|
HC DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
OP
|
$1,342.32
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$124.27 |
| Max. Negotiated Rate |
$1,568.21 |
| Rate for Payer: Aetna Commercial |
$1,140.97
|
| Rate for Payer: Aetna Medicare |
$518.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$124.27
|
| Rate for Payer: BCN Commercial |
$124.27
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$939.62
|
| Rate for Payer: Cofinity Commercial |
$1,154.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$939.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Healthscope Commercial |
$1,208.09
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: Nomi Health Commercial |
$1,047.80
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Commercial |
$1,140.97
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,568.21
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,254.57
|
| Rate for Payer: Priority Health SBD |
$845.66
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.47
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$280.91
|
| Rate for Payer: VA VA |
$498.95
|
|
|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$1,657.20
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,044.04 |
| Max. Negotiated Rate |
$1,491.48 |
| Rate for Payer: Aetna Commercial |
$1,408.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,077.18
|
| Rate for Payer: Cash Price |
$1,325.76
|
| Rate for Payer: Cofinity Commercial |
$1,160.04
|
| Rate for Payer: Cofinity Commercial |
$1,425.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,160.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,325.76
|
| Rate for Payer: Healthscope Commercial |
$1,491.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,408.62
|
| Rate for Payer: PHP Commercial |
$1,408.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,077.18
|
| Rate for Payer: Priority Health SBD |
$1,044.04
|
|
|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$1,657.20
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.58 |
| Max. Negotiated Rate |
$1,491.48 |
| Rate for Payer: Aetna Commercial |
$1,408.62
|
| Rate for Payer: Aetna Medicare |
$828.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,077.18
|
| Rate for Payer: BCBS Complete |
$662.88
|
| Rate for Payer: BCBS Trust/PPO |
$257.42
|
| Rate for Payer: BCN Commercial |
$257.42
|
| Rate for Payer: Cash Price |
$1,325.76
|
| Rate for Payer: Cash Price |
$1,325.76
|
| Rate for Payer: Cash Price |
$1,325.76
|
| Rate for Payer: Cofinity Commercial |
$1,425.19
|
| Rate for Payer: Cofinity Commercial |
$1,160.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,160.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,325.76
|
| Rate for Payer: Healthscope Commercial |
$1,491.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,408.62
|
| Rate for Payer: PHP Commercial |
$1,408.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,077.18
|
| Rate for Payer: Priority Health SBD |
$1,044.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.58
|
| Rate for Payer: UHC Core |
$878.00
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.12 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna Medicare |
$187.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.98
|
| Rate for Payer: BCBS Complete |
$150.14
|
| Rate for Payer: BCBS Trust/PPO |
$50.76
|
| Rate for Payer: BCN Commercial |
$50.76
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$262.75
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: Priority Health SBD |
$236.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.12
|
| Rate for Payer: UHC Core |
$878.00
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.48 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.98
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$262.75
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: Priority Health SBD |
$236.48
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
IP
|
$382.87
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.21 |
| Max. Negotiated Rate |
$344.58 |
| Rate for Payer: Aetna Commercial |
$325.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.87
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$268.01
|
| Rate for Payer: Cofinity Commercial |
$329.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$268.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Healthscope Commercial |
$344.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: PHP Commercial |
$325.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.87
|
| Rate for Payer: Priority Health SBD |
$241.21
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
OP
|
$382.87
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$325.44
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.87
|
| 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 |
$95.24
|
| Rate for Payer: BCN Commercial |
$95.24
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$329.27
|
| Rate for Payer: Cofinity Commercial |
$268.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$268.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$344.58
|
| 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 |
$325.44
|
| Rate for Payer: Nomi Health Commercial |
$408.83
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$325.44
|
| 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 |
$248.87
|
| 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 |
$241.21
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.49
|
| 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
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
IP
|
$520.20
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$327.73 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$364.14
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: Priority Health SBD |
$327.73
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
OP
|
$520.20
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.33 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| 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 |
$60.65
|
| Rate for Payer: BCN Commercial |
$60.65
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$364.14
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| 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 |
$442.17
|
| 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 |
$442.17
|
| 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 |
$338.13
|
| 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 |
$327.73
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.33
|
| 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
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$851.15
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$723.48
|
| Rate for Payer: Aetna Medicare |
$425.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.25
|
| Rate for Payer: BCBS Complete |
$340.46
|
| Rate for Payer: BCBS Trust/PPO |
$151.55
|
| Rate for Payer: BCN Commercial |
$151.55
|
| Rate for Payer: Cash Price |
$680.92
|
| Rate for Payer: Cash Price |
$680.92
|
| Rate for Payer: Cash Price |
$680.92
|
| Rate for Payer: Cofinity Commercial |
$731.99
|
| Rate for Payer: Cofinity Commercial |
$595.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$595.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.92
|
| Rate for Payer: Healthscope Commercial |
$766.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$723.48
|
| Rate for Payer: PHP Commercial |
$723.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.25
|
| Rate for Payer: Priority Health SBD |
$536.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.58
|
| Rate for Payer: UHC Core |
$878.00
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$851.15
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$536.22 |
| Max. Negotiated Rate |
$766.04 |
| Rate for Payer: Aetna Commercial |
$723.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.25
|
| Rate for Payer: Cash Price |
$680.92
|
| Rate for Payer: Cofinity Commercial |
$595.80
|
| Rate for Payer: Cofinity Commercial |
$731.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$595.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.92
|
| Rate for Payer: Healthscope Commercial |
$766.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$723.48
|
| Rate for Payer: PHP Commercial |
$723.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.25
|
| Rate for Payer: Priority Health SBD |
$536.22
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
OP
|
$94.42
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.09 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$80.26
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$29.69
|
| Rate for Payer: BCN Commercial |
$29.69
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$75.54
|
| Rate for Payer: Cash Price |
$75.54
|
| Rate for Payer: Cash Price |
$75.54
|
| Rate for Payer: Cofinity Commercial |
$66.09
|
| Rate for Payer: Cofinity Commercial |
$81.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$84.98
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.26
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$80.26
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$59.48
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.09
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$32.77
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
IP
|
$94.42
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.48 |
| Max. Negotiated Rate |
$84.98 |
| Rate for Payer: Aetna Commercial |
$80.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.37
|
| Rate for Payer: Cash Price |
$75.54
|
| Rate for Payer: Cofinity Commercial |
$66.09
|
| Rate for Payer: Cofinity Commercial |
$81.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.54
|
| Rate for Payer: Healthscope Commercial |
$84.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.26
|
| Rate for Payer: PHP Commercial |
$80.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.37
|
| Rate for Payer: Priority Health SBD |
$59.48
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
OP
|
$114.46
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.08 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$97.29
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$48.44
|
| Rate for Payer: BCN Commercial |
$48.44
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$91.57
|
| Rate for Payer: Cash Price |
$91.57
|
| Rate for Payer: Cash Price |
$91.57
|
| Rate for Payer: Cofinity Commercial |
$80.12
|
| Rate for Payer: Cofinity Commercial |
$98.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$103.01
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.29
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$97.29
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$72.11
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.08
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$32.77
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
IP
|
$114.46
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.11 |
| Max. Negotiated Rate |
$103.01 |
| Rate for Payer: Aetna Commercial |
$97.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.40
|
| Rate for Payer: Cash Price |
$91.57
|
| Rate for Payer: Cofinity Commercial |
$80.12
|
| Rate for Payer: Cofinity Commercial |
$98.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.57
|
| Rate for Payer: Healthscope Commercial |
$103.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.29
|
| Rate for Payer: PHP Commercial |
$97.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.40
|
| Rate for Payer: Priority Health SBD |
$72.11
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,113.39
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.71 |
| Max. Negotiated Rate |
$1,885.01 |
| Rate for Payer: Aetna Commercial |
$946.38
|
| Rate for Payer: Aetna Medicare |
$623.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$430.20
|
| Rate for Payer: BCN Commercial |
$430.20
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$890.71
|
| Rate for Payer: Cash Price |
$890.71
|
| Rate for Payer: Cash Price |
$890.71
|
| Rate for Payer: Cofinity Commercial |
$957.52
|
| Rate for Payer: Cofinity Commercial |
$779.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$779.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$890.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Healthscope Commercial |
$1,002.05
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.38
|
| Rate for Payer: Nomi Health Commercial |
$1,259.48
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$946.38
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,885.01
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.01
|
| Rate for Payer: Priority Health SBD |
$701.44
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.71
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$337.66
|
| Rate for Payer: VA VA |
$599.75
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$1,113.39
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$701.44 |
| Max. Negotiated Rate |
$1,002.05 |
| Rate for Payer: Aetna Commercial |
$946.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.70
|
| Rate for Payer: Cash Price |
$890.71
|
| Rate for Payer: Cofinity Commercial |
$779.37
|
| Rate for Payer: Cofinity Commercial |
$957.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$779.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$890.71
|
| Rate for Payer: Healthscope Commercial |
$1,002.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.38
|
| Rate for Payer: PHP Commercial |
$946.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.70
|
| Rate for Payer: Priority Health SBD |
$701.44
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
IP
|
$1,887.00
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,188.81 |
| Max. Negotiated Rate |
$1,698.30 |
| Rate for Payer: Aetna Commercial |
$1,603.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.55
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$1,320.90
|
| Rate for Payer: Cofinity Commercial |
$1,622.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,320.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.60
|
| Rate for Payer: Healthscope Commercial |
$1,698.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.95
|
| Rate for Payer: PHP Commercial |
$1,603.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,226.55
|
| Rate for Payer: Priority Health SBD |
$1,188.81
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
OP
|
$1,887.00
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$291.44 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$1,603.95
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$352.94
|
| Rate for Payer: BCN Commercial |
$352.94
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$1,622.82
|
| Rate for Payer: Cofinity Commercial |
$1,320.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,320.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,698.30
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.95
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$1,603.95
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,226.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$1,188.81
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.44
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
IP
|
$4,080.00
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,570.40 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,652.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,856.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health SBD |
$2,570.40
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
OP
|
$4,080.00
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$441.55 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,652.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Cofinity Commercial |
$2,856.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,856.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$2,570.40
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.55
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
OP
|
$509.07
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.97 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$432.71
|
| Rate for Payer: Aetna Medicare |
$254.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.90
|
| Rate for Payer: BCBS Complete |
$203.63
|
| Rate for Payer: BCBS Trust/PPO |
$84.12
|
| Rate for Payer: BCN Commercial |
$84.12
|
| Rate for Payer: Cash Price |
$407.26
|
| Rate for Payer: Cash Price |
$407.26
|
| Rate for Payer: Cash Price |
$407.26
|
| Rate for Payer: Cofinity Commercial |
$356.35
|
| Rate for Payer: Cofinity Commercial |
$437.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$356.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.26
|
| Rate for Payer: Healthscope Commercial |
$458.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.71
|
| Rate for Payer: PHP Commercial |
$432.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.90
|
| Rate for Payer: Priority Health SBD |
$320.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.97
|
| Rate for Payer: UHC Core |
$878.00
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
IP
|
$509.07
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$320.71 |
| Max. Negotiated Rate |
$458.16 |
| Rate for Payer: Aetna Commercial |
$432.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.90
|
| Rate for Payer: Cash Price |
$407.26
|
| Rate for Payer: Cofinity Commercial |
$356.35
|
| Rate for Payer: Cofinity Commercial |
$437.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$356.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.26
|
| Rate for Payer: Healthscope Commercial |
$458.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.71
|
| Rate for Payer: PHP Commercial |
$432.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.90
|
| Rate for Payer: Priority Health SBD |
$320.71
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$645.08
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.86 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$548.32
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$184.43
|
| Rate for Payer: BCN Commercial |
$184.43
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cofinity Commercial |
$554.77
|
| Rate for Payer: Cofinity Commercial |
$451.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$451.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$580.57
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.32
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$548.32
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$406.40
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.86
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$645.08
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$406.40 |
| Max. Negotiated Rate |
$580.57 |
| Rate for Payer: Aetna Commercial |
$548.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.30
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cofinity Commercial |
$451.56
|
| Rate for Payer: Cofinity Commercial |
$554.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$451.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.06
|
| Rate for Payer: Healthscope Commercial |
$580.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.32
|
| Rate for Payer: PHP Commercial |
$548.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.30
|
| Rate for Payer: Priority Health SBD |
$406.40
|
|
