|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$129.66
|
| Rate for Payer: Aetna Medicare |
$100.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.66
|
| Rate for Payer: BCBS Complete |
$238.40
|
| Rate for Payer: BCBS MAPPO |
$96.76
|
| Rate for Payer: BCN Medicare Advantage |
$96.76
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$139.33
|
| Rate for Payer: Cofinity Commercial |
$129.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.76
|
| Rate for Payer: Healthscope Commercial |
$154.82
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$387.40
|
| Rate for Payer: Nomi Health Commercial |
$116.11
|
| Rate for Payer: PACE SWMI |
$96.76
|
| Rate for Payer: PHP Medicare Advantage |
$96.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health Medicare |
$96.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.76
|
| Rate for Payer: UHC Medicare Advantage |
$96.76
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$261.45 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna Commercial |
$352.75
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$356.90
|
| Rate for Payer: Cofinity Commercial |
$290.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$352.75
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$261.45
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,502.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$500.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$261.45 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Aetna Commercial |
$352.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.75
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$290.50
|
| Rate for Payer: Cofinity Commercial |
$356.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: PHP Commercial |
$352.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health SBD |
$261.45
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$166.00 |
| Max. Negotiated Rate |
$339.31 |
| Rate for Payer: Aetna Commercial |
$245.77
|
| Rate for Payer: Aetna Medicare |
$190.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.77
|
| Rate for Payer: BCBS Complete |
$166.00
|
| Rate for Payer: BCBS MAPPO |
$183.41
|
| Rate for Payer: BCN Medicare Advantage |
$183.41
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$264.11
|
| Rate for Payer: Cofinity Commercial |
$245.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.41
|
| Rate for Payer: Healthscope Commercial |
$339.31
|
| Rate for Payer: Healthscope Commercial |
$293.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.75
|
| Rate for Payer: Nomi Health Commercial |
$220.09
|
| Rate for Payer: PACE SWMI |
$183.41
|
| Rate for Payer: PHP Medicare Advantage |
$183.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health Medicare |
$183.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.41
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$166.00 |
| Max. Negotiated Rate |
$339.31 |
| Rate for Payer: Aetna Commercial |
$245.77
|
| Rate for Payer: Aetna Medicare |
$190.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.77
|
| Rate for Payer: BCBS Complete |
$166.00
|
| Rate for Payer: BCBS MAPPO |
$183.41
|
| Rate for Payer: BCN Medicare Advantage |
$183.41
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$264.11
|
| Rate for Payer: Cofinity Commercial |
$245.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.41
|
| Rate for Payer: Healthscope Commercial |
$339.31
|
| Rate for Payer: Healthscope Commercial |
$293.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.75
|
| Rate for Payer: Nomi Health Commercial |
$220.09
|
| Rate for Payer: PACE SWMI |
$183.41
|
| Rate for Payer: PHP Medicare Advantage |
$183.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health Medicare |
$183.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.41
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
OP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,016.82 |
| Max. Negotiated Rate |
$7,528.73 |
| Rate for Payer: Aetna Commercial |
$1,371.90
|
| Rate for Payer: Aetna Medicare |
$2,781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,129.80
|
| Rate for Payer: Cofinity Commercial |
$1,388.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,129.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$1,452.60
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$1,371.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health SBD |
$1,016.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,505.80
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,016.82 |
| Max. Negotiated Rate |
$1,452.60 |
| Rate for Payer: Aetna Commercial |
$1,371.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.10
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,129.80
|
| Rate for Payer: Cofinity Commercial |
$1,388.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,129.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Healthscope Commercial |
$1,452.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: PHP Commercial |
$1,371.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health SBD |
$1,016.82
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$462.98 |
| Max. Negotiated Rate |
$1,049.10 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$481.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.69
|
| Rate for Payer: BCBS Complete |
$645.60
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Healthscope Commercial |
$740.77
|
| Rate for Payer: Healthscope Commercial |
$856.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.10
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health Medicare |
$462.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$462.98 |
| Max. Negotiated Rate |
$1,049.10 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$481.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.39
|
| Rate for Payer: BCBS Complete |
$645.60
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Healthscope Commercial |
$740.77
|
| Rate for Payer: Healthscope Commercial |
$856.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.10
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health Medicare |
$462.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$339.69 |
| Max. Negotiated Rate |
$713.70 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$353.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.15
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Healthscope Commercial |
$543.50
|
| Rate for Payer: Healthscope Commercial |
$628.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.70
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$339.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$691.74 |
| Max. Negotiated Rate |
$7,528.73 |
| Rate for Payer: Aetna Commercial |
$933.30
|
| Rate for Payer: Aetna Medicare |
$2,781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$768.60
|
| Rate for Payer: Cofinity Commercial |
$944.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$768.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$988.20
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$933.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health SBD |
$691.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,505.80
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$691.74 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Aetna Commercial |
$933.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.70
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$768.60
|
| Rate for Payer: Cofinity Commercial |
$944.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$768.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Healthscope Commercial |
$988.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: PHP Commercial |
$933.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health SBD |
$691.74
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$339.69 |
| Max. Negotiated Rate |
$713.70 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$353.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.18
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Healthscope Commercial |
$628.43
|
| Rate for Payer: Healthscope Commercial |
$543.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.70
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$339.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
OP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$711.27 |
| Max. Negotiated Rate |
$7,528.73 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna Medicare |
$2,781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Cofinity Commercial |
$790.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$790.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health SBD |
$711.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,505.80
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$306.79 |
| Max. Negotiated Rate |
$733.85 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$319.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.10
|
| Rate for Payer: BCBS Complete |
$451.60
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Healthscope Commercial |
$490.86
|
| Rate for Payer: Healthscope Commercial |
$567.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.85
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health Medicare |
$306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
IP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$711.27 |
| Max. Negotiated Rate |
$1,016.10 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.85
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$790.30
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$790.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health SBD |
$711.27
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$306.79 |
| Max. Negotiated Rate |
$733.85 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$319.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.10
|
| Rate for Payer: BCBS Complete |
$451.60
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Healthscope Commercial |
$490.86
|
| Rate for Payer: Healthscope Commercial |
$567.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.85
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health Medicare |
$306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
|
|
PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
HCPCS 46257
|
| Min. Negotiated Rate |
$297.20 |
| Max. Negotiated Rate |
$735.41 |
| Rate for Payer: Aetna Commercial |
$532.68
|
| Rate for Payer: Aetna Medicare |
$413.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.68
|
| Rate for Payer: BCBS Complete |
$297.20
|
| Rate for Payer: BCBS MAPPO |
$397.52
|
| Rate for Payer: BCN Medicare Advantage |
$397.52
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cofinity Commercial |
$572.43
|
| Rate for Payer: Cofinity Commercial |
$532.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.52
|
| Rate for Payer: Healthscope Commercial |
$735.41
|
| Rate for Payer: Healthscope Commercial |
$636.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$482.95
|
| Rate for Payer: Nomi Health Commercial |
$477.02
|
| Rate for Payer: PACE SWMI |
$397.52
|
| Rate for Payer: PHP Medicare Advantage |
$397.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.95
|
| Rate for Payer: Priority Health Medicare |
$397.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.52
|
| Rate for Payer: UHC Medicare Advantage |
$397.52
|
|
|
PR HEMORRHOIDOPEXY STAPLING
|
Professional
|
Both
|
$646.00
|
|
|
Service Code
|
HCPCS 46947
|
| Min. Negotiated Rate |
$258.40 |
| Max. Negotiated Rate |
$692.38 |
| Rate for Payer: Aetna Commercial |
$501.51
|
| Rate for Payer: Aetna Medicare |
$389.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.51
|
| Rate for Payer: BCBS Complete |
$258.40
|
| Rate for Payer: BCBS MAPPO |
$374.26
|
| Rate for Payer: BCN Medicare Advantage |
$374.26
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Cofinity Commercial |
$538.93
|
| Rate for Payer: Cofinity Commercial |
$501.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.26
|
| Rate for Payer: Healthscope Commercial |
$598.82
|
| Rate for Payer: Healthscope Commercial |
$692.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.90
|
| Rate for Payer: Nomi Health Commercial |
$449.11
|
| Rate for Payer: PACE SWMI |
$374.26
|
| Rate for Payer: PHP Medicare Advantage |
$374.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.90
|
| Rate for Payer: Priority Health Medicare |
$374.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.26
|
| Rate for Payer: UHC Medicare Advantage |
$374.26
|
|
|
PR HEPATECTOMY RESCJ PARTIAL LOBECTOMY
|
Professional
|
Both
|
$4,633.00
|
|
|
Service Code
|
HCPCS 47120
|
| Min. Negotiated Rate |
$1,853.20 |
| Max. Negotiated Rate |
$4,184.46 |
| Rate for Payer: Aetna Commercial |
$3,030.91
|
| Rate for Payer: Aetna Medicare |
$2,352.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,257.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,030.91
|
| Rate for Payer: BCBS Complete |
$1,853.20
|
| Rate for Payer: BCBS MAPPO |
$2,261.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,261.87
|
| Rate for Payer: Cash Price |
$3,706.40
|
| Rate for Payer: Cash Price |
$3,706.40
|
| Rate for Payer: Cofinity Commercial |
$3,257.09
|
| Rate for Payer: Cofinity Commercial |
$3,030.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,261.87
|
| Rate for Payer: Healthscope Commercial |
$4,184.46
|
| Rate for Payer: Healthscope Commercial |
$3,618.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,374.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,011.45
|
| Rate for Payer: Nomi Health Commercial |
$2,714.24
|
| Rate for Payer: PACE SWMI |
$2,261.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,261.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,011.45
|
| Rate for Payer: Priority Health Medicare |
$2,261.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,261.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,261.87
|
|
|
PR HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY
|
Professional
|
Both
|
$6,159.00
|
|
|
Service Code
|
HCPCS 47130
|
| Min. Negotiated Rate |
$2,463.60 |
| Max. Negotiated Rate |
$5,926.25 |
| Rate for Payer: Aetna Commercial |
$4,292.53
|
| Rate for Payer: Aetna Medicare |
$3,331.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,612.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,292.53
|
| Rate for Payer: BCBS Complete |
$2,463.60
|
| Rate for Payer: BCBS MAPPO |
$3,203.38
|
| Rate for Payer: BCN Medicare Advantage |
$3,203.38
|
| Rate for Payer: Cash Price |
$4,927.20
|
| Rate for Payer: Cash Price |
$4,927.20
|
| Rate for Payer: Cofinity Commercial |
$4,612.87
|
| Rate for Payer: Cofinity Commercial |
$4,292.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,203.38
|
| Rate for Payer: Healthscope Commercial |
$5,125.41
|
| Rate for Payer: Healthscope Commercial |
$5,926.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,363.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,003.35
|
| Rate for Payer: Nomi Health Commercial |
$3,844.06
|
| Rate for Payer: PACE SWMI |
$3,203.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,203.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,003.35
|
| Rate for Payer: Priority Health Medicare |
$3,203.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,203.38
|
| Rate for Payer: UHC Medicare Advantage |
$3,203.38
|
|
|
PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 90636
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
|
|
PR HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 90371
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$248.25 |
| Rate for Payer: Aetna Commercial |
$179.81
|
| Rate for Payer: Aetna Medicare |
$139.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.23
|
| Rate for Payer: BCBS Complete |
$72.80
|
| Rate for Payer: BCBS MAPPO |
$134.19
|
| Rate for Payer: BCN Medicare Advantage |
$134.19
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$193.23
|
| Rate for Payer: Cofinity Commercial |
$179.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.19
|
| Rate for Payer: Healthscope Commercial |
$248.25
|
| Rate for Payer: Healthscope Commercial |
$214.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.30
|
| Rate for Payer: Nomi Health Commercial |
$161.03
|
| Rate for Payer: PACE SWMI |
$134.19
|
| Rate for Payer: PHP Medicare Advantage |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health Medicare |
$134.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.19
|
| Rate for Payer: UHC Medicare Advantage |
$134.19
|
|
|
PR HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 47010
|
| Min. Negotiated Rate |
$897.20 |
| Max. Negotiated Rate |
$2,176.32 |
| Rate for Payer: Aetna Commercial |
$1,576.36
|
| Rate for Payer: Aetna Medicare |
$1,223.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,576.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,694.00
|
| Rate for Payer: BCBS Complete |
$897.20
|
| Rate for Payer: BCBS MAPPO |
$1,176.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,176.39
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Cofinity Commercial |
$1,576.36
|
| Rate for Payer: Cofinity Commercial |
$1,694.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,176.39
|
| Rate for Payer: Healthscope Commercial |
$1,882.22
|
| Rate for Payer: Healthscope Commercial |
$2,176.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,235.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,457.95
|
| Rate for Payer: Nomi Health Commercial |
$1,411.67
|
| Rate for Payer: PACE SWMI |
$1,176.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,176.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
| Rate for Payer: Priority Health Medicare |
$1,176.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,176.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,176.39
|
|
|
PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 90633
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
