65
|
|
|
Service Code
|
NDC 59746011506
|
| Hospital Charge Code |
6582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$171.18 |
| Max. Negotiated Rate |
$462.65 |
| Rate for Payer: Aetna Commercial |
$416.38
|
| Rate for Payer: Aetna Medicare |
$171.18
|
| Rate for Payer: ASR ASR |
$448.77
|
| Rate for Payer: BCBS Complete |
$185.06
|
| Rate for Payer: BCBS Trust/PPO |
$381.45
|
| Rate for Payer: BCN Commercial |
$381.45
|
| Rate for Payer: Cash Price |
$370.12
|
| Rate for Payer: Cofinity Commercial |
$434.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.12
|
| Rate for Payer: Healthscope Commercial |
$448.77
|
| Rate for Payer: Healthscope Whirlpool |
$462.65
|
| Rate for Payer: Mclaren Commercial |
$416.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$370.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.25
|
| Rate for Payer: Nomi Health Commercial |
$379.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$405.37
|
| Rate for Payer: Priority Health Narrow Network |
$324.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$407.13
|
|
|
PROCHLORPERAZINE MALEATE 10 MG TABLET
|
Facility
|
OP
|
$3.03
|
|
|
Service Code
|
NDC 51079054201
|
| Hospital Charge Code |
6582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.12 |
| Max. Negotiated Rate |
$3.03 |
| Rate for Payer: Aetna Commercial |
$2.73
|
| Rate for Payer: Aetna Medicare |
$1.12
|
| Rate for Payer: ASR ASR |
$2.94
|
| Rate for Payer: BCBS Complete |
$1.21
|
| Rate for Payer: BCBS Trust/PPO |
$2.50
|
| Rate for Payer: BCN Commercial |
$2.50
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Cofinity Commercial |
$2.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.42
|
| Rate for Payer: Healthscope Commercial |
$2.94
|
| Rate for Payer: Healthscope Whirlpool |
$3.03
|
| Rate for Payer: Mclaren Commercial |
$2.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.57
|
| Rate for Payer: Nomi Health Commercial |
$2.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.65
|
| Rate for Payer: Priority Health Narrow Network |
$2.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.67
|
|
|
PROCHLORPERAZINE MALEATE 10 MG TABLET
|
Facility
|
IP
|
$462.65
|
|
|
Service Code
|
NDC 59746011506
|
| Hospital Charge Code |
6582
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$346.99 |
| Max. Negotiated Rate |
$462.65 |
| Rate for Payer: Aetna Commercial |
$416.38
|
| Rate for Payer: ASR ASR |
$448.77
|
| Rate for Payer: BCBS Trust/PPO |
$379.93
|
| Rate for Payer: BCN Commercial |
$379.93
|
| Rate for Payer: Cash Price |
$370.12
|
| Rate for Payer: Cofinity Commercial |
$434.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.12
|
| Rate for Payer: Healthscope Commercial |
$448.77
|
| Rate for Payer: Healthscope Whirlpool |
$462.65
|
| Rate for Payer: Mclaren Commercial |
$416.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.25
|
| Rate for Payer: Nomi Health Commercial |
$379.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$407.13
|
|
|
PR OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 99241
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$87.00 |
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.00
|
|
|
PR OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
HCPCS 99245
|
| Min. Negotiated Rate |
$113.96 |
| Max. Negotiated Rate |
$286.50 |
| Rate for Payer: Aetna Commercial |
$196.80
|
| Rate for Payer: BCBS Complete |
$119.66
|
| Rate for Payer: BCN Commercial |
$266.42
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Meridian Medicaid |
$119.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$239.64
|
| Rate for Payer: Priority Health Narrow Network |
$239.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$273.26
|
| Rate for Payer: UHC Exchange |
$273.26
|
| Rate for Payer: UHC Medicaid |
$113.96
|
| Rate for Payer: UHCCP Medicaid |
$113.96
|
|
|
PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 99243
|
| Min. Negotiated Rate |
$55.81 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$98.89
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCN Commercial |
$130.97
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$117.81
|
| Rate for Payer: Priority Health Narrow Network |
$117.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.31
|
| Rate for Payer: UHC Exchange |
$137.31
|
| Rate for Payer: UHC Medicaid |
$55.81
|
| Rate for Payer: UHCCP Medicaid |
$55.81
|
|
|
PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 99244
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial |
$159.16
|
| Rate for Payer: BCBS Complete |
$89.46
|
| Rate for Payer: BCN Commercial |
$198.70
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Meridian Medicaid |
$89.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$178.72
|
| Rate for Payer: Priority Health Narrow Network |
$178.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.02
|
| Rate for Payer: UHC Exchange |
$221.02
|
| Rate for Payer: UHC Medicaid |
$85.20
|
| Rate for Payer: UHCCP Medicaid |
$85.20
|
|
|
PR OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES
|
Professional
|
Both
|
$156.00
|
|
|
Service Code
|
HCPCS 99242
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Commercial |
$70.73
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCN Commercial |
$82.17
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$73.91
|
| Rate for Payer: Priority Health Narrow Network |
$73.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.22
|
| Rate for Payer: UHC Exchange |
$98.22
|
| Rate for Payer: UHC Medicaid |
$35.36
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
|
|
PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 99215
|
| Min. Negotiated Rate |
$110.52 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna Commercial |
$166.58
|
| Rate for Payer: Aetna Medicare |
$124.31
|
| Rate for Payer: BCBS Complete |
$116.05
|
| Rate for Payer: BCBS MAPPO |
$124.31
|
| Rate for Payer: BCN Commercial |
$157.73
|
| Rate for Payer: BCN Medicare Advantage |
$124.31
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$179.01
|
| Rate for Payer: Cofinity Commercial |
$166.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.31
|
| Rate for Payer: Healthscope Commercial |
$136.74
|
| Rate for Payer: Healthscope Whirlpool |
$136.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.53
|
| Rate for Payer: Meridian Medicaid |
$116.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.74
|
| Rate for Payer: Nomi Health Commercial |
$149.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$124.31
|
| Rate for Payer: PHP Medicare Advantage |
$124.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$162.63
|
| Rate for Payer: Priority Health Medicare |
$124.31
|
| Rate for Payer: Priority Health Narrow Network |
$162.63
|
| Rate for Payer: Railroad Medicare Medicare |
$124.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.31
|
| Rate for Payer: UHC Exchange |
$157.55
|
| Rate for Payer: UHC Medicaid |
$110.52
|
| Rate for Payer: UHCCP DNSP |
$124.31
|
| Rate for Payer: UHCCP Medicaid |
$110.52
|
|
