|
PR REMOT IMAGE SUBMIT BY PT
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS G2010
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Trust/PPO |
$119.40
|
| Rate for Payer: BCN Commercial |
$17.59
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.12
|
| Rate for Payer: Priority Health Narrow Network |
$12.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.47
|
| Rate for Payer: UHC Exchange |
$10.47
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
|
|
PR REMOVAL ANAL SETON OTHER MARKER
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 46030
|
| Min. Negotiated Rate |
$96.40 |
| Max. Negotiated Rate |
$1,184.45 |
| Rate for Payer: Aetna Commercial |
$119.25
|
| Rate for Payer: Aetna Medicare |
$120.50
|
| Rate for Payer: BCBS Complete |
$96.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.45
|
| Rate for Payer: BCN Commercial |
$377.75
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.51
|
| Rate for Payer: Priority Health Narrow Network |
$154.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.69
|
| Rate for Payer: UHC Exchange |
$104.69
|
|
|
PR REMOVAL ANKLE IMPLANT
|
Professional
|
Both
|
$1,822.00
|
|
|
Service Code
|
HCPCS 27704
|
| Min. Negotiated Rate |
$368.28 |
| Max. Negotiated Rate |
$2,348.82 |
| Rate for Payer: Aetna Commercial |
$760.19
|
| Rate for Payer: Aetna Medicare |
$911.00
|
| Rate for Payer: BCBS Complete |
$386.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,348.82
|
| Rate for Payer: BCN Commercial |
$835.15
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Meridian Medicaid |
$386.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,184.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$876.26
|
| Rate for Payer: Priority Health Narrow Network |
$876.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$652.08
|
| Rate for Payer: UHC Exchange |
$652.08
|
| Rate for Payer: UHCCP Medicaid |
$368.28
|
|
|
PR REMOVAL ANTERIOR INSTRUMENTATION
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 22855
|
| Min. Negotiated Rate |
$210.26 |
| Max. Negotiated Rate |
$2,627.95 |
| Rate for Payer: Aetna Commercial |
$1,487.03
|
| Rate for Payer: Aetna Medicare |
$2,021.50
|
| Rate for Payer: BCBS Complete |
$755.72
|
| Rate for Payer: BCBS Trust/PPO |
$210.26
|
| Rate for Payer: BCN Commercial |
$1,795.01
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Meridian Medicaid |
$755.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$719.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,627.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,710.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,710.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,294.24
|
| Rate for Payer: UHC Exchange |
$1,294.24
|
| Rate for Payer: UHCCP Medicaid |
$719.73
|
|
|
PR REMOVAL/BIVALVING FULL ARM/FULL LEG CAST
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 29705
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$1,732.82 |
| Rate for Payer: Aetna Commercial |
$61.11
|
| Rate for Payer: Aetna Medicare |
$58.50
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,732.82
|
| Rate for Payer: BCN Commercial |
$91.87
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.67
|
| Rate for Payer: Priority Health Narrow Network |
$67.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.97
|
| Rate for Payer: UHC Exchange |
$54.97
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
PR REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 59871
|
| Min. Negotiated Rate |
$85.41 |
| Max. Negotiated Rate |
$714.79 |
| Rate for Payer: Aetna Commercial |
$144.84
|
| Rate for Payer: Aetna Medicare |
$185.00
|
| Rate for Payer: BCBS Complete |
$89.68
|
| Rate for Payer: BCBS Trust/PPO |
$714.79
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Meridian Medicaid |
$89.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.24
|
| Rate for Payer: Priority Health Narrow Network |
$187.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.81
|
| Rate for Payer: UHC Exchange |
$153.81
|
| Rate for Payer: UHCCP Medicaid |
$85.41
|
|
|
PR REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 21029
|
| Min. Negotiated Rate |
$406.62 |
| Max. Negotiated Rate |
$3,995.58 |
| Rate for Payer: Aetna Commercial |
$818.18
|
| Rate for Payer: Aetna Medicare |
$774.50
|
| Rate for Payer: BCBS Complete |
$426.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,995.58
|
| Rate for Payer: BCN Commercial |
$1,128.35
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Meridian Medicaid |
$426.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$960.23
|
| Rate for Payer: Priority Health Narrow Network |
$960.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$732.72
|
| Rate for Payer: UHC Exchange |
$732.72
|
| Rate for Payer: UHCCP Medicaid |
$406.62
|
|
|
PR REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 64570
|
| Min. Negotiated Rate |
$427.92 |
| Max. Negotiated Rate |
$1,285.30 |
| Rate for Payer: Aetna Commercial |
$944.34
|
| Rate for Payer: Aetna Medicare |
$770.50
|
| Rate for Payer: BCBS Complete |
$509.25
|
| Rate for Payer: BCBS Trust/PPO |
$427.92
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Meridian Medicaid |
$509.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,285.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,285.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$731.75
|
| Rate for Payer: UHC Exchange |
$731.75
|
| Rate for Payer: UHCCP Medicaid |
$485.00
|
|
|
PR REMOVAL EMBEDDED FOREIGN BODY EYELID
|
Professional
|
Both
|
$480.00
|
|
|
Service Code
|
HCPCS 67938
|
| Min. Negotiated Rate |
$73.06 |
| Max. Negotiated Rate |
$1,699.01 |
| Rate for Payer: Aetna Commercial |
$151.12
|
| Rate for Payer: Aetna Medicare |
$240.00
|
| Rate for Payer: BCBS Complete |
$76.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,699.01
|
| Rate for Payer: BCN Commercial |
$399.74
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Meridian Medicaid |
$76.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.30
|
| Rate for Payer: Priority Health Narrow Network |
$205.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$121.35
|
| Rate for Payer: UHC Exchange |
$121.35
|
| Rate for Payer: UHCCP Medicaid |
$73.06
|
|
|
PR REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
HCPCS 20694
|
| Min. Negotiated Rate |
$224.72 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$448.62
|
| Rate for Payer: Aetna Medicare |
$477.00
|
| Rate for Payer: BCBS Complete |
$235.96
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$634.30
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Meridian Medicaid |
$235.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$530.24
|
| Rate for Payer: Priority Health Narrow Network |
$530.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$381.37
|
| Rate for Payer: UHC Exchange |
$381.37
|
| Rate for Payer: UHCCP Medicaid |
$224.72
|
|
|
PR REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 65205
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$238.26 |
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Medicare |
$97.00
|
| Rate for Payer: BCBS Complete |
$19.24
|
| Rate for Payer: BCBS Trust/PPO |
$238.26
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$19.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.31
|
| Rate for Payer: Priority Health Narrow Network |
$50.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.60
|
| Rate for Payer: UHC Exchange |
$47.60
|
| Rate for Payer: UHCCP Medicaid |
$18.32
|
|
|
PR REMOVAL FOREIGN BODY DEEP PENILE TISSUE
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 54115
|
| Min. Negotiated Rate |
$275.62 |
| Max. Negotiated Rate |
$2,119.54 |
| Rate for Payer: Aetna Commercial |
$543.74
|
| Rate for Payer: Aetna Medicare |
$425.00
|
| Rate for Payer: BCBS Complete |
$289.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,119.54
|
| Rate for Payer: BCN Commercial |
$663.13
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Meridian Medicaid |
$289.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$552.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.38
|
| Rate for Payer: Priority Health Narrow Network |
$684.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$505.67
|
| Rate for Payer: UHC Exchange |
$505.67
|
| Rate for Payer: UHCCP Medicaid |
$275.62
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 27372
|
| Hospital Charge Code |
27372
|
| Min. Negotiated Rate |
$262.84 |
| Max. Negotiated Rate |
$3,545.42 |
| Rate for Payer: Aetna Commercial |
$533.27
|
| Rate for Payer: Aetna Medicare |
$557.00
|
| Rate for Payer: BCBS Complete |
$275.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,545.42
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Meridian Medicaid |
$275.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.29
|
| Rate for Payer: Priority Health Narrow Network |
$620.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.08
|
| Rate for Payer: UHC Exchange |
$458.08
|
| Rate for Payer: UHCCP Medicaid |
$262.84
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
OP
|
$1,114.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$724.10 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,002.60
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$1,080.58
|
| Rate for Payer: ASR Commercial |
$1,080.58
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$912.25
|
| Rate for Payer: BCN Commercial |
$863.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$1,047.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,114.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,080.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,002.60
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.90
|
| Rate for Payer: Nomi Health Commercial |
$913.48
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,614.65
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,891.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$980.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 27372
|
| Min. Negotiated Rate |
$262.84 |
| Max. Negotiated Rate |
$3,545.42 |
| Rate for Payer: Aetna Commercial |
$533.27
|
| Rate for Payer: Aetna Medicare |
$557.00
|
| Rate for Payer: BCBS Complete |
$275.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,545.42
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Meridian Medicaid |
$275.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.29
|
| Rate for Payer: Priority Health Narrow Network |
$620.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.08
|
| Rate for Payer: UHC Exchange |
$458.08
|
| Rate for Payer: UHCCP Medicaid |
$262.84
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
IP
|
$1,114.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$724.10 |
| Max. Negotiated Rate |
$1,114.00 |
| Rate for Payer: Aetna Commercial |
$1,002.60
|
| Rate for Payer: ASR ASR |
$1,080.58
|
| Rate for Payer: ASR Commercial |
$1,080.58
|
| Rate for Payer: BCBS Trust/PPO |
$907.80
|
| Rate for Payer: BCN Commercial |
$863.68
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$1,047.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.20
|
| Rate for Payer: Healthscope Commercial |
$1,114.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,080.58
|
| Rate for Payer: Mclaren Commercial |
$1,002.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.90
|
| Rate for Payer: Nomi Health Commercial |
$913.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$980.32
|
|
|
PR REMOVAL FOREIGN BODY FOOT COMPLICATED
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 28193
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$1,271.09 |
| Rate for Payer: Aetna Commercial |
$486.43
|
| Rate for Payer: Aetna Medicare |
$471.00
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.09
|
| Rate for Payer: BCN Commercial |
$756.96
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.78
|
| Rate for Payer: Priority Health Narrow Network |
$561.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.33
|
| Rate for Payer: UHC Exchange |
$440.33
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
|
|
PR REMOVAL FOREIGN BODY FOOT DEEP
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 28192
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: Aetna Commercial |
$411.56
|
| Rate for Payer: Aetna Medicare |
$382.50
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.05
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.32
|
| Rate for Payer: Priority Health Narrow Network |
$477.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.92
|
| Rate for Payer: UHC Exchange |
$370.92
|
| Rate for Payer: UHCCP Medicaid |
$202.35
|
|
|
PR REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 28190
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$996.37 |
| Rate for Payer: Aetna Commercial |
$176.00
|
| Rate for Payer: Aetna Medicare |
$299.00
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS Trust/PPO |
$996.37
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.54
|
| Rate for Payer: Priority Health Narrow Network |
$203.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.14
|
| Rate for Payer: UHC Exchange |
$156.14
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES
|
Professional
|
Both
|
$369.00
|
|
|
Service Code
|
HCPCS 30310
|
| Min. Negotiated Rate |
$132.49 |
| Max. Negotiated Rate |
$1,405.81 |
| Rate for Payer: Aetna Commercial |
$262.26
|
| Rate for Payer: Aetna Medicare |
$184.50
|
| Rate for Payer: BCBS Complete |
$139.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.81
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Meridian Medicaid |
$139.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.98
|
| Rate for Payer: Priority Health Narrow Network |
$291.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.59
|
| Rate for Payer: UHC Exchange |
$219.59
|
| Rate for Payer: UHCCP Medicaid |
$132.49
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 30300
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$829.43 |
| Rate for Payer: Aetna Commercial |
$151.15
|
| Rate for Payer: Aetna Medicare |
$196.00
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS Trust/PPO |
$829.43
|
| Rate for Payer: BCN Commercial |
$311.29
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.41
|
| Rate for Payer: Priority Health Narrow Network |
$172.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.77
|
| Rate for Payer: UHC Exchange |
$130.77
|
| Rate for Payer: UHCCP Medicaid |
$77.96
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 20520
|
| Min. Negotiated Rate |
$96.06 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$202.50
|
| Rate for Payer: BCBS Complete |
$100.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Meridian Medicaid |
$100.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.47
|
| Rate for Payer: Priority Health Narrow Network |
$227.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.14
|
| Rate for Payer: UHC Exchange |
$163.14
|
| Rate for Payer: UHCCP Medicaid |
$96.06
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
20520
|
| Min. Negotiated Rate |
$96.06 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$202.50
|
| Rate for Payer: BCBS Complete |
$100.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Meridian Medicaid |
$100.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.47
|
| Rate for Payer: Priority Health Narrow Network |
$227.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.14
|
| Rate for Payer: UHC Exchange |
$163.14
|
| Rate for Payer: UHCCP Medicaid |
$96.06
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$405.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$263.25 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$364.50
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$392.85
|
| Rate for Payer: ASR Commercial |
$392.85
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$331.65
|
| Rate for Payer: BCN Commercial |
$314.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$380.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Healthscope Whirlpool |
$392.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$364.50
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.25
|
| Rate for Payer: Nomi Health Commercial |
$332.10
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.70
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$615.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$356.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$405.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$263.25 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$364.50
|
| Rate for Payer: ASR ASR |
$392.85
|
| Rate for Payer: ASR Commercial |
$392.85
|
| Rate for Payer: BCBS Trust/PPO |
$330.03
|
| Rate for Payer: BCN Commercial |
$314.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$380.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.00
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Healthscope Whirlpool |
$392.85
|
| Rate for Payer: Mclaren Commercial |
$364.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.25
|
| Rate for Payer: Nomi Health Commercial |
$332.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$356.40
|
|
