|
PR DRUG SCREEN MULTIP CLASS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS G0431
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$42.70 |
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
|
|
PR DRUG SCREEN PANEL 10 WITH BATH SALTS
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 00124
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
|
|
PR DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS
|
Professional
|
Both
|
$2,386.00
|
|
|
Service Code
|
HCPCS 36838
|
| Min. Negotiated Rate |
$711.42 |
| Max. Negotiated Rate |
$1,774.08 |
| Rate for Payer: Aetna Commercial |
$1,506.75
|
| Rate for Payer: Aetna Medicare |
$1,169.42
|
| Rate for Payer: BCBS Complete |
$746.99
|
| Rate for Payer: BCBS MAPPO |
$1,124.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.13
|
| Rate for Payer: BCN Commercial |
$1,629.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,124.44
|
| Rate for Payer: Cash Price |
$1,908.80
|
| Rate for Payer: Cash Price |
$1,908.80
|
| Rate for Payer: Cofinity Commercial |
$1,619.19
|
| Rate for Payer: Cofinity Commercial |
$1,506.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,124.44
|
| Rate for Payer: Mclaren Medicaid |
$711.42
|
| Rate for Payer: Meridian Medicaid |
$746.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,180.66
|
| Rate for Payer: PACE SWMI |
$1,124.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,124.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,670.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,774.08
|
| Rate for Payer: Priority Health Medicare |
$1,124.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,774.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,124.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,124.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,158.17
|
|
|
PR DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 17107
|
| Min. Negotiated Rate |
$230.25 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Aetna Commercial |
$379.73
|
| Rate for Payer: BCBS Complete |
$241.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,712.50
|
| Rate for Payer: BCN Commercial |
$523.42
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Mclaren Medicaid |
$230.25
|
| Rate for Payer: Meridian Medicaid |
$241.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$437.76
|
|
|
PR DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 17108
|
| Min. Negotiated Rate |
$337.82 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$684.19
|
| Rate for Payer: Aetna Medicare |
$531.01
|
| Rate for Payer: BCBS Complete |
$354.71
|
| Rate for Payer: BCBS MAPPO |
$510.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.00
|
| Rate for Payer: BCN Commercial |
$742.53
|
| Rate for Payer: BCN Medicare Advantage |
$510.59
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$735.25
|
| Rate for Payer: Cofinity Commercial |
$684.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.59
|
| Rate for Payer: Mclaren Medicaid |
$337.82
|
| Rate for Payer: Meridian Medicaid |
$354.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$536.12
|
| Rate for Payer: PACE SWMI |
$510.59
|
| Rate for Payer: PHP Medicare Advantage |
$510.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.46
|
| Rate for Payer: Priority Health Medicare |
$510.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$642.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.59
|
| Rate for Payer: UHC Medicare Advantage |
$525.91
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
OP
|
$848.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$201.40 |
| Max. Negotiated Rate |
$1,933.98 |
| Rate for Payer: Aetna Commercial |
$720.80
|
| Rate for Payer: Aetna Medicare |
$220.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$265.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$265.00
|
| Rate for Payer: BCBS Complete |
$1,933.98
|
| Rate for Payer: BCBS MAPPO |
$212.00
|
| Rate for Payer: BCBS Trust/PPO |
$659.32
|
| Rate for Payer: BCN Commercial |
$659.32
|
| Rate for Payer: BCN Medicare Advantage |
$212.00
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$729.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$678.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.00
|
| Rate for Payer: Healthscope Commercial |
$763.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$636.00
|
| Rate for Payer: Mclaren Medicaid |
$1,841.89
|
| Rate for Payer: Meridian Medicaid |
$1,933.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$222.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$720.80
|
| Rate for Payer: PACE Senior Care Partners |
$201.40
|
| Rate for Payer: PACE SWMI |
$212.00
|
| Rate for Payer: PHP Commercial |
$720.80
|
| Rate for Payer: PHP Medicare Advantage |
$212.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,841.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$737.76
|
| Rate for Payer: Priority Health Medicare |
$212.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$212.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.24
|
| Rate for Payer: UHC Core |
$708.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.00
|
| Rate for Payer: UHC Medicare Advantage |
$218.36
|
| Rate for Payer: VA VA |
$212.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$636.00
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
IP
|
$848.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$517.20 |
| Max. Negotiated Rate |
$763.20 |
| Rate for Payer: Aetna Commercial |
$720.80
|
| Rate for Payer: BCBS Trust/PPO |
$655.33
|
| Rate for Payer: BCN Commercial |
$655.33
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$729.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$678.40
|
| Rate for Payer: Healthscope Commercial |
$763.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$636.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$720.80
|
| Rate for Payer: PHP Commercial |
$720.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$737.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$517.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.24
|
| Rate for Payer: UHC Core |
$708.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$636.00
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
HCPCS 46924
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$237.56
|
| Rate for Payer: Aetna Medicare |
$184.37
|
| Rate for Payer: BCBS Complete |
$122.12
|
| Rate for Payer: BCBS MAPPO |
$177.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$809.25
|
| Rate for Payer: BCN Medicare Advantage |
$177.28
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$255.28
|
| Rate for Payer: Cofinity Commercial |
$237.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.28
|
| Rate for Payer: Mclaren Medicaid |
$116.30
|
| Rate for Payer: Meridian Medicaid |
$122.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.14
|
| Rate for Payer: PACE SWMI |
$177.28
|
| Rate for Payer: PHP Medicare Advantage |
$177.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.91
|
| Rate for Payer: Priority Health Medicare |
$177.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$316.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.28
|
| Rate for Payer: UHC Medicare Advantage |
$182.60
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
HCPCS 46924
|
| Hospital Charge Code |
46924
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$237.56
|
| Rate for Payer: Aetna Medicare |
$184.37
|
| Rate for Payer: BCBS Complete |
$122.12
|
| Rate for Payer: BCBS MAPPO |
$177.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$809.25
|
| Rate for Payer: BCN Medicare Advantage |
$177.28
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$237.56
|
| Rate for Payer: Cofinity Commercial |
$255.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.28
|
| Rate for Payer: Mclaren Medicaid |
$116.30
|
| Rate for Payer: Meridian Medicaid |
$122.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.14
|
| Rate for Payer: PACE SWMI |
$177.28
|
| Rate for Payer: PHP Medicare Advantage |
$177.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.91
|
| Rate for Payer: Priority Health Medicare |
$177.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$316.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.28
|
| Rate for Payer: UHC Medicare Advantage |
$182.60
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 46900
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$179.28
|
| Rate for Payer: Aetna Medicare |
$139.14
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$133.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$133.79
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$192.66
|
| Rate for Payer: Cofinity Commercial |
$179.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.79
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.48
|
| Rate for Payer: PACE SWMI |
$133.79
|
| Rate for Payer: PHP Medicare Advantage |
$133.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.07
|
| Rate for Payer: Priority Health Medicare |
$133.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.79
|
| Rate for Payer: UHC Medicare Advantage |
$137.80
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$89.06 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: Aetna Medicare |
$97.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.19
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$93.75
|
| Rate for Payer: BCBS Trust/PPO |
$291.56
|
| Rate for Payer: BCN Commercial |
$291.56
|
| Rate for Payer: BCN Medicare Advantage |
$93.75
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.75
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PACE Senior Care Partners |
$89.06
|
| Rate for Payer: PACE SWMI |
$93.75
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: PHP Medicare Advantage |
$93.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.25
|
| Rate for Payer: Priority Health Medicare |
$93.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.71
|
| Rate for Payer: Railroad Medicare Medicare |
$93.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.00
|
| Rate for Payer: UHC Core |
$313.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.75
|
| Rate for Payer: UHC Medicare Advantage |
$96.56
|
| Rate for Payer: VA VA |
$93.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$228.71 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: BCBS Trust/PPO |
$289.80
|
| Rate for Payer: BCN Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.00
|
| Rate for Payer: UHC Core |
$313.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$179.28
|
| Rate for Payer: Aetna Medicare |
$139.14
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$133.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$133.79
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$192.66
|
| Rate for Payer: Cofinity Commercial |
$179.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.79
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.48
|
| Rate for Payer: PACE SWMI |
$133.79
|
| Rate for Payer: PHP Medicare Advantage |
$133.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.07
|
| Rate for Payer: Priority Health Medicare |
$133.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.79
|
| Rate for Payer: UHC Medicare Advantage |
$137.80
|
|
|
PR DSTRJ LESION ANUS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 46916
|
| Min. Negotiated Rate |
$91.16 |
| Max. Negotiated Rate |
$1,647.77 |
| Rate for Payer: Aetna Commercial |
$183.79
|
| Rate for Payer: Aetna Medicare |
$142.65
|
| Rate for Payer: BCBS Complete |
$95.72
|
| Rate for Payer: BCBS MAPPO |
$137.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.77
|
| Rate for Payer: BCN Commercial |
$383.13
|
| Rate for Payer: BCN Medicare Advantage |
$137.16
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$197.51
|
| Rate for Payer: Cofinity Commercial |
$183.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.16
|
| Rate for Payer: Mclaren Medicaid |
$91.16
|
| Rate for Payer: Meridian Medicaid |
$95.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.02
|
| Rate for Payer: PACE SWMI |
$137.16
|
| Rate for Payer: PHP Medicare Advantage |
$137.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.12
|
| Rate for Payer: Priority Health Medicare |
$137.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.16
|
| Rate for Payer: UHC Medicare Advantage |
$141.27
|
|
|
PR DSTRJ LESION ANUS SIMPLE LASER SURG
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 46917
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$1,832.14 |
| Rate for Payer: Aetna Commercial |
$169.16
|
| Rate for Payer: Aetna Medicare |
$131.29
|
| Rate for Payer: BCBS Complete |
$87.22
|
| Rate for Payer: BCBS MAPPO |
$126.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.14
|
| Rate for Payer: BCN Commercial |
$659.72
|
| Rate for Payer: BCN Medicare Advantage |
$126.24
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$181.79
|
| Rate for Payer: Cofinity Commercial |
$169.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.24
|
| Rate for Payer: Mclaren Medicaid |
$83.07
|
| Rate for Payer: Meridian Medicaid |
$87.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.55
|
| Rate for Payer: PACE SWMI |
$126.24
|
| Rate for Payer: PHP Medicare Advantage |
$126.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.38
|
| Rate for Payer: Priority Health Medicare |
$126.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.24
|
| Rate for Payer: UHC Medicare Advantage |
$130.03
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
OP
|
$461.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$109.49 |
| Max. Negotiated Rate |
$1,933.98 |
| Rate for Payer: Aetna Commercial |
$391.85
|
| Rate for Payer: Aetna Medicare |
$119.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.06
|
| Rate for Payer: BCBS Complete |
$1,933.98
|
| Rate for Payer: BCBS MAPPO |
$115.25
|
| Rate for Payer: BCBS Trust/PPO |
$358.43
|
| Rate for Payer: BCN Commercial |
$358.43
|
| Rate for Payer: BCN Medicare Advantage |
$115.25
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$396.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.25
|
| Rate for Payer: Healthscope Commercial |
$414.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.75
|
| Rate for Payer: Mclaren Medicaid |
$1,841.89
|
| Rate for Payer: Meridian Medicaid |
$1,933.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$121.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$391.85
|
| Rate for Payer: PACE Senior Care Partners |
$109.49
|
| Rate for Payer: PACE SWMI |
$115.25
|
| Rate for Payer: PHP Commercial |
$391.85
|
| Rate for Payer: PHP Medicare Advantage |
$115.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,841.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$322.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$401.07
|
| Rate for Payer: Priority Health Medicare |
$115.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.16
|
| Rate for Payer: Railroad Medicare Medicare |
$115.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.68
|
| Rate for Payer: UHC Core |
$384.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.25
|
| Rate for Payer: UHC Medicare Advantage |
$118.71
|
| Rate for Payer: VA VA |
$115.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.75
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
IP
|
$461.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$281.16 |
| Max. Negotiated Rate |
$414.90 |
| Rate for Payer: Aetna Commercial |
$391.85
|
| Rate for Payer: BCBS Trust/PPO |
$356.26
|
| Rate for Payer: BCN Commercial |
$356.26
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$396.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.80
|
| Rate for Payer: Healthscope Commercial |
$414.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$391.85
|
| Rate for Payer: PHP Commercial |
$391.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$322.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$401.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.68
|
| Rate for Payer: UHC Core |
$384.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.75
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$507.00
|
|
|
Service Code
|
HCPCS 46922
|
| Hospital Charge Code |
46922
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$181.19
|
| Rate for Payer: Aetna Medicare |
$140.63
|
| Rate for Payer: BCBS Complete |
$93.26
|
| Rate for Payer: BCBS MAPPO |
$135.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: BCN Medicare Advantage |
$135.22
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cofinity Commercial |
$194.72
|
| Rate for Payer: Cofinity Commercial |
$181.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.22
|
| Rate for Payer: Mclaren Medicaid |
$88.82
|
| Rate for Payer: Meridian Medicaid |
$93.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$141.98
|
| Rate for Payer: PACE SWMI |
$135.22
|
| Rate for Payer: PHP Medicare Advantage |
$135.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.83
|
| Rate for Payer: Priority Health Medicare |
$135.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.22
|
| Rate for Payer: UHC Medicare Advantage |
$139.28
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$507.00
|
|
|
Service Code
|
HCPCS 46922
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$181.19
|
| Rate for Payer: Aetna Medicare |
$140.63
|
| Rate for Payer: BCBS Complete |
$93.26
|
| Rate for Payer: BCBS MAPPO |
$135.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: BCN Medicare Advantage |
$135.22
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cofinity Commercial |
$194.72
|
| Rate for Payer: Cofinity Commercial |
$181.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.22
|
| Rate for Payer: Mclaren Medicaid |
$88.82
|
| Rate for Payer: Meridian Medicaid |
$93.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$141.98
|
| Rate for Payer: PACE SWMI |
$135.22
|
| Rate for Payer: PHP Medicare Advantage |
$135.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.83
|
| Rate for Payer: Priority Health Medicare |
$135.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.22
|
| Rate for Payer: UHC Medicare Advantage |
$139.28
|
|
|
PR DSTRJ LESION ANUS SMPL ELTRDSICCATION
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 46910
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$2,583.92 |
| Rate for Payer: Aetna Commercial |
$176.26
|
| Rate for Payer: Aetna Medicare |
$136.80
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$131.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,583.92
|
| Rate for Payer: BCN Commercial |
$387.03
|
| Rate for Payer: BCN Medicare Advantage |
$131.54
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$176.26
|
| Rate for Payer: Cofinity Commercial |
$189.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.54
|
| Rate for Payer: Mclaren Medicaid |
$87.12
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.12
|
| Rate for Payer: PACE SWMI |
$131.54
|
| Rate for Payer: PHP Medicare Advantage |
$131.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.37
|
| Rate for Payer: Priority Health Medicare |
$131.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.54
|
| Rate for Payer: UHC Medicare Advantage |
$135.49
|
|
|
PR DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 42160
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$342.56 |
| Rate for Payer: Aetna Commercial |
$187.22
|
| Rate for Payer: Aetna Medicare |
$145.31
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$139.72
|
| Rate for Payer: BCBS Trust/PPO |
$264.46
|
| Rate for Payer: BCN Commercial |
$342.56
|
| Rate for Payer: BCN Medicare Advantage |
$139.72
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$187.22
|
| Rate for Payer: Cofinity Commercial |
$201.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.72
|
| Rate for Payer: Mclaren Medicaid |
$90.53
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.71
|
| Rate for Payer: PACE SWMI |
$139.72
|
| Rate for Payer: PHP Medicare Advantage |
$139.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.82
|
| Rate for Payer: Priority Health Medicare |
$139.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.72
|
| Rate for Payer: UHC Medicare Advantage |
$143.91
|
|
|
PR DSTRJ LESION PENIS EXTENSIVE
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 54065
|
| Min. Negotiated Rate |
$110.12 |
| Max. Negotiated Rate |
$1,527.84 |
| Rate for Payer: Aetna Commercial |
$222.91
|
| Rate for Payer: Aetna Medicare |
$173.00
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCBS MAPPO |
$166.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.84
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: BCN Medicare Advantage |
$166.35
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$222.91
|
| Rate for Payer: Cofinity Commercial |
$239.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.35
|
| Rate for Payer: Mclaren Medicaid |
$110.12
|
| Rate for Payer: Meridian Medicaid |
$115.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.67
|
| Rate for Payer: PACE SWMI |
$166.35
|
| Rate for Payer: PHP Medicare Advantage |
$166.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.57
|
| Rate for Payer: Priority Health Medicare |
$166.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.35
|
| Rate for Payer: UHC Medicare Advantage |
$171.34
|
|
|
PR DSTRJ LESION PENIS SIMPLE CHEMICAL
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 54050
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$1,664.67 |
| Rate for Payer: Aetna Commercial |
$138.45
|
| Rate for Payer: Aetna Medicare |
$107.45
|
| Rate for Payer: BCBS Complete |
$72.24
|
| Rate for Payer: BCBS MAPPO |
$103.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.67
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: BCN Medicare Advantage |
$103.32
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$138.45
|
| Rate for Payer: Cofinity Commercial |
$148.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.32
|
| Rate for Payer: Mclaren Medicaid |
$68.80
|
| Rate for Payer: Meridian Medicaid |
$72.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.49
|
| Rate for Payer: PACE SWMI |
$103.32
|
| Rate for Payer: PHP Medicare Advantage |
$103.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.37
|
| Rate for Payer: Priority Health Medicare |
$103.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.32
|
| Rate for Payer: UHC Medicare Advantage |
$106.42
|
|
|
PR DSTRJ LESION PENIS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 54056
|
| Min. Negotiated Rate |
$71.99 |
| Max. Negotiated Rate |
$1,380.45 |
| Rate for Payer: Aetna Commercial |
$143.61
|
| Rate for Payer: Aetna Medicare |
$111.46
|
| Rate for Payer: BCBS Complete |
$75.59
|
| Rate for Payer: BCBS MAPPO |
$107.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.45
|
| Rate for Payer: BCN Commercial |
$169.24
|
| Rate for Payer: BCN Medicare Advantage |
$107.17
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$154.32
|
| Rate for Payer: Cofinity Commercial |
$143.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.17
|
| Rate for Payer: Mclaren Medicaid |
$71.99
|
| Rate for Payer: Meridian Medicaid |
$75.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.53
|
| Rate for Payer: PACE SWMI |
$107.17
|
| Rate for Payer: PHP Medicare Advantage |
$107.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.41
|
| Rate for Payer: Priority Health Medicare |
$107.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.17
|
| Rate for Payer: UHC Medicare Advantage |
$110.39
|
|
|
PR DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 54055
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$1,009.58 |
| Rate for Payer: Aetna Commercial |
$124.63
|
| Rate for Payer: Aetna Medicare |
$96.73
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$93.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
| Rate for Payer: BCN Commercial |
$201.34
|
| Rate for Payer: BCN Medicare Advantage |
$93.01
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$124.63
|
| Rate for Payer: Cofinity Commercial |
$133.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.01
|
| Rate for Payer: Mclaren Medicaid |
$61.77
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.66
|
| Rate for Payer: PACE SWMI |
$93.01
|
| Rate for Payer: PHP Medicare Advantage |
$93.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.55
|
| Rate for Payer: Priority Health Medicare |
$93.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.01
|
| Rate for Payer: UHC Medicare Advantage |
$95.80
|
|
