|
PR EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 42815
|
| Min. Negotiated Rate |
$278.41 |
| Max. Negotiated Rate |
$95,683.00 |
| Rate for Payer: Aetna Commercial |
$684.15
|
| Rate for Payer: Aetna Medicare |
$530.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.21
|
| Rate for Payer: BCBS Complete |
$364.33
|
| Rate for Payer: BCBS MAPPO |
$510.56
|
| Rate for Payer: BCBS Trust/PPO |
$278.41
|
| Rate for Payer: BCN Commercial |
$796.55
|
| Rate for Payer: BCN Medicare Advantage |
$510.56
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cofinity Commercial |
$735.21
|
| Rate for Payer: Cofinity Commercial |
$684.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.56
|
| Rate for Payer: Healthscope Commercial |
$944.54
|
| Rate for Payer: Healthscope Commercial |
$816.90
|
| Rate for Payer: Mclaren Medicaid |
$346.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.09
|
| Rate for Payer: Meridian Medicaid |
$364.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,683.00
|
| Rate for Payer: Nomi Health Commercial |
$612.67
|
| Rate for Payer: PACE SWMI |
$510.56
|
| Rate for Payer: PHP Medicare Advantage |
$510.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$971.85
|
| Rate for Payer: Priority Health Medicare |
$510.56
|
| Rate for Payer: Priority Health Narrow Network |
$971.85
|
| Rate for Payer: Priority Health SBD |
$971.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$672.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.56
|
| Rate for Payer: UHC Exchange |
$672.05
|
| Rate for Payer: UHC Medicare Advantage |
$510.56
|
| Rate for Payer: UHCCP Medicaid |
$346.98
|
|
|
PR EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 42810
|
| Min. Negotiated Rate |
$183.82 |
| Max. Negotiated Rate |
$49,597.00 |
| Rate for Payer: Aetna Commercial |
$359.48
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.31
|
| Rate for Payer: BCBS Complete |
$193.01
|
| Rate for Payer: BCBS MAPPO |
$268.27
|
| Rate for Payer: BCBS Trust/PPO |
$196.53
|
| Rate for Payer: BCN Commercial |
$575.66
|
| Rate for Payer: BCN Medicare Advantage |
$268.27
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$386.31
|
| Rate for Payer: Cofinity Commercial |
$359.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.27
|
| Rate for Payer: Healthscope Commercial |
$496.30
|
| Rate for Payer: Healthscope Commercial |
$429.23
|
| Rate for Payer: Mclaren Medicaid |
$183.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.68
|
| Rate for Payer: Meridian Medicaid |
$193.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49,597.00
|
| Rate for Payer: Nomi Health Commercial |
$321.92
|
| Rate for Payer: PACE SWMI |
$268.27
|
| Rate for Payer: PHP Medicare Advantage |
$268.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.07
|
| Rate for Payer: Priority Health Medicare |
$268.27
|
| Rate for Payer: Priority Health Narrow Network |
$513.07
|
| Rate for Payer: Priority Health SBD |
$513.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.27
|
| Rate for Payer: UHC Exchange |
$421.34
|
| Rate for Payer: UHC Medicare Advantage |
$268.27
|
| Rate for Payer: UHCCP Medicaid |
$183.82
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Facility
|
OP
|
$1,263.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
19125
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$496.77 |
| Max. Negotiated Rate |
$11,792.02 |
| Rate for Payer: Aetna Commercial |
$1,073.55
|
| Rate for Payer: Aetna Medicare |
$3,901.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,689.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,689.81
|
| Rate for Payer: BCBS Complete |
$2,111.54
|
| Rate for Payer: BCBS MAPPO |
$3,751.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,557.30
|
| Rate for Payer: BCCCP Commercial |
$569.78
|
| Rate for Payer: BCN Commercial |
$1,557.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,751.85
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$884.10
|
| Rate for Payer: Cofinity Commercial |
$1,086.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$884.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,010.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,751.85
|
| Rate for Payer: Healthscope Commercial |
$1,136.70
|
| Rate for Payer: Mclaren Medicaid |
$2,010.99
|
| Rate for Payer: Mclaren Medicare |
$3,751.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,939.44
|
| Rate for Payer: Meridian Medicaid |
$2,111.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,314.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,073.55
|
| Rate for Payer: Nomi Health Commercial |
$7,878.88
|
| Rate for Payer: PACE Medicare |
$3,564.26
|
| Rate for Payer: PACE SWMI |
$3,751.85
|
| Rate for Payer: PHP Commercial |
$1,073.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,751.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,010.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,792.02
|
| Rate for Payer: Priority Health Medicare |
$3,751.85
|
| Rate for Payer: Priority Health Narrow Network |
$9,433.62
|
| Rate for Payer: Priority Health SBD |
$795.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,751.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.77
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,751.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,751.85
|
| Rate for Payer: UHCCP Medicaid |
$2,112.29
|
| Rate for Payer: VA VA |
$3,751.85
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Facility
|
IP
|
$1,263.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
19125
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$795.69 |
| Max. Negotiated Rate |
$1,136.70 |
| Rate for Payer: Aetna Commercial |
$1,073.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.95
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$1,086.18
|
| Rate for Payer: Cofinity Commercial |
$884.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$884.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,010.40
|
| Rate for Payer: Healthscope Commercial |
$1,136.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,073.55
|
| Rate for Payer: PHP Commercial |
$1,073.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health SBD |
$795.69
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 19125
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$82,375.00 |
| Rate for Payer: Aetna Commercial |
$602.16
|
| Rate for Payer: Aetna Medicare |
$467.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.09
|
| Rate for Payer: BCBS Complete |
$315.57
|
| Rate for Payer: BCBS MAPPO |
$449.37
|
| Rate for Payer: BCBS Trust/PPO |
$13.80
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$449.37
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$647.09
|
| Rate for Payer: Cofinity Commercial |
$602.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.37
|
| Rate for Payer: Healthscope Commercial |
$831.33
|
| Rate for Payer: Healthscope Commercial |
$718.99
|
| Rate for Payer: Mclaren Medicaid |
$300.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.84
|
| Rate for Payer: Meridian Medicaid |
$315.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,375.00
|
| Rate for Payer: Nomi Health Commercial |
$539.24
|
| Rate for Payer: PACE SWMI |
$449.37
|
| Rate for Payer: PHP Medicare Advantage |
$449.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.13
|
| Rate for Payer: Priority Health Medicare |
$449.37
|
| Rate for Payer: Priority Health Narrow Network |
$632.13
|
| Rate for Payer: Priority Health SBD |
$632.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.37
|
| Rate for Payer: UHC Exchange |
$474.93
|
| Rate for Payer: UHC Medicare Advantage |
$449.37
|
| Rate for Payer: UHCCP Medicaid |
$300.54
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 19125
|
| Hospital Charge Code |
19125
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$82,375.00 |
| Rate for Payer: Aetna Commercial |
$602.16
|
| Rate for Payer: Aetna Medicare |
$467.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.09
|
| Rate for Payer: BCBS Complete |
$315.57
|
| Rate for Payer: BCBS MAPPO |
$449.37
|
| Rate for Payer: BCBS Trust/PPO |
$13.80
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$449.37
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$602.16
|
| Rate for Payer: Cofinity Commercial |
$647.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.37
|
| Rate for Payer: Healthscope Commercial |
$831.33
|
| Rate for Payer: Healthscope Commercial |
$718.99
|
| Rate for Payer: Mclaren Medicaid |
$300.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.84
|
| Rate for Payer: Meridian Medicaid |
$315.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82,375.00
|
| Rate for Payer: Nomi Health Commercial |
$539.24
|
| Rate for Payer: PACE SWMI |
$449.37
|
| Rate for Payer: PHP Medicare Advantage |
$449.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.13
|
| Rate for Payer: Priority Health Medicare |
$449.37
|
| Rate for Payer: Priority Health Narrow Network |
$632.13
|
| Rate for Payer: Priority Health SBD |
$632.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.37
|
| Rate for Payer: UHC Exchange |
$474.93
|
| Rate for Payer: UHC Medicare Advantage |
$449.37
|
| Rate for Payer: UHCCP Medicaid |
$300.54
|
|
|
PR EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 19126
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$28,710.00 |
| Rate for Payer: Aetna Commercial |
$208.22
|
| Rate for Payer: Aetna Medicare |
$161.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.76
|
| Rate for Payer: BCBS Complete |
$106.90
|
| Rate for Payer: BCBS MAPPO |
$155.39
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$232.12
|
| Rate for Payer: BCN Medicare Advantage |
$155.39
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$223.76
|
| Rate for Payer: Cofinity Commercial |
$208.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.39
|
| Rate for Payer: Healthscope Commercial |
$287.47
|
| Rate for Payer: Healthscope Commercial |
$248.62
|
| Rate for Payer: Mclaren Medicaid |
$101.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.16
|
| Rate for Payer: Meridian Medicaid |
$106.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,710.00
|
| Rate for Payer: Nomi Health Commercial |
$186.47
|
| Rate for Payer: PACE SWMI |
$155.39
|
| Rate for Payer: PHP Medicare Advantage |
$155.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.37
|
| Rate for Payer: Priority Health Medicare |
$155.39
|
| Rate for Payer: Priority Health Narrow Network |
$215.37
|
| Rate for Payer: Priority Health SBD |
$215.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.39
|
| Rate for Payer: UHC Exchange |
$175.99
|
| Rate for Payer: UHC Medicare Advantage |
$155.39
|
| Rate for Payer: UHCCP Medicaid |
$101.81
|
|
|
PR EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY
|
Professional
|
Both
|
$2,765.00
|
|
|
Service Code
|
HCPCS 60600
|
| Min. Negotiated Rate |
$529.36 |
| Max. Negotiated Rate |
$244,172.00 |
| Rate for Payer: Aetna Commercial |
$1,754.35
|
| Rate for Payer: Aetna Medicare |
$1,361.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,754.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,885.28
|
| Rate for Payer: BCBS Complete |
$902.43
|
| Rate for Payer: BCBS MAPPO |
$1,309.22
|
| Rate for Payer: BCBS Trust/PPO |
$529.36
|
| Rate for Payer: BCN Commercial |
$1,977.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,309.22
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Cofinity Commercial |
$1,885.28
|
| Rate for Payer: Cofinity Commercial |
$1,754.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,309.22
|
| Rate for Payer: Healthscope Commercial |
$2,422.06
|
| Rate for Payer: Healthscope Commercial |
$2,094.75
|
| Rate for Payer: Mclaren Medicaid |
$859.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,374.68
|
| Rate for Payer: Meridian Medicaid |
$902.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244,172.00
|
| Rate for Payer: Nomi Health Commercial |
$1,571.06
|
| Rate for Payer: PACE SWMI |
$1,309.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,309.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$859.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,189.00
|
| Rate for Payer: Priority Health Medicare |
$1,309.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,189.00
|
| Rate for Payer: Priority Health SBD |
$2,189.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,418.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,309.22
|
| Rate for Payer: UHC Exchange |
$1,418.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,309.22
|
| Rate for Payer: UHCCP Medicaid |
$859.46
|
|
|
PR EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 26596
|
| Min. Negotiated Rate |
$72.17 |
| Max. Negotiated Rate |
$144,799.00 |
| Rate for Payer: Aetna Commercial |
$1,039.55
|
| Rate for Payer: Aetna Medicare |
$806.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,117.12
|
| Rate for Payer: BCBS Complete |
$556.67
|
| Rate for Payer: BCBS MAPPO |
$775.78
|
| Rate for Payer: BCBS Trust/PPO |
$72.17
|
| Rate for Payer: BCN Commercial |
$1,213.39
|
| Rate for Payer: BCN Medicare Advantage |
$775.78
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$1,117.12
|
| Rate for Payer: Cofinity Commercial |
$1,039.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.78
|
| Rate for Payer: Healthscope Commercial |
$1,435.19
|
| Rate for Payer: Healthscope Commercial |
$1,241.25
|
| Rate for Payer: Mclaren Medicaid |
$530.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.57
|
| Rate for Payer: Meridian Medicaid |
$556.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144,799.00
|
| Rate for Payer: Nomi Health Commercial |
$930.94
|
| Rate for Payer: PACE SWMI |
$775.78
|
| Rate for Payer: PHP Medicare Advantage |
$775.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,265.54
|
| Rate for Payer: Priority Health Medicare |
$775.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,265.54
|
| Rate for Payer: Priority Health SBD |
$1,265.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$826.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.78
|
| Rate for Payer: UHC Exchange |
$826.55
|
| Rate for Payer: UHC Medicare Advantage |
$775.78
|
| Rate for Payer: UHCCP Medicaid |
$530.16
|
|
|
PR EXC CRV STUMP VAG APPR W/RPR NTRCL
|
Professional
|
Both
|
$1,282.00
|
|
|
Service Code
|
HCPCS 57556
|
| Min. Negotiated Rate |
$377.44 |
| Max. Negotiated Rate |
$104,998.00 |
| Rate for Payer: Aetna Commercial |
$753.64
|
| Rate for Payer: Aetna Medicare |
$584.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$809.88
|
| Rate for Payer: BCBS Complete |
$396.31
|
| Rate for Payer: BCBS MAPPO |
$562.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,301.73
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: BCN Medicare Advantage |
$562.42
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cofinity Commercial |
$809.88
|
| Rate for Payer: Cofinity Commercial |
$753.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.42
|
| Rate for Payer: Healthscope Commercial |
$899.87
|
| Rate for Payer: Healthscope Commercial |
$1,040.48
|
| Rate for Payer: Mclaren Medicaid |
$377.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.54
|
| Rate for Payer: Meridian Medicaid |
$396.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104,998.00
|
| Rate for Payer: Nomi Health Commercial |
$674.90
|
| Rate for Payer: PACE SWMI |
$562.42
|
| Rate for Payer: PHP Medicare Advantage |
$562.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$833.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$881.48
|
| Rate for Payer: Priority Health Medicare |
$562.42
|
| Rate for Payer: Priority Health Narrow Network |
$881.48
|
| Rate for Payer: Priority Health SBD |
$881.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$562.42
|
| Rate for Payer: UHC Exchange |
$748.60
|
| Rate for Payer: UHC Medicare Advantage |
$562.42
|
| Rate for Payer: UHCCP Medicaid |
$377.44
|
|
|
PR EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ
|
Professional
|
Both
|
$4,205.00
|
|
|
Service Code
|
HCPCS 38555
|
| Min. Negotiated Rate |
$556.83 |
| Max. Negotiated Rate |
$183,181.00 |
| Rate for Payer: Aetna Commercial |
$1,333.77
|
| Rate for Payer: Aetna Medicare |
$1,035.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.30
|
| Rate for Payer: BCBS Complete |
$695.77
|
| Rate for Payer: BCBS MAPPO |
$995.35
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: BCN Commercial |
$1,501.71
|
| Rate for Payer: BCN Medicare Advantage |
$995.35
|
| Rate for Payer: Cash Price |
$3,364.00
|
| Rate for Payer: Cash Price |
$3,364.00
|
| Rate for Payer: Cofinity Commercial |
$1,433.30
|
| Rate for Payer: Cofinity Commercial |
$1,333.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$995.35
|
| Rate for Payer: Healthscope Commercial |
$1,841.40
|
| Rate for Payer: Healthscope Commercial |
$1,592.56
|
| Rate for Payer: Mclaren Medicaid |
$662.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,045.12
|
| Rate for Payer: Meridian Medicaid |
$695.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183,181.00
|
| Rate for Payer: Nomi Health Commercial |
$1,194.42
|
| Rate for Payer: PACE SWMI |
$995.35
|
| Rate for Payer: PHP Medicare Advantage |
$995.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,733.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,057.84
|
| Rate for Payer: Priority Health Medicare |
$995.35
|
| Rate for Payer: Priority Health Narrow Network |
$2,057.84
|
| Rate for Payer: Priority Health SBD |
$2,057.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,057.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$995.35
|
| Rate for Payer: UHC Exchange |
$1,057.93
|
| Rate for Payer: UHC Medicare Advantage |
$995.35
|
| Rate for Payer: UHCCP Medicaid |
$662.64
|
|
|
PR EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38550
|
| Min. Negotiated Rate |
$339.95 |
| Max. Negotiated Rate |
$92,772.00 |
| Rate for Payer: Aetna Commercial |
$678.08
|
| Rate for Payer: Aetna Medicare |
$526.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.68
|
| Rate for Payer: BCBS Complete |
$356.95
|
| Rate for Payer: BCBS MAPPO |
$506.03
|
| Rate for Payer: BCBS Trust/PPO |
$608.07
|
| Rate for Payer: BCN Commercial |
$766.24
|
| Rate for Payer: BCN Medicare Advantage |
$506.03
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$728.68
|
| Rate for Payer: Cofinity Commercial |
$678.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.03
|
| Rate for Payer: Healthscope Commercial |
$936.16
|
| Rate for Payer: Healthscope Commercial |
$809.65
|
| Rate for Payer: Mclaren Medicaid |
$339.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.33
|
| Rate for Payer: Meridian Medicaid |
$356.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92,772.00
|
| Rate for Payer: Nomi Health Commercial |
$607.24
|
| Rate for Payer: PACE SWMI |
$506.03
|
| Rate for Payer: PHP Medicare Advantage |
$506.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.88
|
| Rate for Payer: Priority Health Medicare |
$506.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,053.88
|
| Rate for Payer: Priority Health SBD |
$1,053.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$490.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.03
|
| Rate for Payer: UHC Exchange |
$490.50
|
| Rate for Payer: UHC Medicare Advantage |
$506.03
|
| Rate for Payer: UHCCP Medicaid |
$339.95
|
|
|
PR EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT
|
Professional
|
Both
|
$2,361.00
|
|
|
Service Code
|
HCPCS 26205
|
| Min. Negotiated Rate |
$32.23 |
| Max. Negotiated Rate |
$107,716.00 |
| Rate for Payer: Aetna Commercial |
$785.92
|
| Rate for Payer: Aetna Medicare |
$609.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.57
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$586.51
|
| Rate for Payer: BCBS Trust/PPO |
$32.23
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: BCN Medicare Advantage |
$586.51
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cofinity Commercial |
$844.57
|
| Rate for Payer: Cofinity Commercial |
$785.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.51
|
| Rate for Payer: Healthscope Commercial |
$938.42
|
| Rate for Payer: Healthscope Commercial |
$1,085.04
|
| Rate for Payer: Mclaren Medicaid |
$397.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.84
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107,716.00
|
| Rate for Payer: Nomi Health Commercial |
$703.81
|
| Rate for Payer: PACE SWMI |
$586.51
|
| Rate for Payer: PHP Medicare Advantage |
$586.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$940.89
|
| Rate for Payer: Priority Health Medicare |
$586.51
|
| Rate for Payer: Priority Health Narrow Network |
$940.89
|
| Rate for Payer: Priority Health SBD |
$940.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.51
|
| Rate for Payer: UHC Exchange |
$620.58
|
| Rate for Payer: UHC Medicare Advantage |
$586.51
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
|
|
PR EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT
|
Professional
|
Both
|
$1,782.00
|
|
|
Service Code
|
HCPCS 26215
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$101,070.00 |
| Rate for Payer: Aetna Commercial |
$735.37
|
| Rate for Payer: Aetna Medicare |
$570.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.24
|
| Rate for Payer: BCBS Complete |
$391.17
|
| Rate for Payer: BCBS MAPPO |
$548.78
|
| Rate for Payer: BCBS Trust/PPO |
$119.40
|
| Rate for Payer: BCN Commercial |
$841.01
|
| Rate for Payer: BCN Medicare Advantage |
$548.78
|
| Rate for Payer: Cash Price |
$1,425.60
|
| Rate for Payer: Cash Price |
$1,425.60
|
| Rate for Payer: Cofinity Commercial |
$790.24
|
| Rate for Payer: Cofinity Commercial |
$735.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.78
|
| Rate for Payer: Healthscope Commercial |
$878.05
|
| Rate for Payer: Healthscope Commercial |
$1,015.24
|
| Rate for Payer: Mclaren Medicaid |
$372.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$576.22
|
| Rate for Payer: Meridian Medicaid |
$391.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101,070.00
|
| Rate for Payer: Nomi Health Commercial |
$658.54
|
| Rate for Payer: PACE SWMI |
$548.78
|
| Rate for Payer: PHP Medicare Advantage |
$548.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,158.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$883.89
|
| Rate for Payer: Priority Health Medicare |
$548.78
|
| Rate for Payer: Priority Health Narrow Network |
$883.89
|
| Rate for Payer: Priority Health SBD |
$883.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$548.78
|
| Rate for Payer: UHC Exchange |
$641.66
|
| Rate for Payer: UHC Medicare Advantage |
$548.78
|
| Rate for Payer: UHCCP Medicaid |
$372.54
|
|
|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 27637
|
| Min. Negotiated Rate |
$489.05 |
| Max. Negotiated Rate |
$131,411.00 |
| Rate for Payer: Aetna Commercial |
$968.65
|
| Rate for Payer: Aetna Medicare |
$751.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.65
|
| Rate for Payer: BCBS Complete |
$513.50
|
| Rate for Payer: BCBS MAPPO |
$722.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.18
|
| Rate for Payer: BCN Commercial |
$1,089.26
|
| Rate for Payer: BCN Medicare Advantage |
$722.87
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$968.65
|
| Rate for Payer: Cofinity Commercial |
$1,040.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.87
|
| Rate for Payer: Healthscope Commercial |
$1,337.31
|
| Rate for Payer: Healthscope Commercial |
$1,156.59
|
| Rate for Payer: Mclaren Medicaid |
$489.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$759.01
|
| Rate for Payer: Meridian Medicaid |
$513.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,411.00
|
| Rate for Payer: Nomi Health Commercial |
$867.44
|
| Rate for Payer: PACE SWMI |
$722.87
|
| Rate for Payer: PHP Medicare Advantage |
$722.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.10
|
| Rate for Payer: Priority Health Medicare |
$722.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.10
|
| Rate for Payer: Priority Health SBD |
$1,154.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$939.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.87
|
| Rate for Payer: UHC Exchange |
$939.65
|
| Rate for Payer: UHC Medicare Advantage |
$722.87
|
| Rate for Payer: UHCCP Medicaid |
$489.05
|
|
|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 27638
|
| Min. Negotiated Rate |
$485.00 |
| Max. Negotiated Rate |
$132,588.00 |
| Rate for Payer: Aetna Commercial |
$963.08
|
| Rate for Payer: Aetna Medicare |
$747.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.08
|
| Rate for Payer: BCBS Complete |
$509.25
|
| Rate for Payer: BCBS MAPPO |
$718.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.37
|
| Rate for Payer: BCN Commercial |
$1,097.08
|
| Rate for Payer: BCN Medicare Advantage |
$718.72
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cofinity Commercial |
$963.08
|
| Rate for Payer: Cofinity Commercial |
$1,034.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$718.72
|
| Rate for Payer: Healthscope Commercial |
$1,329.63
|
| Rate for Payer: Healthscope Commercial |
$1,149.95
|
| Rate for Payer: Mclaren Medicaid |
$485.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$754.66
|
| Rate for Payer: Meridian Medicaid |
$509.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132,588.00
|
| Rate for Payer: Nomi Health Commercial |
$862.46
|
| Rate for Payer: PACE SWMI |
$718.72
|
| Rate for Payer: PHP Medicare Advantage |
$718.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,438.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,144.43
|
| Rate for Payer: Priority Health Medicare |
$718.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,144.43
|
| Rate for Payer: Priority Health SBD |
$1,144.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,002.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$718.72
|
| Rate for Payer: UHC Exchange |
$1,002.08
|
| Rate for Payer: UHC Medicare Advantage |
$718.72
|
| Rate for Payer: UHCCP Medicaid |
$485.00
|
|
|
PR EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 28104
|
| Min. Negotiated Rate |
$232.17 |
| Max. Negotiated Rate |
$62,019.00 |
| Rate for Payer: Aetna Commercial |
$457.85
|
| Rate for Payer: Aetna Medicare |
$355.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.02
|
| Rate for Payer: BCBS Complete |
$243.78
|
| Rate for Payer: BCBS MAPPO |
$341.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,143.77
|
| Rate for Payer: BCN Commercial |
$761.85
|
| Rate for Payer: BCN Medicare Advantage |
$341.68
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$492.02
|
| Rate for Payer: Cofinity Commercial |
$457.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.68
|
| Rate for Payer: Healthscope Commercial |
$632.11
|
| Rate for Payer: Healthscope Commercial |
$546.69
|
| Rate for Payer: Mclaren Medicaid |
$232.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.76
|
| Rate for Payer: Meridian Medicaid |
$243.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,019.00
|
| Rate for Payer: Nomi Health Commercial |
$410.02
|
| Rate for Payer: PACE SWMI |
$341.68
|
| Rate for Payer: PHP Medicare Advantage |
$341.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.02
|
| Rate for Payer: Priority Health Medicare |
$341.68
|
| Rate for Payer: Priority Health Narrow Network |
$547.02
|
| Rate for Payer: Priority Health SBD |
$547.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$562.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.68
|
| Rate for Payer: UHC Exchange |
$562.81
|
| Rate for Payer: UHC Medicare Advantage |
$341.68
|
| Rate for Payer: UHCCP Medicaid |
$232.17
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 24116
|
| Min. Negotiated Rate |
$82.41 |
| Max. Negotiated Rate |
$152,926.00 |
| Rate for Payer: Aetna Commercial |
$1,113.06
|
| Rate for Payer: Aetna Medicare |
$863.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,196.12
|
| Rate for Payer: BCBS Complete |
$587.75
|
| Rate for Payer: BCBS MAPPO |
$830.64
|
| Rate for Payer: BCBS Trust/PPO |
$82.41
|
| Rate for Payer: BCN Commercial |
$1,264.70
|
| Rate for Payer: BCN Medicare Advantage |
$830.64
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,196.12
|
| Rate for Payer: Cofinity Commercial |
$1,113.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$830.64
|
| Rate for Payer: Healthscope Commercial |
$1,536.68
|
| Rate for Payer: Healthscope Commercial |
$1,329.02
|
| Rate for Payer: Mclaren Medicaid |
$559.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$872.17
|
| Rate for Payer: Meridian Medicaid |
$587.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152,926.00
|
| Rate for Payer: Nomi Health Commercial |
$996.77
|
| Rate for Payer: PACE SWMI |
$830.64
|
| Rate for Payer: PHP Medicare Advantage |
$830.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,327.62
|
| Rate for Payer: Priority Health Medicare |
$830.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,327.62
|
| Rate for Payer: Priority Health SBD |
$1,327.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$830.64
|
| Rate for Payer: UHC Exchange |
$1,059.07
|
| Rate for Payer: UHC Medicare Advantage |
$830.64
|
| Rate for Payer: UHCCP Medicaid |
$559.76
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 23140
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$98,780.00 |
| Rate for Payer: Aetna Commercial |
$721.36
|
| Rate for Payer: Aetna Medicare |
$559.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.20
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS MAPPO |
$538.33
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$821.96
|
| Rate for Payer: BCN Medicare Advantage |
$538.33
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$721.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.33
|
| Rate for Payer: Healthscope Commercial |
$995.91
|
| Rate for Payer: Healthscope Commercial |
$861.33
|
| Rate for Payer: Mclaren Medicaid |
$365.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.25
|
| Rate for Payer: Meridian Medicaid |
$383.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98,780.00
|
| Rate for Payer: Nomi Health Commercial |
$646.00
|
| Rate for Payer: PACE SWMI |
$538.33
|
| Rate for Payer: PHP Medicare Advantage |
$538.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$865.07
|
| Rate for Payer: Priority Health Medicare |
$538.33
|
| Rate for Payer: Priority Health Narrow Network |
$865.07
|
| Rate for Payer: Priority Health SBD |
$865.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.33
|
| Rate for Payer: UHC Exchange |
$634.09
|
| Rate for Payer: UHC Medicare Advantage |
$538.33
|
| Rate for Payer: UHCCP Medicaid |
$365.30
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$114.64 |
| Max. Negotiated Rate |
$94,698.00 |
| Rate for Payer: Aetna Commercial |
$693.57
|
| Rate for Payer: Aetna Medicare |
$538.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.33
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$517.59
|
| Rate for Payer: BCBS Trust/PPO |
$114.64
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$517.59
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$745.33
|
| Rate for Payer: Cofinity Commercial |
$693.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.59
|
| Rate for Payer: Healthscope Commercial |
$957.54
|
| Rate for Payer: Healthscope Commercial |
$828.14
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.47
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,698.00
|
| Rate for Payer: Nomi Health Commercial |
$621.11
|
| Rate for Payer: PACE SWMI |
$517.59
|
| Rate for Payer: PHP Medicare Advantage |
$517.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$829.95
|
| Rate for Payer: Priority Health Medicare |
$517.59
|
| Rate for Payer: Priority Health Narrow Network |
$829.95
|
| Rate for Payer: Priority Health SBD |
$829.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.59
|
| Rate for Payer: UHC Exchange |
$566.02
|
| Rate for Payer: UHC Medicare Advantage |
$517.59
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Facility
|
OP
|
$1,253.00
|
|
|
Service Code
|
CPT 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$569.78 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$1,065.05
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.51
|
| Rate for Payer: BCN Commercial |
$1,089.51
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$877.10
|
| Rate for Payer: Cofinity Commercial |
$1,077.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$877.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,127.70
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.05
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,065.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$789.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.78
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Facility
|
IP
|
$1,253.00
|
|
|
Service Code
|
CPT 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$789.39 |
| Max. Negotiated Rate |
$1,127.70 |
| Rate for Payer: Aetna Commercial |
$1,065.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.45
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$1,077.58
|
| Rate for Payer: Cofinity Commercial |
$877.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$877.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.40
|
| Rate for Payer: Healthscope Commercial |
$1,127.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.05
|
| Rate for Payer: PHP Commercial |
$1,065.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health SBD |
$789.39
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 24120
|
| Min. Negotiated Rate |
$114.64 |
| Max. Negotiated Rate |
$94,698.00 |
| Rate for Payer: Aetna Commercial |
$693.57
|
| Rate for Payer: Aetna Medicare |
$538.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.33
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$517.59
|
| Rate for Payer: BCBS Trust/PPO |
$114.64
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$517.59
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$745.33
|
| Rate for Payer: Cofinity Commercial |
$693.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.59
|
| Rate for Payer: Healthscope Commercial |
$957.54
|
| Rate for Payer: Healthscope Commercial |
$828.14
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.47
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,698.00
|
| Rate for Payer: Nomi Health Commercial |
$621.11
|
| Rate for Payer: PACE SWMI |
$517.59
|
| Rate for Payer: PHP Medicare Advantage |
$517.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$829.95
|
| Rate for Payer: Priority Health Medicare |
$517.59
|
| Rate for Payer: Priority Health Narrow Network |
$829.95
|
| Rate for Payer: Priority Health SBD |
$829.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.59
|
| Rate for Payer: UHC Exchange |
$566.02
|
| Rate for Payer: UHC Medicare Advantage |
$517.59
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
HCPCS 23155
|
| Min. Negotiated Rate |
$59.01 |
| Max. Negotiated Rate |
$141,797.00 |
| Rate for Payer: Aetna Commercial |
$1,033.85
|
| Rate for Payer: Aetna Medicare |
$802.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,111.00
|
| Rate for Payer: BCBS Complete |
$547.49
|
| Rate for Payer: BCBS MAPPO |
$771.53
|
| Rate for Payer: BCBS Trust/PPO |
$59.01
|
| Rate for Payer: BCN Commercial |
$1,175.76
|
| Rate for Payer: BCN Medicare Advantage |
$771.53
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cofinity Commercial |
$1,111.00
|
| Rate for Payer: Cofinity Commercial |
$1,033.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.53
|
| Rate for Payer: Healthscope Commercial |
$1,427.33
|
| Rate for Payer: Healthscope Commercial |
$1,234.45
|
| Rate for Payer: Mclaren Medicaid |
$521.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$810.11
|
| Rate for Payer: Meridian Medicaid |
$547.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141,797.00
|
| Rate for Payer: Nomi Health Commercial |
$925.84
|
| Rate for Payer: PACE SWMI |
$771.53
|
| Rate for Payer: PHP Medicare Advantage |
$771.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.98
|
| Rate for Payer: Priority Health Medicare |
$771.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,233.98
|
| Rate for Payer: Priority Health SBD |
$1,233.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.53
|
| Rate for Payer: UHC Exchange |
$960.36
|
| Rate for Payer: UHC Medicare Advantage |
$771.53
|
| Rate for Payer: UHCCP Medicaid |
$521.42
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT
|
Professional
|
Both
|
$1,299.00
|
|
|
Service Code
|
HCPCS 23156
|
| Min. Negotiated Rate |
$32.26 |
| Max. Negotiated Rate |
$120,823.00 |
| Rate for Payer: Aetna Commercial |
$882.55
|
| Rate for Payer: Aetna Medicare |
$684.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.41
|
| Rate for Payer: BCBS Complete |
$467.88
|
| Rate for Payer: BCBS MAPPO |
$658.62
|
| Rate for Payer: BCBS Trust/PPO |
$32.26
|
| Rate for Payer: BCN Commercial |
$1,002.76
|
| Rate for Payer: BCN Medicare Advantage |
$658.62
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cofinity Commercial |
$948.41
|
| Rate for Payer: Cofinity Commercial |
$882.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.62
|
| Rate for Payer: Healthscope Commercial |
$1,218.45
|
| Rate for Payer: Healthscope Commercial |
$1,053.79
|
| Rate for Payer: Mclaren Medicaid |
$445.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.55
|
| Rate for Payer: Meridian Medicaid |
$467.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120,823.00
|
| Rate for Payer: Nomi Health Commercial |
$790.34
|
| Rate for Payer: PACE SWMI |
$658.62
|
| Rate for Payer: PHP Medicare Advantage |
$658.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.34
|
| Rate for Payer: Priority Health Medicare |
$658.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,053.34
|
| Rate for Payer: Priority Health SBD |
$1,053.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$822.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.62
|
| Rate for Payer: UHC Exchange |
$822.94
|
| Rate for Payer: UHC Medicare Advantage |
$658.62
|
| Rate for Payer: UHCCP Medicaid |
$445.60
|
|
