|
PR RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD
|
Professional
|
Both
|
$2,290.00
|
|
|
Service Code
|
HCPCS 54417
|
| Min. Negotiated Rate |
$575.74 |
| Max. Negotiated Rate |
$158,049.00 |
| Rate for Payer: Aetna Commercial |
$1,151.58
|
| Rate for Payer: Aetna Medicare |
$893.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,151.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.52
|
| Rate for Payer: BCBS Complete |
$604.53
|
| Rate for Payer: BCBS MAPPO |
$859.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,176.77
|
| Rate for Payer: BCN Commercial |
$1,295.97
|
| Rate for Payer: BCN Medicare Advantage |
$859.39
|
| Rate for Payer: Cash Price |
$1,832.00
|
| Rate for Payer: Cash Price |
$1,832.00
|
| Rate for Payer: Cofinity Commercial |
$1,237.52
|
| Rate for Payer: Cofinity Commercial |
$1,151.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.39
|
| Rate for Payer: Healthscope Commercial |
$1,589.87
|
| Rate for Payer: Healthscope Commercial |
$1,375.02
|
| Rate for Payer: Mclaren Medicaid |
$575.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$902.36
|
| Rate for Payer: Meridian Medicaid |
$604.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158,049.00
|
| Rate for Payer: Nomi Health Commercial |
$1,031.27
|
| Rate for Payer: PACE SWMI |
$859.39
|
| Rate for Payer: PHP Medicare Advantage |
$859.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,488.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,429.50
|
| Rate for Payer: Priority Health Medicare |
$859.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,429.50
|
| Rate for Payer: Priority Health SBD |
$1,429.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$859.39
|
| Rate for Payer: UHC Exchange |
$944.94
|
| Rate for Payer: UHC Medicare Advantage |
$859.39
|
| Rate for Payer: UHCCP Medicaid |
$575.74
|
|
|
PR RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 50387
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$14,634.00 |
| Rate for Payer: Aetna Commercial |
$105.14
|
| Rate for Payer: Aetna Medicare |
$81.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.98
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$78.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,379.54
|
| Rate for Payer: BCN Commercial |
$822.45
|
| Rate for Payer: BCN Medicare Advantage |
$78.46
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$112.98
|
| Rate for Payer: Cofinity Commercial |
$105.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.46
|
| Rate for Payer: Healthscope Commercial |
$145.15
|
| Rate for Payer: Healthscope Commercial |
$125.54
|
| Rate for Payer: Mclaren Medicaid |
$51.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.38
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,634.00
|
| Rate for Payer: Nomi Health Commercial |
$94.15
|
| Rate for Payer: PACE SWMI |
$78.46
|
| Rate for Payer: PHP Medicare Advantage |
$78.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.90
|
| Rate for Payer: Priority Health Medicare |
$78.46
|
| Rate for Payer: Priority Health Narrow Network |
$128.90
|
| Rate for Payer: Priority Health SBD |
$128.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.46
|
| Rate for Payer: UHC Exchange |
$112.44
|
| Rate for Payer: UHC Medicare Advantage |
$78.46
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE
|
Professional
|
Both
|
$1,698.00
|
|
|
Service Code
|
HCPCS 69711
|
| Min. Negotiated Rate |
$535.48 |
| Max. Negotiated Rate |
$148,160.00 |
| Rate for Payer: Aetna Commercial |
$1,051.15
|
| Rate for Payer: Aetna Medicare |
$815.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.59
|
| Rate for Payer: BCBS Complete |
$562.25
|
| Rate for Payer: BCBS MAPPO |
$784.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,026.10
|
| Rate for Payer: BCN Commercial |
$1,238.80
|
| Rate for Payer: BCN Medicare Advantage |
$784.44
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Cofinity Commercial |
$1,129.59
|
| Rate for Payer: Cofinity Commercial |
$1,051.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$784.44
|
| Rate for Payer: Healthscope Commercial |
$1,451.21
|
| Rate for Payer: Healthscope Commercial |
$1,255.10
|
| Rate for Payer: Mclaren Medicaid |
$535.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$823.66
|
| Rate for Payer: Meridian Medicaid |
$562.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148,160.00
|
| Rate for Payer: Nomi Health Commercial |
$941.33
|
| Rate for Payer: PACE SWMI |
$784.44
|
| Rate for Payer: PHP Medicare Advantage |
$784.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$535.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,231.02
|
| Rate for Payer: Priority Health Medicare |
$784.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.02
|
| Rate for Payer: Priority Health SBD |
$1,231.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$893.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$784.44
|
| Rate for Payer: UHC Exchange |
$893.83
|
| Rate for Payer: UHC Medicare Advantage |
$784.44
|
| Rate for Payer: UHCCP Medicaid |
$535.48
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 19330
|
| Min. Negotiated Rate |
$418.55 |
| Max. Negotiated Rate |
$114,313.00 |
| Rate for Payer: Aetna Commercial |
$829.94
|
| Rate for Payer: Aetna Medicare |
$644.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$829.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.88
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$619.36
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$947.54
|
| Rate for Payer: BCN Medicare Advantage |
$619.36
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$891.88
|
| Rate for Payer: Cofinity Commercial |
$829.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.36
|
| Rate for Payer: Healthscope Commercial |
$990.98
|
| Rate for Payer: Healthscope Commercial |
$1,145.82
|
| Rate for Payer: Mclaren Medicaid |
$418.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.33
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114,313.00
|
| Rate for Payer: Nomi Health Commercial |
$743.23
|
| Rate for Payer: PACE SWMI |
$619.36
|
| Rate for Payer: PHP Medicare Advantage |
$619.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.65
|
| Rate for Payer: Priority Health Medicare |
$619.36
|
| Rate for Payer: Priority Health Narrow Network |
$878.65
|
| Rate for Payer: Priority Health SBD |
$878.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.36
|
| Rate for Payer: UHC Exchange |
$579.03
|
| Rate for Payer: UHC Medicare Advantage |
$619.36
|
| Rate for Payer: UHCCP Medicaid |
$418.55
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Facility
|
IP
|
$1,145.00
|
|
|
Service Code
|
CPT 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$721.35 |
| Max. Negotiated Rate |
$1,030.50 |
| Rate for Payer: Aetna Commercial |
$973.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.25
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$801.50
|
| Rate for Payer: Cofinity Commercial |
$984.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$801.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.00
|
| Rate for Payer: Healthscope Commercial |
$1,030.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.25
|
| Rate for Payer: PHP Commercial |
$973.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health SBD |
$721.35
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$418.55 |
| Max. Negotiated Rate |
$114,313.00 |
| Rate for Payer: Aetna Commercial |
$829.94
|
| Rate for Payer: Aetna Medicare |
$644.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$829.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.88
|
| Rate for Payer: BCBS Complete |
$439.48
|
| Rate for Payer: BCBS MAPPO |
$619.36
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$947.54
|
| Rate for Payer: BCN Medicare Advantage |
$619.36
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$891.88
|
| Rate for Payer: Cofinity Commercial |
$829.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.36
|
| Rate for Payer: Healthscope Commercial |
$990.98
|
| Rate for Payer: Healthscope Commercial |
$1,145.82
|
| Rate for Payer: Mclaren Medicaid |
$418.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.33
|
| Rate for Payer: Meridian Medicaid |
$439.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114,313.00
|
| Rate for Payer: Nomi Health Commercial |
$743.23
|
| Rate for Payer: PACE SWMI |
$619.36
|
| Rate for Payer: PHP Medicare Advantage |
$619.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.65
|
| Rate for Payer: Priority Health Medicare |
$619.36
|
| Rate for Payer: Priority Health Narrow Network |
$878.65
|
| Rate for Payer: Priority Health SBD |
$878.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.36
|
| Rate for Payer: UHC Exchange |
$579.03
|
| Rate for Payer: UHC Medicare Advantage |
$619.36
|
| Rate for Payer: UHCCP Medicaid |
$418.55
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Facility
|
OP
|
$1,145.00
|
|
|
Service Code
|
CPT 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$683.53 |
| Max. Negotiated Rate |
$11,792.02 |
| Rate for Payer: Aetna Commercial |
$973.25
|
| Rate for Payer: Aetna Medicare |
$3,901.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,689.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,689.81
|
| Rate for Payer: BCBS Complete |
$2,111.54
|
| Rate for Payer: BCBS MAPPO |
$3,751.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.69
|
| Rate for Payer: BCN Commercial |
$1,254.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,751.85
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$801.50
|
| Rate for Payer: Cofinity Commercial |
$984.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$801.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,751.85
|
| Rate for Payer: Healthscope Commercial |
$1,030.50
|
| Rate for Payer: Mclaren Medicaid |
$2,010.99
|
| Rate for Payer: Mclaren Medicare |
$3,751.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,939.44
|
| Rate for Payer: Meridian Medicaid |
$2,111.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,314.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.25
|
| Rate for Payer: Nomi Health Commercial |
$11,255.55
|
| Rate for Payer: PACE Medicare |
$3,564.26
|
| Rate for Payer: PACE SWMI |
$3,751.85
|
| Rate for Payer: PHP Commercial |
$973.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,751.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,010.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,792.02
|
| Rate for Payer: Priority Health Medicare |
$3,751.85
|
| Rate for Payer: Priority Health Narrow Network |
$9,433.62
|
| Rate for Payer: Priority Health SBD |
$721.35
|
| Rate for Payer: Railroad Medicare Medicare |
$3,751.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$683.53
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,751.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,751.85
|
| Rate for Payer: UHCCP Medicaid |
$2,112.29
|
| Rate for Payer: VA VA |
$3,751.85
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY EA ADDL 10
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 11201
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$2,921.00 |
| Rate for Payer: Aetna Commercial |
$20.41
|
| Rate for Payer: Aetna Medicare |
$15.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.93
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: BCBS MAPPO |
$15.23
|
| Rate for Payer: BCBS Trust/PPO |
$106.97
|
| Rate for Payer: BCN Commercial |
$21.60
|
| Rate for Payer: BCN Medicare Advantage |
$15.23
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.23
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Healthscope Commercial |
$24.37
|
| Rate for Payer: Mclaren Medicaid |
$10.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.99
|
| Rate for Payer: Meridian Medicaid |
$10.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,921.00
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: PACE SWMI |
$15.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.68
|
| Rate for Payer: Priority Health Medicare |
$15.23
|
| Rate for Payer: Priority Health Narrow Network |
$21.68
|
| Rate for Payer: Priority Health SBD |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.23
|
| Rate for Payer: UHC Exchange |
$37.47
|
| Rate for Payer: UHC Medicare Advantage |
$15.23
|
| Rate for Payer: UHCCP Medicaid |
$10.22
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 11200
|
| Hospital Charge Code |
11200
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$13,216.00 |
| Rate for Payer: Aetna Commercial |
$96.08
|
| Rate for Payer: Aetna Medicare |
$74.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.08
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS MAPPO |
$71.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.75
|
| Rate for Payer: BCN Commercial |
$107.59
|
| Rate for Payer: BCN Medicare Advantage |
$71.70
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$96.08
|
| Rate for Payer: Cofinity Commercial |
$103.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.70
|
| Rate for Payer: Healthscope Commercial |
$132.64
|
| Rate for Payer: Healthscope Commercial |
$114.72
|
| Rate for Payer: Mclaren Medicaid |
$49.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.28
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,216.00
|
| Rate for Payer: Nomi Health Commercial |
$86.04
|
| Rate for Payer: PACE SWMI |
$71.70
|
| Rate for Payer: PHP Medicare Advantage |
$71.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.29
|
| Rate for Payer: Priority Health Medicare |
$71.70
|
| Rate for Payer: Priority Health Narrow Network |
$104.29
|
| Rate for Payer: Priority Health SBD |
$104.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.70
|
| Rate for Payer: UHC Exchange |
$77.37
|
| Rate for Payer: UHC Medicare Advantage |
$71.70
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$110.25 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$148.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.75
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$122.50
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.00
|
| Rate for Payer: Healthscope Commercial |
$157.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.75
|
| Rate for Payer: PHP Commercial |
$148.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health SBD |
$110.25
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$79.28 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$148.75
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$83.76
|
| Rate for Payer: BCN Commercial |
$83.76
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$122.50
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$157.50
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.75
|
| Rate for Payer: Nomi Health Commercial |
$584.04
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$148.75
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$110.25
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.28
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$109.60
|
| Rate for Payer: VA VA |
$194.68
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 11200
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$13,216.00 |
| Rate for Payer: Aetna Commercial |
$96.08
|
| Rate for Payer: Aetna Medicare |
$74.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.08
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS MAPPO |
$71.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.75
|
| Rate for Payer: BCN Commercial |
$107.59
|
| Rate for Payer: BCN Medicare Advantage |
$71.70
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$96.08
|
| Rate for Payer: Cofinity Commercial |
$103.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.70
|
| Rate for Payer: Healthscope Commercial |
$132.64
|
| Rate for Payer: Healthscope Commercial |
$114.72
|
| Rate for Payer: Mclaren Medicaid |
$49.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.28
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,216.00
|
| Rate for Payer: Nomi Health Commercial |
$86.04
|
| Rate for Payer: PACE SWMI |
$71.70
|
| Rate for Payer: PHP Medicare Advantage |
$71.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.29
|
| Rate for Payer: Priority Health Medicare |
$71.70
|
| Rate for Payer: Priority Health Narrow Network |
$104.29
|
| Rate for Payer: Priority Health SBD |
$104.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.70
|
| Rate for Payer: UHC Exchange |
$77.37
|
| Rate for Payer: UHC Medicare Advantage |
$71.70
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
|
|
PR RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR
|
Professional
|
Both
|
$3,942.00
|
|
|
Service Code
|
HCPCS 63662
|
| Min. Negotiated Rate |
$556.57 |
| Max. Negotiated Rate |
$152,141.00 |
| Rate for Payer: Aetna Commercial |
$1,118.06
|
| Rate for Payer: Aetna Medicare |
$867.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,118.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,201.49
|
| Rate for Payer: BCBS Complete |
$584.40
|
| Rate for Payer: BCBS MAPPO |
$834.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.15
|
| Rate for Payer: BCN Commercial |
$1,251.99
|
| Rate for Payer: BCN Medicare Advantage |
$834.37
|
| Rate for Payer: Cash Price |
$3,153.60
|
| Rate for Payer: Cash Price |
$3,153.60
|
| Rate for Payer: Cofinity Commercial |
$1,201.49
|
| Rate for Payer: Cofinity Commercial |
$1,118.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$834.37
|
| Rate for Payer: Healthscope Commercial |
$1,334.99
|
| Rate for Payer: Healthscope Commercial |
$1,543.58
|
| Rate for Payer: Mclaren Medicaid |
$556.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.09
|
| Rate for Payer: Meridian Medicaid |
$584.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152,141.00
|
| Rate for Payer: Nomi Health Commercial |
$1,001.24
|
| Rate for Payer: PACE SWMI |
$834.37
|
| Rate for Payer: PHP Medicare Advantage |
$834.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,562.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,478.09
|
| Rate for Payer: Priority Health Medicare |
$834.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,478.09
|
| Rate for Payer: Priority Health SBD |
$1,478.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$834.37
|
| Rate for Payer: UHC Medicare Advantage |
$834.37
|
| Rate for Payer: UHCCP Medicaid |
$556.57
|
|
|
PR RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR
|
Professional
|
Both
|
$1,821.00
|
|
|
Service Code
|
HCPCS 63661
|
| Min. Negotiated Rate |
$213.21 |
| Max. Negotiated Rate |
$58,190.00 |
| Rate for Payer: Aetna Commercial |
$426.33
|
| Rate for Payer: Aetna Medicare |
$330.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.15
|
| Rate for Payer: BCBS Complete |
$223.87
|
| Rate for Payer: BCBS MAPPO |
$318.16
|
| Rate for Payer: BCBS Trust/PPO |
$409.43
|
| Rate for Payer: BCN Commercial |
$1,003.26
|
| Rate for Payer: BCN Medicare Advantage |
$318.16
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cofinity Commercial |
$458.15
|
| Rate for Payer: Cofinity Commercial |
$426.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.16
|
| Rate for Payer: Healthscope Commercial |
$509.06
|
| Rate for Payer: Healthscope Commercial |
$588.60
|
| Rate for Payer: Mclaren Medicaid |
$213.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.07
|
| Rate for Payer: Meridian Medicaid |
$223.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,190.00
|
| Rate for Payer: Nomi Health Commercial |
$381.79
|
| Rate for Payer: PACE SWMI |
$318.16
|
| Rate for Payer: PHP Medicare Advantage |
$318.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.87
|
| Rate for Payer: Priority Health Medicare |
$318.16
|
| Rate for Payer: Priority Health Narrow Network |
$565.87
|
| Rate for Payer: Priority Health SBD |
$565.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.16
|
| Rate for Payer: UHC Medicare Advantage |
$318.16
|
| Rate for Payer: UHCCP Medicaid |
$213.21
|
|
|
PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 62365
|
| Min. Negotiated Rate |
$178.57 |
| Max. Negotiated Rate |
$52,565.00 |
| Rate for Payer: Aetna Commercial |
$386.01
|
| Rate for Payer: Aetna Medicare |
$299.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.82
|
| Rate for Payer: BCBS Complete |
$203.74
|
| Rate for Payer: BCBS MAPPO |
$288.07
|
| Rate for Payer: BCBS Trust/PPO |
$178.57
|
| Rate for Payer: BCN Commercial |
$434.93
|
| Rate for Payer: BCN Medicare Advantage |
$288.07
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cofinity Commercial |
$414.82
|
| Rate for Payer: Cofinity Commercial |
$386.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.07
|
| Rate for Payer: Healthscope Commercial |
$532.93
|
| Rate for Payer: Healthscope Commercial |
$460.91
|
| Rate for Payer: Mclaren Medicaid |
$194.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.47
|
| Rate for Payer: Meridian Medicaid |
$203.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,565.00
|
| Rate for Payer: Nomi Health Commercial |
$345.68
|
| Rate for Payer: PACE SWMI |
$288.07
|
| Rate for Payer: PHP Medicare Advantage |
$288.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.25
|
| Rate for Payer: Priority Health Medicare |
$288.07
|
| Rate for Payer: Priority Health Narrow Network |
$515.25
|
| Rate for Payer: Priority Health SBD |
$515.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.07
|
| Rate for Payer: UHC Exchange |
$438.28
|
| Rate for Payer: UHC Medicare Advantage |
$288.07
|
| Rate for Payer: UHCCP Medicaid |
$194.04
|
|
|
PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 26392
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$176,686.00 |
| Rate for Payer: Aetna Commercial |
$1,258.10
|
| Rate for Payer: Aetna Medicare |
$976.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.99
|
| Rate for Payer: BCBS Complete |
$675.87
|
| Rate for Payer: BCBS MAPPO |
$938.88
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$1,485.09
|
| Rate for Payer: BCN Medicare Advantage |
$938.88
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,351.99
|
| Rate for Payer: Cofinity Commercial |
$1,258.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.88
|
| Rate for Payer: Healthscope Commercial |
$1,736.93
|
| Rate for Payer: Healthscope Commercial |
$1,502.21
|
| Rate for Payer: Mclaren Medicaid |
$643.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.82
|
| Rate for Payer: Meridian Medicaid |
$675.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176,686.00
|
| Rate for Payer: Nomi Health Commercial |
$1,126.66
|
| Rate for Payer: PACE SWMI |
$938.88
|
| Rate for Payer: PHP Medicare Advantage |
$938.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.90
|
| Rate for Payer: Priority Health Medicare |
$938.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,544.90
|
| Rate for Payer: Priority Health SBD |
$1,544.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$938.88
|
| Rate for Payer: UHC Exchange |
$1,300.82
|
| Rate for Payer: UHC Medicare Advantage |
$938.88
|
| Rate for Payer: UHCCP Medicaid |
$643.69
|
|
|
PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 46754
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$42,212.00 |
| Rate for Payer: Aetna Commercial |
$307.57
|
| Rate for Payer: Aetna Medicare |
$238.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.52
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$229.53
|
| Rate for Payer: BCBS Trust/PPO |
$396.75
|
| Rate for Payer: BCN Commercial |
$512.14
|
| Rate for Payer: BCN Medicare Advantage |
$229.53
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$330.52
|
| Rate for Payer: Cofinity Commercial |
$307.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.53
|
| Rate for Payer: Healthscope Commercial |
$424.63
|
| Rate for Payer: Healthscope Commercial |
$367.25
|
| Rate for Payer: Mclaren Medicaid |
$157.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.01
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,212.00
|
| Rate for Payer: Nomi Health Commercial |
$275.44
|
| Rate for Payer: PACE SWMI |
$229.53
|
| Rate for Payer: PHP Medicare Advantage |
$229.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.31
|
| Rate for Payer: Priority Health Medicare |
$229.53
|
| Rate for Payer: Priority Health Narrow Network |
$437.31
|
| Rate for Payer: Priority Health SBD |
$437.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.53
|
| Rate for Payer: UHC Exchange |
$308.37
|
| Rate for Payer: UHC Medicare Advantage |
$229.53
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
|
|
PR RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 33234
|
| Min. Negotiated Rate |
$305.44 |
| Max. Negotiated Rate |
$85,489.00 |
| Rate for Payer: Aetna Commercial |
$615.44
|
| Rate for Payer: Aetna Medicare |
$477.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$661.36
|
| Rate for Payer: BCBS Complete |
$320.71
|
| Rate for Payer: BCBS MAPPO |
$459.28
|
| Rate for Payer: BCN Commercial |
$700.27
|
| Rate for Payer: BCN Medicare Advantage |
$459.28
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cofinity Commercial |
$661.36
|
| Rate for Payer: Cofinity Commercial |
$615.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.28
|
| Rate for Payer: Healthscope Commercial |
$849.67
|
| Rate for Payer: Healthscope Commercial |
$734.85
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$482.24
|
| Rate for Payer: Meridian Medicaid |
$320.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,489.00
|
| Rate for Payer: Nomi Health Commercial |
$551.14
|
| Rate for Payer: PACE SWMI |
$459.28
|
| Rate for Payer: PHP Medicare Advantage |
$459.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$759.45
|
| Rate for Payer: Priority Health Medicare |
$459.28
|
| Rate for Payer: Priority Health Narrow Network |
$759.45
|
| Rate for Payer: Priority Health SBD |
$759.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$654.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$459.28
|
| Rate for Payer: UHC Exchange |
$654.17
|
| Rate for Payer: UHC Medicare Advantage |
$459.28
|
| Rate for Payer: UHCCP Medicaid |
$305.44
|
|
|
PR RMVL TRANSVNS PM ELTRD DUAL LEAD SYS
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 33235
|
| Min. Negotiated Rate |
$401.29 |
| Max. Negotiated Rate |
$112,421.00 |
| Rate for Payer: Aetna Commercial |
$807.55
|
| Rate for Payer: Aetna Medicare |
$626.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.82
|
| Rate for Payer: BCBS Complete |
$421.35
|
| Rate for Payer: BCBS MAPPO |
$602.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.11
|
| Rate for Payer: BCN Commercial |
$921.64
|
| Rate for Payer: BCN Medicare Advantage |
$602.65
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$867.82
|
| Rate for Payer: Cofinity Commercial |
$807.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.65
|
| Rate for Payer: Healthscope Commercial |
$964.24
|
| Rate for Payer: Healthscope Commercial |
$1,114.90
|
| Rate for Payer: Mclaren Medicaid |
$401.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.78
|
| Rate for Payer: Meridian Medicaid |
$421.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112,421.00
|
| Rate for Payer: Nomi Health Commercial |
$723.18
|
| Rate for Payer: PACE SWMI |
$602.65
|
| Rate for Payer: PHP Medicare Advantage |
$602.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$401.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$998.24
|
| Rate for Payer: Priority Health Medicare |
$602.65
|
| Rate for Payer: Priority Health Narrow Network |
$998.24
|
| Rate for Payer: Priority Health SBD |
$998.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$675.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.65
|
| Rate for Payer: UHC Exchange |
$675.59
|
| Rate for Payer: UHC Medicare Advantage |
$602.65
|
| Rate for Payer: UHCCP Medicaid |
$401.29
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 36590
|
| Hospital Charge Code |
36590
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$33,457.00 |
| Rate for Payer: Aetna Commercial |
$241.08
|
| Rate for Payer: Aetna Medicare |
$187.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.07
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCBS MAPPO |
$179.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.68
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$179.91
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$259.07
|
| Rate for Payer: Cofinity Commercial |
$241.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.91
|
| Rate for Payer: Healthscope Commercial |
$332.83
|
| Rate for Payer: Healthscope Commercial |
$287.86
|
| Rate for Payer: Mclaren Medicaid |
$120.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.91
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,457.00
|
| Rate for Payer: Nomi Health Commercial |
$215.89
|
| Rate for Payer: PACE SWMI |
$179.91
|
| Rate for Payer: PHP Medicare Advantage |
$179.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.89
|
| Rate for Payer: Priority Health Medicare |
$179.91
|
| Rate for Payer: Priority Health Narrow Network |
$298.89
|
| Rate for Payer: Priority Health SBD |
$298.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.91
|
| Rate for Payer: UHC Exchange |
$415.92
|
| Rate for Payer: UHC Medicare Advantage |
$179.91
|
| Rate for Payer: UHCCP Medicaid |
$120.35
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
IP
|
$716.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$451.08 |
| Max. Negotiated Rate |
$644.40 |
| Rate for Payer: Aetna Commercial |
$608.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.40
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$501.20
|
| Rate for Payer: Cofinity Commercial |
$615.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$501.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.80
|
| Rate for Payer: Healthscope Commercial |
$644.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.60
|
| Rate for Payer: PHP Commercial |
$608.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health SBD |
$451.08
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 36590
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$33,457.00 |
| Rate for Payer: Aetna Commercial |
$241.08
|
| Rate for Payer: Aetna Medicare |
$187.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.07
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCBS MAPPO |
$179.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.68
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$179.91
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$259.07
|
| Rate for Payer: Cofinity Commercial |
$241.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.91
|
| Rate for Payer: Healthscope Commercial |
$332.83
|
| Rate for Payer: Healthscope Commercial |
$287.86
|
| Rate for Payer: Mclaren Medicaid |
$120.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.91
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,457.00
|
| Rate for Payer: Nomi Health Commercial |
$215.89
|
| Rate for Payer: PACE SWMI |
$179.91
|
| Rate for Payer: PHP Medicare Advantage |
$179.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.89
|
| Rate for Payer: Priority Health Medicare |
$179.91
|
| Rate for Payer: Priority Health Narrow Network |
$298.89
|
| Rate for Payer: Priority Health SBD |
$298.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.91
|
| Rate for Payer: UHC Exchange |
$415.92
|
| Rate for Payer: UHC Medicare Advantage |
$179.91
|
| Rate for Payer: UHCCP Medicaid |
$120.35
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
OP
|
$716.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$199.44 |
| Max. Negotiated Rate |
$4,783.71 |
| Rate for Payer: Aetna Commercial |
$608.60
|
| Rate for Payer: Aetna Medicare |
$1,582.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$679.23
|
| Rate for Payer: BCN Commercial |
$679.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$501.20
|
| Rate for Payer: Cofinity Commercial |
$615.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$501.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$644.40
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.60
|
| Rate for Payer: Nomi Health Commercial |
$4,566.09
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$608.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,783.71
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$3,826.97
|
| Rate for Payer: Priority Health SBD |
$451.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.44
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$856.90
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
OP
|
$429.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$142.76 |
| Max. Negotiated Rate |
$1,903.90 |
| Rate for Payer: Aetna Commercial |
$364.65
|
| Rate for Payer: Aetna Medicare |
$629.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.20
|
| Rate for Payer: BCBS Complete |
$340.92
|
| Rate for Payer: BCBS MAPPO |
$605.76
|
| Rate for Payer: BCBS Trust/PPO |
$489.12
|
| Rate for Payer: BCN Commercial |
$489.12
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$368.94
|
| Rate for Payer: Cofinity Commercial |
$300.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$386.10
|
| Rate for Payer: Mclaren Medicaid |
$324.69
|
| Rate for Payer: Mclaren Medicare |
$605.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.05
|
| Rate for Payer: Meridian Medicaid |
$340.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.65
|
| Rate for Payer: Nomi Health Commercial |
$1,817.28
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$364.65
|
| Rate for Payer: PHP Medicare Advantage |
$605.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,903.90
|
| Rate for Payer: Priority Health Medicare |
$605.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,523.12
|
| Rate for Payer: Priority Health SBD |
$270.27
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.76
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$341.04
|
| Rate for Payer: VA VA |
$605.76
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$429.00
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$24,030.00 |
| Rate for Payer: Aetna Commercial |
$172.97
|
| Rate for Payer: Aetna Medicare |
$134.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.88
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS MAPPO |
$129.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.15
|
| Rate for Payer: BCN Commercial |
$240.92
|
| Rate for Payer: BCN Medicare Advantage |
$129.08
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$185.88
|
| Rate for Payer: Cofinity Commercial |
$172.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.08
|
| Rate for Payer: Healthscope Commercial |
$238.80
|
| Rate for Payer: Healthscope Commercial |
$206.53
|
| Rate for Payer: Mclaren Medicaid |
$86.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.53
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,030.00
|
| Rate for Payer: Nomi Health Commercial |
$154.90
|
| Rate for Payer: PACE SWMI |
$129.08
|
| Rate for Payer: PHP Medicare Advantage |
$129.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.33
|
| Rate for Payer: Priority Health Medicare |
$129.08
|
| Rate for Payer: Priority Health Narrow Network |
$214.33
|
| Rate for Payer: Priority Health SBD |
$214.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.08
|
| Rate for Payer: UHC Exchange |
$197.38
|
| Rate for Payer: UHC Medicare Advantage |
$129.08
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
