|
PR EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 69110
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$573.32 |
| Rate for Payer: Aetna Commercial |
$386.00
|
| Rate for Payer: Aetna Medicare |
$299.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.81
|
| Rate for Payer: BCBS Complete |
$201.28
|
| Rate for Payer: BCBS MAPPO |
$288.06
|
| Rate for Payer: BCN Commercial |
$492.50
|
| Rate for Payer: BCN Medicare Advantage |
$288.06
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cofinity Commercial |
$414.81
|
| Rate for Payer: Cofinity Commercial |
$386.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.06
|
| Rate for Payer: Healthscope Commercial |
$532.91
|
| Rate for Payer: Healthscope Commercial |
$460.90
|
| Rate for Payer: Mclaren Medicaid |
$191.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.46
|
| Rate for Payer: Meridian Medicaid |
$201.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$316.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$573.32
|
| Rate for Payer: Nomi Health Commercial |
$345.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$482.25
|
| Rate for Payer: PACE SWMI |
$288.06
|
| Rate for Payer: PHP Medicare Advantage |
$288.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$486.65
|
| Rate for Payer: Priority Health Medicare |
$288.06
|
| Rate for Payer: Priority Health SBD |
$486.65
|
| Rate for Payer: Priority Health Tiered Network |
$486.65
|
| Rate for Payer: Railroad Medicare Medicare |
$288.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.75
|
| Rate for Payer: UHC Core |
$554.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.06
|
| Rate for Payer: UHC Exchange |
$554.75
|
| Rate for Payer: UHC Medicaid |
$191.70
|
| Rate for Payer: UHCCP Medicaid |
$191.70
|
|
|
PR EXCISION FACIAL BONE
|
Professional
|
Both
|
$1,028.00
|
|
|
Service Code
|
HCPCS 21026
|
| Min. Negotiated Rate |
$263.69 |
| Max. Negotiated Rate |
$779.09 |
| Rate for Payer: Aetna Commercial |
$534.79
|
| Rate for Payer: Aetna Medicare |
$415.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.70
|
| Rate for Payer: BCBS Complete |
$276.87
|
| Rate for Payer: BCBS MAPPO |
$399.10
|
| Rate for Payer: BCN Commercial |
$662.81
|
| Rate for Payer: BCN Medicare Advantage |
$399.10
|
| Rate for Payer: Cash Price |
$822.40
|
| Rate for Payer: Cash Price |
$822.40
|
| Rate for Payer: Cofinity Commercial |
$574.70
|
| Rate for Payer: Cofinity Commercial |
$534.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.10
|
| Rate for Payer: Healthscope Commercial |
$738.34
|
| Rate for Payer: Healthscope Commercial |
$638.56
|
| Rate for Payer: Mclaren Medicaid |
$263.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.06
|
| Rate for Payer: Meridian Medicaid |
$276.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.83
|
| Rate for Payer: Nomi Health Commercial |
$478.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$771.00
|
| Rate for Payer: PACE SWMI |
$399.10
|
| Rate for Payer: PHP Medicare Advantage |
$399.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$708.53
|
| Rate for Payer: Priority Health Medicare |
$399.10
|
| Rate for Payer: Priority Health SBD |
$708.53
|
| Rate for Payer: Priority Health Tiered Network |
$708.53
|
| Rate for Payer: Railroad Medicare Medicare |
$399.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.09
|
| Rate for Payer: UHC Core |
$779.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$399.10
|
| Rate for Payer: UHC Exchange |
$779.09
|
| Rate for Payer: UHC Medicaid |
$263.69
|
| Rate for Payer: UHCCP Medicaid |
$263.69
|
|
|
PR EXCISION/FULGURATION URETHRAL PROLAPSE
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 53275
|
| Min. Negotiated Rate |
$152.08 |
| Max. Negotiated Rate |
$667.50 |
| Rate for Payer: Aetna Commercial |
$315.13
|
| Rate for Payer: Aetna Medicare |
$244.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.64
|
| Rate for Payer: BCBS Complete |
$159.68
|
| Rate for Payer: BCBS MAPPO |
$235.17
|
| Rate for Payer: BCN Commercial |
$393.40
|
| Rate for Payer: BCN Medicare Advantage |
$235.17
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$338.64
|
| Rate for Payer: Cofinity Commercial |
$315.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.17
|
| Rate for Payer: Healthscope Commercial |
$435.06
|
| Rate for Payer: Healthscope Commercial |
$376.27
|
| Rate for Payer: Mclaren Medicaid |
$152.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.93
|
| Rate for Payer: Meridian Medicaid |
$159.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$258.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.63
|
| Rate for Payer: Nomi Health Commercial |
$282.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$235.17
|
| Rate for Payer: PHP Medicare Advantage |
$235.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.55
|
| Rate for Payer: Priority Health Medicare |
$235.17
|
| Rate for Payer: Priority Health SBD |
$428.55
|
| Rate for Payer: Priority Health Tiered Network |
$428.55
|
| Rate for Payer: Railroad Medicare Medicare |
$235.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.77
|
| Rate for Payer: UHC Core |
$462.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$235.17
|
| Rate for Payer: UHC Exchange |
$462.77
|
| Rate for Payer: UHC Medicaid |
$152.08
|
| Rate for Payer: UHCCP Medicaid |
$152.08
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY
|
Professional
|
Both
|
$1,139.00
|
|
|
Service Code
|
HCPCS 25111
|
| Min. Negotiated Rate |
$204.69 |
| Max. Negotiated Rate |
$854.25 |
| Rate for Payer: Aetna Commercial |
$412.48
|
| Rate for Payer: Aetna Medicare |
$320.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.26
|
| Rate for Payer: BCBS Complete |
$214.92
|
| Rate for Payer: BCBS MAPPO |
$307.82
|
| Rate for Payer: BCN Commercial |
$505.95
|
| Rate for Payer: BCN Medicare Advantage |
$307.82
|
| Rate for Payer: Cash Price |
$911.20
|
| Rate for Payer: Cash Price |
$911.20
|
| Rate for Payer: Cofinity Commercial |
$443.26
|
| Rate for Payer: Cofinity Commercial |
$412.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.82
|
| Rate for Payer: Healthscope Commercial |
$569.47
|
| Rate for Payer: Healthscope Commercial |
$492.51
|
| Rate for Payer: Mclaren Medicaid |
$204.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.21
|
| Rate for Payer: Meridian Medicaid |
$214.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$575.37
|
| Rate for Payer: Nomi Health Commercial |
$369.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$854.25
|
| Rate for Payer: PACE SWMI |
$307.82
|
| Rate for Payer: PHP Medicare Advantage |
$307.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$540.84
|
| Rate for Payer: Priority Health Medicare |
$307.82
|
| Rate for Payer: Priority Health SBD |
$540.84
|
| Rate for Payer: Priority Health Tiered Network |
$540.84
|
| Rate for Payer: Railroad Medicare Medicare |
$307.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.13
|
| Rate for Payer: UHC Core |
$553.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.82
|
| Rate for Payer: UHC Exchange |
$553.13
|
| Rate for Payer: UHC Medicaid |
$204.69
|
| Rate for Payer: UHCCP Medicaid |
$204.69
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 25112
|
| Min. Negotiated Rate |
$240.48 |
| Max. Negotiated Rate |
$888.75 |
| Rate for Payer: Aetna Commercial |
$487.57
|
| Rate for Payer: Aetna Medicare |
$378.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.96
|
| Rate for Payer: BCBS Complete |
$252.50
|
| Rate for Payer: BCBS MAPPO |
$363.86
|
| Rate for Payer: BCN Commercial |
$606.04
|
| Rate for Payer: BCN Medicare Advantage |
$363.86
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$523.96
|
| Rate for Payer: Cofinity Commercial |
$487.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.86
|
| Rate for Payer: Healthscope Commercial |
$673.14
|
| Rate for Payer: Healthscope Commercial |
$582.18
|
| Rate for Payer: Mclaren Medicaid |
$240.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.05
|
| Rate for Payer: Meridian Medicaid |
$252.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$400.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$693.81
|
| Rate for Payer: Nomi Health Commercial |
$436.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$888.75
|
| Rate for Payer: PACE SWMI |
$363.86
|
| Rate for Payer: PHP Medicare Advantage |
$363.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$647.85
|
| Rate for Payer: Priority Health Medicare |
$363.86
|
| Rate for Payer: Priority Health SBD |
$647.85
|
| Rate for Payer: Priority Health Tiered Network |
$647.85
|
| Rate for Payer: Railroad Medicare Medicare |
$363.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.18
|
| Rate for Payer: UHC Core |
$670.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$363.86
|
| Rate for Payer: UHC Exchange |
$670.18
|
| Rate for Payer: UHC Medicaid |
$240.48
|
| Rate for Payer: UHCCP Medicaid |
$240.48
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Professional
|
Both
|
$862.00
|
|
|
Service Code
|
HCPCS 11451
|
| Min. Negotiated Rate |
$204.05 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna Commercial |
$417.96
|
| Rate for Payer: Aetna Medicare |
$324.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.15
|
| Rate for Payer: BCBS Complete |
$214.25
|
| Rate for Payer: BCBS MAPPO |
$311.91
|
| Rate for Payer: BCN Commercial |
$504.96
|
| Rate for Payer: BCN Medicare Advantage |
$311.91
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$449.15
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.91
|
| Rate for Payer: Healthscope Commercial |
$577.03
|
| Rate for Payer: Healthscope Commercial |
$499.06
|
| Rate for Payer: Mclaren Medicaid |
$204.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.51
|
| Rate for Payer: Meridian Medicaid |
$214.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.42
|
| Rate for Payer: Nomi Health Commercial |
$374.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$646.50
|
| Rate for Payer: PACE SWMI |
$311.91
|
| Rate for Payer: PHP Medicare Advantage |
$311.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$462.16
|
| Rate for Payer: Priority Health Medicare |
$311.91
|
| Rate for Payer: Priority Health SBD |
$462.16
|
| Rate for Payer: Priority Health Tiered Network |
$462.16
|
| Rate for Payer: Railroad Medicare Medicare |
$311.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.14
|
| Rate for Payer: UHC Core |
$569.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.91
|
| Rate for Payer: UHC Exchange |
$569.14
|
| Rate for Payer: UHC Medicaid |
$204.05
|
| Rate for Payer: UHCCP Medicaid |
$204.05
|
|
|
PR EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 11450
|
| Min. Negotiated Rate |
$162.52 |
| Max. Negotiated Rate |
$566.25 |
| Rate for Payer: Aetna Commercial |
$330.98
|
| Rate for Payer: Aetna Medicare |
$256.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.68
|
| Rate for Payer: BCBS Complete |
$170.65
|
| Rate for Payer: BCBS MAPPO |
$247.00
|
| Rate for Payer: BCN Commercial |
$399.39
|
| Rate for Payer: BCN Medicare Advantage |
$247.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$355.68
|
| Rate for Payer: Cofinity Commercial |
$330.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.00
|
| Rate for Payer: Healthscope Commercial |
$456.95
|
| Rate for Payer: Healthscope Commercial |
$395.20
|
| Rate for Payer: Mclaren Medicaid |
$162.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.35
|
| Rate for Payer: Meridian Medicaid |
$170.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.14
|
| Rate for Payer: Nomi Health Commercial |
$296.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$566.25
|
| Rate for Payer: PACE SWMI |
$247.00
|
| Rate for Payer: PHP Medicare Advantage |
$247.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$365.54
|
| Rate for Payer: Priority Health Medicare |
$247.00
|
| Rate for Payer: Priority Health SBD |
$365.54
|
| Rate for Payer: Priority Health Tiered Network |
$365.54
|
| Rate for Payer: Railroad Medicare Medicare |
$247.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.77
|
| Rate for Payer: UHC Core |
$443.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$247.00
|
| Rate for Payer: UHC Exchange |
$443.77
|
| Rate for Payer: UHC Medicaid |
$162.52
|
| Rate for Payer: UHCCP Medicaid |
$162.52
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 11463
|
| Min. Negotiated Rate |
$201.29 |
| Max. Negotiated Rate |
$589.55 |
| Rate for Payer: Aetna Commercial |
$411.49
|
| Rate for Payer: Aetna Medicare |
$319.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.20
|
| Rate for Payer: BCBS Complete |
$211.35
|
| Rate for Payer: BCBS MAPPO |
$307.08
|
| Rate for Payer: BCN Commercial |
$501.96
|
| Rate for Payer: BCN Medicare Advantage |
$307.08
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cofinity Commercial |
$442.20
|
| Rate for Payer: Cofinity Commercial |
$411.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.08
|
| Rate for Payer: Healthscope Commercial |
$568.10
|
| Rate for Payer: Healthscope Commercial |
$491.33
|
| Rate for Payer: Mclaren Medicaid |
$201.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.43
|
| Rate for Payer: Meridian Medicaid |
$211.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$337.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.55
|
| Rate for Payer: Nomi Health Commercial |
$368.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.50
|
| Rate for Payer: PACE SWMI |
$307.08
|
| Rate for Payer: PHP Medicare Advantage |
$307.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$459.42
|
| Rate for Payer: Priority Health Medicare |
$307.08
|
| Rate for Payer: Priority Health SBD |
$459.42
|
| Rate for Payer: Priority Health Tiered Network |
$459.42
|
| Rate for Payer: Railroad Medicare Medicare |
$307.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$573.78
|
| Rate for Payer: UHC Core |
$573.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.08
|
| Rate for Payer: UHC Exchange |
$573.78
|
| Rate for Payer: UHC Medicaid |
$201.29
|
| Rate for Payer: UHCCP Medicaid |
$201.29
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS 11462
|
| Min. Negotiated Rate |
$154.85 |
| Max. Negotiated Rate |
$436.25 |
| Rate for Payer: Aetna Commercial |
$314.67
|
| Rate for Payer: Aetna Medicare |
$244.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.16
|
| Rate for Payer: BCBS Complete |
$162.59
|
| Rate for Payer: BCBS MAPPO |
$234.83
|
| Rate for Payer: BCN Commercial |
$382.95
|
| Rate for Payer: BCN Medicare Advantage |
$234.83
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cofinity Commercial |
$338.16
|
| Rate for Payer: Cofinity Commercial |
$314.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.83
|
| Rate for Payer: Healthscope Commercial |
$434.44
|
| Rate for Payer: Healthscope Commercial |
$375.73
|
| Rate for Payer: Mclaren Medicaid |
$154.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.57
|
| Rate for Payer: Meridian Medicaid |
$162.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$258.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$436.25
|
| Rate for Payer: Nomi Health Commercial |
$281.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$365.25
|
| Rate for Payer: PACE SWMI |
$234.83
|
| Rate for Payer: PHP Medicare Advantage |
$234.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$350.49
|
| Rate for Payer: Priority Health Medicare |
$234.83
|
| Rate for Payer: Priority Health SBD |
$350.49
|
| Rate for Payer: Priority Health Tiered Network |
$350.49
|
| Rate for Payer: Railroad Medicare Medicare |
$234.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.12
|
| Rate for Payer: UHC Core |
$422.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$234.83
|
| Rate for Payer: UHC Exchange |
$422.12
|
| Rate for Payer: UHC Medicaid |
$154.85
|
| Rate for Payer: UHCCP Medicaid |
$154.85
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 11471
|
| Min. Negotiated Rate |
$211.51 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$433.24
|
| Rate for Payer: Aetna Medicare |
$336.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.57
|
| Rate for Payer: BCBS Complete |
$222.09
|
| Rate for Payer: BCBS MAPPO |
$323.31
|
| Rate for Payer: BCN Commercial |
$532.34
|
| Rate for Payer: BCN Medicare Advantage |
$323.31
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$465.57
|
| Rate for Payer: Cofinity Commercial |
$433.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.31
|
| Rate for Payer: Healthscope Commercial |
$598.12
|
| Rate for Payer: Healthscope Commercial |
$517.30
|
| Rate for Payer: Mclaren Medicaid |
$211.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.48
|
| Rate for Payer: Meridian Medicaid |
$222.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$618.07
|
| Rate for Payer: Nomi Health Commercial |
$387.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$762.00
|
| Rate for Payer: PACE SWMI |
$323.31
|
| Rate for Payer: PHP Medicare Advantage |
$323.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$487.22
|
| Rate for Payer: Priority Health Medicare |
$323.31
|
| Rate for Payer: Priority Health SBD |
$487.22
|
| Rate for Payer: Priority Health Tiered Network |
$487.22
|
| Rate for Payer: Railroad Medicare Medicare |
$323.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.63
|
| Rate for Payer: UHC Core |
$606.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$323.31
|
| Rate for Payer: UHC Exchange |
$606.63
|
| Rate for Payer: UHC Medicaid |
$211.51
|
| Rate for Payer: UHCCP Medicaid |
$211.51
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$937.00
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$179.13 |
| Max. Negotiated Rate |
$702.75 |
| Rate for Payer: Aetna Commercial |
$365.51
|
| Rate for Payer: Aetna Medicare |
$283.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.79
|
| Rate for Payer: BCBS Complete |
$188.09
|
| Rate for Payer: BCBS MAPPO |
$272.77
|
| Rate for Payer: BCN Commercial |
$436.23
|
| Rate for Payer: BCN Medicare Advantage |
$272.77
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cash Price |
$749.60
|
| Rate for Payer: Cofinity Commercial |
$392.79
|
| Rate for Payer: Cofinity Commercial |
$365.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.77
|
| Rate for Payer: Healthscope Commercial |
$504.62
|
| Rate for Payer: Healthscope Commercial |
$436.43
|
| Rate for Payer: Mclaren Medicaid |
$179.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.41
|
| Rate for Payer: Meridian Medicaid |
$188.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.84
|
| Rate for Payer: Nomi Health Commercial |
$327.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.75
|
| Rate for Payer: PACE SWMI |
$272.77
|
| Rate for Payer: PHP Medicare Advantage |
$272.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$399.27
|
| Rate for Payer: Priority Health Medicare |
$272.77
|
| Rate for Payer: Priority Health SBD |
$399.27
|
| Rate for Payer: Priority Health Tiered Network |
$399.27
|
| Rate for Payer: Railroad Medicare Medicare |
$272.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$489.79
|
| Rate for Payer: UHC Core |
$489.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$272.77
|
| Rate for Payer: UHC Exchange |
$489.79
|
| Rate for Payer: UHC Medicaid |
$179.13
|
| Rate for Payer: UHCCP Medicaid |
$179.13
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,898.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$300.33 |
| Max. Negotiated Rate |
$1,423.50 |
| Rate for Payer: Aetna Commercial |
$619.24
|
| Rate for Payer: Aetna Medicare |
$480.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.45
|
| Rate for Payer: BCBS Complete |
$315.35
|
| Rate for Payer: BCBS MAPPO |
$462.12
|
| Rate for Payer: BCN Commercial |
$769.88
|
| Rate for Payer: BCN Medicare Advantage |
$462.12
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Cash Price |
$1,518.40
|
| Rate for Payer: Cofinity Commercial |
$665.45
|
| Rate for Payer: Cofinity Commercial |
$619.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.12
|
| Rate for Payer: Healthscope Commercial |
$854.92
|
| Rate for Payer: Healthscope Commercial |
$739.39
|
| Rate for Payer: Mclaren Medicaid |
$300.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$485.23
|
| Rate for Payer: Meridian Medicaid |
$315.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$508.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$899.14
|
| Rate for Payer: Nomi Health Commercial |
$554.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.50
|
| Rate for Payer: PACE SWMI |
$462.12
|
| Rate for Payer: PHP Medicare Advantage |
$462.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$838.65
|
| Rate for Payer: Priority Health Medicare |
$462.12
|
| Rate for Payer: Priority Health SBD |
$838.65
|
| Rate for Payer: Priority Health Tiered Network |
$838.65
|
| Rate for Payer: Railroad Medicare Medicare |
$462.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.47
|
| Rate for Payer: UHC Core |
$898.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$462.12
|
| Rate for Payer: UHC Exchange |
$898.47
|
| Rate for Payer: UHC Medicaid |
$300.33
|
| Rate for Payer: UHCCP Medicaid |
$300.33
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
IP
|
$1,294.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$815.22 |
| Max. Negotiated Rate |
$1,164.60 |
| Rate for Payer: Aetna Commercial |
$1,099.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.10
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Advantage |
$905.80
|
| Rate for Payer: Cofinity Commercial |
$1,112.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.20
|
| Rate for Payer: Healthscope Commercial |
$1,164.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,099.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PHP Commercial |
$1,099.90
|
| Rate for Payer: Priority Health SBD |
$815.22
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
55040
|
| Min. Negotiated Rate |
$200.86 |
| Max. Negotiated Rate |
$970.50 |
| Rate for Payer: Aetna Commercial |
$412.88
|
| Rate for Payer: Aetna Medicare |
$320.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.69
|
| Rate for Payer: BCBS Complete |
$210.90
|
| Rate for Payer: BCBS MAPPO |
$308.12
|
| Rate for Payer: BCN Commercial |
$511.43
|
| Rate for Payer: BCN Medicare Advantage |
$308.12
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$412.88
|
| Rate for Payer: Cofinity Commercial |
$443.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.12
|
| Rate for Payer: Healthscope Commercial |
$570.02
|
| Rate for Payer: Healthscope Commercial |
$492.99
|
| Rate for Payer: Mclaren Medicaid |
$200.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.53
|
| Rate for Payer: Meridian Medicaid |
$210.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$593.68
|
| Rate for Payer: Nomi Health Commercial |
$369.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PACE SWMI |
$308.12
|
| Rate for Payer: PHP Medicare Advantage |
$308.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$557.11
|
| Rate for Payer: Priority Health Medicare |
$308.12
|
| Rate for Payer: Priority Health SBD |
$557.11
|
| Rate for Payer: Priority Health Tiered Network |
$557.11
|
| Rate for Payer: Railroad Medicare Medicare |
$308.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.96
|
| Rate for Payer: UHC Core |
$590.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$308.12
|
| Rate for Payer: UHC Exchange |
$590.96
|
| Rate for Payer: UHC Medicaid |
$200.86
|
| Rate for Payer: UHCCP Medicaid |
$200.86
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
OP
|
$1,294.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$815.22 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna Commercial |
$1,099.90
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,296.55
|
| Rate for Payer: BCN Commercial |
$2,296.55
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Advantage |
$905.80
|
| Rate for Payer: Cofinity Commercial |
$1,112.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$1,164.60
|
| Rate for Payer: Mclaren Medicaid |
$1,865.82
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,099.90
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$1,099.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$815.22
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$200.86 |
| Max. Negotiated Rate |
$970.50 |
| Rate for Payer: Aetna Commercial |
$412.88
|
| Rate for Payer: Aetna Medicare |
$320.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.69
|
| Rate for Payer: BCBS Complete |
$210.90
|
| Rate for Payer: BCBS MAPPO |
$308.12
|
| Rate for Payer: BCN Commercial |
$511.43
|
| Rate for Payer: BCN Medicare Advantage |
$308.12
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$443.69
|
| Rate for Payer: Cofinity Commercial |
$412.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.12
|
| Rate for Payer: Healthscope Commercial |
$570.02
|
| Rate for Payer: Healthscope Commercial |
$492.99
|
| Rate for Payer: Mclaren Medicaid |
$200.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.53
|
| Rate for Payer: Meridian Medicaid |
$210.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$593.68
|
| Rate for Payer: Nomi Health Commercial |
$369.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PACE SWMI |
$308.12
|
| Rate for Payer: PHP Medicare Advantage |
$308.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$557.11
|
| Rate for Payer: Priority Health Medicare |
$308.12
|
| Rate for Payer: Priority Health SBD |
$557.11
|
| Rate for Payer: Priority Health Tiered Network |
$557.11
|
| Rate for Payer: Railroad Medicare Medicare |
$308.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.96
|
| Rate for Payer: UHC Core |
$590.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$308.12
|
| Rate for Payer: UHC Exchange |
$590.96
|
| Rate for Payer: UHC Medicaid |
$200.86
|
| Rate for Payer: UHCCP Medicaid |
$200.86
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$4,164.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$1,098.87 |
| Max. Negotiated Rate |
$3,425.78 |
| Rate for Payer: Aetna Commercial |
$2,338.97
|
| Rate for Payer: Aetna Medicare |
$1,815.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,338.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,513.52
|
| Rate for Payer: BCBS Complete |
$1,153.81
|
| Rate for Payer: BCBS MAPPO |
$1,745.50
|
| Rate for Payer: BCN Commercial |
$2,791.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,745.50
|
| Rate for Payer: Cash Price |
$3,331.20
|
| Rate for Payer: Cash Price |
$3,331.20
|
| Rate for Payer: Cofinity Commercial |
$2,513.52
|
| Rate for Payer: Cofinity Commercial |
$2,338.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,745.50
|
| Rate for Payer: Healthscope Commercial |
$3,229.18
|
| Rate for Payer: Healthscope Commercial |
$2,792.80
|
| Rate for Payer: Mclaren Medicaid |
$1,098.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,832.78
|
| Rate for Payer: Meridian Medicaid |
$1,153.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,920.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,374.57
|
| Rate for Payer: Nomi Health Commercial |
$2,094.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,123.00
|
| Rate for Payer: PACE SWMI |
$1,745.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,745.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,098.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,002.09
|
| Rate for Payer: Priority Health Medicare |
$1,745.50
|
| Rate for Payer: Priority Health SBD |
$3,002.09
|
| Rate for Payer: Priority Health Tiered Network |
$3,002.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,745.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,425.78
|
| Rate for Payer: UHC Core |
$3,425.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,745.50
|
| Rate for Payer: UHC Exchange |
$3,425.78
|
| Rate for Payer: UHC Medicaid |
$1,098.87
|
| Rate for Payer: UHCCP Medicaid |
$1,098.87
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$2,065.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$330.36 |
| Max. Negotiated Rate |
$1,548.75 |
| Rate for Payer: Aetna Commercial |
$692.87
|
| Rate for Payer: Aetna Medicare |
$537.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.58
|
| Rate for Payer: BCBS Complete |
$346.88
|
| Rate for Payer: BCBS MAPPO |
$517.07
|
| Rate for Payer: BCN Commercial |
$826.65
|
| Rate for Payer: BCN Medicare Advantage |
$517.07
|
| Rate for Payer: Cash Price |
$1,652.00
|
| Rate for Payer: Cash Price |
$1,652.00
|
| Rate for Payer: Cofinity Commercial |
$744.58
|
| Rate for Payer: Cofinity Commercial |
$692.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.07
|
| Rate for Payer: Healthscope Commercial |
$956.58
|
| Rate for Payer: Healthscope Commercial |
$827.31
|
| Rate for Payer: Mclaren Medicaid |
$330.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$542.92
|
| Rate for Payer: Meridian Medicaid |
$346.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$568.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$996.77
|
| Rate for Payer: Nomi Health Commercial |
$620.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,548.75
|
| Rate for Payer: PACE SWMI |
$517.07
|
| Rate for Payer: PHP Medicare Advantage |
$517.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$888.95
|
| Rate for Payer: Priority Health Medicare |
$517.07
|
| Rate for Payer: Priority Health SBD |
$888.95
|
| Rate for Payer: Priority Health Tiered Network |
$888.95
|
| Rate for Payer: Railroad Medicare Medicare |
$517.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,005.74
|
| Rate for Payer: UHC Core |
$1,005.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$517.07
|
| Rate for Payer: UHC Exchange |
$1,005.74
|
| Rate for Payer: UHC Medicaid |
$330.36
|
| Rate for Payer: UHCCP Medicaid |
$330.36
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$829.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$250.70 |
| Max. Negotiated Rate |
$727.81 |
| Rate for Payer: Aetna Commercial |
$498.76
|
| Rate for Payer: Aetna Medicare |
$387.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$535.98
|
| Rate for Payer: BCBS Complete |
$263.24
|
| Rate for Payer: BCBS MAPPO |
$372.21
|
| Rate for Payer: BCN Commercial |
$623.48
|
| Rate for Payer: BCN Medicare Advantage |
$372.21
|
| Rate for Payer: Cash Price |
$663.20
|
| Rate for Payer: Cash Price |
$663.20
|
| Rate for Payer: Cofinity Commercial |
$535.98
|
| Rate for Payer: Cofinity Commercial |
$498.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.21
|
| Rate for Payer: Healthscope Commercial |
$688.59
|
| Rate for Payer: Healthscope Commercial |
$595.54
|
| Rate for Payer: Mclaren Medicaid |
$250.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.82
|
| Rate for Payer: Meridian Medicaid |
$263.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.81
|
| Rate for Payer: Nomi Health Commercial |
$446.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.75
|
| Rate for Payer: PACE SWMI |
$372.21
|
| Rate for Payer: PHP Medicare Advantage |
$372.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$587.13
|
| Rate for Payer: Priority Health Medicare |
$372.21
|
| Rate for Payer: Priority Health SBD |
$587.13
|
| Rate for Payer: Priority Health Tiered Network |
$587.13
|
| Rate for Payer: Railroad Medicare Medicare |
$372.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.13
|
| Rate for Payer: UHC Core |
$669.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.21
|
| Rate for Payer: UHC Exchange |
$669.13
|
| Rate for Payer: UHC Medicaid |
$250.70
|
| Rate for Payer: UHCCP Medicaid |
$250.70
|
|
|
PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 28080
|
| Min. Negotiated Rate |
$235.79 |
| Max. Negotiated Rate |
$684.75 |
| Rate for Payer: Aetna Commercial |
$476.13
|
| Rate for Payer: Aetna Medicare |
$369.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.66
|
| Rate for Payer: BCBS Complete |
$247.58
|
| Rate for Payer: BCBS MAPPO |
$355.32
|
| Rate for Payer: BCN Commercial |
$640.07
|
| Rate for Payer: BCN Medicare Advantage |
$355.32
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Cofinity Commercial |
$476.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.32
|
| Rate for Payer: Healthscope Commercial |
$657.34
|
| Rate for Payer: Healthscope Commercial |
$568.51
|
| Rate for Payer: Mclaren Medicaid |
$235.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.09
|
| Rate for Payer: Meridian Medicaid |
$247.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$390.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$658.33
|
| Rate for Payer: Nomi Health Commercial |
$426.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.75
|
| Rate for Payer: PACE SWMI |
$355.32
|
| Rate for Payer: PHP Medicare Advantage |
$355.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$622.82
|
| Rate for Payer: Priority Health Medicare |
$355.32
|
| Rate for Payer: Priority Health SBD |
$622.82
|
| Rate for Payer: Priority Health Tiered Network |
$622.82
|
| Rate for Payer: Railroad Medicare Medicare |
$355.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$638.74
|
| Rate for Payer: UHC Core |
$638.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$355.32
|
| Rate for Payer: UHC Exchange |
$638.74
|
| Rate for Payer: UHC Medicaid |
$235.79
|
| Rate for Payer: UHCCP Medicaid |
$235.79
|
|
|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$211.08 |
| Max. Negotiated Rate |
$613.50 |
| Rate for Payer: Aetna Commercial |
$429.16
|
| Rate for Payer: Aetna Medicare |
$333.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.19
|
| Rate for Payer: BCBS Complete |
$221.63
|
| Rate for Payer: BCBS MAPPO |
$320.27
|
| Rate for Payer: BCN Commercial |
$494.00
|
| Rate for Payer: BCN Medicare Advantage |
$320.27
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cofinity Commercial |
$461.19
|
| Rate for Payer: Cofinity Commercial |
$429.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.27
|
| Rate for Payer: Healthscope Commercial |
$592.50
|
| Rate for Payer: Healthscope Commercial |
$512.43
|
| Rate for Payer: Mclaren Medicaid |
$211.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.28
|
| Rate for Payer: Meridian Medicaid |
$221.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$352.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$568.69
|
| Rate for Payer: Nomi Health Commercial |
$384.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$613.50
|
| Rate for Payer: PACE SWMI |
$320.27
|
| Rate for Payer: PHP Medicare Advantage |
$320.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$452.14
|
| Rate for Payer: Priority Health Medicare |
$320.27
|
| Rate for Payer: Priority Health SBD |
$452.14
|
| Rate for Payer: Priority Health Tiered Network |
$452.14
|
| Rate for Payer: Railroad Medicare Medicare |
$320.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.16
|
| Rate for Payer: UHC Core |
$549.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$320.27
|
| Rate for Payer: UHC Exchange |
$549.16
|
| Rate for Payer: UHC Medicaid |
$211.08
|
| Rate for Payer: UHCCP Medicaid |
$211.08
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$454.50 |
| Rate for Payer: Aetna Commercial |
$259.46
|
| Rate for Payer: Aetna Medicare |
$201.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.83
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS MAPPO |
$193.63
|
| Rate for Payer: BCN Commercial |
$327.67
|
| Rate for Payer: BCN Medicare Advantage |
$193.63
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cofinity Commercial |
$278.83
|
| Rate for Payer: Cofinity Commercial |
$259.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.63
|
| Rate for Payer: Healthscope Commercial |
$358.22
|
| Rate for Payer: Healthscope Commercial |
$309.81
|
| Rate for Payer: Mclaren Medicaid |
$128.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.31
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$212.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.19
|
| Rate for Payer: Nomi Health Commercial |
$232.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$454.50
|
| Rate for Payer: PACE SWMI |
$193.63
|
| Rate for Payer: PHP Medicare Advantage |
$193.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$399.25
|
| Rate for Payer: Priority Health Medicare |
$193.63
|
| Rate for Payer: Priority Health SBD |
$399.25
|
| Rate for Payer: Priority Health Tiered Network |
$399.25
|
| Rate for Payer: Railroad Medicare Medicare |
$193.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.19
|
| Rate for Payer: UHC Core |
$370.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$193.63
|
| Rate for Payer: UHC Exchange |
$370.19
|
| Rate for Payer: UHC Medicaid |
$128.44
|
| Rate for Payer: UHCCP Medicaid |
$128.44
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,807.50 |
| Rate for Payer: Aetna Commercial |
$660.03
|
| Rate for Payer: Aetna Medicare |
$512.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.29
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$492.56
|
| Rate for Payer: BCN Commercial |
$811.71
|
| Rate for Payer: BCN Medicare Advantage |
$492.56
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$709.29
|
| Rate for Payer: Cofinity Commercial |
$660.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.56
|
| Rate for Payer: Healthscope Commercial |
$911.24
|
| Rate for Payer: Healthscope Commercial |
$788.10
|
| Rate for Payer: Mclaren Medicaid |
$323.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.19
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$541.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$937.80
|
| Rate for Payer: Nomi Health Commercial |
$591.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,807.50
|
| Rate for Payer: PACE SWMI |
$492.56
|
| Rate for Payer: PHP Medicare Advantage |
$492.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$867.70
|
| Rate for Payer: Priority Health Medicare |
$492.56
|
| Rate for Payer: Priority Health SBD |
$867.70
|
| Rate for Payer: Priority Health Tiered Network |
$867.70
|
| Rate for Payer: Railroad Medicare Medicare |
$492.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.57
|
| Rate for Payer: UHC Core |
$915.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$492.56
|
| Rate for Payer: UHC Exchange |
$915.57
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$1,564.83 |
| Rate for Payer: Aetna Commercial |
$1,075.64
|
| Rate for Payer: Aetna Medicare |
$834.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.92
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS MAPPO |
$802.72
|
| Rate for Payer: BCN Commercial |
$1,284.30
|
| Rate for Payer: BCN Medicare Advantage |
$802.72
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,155.92
|
| Rate for Payer: Cofinity Commercial |
$1,075.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.72
|
| Rate for Payer: Healthscope Commercial |
$1,485.03
|
| Rate for Payer: Healthscope Commercial |
$1,284.35
|
| Rate for Payer: Mclaren Medicaid |
$515.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.86
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$882.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,525.03
|
| Rate for Payer: Nomi Health Commercial |
$963.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,164.75
|
| Rate for Payer: PACE SWMI |
$802.72
|
| Rate for Payer: PHP Medicare Advantage |
$802.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,564.83
|
| Rate for Payer: Priority Health Medicare |
$802.72
|
| Rate for Payer: Priority Health SBD |
$1,564.83
|
| Rate for Payer: Priority Health Tiered Network |
$1,564.83
|
| Rate for Payer: Railroad Medicare Medicare |
$802.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,485.56
|
| Rate for Payer: UHC Core |
$1,485.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.72
|
| Rate for Payer: UHC Exchange |
$1,485.56
|
| Rate for Payer: UHC Medicaid |
$515.46
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
|
|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$667.76 |
| Max. Negotiated Rate |
$2,039.92 |
| Rate for Payer: Aetna Commercial |
$1,397.37
|
| Rate for Payer: Aetna Medicare |
$1,084.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,397.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,501.65
|
| Rate for Payer: BCBS Complete |
$701.15
|
| Rate for Payer: BCBS MAPPO |
$1,042.81
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,042.81
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$1,501.65
|
| Rate for Payer: Cofinity Commercial |
$1,397.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,042.81
|
| Rate for Payer: Healthscope Commercial |
$1,929.20
|
| Rate for Payer: Healthscope Commercial |
$1,668.50
|
| Rate for Payer: Mclaren Medicaid |
$667.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,094.95
|
| Rate for Payer: Meridian Medicaid |
$701.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,147.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,997.87
|
| Rate for Payer: Nomi Health Commercial |
$1,251.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,757.25
|
| Rate for Payer: PACE SWMI |
$1,042.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,042.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,039.92
|
| Rate for Payer: Priority Health Medicare |
$1,042.81
|
| Rate for Payer: Priority Health SBD |
$2,039.92
|
| Rate for Payer: Priority Health Tiered Network |
$2,039.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,042.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,970.93
|
| Rate for Payer: UHC Core |
$1,970.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,042.81
|
| Rate for Payer: UHC Exchange |
$1,970.93
|
| Rate for Payer: UHC Medicaid |
$667.76
|
| Rate for Payer: UHCCP Medicaid |
$667.76
|
|
