|
PR INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 11107
|
| Min. Negotiated Rate |
$28.88 |
| Max. Negotiated Rate |
$92.30 |
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Medicare |
$30.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.59
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$28.88
|
| Rate for Payer: BCN Medicare Advantage |
$28.88
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.88
|
| Rate for Payer: Healthscope Commercial |
$46.21
|
| Rate for Payer: Healthscope Commercial |
$53.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.30
|
| Rate for Payer: Nomi Health Commercial |
$34.66
|
| Rate for Payer: PACE SWMI |
$28.88
|
| Rate for Payer: PHP Medicare Advantage |
$28.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health Medicare |
$28.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.88
|
| Rate for Payer: UHC Medicare Advantage |
$28.88
|
|
|
PR INCISIONAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 11106
|
| Min. Negotiated Rate |
$53.81 |
| Max. Negotiated Rate |
$191.75 |
| Rate for Payer: Aetna Commercial |
$72.11
|
| Rate for Payer: Aetna Medicare |
$55.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.11
|
| Rate for Payer: BCBS Complete |
$118.00
|
| Rate for Payer: BCBS MAPPO |
$53.81
|
| Rate for Payer: BCN Medicare Advantage |
$53.81
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$77.49
|
| Rate for Payer: Cofinity Commercial |
$72.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.81
|
| Rate for Payer: Healthscope Commercial |
$99.55
|
| Rate for Payer: Healthscope Commercial |
$86.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.75
|
| Rate for Payer: Nomi Health Commercial |
$64.57
|
| Rate for Payer: PACE SWMI |
$53.81
|
| Rate for Payer: PHP Medicare Advantage |
$53.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
| Rate for Payer: Priority Health Medicare |
$53.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.81
|
| Rate for Payer: UHC Medicare Advantage |
$53.81
|
|
|
PR INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 44900
|
| Min. Negotiated Rate |
$554.40 |
| Max. Negotiated Rate |
$1,411.31 |
| Rate for Payer: Aetna Commercial |
$1,022.25
|
| Rate for Payer: Aetna Medicare |
$793.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,098.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,022.25
|
| Rate for Payer: BCBS Complete |
$554.40
|
| Rate for Payer: BCBS MAPPO |
$762.87
|
| Rate for Payer: BCN Medicare Advantage |
$762.87
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$1,098.53
|
| Rate for Payer: Cofinity Commercial |
$1,022.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$762.87
|
| Rate for Payer: Healthscope Commercial |
$1,220.59
|
| Rate for Payer: Healthscope Commercial |
$1,411.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$900.90
|
| Rate for Payer: Nomi Health Commercial |
$915.44
|
| Rate for Payer: PACE SWMI |
$762.87
|
| Rate for Payer: PHP Medicare Advantage |
$762.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health Medicare |
$762.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$762.87
|
| Rate for Payer: UHC Medicare Advantage |
$762.87
|
|
|
PR INCISION BONE CORTEX FOOT
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 28005
|
| Min. Negotiated Rate |
$460.80 |
| Max. Negotiated Rate |
$1,010.93 |
| Rate for Payer: Aetna Commercial |
$732.24
|
| Rate for Payer: Aetna Medicare |
$568.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$786.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.24
|
| Rate for Payer: BCBS Complete |
$460.80
|
| Rate for Payer: BCBS MAPPO |
$546.45
|
| Rate for Payer: BCN Medicare Advantage |
$546.45
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$786.89
|
| Rate for Payer: Cofinity Commercial |
$732.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.45
|
| Rate for Payer: Healthscope Commercial |
$874.32
|
| Rate for Payer: Healthscope Commercial |
$1,010.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$748.80
|
| Rate for Payer: Nomi Health Commercial |
$655.74
|
| Rate for Payer: PACE SWMI |
$546.45
|
| Rate for Payer: PHP Medicare Advantage |
$546.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.80
|
| Rate for Payer: Priority Health Medicare |
$546.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.45
|
| Rate for Payer: UHC Medicare Advantage |
$546.45
|
|
|
PR INCISION BONE CORTEX HAND/FINGER
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 26034
|
| Min. Negotiated Rate |
$380.80 |
| Max. Negotiated Rate |
$986.18 |
| Rate for Payer: Aetna Commercial |
$714.31
|
| Rate for Payer: Aetna Medicare |
$554.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$714.31
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS MAPPO |
$533.07
|
| Rate for Payer: BCN Medicare Advantage |
$533.07
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$767.62
|
| Rate for Payer: Cofinity Commercial |
$714.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$533.07
|
| Rate for Payer: Healthscope Commercial |
$852.91
|
| Rate for Payer: Healthscope Commercial |
$986.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$618.80
|
| Rate for Payer: Nomi Health Commercial |
$639.68
|
| Rate for Payer: PACE SWMI |
$533.07
|
| Rate for Payer: PHP Medicare Advantage |
$533.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health Medicare |
$533.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$533.07
|
| Rate for Payer: UHC Medicare Advantage |
$533.07
|
|
|
PR INCISION BONE CORTEX PELVIS&/HIP JOINT
|
Professional
|
Both
|
$2,070.00
|
|
|
Service Code
|
HCPCS 26992
|
| Min. Negotiated Rate |
$828.00 |
| Max. Negotiated Rate |
$1,779.50 |
| Rate for Payer: Aetna Commercial |
$1,288.93
|
| Rate for Payer: Aetna Medicare |
$1,000.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,385.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,288.93
|
| Rate for Payer: BCBS Complete |
$828.00
|
| Rate for Payer: BCBS MAPPO |
$961.89
|
| Rate for Payer: BCN Medicare Advantage |
$961.89
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,385.12
|
| Rate for Payer: Cofinity Commercial |
$1,288.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$961.89
|
| Rate for Payer: Healthscope Commercial |
$1,779.50
|
| Rate for Payer: Healthscope Commercial |
$1,539.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,009.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,345.50
|
| Rate for Payer: Nomi Health Commercial |
$1,154.27
|
| Rate for Payer: PACE SWMI |
$961.89
|
| Rate for Payer: PHP Medicare Advantage |
$961.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,345.50
|
| Rate for Payer: Priority Health Medicare |
$961.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$961.89
|
| Rate for Payer: UHC Medicare Advantage |
$961.89
|
|
|
PR INCISION BONE CORTEX SHOULDER AREA
|
Professional
|
Both
|
$1,359.00
|
|
|
Service Code
|
HCPCS 23035
|
| Min. Negotiated Rate |
$543.60 |
| Max. Negotiated Rate |
$1,216.69 |
| Rate for Payer: Aetna Commercial |
$881.28
|
| Rate for Payer: Aetna Medicare |
$683.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$947.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.28
|
| Rate for Payer: BCBS Complete |
$543.60
|
| Rate for Payer: BCBS MAPPO |
$657.67
|
| Rate for Payer: BCN Medicare Advantage |
$657.67
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cofinity Commercial |
$947.04
|
| Rate for Payer: Cofinity Commercial |
$881.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.67
|
| Rate for Payer: Healthscope Commercial |
$1,052.27
|
| Rate for Payer: Healthscope Commercial |
$1,216.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$883.35
|
| Rate for Payer: Nomi Health Commercial |
$789.20
|
| Rate for Payer: PACE SWMI |
$657.67
|
| Rate for Payer: PHP Medicare Advantage |
$657.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$883.35
|
| Rate for Payer: Priority Health Medicare |
$657.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.67
|
| Rate for Payer: UHC Medicare Advantage |
$657.67
|
|
|
PR INCISION DEEP BONE CORTEX FOREARM&/WRIST
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS 25035
|
| Min. Negotiated Rate |
$571.26 |
| Max. Negotiated Rate |
$1,060.80 |
| Rate for Payer: Aetna Commercial |
$765.49
|
| Rate for Payer: Aetna Medicare |
$594.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.49
|
| Rate for Payer: BCBS Complete |
$652.80
|
| Rate for Payer: BCBS MAPPO |
$571.26
|
| Rate for Payer: BCN Medicare Advantage |
$571.26
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cofinity Commercial |
$822.61
|
| Rate for Payer: Cofinity Commercial |
$765.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.26
|
| Rate for Payer: Healthscope Commercial |
$914.02
|
| Rate for Payer: Healthscope Commercial |
$1,056.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.80
|
| Rate for Payer: Nomi Health Commercial |
$685.51
|
| Rate for Payer: PACE SWMI |
$571.26
|
| Rate for Payer: PHP Medicare Advantage |
$571.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,060.80
|
| Rate for Payer: Priority Health Medicare |
$571.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.26
|
| Rate for Payer: UHC Medicare Advantage |
$571.26
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Facility
|
OP
|
$367.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
10061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$311.95
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$256.90
|
| Rate for Payer: Cofinity Commercial |
$315.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$330.30
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.95
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$311.95
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$231.21
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
10061
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$320.86 |
| Rate for Payer: Aetna Commercial |
$232.41
|
| Rate for Payer: Aetna Medicare |
$180.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.75
|
| Rate for Payer: BCBS Complete |
$146.80
|
| Rate for Payer: BCBS MAPPO |
$173.44
|
| Rate for Payer: BCN Medicare Advantage |
$173.44
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$249.75
|
| Rate for Payer: Cofinity Commercial |
$232.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.44
|
| Rate for Payer: Healthscope Commercial |
$277.50
|
| Rate for Payer: Healthscope Commercial |
$320.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.55
|
| Rate for Payer: Nomi Health Commercial |
$208.13
|
| Rate for Payer: PACE SWMI |
$173.44
|
| Rate for Payer: PHP Medicare Advantage |
$173.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health Medicare |
$173.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.44
|
| Rate for Payer: UHC Medicare Advantage |
$173.44
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Facility
|
IP
|
$367.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
10061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$231.21 |
| Max. Negotiated Rate |
$330.30 |
| Rate for Payer: Aetna Commercial |
$311.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.55
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$256.90
|
| Rate for Payer: Cofinity Commercial |
$315.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.60
|
| Rate for Payer: Healthscope Commercial |
$330.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.95
|
| Rate for Payer: PHP Commercial |
$311.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health SBD |
$231.21
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 10061
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$320.86 |
| Rate for Payer: Aetna Commercial |
$232.41
|
| Rate for Payer: Aetna Medicare |
$180.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.41
|
| Rate for Payer: BCBS Complete |
$146.80
|
| Rate for Payer: BCBS MAPPO |
$173.44
|
| Rate for Payer: BCN Medicare Advantage |
$173.44
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$249.75
|
| Rate for Payer: Cofinity Commercial |
$232.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.44
|
| Rate for Payer: Healthscope Commercial |
$277.50
|
| Rate for Payer: Healthscope Commercial |
$320.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.55
|
| Rate for Payer: Nomi Health Commercial |
$208.13
|
| Rate for Payer: PACE SWMI |
$173.44
|
| Rate for Payer: PHP Medicare Advantage |
$173.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health Medicare |
$173.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.44
|
| Rate for Payer: UHC Medicare Advantage |
$173.44
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
10060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$128.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$115.92
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$109.10
|
| Rate for Payer: VA VA |
$193.79
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 10060
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$185.17 |
| Rate for Payer: Aetna Commercial |
$134.12
|
| Rate for Payer: Aetna Medicare |
$104.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.12
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$100.09
|
| Rate for Payer: BCN Medicare Advantage |
$100.09
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$144.13
|
| Rate for Payer: Cofinity Commercial |
$134.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.09
|
| Rate for Payer: Healthscope Commercial |
$185.17
|
| Rate for Payer: Healthscope Commercial |
$160.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.60
|
| Rate for Payer: Nomi Health Commercial |
$120.11
|
| Rate for Payer: PACE SWMI |
$100.09
|
| Rate for Payer: PHP Medicare Advantage |
$100.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$100.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.09
|
| Rate for Payer: UHC Medicare Advantage |
$100.09
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
10060
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$185.17 |
| Rate for Payer: Aetna Commercial |
$134.12
|
| Rate for Payer: Aetna Medicare |
$104.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.13
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$100.09
|
| Rate for Payer: BCN Medicare Advantage |
$100.09
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$144.13
|
| Rate for Payer: Cofinity Commercial |
$134.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.09
|
| Rate for Payer: Healthscope Commercial |
$160.14
|
| Rate for Payer: Healthscope Commercial |
$185.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.60
|
| Rate for Payer: Nomi Health Commercial |
$120.11
|
| Rate for Payer: PACE SWMI |
$100.09
|
| Rate for Payer: PHP Medicare Advantage |
$100.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$100.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.09
|
| Rate for Payer: UHC Medicare Advantage |
$100.09
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
10060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$115.92 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.60
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$128.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health SBD |
$115.92
|
|
|
PR INCISION&DRAINAGE BURSA FOOT
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 28001
|
| Min. Negotiated Rate |
$91.98 |
| Max. Negotiated Rate |
$288.60 |
| Rate for Payer: Aetna Commercial |
$123.25
|
| Rate for Payer: Aetna Medicare |
$95.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.25
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS MAPPO |
$91.98
|
| Rate for Payer: BCN Medicare Advantage |
$91.98
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$132.45
|
| Rate for Payer: Cofinity Commercial |
$123.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.98
|
| Rate for Payer: Healthscope Commercial |
$147.17
|
| Rate for Payer: Healthscope Commercial |
$170.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.60
|
| Rate for Payer: Nomi Health Commercial |
$110.38
|
| Rate for Payer: PACE SWMI |
$91.98
|
| Rate for Payer: PHP Medicare Advantage |
$91.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health Medicare |
$91.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.98
|
| Rate for Payer: UHC Medicare Advantage |
$91.98
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$423.99 |
| Max. Negotiated Rate |
$605.70 |
| Rate for Payer: Aetna Commercial |
$572.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.45
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$471.10
|
| Rate for Payer: Cofinity Commercial |
$578.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.40
|
| Rate for Payer: Healthscope Commercial |
$605.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.05
|
| Rate for Payer: PHP Commercial |
$572.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health SBD |
$423.99
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$673.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$423.99 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna Commercial |
$572.05
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$578.78
|
| Rate for Payer: Cofinity Commercial |
$471.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$605.70
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.05
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$572.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$423.99
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,571.50
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 10180
|
| Hospital Charge Code |
10180
|
| Min. Negotiated Rate |
$171.33 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Commercial |
$229.58
|
| Rate for Payer: Aetna Medicare |
$178.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.72
|
| Rate for Payer: BCBS Complete |
$269.20
|
| Rate for Payer: BCBS MAPPO |
$171.33
|
| Rate for Payer: BCN Medicare Advantage |
$171.33
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$229.58
|
| Rate for Payer: Cofinity Commercial |
$246.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.33
|
| Rate for Payer: Healthscope Commercial |
$316.96
|
| Rate for Payer: Healthscope Commercial |
$274.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$437.45
|
| Rate for Payer: Nomi Health Commercial |
$205.60
|
| Rate for Payer: PACE SWMI |
$171.33
|
| Rate for Payer: PHP Medicare Advantage |
$171.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health Medicare |
$171.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.33
|
| Rate for Payer: UHC Medicare Advantage |
$171.33
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 10180
|
| Min. Negotiated Rate |
$171.33 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Commercial |
$229.58
|
| Rate for Payer: Aetna Medicare |
$178.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.58
|
| Rate for Payer: BCBS Complete |
$269.20
|
| Rate for Payer: BCBS MAPPO |
$171.33
|
| Rate for Payer: BCN Medicare Advantage |
$171.33
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$246.72
|
| Rate for Payer: Cofinity Commercial |
$229.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.33
|
| Rate for Payer: Healthscope Commercial |
$316.96
|
| Rate for Payer: Healthscope Commercial |
$274.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$437.45
|
| Rate for Payer: Nomi Health Commercial |
$205.60
|
| Rate for Payer: PACE SWMI |
$171.33
|
| Rate for Payer: PHP Medicare Advantage |
$171.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health Medicare |
$171.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.33
|
| Rate for Payer: UHC Medicare Advantage |
$171.33
|
|
|
PR INCISION & DRAINAGE FOREARM&/WRIST BURSA
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
HCPCS 25031
|
| Min. Negotiated Rate |
$291.60 |
| Max. Negotiated Rate |
$661.62 |
| Rate for Payer: Aetna Commercial |
$479.22
|
| Rate for Payer: Aetna Medicare |
$371.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.22
|
| Rate for Payer: BCBS Complete |
$291.60
|
| Rate for Payer: BCBS MAPPO |
$357.63
|
| Rate for Payer: BCN Medicare Advantage |
$357.63
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cofinity Commercial |
$514.99
|
| Rate for Payer: Cofinity Commercial |
$479.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.63
|
| Rate for Payer: Healthscope Commercial |
$572.21
|
| Rate for Payer: Healthscope Commercial |
$661.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$473.85
|
| Rate for Payer: Nomi Health Commercial |
$429.16
|
| Rate for Payer: PACE SWMI |
$357.63
|
| Rate for Payer: PHP Medicare Advantage |
$357.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.85
|
| Rate for Payer: Priority Health Medicare |
$357.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.63
|
| Rate for Payer: UHC Medicare Advantage |
$357.63
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,140.00
|
|
|
Service Code
|
HCPCS 27603
|
| Min. Negotiated Rate |
$371.50 |
| Max. Negotiated Rate |
$741.00 |
| Rate for Payer: Aetna Commercial |
$497.81
|
| Rate for Payer: Aetna Medicare |
$386.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.81
|
| Rate for Payer: BCBS Complete |
$456.00
|
| Rate for Payer: BCBS MAPPO |
$371.50
|
| Rate for Payer: BCN Medicare Advantage |
$371.50
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cofinity Commercial |
$534.96
|
| Rate for Payer: Cofinity Commercial |
$497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.50
|
| Rate for Payer: Healthscope Commercial |
$687.27
|
| Rate for Payer: Healthscope Commercial |
$594.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.00
|
| Rate for Payer: Nomi Health Commercial |
$445.80
|
| Rate for Payer: PACE SWMI |
$371.50
|
| Rate for Payer: PHP Medicare Advantage |
$371.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.00
|
| Rate for Payer: Priority Health Medicare |
$371.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.50
|
| Rate for Payer: UHC Medicare Advantage |
$371.50
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 27604
|
| Min. Negotiated Rate |
$319.47 |
| Max. Negotiated Rate |
$591.02 |
| Rate for Payer: Aetna Commercial |
$428.09
|
| Rate for Payer: Aetna Medicare |
$332.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.09
|
| Rate for Payer: BCBS Complete |
$355.20
|
| Rate for Payer: BCBS MAPPO |
$319.47
|
| Rate for Payer: BCN Medicare Advantage |
$319.47
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cofinity Commercial |
$460.04
|
| Rate for Payer: Cofinity Commercial |
$428.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.47
|
| Rate for Payer: Healthscope Commercial |
$511.15
|
| Rate for Payer: Healthscope Commercial |
$591.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$577.20
|
| Rate for Payer: Nomi Health Commercial |
$383.36
|
| Rate for Payer: PACE SWMI |
$319.47
|
| Rate for Payer: PHP Medicare Advantage |
$319.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.20
|
| Rate for Payer: Priority Health Medicare |
$319.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.47
|
| Rate for Payer: UHC Medicare Advantage |
$319.47
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 10081
|
| Min. Negotiated Rate |
$164.08 |
| Max. Negotiated Rate |
$303.55 |
| Rate for Payer: Aetna Commercial |
$219.87
|
| Rate for Payer: Aetna Medicare |
$170.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.87
|
| Rate for Payer: BCBS Complete |
$181.60
|
| Rate for Payer: BCBS MAPPO |
$164.08
|
| Rate for Payer: BCN Medicare Advantage |
$164.08
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cofinity Commercial |
$236.28
|
| Rate for Payer: Cofinity Commercial |
$219.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.08
|
| Rate for Payer: Healthscope Commercial |
$303.55
|
| Rate for Payer: Healthscope Commercial |
$262.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.10
|
| Rate for Payer: Nomi Health Commercial |
$196.90
|
| Rate for Payer: PACE SWMI |
$164.08
|
| Rate for Payer: PHP Medicare Advantage |
$164.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.10
|
| Rate for Payer: Priority Health Medicare |
$164.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.08
|
| Rate for Payer: UHC Medicare Advantage |
$164.08
|
|
