|
PR EXCISION OF PENILE PLAQUE
|
Professional
|
Both
|
$1,222.00
|
|
|
Service Code
|
HCPCS 54110
|
| Min. Negotiated Rate |
$362.53 |
| Max. Negotiated Rate |
$1,100.27 |
| Rate for Payer: Aetna Commercial |
$750.11
|
| Rate for Payer: Aetna Medicare |
$582.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.08
|
| Rate for Payer: BCBS Complete |
$380.66
|
| Rate for Payer: BCBS MAPPO |
$559.78
|
| Rate for Payer: BCN Commercial |
$937.20
|
| Rate for Payer: BCN Medicare Advantage |
$559.78
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cofinity Commercial |
$806.08
|
| Rate for Payer: Cofinity Commercial |
$750.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.78
|
| Rate for Payer: Healthscope Commercial |
$895.65
|
| Rate for Payer: Healthscope Commercial |
$1,035.59
|
| Rate for Payer: Mclaren Medicaid |
$362.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.77
|
| Rate for Payer: Meridian Medicaid |
$380.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$615.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.94
|
| Rate for Payer: Nomi Health Commercial |
$671.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.50
|
| Rate for Payer: PACE SWMI |
$559.78
|
| Rate for Payer: PHP Medicare Advantage |
$559.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,020.91
|
| Rate for Payer: Priority Health Medicare |
$559.78
|
| Rate for Payer: Priority Health SBD |
$1,020.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,020.91
|
| Rate for Payer: Railroad Medicare Medicare |
$559.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.27
|
| Rate for Payer: UHC Core |
$1,100.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$559.78
|
| Rate for Payer: UHC Exchange |
$1,100.27
|
| Rate for Payer: UHC Medicaid |
$362.53
|
| Rate for Payer: UHCCP Medicaid |
$362.53
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$630.00
|
|
|
Service Code
|
HCPCS 24105
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$637.00 |
| Rate for Payer: Aetna Commercial |
$459.67
|
| Rate for Payer: Aetna Medicare |
$356.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.98
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS MAPPO |
$343.04
|
| Rate for Payer: BCN Commercial |
$559.23
|
| Rate for Payer: BCN Medicare Advantage |
$343.04
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$493.98
|
| Rate for Payer: Cofinity Commercial |
$459.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.04
|
| Rate for Payer: Healthscope Commercial |
$634.62
|
| Rate for Payer: Healthscope Commercial |
$548.86
|
| Rate for Payer: Mclaren Medicaid |
$228.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.19
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$377.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.00
|
| Rate for Payer: Nomi Health Commercial |
$411.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| Rate for Payer: PACE SWMI |
$343.04
|
| Rate for Payer: PHP Medicare Advantage |
$343.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$597.80
|
| Rate for Payer: Priority Health Medicare |
$343.04
|
| Rate for Payer: Priority Health SBD |
$597.80
|
| Rate for Payer: Priority Health Tiered Network |
$597.80
|
| Rate for Payer: Railroad Medicare Medicare |
$343.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.95
|
| Rate for Payer: UHC Core |
$608.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$343.04
|
| Rate for Payer: UHC Exchange |
$608.95
|
| Rate for Payer: UHC Medicaid |
$228.34
|
| Rate for Payer: UHCCP Medicaid |
$228.34
|
|
|
PR EXCISION OR FULGURATION SKENES GLANDS
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 53270
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$324.72 |
| Rate for Payer: Aetna Commercial |
$222.96
|
| Rate for Payer: Aetna Medicare |
$173.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.60
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS MAPPO |
$166.39
|
| Rate for Payer: BCN Commercial |
$279.37
|
| Rate for Payer: BCN Medicare Advantage |
$166.39
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$239.60
|
| Rate for Payer: Cofinity Commercial |
$222.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.39
|
| Rate for Payer: Healthscope Commercial |
$307.82
|
| Rate for Payer: Healthscope Commercial |
$266.22
|
| Rate for Payer: Mclaren Medicaid |
$107.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.71
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.72
|
| Rate for Payer: Nomi Health Commercial |
$199.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.50
|
| Rate for Payer: PACE SWMI |
$166.39
|
| Rate for Payer: PHP Medicare Advantage |
$166.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$304.32
|
| Rate for Payer: Priority Health Medicare |
$166.39
|
| Rate for Payer: Priority Health SBD |
$304.32
|
| Rate for Payer: Priority Health Tiered Network |
$304.32
|
| Rate for Payer: Railroad Medicare Medicare |
$166.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.14
|
| Rate for Payer: UHC Core |
$323.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$166.39
|
| Rate for Payer: UHC Exchange |
$323.14
|
| Rate for Payer: UHC Medicaid |
$107.99
|
| Rate for Payer: UHCCP Medicaid |
$107.99
|
|
|
PR EXCISION PILONIDAL CYST/SINUS COMPLICATED
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 11772
|
| Min. Negotiated Rate |
$365.72 |
| Max. Negotiated Rate |
$1,029.89 |
| Rate for Payer: Aetna Commercial |
$745.98
|
| Rate for Payer: Aetna Medicare |
$578.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.65
|
| Rate for Payer: BCBS Complete |
$384.01
|
| Rate for Payer: BCBS MAPPO |
$556.70
|
| Rate for Payer: BCN Commercial |
$876.45
|
| Rate for Payer: BCN Medicare Advantage |
$556.70
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cofinity Commercial |
$801.65
|
| Rate for Payer: Cofinity Commercial |
$745.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$556.70
|
| Rate for Payer: Healthscope Commercial |
$890.72
|
| Rate for Payer: Healthscope Commercial |
$1,029.89
|
| Rate for Payer: Mclaren Medicaid |
$365.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$584.53
|
| Rate for Payer: Meridian Medicaid |
$384.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$612.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,021.88
|
| Rate for Payer: Nomi Health Commercial |
$668.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$891.75
|
| Rate for Payer: PACE SWMI |
$556.70
|
| Rate for Payer: PHP Medicare Advantage |
$556.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$802.18
|
| Rate for Payer: Priority Health Medicare |
$556.70
|
| Rate for Payer: Priority Health SBD |
$802.18
|
| Rate for Payer: Priority Health Tiered Network |
$802.18
|
| Rate for Payer: Railroad Medicare Medicare |
$556.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,006.12
|
| Rate for Payer: UHC Core |
$1,006.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$556.70
|
| Rate for Payer: UHC Exchange |
$1,006.12
|
| Rate for Payer: UHC Medicaid |
$365.72
|
| Rate for Payer: UHCCP Medicaid |
$365.72
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,383.00
|
|
|
Service Code
|
HCPCS 11771
|
| Hospital Charge Code |
11771
|
| Min. Negotiated Rate |
$281.80 |
| Max. Negotiated Rate |
$1,037.25 |
| Rate for Payer: Aetna Commercial |
$577.58
|
| Rate for Payer: Aetna Medicare |
$448.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.68
|
| Rate for Payer: BCBS Complete |
$295.89
|
| Rate for Payer: BCBS MAPPO |
$431.03
|
| Rate for Payer: BCN Commercial |
$682.23
|
| Rate for Payer: BCN Medicare Advantage |
$431.03
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$620.68
|
| Rate for Payer: Cofinity Commercial |
$577.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.03
|
| Rate for Payer: Healthscope Commercial |
$797.41
|
| Rate for Payer: Healthscope Commercial |
$689.65
|
| Rate for Payer: Mclaren Medicaid |
$281.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.58
|
| Rate for Payer: Meridian Medicaid |
$295.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$474.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.01
|
| Rate for Payer: Nomi Health Commercial |
$517.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
| Rate for Payer: PACE SWMI |
$431.03
|
| Rate for Payer: PHP Medicare Advantage |
$431.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$624.42
|
| Rate for Payer: Priority Health Medicare |
$431.03
|
| Rate for Payer: Priority Health SBD |
$624.42
|
| Rate for Payer: Priority Health Tiered Network |
$624.42
|
| Rate for Payer: Railroad Medicare Medicare |
$431.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.69
|
| Rate for Payer: UHC Core |
$771.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$431.03
|
| Rate for Payer: UHC Exchange |
$771.69
|
| Rate for Payer: UHC Medicaid |
$281.80
|
| Rate for Payer: UHCCP Medicaid |
$281.80
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Facility
|
OP
|
$1,383.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
11771
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$871.29 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$1,175.55
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.72
|
| Rate for Payer: BCN Commercial |
$2,458.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Advantage |
$968.10
|
| Rate for Payer: Cofinity Commercial |
$1,189.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,244.70
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.55
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$1,175.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$871.29
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,383.00
|
|
|
Service Code
|
HCPCS 11771
|
| Min. Negotiated Rate |
$281.80 |
| Max. Negotiated Rate |
$1,037.25 |
| Rate for Payer: Aetna Commercial |
$577.58
|
| Rate for Payer: Aetna Medicare |
$448.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.68
|
| Rate for Payer: BCBS Complete |
$295.89
|
| Rate for Payer: BCBS MAPPO |
$431.03
|
| Rate for Payer: BCN Commercial |
$682.23
|
| Rate for Payer: BCN Medicare Advantage |
$431.03
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$620.68
|
| Rate for Payer: Cofinity Commercial |
$577.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.03
|
| Rate for Payer: Healthscope Commercial |
$797.41
|
| Rate for Payer: Healthscope Commercial |
$689.65
|
| Rate for Payer: Mclaren Medicaid |
$281.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.58
|
| Rate for Payer: Meridian Medicaid |
$295.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$474.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.01
|
| Rate for Payer: Nomi Health Commercial |
$517.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
| Rate for Payer: PACE SWMI |
$431.03
|
| Rate for Payer: PHP Medicare Advantage |
$431.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$624.42
|
| Rate for Payer: Priority Health Medicare |
$431.03
|
| Rate for Payer: Priority Health SBD |
$624.42
|
| Rate for Payer: Priority Health Tiered Network |
$624.42
|
| Rate for Payer: Railroad Medicare Medicare |
$431.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.69
|
| Rate for Payer: UHC Core |
$771.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$431.03
|
| Rate for Payer: UHC Exchange |
$771.69
|
| Rate for Payer: UHC Medicaid |
$281.80
|
| Rate for Payer: UHCCP Medicaid |
$281.80
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Facility
|
IP
|
$1,383.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
11771
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$871.29 |
| Max. Negotiated Rate |
$1,244.70 |
| Rate for Payer: Aetna Commercial |
$1,175.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.95
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Advantage |
$968.10
|
| Rate for Payer: Cofinity Commercial |
$1,189.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.40
|
| Rate for Payer: Healthscope Commercial |
$1,244.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
| Rate for Payer: PHP Commercial |
$1,175.55
|
| Rate for Payer: Priority Health SBD |
$871.29
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Professional
|
Both
|
$536.00
|
|
|
Service Code
|
HCPCS 11770
|
| Hospital Charge Code |
11770
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$402.00 |
| Rate for Payer: Aetna Commercial |
$237.46
|
| Rate for Payer: Aetna Medicare |
$184.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.18
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.21
|
| Rate for Payer: BCN Commercial |
$278.87
|
| Rate for Payer: BCN Medicare Advantage |
$177.21
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cofinity Commercial |
$255.18
|
| Rate for Payer: Cofinity Commercial |
$237.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.21
|
| Rate for Payer: Healthscope Commercial |
$327.84
|
| Rate for Payer: Healthscope Commercial |
$283.54
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.07
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.79
|
| Rate for Payer: Nomi Health Commercial |
$212.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.00
|
| Rate for Payer: PACE SWMI |
$177.21
|
| Rate for Payer: PHP Medicare Advantage |
$177.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$255.24
|
| Rate for Payer: Priority Health Medicare |
$177.21
|
| Rate for Payer: Priority Health SBD |
$255.24
|
| Rate for Payer: Priority Health Tiered Network |
$255.24
|
| Rate for Payer: Railroad Medicare Medicare |
$177.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.97
|
| Rate for Payer: UHC Core |
$323.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.21
|
| Rate for Payer: UHC Exchange |
$323.97
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Professional
|
Both
|
$536.00
|
|
|
Service Code
|
HCPCS 11770
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$402.00 |
| Rate for Payer: PHP Medicare Advantage |
$177.21
|
| Rate for Payer: Aetna Commercial |
$237.46
|
| Rate for Payer: Aetna Medicare |
$184.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.18
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.21
|
| Rate for Payer: BCN Commercial |
$278.87
|
| Rate for Payer: BCN Medicare Advantage |
$177.21
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cofinity Commercial |
$255.18
|
| Rate for Payer: Cofinity Commercial |
$237.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.21
|
| Rate for Payer: Healthscope Commercial |
$327.84
|
| Rate for Payer: Healthscope Commercial |
$283.54
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.07
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.79
|
| Rate for Payer: Nomi Health Commercial |
$212.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.00
|
| Rate for Payer: PACE SWMI |
$177.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$255.24
|
| Rate for Payer: Priority Health Medicare |
$177.21
|
| Rate for Payer: Priority Health SBD |
$255.24
|
| Rate for Payer: Priority Health Tiered Network |
$255.24
|
| Rate for Payer: Railroad Medicare Medicare |
$177.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.97
|
| Rate for Payer: UHC Core |
$323.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.21
|
| Rate for Payer: UHC Exchange |
$323.97
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
IP
|
$536.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
11770
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$337.68 |
| Max. Negotiated Rate |
$482.40 |
| Rate for Payer: Aetna Commercial |
$455.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.40
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cofinity Advantage |
$375.20
|
| Rate for Payer: Cofinity Commercial |
$460.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.80
|
| Rate for Payer: Healthscope Commercial |
$482.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.00
|
| Rate for Payer: PHP Commercial |
$455.60
|
| Rate for Payer: Priority Health SBD |
$337.68
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
OP
|
$536.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
11770
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$337.68 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$455.60
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,152.59
|
| Rate for Payer: BCN Commercial |
$2,152.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cofinity Advantage |
$375.20
|
| Rate for Payer: Cofinity Commercial |
$460.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$482.40
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.60
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.00
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$455.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$337.68
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 27340
|
| Min. Negotiated Rate |
$235.79 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Aetna Commercial |
$477.25
|
| Rate for Payer: Aetna Medicare |
$370.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.87
|
| Rate for Payer: BCBS Complete |
$247.58
|
| Rate for Payer: BCBS MAPPO |
$356.16
|
| Rate for Payer: BCN Commercial |
$580.15
|
| Rate for Payer: BCN Medicare Advantage |
$356.16
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$512.87
|
| Rate for Payer: Cofinity Commercial |
$477.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.16
|
| Rate for Payer: Healthscope Commercial |
$658.90
|
| Rate for Payer: Healthscope Commercial |
$569.86
|
| Rate for Payer: Mclaren Medicaid |
$235.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.97
|
| Rate for Payer: Meridian Medicaid |
$247.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$391.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$664.38
|
| Rate for Payer: Nomi Health Commercial |
$427.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.00
|
| Rate for Payer: PACE SWMI |
$356.16
|
| Rate for Payer: PHP Medicare Advantage |
$356.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$620.17
|
| Rate for Payer: Priority Health Medicare |
$356.16
|
| Rate for Payer: Priority Health SBD |
$620.17
|
| Rate for Payer: Priority Health Tiered Network |
$620.17
|
| Rate for Payer: Railroad Medicare Medicare |
$356.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.34
|
| Rate for Payer: UHC Core |
$642.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$356.16
|
| Rate for Payer: UHC Exchange |
$642.34
|
| Rate for Payer: UHC Medicaid |
$235.79
|
| Rate for Payer: UHCCP Medicaid |
$235.79
|
|
|
PR EXCISION RADIAL HEAD
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 24130
|
| Min. Negotiated Rate |
$309.49 |
| Max. Negotiated Rate |
$970.50 |
| Rate for Payer: Aetna Commercial |
$630.01
|
| Rate for Payer: Aetna Medicare |
$488.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.03
|
| Rate for Payer: BCBS Complete |
$324.96
|
| Rate for Payer: BCBS MAPPO |
$470.16
|
| Rate for Payer: BCN Commercial |
$790.79
|
| Rate for Payer: BCN Medicare Advantage |
$470.16
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$677.03
|
| Rate for Payer: Cofinity Commercial |
$630.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.16
|
| Rate for Payer: Healthscope Commercial |
$869.80
|
| Rate for Payer: Healthscope Commercial |
$752.26
|
| Rate for Payer: Mclaren Medicaid |
$309.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.67
|
| Rate for Payer: Meridian Medicaid |
$324.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.97
|
| Rate for Payer: Nomi Health Commercial |
$564.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PACE SWMI |
$470.16
|
| Rate for Payer: PHP Medicare Advantage |
$470.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$845.33
|
| Rate for Payer: Priority Health Medicare |
$470.16
|
| Rate for Payer: Priority Health SBD |
$845.33
|
| Rate for Payer: Priority Health Tiered Network |
$845.33
|
| Rate for Payer: Railroad Medicare Medicare |
$470.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$884.72
|
| Rate for Payer: UHC Core |
$884.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$470.16
|
| Rate for Payer: UHC Exchange |
$884.72
|
| Rate for Payer: UHC Medicaid |
$309.49
|
| Rate for Payer: UHCCP Medicaid |
$309.49
|
|
|
PR EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN
|
Professional
|
Both
|
$1,187.00
|
|
|
Service Code
|
HCPCS 67961
|
| Min. Negotiated Rate |
$249.00 |
| Max. Negotiated Rate |
$890.25 |
| Rate for Payer: Aetna Commercial |
$504.47
|
| Rate for Payer: Aetna Medicare |
$391.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.12
|
| Rate for Payer: BCBS Complete |
$261.45
|
| Rate for Payer: BCBS MAPPO |
$376.47
|
| Rate for Payer: BCN Commercial |
$674.27
|
| Rate for Payer: BCN Medicare Advantage |
$376.47
|
| Rate for Payer: Cash Price |
$949.60
|
| Rate for Payer: Cash Price |
$949.60
|
| Rate for Payer: Cofinity Commercial |
$542.12
|
| Rate for Payer: Cofinity Commercial |
$504.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.47
|
| Rate for Payer: Healthscope Commercial |
$696.47
|
| Rate for Payer: Healthscope Commercial |
$602.35
|
| Rate for Payer: Mclaren Medicaid |
$249.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.29
|
| Rate for Payer: Meridian Medicaid |
$261.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$414.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$777.73
|
| Rate for Payer: Nomi Health Commercial |
$451.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$890.25
|
| Rate for Payer: PACE SWMI |
$376.47
|
| Rate for Payer: PHP Medicare Advantage |
$376.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$789.79
|
| Rate for Payer: Priority Health Medicare |
$376.47
|
| Rate for Payer: Priority Health SBD |
$789.79
|
| Rate for Payer: Priority Health Tiered Network |
$789.79
|
| Rate for Payer: Railroad Medicare Medicare |
$376.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.66
|
| Rate for Payer: UHC Core |
$772.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$376.47
|
| Rate for Payer: UHC Exchange |
$772.66
|
| Rate for Payer: UHC Medicaid |
$249.00
|
| Rate for Payer: UHCCP Medicaid |
$249.00
|
|
|
PR EXCISION RIB PARTIAL
|
Professional
|
Both
|
$1,674.00
|
|
|
Service Code
|
HCPCS 21600
|
| Min. Negotiated Rate |
$362.10 |
| Max. Negotiated Rate |
$1,255.50 |
| Rate for Payer: Aetna Commercial |
$738.49
|
| Rate for Payer: Aetna Medicare |
$573.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.60
|
| Rate for Payer: BCBS Complete |
$380.20
|
| Rate for Payer: BCBS MAPPO |
$551.11
|
| Rate for Payer: BCN Commercial |
$870.97
|
| Rate for Payer: BCN Medicare Advantage |
$551.11
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Cash Price |
$1,339.20
|
| Rate for Payer: Cofinity Commercial |
$793.60
|
| Rate for Payer: Cofinity Commercial |
$738.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.11
|
| Rate for Payer: Healthscope Commercial |
$881.78
|
| Rate for Payer: Healthscope Commercial |
$1,019.55
|
| Rate for Payer: Mclaren Medicaid |
$362.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.67
|
| Rate for Payer: Meridian Medicaid |
$380.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$606.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.16
|
| Rate for Payer: Nomi Health Commercial |
$661.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,255.50
|
| Rate for Payer: PACE SWMI |
$551.11
|
| Rate for Payer: PHP Medicare Advantage |
$551.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$931.04
|
| Rate for Payer: Priority Health Medicare |
$551.11
|
| Rate for Payer: Priority Health SBD |
$931.04
|
| Rate for Payer: Priority Health Tiered Network |
$931.04
|
| Rate for Payer: Railroad Medicare Medicare |
$551.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$962.92
|
| Rate for Payer: UHC Core |
$962.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$551.11
|
| Rate for Payer: UHC Exchange |
$962.92
|
| Rate for Payer: UHC Medicaid |
$362.10
|
| Rate for Payer: UHCCP Medicaid |
$362.10
|
|
|
PR EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
HCPCS 15931
|
| Min. Negotiated Rate |
$429.41 |
| Max. Negotiated Rate |
$1,254.15 |
| Rate for Payer: Aetna Commercial |
$885.34
|
| Rate for Payer: Aetna Medicare |
$687.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$885.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$951.41
|
| Rate for Payer: BCBS Complete |
$450.88
|
| Rate for Payer: BCBS MAPPO |
$660.70
|
| Rate for Payer: BCN Commercial |
$1,066.68
|
| Rate for Payer: BCN Medicare Advantage |
$660.70
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$951.41
|
| Rate for Payer: Cofinity Commercial |
$885.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$660.70
|
| Rate for Payer: Healthscope Commercial |
$1,222.30
|
| Rate for Payer: Healthscope Commercial |
$1,057.12
|
| Rate for Payer: Mclaren Medicaid |
$429.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$693.74
|
| Rate for Payer: Meridian Medicaid |
$450.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$726.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,254.15
|
| Rate for Payer: Nomi Health Commercial |
$792.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$906.75
|
| Rate for Payer: PACE SWMI |
$660.70
|
| Rate for Payer: PHP Medicare Advantage |
$660.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$976.28
|
| Rate for Payer: Priority Health Medicare |
$660.70
|
| Rate for Payer: Priority Health SBD |
$976.28
|
| Rate for Payer: Priority Health Tiered Network |
$976.28
|
| Rate for Payer: Railroad Medicare Medicare |
$660.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.24
|
| Rate for Payer: UHC Core |
$1,225.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$660.70
|
| Rate for Payer: UHC Exchange |
$1,225.24
|
| Rate for Payer: UHC Medicaid |
$429.41
|
| Rate for Payer: UHCCP Medicaid |
$429.41
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$453.00
|
|
|
Service Code
|
HCPCS 46220
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$339.75 |
| Rate for Payer: Aetna Commercial |
$155.21
|
| Rate for Payer: Aetna Medicare |
$120.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.80
|
| Rate for Payer: BCBS Complete |
$80.06
|
| Rate for Payer: BCBS MAPPO |
$115.83
|
| Rate for Payer: BCN Commercial |
$184.25
|
| Rate for Payer: BCN Medicare Advantage |
$115.83
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cofinity Commercial |
$166.80
|
| Rate for Payer: Cofinity Commercial |
$155.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.83
|
| Rate for Payer: Healthscope Commercial |
$214.29
|
| Rate for Payer: Healthscope Commercial |
$185.33
|
| Rate for Payer: Mclaren Medicaid |
$76.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.62
|
| Rate for Payer: Meridian Medicaid |
$80.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.93
|
| Rate for Payer: Nomi Health Commercial |
$139.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$339.75
|
| Rate for Payer: PACE SWMI |
$115.83
|
| Rate for Payer: PHP Medicare Advantage |
$115.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$224.50
|
| Rate for Payer: Priority Health Medicare |
$115.83
|
| Rate for Payer: Priority Health SBD |
$224.50
|
| Rate for Payer: Priority Health Tiered Network |
$224.50
|
| Rate for Payer: Railroad Medicare Medicare |
$115.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.15
|
| Rate for Payer: UHC Core |
$207.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.83
|
| Rate for Payer: UHC Exchange |
$207.15
|
| Rate for Payer: UHC Medicaid |
$76.25
|
| Rate for Payer: UHCCP Medicaid |
$76.25
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$453.00
|
|
|
Service Code
|
HCPCS 46220
|
| Hospital Charge Code |
46220
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$339.75 |
| Rate for Payer: Aetna Commercial |
$155.21
|
| Rate for Payer: Aetna Medicare |
$120.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.80
|
| Rate for Payer: BCBS Complete |
$80.06
|
| Rate for Payer: BCBS MAPPO |
$115.83
|
| Rate for Payer: BCN Commercial |
$184.25
|
| Rate for Payer: BCN Medicare Advantage |
$115.83
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cofinity Commercial |
$166.80
|
| Rate for Payer: Cofinity Commercial |
$155.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.83
|
| Rate for Payer: Healthscope Commercial |
$214.29
|
| Rate for Payer: Healthscope Commercial |
$185.33
|
| Rate for Payer: Mclaren Medicaid |
$76.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.62
|
| Rate for Payer: Meridian Medicaid |
$80.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.93
|
| Rate for Payer: Nomi Health Commercial |
$139.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$339.75
|
| Rate for Payer: PACE SWMI |
$115.83
|
| Rate for Payer: PHP Medicare Advantage |
$115.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$224.50
|
| Rate for Payer: Priority Health Medicare |
$115.83
|
| Rate for Payer: Priority Health SBD |
$224.50
|
| Rate for Payer: Priority Health Tiered Network |
$224.50
|
| Rate for Payer: Railroad Medicare Medicare |
$115.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.15
|
| Rate for Payer: UHC Core |
$207.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.83
|
| Rate for Payer: UHC Exchange |
$207.15
|
| Rate for Payer: UHC Medicaid |
$76.25
|
| Rate for Payer: UHCCP Medicaid |
$76.25
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
IP
|
$453.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$285.39 |
| Max. Negotiated Rate |
$407.70 |
| Rate for Payer: Aetna Commercial |
$385.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.45
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cofinity Advantage |
$317.10
|
| Rate for Payer: Cofinity Commercial |
$389.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.40
|
| Rate for Payer: Healthscope Commercial |
$407.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$339.75
|
| Rate for Payer: PHP Commercial |
$385.05
|
| Rate for Payer: Priority Health SBD |
$285.39
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
OP
|
$453.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$285.39 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Commercial |
$385.05
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$877.10
|
| Rate for Payer: BCN Commercial |
$877.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cofinity Advantage |
$317.10
|
| Rate for Payer: Cofinity Commercial |
$389.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$407.70
|
| Rate for Payer: Mclaren Medicaid |
$623.59
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.05
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$339.75
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$385.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health SBD |
$285.39
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
PR EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$696.00
|
|
|
Service Code
|
HCPCS 69145
|
| Min. Negotiated Rate |
$151.23 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: PHP Medicare Advantage |
$226.97
|
| Rate for Payer: Aetna Commercial |
$304.14
|
| Rate for Payer: Aetna Medicare |
$236.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.84
|
| Rate for Payer: BCBS Complete |
$158.79
|
| Rate for Payer: BCBS MAPPO |
$226.97
|
| Rate for Payer: BCN Commercial |
$386.44
|
| Rate for Payer: BCN Medicare Advantage |
$226.97
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cofinity Commercial |
$326.84
|
| Rate for Payer: Cofinity Commercial |
$304.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.97
|
| Rate for Payer: Healthscope Commercial |
$419.89
|
| Rate for Payer: Healthscope Commercial |
$363.15
|
| Rate for Payer: Mclaren Medicaid |
$151.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.32
|
| Rate for Payer: Meridian Medicaid |
$158.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$249.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.81
|
| Rate for Payer: Nomi Health Commercial |
$272.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$522.00
|
| Rate for Payer: PACE SWMI |
$226.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$381.84
|
| Rate for Payer: Priority Health Medicare |
$226.97
|
| Rate for Payer: Priority Health SBD |
$381.84
|
| Rate for Payer: Priority Health Tiered Network |
$381.84
|
| Rate for Payer: Railroad Medicare Medicare |
$226.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.67
|
| Rate for Payer: UHC Core |
$426.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.97
|
| Rate for Payer: UHC Exchange |
$426.67
|
| Rate for Payer: UHC Medicaid |
$151.23
|
| Rate for Payer: UHCCP Medicaid |
$151.23
|
|
|
PR EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 54840
|
| Min. Negotiated Rate |
$190.42 |
| Max. Negotiated Rate |
$566.95 |
| Rate for Payer: Aetna Commercial |
$391.71
|
| Rate for Payer: Aetna Medicare |
$304.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$420.94
|
| Rate for Payer: BCBS Complete |
$199.94
|
| Rate for Payer: BCBS MAPPO |
$292.32
|
| Rate for Payer: BCN Commercial |
$486.03
|
| Rate for Payer: BCN Medicare Advantage |
$292.32
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$420.94
|
| Rate for Payer: Cofinity Commercial |
$391.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.32
|
| Rate for Payer: Healthscope Commercial |
$540.79
|
| Rate for Payer: Healthscope Commercial |
$467.71
|
| Rate for Payer: Mclaren Medicaid |
$190.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.94
|
| Rate for Payer: Meridian Medicaid |
$199.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.95
|
| Rate for Payer: Nomi Health Commercial |
$350.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$462.00
|
| Rate for Payer: PACE SWMI |
$292.32
|
| Rate for Payer: PHP Medicare Advantage |
$292.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$529.44
|
| Rate for Payer: Priority Health Medicare |
$292.32
|
| Rate for Payer: Priority Health SBD |
$529.44
|
| Rate for Payer: Priority Health Tiered Network |
$529.44
|
| Rate for Payer: Railroad Medicare Medicare |
$292.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.93
|
| Rate for Payer: UHC Core |
$563.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$292.32
|
| Rate for Payer: UHC Exchange |
$563.93
|
| Rate for Payer: UHC Medicaid |
$190.42
|
| Rate for Payer: UHCCP Medicaid |
$190.42
|
|
|
PR EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 42440
|
| Min. Negotiated Rate |
$236.22 |
| Max. Negotiated Rate |
$1,755.00 |
| Rate for Payer: Aetna Commercial |
$485.11
|
| Rate for Payer: Aetna Medicare |
$376.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.31
|
| Rate for Payer: BCBS Complete |
$248.03
|
| Rate for Payer: BCBS MAPPO |
$362.02
|
| Rate for Payer: BCN Commercial |
$628.95
|
| Rate for Payer: BCN Medicare Advantage |
$362.02
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cofinity Commercial |
$521.31
|
| Rate for Payer: Cofinity Commercial |
$485.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.02
|
| Rate for Payer: Healthscope Commercial |
$669.74
|
| Rate for Payer: Healthscope Commercial |
$579.23
|
| Rate for Payer: Mclaren Medicaid |
$236.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.12
|
| Rate for Payer: Meridian Medicaid |
$248.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$738.11
|
| Rate for Payer: Nomi Health Commercial |
$434.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,755.00
|
| Rate for Payer: PACE SWMI |
$362.02
|
| Rate for Payer: PHP Medicare Advantage |
$362.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$766.34
|
| Rate for Payer: Priority Health Medicare |
$362.02
|
| Rate for Payer: Priority Health SBD |
$766.34
|
| Rate for Payer: Priority Health Tiered Network |
$766.34
|
| Rate for Payer: Railroad Medicare Medicare |
$362.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.26
|
| Rate for Payer: UHC Core |
$715.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.02
|
| Rate for Payer: UHC Exchange |
$715.26
|
| Rate for Payer: UHC Medicaid |
$236.22
|
| Rate for Payer: UHCCP Medicaid |
$236.22
|
|
|
PR EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 30120
|
| Min. Negotiated Rate |
$238.77 |
| Max. Negotiated Rate |
$799.50 |
| Rate for Payer: Aetna Commercial |
$485.82
|
| Rate for Payer: Aetna Medicare |
$377.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.07
|
| Rate for Payer: BCBS Complete |
$250.71
|
| Rate for Payer: BCBS MAPPO |
$362.55
|
| Rate for Payer: BCN Commercial |
$634.43
|
| Rate for Payer: BCN Medicare Advantage |
$362.55
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cofinity Commercial |
$522.07
|
| Rate for Payer: Cofinity Commercial |
$485.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.55
|
| Rate for Payer: Healthscope Commercial |
$670.72
|
| Rate for Payer: Healthscope Commercial |
$580.08
|
| Rate for Payer: Mclaren Medicaid |
$238.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.68
|
| Rate for Payer: Meridian Medicaid |
$250.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.72
|
| Rate for Payer: Nomi Health Commercial |
$435.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$799.50
|
| Rate for Payer: PACE SWMI |
$362.55
|
| Rate for Payer: PHP Medicare Advantage |
$362.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$597.44
|
| Rate for Payer: Priority Health Medicare |
$362.55
|
| Rate for Payer: Priority Health SBD |
$597.44
|
| Rate for Payer: Priority Health Tiered Network |
$597.44
|
| Rate for Payer: Railroad Medicare Medicare |
$362.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.78
|
| Rate for Payer: UHC Core |
$733.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.55
|
| Rate for Payer: UHC Exchange |
$733.78
|
| Rate for Payer: UHC Medicaid |
$238.77
|
| Rate for Payer: UHCCP Medicaid |
$238.77
|
|
