|
PR TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 58200
|
| Min. Negotiated Rate |
$964.00 |
| Max. Negotiated Rate |
$1,871.18 |
| Rate for Payer: Aetna Commercial |
$1,741.24
|
| Rate for Payer: Aetna Medicare |
$1,299.43
|
| Rate for Payer: BCBS Complete |
$964.00
|
| Rate for Payer: BCBS MAPPO |
$1,299.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,299.43
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$1,871.18
|
| Rate for Payer: Cofinity Commercial |
$1,741.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,299.43
|
| Rate for Payer: Healthscope Commercial |
$1,559.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,559.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,364.40
|
| Rate for Payer: Nomi Health Commercial |
$1,559.32
|
| Rate for Payer: PACE SWMI |
$1,299.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,299.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.50
|
| Rate for Payer: Priority Health Medicare |
$1,299.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,299.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,299.43
|
| Rate for Payer: UHCCP DNSP |
$1,299.43
|
|
|
PR TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY
|
Professional
|
Both
|
$3,357.00
|
|
|
Service Code
|
HCPCS 58152
|
| Min. Negotiated Rate |
$1,189.85 |
| Max. Negotiated Rate |
$2,182.05 |
| Rate for Payer: Aetna Commercial |
$1,594.40
|
| Rate for Payer: Aetna Medicare |
$1,189.85
|
| Rate for Payer: BCBS Complete |
$1,342.80
|
| Rate for Payer: BCBS MAPPO |
$1,189.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,189.85
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,713.38
|
| Rate for Payer: Cofinity Commercial |
$1,594.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,189.85
|
| Rate for Payer: Healthscope Commercial |
$1,427.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,427.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,249.34
|
| Rate for Payer: Nomi Health Commercial |
$1,427.82
|
| Rate for Payer: PACE SWMI |
$1,189.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,189.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.05
|
| Rate for Payer: Priority Health Medicare |
$1,189.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,189.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,189.85
|
| Rate for Payer: UHCCP DNSP |
$1,189.85
|
|
|
PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY
|
Professional
|
Both
|
$3,216.00
|
|
|
Service Code
|
HCPCS 58150
|
| Min. Negotiated Rate |
$979.07 |
| Max. Negotiated Rate |
$2,090.40 |
| Rate for Payer: Aetna Commercial |
$1,311.95
|
| Rate for Payer: Aetna Medicare |
$979.07
|
| Rate for Payer: BCBS Complete |
$1,286.40
|
| Rate for Payer: BCBS MAPPO |
$979.07
|
| Rate for Payer: BCN Medicare Advantage |
$979.07
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cofinity Commercial |
$1,409.86
|
| Rate for Payer: Cofinity Commercial |
$1,311.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.07
|
| Rate for Payer: Healthscope Commercial |
$1,174.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,174.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.02
|
| Rate for Payer: Nomi Health Commercial |
$1,174.88
|
| Rate for Payer: PACE SWMI |
$979.07
|
| Rate for Payer: PHP Medicare Advantage |
$979.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,090.40
|
| Rate for Payer: Priority Health Medicare |
$979.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$979.07
|
| Rate for Payer: UHC Medicare Advantage |
$979.07
|
| Rate for Payer: UHCCP DNSP |
$979.07
|
|
|
PR TOTAL DISC ARTHRP ANT 2ND LEVEL CERVICAL
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 22858
|
| Min. Negotiated Rate |
$430.40 |
| Max. Negotiated Rate |
$712.32 |
| Rate for Payer: Aetna Commercial |
$662.86
|
| Rate for Payer: Aetna Medicare |
$494.67
|
| Rate for Payer: BCBS Complete |
$430.40
|
| Rate for Payer: BCBS MAPPO |
$494.67
|
| Rate for Payer: BCN Medicare Advantage |
$494.67
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$712.32
|
| Rate for Payer: Cofinity Commercial |
$662.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.67
|
| Rate for Payer: Healthscope Commercial |
$593.60
|
| Rate for Payer: Healthscope Whirlpool |
$593.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.40
|
| Rate for Payer: Nomi Health Commercial |
$593.60
|
| Rate for Payer: PACE SWMI |
$494.67
|
| Rate for Payer: PHP Medicare Advantage |
$494.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$699.40
|
| Rate for Payer: Priority Health Medicare |
$494.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$494.67
|
| Rate for Payer: UHC Medicare Advantage |
$494.67
|
| Rate for Payer: UHCCP DNSP |
$494.67
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 22856
|
| Min. Negotiated Rate |
$1,367.20 |
| Max. Negotiated Rate |
$2,284.46 |
| Rate for Payer: Aetna Commercial |
$2,125.82
|
| Rate for Payer: Aetna Medicare |
$1,586.43
|
| Rate for Payer: BCBS Complete |
$1,367.20
|
| Rate for Payer: BCBS MAPPO |
$1,586.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,586.43
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cofinity Commercial |
$2,284.46
|
| Rate for Payer: Cofinity Commercial |
$2,125.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,586.43
|
| Rate for Payer: Healthscope Commercial |
$1,903.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,665.75
|
| Rate for Payer: Nomi Health Commercial |
$1,903.72
|
| Rate for Payer: PACE SWMI |
$1,586.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,586.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.70
|
| Rate for Payer: Priority Health Medicare |
$1,586.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,586.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,586.43
|
| Rate for Payer: UHCCP DNSP |
$1,586.43
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR
|
Professional
|
Both
|
$7,045.00
|
|
|
Service Code
|
HCPCS 22857
|
| Min. Negotiated Rate |
$1,682.29 |
| Max. Negotiated Rate |
$4,579.25 |
| Rate for Payer: Aetna Commercial |
$2,254.27
|
| Rate for Payer: Aetna Medicare |
$1,682.29
|
| Rate for Payer: BCBS Complete |
$2,818.00
|
| Rate for Payer: BCBS MAPPO |
$1,682.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,682.29
|
| Rate for Payer: Cash Price |
$5,636.00
|
| Rate for Payer: Cash Price |
$5,636.00
|
| Rate for Payer: Cofinity Commercial |
$2,422.50
|
| Rate for Payer: Cofinity Commercial |
$2,254.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,682.29
|
| Rate for Payer: Healthscope Commercial |
$2,018.75
|
| Rate for Payer: Healthscope Whirlpool |
$2,018.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,766.40
|
| Rate for Payer: Nomi Health Commercial |
$2,018.75
|
| Rate for Payer: PACE SWMI |
$1,682.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,682.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,579.25
|
| Rate for Payer: Priority Health Medicare |
$1,682.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,682.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,682.29
|
| Rate for Payer: UHCCP DNSP |
$1,682.29
|
|
|
PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY
|
Professional
|
Both
|
$5,885.00
|
|
|
Service Code
|
HCPCS 43112
|
| Min. Negotiated Rate |
$2,354.00 |
| Max. Negotiated Rate |
$4,734.72 |
| Rate for Payer: Aetna Commercial |
$4,405.92
|
| Rate for Payer: Aetna Medicare |
$3,288.00
|
| Rate for Payer: BCBS Complete |
$2,354.00
|
| Rate for Payer: BCBS MAPPO |
$3,288.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,288.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cash Price |
$4,708.00
|
| Rate for Payer: Cofinity Commercial |
$4,734.72
|
| Rate for Payer: Cofinity Commercial |
$4,405.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,288.00
|
| Rate for Payer: Healthscope Commercial |
$3,945.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,945.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,452.40
|
| Rate for Payer: Nomi Health Commercial |
$3,945.60
|
| Rate for Payer: PACE SWMI |
$3,288.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,288.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.25
|
| Rate for Payer: Priority Health Medicare |
$3,288.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,288.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,288.00
|
| Rate for Payer: UHCCP DNSP |
$3,288.00
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,654.25 |
| Max. Negotiated Rate |
$2,545.00 |
| Rate for Payer: Aetna Commercial |
$2,290.50
|
| Rate for Payer: ASR ASR |
$2,468.65
|
| Rate for Payer: ASR Commercial |
$2,468.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.92
|
| Rate for Payer: BCN Commercial |
$1,973.14
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$2,392.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Healthscope Commercial |
$2,545.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,468.65
|
| Rate for Payer: Mclaren Commercial |
$2,290.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: Nomi Health Commercial |
$2,086.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,239.60
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
OP
|
$2,545.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,654.25 |
| Max. Negotiated Rate |
$8,819.70 |
| Rate for Payer: Aetna Commercial |
$2,290.50
|
| Rate for Payer: Aetna Medicare |
$5,690.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: ASR ASR |
$2,468.65
|
| Rate for Payer: ASR Commercial |
$2,468.65
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,084.10
|
| Rate for Payer: BCN Commercial |
$1,973.14
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$2,392.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$2,545.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,468.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,690.13
|
| Rate for Payer: Mclaren Commercial |
$2,290.50
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.25
|
| Rate for Payer: Nomi Health Commercial |
$2,086.90
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$6,259.14
|
| Rate for Payer: PHP Medicaid |
$3,049.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,229.93
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,784.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,239.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$8,819.70
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP DNSP |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: VA VA |
$5,690.13
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$680.87 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$680.87
|
| Rate for Payer: BCBS Complete |
$1,018.00
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Healthscope Commercial |
$817.04
|
| Rate for Payer: Healthscope Whirlpool |
$817.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health Medicare |
$680.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
| Rate for Payer: UHCCP DNSP |
$680.87
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,545.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$680.87 |
| Max. Negotiated Rate |
$1,654.25 |
| Rate for Payer: Aetna Commercial |
$912.37
|
| Rate for Payer: Aetna Medicare |
$680.87
|
| Rate for Payer: BCBS Complete |
$1,018.00
|
| Rate for Payer: BCBS MAPPO |
$680.87
|
| Rate for Payer: BCN Medicare Advantage |
$680.87
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cash Price |
$2,036.00
|
| Rate for Payer: Cofinity Commercial |
$980.45
|
| Rate for Payer: Cofinity Commercial |
$912.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.87
|
| Rate for Payer: Healthscope Commercial |
$817.04
|
| Rate for Payer: Healthscope Whirlpool |
$817.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.91
|
| Rate for Payer: Nomi Health Commercial |
$817.04
|
| Rate for Payer: PACE SWMI |
$680.87
|
| Rate for Payer: PHP Medicare Advantage |
$680.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.25
|
| Rate for Payer: Priority Health Medicare |
$680.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.87
|
| Rate for Payer: UHC Medicare Advantage |
$680.87
|
| Rate for Payer: UHCCP DNSP |
$680.87
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,437.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$574.80 |
| Max. Negotiated Rate |
$1,302.48 |
| Rate for Payer: Aetna Commercial |
$1,212.03
|
| Rate for Payer: Aetna Medicare |
$904.50
|
| Rate for Payer: BCBS Complete |
$574.80
|
| Rate for Payer: BCBS MAPPO |
$904.50
|
| Rate for Payer: BCN Medicare Advantage |
$904.50
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cash Price |
$1,149.60
|
| Rate for Payer: Cofinity Commercial |
$1,302.48
|
| Rate for Payer: Cofinity Commercial |
$1,212.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.50
|
| Rate for Payer: Healthscope Commercial |
$1,085.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,085.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.73
|
| Rate for Payer: Nomi Health Commercial |
$1,085.40
|
| Rate for Payer: PACE SWMI |
$904.50
|
| Rate for Payer: PHP Medicare Advantage |
$904.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.05
|
| Rate for Payer: Priority Health Medicare |
$904.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.50
|
| Rate for Payer: UHC Medicare Advantage |
$904.50
|
| Rate for Payer: UHCCP DNSP |
$904.50
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$2,229.60 |
| Max. Negotiated Rate |
$4,117.75 |
| Rate for Payer: Aetna Commercial |
$3,831.80
|
| Rate for Payer: Aetna Medicare |
$2,859.55
|
| Rate for Payer: BCBS Complete |
$2,229.60
|
| Rate for Payer: BCBS MAPPO |
$2,859.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,859.55
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cofinity Commercial |
$4,117.75
|
| Rate for Payer: Cofinity Commercial |
$3,831.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,859.55
|
| Rate for Payer: Healthscope Commercial |
$3,431.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,431.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,002.53
|
| Rate for Payer: Nomi Health Commercial |
$3,431.46
|
| Rate for Payer: PACE SWMI |
$2,859.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,859.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health Medicare |
$2,859.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,859.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,859.55
|
| Rate for Payer: UHCCP DNSP |
$2,859.55
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$7,965.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$3,186.00 |
| Max. Negotiated Rate |
$5,269.26 |
| Rate for Payer: Aetna Commercial |
$4,903.34
|
| Rate for Payer: Aetna Medicare |
$3,659.21
|
| Rate for Payer: BCBS Complete |
$3,186.00
|
| Rate for Payer: BCBS MAPPO |
$3,659.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,659.21
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cash Price |
$6,372.00
|
| Rate for Payer: Cofinity Commercial |
$5,269.26
|
| Rate for Payer: Cofinity Commercial |
$4,903.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,659.21
|
| Rate for Payer: Healthscope Commercial |
$4,391.05
|
| Rate for Payer: Healthscope Whirlpool |
$4,391.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,842.17
|
| Rate for Payer: Nomi Health Commercial |
$4,391.05
|
| Rate for Payer: PACE SWMI |
$3,659.21
|
| Rate for Payer: PHP Medicare Advantage |
$3,659.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,177.25
|
| Rate for Payer: Priority Health Medicare |
$3,659.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,659.21
|
| Rate for Payer: UHC Medicare Advantage |
$3,659.21
|
| Rate for Payer: UHCCP DNSP |
$3,659.21
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,232.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$190.04 |
| Max. Negotiated Rate |
$800.80 |
| Rate for Payer: Aetna Commercial |
$254.65
|
| Rate for Payer: Aetna Medicare |
$190.04
|
| Rate for Payer: BCBS Complete |
$492.80
|
| Rate for Payer: BCBS MAPPO |
$190.04
|
| Rate for Payer: BCN Medicare Advantage |
$190.04
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cash Price |
$985.60
|
| Rate for Payer: Cofinity Commercial |
$273.66
|
| Rate for Payer: Cofinity Commercial |
$254.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.04
|
| Rate for Payer: Healthscope Commercial |
$228.05
|
| Rate for Payer: Healthscope Whirlpool |
$228.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.54
|
| Rate for Payer: Nomi Health Commercial |
$228.05
|
| Rate for Payer: PACE SWMI |
$190.04
|
| Rate for Payer: PHP Medicare Advantage |
$190.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.80
|
| Rate for Payer: Priority Health Medicare |
$190.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.04
|
| Rate for Payer: UHC Medicare Advantage |
$190.04
|
| Rate for Payer: UHCCP DNSP |
$190.04
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$46.62 |
| Max. Negotiated Rate |
$115.05 |
| Rate for Payer: Aetna Commercial |
$62.47
|
| Rate for Payer: Aetna Medicare |
$46.62
|
| Rate for Payer: BCBS Complete |
$70.80
|
| Rate for Payer: BCBS MAPPO |
$46.62
|
| Rate for Payer: BCN Medicare Advantage |
$46.62
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$67.13
|
| Rate for Payer: Cofinity Commercial |
$62.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.62
|
| Rate for Payer: Healthscope Commercial |
$55.94
|
| Rate for Payer: Healthscope Whirlpool |
$55.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.95
|
| Rate for Payer: Nomi Health Commercial |
$55.94
|
| Rate for Payer: PACE SWMI |
$46.62
|
| Rate for Payer: PHP Medicare Advantage |
$46.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health Medicare |
$46.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.62
|
| Rate for Payer: UHC Medicare Advantage |
$46.62
|
| Rate for Payer: UHCCP DNSP |
$46.62
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$232.40 |
| Max. Negotiated Rate |
$513.23 |
| Rate for Payer: Aetna Commercial |
$477.59
|
| Rate for Payer: Aetna Medicare |
$356.41
|
| Rate for Payer: BCBS Complete |
$232.40
|
| Rate for Payer: BCBS MAPPO |
$356.41
|
| Rate for Payer: BCN Medicare Advantage |
$356.41
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cofinity Commercial |
$513.23
|
| Rate for Payer: Cofinity Commercial |
$477.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.41
|
| Rate for Payer: Healthscope Commercial |
$427.69
|
| Rate for Payer: Healthscope Whirlpool |
$427.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.23
|
| Rate for Payer: Nomi Health Commercial |
$427.69
|
| Rate for Payer: PACE SWMI |
$356.41
|
| Rate for Payer: PHP Medicare Advantage |
$356.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.65
|
| Rate for Payer: Priority Health Medicare |
$356.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.41
|
| Rate for Payer: UHC Medicare Advantage |
$356.41
|
| Rate for Payer: UHCCP DNSP |
$356.41
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$317.88 |
| Max. Negotiated Rate |
$618.80 |
| Rate for Payer: Aetna Commercial |
$425.96
|
| Rate for Payer: Aetna Medicare |
$317.88
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS MAPPO |
$317.88
|
| Rate for Payer: BCN Medicare Advantage |
$317.88
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$457.75
|
| Rate for Payer: Cofinity Commercial |
$425.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.88
|
| Rate for Payer: Healthscope Commercial |
$381.46
|
| Rate for Payer: Healthscope Whirlpool |
$381.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.77
|
| Rate for Payer: Nomi Health Commercial |
$381.46
|
| Rate for Payer: PACE SWMI |
$317.88
|
| Rate for Payer: PHP Medicare Advantage |
$317.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health Medicare |
$317.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.88
|
| Rate for Payer: UHC Medicare Advantage |
$317.88
|
| Rate for Payer: UHCCP DNSP |
$317.88
|
|
|
PR TRACHEOBRONCHOSCOPY THRU EST TRACHEOSTOMY INC
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$300.30 |
| Rate for Payer: Aetna Commercial |
$147.35
|
| Rate for Payer: Aetna Medicare |
$109.96
|
| Rate for Payer: BCBS Complete |
$184.80
|
| Rate for Payer: BCBS MAPPO |
$109.96
|
| Rate for Payer: BCN Medicare Advantage |
$109.96
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cofinity Commercial |
$158.34
|
| Rate for Payer: Cofinity Commercial |
$147.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.96
|
| Rate for Payer: Healthscope Commercial |
$131.95
|
| Rate for Payer: Healthscope Whirlpool |
$131.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.46
|
| Rate for Payer: Nomi Health Commercial |
$131.95
|
| Rate for Payer: PACE SWMI |
$109.96
|
| Rate for Payer: PHP Medicare Advantage |
$109.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.30
|
| Rate for Payer: Priority Health Medicare |
$109.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.96
|
| Rate for Payer: UHC Medicare Advantage |
$109.96
|
| Rate for Payer: UHCCP DNSP |
$109.96
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,405.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$1,257.95 |
| Max. Negotiated Rate |
$2,863.25 |
| Rate for Payer: Aetna Commercial |
$1,685.65
|
| Rate for Payer: Aetna Medicare |
$1,257.95
|
| Rate for Payer: BCBS Complete |
$1,762.00
|
| Rate for Payer: BCBS MAPPO |
$1,257.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.95
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cash Price |
$3,524.00
|
| Rate for Payer: Cofinity Commercial |
$1,811.45
|
| Rate for Payer: Cofinity Commercial |
$1,685.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.95
|
| Rate for Payer: Healthscope Commercial |
$1,509.54
|
| Rate for Payer: Healthscope Whirlpool |
$1,509.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.85
|
| Rate for Payer: Nomi Health Commercial |
$1,509.54
|
| Rate for Payer: PACE SWMI |
$1,257.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,863.25
|
| Rate for Payer: Priority Health Medicare |
$1,257.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.95
|
| Rate for Payer: UHCCP DNSP |
$1,257.95
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,355.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$542.00 |
| Max. Negotiated Rate |
$959.83 |
| Rate for Payer: Aetna Commercial |
$893.18
|
| Rate for Payer: Aetna Medicare |
$666.55
|
| Rate for Payer: BCBS Complete |
$542.00
|
| Rate for Payer: BCBS MAPPO |
$666.55
|
| Rate for Payer: BCN Medicare Advantage |
$666.55
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cash Price |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$959.83
|
| Rate for Payer: Cofinity Commercial |
$893.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.55
|
| Rate for Payer: Healthscope Commercial |
$799.86
|
| Rate for Payer: Healthscope Whirlpool |
$799.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$699.88
|
| Rate for Payer: Nomi Health Commercial |
$799.86
|
| Rate for Payer: PACE SWMI |
$666.55
|
| Rate for Payer: PHP Medicare Advantage |
$666.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$880.75
|
| Rate for Payer: Priority Health Medicare |
$666.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$666.55
|
| Rate for Payer: UHC Medicare Advantage |
$666.55
|
| Rate for Payer: UHCCP DNSP |
$666.55
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$364.80 |
| Max. Negotiated Rate |
$592.80 |
| Rate for Payer: Aetna Commercial |
$528.39
|
| Rate for Payer: Aetna Medicare |
$394.32
|
| Rate for Payer: BCBS Complete |
$364.80
|
| Rate for Payer: BCBS MAPPO |
$394.32
|
| Rate for Payer: BCN Medicare Advantage |
$394.32
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$567.82
|
| Rate for Payer: Cofinity Commercial |
$528.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.32
|
| Rate for Payer: Healthscope Commercial |
$473.18
|
| Rate for Payer: Healthscope Whirlpool |
$473.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.04
|
| Rate for Payer: Nomi Health Commercial |
$473.18
|
| Rate for Payer: PACE SWMI |
$394.32
|
| Rate for Payer: PHP Medicare Advantage |
$394.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.80
|
| Rate for Payer: Priority Health Medicare |
$394.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.32
|
| Rate for Payer: UHC Medicare Advantage |
$394.32
|
| Rate for Payer: UHCCP DNSP |
$394.32
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$320.18 |
| Max. Negotiated Rate |
$525.85 |
| Rate for Payer: Aetna Commercial |
$429.04
|
| Rate for Payer: Aetna Medicare |
$320.18
|
| Rate for Payer: BCBS Complete |
$323.60
|
| Rate for Payer: BCBS MAPPO |
$320.18
|
| Rate for Payer: BCN Medicare Advantage |
$320.18
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$461.06
|
| Rate for Payer: Cofinity Commercial |
$429.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.18
|
| Rate for Payer: Healthscope Commercial |
$384.22
|
| Rate for Payer: Healthscope Whirlpool |
$384.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.19
|
| Rate for Payer: Nomi Health Commercial |
$384.22
|
| Rate for Payer: PACE SWMI |
$320.18
|
| Rate for Payer: PHP Medicare Advantage |
$320.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health Medicare |
$320.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.18
|
| Rate for Payer: UHC Medicare Advantage |
$320.18
|
| Rate for Payer: UHCCP DNSP |
$320.18
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$306.41 |
| Max. Negotiated Rate |
$772.85 |
| Rate for Payer: Aetna Commercial |
$410.59
|
| Rate for Payer: Aetna Medicare |
$306.41
|
| Rate for Payer: BCBS Complete |
$475.60
|
| Rate for Payer: BCBS MAPPO |
$306.41
|
| Rate for Payer: BCN Medicare Advantage |
$306.41
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cofinity Commercial |
$441.23
|
| Rate for Payer: Cofinity Commercial |
$410.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.41
|
| Rate for Payer: Healthscope Commercial |
$367.69
|
| Rate for Payer: Healthscope Whirlpool |
$367.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.73
|
| Rate for Payer: Nomi Health Commercial |
$367.69
|
| Rate for Payer: PACE SWMI |
$306.41
|
| Rate for Payer: PHP Medicare Advantage |
$306.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.85
|
| Rate for Payer: Priority Health Medicare |
$306.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.41
|
| Rate for Payer: UHC Medicare Advantage |
$306.41
|
| Rate for Payer: UHCCP DNSP |
$306.41
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$619.60 |
| Max. Negotiated Rate |
$1,289.68 |
| Rate for Payer: Aetna Commercial |
$1,200.12
|
| Rate for Payer: Aetna Medicare |
$895.61
|
| Rate for Payer: BCBS Complete |
$619.60
|
| Rate for Payer: BCBS MAPPO |
$895.61
|
| Rate for Payer: BCN Medicare Advantage |
$895.61
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,289.68
|
| Rate for Payer: Cofinity Commercial |
$1,200.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.61
|
| Rate for Payer: Healthscope Commercial |
$1,074.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,074.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$940.39
|
| Rate for Payer: Nomi Health Commercial |
$1,074.73
|
| Rate for Payer: PACE SWMI |
$895.61
|
| Rate for Payer: PHP Medicare Advantage |
$895.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health Medicare |
$895.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$895.61
|
| Rate for Payer: UHC Medicare Advantage |
$895.61
|
| Rate for Payer: UHCCP DNSP |
$895.61
|
|
