|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Facility
|
IP
|
$635.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$400.05 |
| Max. Negotiated Rate |
$571.50 |
| Rate for Payer: Aetna Commercial |
$539.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.75
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$444.50
|
| Rate for Payer: Cofinity Commercial |
$546.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$444.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.00
|
| Rate for Payer: Healthscope Commercial |
$571.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.75
|
| Rate for Payer: PHP Commercial |
$539.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health SBD |
$400.05
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 11463
|
| Min. Negotiated Rate |
$214.70 |
| Max. Negotiated Rate |
$58,955.00 |
| Rate for Payer: Aetna Commercial |
$425.12
|
| Rate for Payer: Aetna Medicare |
$329.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.84
|
| Rate for Payer: BCBS Complete |
$225.44
|
| Rate for Payer: BCBS MAPPO |
$317.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.25
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: BCN Medicare Advantage |
$317.25
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$456.84
|
| Rate for Payer: Cofinity Commercial |
$425.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.25
|
| Rate for Payer: Healthscope Commercial |
$586.91
|
| Rate for Payer: Healthscope Commercial |
$507.60
|
| Rate for Payer: Mclaren Medicaid |
$214.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.11
|
| Rate for Payer: Meridian Medicaid |
$225.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,955.00
|
| Rate for Payer: Nomi Health Commercial |
$380.70
|
| Rate for Payer: PACE SWMI |
$317.25
|
| Rate for Payer: PHP Medicare Advantage |
$317.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.68
|
| Rate for Payer: Priority Health Medicare |
$317.25
|
| Rate for Payer: Priority Health Narrow Network |
$454.68
|
| Rate for Payer: Priority Health SBD |
$454.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$450.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.25
|
| Rate for Payer: UHC Exchange |
$450.39
|
| Rate for Payer: UHC Medicare Advantage |
$317.25
|
| Rate for Payer: UHCCP Medicaid |
$214.70
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Facility
|
OP
|
$635.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$353.21 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$539.75
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$546.10
|
| Rate for Payer: Cofinity Commercial |
$444.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$444.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$571.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.75
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$539.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$400.05
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.21
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$214.70 |
| Max. Negotiated Rate |
$58,955.00 |
| Rate for Payer: Aetna Commercial |
$425.12
|
| Rate for Payer: Aetna Medicare |
$329.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.84
|
| Rate for Payer: BCBS Complete |
$225.44
|
| Rate for Payer: BCBS MAPPO |
$317.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.25
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: BCN Medicare Advantage |
$317.25
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$456.84
|
| Rate for Payer: Cofinity Commercial |
$425.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.25
|
| Rate for Payer: Healthscope Commercial |
$586.91
|
| Rate for Payer: Healthscope Commercial |
$507.60
|
| Rate for Payer: Mclaren Medicaid |
$214.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.11
|
| Rate for Payer: Meridian Medicaid |
$225.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,955.00
|
| Rate for Payer: Nomi Health Commercial |
$380.70
|
| Rate for Payer: PACE SWMI |
$317.25
|
| Rate for Payer: PHP Medicare Advantage |
$317.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.68
|
| Rate for Payer: Priority Health Medicare |
$317.25
|
| Rate for Payer: Priority Health Narrow Network |
$454.68
|
| Rate for Payer: Priority Health SBD |
$454.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$450.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.25
|
| Rate for Payer: UHC Exchange |
$450.39
|
| Rate for Payer: UHC Medicare Advantage |
$317.25
|
| Rate for Payer: UHCCP Medicaid |
$214.70
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$43,625.00 |
| Rate for Payer: Aetna Commercial |
$322.73
|
| Rate for Payer: Aetna Medicare |
$250.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.81
|
| Rate for Payer: BCBS Complete |
$171.99
|
| Rate for Payer: BCBS MAPPO |
$240.84
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$615.25
|
| Rate for Payer: BCN Medicare Advantage |
$240.84
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$346.81
|
| Rate for Payer: Cofinity Commercial |
$322.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.84
|
| Rate for Payer: Healthscope Commercial |
$445.55
|
| Rate for Payer: Healthscope Commercial |
$385.34
|
| Rate for Payer: Mclaren Medicaid |
$163.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.88
|
| Rate for Payer: Meridian Medicaid |
$171.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,625.00
|
| Rate for Payer: Nomi Health Commercial |
$289.01
|
| Rate for Payer: PACE SWMI |
$240.84
|
| Rate for Payer: PHP Medicare Advantage |
$240.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.34
|
| Rate for Payer: Priority Health Medicare |
$240.84
|
| Rate for Payer: Priority Health Narrow Network |
$341.34
|
| Rate for Payer: Priority Health SBD |
$341.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.84
|
| Rate for Payer: UHC Exchange |
$316.23
|
| Rate for Payer: UHC Medicare Advantage |
$240.84
|
| Rate for Payer: UHCCP Medicaid |
$163.80
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$264.10 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$402.05
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$406.78
|
| Rate for Payer: Cofinity Commercial |
$331.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$331.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$425.70
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.05
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$402.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$297.99
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.10
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Facility
|
IP
|
$473.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$297.99 |
| Max. Negotiated Rate |
$425.70 |
| Rate for Payer: Aetna Commercial |
$402.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.45
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$331.10
|
| Rate for Payer: Cofinity Commercial |
$406.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$331.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.40
|
| Rate for Payer: Healthscope Commercial |
$425.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.05
|
| Rate for Payer: PHP Commercial |
$402.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health SBD |
$297.99
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 11462
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$43,625.00 |
| Rate for Payer: Aetna Commercial |
$322.73
|
| Rate for Payer: Aetna Medicare |
$250.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.81
|
| Rate for Payer: BCBS Complete |
$171.99
|
| Rate for Payer: BCBS MAPPO |
$240.84
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$615.25
|
| Rate for Payer: BCN Medicare Advantage |
$240.84
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$346.81
|
| Rate for Payer: Cofinity Commercial |
$322.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.84
|
| Rate for Payer: Healthscope Commercial |
$445.55
|
| Rate for Payer: Healthscope Commercial |
$385.34
|
| Rate for Payer: Mclaren Medicaid |
$163.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.88
|
| Rate for Payer: Meridian Medicaid |
$171.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,625.00
|
| Rate for Payer: Nomi Health Commercial |
$289.01
|
| Rate for Payer: PACE SWMI |
$240.84
|
| Rate for Payer: PHP Medicare Advantage |
$240.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.34
|
| Rate for Payer: Priority Health Medicare |
$240.84
|
| Rate for Payer: Priority Health Narrow Network |
$341.34
|
| Rate for Payer: Priority Health SBD |
$341.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.84
|
| Rate for Payer: UHC Exchange |
$316.23
|
| Rate for Payer: UHC Medicare Advantage |
$240.84
|
| Rate for Payer: UHCCP Medicaid |
$163.80
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$372.74 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$838.10
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,075.65
|
| Rate for Payer: BCN Commercial |
$1,075.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$847.96
|
| Rate for Payer: Cofinity Commercial |
$690.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$690.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$788.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$887.40
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.10
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$838.10
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$621.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.74
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$61,807.00 |
| Rate for Payer: Aetna Commercial |
$451.42
|
| Rate for Payer: Aetna Medicare |
$350.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.11
|
| Rate for Payer: BCBS Complete |
$239.08
|
| Rate for Payer: BCBS MAPPO |
$336.88
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$796.55
|
| Rate for Payer: BCN Medicare Advantage |
$336.88
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$485.11
|
| Rate for Payer: Cofinity Commercial |
$451.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.88
|
| Rate for Payer: Healthscope Commercial |
$623.23
|
| Rate for Payer: Healthscope Commercial |
$539.01
|
| Rate for Payer: Mclaren Medicaid |
$227.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.72
|
| Rate for Payer: Meridian Medicaid |
$239.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,807.00
|
| Rate for Payer: Nomi Health Commercial |
$404.26
|
| Rate for Payer: PACE SWMI |
$336.88
|
| Rate for Payer: PHP Medicare Advantage |
$336.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.51
|
| Rate for Payer: Priority Health Medicare |
$336.88
|
| Rate for Payer: Priority Health Narrow Network |
$479.51
|
| Rate for Payer: Priority Health SBD |
$479.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.88
|
| Rate for Payer: UHC Exchange |
$161.08
|
| Rate for Payer: UHC Medicare Advantage |
$336.88
|
| Rate for Payer: UHCCP Medicaid |
$227.70
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11471
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$61,807.00 |
| Rate for Payer: Aetna Commercial |
$451.42
|
| Rate for Payer: Aetna Medicare |
$350.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.11
|
| Rate for Payer: BCBS Complete |
$239.08
|
| Rate for Payer: BCBS MAPPO |
$336.88
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$796.55
|
| Rate for Payer: BCN Medicare Advantage |
$336.88
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$485.11
|
| Rate for Payer: Cofinity Commercial |
$451.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.88
|
| Rate for Payer: Healthscope Commercial |
$623.23
|
| Rate for Payer: Healthscope Commercial |
$539.01
|
| Rate for Payer: Mclaren Medicaid |
$227.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.72
|
| Rate for Payer: Meridian Medicaid |
$239.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,807.00
|
| Rate for Payer: Nomi Health Commercial |
$404.26
|
| Rate for Payer: PACE SWMI |
$336.88
|
| Rate for Payer: PHP Medicare Advantage |
$336.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.51
|
| Rate for Payer: Priority Health Medicare |
$336.88
|
| Rate for Payer: Priority Health Narrow Network |
$479.51
|
| Rate for Payer: Priority Health SBD |
$479.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.88
|
| Rate for Payer: UHC Exchange |
$161.08
|
| Rate for Payer: UHC Medicare Advantage |
$336.88
|
| Rate for Payer: UHCCP Medicaid |
$227.70
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$621.18 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Aetna Commercial |
$838.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.90
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$690.20
|
| Rate for Payer: Cofinity Commercial |
$847.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$690.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$788.80
|
| Rate for Payer: Healthscope Commercial |
$887.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.10
|
| Rate for Payer: PHP Commercial |
$838.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health SBD |
$621.18
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$50,684.00 |
| Rate for Payer: Aetna Commercial |
$369.08
|
| Rate for Payer: Aetna Medicare |
$286.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.62
|
| Rate for Payer: BCBS Complete |
$195.92
|
| Rate for Payer: BCBS MAPPO |
$275.43
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$673.89
|
| Rate for Payer: BCN Medicare Advantage |
$275.43
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cofinity Commercial |
$396.62
|
| Rate for Payer: Cofinity Commercial |
$369.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.43
|
| Rate for Payer: Healthscope Commercial |
$509.55
|
| Rate for Payer: Healthscope Commercial |
$440.69
|
| Rate for Payer: Mclaren Medicaid |
$186.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.20
|
| Rate for Payer: Meridian Medicaid |
$195.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50,684.00
|
| Rate for Payer: Nomi Health Commercial |
$330.52
|
| Rate for Payer: PACE SWMI |
$275.43
|
| Rate for Payer: PHP Medicare Advantage |
$275.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$591.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.92
|
| Rate for Payer: Priority Health Medicare |
$275.43
|
| Rate for Payer: Priority Health Narrow Network |
$391.92
|
| Rate for Payer: Priority Health SBD |
$391.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.43
|
| Rate for Payer: UHC Exchange |
$464.25
|
| Rate for Payer: UHC Medicare Advantage |
$275.43
|
| Rate for Payer: UHCCP Medicaid |
$186.59
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$89,914.00 |
| Rate for Payer: Aetna Commercial |
$655.22
|
| Rate for Payer: Aetna Medicare |
$508.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$655.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.12
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS MAPPO |
$488.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: BCN Commercial |
$740.83
|
| Rate for Payer: BCN Medicare Advantage |
$488.97
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$704.12
|
| Rate for Payer: Cofinity Commercial |
$655.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.97
|
| Rate for Payer: Healthscope Commercial |
$904.59
|
| Rate for Payer: Healthscope Commercial |
$782.35
|
| Rate for Payer: Mclaren Medicaid |
$329.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.42
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89,914.00
|
| Rate for Payer: Nomi Health Commercial |
$586.76
|
| Rate for Payer: PACE SWMI |
$488.97
|
| Rate for Payer: PHP Medicare Advantage |
$488.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.66
|
| Rate for Payer: Priority Health Medicare |
$488.97
|
| Rate for Payer: Priority Health Narrow Network |
$819.66
|
| Rate for Payer: Priority Health SBD |
$819.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$488.97
|
| Rate for Payer: UHC Exchange |
$727.33
|
| Rate for Payer: UHC Medicare Advantage |
$488.97
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$89,914.00 |
| Rate for Payer: Aetna Commercial |
$655.22
|
| Rate for Payer: Aetna Medicare |
$508.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$655.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.12
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS MAPPO |
$488.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: BCN Commercial |
$740.83
|
| Rate for Payer: BCN Medicare Advantage |
$488.97
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$704.12
|
| Rate for Payer: Cofinity Commercial |
$655.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.97
|
| Rate for Payer: Healthscope Commercial |
$904.59
|
| Rate for Payer: Healthscope Commercial |
$782.35
|
| Rate for Payer: Mclaren Medicaid |
$329.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.42
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89,914.00
|
| Rate for Payer: Nomi Health Commercial |
$586.76
|
| Rate for Payer: PACE SWMI |
$488.97
|
| Rate for Payer: PHP Medicare Advantage |
$488.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.66
|
| Rate for Payer: Priority Health Medicare |
$488.97
|
| Rate for Payer: Priority Health Narrow Network |
$819.66
|
| Rate for Payer: Priority Health SBD |
$819.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$488.97
|
| Rate for Payer: UHC Exchange |
$727.33
|
| Rate for Payer: UHC Medicare Advantage |
$488.97
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
IP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$1,161.09 |
| Max. Negotiated Rate |
$1,658.70 |
| Rate for Payer: Aetna Commercial |
$1,566.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,197.95
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,584.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,290.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,474.40
|
| Rate for Payer: Healthscope Commercial |
$1,658.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: PHP Commercial |
$1,566.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health SBD |
$1,161.09
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
OP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$542.56 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna Commercial |
$1,566.55
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,197.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,516.33
|
| Rate for Payer: BCN Commercial |
$1,516.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,584.98
|
| Rate for Payer: Cofinity Commercial |
$1,290.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,290.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,474.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,658.70
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$1,566.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$1,161.09
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.56
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,946.69
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$59,368.00 |
| Rate for Payer: Aetna Commercial |
$434.39
|
| Rate for Payer: Aetna Medicare |
$337.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.80
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS MAPPO |
$324.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$324.17
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$466.80
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.17
|
| Rate for Payer: Healthscope Commercial |
$599.71
|
| Rate for Payer: Healthscope Commercial |
$518.67
|
| Rate for Payer: Mclaren Medicaid |
$218.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.38
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,368.00
|
| Rate for Payer: Nomi Health Commercial |
$389.00
|
| Rate for Payer: PACE SWMI |
$324.17
|
| Rate for Payer: PHP Medicare Advantage |
$324.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.79
|
| Rate for Payer: Priority Health Medicare |
$324.17
|
| Rate for Payer: Priority Health Narrow Network |
$543.79
|
| Rate for Payer: Priority Health SBD |
$543.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$518.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.17
|
| Rate for Payer: UHC Exchange |
$518.03
|
| Rate for Payer: UHC Medicare Advantage |
$324.17
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
OP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$359.10 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna Commercial |
$1,067.60
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,792.96
|
| Rate for Payer: BCN Commercial |
$1,792.96
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$879.20
|
| Rate for Payer: Cofinity Commercial |
$1,080.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$879.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,130.40
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$1,067.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$791.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.10
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,946.69
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
55040
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$59,368.00 |
| Rate for Payer: Aetna Commercial |
$434.39
|
| Rate for Payer: Aetna Medicare |
$337.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.80
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS MAPPO |
$324.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$324.17
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$466.80
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.17
|
| Rate for Payer: Healthscope Commercial |
$599.71
|
| Rate for Payer: Healthscope Commercial |
$518.67
|
| Rate for Payer: Mclaren Medicaid |
$218.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.38
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,368.00
|
| Rate for Payer: Nomi Health Commercial |
$389.00
|
| Rate for Payer: PACE SWMI |
$324.17
|
| Rate for Payer: PHP Medicare Advantage |
$324.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.79
|
| Rate for Payer: Priority Health Medicare |
$324.17
|
| Rate for Payer: Priority Health Narrow Network |
$543.79
|
| Rate for Payer: Priority Health SBD |
$543.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$518.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.17
|
| Rate for Payer: UHC Exchange |
$518.03
|
| Rate for Payer: UHC Medicare Advantage |
$324.17
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
IP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$791.28 |
| Max. Negotiated Rate |
$1,130.40 |
| Rate for Payer: Aetna Commercial |
$1,067.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.40
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,080.16
|
| Rate for Payer: Cofinity Commercial |
$879.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$879.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Healthscope Commercial |
$1,130.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: PHP Commercial |
$1,067.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health SBD |
$791.28
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$1,120.00 |
| Max. Negotiated Rate |
$337,457.00 |
| Rate for Payer: Aetna Commercial |
$2,461.98
|
| Rate for Payer: Aetna Medicare |
$1,910.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,461.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,645.71
|
| Rate for Payer: BCBS Complete |
$1,253.78
|
| Rate for Payer: BCBS MAPPO |
$1,837.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.00
|
| Rate for Payer: BCN Commercial |
$2,709.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,837.30
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cofinity Commercial |
$2,645.71
|
| Rate for Payer: Cofinity Commercial |
$2,461.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,837.30
|
| Rate for Payer: Healthscope Commercial |
$3,399.00
|
| Rate for Payer: Healthscope Commercial |
$2,939.68
|
| Rate for Payer: Mclaren Medicaid |
$1,194.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,929.16
|
| Rate for Payer: Meridian Medicaid |
$1,253.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337,457.00
|
| Rate for Payer: Nomi Health Commercial |
$2,204.76
|
| Rate for Payer: PACE SWMI |
$1,837.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,837.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,194.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,627.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,971.84
|
| Rate for Payer: Priority Health Medicare |
$1,837.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,971.84
|
| Rate for Payer: Priority Health SBD |
$2,971.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,141.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,837.30
|
| Rate for Payer: UHC Exchange |
$2,141.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,837.30
|
| Rate for Payer: UHCCP Medicaid |
$1,194.08
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$2,005.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$99,677.00 |
| Rate for Payer: Aetna Commercial |
$718.70
|
| Rate for Payer: Aetna Medicare |
$557.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.33
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$536.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.68
|
| Rate for Payer: BCN Commercial |
$810.72
|
| Rate for Payer: BCN Medicare Advantage |
$536.34
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cofinity Commercial |
$772.33
|
| Rate for Payer: Cofinity Commercial |
$718.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.34
|
| Rate for Payer: Healthscope Commercial |
$992.23
|
| Rate for Payer: Healthscope Commercial |
$858.14
|
| Rate for Payer: Mclaren Medicaid |
$353.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.16
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99,677.00
|
| Rate for Payer: Nomi Health Commercial |
$643.61
|
| Rate for Payer: PACE SWMI |
$536.34
|
| Rate for Payer: PHP Medicare Advantage |
$536.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.95
|
| Rate for Payer: Priority Health Medicare |
$536.34
|
| Rate for Payer: Priority Health Narrow Network |
$884.95
|
| Rate for Payer: Priority Health SBD |
$884.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$839.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.34
|
| Rate for Payer: UHC Exchange |
$839.09
|
| Rate for Payer: UHC Medicare Advantage |
$536.34
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$266.68 |
| Max. Negotiated Rate |
$72,781.00 |
| Rate for Payer: Aetna Commercial |
$513.43
|
| Rate for Payer: Aetna Medicare |
$398.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.75
|
| Rate for Payer: BCBS Complete |
$280.01
|
| Rate for Payer: BCBS MAPPO |
$383.16
|
| Rate for Payer: BCBS Trust/PPO |
$674.64
|
| Rate for Payer: BCN Commercial |
$619.16
|
| Rate for Payer: BCN Medicare Advantage |
$383.16
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$551.75
|
| Rate for Payer: Cofinity Commercial |
$513.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.16
|
| Rate for Payer: Healthscope Commercial |
$708.85
|
| Rate for Payer: Healthscope Commercial |
$613.06
|
| Rate for Payer: Mclaren Medicaid |
$266.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.32
|
| Rate for Payer: Meridian Medicaid |
$280.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,781.00
|
| Rate for Payer: Nomi Health Commercial |
$459.79
|
| Rate for Payer: PACE SWMI |
$383.16
|
| Rate for Payer: PHP Medicare Advantage |
$383.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$583.96
|
| Rate for Payer: Priority Health Medicare |
$383.16
|
| Rate for Payer: Priority Health Narrow Network |
$583.96
|
| Rate for Payer: Priority Health SBD |
$583.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.16
|
| Rate for Payer: UHC Exchange |
$368.05
|
| Rate for Payer: UHC Medicare Advantage |
$383.16
|
| Rate for Payer: UHCCP Medicaid |
$266.68
|
|
|
PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 28080
|
| Min. Negotiated Rate |
$249.21 |
| Max. Negotiated Rate |
$65,833.00 |
| Rate for Payer: Aetna Commercial |
$486.76
|
| Rate for Payer: Aetna Medicare |
$377.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.08
|
| Rate for Payer: BCBS Complete |
$261.67
|
| Rate for Payer: BCBS MAPPO |
$363.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.45
|
| Rate for Payer: BCN Commercial |
$853.39
|
| Rate for Payer: BCN Medicare Advantage |
$363.25
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cofinity Commercial |
$523.08
|
| Rate for Payer: Cofinity Commercial |
$486.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.25
|
| Rate for Payer: Healthscope Commercial |
$672.01
|
| Rate for Payer: Healthscope Commercial |
$581.20
|
| Rate for Payer: Mclaren Medicaid |
$249.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.41
|
| Rate for Payer: Meridian Medicaid |
$261.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65,833.00
|
| Rate for Payer: Nomi Health Commercial |
$435.90
|
| Rate for Payer: PACE SWMI |
$363.25
|
| Rate for Payer: PHP Medicare Advantage |
$363.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.68
|
| Rate for Payer: Priority Health Medicare |
$363.25
|
| Rate for Payer: Priority Health Narrow Network |
$584.68
|
| Rate for Payer: Priority Health SBD |
$584.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.25
|
| Rate for Payer: UHC Exchange |
$477.92
|
| Rate for Payer: UHC Medicare Advantage |
$363.25
|
| Rate for Payer: UHCCP Medicaid |
$249.21
|
|
