|
PR EXCISION NASAL POLYP EXTENSIVE
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 30115
|
| Min. Negotiated Rate |
$298.41 |
| Max. Negotiated Rate |
$81,972.00 |
| Rate for Payer: Aetna Commercial |
$577.49
|
| Rate for Payer: Aetna Medicare |
$448.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.58
|
| Rate for Payer: BCBS Complete |
$313.33
|
| Rate for Payer: BCBS MAPPO |
$430.96
|
| Rate for Payer: BCBS Trust/PPO |
$893.36
|
| Rate for Payer: BCN Commercial |
$693.93
|
| Rate for Payer: BCN Medicare Advantage |
$430.96
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$620.58
|
| Rate for Payer: Cofinity Commercial |
$577.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.96
|
| Rate for Payer: Healthscope Commercial |
$797.28
|
| Rate for Payer: Healthscope Commercial |
$689.54
|
| Rate for Payer: Mclaren Medicaid |
$298.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.51
|
| Rate for Payer: Meridian Medicaid |
$313.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81,972.00
|
| Rate for Payer: Nomi Health Commercial |
$517.15
|
| Rate for Payer: PACE SWMI |
$430.96
|
| Rate for Payer: PHP Medicare Advantage |
$430.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$653.96
|
| Rate for Payer: Priority Health Medicare |
$430.96
|
| Rate for Payer: Priority Health Narrow Network |
$653.96
|
| Rate for Payer: Priority Health SBD |
$653.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.96
|
| Rate for Payer: UHC Exchange |
$382.24
|
| Rate for Payer: UHC Medicare Advantage |
$430.96
|
| Rate for Payer: UHCCP Medicaid |
$298.41
|
|
|
PR EXCISION NASAL POLYP SIMPLE
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 30110
|
| Min. Negotiated Rate |
$86.27 |
| Max. Negotiated Rate |
$23,260.00 |
| Rate for Payer: Aetna Commercial |
$169.12
|
| Rate for Payer: Aetna Medicare |
$131.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.74
|
| Rate for Payer: BCBS Complete |
$90.58
|
| Rate for Payer: BCBS MAPPO |
$126.21
|
| Rate for Payer: BCBS Trust/PPO |
$937.20
|
| Rate for Payer: BCN Commercial |
$367.97
|
| Rate for Payer: BCN Medicare Advantage |
$126.21
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$181.74
|
| Rate for Payer: Cofinity Commercial |
$169.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.21
|
| Rate for Payer: Healthscope Commercial |
$233.49
|
| Rate for Payer: Healthscope Commercial |
$201.94
|
| Rate for Payer: Mclaren Medicaid |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.52
|
| Rate for Payer: Meridian Medicaid |
$90.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,260.00
|
| Rate for Payer: Nomi Health Commercial |
$151.45
|
| Rate for Payer: PACE SWMI |
$126.21
|
| Rate for Payer: PHP Medicare Advantage |
$126.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.78
|
| Rate for Payer: Priority Health Medicare |
$126.21
|
| Rate for Payer: Priority Health Narrow Network |
$186.78
|
| Rate for Payer: Priority Health SBD |
$186.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.21
|
| Rate for Payer: UHC Exchange |
$203.03
|
| Rate for Payer: UHC Medicare Advantage |
$126.21
|
| Rate for Payer: UHCCP Medicaid |
$86.27
|
|
|
PR EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 64778
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$32,117.00 |
| Rate for Payer: Aetna Commercial |
$231.59
|
| Rate for Payer: Aetna Medicare |
$179.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.88
|
| Rate for Payer: BCBS Complete |
$120.32
|
| Rate for Payer: BCBS MAPPO |
$172.83
|
| Rate for Payer: BCBS Trust/PPO |
$291.09
|
| Rate for Payer: BCN Commercial |
$261.93
|
| Rate for Payer: BCN Medicare Advantage |
$172.83
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$248.88
|
| Rate for Payer: Cofinity Commercial |
$231.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.83
|
| Rate for Payer: Healthscope Commercial |
$319.74
|
| Rate for Payer: Healthscope Commercial |
$276.53
|
| Rate for Payer: Mclaren Medicaid |
$114.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.47
|
| Rate for Payer: Meridian Medicaid |
$120.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,117.00
|
| Rate for Payer: Nomi Health Commercial |
$207.40
|
| Rate for Payer: PACE SWMI |
$172.83
|
| Rate for Payer: PHP Medicare Advantage |
$172.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.27
|
| Rate for Payer: Priority Health Medicare |
$172.83
|
| Rate for Payer: Priority Health Narrow Network |
$304.27
|
| Rate for Payer: Priority Health SBD |
$304.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.83
|
| Rate for Payer: UHC Exchange |
$217.53
|
| Rate for Payer: UHC Medicare Advantage |
$172.83
|
| Rate for Payer: UHCCP Medicaid |
$114.59
|
|
|
PR EXCISION NEUROMA SCIATIC NERVE
|
Professional
|
Both
|
$3,548.00
|
|
|
Service Code
|
HCPCS 64786
|
| Min. Negotiated Rate |
$154.26 |
| Max. Negotiated Rate |
$180,122.00 |
| Rate for Payer: Aetna Commercial |
$1,310.88
|
| Rate for Payer: Aetna Medicare |
$1,017.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,408.71
|
| Rate for Payer: BCBS Complete |
$680.35
|
| Rate for Payer: BCBS MAPPO |
$978.27
|
| Rate for Payer: BCBS Trust/PPO |
$154.26
|
| Rate for Payer: BCN Commercial |
$1,470.43
|
| Rate for Payer: BCN Medicare Advantage |
$978.27
|
| Rate for Payer: Cash Price |
$2,838.40
|
| Rate for Payer: Cash Price |
$2,838.40
|
| Rate for Payer: Cofinity Commercial |
$1,408.71
|
| Rate for Payer: Cofinity Commercial |
$1,310.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$978.27
|
| Rate for Payer: Healthscope Commercial |
$1,809.80
|
| Rate for Payer: Healthscope Commercial |
$1,565.23
|
| Rate for Payer: Mclaren Medicaid |
$647.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,027.18
|
| Rate for Payer: Meridian Medicaid |
$680.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180,122.00
|
| Rate for Payer: Nomi Health Commercial |
$1,173.92
|
| Rate for Payer: PACE SWMI |
$978.27
|
| Rate for Payer: PHP Medicare Advantage |
$978.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$647.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,306.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,720.37
|
| Rate for Payer: Priority Health Medicare |
$978.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,720.37
|
| Rate for Payer: Priority Health SBD |
$1,720.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,201.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$978.27
|
| Rate for Payer: UHC Exchange |
$1,201.55
|
| Rate for Payer: UHC Medicare Advantage |
$978.27
|
| Rate for Payer: UHCCP Medicaid |
$647.95
|
|
|
PR EXCISION OF BULBOURETHRAL GLAND
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 53250
|
| Min. Negotiated Rate |
$256.24 |
| Max. Negotiated Rate |
$69,617.00 |
| Rate for Payer: Aetna Commercial |
$509.27
|
| Rate for Payer: Aetna Medicare |
$395.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.27
|
| Rate for Payer: BCBS Complete |
$269.05
|
| Rate for Payer: BCBS MAPPO |
$380.05
|
| Rate for Payer: BCBS Trust/PPO |
$419.47
|
| Rate for Payer: BCN Commercial |
$574.19
|
| Rate for Payer: BCN Medicare Advantage |
$380.05
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$547.27
|
| Rate for Payer: Cofinity Commercial |
$509.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.05
|
| Rate for Payer: Healthscope Commercial |
$703.09
|
| Rate for Payer: Healthscope Commercial |
$608.08
|
| Rate for Payer: Mclaren Medicaid |
$256.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.05
|
| Rate for Payer: Meridian Medicaid |
$269.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69,617.00
|
| Rate for Payer: Nomi Health Commercial |
$456.06
|
| Rate for Payer: PACE SWMI |
$380.05
|
| Rate for Payer: PHP Medicare Advantage |
$380.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$634.86
|
| Rate for Payer: Priority Health Medicare |
$380.05
|
| Rate for Payer: Priority Health Narrow Network |
$634.86
|
| Rate for Payer: Priority Health SBD |
$634.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$481.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.05
|
| Rate for Payer: UHC Exchange |
$481.91
|
| Rate for Payer: UHC Medicare Advantage |
$380.05
|
| Rate for Payer: UHCCP Medicaid |
$256.24
|
|
|
PR EXCISION OF PENILE PLAQUE
|
Professional
|
Both
|
$1,186.00
|
|
|
Service Code
|
HCPCS 54110
|
| Min. Negotiated Rate |
$400.87 |
| Max. Negotiated Rate |
$109,694.00 |
| Rate for Payer: Aetna Commercial |
$800.14
|
| Rate for Payer: Aetna Medicare |
$621.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.85
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS MAPPO |
$597.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,843.84
|
| Rate for Payer: BCN Commercial |
$901.13
|
| Rate for Payer: BCN Medicare Advantage |
$597.12
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cofinity Commercial |
$859.85
|
| Rate for Payer: Cofinity Commercial |
$800.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.12
|
| Rate for Payer: Healthscope Commercial |
$955.39
|
| Rate for Payer: Healthscope Commercial |
$1,104.67
|
| Rate for Payer: Mclaren Medicaid |
$400.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.98
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109,694.00
|
| Rate for Payer: Nomi Health Commercial |
$716.54
|
| Rate for Payer: PACE SWMI |
$597.12
|
| Rate for Payer: PHP Medicare Advantage |
$597.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$995.97
|
| Rate for Payer: Priority Health Medicare |
$597.12
|
| Rate for Payer: Priority Health Narrow Network |
$995.97
|
| Rate for Payer: Priority Health SBD |
$995.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.12
|
| Rate for Payer: UHC Exchange |
$758.52
|
| Rate for Payer: UHC Medicare Advantage |
$597.12
|
| Rate for Payer: UHCCP Medicaid |
$400.87
|
|
|
PR EXCISION OLECRANON BURSA
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$384.08 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,690.58
|
| Rate for Payer: BCN Commercial |
$1,690.58
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.08
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 24105
|
| Min. Negotiated Rate |
$206.04 |
| Max. Negotiated Rate |
$63,700.00 |
| Rate for Payer: Aetna Commercial |
$466.43
|
| Rate for Payer: Aetna Medicare |
$362.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.24
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$348.08
|
| Rate for Payer: BCBS Trust/PPO |
$206.04
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: BCN Medicare Advantage |
$348.08
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$501.24
|
| Rate for Payer: Cofinity Commercial |
$466.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.08
|
| Rate for Payer: Healthscope Commercial |
$643.95
|
| Rate for Payer: Healthscope Commercial |
$556.93
|
| Rate for Payer: Mclaren Medicaid |
$239.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.48
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,700.00
|
| Rate for Payer: Nomi Health Commercial |
$417.70
|
| Rate for Payer: PACE SWMI |
$348.08
|
| Rate for Payer: PHP Medicare Advantage |
$348.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.86
|
| Rate for Payer: Priority Health Medicare |
$348.08
|
| Rate for Payer: Priority Health Narrow Network |
$565.86
|
| Rate for Payer: Priority Health SBD |
$565.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.08
|
| Rate for Payer: UHC Exchange |
$418.17
|
| Rate for Payer: UHC Medicare Advantage |
$348.08
|
| Rate for Payer: UHCCP Medicaid |
$239.20
|
|
|
PR EXCISION OLECRANON BURSA
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$385.56 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health SBD |
$385.56
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$206.04 |
| Max. Negotiated Rate |
$63,700.00 |
| Rate for Payer: Aetna Commercial |
$466.43
|
| Rate for Payer: Aetna Medicare |
$362.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.24
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$348.08
|
| Rate for Payer: BCBS Trust/PPO |
$206.04
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: BCN Medicare Advantage |
$348.08
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$501.24
|
| Rate for Payer: Cofinity Commercial |
$466.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.08
|
| Rate for Payer: Healthscope Commercial |
$643.95
|
| Rate for Payer: Healthscope Commercial |
$556.93
|
| Rate for Payer: Mclaren Medicaid |
$239.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.48
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,700.00
|
| Rate for Payer: Nomi Health Commercial |
$417.70
|
| Rate for Payer: PACE SWMI |
$348.08
|
| Rate for Payer: PHP Medicare Advantage |
$348.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.86
|
| Rate for Payer: Priority Health Medicare |
$348.08
|
| Rate for Payer: Priority Health Narrow Network |
$565.86
|
| Rate for Payer: Priority Health SBD |
$565.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.08
|
| Rate for Payer: UHC Exchange |
$418.17
|
| Rate for Payer: UHC Medicare Advantage |
$348.08
|
| Rate for Payer: UHCCP Medicaid |
$239.20
|
|
|
PR EXCISION OR FULGURATION SKENES GLANDS
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 53270
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$32,472.00 |
| Rate for Payer: Aetna Commercial |
$238.06
|
| Rate for Payer: Aetna Medicare |
$184.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.83
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$177.66
|
| Rate for Payer: BCBS Trust/PPO |
$772.90
|
| Rate for Payer: BCN Commercial |
$307.38
|
| Rate for Payer: BCN Medicare Advantage |
$177.66
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$255.83
|
| Rate for Payer: Cofinity Commercial |
$238.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.66
|
| Rate for Payer: Healthscope Commercial |
$328.67
|
| Rate for Payer: Healthscope Commercial |
$284.26
|
| Rate for Payer: Mclaren Medicaid |
$119.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.54
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,472.00
|
| Rate for Payer: Nomi Health Commercial |
$213.19
|
| Rate for Payer: PACE SWMI |
$177.66
|
| Rate for Payer: PHP Medicare Advantage |
$177.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.60
|
| Rate for Payer: Priority Health Medicare |
$177.66
|
| Rate for Payer: Priority Health Narrow Network |
$295.60
|
| Rate for Payer: Priority Health SBD |
$295.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.66
|
| Rate for Payer: UHC Exchange |
$356.16
|
| Rate for Payer: UHC Medicare Advantage |
$177.66
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
|
|
PR EXCISION PILONIDAL CYST/SINUS COMPLICATED
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 11772
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$102,188.00 |
| Rate for Payer: Aetna Commercial |
$742.63
|
| Rate for Payer: Aetna Medicare |
$576.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.05
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$554.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.51
|
| Rate for Payer: BCN Commercial |
$1,137.15
|
| Rate for Payer: BCN Medicare Advantage |
$554.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$798.05
|
| Rate for Payer: Cofinity Commercial |
$742.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.20
|
| Rate for Payer: Healthscope Commercial |
$886.72
|
| Rate for Payer: Healthscope Commercial |
$1,025.27
|
| Rate for Payer: Mclaren Medicaid |
$374.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$581.91
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,188.00
|
| Rate for Payer: Nomi Health Commercial |
$665.04
|
| Rate for Payer: PACE SWMI |
$554.20
|
| Rate for Payer: PHP Medicare Advantage |
$554.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$790.60
|
| Rate for Payer: Priority Health Medicare |
$554.20
|
| Rate for Payer: Priority Health Narrow Network |
$790.60
|
| Rate for Payer: Priority Health SBD |
$790.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.20
|
| Rate for Payer: UHC Exchange |
$697.23
|
| Rate for Payer: UHC Medicare Advantage |
$554.20
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 11771
|
| Hospital Charge Code |
11771
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$79,601.00 |
| Rate for Payer: Aetna Commercial |
$580.47
|
| Rate for Payer: Aetna Medicare |
$450.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.79
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$433.19
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$925.56
|
| Rate for Payer: BCN Medicare Advantage |
$433.19
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$623.79
|
| Rate for Payer: Cofinity Commercial |
$580.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.19
|
| Rate for Payer: Healthscope Commercial |
$801.40
|
| Rate for Payer: Healthscope Commercial |
$693.10
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.85
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,601.00
|
| Rate for Payer: Nomi Health Commercial |
$519.83
|
| Rate for Payer: PACE SWMI |
$433.19
|
| Rate for Payer: PHP Medicare Advantage |
$433.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.97
|
| Rate for Payer: Priority Health Medicare |
$433.19
|
| Rate for Payer: Priority Health Narrow Network |
$614.97
|
| Rate for Payer: Priority Health SBD |
$614.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.19
|
| Rate for Payer: UHC Exchange |
$575.44
|
| Rate for Payer: UHC Medicare Advantage |
$433.19
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 11771
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$79,601.00 |
| Rate for Payer: Aetna Commercial |
$580.47
|
| Rate for Payer: Aetna Medicare |
$450.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.79
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$433.19
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$925.56
|
| Rate for Payer: BCN Medicare Advantage |
$433.19
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$623.79
|
| Rate for Payer: Cofinity Commercial |
$580.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.19
|
| Rate for Payer: Healthscope Commercial |
$801.40
|
| Rate for Payer: Healthscope Commercial |
$693.10
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.85
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,601.00
|
| Rate for Payer: Nomi Health Commercial |
$519.83
|
| Rate for Payer: PACE SWMI |
$433.19
|
| Rate for Payer: PHP Medicare Advantage |
$433.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.97
|
| Rate for Payer: Priority Health Medicare |
$433.19
|
| Rate for Payer: Priority Health Narrow Network |
$614.97
|
| Rate for Payer: Priority Health SBD |
$614.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.19
|
| Rate for Payer: UHC Exchange |
$575.44
|
| Rate for Payer: UHC Medicare Advantage |
$433.19
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Facility
|
OP
|
$1,343.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
11771
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$479.64 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,141.55
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.95
|
| 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 |
$1,919.56
|
| Rate for Payer: BCN Commercial |
$1,919.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$940.10
|
| Rate for Payer: Cofinity Commercial |
$1,154.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$940.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,208.70
|
| 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 |
$1,141.55
|
| 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 |
$1,141.55
|
| 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 |
$872.95
|
| 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 |
$846.09
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.64
|
| 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 PILONIDAL CYST/SINUS EXTENSIVE
|
Facility
|
IP
|
$1,343.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
11771
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$846.09 |
| Max. Negotiated Rate |
$1,208.70 |
| Rate for Payer: Aetna Commercial |
$1,141.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.95
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.98
|
| Rate for Payer: Cofinity Commercial |
$940.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$940.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.40
|
| Rate for Payer: Healthscope Commercial |
$1,208.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.55
|
| Rate for Payer: PHP Commercial |
$1,141.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health SBD |
$846.09
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 11770
|
| Hospital Charge Code |
11770
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$32,879.00 |
| Rate for Payer: Aetna Commercial |
$238.20
|
| Rate for Payer: Aetna Medicare |
$184.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.97
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$177.76
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$523.86
|
| Rate for Payer: BCN Medicare Advantage |
$177.76
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$255.97
|
| Rate for Payer: Cofinity Commercial |
$238.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.76
|
| Rate for Payer: Healthscope Commercial |
$328.86
|
| Rate for Payer: Healthscope Commercial |
$284.42
|
| Rate for Payer: Mclaren Medicaid |
$119.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.65
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,879.00
|
| Rate for Payer: Nomi Health Commercial |
$213.31
|
| Rate for Payer: PACE SWMI |
$177.76
|
| Rate for Payer: PHP Medicare Advantage |
$177.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.85
|
| Rate for Payer: Priority Health Medicare |
$177.76
|
| Rate for Payer: Priority Health Narrow Network |
$252.85
|
| Rate for Payer: Priority Health SBD |
$252.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.76
|
| Rate for Payer: UHC Exchange |
$276.15
|
| Rate for Payer: UHC Medicare Advantage |
$177.76
|
| Rate for Payer: UHCCP Medicaid |
$119.28
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 11770
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$32,879.00 |
| Rate for Payer: Aetna Commercial |
$238.20
|
| Rate for Payer: Aetna Medicare |
$184.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.97
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$177.76
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$523.86
|
| Rate for Payer: BCN Medicare Advantage |
$177.76
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$255.97
|
| Rate for Payer: Cofinity Commercial |
$238.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.76
|
| Rate for Payer: Healthscope Commercial |
$328.86
|
| Rate for Payer: Healthscope Commercial |
$284.42
|
| Rate for Payer: Mclaren Medicaid |
$119.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.65
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,879.00
|
| Rate for Payer: Nomi Health Commercial |
$213.31
|
| Rate for Payer: PACE SWMI |
$177.76
|
| Rate for Payer: PHP Medicare Advantage |
$177.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.85
|
| Rate for Payer: Priority Health Medicare |
$177.76
|
| Rate for Payer: Priority Health Narrow Network |
$252.85
|
| Rate for Payer: Priority Health SBD |
$252.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.76
|
| Rate for Payer: UHC Exchange |
$276.15
|
| Rate for Payer: UHC Medicare Advantage |
$177.76
|
| Rate for Payer: UHCCP Medicaid |
$119.28
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
IP
|
$520.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
11770
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$364.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health SBD |
$327.60
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
OP
|
$520.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
11770
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$197.94 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.00
|
| 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 |
$1,680.56
|
| Rate for Payer: BCN Commercial |
$1,680.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Cofinity Commercial |
$364.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| 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 |
$442.00
|
| 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 |
$442.00
|
| 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 |
$338.00
|
| 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 |
$327.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.94
|
| 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 PREPATELLAR BURSA
|
Facility
|
OP
|
$1,301.00
|
|
|
Service Code
|
CPT 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$401.15 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$1,105.85
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.51
|
| Rate for Payer: BCN Commercial |
$1,089.51
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$910.70
|
| Rate for Payer: Cofinity Commercial |
$1,118.86
|
| 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 |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,170.90
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,105.85
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,105.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$819.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.15
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Facility
|
IP
|
$1,301.00
|
|
|
Service Code
|
CPT 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$819.63 |
| Max. Negotiated Rate |
$1,170.90 |
| Rate for Payer: Aetna Commercial |
$1,105.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.65
|
| 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: Healthscope Commercial |
$1,170.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,105.85
|
| Rate for Payer: PHP Commercial |
$1,105.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health SBD |
$819.63
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$66,438.00 |
| Rate for Payer: Aetna Commercial |
$486.45
|
| Rate for Payer: Aetna Medicare |
$377.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.75
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS MAPPO |
$363.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.03
|
| Rate for Payer: BCN Commercial |
$556.12
|
| 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: Mclaren Medicaid |
$248.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.17
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66,438.00
|
| 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 Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$587.73
|
| Rate for Payer: Priority Health Medicare |
$363.02
|
| Rate for Payer: Priority Health Narrow Network |
$587.73
|
| Rate for Payer: Priority Health SBD |
$587.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.02
|
| Rate for Payer: UHC Exchange |
$463.24
|
| Rate for Payer: UHC Medicare Advantage |
$363.02
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27340
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$66,438.00 |
| Rate for Payer: Aetna Commercial |
$486.45
|
| Rate for Payer: Aetna Medicare |
$377.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.75
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS MAPPO |
$363.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.03
|
| Rate for Payer: BCN Commercial |
$556.12
|
| 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: Mclaren Medicaid |
$248.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.17
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66,438.00
|
| 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 Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$587.73
|
| Rate for Payer: Priority Health Medicare |
$363.02
|
| Rate for Payer: Priority Health Narrow Network |
$587.73
|
| Rate for Payer: Priority Health SBD |
$587.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.02
|
| Rate for Payer: UHC Exchange |
$463.24
|
| Rate for Payer: UHC Medicare Advantage |
$363.02
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
|
|
PR EXCISION RADIAL HEAD
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 24130
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$91,197.00 |
| Rate for Payer: Aetna Commercial |
$666.13
|
| Rate for Payer: Aetna Medicare |
$516.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.84
|
| Rate for Payer: BCBS Complete |
$355.15
|
| Rate for Payer: BCBS MAPPO |
$497.11
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$760.38
|
| 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 |
$919.65
|
| Rate for Payer: Healthscope Commercial |
$795.38
|
| Rate for Payer: Mclaren Medicaid |
$338.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.97
|
| Rate for Payer: Meridian Medicaid |
$355.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91,197.00
|
| 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 Choice Medicaid |
$338.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.37
|
| Rate for Payer: Priority Health Medicare |
$497.11
|
| Rate for Payer: Priority Health Narrow Network |
$796.37
|
| Rate for Payer: Priority Health SBD |
$796.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$664.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$497.11
|
| Rate for Payer: UHC Exchange |
$664.10
|
| Rate for Payer: UHC Medicare Advantage |
$497.11
|
| Rate for Payer: UHCCP Medicaid |
$338.24
|
|
