|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$363.02 |
| Max. Negotiated Rate |
$845.65 |
| Rate for Payer: Aetna Commercial |
$486.45
|
| Rate for Payer: Aetna Medicare |
$377.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.45
|
| Rate for Payer: BCBS Complete |
$520.40
|
| Rate for Payer: BCBS MAPPO |
$363.02
|
| Rate for Payer: BCN Medicare Advantage |
$363.02
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$522.75
|
| Rate for Payer: Cofinity Commercial |
$486.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.02
|
| Rate for Payer: Healthscope Commercial |
$671.59
|
| Rate for Payer: Healthscope Commercial |
$580.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.65
|
| Rate for Payer: Nomi Health Commercial |
$435.62
|
| Rate for Payer: PACE SWMI |
$363.02
|
| Rate for Payer: PHP Medicare Advantage |
$363.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$363.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.02
|
| Rate for Payer: UHC Medicare Advantage |
$363.02
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Facility
|
OP
|
$1,301.00
|
|
|
Service Code
|
CPT 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$819.63 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$1,105.85
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$1,118.86
|
| Rate for Payer: Cofinity Commercial |
$910.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$910.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$1,170.90
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,105.85
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$1,105.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$819.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27340
|
| Min. Negotiated Rate |
$363.02 |
| Max. Negotiated Rate |
$845.65 |
| Rate for Payer: Aetna Commercial |
$486.45
|
| Rate for Payer: Aetna Medicare |
$377.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.45
|
| Rate for Payer: BCBS Complete |
$520.40
|
| Rate for Payer: BCBS MAPPO |
$363.02
|
| Rate for Payer: BCN Medicare Advantage |
$363.02
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$522.75
|
| Rate for Payer: Cofinity Commercial |
$486.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.02
|
| Rate for Payer: Healthscope Commercial |
$671.59
|
| Rate for Payer: Healthscope Commercial |
$580.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.65
|
| Rate for Payer: Nomi Health Commercial |
$435.62
|
| Rate for Payer: PACE SWMI |
$363.02
|
| Rate for Payer: PHP Medicare Advantage |
$363.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$363.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.02
|
| Rate for Payer: UHC Medicare Advantage |
$363.02
|
|
|
PR EXCISION RADIAL HEAD
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 24130
|
| Min. Negotiated Rate |
$497.11 |
| Max. Negotiated Rate |
$919.65 |
| Rate for Payer: Aetna Commercial |
$666.13
|
| Rate for Payer: Aetna Medicare |
$516.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.13
|
| Rate for Payer: BCBS Complete |
$502.40
|
| Rate for Payer: BCBS MAPPO |
$497.11
|
| Rate for Payer: BCN Medicare Advantage |
$497.11
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$715.84
|
| Rate for Payer: Cofinity Commercial |
$666.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$497.11
|
| Rate for Payer: Healthscope Commercial |
$795.38
|
| Rate for Payer: Healthscope Commercial |
$919.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.40
|
| Rate for Payer: Nomi Health Commercial |
$596.53
|
| Rate for Payer: PACE SWMI |
$497.11
|
| Rate for Payer: PHP Medicare Advantage |
$497.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health Medicare |
$497.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$497.11
|
| Rate for Payer: UHC Medicare Advantage |
$497.11
|
|
|
PR EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 67961
|
| Min. Negotiated Rate |
$420.10 |
| Max. Negotiated Rate |
$777.18 |
| Rate for Payer: Aetna Commercial |
$562.93
|
| Rate for Payer: Aetna Medicare |
$436.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.93
|
| Rate for Payer: BCBS Complete |
$460.80
|
| Rate for Payer: BCBS MAPPO |
$420.10
|
| Rate for Payer: BCN Medicare Advantage |
$420.10
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$604.94
|
| Rate for Payer: Cofinity Commercial |
$562.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.10
|
| Rate for Payer: Healthscope Commercial |
$777.18
|
| Rate for Payer: Healthscope Commercial |
$672.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$748.80
|
| Rate for Payer: Nomi Health Commercial |
$504.12
|
| Rate for Payer: PACE SWMI |
$420.10
|
| Rate for Payer: PHP Medicare Advantage |
$420.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.80
|
| Rate for Payer: Priority Health Medicare |
$420.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.10
|
| Rate for Payer: UHC Medicare Advantage |
$420.10
|
|
|
PR EXCISION RIB PARTIAL
|
Professional
|
Both
|
$1,625.00
|
|
|
Service Code
|
HCPCS 21600
|
| Min. Negotiated Rate |
$550.70 |
| Max. Negotiated Rate |
$1,056.25 |
| Rate for Payer: Aetna Commercial |
$737.94
|
| Rate for Payer: Aetna Medicare |
$572.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.94
|
| Rate for Payer: BCBS Complete |
$650.00
|
| Rate for Payer: BCBS MAPPO |
$550.70
|
| Rate for Payer: BCN Medicare Advantage |
$550.70
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cofinity Commercial |
$793.01
|
| Rate for Payer: Cofinity Commercial |
$737.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.70
|
| Rate for Payer: Healthscope Commercial |
$1,018.79
|
| Rate for Payer: Healthscope Commercial |
$881.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,056.25
|
| Rate for Payer: Nomi Health Commercial |
$660.84
|
| Rate for Payer: PACE SWMI |
$550.70
|
| Rate for Payer: PHP Medicare Advantage |
$550.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,056.25
|
| Rate for Payer: Priority Health Medicare |
$550.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.70
|
| Rate for Payer: UHC Medicare Advantage |
$550.70
|
|
|
PR EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 15931
|
| Min. Negotiated Rate |
$469.60 |
| Max. Negotiated Rate |
$1,258.67 |
| Rate for Payer: Aetna Commercial |
$911.68
|
| Rate for Payer: Aetna Medicare |
$707.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$979.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$911.68
|
| Rate for Payer: BCBS Complete |
$469.60
|
| Rate for Payer: BCBS MAPPO |
$680.36
|
| Rate for Payer: BCN Medicare Advantage |
$680.36
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cofinity Commercial |
$979.72
|
| Rate for Payer: Cofinity Commercial |
$911.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.36
|
| Rate for Payer: Healthscope Commercial |
$1,258.67
|
| Rate for Payer: Healthscope Commercial |
$1,088.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$763.10
|
| Rate for Payer: Nomi Health Commercial |
$816.43
|
| Rate for Payer: PACE SWMI |
$680.36
|
| Rate for Payer: PHP Medicare Advantage |
$680.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.10
|
| Rate for Payer: Priority Health Medicare |
$680.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.36
|
| Rate for Payer: UHC Medicare Advantage |
$680.36
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
OP
|
$440.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna Commercial |
$374.00
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cofinity Commercial |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$308.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$396.00
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.00
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$374.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$277.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,236.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$647.41
|
| Rate for Payer: VA VA |
$1,149.93
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$440.00
|
|
|
Service Code
|
HCPCS 46220
|
| Hospital Charge Code |
46220
|
| Min. Negotiated Rate |
$116.12 |
| Max. Negotiated Rate |
$286.00 |
| Rate for Payer: Aetna Commercial |
$155.60
|
| Rate for Payer: Aetna Medicare |
$120.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.60
|
| Rate for Payer: BCBS Complete |
$176.00
|
| Rate for Payer: BCBS MAPPO |
$116.12
|
| Rate for Payer: BCN Medicare Advantage |
$116.12
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cofinity Commercial |
$167.21
|
| Rate for Payer: Cofinity Commercial |
$155.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.12
|
| Rate for Payer: Healthscope Commercial |
$185.79
|
| Rate for Payer: Healthscope Commercial |
$214.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.00
|
| Rate for Payer: Nomi Health Commercial |
$139.34
|
| Rate for Payer: PACE SWMI |
$116.12
|
| Rate for Payer: PHP Medicare Advantage |
$116.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health Medicare |
$116.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.12
|
| Rate for Payer: UHC Medicare Advantage |
$116.12
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$440.00
|
|
|
Service Code
|
HCPCS 46220
|
| Min. Negotiated Rate |
$116.12 |
| Max. Negotiated Rate |
$286.00 |
| Rate for Payer: Aetna Commercial |
$155.60
|
| Rate for Payer: Aetna Medicare |
$120.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.60
|
| Rate for Payer: BCBS Complete |
$176.00
|
| Rate for Payer: BCBS MAPPO |
$116.12
|
| Rate for Payer: BCN Medicare Advantage |
$116.12
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cofinity Commercial |
$167.21
|
| Rate for Payer: Cofinity Commercial |
$155.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.12
|
| Rate for Payer: Healthscope Commercial |
$185.79
|
| Rate for Payer: Healthscope Commercial |
$214.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.00
|
| Rate for Payer: Nomi Health Commercial |
$139.34
|
| Rate for Payer: PACE SWMI |
$116.12
|
| Rate for Payer: PHP Medicare Advantage |
$116.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health Medicare |
$116.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.12
|
| Rate for Payer: UHC Medicare Advantage |
$116.12
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
IP
|
$440.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Aetna Commercial |
$374.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.00
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cofinity Commercial |
$308.00
|
| Rate for Payer: Cofinity Commercial |
$378.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.00
|
| Rate for Payer: Healthscope Commercial |
$396.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.00
|
| Rate for Payer: PHP Commercial |
$374.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health SBD |
$277.20
|
|
|
PR EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$676.00
|
|
|
Service Code
|
HCPCS 69145
|
| Min. Negotiated Rate |
$239.75 |
| Max. Negotiated Rate |
$443.54 |
| Rate for Payer: Aetna Commercial |
$321.26
|
| Rate for Payer: Aetna Medicare |
$249.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.26
|
| Rate for Payer: BCBS Complete |
$270.40
|
| Rate for Payer: BCBS MAPPO |
$239.75
|
| Rate for Payer: BCN Medicare Advantage |
$239.75
|
| Rate for Payer: Cash Price |
$540.80
|
| Rate for Payer: Cash Price |
$540.80
|
| Rate for Payer: Cofinity Commercial |
$345.24
|
| Rate for Payer: Cofinity Commercial |
$321.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.75
|
| Rate for Payer: Healthscope Commercial |
$443.54
|
| Rate for Payer: Healthscope Commercial |
$383.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.40
|
| Rate for Payer: Nomi Health Commercial |
$287.70
|
| Rate for Payer: PACE SWMI |
$239.75
|
| Rate for Payer: PHP Medicare Advantage |
$239.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.40
|
| Rate for Payer: Priority Health Medicare |
$239.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.75
|
| Rate for Payer: UHC Medicare Advantage |
$239.75
|
|
|
PR EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 54840
|
| Min. Negotiated Rate |
$239.20 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$412.87
|
| Rate for Payer: Aetna Medicare |
$320.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.87
|
| Rate for Payer: BCBS Complete |
$239.20
|
| Rate for Payer: BCBS MAPPO |
$308.11
|
| Rate for Payer: BCN Medicare Advantage |
$308.11
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$443.68
|
| Rate for Payer: Cofinity Commercial |
$412.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.11
|
| Rate for Payer: Healthscope Commercial |
$492.98
|
| Rate for Payer: Healthscope Commercial |
$570.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.70
|
| Rate for Payer: Nomi Health Commercial |
$369.73
|
| Rate for Payer: PACE SWMI |
$308.11
|
| Rate for Payer: PHP Medicare Advantage |
$308.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.70
|
| Rate for Payer: Priority Health Medicare |
$308.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.11
|
| Rate for Payer: UHC Medicare Advantage |
$308.11
|
|
|
PR EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND
|
Professional
|
Both
|
$2,272.00
|
|
|
Service Code
|
HCPCS 42440
|
| Min. Negotiated Rate |
$397.31 |
| Max. Negotiated Rate |
$1,476.80 |
| Rate for Payer: Aetna Commercial |
$532.40
|
| Rate for Payer: Aetna Medicare |
$413.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.40
|
| Rate for Payer: BCBS Complete |
$908.80
|
| Rate for Payer: BCBS MAPPO |
$397.31
|
| Rate for Payer: BCN Medicare Advantage |
$397.31
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cofinity Commercial |
$572.13
|
| Rate for Payer: Cofinity Commercial |
$532.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.31
|
| Rate for Payer: Healthscope Commercial |
$735.02
|
| Rate for Payer: Healthscope Commercial |
$635.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.80
|
| Rate for Payer: Nomi Health Commercial |
$476.77
|
| Rate for Payer: PACE SWMI |
$397.31
|
| Rate for Payer: PHP Medicare Advantage |
$397.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,476.80
|
| Rate for Payer: Priority Health Medicare |
$397.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.31
|
| Rate for Payer: UHC Medicare Advantage |
$397.31
|
|
|
PR EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA
|
Professional
|
Both
|
$1,035.00
|
|
|
Service Code
|
HCPCS 30120
|
| Min. Negotiated Rate |
$397.71 |
| Max. Negotiated Rate |
$735.76 |
| Rate for Payer: Aetna Commercial |
$532.93
|
| Rate for Payer: Aetna Medicare |
$413.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.93
|
| Rate for Payer: BCBS Complete |
$414.00
|
| Rate for Payer: BCBS MAPPO |
$397.71
|
| Rate for Payer: BCN Medicare Advantage |
$397.71
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cofinity Commercial |
$572.70
|
| Rate for Payer: Cofinity Commercial |
$532.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.71
|
| Rate for Payer: Healthscope Commercial |
$636.34
|
| Rate for Payer: Healthscope Commercial |
$735.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.75
|
| Rate for Payer: Nomi Health Commercial |
$477.25
|
| Rate for Payer: PACE SWMI |
$397.71
|
| Rate for Payer: PHP Medicare Advantage |
$397.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.75
|
| Rate for Payer: Priority Health Medicare |
$397.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.71
|
| Rate for Payer: UHC Medicare Advantage |
$397.71
|
|
|
PR EXCISION SYNOVIAL CYST POPLITEAL SPACE
|
Professional
|
Both
|
$1,640.00
|
|
|
Service Code
|
HCPCS 27345
|
| Min. Negotiated Rate |
$472.92 |
| Max. Negotiated Rate |
$1,066.00 |
| Rate for Payer: Aetna Commercial |
$633.71
|
| Rate for Payer: Aetna Medicare |
$491.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.71
|
| Rate for Payer: BCBS Complete |
$656.00
|
| Rate for Payer: BCBS MAPPO |
$472.92
|
| Rate for Payer: BCN Medicare Advantage |
$472.92
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cofinity Commercial |
$681.00
|
| Rate for Payer: Cofinity Commercial |
$633.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.92
|
| Rate for Payer: Healthscope Commercial |
$874.90
|
| Rate for Payer: Healthscope Commercial |
$756.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,066.00
|
| Rate for Payer: Nomi Health Commercial |
$567.50
|
| Rate for Payer: PACE SWMI |
$472.92
|
| Rate for Payer: PHP Medicare Advantage |
$472.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.00
|
| Rate for Payer: Priority Health Medicare |
$472.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$472.92
|
| Rate for Payer: UHC Medicare Advantage |
$472.92
|
|
|
PR EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 26180
|
| Min. Negotiated Rate |
$436.63 |
| Max. Negotiated Rate |
$826.80 |
| Rate for Payer: Aetna Commercial |
$585.08
|
| Rate for Payer: Aetna Medicare |
$454.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.08
|
| Rate for Payer: BCBS Complete |
$508.80
|
| Rate for Payer: BCBS MAPPO |
$436.63
|
| Rate for Payer: BCN Medicare Advantage |
$436.63
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$628.75
|
| Rate for Payer: Cofinity Commercial |
$585.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.63
|
| Rate for Payer: Healthscope Commercial |
$698.61
|
| Rate for Payer: Healthscope Commercial |
$807.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.80
|
| Rate for Payer: Nomi Health Commercial |
$523.96
|
| Rate for Payer: PACE SWMI |
$436.63
|
| Rate for Payer: PHP Medicare Advantage |
$436.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.80
|
| Rate for Payer: Priority Health Medicare |
$436.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.63
|
| Rate for Payer: UHC Medicare Advantage |
$436.63
|
|
|
PR EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 26170
|
| Min. Negotiated Rate |
$394.74 |
| Max. Negotiated Rate |
$730.27 |
| Rate for Payer: Aetna Commercial |
$528.95
|
| Rate for Payer: Aetna Medicare |
$410.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.95
|
| Rate for Payer: BCBS Complete |
$445.60
|
| Rate for Payer: BCBS MAPPO |
$394.74
|
| Rate for Payer: BCN Medicare Advantage |
$394.74
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$568.43
|
| Rate for Payer: Cofinity Commercial |
$528.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.74
|
| Rate for Payer: Healthscope Commercial |
$730.27
|
| Rate for Payer: Healthscope Commercial |
$631.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$724.10
|
| Rate for Payer: Nomi Health Commercial |
$473.69
|
| Rate for Payer: PACE SWMI |
$394.74
|
| Rate for Payer: PHP Medicare Advantage |
$394.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health Medicare |
$394.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.74
|
| Rate for Payer: UHC Medicare Advantage |
$394.74
|
|
|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS
|
Professional
|
Both
|
$2,074.00
|
|
|
Service Code
|
HCPCS 60280
|
| Min. Negotiated Rate |
$432.94 |
| Max. Negotiated Rate |
$1,348.10 |
| Rate for Payer: Aetna Commercial |
$580.14
|
| Rate for Payer: Aetna Medicare |
$450.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.14
|
| Rate for Payer: BCBS Complete |
$829.60
|
| Rate for Payer: BCBS MAPPO |
$432.94
|
| Rate for Payer: BCN Medicare Advantage |
$432.94
|
| Rate for Payer: Cash Price |
$1,659.20
|
| Rate for Payer: Cash Price |
$1,659.20
|
| Rate for Payer: Cofinity Commercial |
$623.43
|
| Rate for Payer: Cofinity Commercial |
$580.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.94
|
| Rate for Payer: Healthscope Commercial |
$692.70
|
| Rate for Payer: Healthscope Commercial |
$800.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,348.10
|
| Rate for Payer: Nomi Health Commercial |
$519.53
|
| Rate for Payer: PACE SWMI |
$432.94
|
| Rate for Payer: PHP Medicare Advantage |
$432.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.10
|
| Rate for Payer: Priority Health Medicare |
$432.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$432.94
|
| Rate for Payer: UHC Medicare Advantage |
$432.94
|
|
|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT
|
Professional
|
Both
|
$2,197.00
|
|
|
Service Code
|
HCPCS 60281
|
| Min. Negotiated Rate |
$569.01 |
| Max. Negotiated Rate |
$1,428.05 |
| Rate for Payer: Aetna Commercial |
$762.47
|
| Rate for Payer: Aetna Medicare |
$591.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.47
|
| Rate for Payer: BCBS Complete |
$878.80
|
| Rate for Payer: BCBS MAPPO |
$569.01
|
| Rate for Payer: BCN Medicare Advantage |
$569.01
|
| Rate for Payer: Cash Price |
$1,757.60
|
| Rate for Payer: Cash Price |
$1,757.60
|
| Rate for Payer: Cofinity Commercial |
$819.37
|
| Rate for Payer: Cofinity Commercial |
$762.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$569.01
|
| Rate for Payer: Healthscope Commercial |
$910.42
|
| Rate for Payer: Healthscope Commercial |
$1,052.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$597.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,428.05
|
| Rate for Payer: Nomi Health Commercial |
$682.81
|
| Rate for Payer: PACE SWMI |
$569.01
|
| Rate for Payer: PHP Medicare Advantage |
$569.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,428.05
|
| Rate for Payer: Priority Health Medicare |
$569.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$569.01
|
| Rate for Payer: UHC Medicare Advantage |
$569.01
|
|
|
PR EXCISION TONSIL TAGS
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 42860
|
| Min. Negotiated Rate |
$152.00 |
| Max. Negotiated Rate |
$342.49 |
| Rate for Payer: Aetna Commercial |
$248.07
|
| Rate for Payer: Aetna Medicare |
$192.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.07
|
| Rate for Payer: BCBS Complete |
$152.00
|
| Rate for Payer: BCBS MAPPO |
$185.13
|
| Rate for Payer: BCN Medicare Advantage |
$185.13
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cofinity Commercial |
$266.59
|
| Rate for Payer: Cofinity Commercial |
$248.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.13
|
| Rate for Payer: Healthscope Commercial |
$296.21
|
| Rate for Payer: Healthscope Commercial |
$342.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.00
|
| Rate for Payer: Nomi Health Commercial |
$222.16
|
| Rate for Payer: PACE SWMI |
$185.13
|
| Rate for Payer: PHP Medicare Advantage |
$185.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.00
|
| Rate for Payer: Priority Health Medicare |
$185.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.13
|
| Rate for Payer: UHC Medicare Advantage |
$185.13
|
|
|
PR EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL
|
Professional
|
Both
|
$3,948.00
|
|
|
Service Code
|
HCPCS 31785
|
| Min. Negotiated Rate |
$1,027.09 |
| Max. Negotiated Rate |
$2,566.20 |
| Rate for Payer: Aetna Commercial |
$1,376.30
|
| Rate for Payer: Aetna Medicare |
$1,068.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.30
|
| Rate for Payer: BCBS Complete |
$1,579.20
|
| Rate for Payer: BCBS MAPPO |
$1,027.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.09
|
| Rate for Payer: Cash Price |
$3,158.40
|
| Rate for Payer: Cash Price |
$3,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,479.01
|
| Rate for Payer: Cofinity Commercial |
$1,376.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.09
|
| Rate for Payer: Healthscope Commercial |
$1,900.12
|
| Rate for Payer: Healthscope Commercial |
$1,643.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,566.20
|
| Rate for Payer: Nomi Health Commercial |
$1,232.51
|
| Rate for Payer: PACE SWMI |
$1,027.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,566.20
|
| Rate for Payer: Priority Health Medicare |
$1,027.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.09
|
|
|
PR EXCISION TROCHANTERIC BURSA/CALCIFICATION
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 27062
|
| Min. Negotiated Rate |
$438.09 |
| Max. Negotiated Rate |
$1,090.70 |
| Rate for Payer: Aetna Commercial |
$587.04
|
| Rate for Payer: Aetna Medicare |
$455.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.04
|
| Rate for Payer: BCBS Complete |
$671.20
|
| Rate for Payer: BCBS MAPPO |
$438.09
|
| Rate for Payer: BCN Medicare Advantage |
$438.09
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cofinity Commercial |
$630.85
|
| Rate for Payer: Cofinity Commercial |
$587.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.09
|
| Rate for Payer: Healthscope Commercial |
$700.94
|
| Rate for Payer: Healthscope Commercial |
$810.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,090.70
|
| Rate for Payer: Nomi Health Commercial |
$525.71
|
| Rate for Payer: PACE SWMI |
$438.09
|
| Rate for Payer: PHP Medicare Advantage |
$438.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.70
|
| Rate for Payer: Priority Health Medicare |
$438.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$438.09
|
| Rate for Payer: UHC Medicare Advantage |
$438.09
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
21931
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$469.35 |
| Max. Negotiated Rate |
$670.50 |
| Rate for Payer: Aetna Commercial |
$633.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.25
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$521.50
|
| Rate for Payer: Cofinity Commercial |
$640.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$521.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Healthscope Commercial |
$670.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: PHP Commercial |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health SBD |
$469.35
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 21931
|
| Min. Negotiated Rate |
$298.00 |
| Max. Negotiated Rate |
$845.75 |
| Rate for Payer: Aetna Commercial |
$612.59
|
| Rate for Payer: Aetna Medicare |
$475.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.59
|
| Rate for Payer: BCBS Complete |
$298.00
|
| Rate for Payer: BCBS MAPPO |
$457.16
|
| Rate for Payer: BCN Medicare Advantage |
$457.16
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$658.31
|
| Rate for Payer: Cofinity Commercial |
$612.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.16
|
| Rate for Payer: Healthscope Commercial |
$845.75
|
| Rate for Payer: Healthscope Commercial |
$731.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$480.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$484.25
|
| Rate for Payer: Nomi Health Commercial |
$548.59
|
| Rate for Payer: PACE SWMI |
$457.16
|
| Rate for Payer: PHP Medicare Advantage |
$457.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health Medicare |
$457.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$457.16
|
| Rate for Payer: UHC Medicare Advantage |
$457.16
|
|
