|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 16025
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$194.44 |
| Rate for Payer: Aetna Commercial |
$133.87
|
| Rate for Payer: Aetna Medicare |
$103.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.86
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$99.90
|
| Rate for Payer: BCN Commercial |
$166.33
|
| Rate for Payer: BCN Medicare Advantage |
$99.90
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$143.86
|
| Rate for Payer: Cofinity Commercial |
$133.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.90
|
| Rate for Payer: Healthscope Commercial |
$184.81
|
| Rate for Payer: Healthscope Commercial |
$159.84
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.89
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.44
|
| Rate for Payer: Nomi Health Commercial |
$119.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.25
|
| Rate for Payer: PACE SWMI |
$99.90
|
| Rate for Payer: PHP Medicare Advantage |
$99.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$152.23
|
| Rate for Payer: Priority Health Medicare |
$99.90
|
| Rate for Payer: Priority Health SBD |
$152.23
|
| Rate for Payer: Priority Health Tiered Network |
$152.23
|
| Rate for Payer: Railroad Medicare Medicare |
$99.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.49
|
| Rate for Payer: UHC Core |
$193.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.90
|
| Rate for Payer: UHC Exchange |
$193.49
|
| Rate for Payer: UHC Medicaid |
$64.97
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 16020
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$106.50 |
| Rate for Payer: Aetna Commercial |
$70.46
|
| Rate for Payer: Aetna Medicare |
$54.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.72
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$52.58
|
| Rate for Payer: BCN Commercial |
$84.16
|
| Rate for Payer: BCN Medicare Advantage |
$52.58
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$75.72
|
| Rate for Payer: Cofinity Commercial |
$70.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.58
|
| Rate for Payer: Healthscope Commercial |
$97.27
|
| Rate for Payer: Healthscope Commercial |
$84.13
|
| Rate for Payer: Mclaren Medicaid |
$34.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.21
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$63.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.50
|
| Rate for Payer: PACE SWMI |
$52.58
|
| Rate for Payer: PHP Medicare Advantage |
$52.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$77.03
|
| Rate for Payer: Priority Health Medicare |
$52.58
|
| Rate for Payer: Priority Health SBD |
$77.03
|
| Rate for Payer: Priority Health Tiered Network |
$77.03
|
| Rate for Payer: Railroad Medicare Medicare |
$52.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.01
|
| Rate for Payer: UHC Core |
$94.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.58
|
| Rate for Payer: UHC Exchange |
$94.01
|
| Rate for Payer: UHC Medicaid |
$34.72
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
|
|
PR DRUG-ELUTING STENTS, SINGLE
|
Professional
|
Both
|
$2,601.00
|
|
|
Service Code
|
HCPCS G0290
|
| Min. Negotiated Rate |
$1,040.40 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Aetna Medicare |
$1,300.50
|
| Rate for Payer: BCBS Complete |
$1,040.40
|
| Rate for Payer: Cash Price |
$2,080.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,690.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.75
|
|
|
PR DRUG SCREEN MULTI DRUG CLASS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS G0434
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
|
|
PR DRUG SCREEN MULTIP CLASS
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS G0431
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna Medicare |
$32.00
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
|
|
PR DRUG SCREEN PANEL 10 WITH BATH SALTS
|
Professional
|
Both
|
$79.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
|
|
PR DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS
|
Professional
|
Both
|
$2,507.00
|
|
|
Service Code
|
HCPCS 36838
|
| Min. Negotiated Rate |
$657.11 |
| Max. Negotiated Rate |
$2,056.35 |
| Rate for Payer: Aetna Commercial |
$1,395.10
|
| Rate for Payer: Aetna Medicare |
$1,082.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,499.21
|
| Rate for Payer: BCBS Complete |
$689.97
|
| Rate for Payer: BCBS MAPPO |
$1,041.12
|
| Rate for Payer: BCN Commercial |
$1,668.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.12
|
| Rate for Payer: Cash Price |
$2,005.60
|
| Rate for Payer: Cash Price |
$2,005.60
|
| Rate for Payer: Cofinity Commercial |
$1,499.21
|
| Rate for Payer: Cofinity Commercial |
$1,395.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.12
|
| Rate for Payer: Healthscope Commercial |
$1,926.07
|
| Rate for Payer: Healthscope Commercial |
$1,665.79
|
| Rate for Payer: Mclaren Medicaid |
$657.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,093.18
|
| Rate for Payer: Meridian Medicaid |
$689.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,023.99
|
| Rate for Payer: Nomi Health Commercial |
$1,249.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,880.25
|
| Rate for Payer: PACE SWMI |
$1,041.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$657.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,793.98
|
| Rate for Payer: Priority Health Medicare |
$1,041.12
|
| Rate for Payer: Priority Health SBD |
$1,793.98
|
| Rate for Payer: Priority Health Tiered Network |
$1,793.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,041.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,056.35
|
| Rate for Payer: UHC Core |
$2,056.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,041.12
|
| Rate for Payer: UHC Exchange |
$2,056.35
|
| Rate for Payer: UHC Medicaid |
$657.11
|
| Rate for Payer: UHCCP Medicaid |
$657.11
|
|
|
PR DSTRJ CUTANEOUS VASCULAR PRLF LES 10.0-50.0SQCM
|
Professional
|
Both
|
$843.00
|
|
|
Service Code
|
HCPCS 17107
|
| Min. Negotiated Rate |
$197.03 |
| Max. Negotiated Rate |
$632.25 |
| Rate for Payer: Aetna Commercial |
$400.90
|
| Rate for Payer: Aetna Medicare |
$311.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.82
|
| Rate for Payer: BCBS Complete |
$206.88
|
| Rate for Payer: BCBS MAPPO |
$299.18
|
| Rate for Payer: BCN Commercial |
$429.61
|
| Rate for Payer: BCN Medicare Advantage |
$299.18
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cofinity Commercial |
$430.82
|
| Rate for Payer: Cofinity Commercial |
$400.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.18
|
| Rate for Payer: Healthscope Commercial |
$553.48
|
| Rate for Payer: Healthscope Commercial |
$478.69
|
| Rate for Payer: Mclaren Medicaid |
$197.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.14
|
| Rate for Payer: Meridian Medicaid |
$206.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.23
|
| Rate for Payer: Nomi Health Commercial |
$359.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.25
|
| Rate for Payer: PACE SWMI |
$299.18
|
| Rate for Payer: PHP Medicare Advantage |
$299.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$498.62
|
| Rate for Payer: Priority Health Medicare |
$299.18
|
| Rate for Payer: Priority Health SBD |
$498.62
|
| Rate for Payer: Priority Health Tiered Network |
$498.62
|
| Rate for Payer: Railroad Medicare Medicare |
$299.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.09
|
| Rate for Payer: UHC Core |
$613.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$299.18
|
| Rate for Payer: UHC Exchange |
$613.09
|
| Rate for Payer: UHC Medicaid |
$197.03
|
| Rate for Payer: UHCCP Medicaid |
$197.03
|
|
|
PR DSTRJ CUTANEOUS VASCULAR PRLF LESIONS>50.0 SQ CM
|
Professional
|
Both
|
$1,205.00
|
|
|
Service Code
|
HCPCS 17108
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$919.06 |
| Rate for Payer: Aetna Commercial |
$592.15
|
| Rate for Payer: Aetna Medicare |
$459.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$636.34
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$441.90
|
| Rate for Payer: BCN Commercial |
$627.93
|
| Rate for Payer: BCN Medicare Advantage |
$441.90
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Commercial |
$636.34
|
| Rate for Payer: Cofinity Commercial |
$592.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.90
|
| Rate for Payer: Healthscope Commercial |
$817.51
|
| Rate for Payer: Healthscope Commercial |
$707.04
|
| Rate for Payer: Mclaren Medicaid |
$289.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$464.00
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$486.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$919.06
|
| Rate for Payer: Nomi Health Commercial |
$530.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$903.75
|
| Rate for Payer: PACE SWMI |
$441.90
|
| Rate for Payer: PHP Medicare Advantage |
$441.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$728.79
|
| Rate for Payer: Priority Health Medicare |
$441.90
|
| Rate for Payer: Priority Health SBD |
$728.79
|
| Rate for Payer: Priority Health Tiered Network |
$728.79
|
| Rate for Payer: Railroad Medicare Medicare |
$441.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$906.96
|
| Rate for Payer: UHC Core |
$906.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$441.90
|
| Rate for Payer: UHC Exchange |
$906.96
|
| Rate for Payer: UHC Medicaid |
$289.25
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
IP
|
$891.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$561.33 |
| Max. Negotiated Rate |
$801.90 |
| Rate for Payer: Aetna Commercial |
$757.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.15
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Advantage |
$623.70
|
| Rate for Payer: Cofinity Commercial |
$766.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.80
|
| Rate for Payer: Healthscope Commercial |
$801.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PHP Commercial |
$757.35
|
| Rate for Payer: Priority Health SBD |
$561.33
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 46924
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Aetna Commercial |
$225.27
|
| Rate for Payer: Aetna Medicare |
$174.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.08
|
| Rate for Payer: BCBS Complete |
$115.19
|
| Rate for Payer: BCBS MAPPO |
$168.11
|
| Rate for Payer: BCN Commercial |
$275.88
|
| Rate for Payer: BCN Medicare Advantage |
$168.11
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$242.08
|
| Rate for Payer: Cofinity Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.11
|
| Rate for Payer: Healthscope Commercial |
$311.00
|
| Rate for Payer: Healthscope Commercial |
$268.98
|
| Rate for Payer: Mclaren Medicaid |
$109.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.52
|
| Rate for Payer: Meridian Medicaid |
$115.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.10
|
| Rate for Payer: Nomi Health Commercial |
$201.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE SWMI |
$168.11
|
| Rate for Payer: PHP Medicare Advantage |
$168.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.14
|
| Rate for Payer: Priority Health Medicare |
$168.11
|
| Rate for Payer: Priority Health SBD |
$336.14
|
| Rate for Payer: Priority Health Tiered Network |
$336.14
|
| Rate for Payer: Railroad Medicare Medicare |
$168.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.00
|
| Rate for Payer: UHC Core |
$316.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.11
|
| Rate for Payer: UHC Exchange |
$316.00
|
| Rate for Payer: UHC Medicaid |
$109.70
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
OP
|
$891.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$561.33 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Commercial |
$757.35
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,126.33
|
| Rate for Payer: BCN Commercial |
$2,126.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Advantage |
$623.70
|
| Rate for Payer: Cofinity Commercial |
$766.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$801.90
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.35
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$757.35
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health SBD |
$561.33
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 46924
|
| Hospital Charge Code |
46924
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Aetna Commercial |
$225.27
|
| Rate for Payer: Aetna Medicare |
$174.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.08
|
| Rate for Payer: BCBS Complete |
$115.19
|
| Rate for Payer: BCBS MAPPO |
$168.11
|
| Rate for Payer: BCN Commercial |
$275.88
|
| Rate for Payer: BCN Medicare Advantage |
$168.11
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$242.08
|
| Rate for Payer: Cofinity Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.11
|
| Rate for Payer: Healthscope Commercial |
$311.00
|
| Rate for Payer: Healthscope Commercial |
$268.98
|
| Rate for Payer: Mclaren Medicaid |
$109.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.52
|
| Rate for Payer: Meridian Medicaid |
$115.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.10
|
| Rate for Payer: Nomi Health Commercial |
$201.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE SWMI |
$168.11
|
| Rate for Payer: PHP Medicare Advantage |
$168.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.14
|
| Rate for Payer: Priority Health Medicare |
$168.11
|
| Rate for Payer: Priority Health SBD |
$336.14
|
| Rate for Payer: Priority Health Tiered Network |
$336.14
|
| Rate for Payer: Railroad Medicare Medicare |
$168.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.00
|
| Rate for Payer: UHC Core |
$316.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.11
|
| Rate for Payer: UHC Exchange |
$316.00
|
| Rate for Payer: UHC Medicaid |
$109.70
|
| Rate for Payer: UHCCP Medicaid |
$109.70
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 46900
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$295.50 |
| Rate for Payer: Aetna Commercial |
$171.57
|
| Rate for Payer: Aetna Medicare |
$133.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.38
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$128.04
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$128.04
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$184.38
|
| Rate for Payer: Cofinity Commercial |
$171.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.04
|
| Rate for Payer: Healthscope Commercial |
$236.87
|
| Rate for Payer: Healthscope Commercial |
$204.86
|
| Rate for Payer: Mclaren Medicaid |
$84.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.44
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.82
|
| Rate for Payer: Nomi Health Commercial |
$153.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.50
|
| Rate for Payer: PACE SWMI |
$128.04
|
| Rate for Payer: PHP Medicare Advantage |
$128.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$254.85
|
| Rate for Payer: Priority Health Medicare |
$128.04
|
| Rate for Payer: Priority Health SBD |
$254.85
|
| Rate for Payer: Priority Health Tiered Network |
$254.85
|
| Rate for Payer: Railroad Medicare Medicare |
$128.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.85
|
| Rate for Payer: UHC Core |
$236.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.04
|
| Rate for Payer: UHC Exchange |
$236.85
|
| Rate for Payer: UHC Medicaid |
$84.35
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
|
|
PR DSTRJ LESION ANUS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 46916
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$318.00 |
| Rate for Payer: Aetna Commercial |
$158.74
|
| Rate for Payer: Aetna Medicare |
$123.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.58
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$118.46
|
| Rate for Payer: BCN Commercial |
$214.13
|
| Rate for Payer: BCN Medicare Advantage |
$118.46
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$170.58
|
| Rate for Payer: Cofinity Commercial |
$158.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.46
|
| Rate for Payer: Healthscope Commercial |
$219.15
|
| Rate for Payer: Healthscope Commercial |
$189.54
|
| Rate for Payer: Mclaren Medicaid |
$77.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.38
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.89
|
| Rate for Payer: Nomi Health Commercial |
$142.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE SWMI |
$118.46
|
| Rate for Payer: PHP Medicare Advantage |
$118.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$260.91
|
| Rate for Payer: Priority Health Medicare |
$118.46
|
| Rate for Payer: Priority Health SBD |
$260.91
|
| Rate for Payer: Priority Health Tiered Network |
$260.91
|
| Rate for Payer: Railroad Medicare Medicare |
$118.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.42
|
| Rate for Payer: UHC Core |
$244.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.46
|
| Rate for Payer: UHC Exchange |
$244.42
|
| Rate for Payer: UHC Medicaid |
$77.96
|
| Rate for Payer: UHCCP Medicaid |
$77.96
|
|
|
PR DSTRJ LESION ANUS SIMPLE LASER SURG
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 46917
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$551.25 |
| Rate for Payer: Aetna Commercial |
$157.97
|
| Rate for Payer: Aetna Medicare |
$122.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.76
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS MAPPO |
$117.89
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$117.89
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$169.76
|
| Rate for Payer: Cofinity Commercial |
$157.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.89
|
| Rate for Payer: Healthscope Commercial |
$218.10
|
| Rate for Payer: Healthscope Commercial |
$188.62
|
| Rate for Payer: Mclaren Medicaid |
$77.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.78
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.23
|
| Rate for Payer: Nomi Health Commercial |
$141.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE SWMI |
$117.89
|
| Rate for Payer: PHP Medicare Advantage |
$117.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$237.85
|
| Rate for Payer: Priority Health Medicare |
$117.89
|
| Rate for Payer: Priority Health SBD |
$237.85
|
| Rate for Payer: Priority Health Tiered Network |
$237.85
|
| Rate for Payer: Railroad Medicare Medicare |
$117.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.22
|
| Rate for Payer: UHC Core |
$223.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$117.89
|
| Rate for Payer: UHC Exchange |
$223.22
|
| Rate for Payer: UHC Medicaid |
$77.11
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 46922
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Aetna Commercial |
$174.99
|
| Rate for Payer: Aetna Medicare |
$135.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.05
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$130.59
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$130.59
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$188.05
|
| Rate for Payer: Cofinity Commercial |
$174.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.59
|
| Rate for Payer: Healthscope Commercial |
$241.59
|
| Rate for Payer: Healthscope Commercial |
$208.94
|
| Rate for Payer: Mclaren Medicaid |
$85.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.12
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.40
|
| Rate for Payer: Nomi Health Commercial |
$156.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE SWMI |
$130.59
|
| Rate for Payer: PHP Medicare Advantage |
$130.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$254.85
|
| Rate for Payer: Priority Health Medicare |
$130.59
|
| Rate for Payer: Priority Health SBD |
$254.85
|
| Rate for Payer: Priority Health Tiered Network |
$254.85
|
| Rate for Payer: Railroad Medicare Medicare |
$130.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.86
|
| Rate for Payer: UHC Core |
$237.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.59
|
| Rate for Payer: UHC Exchange |
$237.86
|
| Rate for Payer: UHC Medicaid |
$85.63
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
IP
|
$533.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$335.79 |
| Max. Negotiated Rate |
$479.70 |
| Rate for Payer: Aetna Commercial |
$453.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.45
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Advantage |
$373.10
|
| Rate for Payer: Cofinity Commercial |
$458.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.40
|
| Rate for Payer: Healthscope Commercial |
$479.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$453.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PHP Commercial |
$453.05
|
| Rate for Payer: Priority Health SBD |
$335.79
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 46922
|
| Hospital Charge Code |
46922
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Aetna Commercial |
$174.99
|
| Rate for Payer: Aetna Medicare |
$135.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.05
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$130.59
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$130.59
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$188.05
|
| Rate for Payer: Cofinity Commercial |
$174.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.59
|
| Rate for Payer: Healthscope Commercial |
$241.59
|
| Rate for Payer: Healthscope Commercial |
$208.94
|
| Rate for Payer: Mclaren Medicaid |
$85.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.12
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.40
|
| Rate for Payer: Nomi Health Commercial |
$156.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE SWMI |
$130.59
|
| Rate for Payer: PHP Medicare Advantage |
$130.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$254.85
|
| Rate for Payer: Priority Health Medicare |
$130.59
|
| Rate for Payer: Priority Health SBD |
$254.85
|
| Rate for Payer: Priority Health Tiered Network |
$254.85
|
| Rate for Payer: Railroad Medicare Medicare |
$130.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.86
|
| Rate for Payer: UHC Core |
$237.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.59
|
| Rate for Payer: UHC Exchange |
$237.86
|
| Rate for Payer: UHC Medicaid |
$85.63
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
OP
|
$533.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$335.79 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Commercial |
$453.05
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,769.22
|
| Rate for Payer: BCN Commercial |
$1,769.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Advantage |
$373.10
|
| Rate for Payer: Cofinity Commercial |
$458.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$479.70
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$453.05
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$453.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health SBD |
$335.79
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
PR DSTRJ LESION ANUS SMPL ELTRDSICCATION
|
Professional
|
Both
|
$427.00
|
|
|
Service Code
|
HCPCS 46910
|
| Min. Negotiated Rate |
$82.86 |
| Max. Negotiated Rate |
$320.25 |
| Rate for Payer: Aetna Commercial |
$169.09
|
| Rate for Payer: Aetna Medicare |
$131.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.71
|
| Rate for Payer: BCBS Complete |
$87.00
|
| Rate for Payer: BCBS MAPPO |
$126.19
|
| Rate for Payer: BCN Commercial |
$203.67
|
| Rate for Payer: BCN Medicare Advantage |
$126.19
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Cash Price |
$341.60
|
| Rate for Payer: Cofinity Commercial |
$181.71
|
| Rate for Payer: Cofinity Commercial |
$169.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.19
|
| Rate for Payer: Healthscope Commercial |
$233.45
|
| Rate for Payer: Healthscope Commercial |
$201.90
|
| Rate for Payer: Mclaren Medicaid |
$82.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.50
|
| Rate for Payer: Meridian Medicaid |
$87.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$138.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.77
|
| Rate for Payer: Nomi Health Commercial |
$151.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$320.25
|
| Rate for Payer: PACE SWMI |
$126.19
|
| Rate for Payer: PHP Medicare Advantage |
$126.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$248.17
|
| Rate for Payer: Priority Health Medicare |
$126.19
|
| Rate for Payer: Priority Health SBD |
$248.17
|
| Rate for Payer: Priority Health Tiered Network |
$248.17
|
| Rate for Payer: Railroad Medicare Medicare |
$126.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.41
|
| Rate for Payer: UHC Core |
$232.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.19
|
| Rate for Payer: UHC Exchange |
$232.41
|
| Rate for Payer: UHC Medicaid |
$82.86
|
| Rate for Payer: UHCCP Medicaid |
$82.86
|
|
|
PR DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 42160
|
| Min. Negotiated Rate |
$82.22 |
| Max. Negotiated Rate |
$332.25 |
| Rate for Payer: Aetna Commercial |
$166.87
|
| Rate for Payer: Aetna Medicare |
$129.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.32
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS MAPPO |
$124.53
|
| Rate for Payer: BCN Commercial |
$211.14
|
| Rate for Payer: BCN Medicare Advantage |
$124.53
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cofinity Commercial |
$179.32
|
| Rate for Payer: Cofinity Commercial |
$166.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.53
|
| Rate for Payer: Healthscope Commercial |
$230.38
|
| Rate for Payer: Healthscope Commercial |
$199.25
|
| Rate for Payer: Mclaren Medicaid |
$82.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.76
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.50
|
| Rate for Payer: Nomi Health Commercial |
$149.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$332.25
|
| Rate for Payer: PACE SWMI |
$124.53
|
| Rate for Payer: PHP Medicare Advantage |
$124.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.27
|
| Rate for Payer: Priority Health Medicare |
$124.53
|
| Rate for Payer: Priority Health SBD |
$257.27
|
| Rate for Payer: Priority Health Tiered Network |
$257.27
|
| Rate for Payer: Railroad Medicare Medicare |
$124.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.59
|
| Rate for Payer: UHC Core |
$249.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.53
|
| Rate for Payer: UHC Exchange |
$249.59
|
| Rate for Payer: UHC Medicaid |
$82.22
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
|
|
PR DSTRJ LESION PENIS EXTENSIVE
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 54065
|
| Min. Negotiated Rate |
$96.06 |
| Max. Negotiated Rate |
$359.25 |
| Rate for Payer: Aetna Commercial |
$196.10
|
| Rate for Payer: Aetna Medicare |
$152.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.73
|
| Rate for Payer: BCBS Complete |
$100.86
|
| Rate for Payer: BCBS MAPPO |
$146.34
|
| Rate for Payer: BCN Commercial |
$262.44
|
| Rate for Payer: BCN Medicare Advantage |
$146.34
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$210.73
|
| Rate for Payer: Cofinity Commercial |
$196.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.34
|
| Rate for Payer: Healthscope Commercial |
$270.73
|
| Rate for Payer: Healthscope Commercial |
$234.14
|
| Rate for Payer: Mclaren Medicaid |
$96.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.66
|
| Rate for Payer: Meridian Medicaid |
$100.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$160.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.43
|
| Rate for Payer: Nomi Health Commercial |
$175.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.25
|
| Rate for Payer: PACE SWMI |
$146.34
|
| Rate for Payer: PHP Medicare Advantage |
$146.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$285.88
|
| Rate for Payer: Priority Health Medicare |
$146.34
|
| Rate for Payer: Priority Health SBD |
$285.88
|
| Rate for Payer: Priority Health Tiered Network |
$285.88
|
| Rate for Payer: Railroad Medicare Medicare |
$146.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.10
|
| Rate for Payer: UHC Core |
$296.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$146.34
|
| Rate for Payer: UHC Exchange |
$296.10
|
| Rate for Payer: UHC Medicaid |
$96.06
|
| Rate for Payer: UHCCP Medicaid |
$96.06
|
|
|
PR DSTRJ LESION PENIS SIMPLE CHEMICAL
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 54050
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$185.98 |
| Rate for Payer: Aetna Commercial |
$124.77
|
| Rate for Payer: Aetna Medicare |
$96.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.08
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$93.11
|
| Rate for Payer: BCN Commercial |
$162.84
|
| Rate for Payer: BCN Medicare Advantage |
$93.11
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$134.08
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.11
|
| Rate for Payer: Healthscope Commercial |
$172.25
|
| Rate for Payer: Healthscope Commercial |
$148.98
|
| Rate for Payer: Mclaren Medicaid |
$61.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.77
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$111.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
| Rate for Payer: PACE SWMI |
$93.11
|
| Rate for Payer: PHP Medicare Advantage |
$93.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$177.38
|
| Rate for Payer: Priority Health Medicare |
$93.11
|
| Rate for Payer: Priority Health SBD |
$177.38
|
| Rate for Payer: Priority Health Tiered Network |
$177.38
|
| Rate for Payer: Railroad Medicare Medicare |
$93.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.38
|
| Rate for Payer: UHC Core |
$179.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.11
|
| Rate for Payer: UHC Exchange |
$179.38
|
| Rate for Payer: UHC Medicaid |
$61.77
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR DSTRJ LESION PENIS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 54056
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Aetna Commercial |
$127.53
|
| Rate for Payer: Aetna Medicare |
$98.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.04
|
| Rate for Payer: BCBS Complete |
$66.42
|
| Rate for Payer: BCBS MAPPO |
$95.17
|
| Rate for Payer: BCN Commercial |
$135.09
|
| Rate for Payer: BCN Medicare Advantage |
$95.17
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$137.04
|
| Rate for Payer: Cofinity Commercial |
$127.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.17
|
| Rate for Payer: Healthscope Commercial |
$176.06
|
| Rate for Payer: Healthscope Commercial |
$152.27
|
| Rate for Payer: Mclaren Medicaid |
$63.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.93
|
| Rate for Payer: Meridian Medicaid |
$66.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.91
|
| Rate for Payer: Nomi Health Commercial |
$114.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.50
|
| Rate for Payer: PACE SWMI |
$95.17
|
| Rate for Payer: PHP Medicare Advantage |
$95.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$186.60
|
| Rate for Payer: Priority Health Medicare |
$95.17
|
| Rate for Payer: Priority Health SBD |
$186.60
|
| Rate for Payer: Priority Health Tiered Network |
$186.60
|
| Rate for Payer: Railroad Medicare Medicare |
$95.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.79
|
| Rate for Payer: UHC Core |
$186.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.17
|
| Rate for Payer: UHC Exchange |
$186.79
|
| Rate for Payer: UHC Medicaid |
$63.26
|
| Rate for Payer: UHCCP Medicaid |
$63.26
|
|
