|
PR DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 94664
|
| Min. Negotiated Rate |
$15.80 |
| Max. Negotiated Rate |
$379.32 |
| Rate for Payer: Aetna Commercial |
$21.17
|
| Rate for Payer: Aetna Medicare |
$16.43
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$15.80
|
| Rate for Payer: BCBS Trust/PPO |
$379.32
|
| Rate for Payer: BCN Commercial |
$24.92
|
| Rate for Payer: BCN Medicare Advantage |
$15.80
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$21.17
|
| Rate for Payer: Cofinity Commercial |
$22.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.59
|
| Rate for Payer: PACE SWMI |
$15.80
|
| Rate for Payer: PHP Medicare Advantage |
$15.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.90
|
| Rate for Payer: Priority Health Medicare |
$15.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.80
|
| Rate for Payer: UHC Medicare Advantage |
$16.27
|
|
|
PR DENOSUMAB INJECTION
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS J0897
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$34.84 |
| Rate for Payer: Aetna Commercial |
$32.42
|
| Rate for Payer: Aetna Medicare |
$25.16
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$24.19
|
| Rate for Payer: BCBS Trust/PPO |
$24.59
|
| Rate for Payer: BCN Commercial |
$22.46
|
| Rate for Payer: BCN Medicare Advantage |
$24.19
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$34.84
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.40
|
| Rate for Payer: PACE SWMI |
$24.19
|
| Rate for Payer: PHP Medicare Advantage |
$24.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health Medicare |
$24.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.19
|
| Rate for Payer: UHC Medicare Advantage |
$24.92
|
|
|
PR DEPO-ESTRADIOL CYPIONATE INJ
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS J1000
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$44.18 |
| Rate for Payer: Aetna Commercial |
$41.11
|
| Rate for Payer: Aetna Medicare |
$31.91
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$30.68
|
| Rate for Payer: BCBS Trust/PPO |
$36.42
|
| Rate for Payer: BCN Commercial |
$29.80
|
| Rate for Payer: BCN Medicare Advantage |
$30.68
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cofinity Commercial |
$44.18
|
| Rate for Payer: Cofinity Commercial |
$41.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: PACE SWMI |
$30.68
|
| Rate for Payer: PHP Medicare Advantage |
$30.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.90
|
| Rate for Payer: Priority Health Medicare |
$30.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.68
|
| Rate for Payer: UHC Medicare Advantage |
$31.60
|
|
|
PR DEPRESSION SCREEN ANNUAL
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0444
|
| Min. Negotiated Rate |
$8.93 |
| Max. Negotiated Rate |
$1,280.07 |
| Rate for Payer: Aetna Commercial |
$11.97
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.07
|
| Rate for Payer: BCN Commercial |
$26.88
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$11.97
|
| Rate for Payer: Cofinity Commercial |
$12.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.80
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Medicare Advantage |
$9.20
|
|
|
PR DERMAGRAFT
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS Q4106
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$281.06 |
| Rate for Payer: Aetna Commercial |
$46.20
|
| Rate for Payer: Aetna Medicare |
$35.86
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$34.48
|
| Rate for Payer: BCBS Trust/PPO |
$281.06
|
| Rate for Payer: BCN Commercial |
$33.86
|
| Rate for Payer: BCN Medicare Advantage |
$34.48
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$49.65
|
| Rate for Payer: Cofinity Commercial |
$46.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.20
|
| Rate for Payer: PACE SWMI |
$34.48
|
| Rate for Payer: PHP Medicare Advantage |
$34.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health Medicare |
$34.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.48
|
| Rate for Payer: UHC Medicare Advantage |
$35.51
|
|
|
PR DERMAL AUTOGRAFT F/S/N/H/F/G/M/D GT 1ST 100
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 15135
|
| Min. Negotiated Rate |
$116.11 |
| Max. Negotiated Rate |
$1,287.66 |
| Rate for Payer: Aetna Commercial |
$994.40
|
| Rate for Payer: Aetna Medicare |
$771.77
|
| Rate for Payer: BCBS Complete |
$508.36
|
| Rate for Payer: BCBS MAPPO |
$742.09
|
| Rate for Payer: BCBS Trust/PPO |
$116.11
|
| Rate for Payer: BCN Commercial |
$1,287.66
|
| Rate for Payer: BCN Medicare Advantage |
$742.09
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$1,068.61
|
| Rate for Payer: Cofinity Commercial |
$994.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$742.09
|
| Rate for Payer: Mclaren Medicaid |
$484.15
|
| Rate for Payer: Meridian Medicaid |
$508.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$779.19
|
| Rate for Payer: PACE SWMI |
$742.09
|
| Rate for Payer: PHP Medicare Advantage |
$742.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.41
|
| Rate for Payer: Priority Health Medicare |
$742.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$931.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$742.09
|
| Rate for Payer: UHC Medicare Advantage |
$764.35
|
|
|
PR DERMAL FILLER JUVEDERM ULTRA
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 00087
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: BCBS Complete |
$270.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.50
|
|
|
PR DERMAL FILLER JUVEDERM ULTRA PR PLUS
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 00089
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
|
|
PR DERMAL FILLER JUVEDERM ULTRA PR PLUS >1
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 00090
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: BCBS Complete |
$270.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.50
|
|
|
PR DERMAL FILLER JUVEDERM VOLLURE
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 00118
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
|
|
PR DERMAL FILLER JUVEDERM VOLUMA
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 00091
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$320.00 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: BCBS Complete |
$320.00
|
| Rate for Payer: Cash Price |
$640.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.00
|
|
|
PR DERMAL FILLER RESTYLANE 1/2 UNIT
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 00252
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
|
|
PR DERMAL FILLER RESTYLANE 1 UNIT
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 00253
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$260.00 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
|
|
PR DERMAL FILLER RESTYLANE DEFYNE
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 00360
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
|
|
PR DERMAL FILLER RESTYLANE LYFT
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 00359
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$260.00 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
|
|
PR DERMAL FILLER RESTYLANE REFYNE
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 00361
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
|
|
PR DERMAL FILLER VOLBELLA
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 00092
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
|
|
PR DERMAL FILLER VOLBELLA >1
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 00120
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$490.00 |
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
|
|
PR DESTROY NERVE,CERV SPINAL MUSCLES
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 64613
|
| Min. Negotiated Rate |
$141.60 |
| Max. Negotiated Rate |
$247.80 |
| Rate for Payer: BCBS Complete |
$141.60
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.80
|
|
|
PR DESTRUCTION BENIGN LESIONS 15/>
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 17111
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$562.50 |
| Rate for Payer: Aetna Commercial |
$106.02
|
| Rate for Payer: Aetna Medicare |
$82.28
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$79.12
|
| Rate for Payer: BCBS Trust/PPO |
$562.50
|
| Rate for Payer: BCN Commercial |
$156.28
|
| Rate for Payer: BCN Medicare Advantage |
$79.12
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$113.93
|
| Rate for Payer: Cofinity Commercial |
$106.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.12
|
| Rate for Payer: Mclaren Medicaid |
$53.46
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.08
|
| Rate for Payer: PACE SWMI |
$79.12
|
| Rate for Payer: PHP Medicare Advantage |
$79.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.70
|
| Rate for Payer: Priority Health Medicare |
$79.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.12
|
| Rate for Payer: UHC Medicare Advantage |
$81.49
|
|
|
PR DESTRUCTION BENIGN LESIONS UP TO 14
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
17110
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$109.17 |
| Max. Negotiated Rate |
$161.10 |
| Rate for Payer: Aetna Commercial |
$152.15
|
| Rate for Payer: BCBS Trust/PPO |
$138.33
|
| Rate for Payer: BCN Commercial |
$138.33
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$153.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.20
|
| Rate for Payer: Healthscope Commercial |
$161.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$152.15
|
| Rate for Payer: PHP Commercial |
$152.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.52
|
| Rate for Payer: UHC Core |
$149.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.25
|
|
|
PR DESTRUCTION BENIGN LESIONS UP TO 14
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 17110
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$4,160.00 |
| Rate for Payer: Aetna Commercial |
$86.10
|
| Rate for Payer: Aetna Medicare |
$66.82
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$64.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.00
|
| Rate for Payer: BCN Commercial |
$133.89
|
| Rate for Payer: BCN Medicare Advantage |
$64.25
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$92.52
|
| Rate for Payer: Cofinity Commercial |
$86.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.25
|
| Rate for Payer: Mclaren Medicaid |
$44.09
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.46
|
| Rate for Payer: PACE SWMI |
$64.25
|
| Rate for Payer: PHP Medicare Advantage |
$64.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.20
|
| Rate for Payer: Priority Health Medicare |
$64.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.25
|
| Rate for Payer: UHC Medicare Advantage |
$66.18
|
|
|
PR DESTRUCTION BENIGN LESIONS UP TO 14
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 17110
|
| Hospital Charge Code |
17110
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$4,160.00 |
| Rate for Payer: Aetna Commercial |
$86.10
|
| Rate for Payer: Aetna Medicare |
$66.82
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$64.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.00
|
| Rate for Payer: BCN Commercial |
$133.89
|
| Rate for Payer: BCN Medicare Advantage |
$64.25
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$86.10
|
| Rate for Payer: Cofinity Commercial |
$92.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.25
|
| Rate for Payer: Mclaren Medicaid |
$44.09
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.46
|
| Rate for Payer: PACE SWMI |
$64.25
|
| Rate for Payer: PHP Medicare Advantage |
$64.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.20
|
| Rate for Payer: Priority Health Medicare |
$64.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.25
|
| Rate for Payer: UHC Medicare Advantage |
$66.18
|
|
|
PR DESTRUCTION BENIGN LESIONS UP TO 14
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
17110
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$42.51 |
| Max. Negotiated Rate |
$161.10 |
| Rate for Payer: Aetna Commercial |
$152.15
|
| Rate for Payer: Aetna Medicare |
$46.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.94
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$44.75
|
| Rate for Payer: BCBS Trust/PPO |
$139.17
|
| Rate for Payer: BCN Commercial |
$139.17
|
| Rate for Payer: BCN Medicare Advantage |
$44.75
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$153.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.75
|
| Rate for Payer: Healthscope Commercial |
$161.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.25
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$152.15
|
| Rate for Payer: PACE Senior Care Partners |
$42.51
|
| Rate for Payer: PACE SWMI |
$44.75
|
| Rate for Payer: PHP Commercial |
$152.15
|
| Rate for Payer: PHP Medicare Advantage |
$44.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.73
|
| Rate for Payer: Priority Health Medicare |
$44.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.17
|
| Rate for Payer: Railroad Medicare Medicare |
$44.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.52
|
| Rate for Payer: UHC Core |
$149.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.75
|
| Rate for Payer: UHC Medicare Advantage |
$46.09
|
| Rate for Payer: VA VA |
$44.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.25
|
|
|
PR DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM
|
Professional
|
Both
|
$618.00
|
|
|
Service Code
|
HCPCS 17106
|
| Min. Negotiated Rate |
$177.00 |
| Max. Negotiated Rate |
$947.65 |
| Rate for Payer: Aetna Commercial |
$357.69
|
| Rate for Payer: Aetna Medicare |
$277.61
|
| Rate for Payer: BCBS Complete |
$185.85
|
| Rate for Payer: BCBS MAPPO |
$266.93
|
| Rate for Payer: BCBS Trust/PPO |
$947.65
|
| Rate for Payer: BCN Commercial |
$403.66
|
| Rate for Payer: BCN Medicare Advantage |
$266.93
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cofinity Commercial |
$357.69
|
| Rate for Payer: Cofinity Commercial |
$384.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.93
|
| Rate for Payer: Mclaren Medicaid |
$177.00
|
| Rate for Payer: Meridian Medicaid |
$185.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$280.28
|
| Rate for Payer: PACE SWMI |
$266.93
|
| Rate for Payer: PHP Medicare Advantage |
$266.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.46
|
| Rate for Payer: Priority Health Medicare |
$266.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$337.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.93
|
| Rate for Payer: UHC Medicare Advantage |
$274.94
|
|
