|
PR RMVL/REVJ SLING STRESS INCONTINENCE
|
Professional
|
Both
|
$1,271.00
|
|
|
Service Code
|
HCPCS 57287
|
| Min. Negotiated Rate |
$420.89 |
| Max. Negotiated Rate |
$1,536.93 |
| Rate for Payer: Aetna Commercial |
$866.42
|
| Rate for Payer: Aetna Medicare |
$646.58
|
| Rate for Payer: BCBS Complete |
$441.93
|
| Rate for Payer: BCBS MAPPO |
$646.58
|
| Rate for Payer: BCN Commercial |
$1,536.93
|
| Rate for Payer: BCN Medicare Advantage |
$646.58
|
| Rate for Payer: Cash Price |
$1,016.80
|
| Rate for Payer: Cash Price |
$1,016.80
|
| Rate for Payer: Cofinity Commercial |
$931.08
|
| Rate for Payer: Cofinity Commercial |
$866.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.58
|
| Rate for Payer: Healthscope Commercial |
$775.90
|
| Rate for Payer: Healthscope Whirlpool |
$775.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.91
|
| Rate for Payer: Meridian Medicaid |
$441.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$711.24
|
| Rate for Payer: Nomi Health Commercial |
$775.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$953.25
|
| Rate for Payer: PACE SWMI |
$646.58
|
| Rate for Payer: PHP Medicare Advantage |
$646.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,126.71
|
| Rate for Payer: Priority Health Medicare |
$646.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,126.71
|
| Rate for Payer: Railroad Medicare Medicare |
$646.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,255.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$646.58
|
| Rate for Payer: UHC Exchange |
$1,255.72
|
| Rate for Payer: UHC Medicaid |
$420.89
|
| Rate for Payer: UHCCP DNSP |
$646.58
|
| Rate for Payer: UHCCP Medicaid |
$420.89
|
|
|
PR RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS
|
Professional
|
Both
|
$1,723.00
|
|
|
Service Code
|
HCPCS 54410
|
| Min. Negotiated Rate |
$498.85 |
| Max. Negotiated Rate |
$1,517.99 |
| Rate for Payer: Aetna Commercial |
$1,033.11
|
| Rate for Payer: Aetna Medicare |
$770.98
|
| Rate for Payer: BCBS Complete |
$523.79
|
| Rate for Payer: BCBS MAPPO |
$770.98
|
| Rate for Payer: BCN Commercial |
$1,293.75
|
| Rate for Payer: BCN Medicare Advantage |
$770.98
|
| Rate for Payer: Cash Price |
$1,378.40
|
| Rate for Payer: Cash Price |
$1,378.40
|
| Rate for Payer: Cofinity Commercial |
$1,110.21
|
| Rate for Payer: Cofinity Commercial |
$1,033.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.98
|
| Rate for Payer: Healthscope Commercial |
$925.18
|
| Rate for Payer: Healthscope Whirlpool |
$925.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.53
|
| Rate for Payer: Meridian Medicaid |
$523.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$848.08
|
| Rate for Payer: Nomi Health Commercial |
$925.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,292.25
|
| Rate for Payer: PACE SWMI |
$770.98
|
| Rate for Payer: PHP Medicare Advantage |
$770.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,409.32
|
| Rate for Payer: Priority Health Medicare |
$770.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,409.32
|
| Rate for Payer: Railroad Medicare Medicare |
$770.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,517.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$770.98
|
| Rate for Payer: UHC Exchange |
$1,517.99
|
| Rate for Payer: UHC Medicaid |
$498.85
|
| Rate for Payer: UHCCP DNSP |
$770.98
|
| Rate for Payer: UHCCP Medicaid |
$498.85
|
|
|
PR RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 50382
|
| Min. Negotiated Rate |
$138.24 |
| Max. Negotiated Rate |
$1,661.25 |
| Rate for Payer: Aetna Commercial |
$290.65
|
| Rate for Payer: Aetna Medicare |
$216.90
|
| Rate for Payer: BCBS Complete |
$145.15
|
| Rate for Payer: BCBS MAPPO |
$216.90
|
| Rate for Payer: BCN Commercial |
$367.51
|
| Rate for Payer: BCN Medicare Advantage |
$216.90
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$312.34
|
| Rate for Payer: Cofinity Commercial |
$290.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.90
|
| Rate for Payer: Healthscope Commercial |
$260.28
|
| Rate for Payer: Healthscope Whirlpool |
$260.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.75
|
| Rate for Payer: Meridian Medicaid |
$145.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$238.59
|
| Rate for Payer: Nomi Health Commercial |
$260.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.25
|
| Rate for Payer: PACE SWMI |
$216.90
|
| Rate for Payer: PHP Medicare Advantage |
$216.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$400.34
|
| Rate for Payer: Priority Health Medicare |
$216.90
|
| Rate for Payer: Priority Health Narrow Network |
$400.34
|
| Rate for Payer: Railroad Medicare Medicare |
$216.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$457.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$216.90
|
| Rate for Payer: UHC Exchange |
$457.46
|
| Rate for Payer: UHC Medicaid |
$138.24
|
| Rate for Payer: UHCCP DNSP |
$216.90
|
| Rate for Payer: UHCCP Medicaid |
$138.24
|
|
|
PR RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD
|
Professional
|
Both
|
$2,732.00
|
|
|
Service Code
|
HCPCS 53448
|
| Min. Negotiated Rate |
$728.89 |
| Max. Negotiated Rate |
$2,261.86 |
| Rate for Payer: Aetna Commercial |
$1,515.74
|
| Rate for Payer: Aetna Medicare |
$1,131.15
|
| Rate for Payer: BCBS Complete |
$765.33
|
| Rate for Payer: BCBS MAPPO |
$1,131.15
|
| Rate for Payer: BCN Commercial |
$1,900.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,131.15
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,628.86
|
| Rate for Payer: Cofinity Commercial |
$1,515.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,131.15
|
| Rate for Payer: Healthscope Commercial |
$1,357.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,357.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.71
|
| Rate for Payer: Meridian Medicaid |
$765.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,244.27
|
| Rate for Payer: Nomi Health Commercial |
$1,357.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,049.00
|
| Rate for Payer: PACE SWMI |
$1,131.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,131.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$728.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,070.59
|
| Rate for Payer: Priority Health Medicare |
$1,131.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,070.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,131.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,261.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,131.15
|
| Rate for Payer: UHC Exchange |
$2,261.86
|
| Rate for Payer: UHC Medicaid |
$728.89
|
| Rate for Payer: UHCCP DNSP |
$1,131.15
|
| Rate for Payer: UHCCP Medicaid |
$728.89
|
|
|
PR RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL
|
Professional
|
Both
|
$2,195.00
|
|
|
Service Code
|
HCPCS 54411
|
| Min. Negotiated Rate |
$592.14 |
| Max. Negotiated Rate |
$1,816.79 |
| Rate for Payer: Aetna Commercial |
$1,227.99
|
| Rate for Payer: Aetna Medicare |
$916.41
|
| Rate for Payer: BCBS Complete |
$621.75
|
| Rate for Payer: BCBS MAPPO |
$916.41
|
| Rate for Payer: BCN Commercial |
$1,539.26
|
| Rate for Payer: BCN Medicare Advantage |
$916.41
|
| Rate for Payer: Cash Price |
$1,756.00
|
| Rate for Payer: Cash Price |
$1,756.00
|
| Rate for Payer: Cofinity Commercial |
$1,319.63
|
| Rate for Payer: Cofinity Commercial |
$1,227.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$916.41
|
| Rate for Payer: Healthscope Commercial |
$1,099.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,099.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$962.23
|
| Rate for Payer: Meridian Medicaid |
$621.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,008.05
|
| Rate for Payer: Nomi Health Commercial |
$1,099.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,646.25
|
| Rate for Payer: PACE SWMI |
$916.41
|
| Rate for Payer: PHP Medicare Advantage |
$916.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,676.75
|
| Rate for Payer: Priority Health Medicare |
$916.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,676.75
|
| Rate for Payer: Railroad Medicare Medicare |
$916.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,816.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$916.41
|
| Rate for Payer: UHC Exchange |
$1,816.79
|
| Rate for Payer: UHC Medicaid |
$592.14
|
| Rate for Payer: UHCCP DNSP |
$916.41
|
| Rate for Payer: UHCCP Medicaid |
$592.14
|
|
|
PR RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC
|
Professional
|
Both
|
$2,590.00
|
|
|
Service Code
|
HCPCS 53447
|
| Min. Negotiated Rate |
$466.04 |
| Max. Negotiated Rate |
$1,942.50 |
| Rate for Payer: Aetna Commercial |
$965.50
|
| Rate for Payer: Aetna Medicare |
$720.52
|
| Rate for Payer: BCBS Complete |
$489.34
|
| Rate for Payer: BCBS MAPPO |
$720.52
|
| Rate for Payer: BCN Commercial |
$1,206.61
|
| Rate for Payer: BCN Medicare Advantage |
$720.52
|
| Rate for Payer: Cash Price |
$2,072.00
|
| Rate for Payer: Cash Price |
$2,072.00
|
| Rate for Payer: Cofinity Commercial |
$965.50
|
| Rate for Payer: Cofinity Commercial |
$1,037.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$720.52
|
| Rate for Payer: Healthscope Commercial |
$864.62
|
| Rate for Payer: Healthscope Whirlpool |
$864.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$756.55
|
| Rate for Payer: Meridian Medicaid |
$489.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$792.57
|
| Rate for Payer: Nomi Health Commercial |
$864.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,942.50
|
| Rate for Payer: PACE SWMI |
$720.52
|
| Rate for Payer: PHP Medicare Advantage |
$720.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$466.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,314.40
|
| Rate for Payer: Priority Health Medicare |
$720.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,314.40
|
| Rate for Payer: Railroad Medicare Medicare |
$720.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,425.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$720.52
|
| Rate for Payer: UHC Exchange |
$1,425.37
|
| Rate for Payer: UHC Medicaid |
$466.04
|
| Rate for Payer: UHCCP DNSP |
$720.52
|
| Rate for Payer: UHCCP Medicaid |
$466.04
|
|
|
PR RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD
|
Professional
|
Both
|
$2,359.00
|
|
|
Service Code
|
HCPCS 54417
|
| Min. Negotiated Rate |
$517.59 |
| Max. Negotiated Rate |
$1,769.25 |
| Rate for Payer: Aetna Commercial |
$1,073.63
|
| Rate for Payer: Aetna Medicare |
$801.22
|
| Rate for Payer: BCBS Complete |
$543.47
|
| Rate for Payer: BCBS MAPPO |
$801.22
|
| Rate for Payer: BCN Commercial |
$1,346.04
|
| Rate for Payer: BCN Medicare Advantage |
$801.22
|
| Rate for Payer: Cash Price |
$1,887.20
|
| Rate for Payer: Cash Price |
$1,887.20
|
| Rate for Payer: Cofinity Commercial |
$1,153.76
|
| Rate for Payer: Cofinity Commercial |
$1,073.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$801.22
|
| Rate for Payer: Healthscope Commercial |
$961.46
|
| Rate for Payer: Healthscope Whirlpool |
$961.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$841.28
|
| Rate for Payer: Meridian Medicaid |
$543.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$881.34
|
| Rate for Payer: Nomi Health Commercial |
$961.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,769.25
|
| Rate for Payer: PACE SWMI |
$801.22
|
| Rate for Payer: PHP Medicare Advantage |
$801.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,466.28
|
| Rate for Payer: Priority Health Medicare |
$801.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,466.28
|
| Rate for Payer: Railroad Medicare Medicare |
$801.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,587.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$801.22
|
| Rate for Payer: UHC Exchange |
$1,587.32
|
| Rate for Payer: UHC Medicaid |
$517.59
|
| Rate for Payer: UHCCP DNSP |
$801.22
|
| Rate for Payer: UHCCP Medicaid |
$517.59
|
|
|
PR RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH
|
Professional
|
Both
|
$1,235.00
|
|
|
Service Code
|
HCPCS 50387
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$926.25 |
| Rate for Payer: Aetna Commercial |
$96.35
|
| Rate for Payer: Aetna Medicare |
$71.90
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.90
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$71.90
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cash Price |
$988.00
|
| Rate for Payer: Cofinity Commercial |
$96.35
|
| Rate for Payer: Cofinity Commercial |
$103.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.90
|
| Rate for Payer: Healthscope Commercial |
$86.28
|
| Rate for Payer: Healthscope Whirlpool |
$86.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.50
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.09
|
| Rate for Payer: Nomi Health Commercial |
$86.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.25
|
| Rate for Payer: PACE SWMI |
$71.90
|
| Rate for Payer: PHP Medicare Advantage |
$71.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$132.37
|
| Rate for Payer: Priority Health Medicare |
$71.90
|
| Rate for Payer: Priority Health Narrow Network |
$132.37
|
| Rate for Payer: Railroad Medicare Medicare |
$71.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$149.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.90
|
| Rate for Payer: UHC Exchange |
$149.76
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP DNSP |
$71.90
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
|
|
PR RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE
|
Professional
|
Both
|
$1,749.00
|
|
|
Service Code
|
HCPCS 69711
|
| Min. Negotiated Rate |
$478.19 |
| Max. Negotiated Rate |
$1,444.43 |
| Rate for Payer: Aetna Commercial |
$972.18
|
| Rate for Payer: Aetna Medicare |
$725.51
|
| Rate for Payer: BCBS Complete |
$502.10
|
| Rate for Payer: BCBS MAPPO |
$725.51
|
| Rate for Payer: BCN Commercial |
$1,251.93
|
| Rate for Payer: BCN Medicare Advantage |
$725.51
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cofinity Commercial |
$972.18
|
| Rate for Payer: Cofinity Commercial |
$1,044.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.51
|
| Rate for Payer: Healthscope Commercial |
$870.61
|
| Rate for Payer: Healthscope Whirlpool |
$870.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$761.79
|
| Rate for Payer: Meridian Medicaid |
$502.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$798.06
|
| Rate for Payer: Nomi Health Commercial |
$870.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,311.75
|
| Rate for Payer: PACE SWMI |
$725.51
|
| Rate for Payer: PHP Medicare Advantage |
$725.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,237.02
|
| Rate for Payer: Priority Health Medicare |
$725.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,237.02
|
| Rate for Payer: Railroad Medicare Medicare |
$725.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,444.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$725.51
|
| Rate for Payer: UHC Exchange |
$1,444.43
|
| Rate for Payer: UHC Medicaid |
$478.19
|
| Rate for Payer: UHCCP DNSP |
$725.51
|
| Rate for Payer: UHCCP Medicaid |
$478.19
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,179.00
|
|
|
Service Code
|
HCPCS 19330
|
| Min. Negotiated Rate |
$377.86 |
| Max. Negotiated Rate |
$1,105.82 |
| Rate for Payer: Aetna Commercial |
$775.44
|
| Rate for Payer: Aetna Medicare |
$578.69
|
| Rate for Payer: BCBS Complete |
$396.75
|
| Rate for Payer: BCBS MAPPO |
$578.69
|
| Rate for Payer: BCN Commercial |
$978.53
|
| Rate for Payer: BCN Medicare Advantage |
$578.69
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cofinity Commercial |
$833.31
|
| Rate for Payer: Cofinity Commercial |
$775.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.69
|
| Rate for Payer: Healthscope Commercial |
$694.43
|
| Rate for Payer: Healthscope Whirlpool |
$694.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$607.62
|
| Rate for Payer: Meridian Medicaid |
$396.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$636.56
|
| Rate for Payer: Nomi Health Commercial |
$694.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$884.25
|
| Rate for Payer: PACE SWMI |
$578.69
|
| Rate for Payer: PHP Medicare Advantage |
$578.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$895.61
|
| Rate for Payer: Priority Health Medicare |
$578.69
|
| Rate for Payer: Priority Health Narrow Network |
$895.61
|
| Rate for Payer: Railroad Medicare Medicare |
$578.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,105.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$578.69
|
| Rate for Payer: UHC Exchange |
$1,105.82
|
| Rate for Payer: UHC Medicaid |
$377.86
|
| Rate for Payer: UHCCP DNSP |
$578.69
|
| Rate for Payer: UHCCP Medicaid |
$377.86
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY EA ADDL 10
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 11201
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$17.31
|
| Rate for Payer: Aetna Medicare |
$12.92
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCN Commercial |
$18.85
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$18.60
|
| Rate for Payer: Cofinity Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$15.50
|
| Rate for Payer: Healthscope Whirlpool |
$15.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.21
|
| Rate for Payer: Nomi Health Commercial |
$15.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.88
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health Narrow Network |
$21.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.92
|
| Rate for Payer: UHC Exchange |
$28.71
|
| Rate for Payer: UHC Medicaid |
$8.31
|
| Rate for Payer: UHCCP DNSP |
$12.92
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$249.89 |
| Rate for Payer: Aetna Commercial |
$162.00
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$174.60
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$148.41
|
| Rate for Payer: BCN Commercial |
$148.41
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$169.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Healthscope Whirlpool |
$180.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$162.00
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.00
|
| Rate for Payer: Nomi Health Commercial |
$147.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.00
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$194.96
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$155.97
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 11200
|
| Hospital Charge Code |
11200
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$88.48
|
| Rate for Payer: Aetna Medicare |
$66.03
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$66.03
|
| Rate for Payer: BCN Commercial |
$91.50
|
| Rate for Payer: BCN Medicare Advantage |
$66.03
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$95.08
|
| Rate for Payer: Cofinity Commercial |
$88.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.03
|
| Rate for Payer: Healthscope Commercial |
$79.24
|
| Rate for Payer: Healthscope Whirlpool |
$79.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.33
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.63
|
| Rate for Payer: Nomi Health Commercial |
$79.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.00
|
| Rate for Payer: PACE SWMI |
$66.03
|
| Rate for Payer: PHP Medicare Advantage |
$66.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$106.20
|
| Rate for Payer: Priority Health Medicare |
$66.03
|
| Rate for Payer: Priority Health Narrow Network |
$106.20
|
| Rate for Payer: Railroad Medicare Medicare |
$66.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.03
|
| Rate for Payer: UHC Exchange |
$125.51
|
| Rate for Payer: UHC Medicaid |
$44.09
|
| Rate for Payer: UHCCP DNSP |
$66.03
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$162.00
|
| Rate for Payer: ASR ASR |
$174.60
|
| Rate for Payer: BCBS Trust/PPO |
$147.82
|
| Rate for Payer: BCN Commercial |
$147.82
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$169.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.00
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Healthscope Whirlpool |
$180.00
|
| Rate for Payer: Mclaren Commercial |
$162.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.00
|
| Rate for Payer: Nomi Health Commercial |
$147.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.00
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 11200
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$88.48
|
| Rate for Payer: Aetna Medicare |
$66.03
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$66.03
|
| Rate for Payer: BCN Commercial |
$91.50
|
| Rate for Payer: BCN Medicare Advantage |
$66.03
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$95.08
|
| Rate for Payer: Cofinity Commercial |
$88.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.03
|
| Rate for Payer: Healthscope Commercial |
$79.24
|
| Rate for Payer: Healthscope Whirlpool |
$79.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.33
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.63
|
| Rate for Payer: Nomi Health Commercial |
$79.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.00
|
| Rate for Payer: PACE SWMI |
$66.03
|
| Rate for Payer: PHP Medicare Advantage |
$66.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$106.20
|
| Rate for Payer: Priority Health Medicare |
$66.03
|
| Rate for Payer: Priority Health Narrow Network |
$106.20
|
| Rate for Payer: Railroad Medicare Medicare |
$66.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$125.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.03
|
| Rate for Payer: UHC Exchange |
$125.51
|
| Rate for Payer: UHC Medicaid |
$44.09
|
| Rate for Payer: UHCCP DNSP |
$66.03
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR
|
Professional
|
Both
|
$4,060.00
|
|
|
Service Code
|
HCPCS 63662
|
| Min. Negotiated Rate |
$541.87 |
| Max. Negotiated Rate |
$3,045.00 |
| Rate for Payer: Aetna Commercial |
$1,118.75
|
| Rate for Payer: Aetna Medicare |
$834.89
|
| Rate for Payer: BCBS Complete |
$568.96
|
| Rate for Payer: BCBS MAPPO |
$834.89
|
| Rate for Payer: BCN Commercial |
$1,301.22
|
| Rate for Payer: BCN Medicare Advantage |
$834.89
|
| Rate for Payer: Cash Price |
$3,248.00
|
| Rate for Payer: Cash Price |
$3,248.00
|
| Rate for Payer: Cofinity Commercial |
$1,202.24
|
| Rate for Payer: Cofinity Commercial |
$1,118.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$834.89
|
| Rate for Payer: Healthscope Commercial |
$1,001.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,001.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.63
|
| Rate for Payer: Meridian Medicaid |
$568.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$918.38
|
| Rate for Payer: Nomi Health Commercial |
$1,001.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,045.00
|
| Rate for Payer: PACE SWMI |
$834.89
|
| Rate for Payer: PHP Medicare Advantage |
$834.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,511.34
|
| Rate for Payer: Priority Health Medicare |
$834.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,511.34
|
| Rate for Payer: Railroad Medicare Medicare |
$834.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,473.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$834.89
|
| Rate for Payer: UHC Exchange |
$1,473.47
|
| Rate for Payer: UHC Medicaid |
$541.87
|
| Rate for Payer: UHCCP DNSP |
$834.89
|
| Rate for Payer: UHCCP Medicaid |
$541.87
|
|
|
PR RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR
|
Professional
|
Both
|
$1,876.00
|
|
|
Service Code
|
HCPCS 63661
|
| Min. Negotiated Rate |
$197.03 |
| Max. Negotiated Rate |
$1,407.00 |
| Rate for Payer: Aetna Commercial |
$406.73
|
| Rate for Payer: Aetna Medicare |
$303.53
|
| Rate for Payer: BCBS Complete |
$206.88
|
| Rate for Payer: BCBS MAPPO |
$303.53
|
| Rate for Payer: BCN Commercial |
$498.48
|
| Rate for Payer: BCN Medicare Advantage |
$303.53
|
| Rate for Payer: Cash Price |
$1,500.80
|
| Rate for Payer: Cash Price |
$1,500.80
|
| Rate for Payer: Cofinity Commercial |
$437.08
|
| Rate for Payer: Cofinity Commercial |
$406.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.53
|
| Rate for Payer: Healthscope Commercial |
$364.24
|
| Rate for Payer: Healthscope Whirlpool |
$364.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.71
|
| Rate for Payer: Meridian Medicaid |
$206.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.88
|
| Rate for Payer: Nomi Health Commercial |
$364.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,407.00
|
| Rate for Payer: PACE SWMI |
$303.53
|
| Rate for Payer: PHP Medicare Advantage |
$303.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$578.98
|
| Rate for Payer: Priority Health Medicare |
$303.53
|
| Rate for Payer: Priority Health Narrow Network |
$578.98
|
| Rate for Payer: Railroad Medicare Medicare |
$303.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.53
|
| Rate for Payer: UHC Exchange |
$567.69
|
| Rate for Payer: UHC Medicaid |
$197.03
|
| Rate for Payer: UHCCP DNSP |
$303.53
|
| Rate for Payer: UHCCP Medicaid |
$197.03
|
|
|
PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 62365
|
| Min. Negotiated Rate |
$188.72 |
| Max. Negotiated Rate |
$1,170.75 |
| Rate for Payer: Aetna Commercial |
$386.44
|
| Rate for Payer: Aetna Medicare |
$288.39
|
| Rate for Payer: BCBS Complete |
$198.16
|
| Rate for Payer: BCBS MAPPO |
$288.39
|
| Rate for Payer: BCN Commercial |
$453.66
|
| Rate for Payer: BCN Medicare Advantage |
$288.39
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$415.28
|
| Rate for Payer: Cofinity Commercial |
$386.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.39
|
| Rate for Payer: Healthscope Commercial |
$346.07
|
| Rate for Payer: Healthscope Whirlpool |
$346.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.81
|
| Rate for Payer: Meridian Medicaid |
$198.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.23
|
| Rate for Payer: Nomi Health Commercial |
$346.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.75
|
| Rate for Payer: PACE SWMI |
$288.39
|
| Rate for Payer: PHP Medicare Advantage |
$288.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$526.92
|
| Rate for Payer: Priority Health Medicare |
$288.39
|
| Rate for Payer: Priority Health Narrow Network |
$526.92
|
| Rate for Payer: Railroad Medicare Medicare |
$288.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$512.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.39
|
| Rate for Payer: UHC Exchange |
$512.97
|
| Rate for Payer: UHC Medicaid |
$188.72
|
| Rate for Payer: UHCCP DNSP |
$288.39
|
| Rate for Payer: UHCCP Medicaid |
$188.72
|
|
|
PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 26392
|
| Min. Negotiated Rate |
$620.26 |
| Max. Negotiated Rate |
$1,690.17 |
| Rate for Payer: Aetna Commercial |
$1,250.89
|
| Rate for Payer: Aetna Medicare |
$933.50
|
| Rate for Payer: BCBS Complete |
$651.27
|
| Rate for Payer: BCBS MAPPO |
$933.50
|
| Rate for Payer: BCN Commercial |
$1,504.90
|
| Rate for Payer: BCN Medicare Advantage |
$933.50
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,344.24
|
| Rate for Payer: Cofinity Commercial |
$1,250.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.50
|
| Rate for Payer: Healthscope Commercial |
$1,120.20
|
| Rate for Payer: Healthscope Whirlpool |
$1,120.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.17
|
| Rate for Payer: Meridian Medicaid |
$651.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,026.85
|
| Rate for Payer: Nomi Health Commercial |
$1,120.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,257.75
|
| Rate for Payer: PACE SWMI |
$933.50
|
| Rate for Payer: PHP Medicare Advantage |
$933.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$620.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,608.69
|
| Rate for Payer: Priority Health Medicare |
$933.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,608.69
|
| Rate for Payer: Railroad Medicare Medicare |
$933.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,690.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$933.50
|
| Rate for Payer: UHC Exchange |
$1,690.17
|
| Rate for Payer: UHC Medicaid |
$620.26
|
| Rate for Payer: UHCCP DNSP |
$933.50
|
| Rate for Payer: UHCCP Medicaid |
$620.26
|
|
|
PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL
|
Professional
|
Both
|
$486.00
|
|
|
Service Code
|
HCPCS 46754
|
| Min. Negotiated Rate |
$152.93 |
| Max. Negotiated Rate |
$447.79 |
| Rate for Payer: Aetna Commercial |
$308.87
|
| Rate for Payer: Aetna Medicare |
$230.50
|
| Rate for Payer: BCBS Complete |
$160.58
|
| Rate for Payer: BCBS MAPPO |
$230.50
|
| Rate for Payer: BCN Commercial |
$367.51
|
| Rate for Payer: BCN Medicare Advantage |
$230.50
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$331.92
|
| Rate for Payer: Cofinity Commercial |
$308.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.50
|
| Rate for Payer: Healthscope Commercial |
$276.60
|
| Rate for Payer: Healthscope Whirlpool |
$276.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.03
|
| Rate for Payer: Meridian Medicaid |
$160.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$253.55
|
| Rate for Payer: Nomi Health Commercial |
$276.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$364.50
|
| Rate for Payer: PACE SWMI |
$230.50
|
| Rate for Payer: PHP Medicare Advantage |
$230.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$447.79
|
| Rate for Payer: Priority Health Medicare |
$230.50
|
| Rate for Payer: Priority Health Narrow Network |
$447.79
|
| Rate for Payer: Railroad Medicare Medicare |
$230.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$406.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$230.50
|
| Rate for Payer: UHC Exchange |
$406.53
|
| Rate for Payer: UHC Medicaid |
$152.93
|
| Rate for Payer: UHCCP DNSP |
$230.50
|
| Rate for Payer: UHCCP Medicaid |
$152.93
|
|
|
PR RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 33234
|
| Min. Negotiated Rate |
$273.71 |
| Max. Negotiated Rate |
$1,296.00 |
| Rate for Payer: Aetna Commercial |
$571.20
|
| Rate for Payer: Aetna Medicare |
$426.27
|
| Rate for Payer: BCBS Complete |
$287.40
|
| Rate for Payer: BCBS MAPPO |
$426.27
|
| Rate for Payer: BCN Commercial |
$714.11
|
| Rate for Payer: BCN Medicare Advantage |
$426.27
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cofinity Commercial |
$613.83
|
| Rate for Payer: Cofinity Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.27
|
| Rate for Payer: Healthscope Commercial |
$511.52
|
| Rate for Payer: Healthscope Whirlpool |
$511.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.58
|
| Rate for Payer: Meridian Medicaid |
$287.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.90
|
| Rate for Payer: Nomi Health Commercial |
$511.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,296.00
|
| Rate for Payer: PACE SWMI |
$426.27
|
| Rate for Payer: PHP Medicare Advantage |
$426.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$767.93
|
| Rate for Payer: Priority Health Medicare |
$426.27
|
| Rate for Payer: Priority Health Narrow Network |
$767.93
|
| Rate for Payer: Railroad Medicare Medicare |
$426.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$859.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$426.27
|
| Rate for Payer: UHC Exchange |
$859.39
|
| Rate for Payer: UHC Medicaid |
$273.71
|
| Rate for Payer: UHCCP DNSP |
$426.27
|
| Rate for Payer: UHCCP Medicaid |
$273.71
|
|
|
PR RMVL TRANSVNS PM ELTRD DUAL LEAD SYS
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 33235
|
| Min. Negotiated Rate |
$362.10 |
| Max. Negotiated Rate |
$1,127.38 |
| Rate for Payer: Aetna Commercial |
$754.30
|
| Rate for Payer: Aetna Medicare |
$562.91
|
| Rate for Payer: BCBS Complete |
$380.20
|
| Rate for Payer: BCBS MAPPO |
$562.91
|
| Rate for Payer: BCN Commercial |
$938.20
|
| Rate for Payer: BCN Medicare Advantage |
$562.91
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$810.59
|
| Rate for Payer: Cofinity Commercial |
$754.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.91
|
| Rate for Payer: Healthscope Commercial |
$675.49
|
| Rate for Payer: Healthscope Whirlpool |
$675.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.06
|
| Rate for Payer: Meridian Medicaid |
$380.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$619.20
|
| Rate for Payer: Nomi Health Commercial |
$675.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.25
|
| Rate for Payer: PACE SWMI |
$562.91
|
| Rate for Payer: PHP Medicare Advantage |
$562.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,008.91
|
| Rate for Payer: Priority Health Medicare |
$562.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,008.91
|
| Rate for Payer: Railroad Medicare Medicare |
$562.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,127.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$562.91
|
| Rate for Payer: UHC Exchange |
$1,127.38
|
| Rate for Payer: UHC Medicaid |
$362.10
|
| Rate for Payer: UHCCP DNSP |
$562.91
|
| Rate for Payer: UHCCP Medicaid |
$362.10
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 36590
|
| Min. Negotiated Rate |
$110.12 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Aetna Commercial |
$228.15
|
| Rate for Payer: Aetna Medicare |
$170.26
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCBS MAPPO |
$170.26
|
| Rate for Payer: BCN Commercial |
$281.36
|
| Rate for Payer: BCN Medicare Advantage |
$170.26
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$245.17
|
| Rate for Payer: Cofinity Commercial |
$228.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.26
|
| Rate for Payer: Healthscope Commercial |
$204.31
|
| Rate for Payer: Healthscope Whirlpool |
$204.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.77
|
| Rate for Payer: Meridian Medicaid |
$115.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.29
|
| Rate for Payer: Nomi Health Commercial |
$204.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PACE SWMI |
$170.26
|
| Rate for Payer: PHP Medicare Advantage |
$170.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$302.57
|
| Rate for Payer: Priority Health Medicare |
$170.26
|
| Rate for Payer: Priority Health Narrow Network |
$302.57
|
| Rate for Payer: Railroad Medicare Medicare |
$170.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$170.26
|
| Rate for Payer: UHC Exchange |
$335.99
|
| Rate for Payer: UHC Medicaid |
$110.12
|
| Rate for Payer: UHCCP DNSP |
$170.26
|
| Rate for Payer: UHCCP Medicaid |
$110.12
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 36590
|
| Hospital Charge Code |
36590
|
| Min. Negotiated Rate |
$110.12 |
| Max. Negotiated Rate |
$552.75 |
| Rate for Payer: Aetna Commercial |
$228.15
|
| Rate for Payer: Aetna Medicare |
$170.26
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCBS MAPPO |
$170.26
|
| Rate for Payer: BCN Commercial |
$281.36
|
| Rate for Payer: BCN Medicare Advantage |
$170.26
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$245.17
|
| Rate for Payer: Cofinity Commercial |
$228.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.26
|
| Rate for Payer: Healthscope Commercial |
$204.31
|
| Rate for Payer: Healthscope Whirlpool |
$204.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.77
|
| Rate for Payer: Meridian Medicaid |
$115.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.29
|
| Rate for Payer: Nomi Health Commercial |
$204.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PACE SWMI |
$170.26
|
| Rate for Payer: PHP Medicare Advantage |
$170.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$302.57
|
| Rate for Payer: Priority Health Medicare |
$170.26
|
| Rate for Payer: Priority Health Narrow Network |
$302.57
|
| Rate for Payer: Railroad Medicare Medicare |
$170.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$170.26
|
| Rate for Payer: UHC Exchange |
$335.99
|
| Rate for Payer: UHC Medicaid |
$110.12
|
| Rate for Payer: UHCCP DNSP |
$170.26
|
| Rate for Payer: UHCCP Medicaid |
$110.12
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
IP
|
$737.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$552.75 |
| Max. Negotiated Rate |
$737.00 |
| Rate for Payer: Aetna Commercial |
$663.30
|
| Rate for Payer: ASR ASR |
$714.89
|
| Rate for Payer: BCBS Trust/PPO |
$605.22
|
| Rate for Payer: BCN Commercial |
$605.22
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$692.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.60
|
| Rate for Payer: Healthscope Commercial |
$714.89
|
| Rate for Payer: Healthscope Whirlpool |
$737.00
|
| Rate for Payer: Mclaren Commercial |
$663.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.45
|
| Rate for Payer: Nomi Health Commercial |
$604.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
|
