PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
OP
|
$1,031.00
|
|
Service Code
|
CPT 19120
|
Hospital Charge Code |
19120
|
Hospital Revenue Code
|
960
|
Min. Negotiated Rate |
$244.86 |
Max. Negotiated Rate |
$2,625.49 |
Rate for Payer: Aetna Commercial |
$876.35
|
Rate for Payer: Aetna Medicare |
$268.06
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.19
|
Rate for Payer: Amish Plain Church Group Commercial |
$322.19
|
Rate for Payer: BCBS Complete |
$2,625.49
|
Rate for Payer: BCBS MAPPO |
$257.75
|
Rate for Payer: BCBS Trust/PPO |
$801.60
|
Rate for Payer: BCCCP Commercial |
$559.44
|
Rate for Payer: BCN Commercial |
$801.60
|
Rate for Payer: BCN Medicare Advantage |
$257.75
|
Rate for Payer: Cash Price |
$824.80
|
Rate for Payer: Cash Price |
$824.80
|
Rate for Payer: Cofinity Commercial |
$886.66
|
Rate for Payer: Encore Health Key Benefits Commercial |
$824.80
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.75
|
Rate for Payer: Healthscope Commercial |
$927.90
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.25
|
Rate for Payer: Mclaren Medicaid |
$2,500.47
|
Rate for Payer: Meridian Medicaid |
$2,625.49
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.64
|
Rate for Payer: MI Amish Medical Board Commercial |
$296.41
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$876.35
|
Rate for Payer: PACE Senior Care Partners |
$244.86
|
Rate for Payer: PACE SWMI |
$257.75
|
Rate for Payer: PHP Commercial |
$876.35
|
Rate for Payer: PHP Medicare Advantage |
$257.75
|
Rate for Payer: Priority Health Choice Medicaid |
$2,500.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$721.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.97
|
Rate for Payer: Priority Health Medicare |
$257.75
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$628.81
|
Rate for Payer: Railroad Medicare Medicare |
$257.75
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$907.28
|
Rate for Payer: UHC Core |
$860.88
|
Rate for Payer: UHC Dual Complete DSNP |
$257.75
|
Rate for Payer: UHC Medicare Advantage |
$265.48
|
Rate for Payer: VA VA |
$257.75
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.25
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,031.00
|
|
Service Code
|
HCPCS 19120
|
Min. Negotiated Rate |
$269.66 |
Max. Negotiated Rate |
$762.83 |
Rate for Payer: Aetna Commercial |
$553.46
|
Rate for Payer: Aetna Medicare |
$429.55
|
Rate for Payer: BCBS Complete |
$283.14
|
Rate for Payer: BCBS MAPPO |
$413.03
|
Rate for Payer: BCBS Trust/PPO |
$540.00
|
Rate for Payer: BCN Commercial |
$762.83
|
Rate for Payer: BCN Medicare Advantage |
$413.03
|
Rate for Payer: Cash Price |
$824.80
|
Rate for Payer: Cash Price |
$824.80
|
Rate for Payer: Cofinity Commercial |
$594.76
|
Rate for Payer: Cofinity Commercial |
$553.46
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.03
|
Rate for Payer: Mclaren Medicaid |
$269.66
|
Rate for Payer: Meridian Medicaid |
$283.14
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$433.68
|
Rate for Payer: PACE SWMI |
$413.03
|
Rate for Payer: PHP Medicare Advantage |
$413.03
|
Rate for Payer: Priority Health Choice Medicaid |
$269.66
|
Rate for Payer: Priority Health Cigna Priority Health |
$721.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.45
|
Rate for Payer: Priority Health Medicare |
$413.03
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$515.45
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$413.03
|
Rate for Payer: UHC Dual Complete DSNP |
$413.03
|
Rate for Payer: UHC Medicare Advantage |
$425.42
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
IP
|
$1,031.00
|
|
Service Code
|
CPT 19120
|
Hospital Charge Code |
19120
|
Hospital Revenue Code
|
960
|
Min. Negotiated Rate |
$628.81 |
Max. Negotiated Rate |
$927.90 |
Rate for Payer: Aetna Commercial |
$876.35
|
Rate for Payer: BCBS Trust/PPO |
$796.76
|
Rate for Payer: BCN Commercial |
$796.76
|
Rate for Payer: Cash Price |
$824.80
|
Rate for Payer: Cofinity Commercial |
$886.66
|
Rate for Payer: Encore Health Key Benefits Commercial |
$824.80
|
Rate for Payer: Healthscope Commercial |
$927.90
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$876.35
|
Rate for Payer: PHP Commercial |
$876.35
|
Rate for Payer: Priority Health Cigna Priority Health |
$721.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$628.81
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$907.28
|
Rate for Payer: UHC Core |
$860.88
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.25
|
|
PR EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS
|
Professional
|
Both
|
$1,383.00
|
|
Service Code
|
HCPCS 60200
|
Min. Negotiated Rate |
$217.13 |
Max. Negotiated Rate |
$981.75 |
Rate for Payer: Aetna Commercial |
$886.62
|
Rate for Payer: Aetna Medicare |
$688.13
|
Rate for Payer: BCBS Complete |
$451.99
|
Rate for Payer: BCBS MAPPO |
$661.66
|
Rate for Payer: BCBS Trust/PPO |
$217.13
|
Rate for Payer: BCN Commercial |
$981.75
|
Rate for Payer: BCN Medicare Advantage |
$661.66
|
Rate for Payer: Cash Price |
$1,106.40
|
Rate for Payer: Cash Price |
$1,106.40
|
Rate for Payer: Cofinity Commercial |
$886.62
|
Rate for Payer: Cofinity Commercial |
$952.79
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.66
|
Rate for Payer: Mclaren Medicaid |
$430.47
|
Rate for Payer: Meridian Medicaid |
$451.99
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$694.74
|
Rate for Payer: PACE SWMI |
$661.66
|
Rate for Payer: PHP Medicare Advantage |
$661.66
|
Rate for Payer: Priority Health Choice Medicaid |
$430.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$968.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.54
|
Rate for Payer: Priority Health Medicare |
$661.66
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$950.54
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$661.66
|
Rate for Payer: UHC Dual Complete DSNP |
$661.66
|
Rate for Payer: UHC Medicare Advantage |
$681.51
|
|
PR EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM
|
Professional
|
Both
|
$3,892.00
|
|
Service Code
|
HCPCS 49204
|
Min. Negotiated Rate |
$624.45 |
Max. Negotiated Rate |
$2,724.40 |
Rate for Payer: Aetna Commercial |
$2,023.68
|
Rate for Payer: Aetna Medicare |
$1,570.62
|
Rate for Payer: BCBS Complete |
$1,021.41
|
Rate for Payer: BCBS MAPPO |
$1,510.21
|
Rate for Payer: BCBS Trust/PPO |
$624.45
|
Rate for Payer: BCN Commercial |
$2,216.64
|
Rate for Payer: BCN Medicare Advantage |
$1,510.21
|
Rate for Payer: Cash Price |
$3,113.60
|
Rate for Payer: Cash Price |
$3,113.60
|
Rate for Payer: Cofinity Commercial |
$2,174.70
|
Rate for Payer: Cofinity Commercial |
$2,023.68
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,510.21
|
Rate for Payer: Mclaren Medicaid |
$972.77
|
Rate for Payer: Meridian Medicaid |
$1,021.41
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,585.72
|
Rate for Payer: PACE SWMI |
$1,510.21
|
Rate for Payer: PHP Medicare Advantage |
$1,510.21
|
Rate for Payer: Priority Health Choice Medicaid |
$972.77
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,724.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,667.04
|
Rate for Payer: Priority Health Medicare |
$1,510.21
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,667.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,510.21
|
Rate for Payer: UHC Dual Complete DSNP |
$1,510.21
|
Rate for Payer: UHC Medicare Advantage |
$1,555.52
|
|
PR EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM
|
Professional
|
Both
|
$3,145.00
|
|
Service Code
|
HCPCS 49205
|
Min. Negotiated Rate |
$366.64 |
Max. Negotiated Rate |
$3,061.58 |
Rate for Payer: Aetna Commercial |
$2,324.24
|
Rate for Payer: Aetna Medicare |
$1,803.89
|
Rate for Payer: BCBS Complete |
$1,171.71
|
Rate for Payer: BCBS MAPPO |
$1,734.51
|
Rate for Payer: BCBS Trust/PPO |
$366.64
|
Rate for Payer: BCN Commercial |
$2,544.55
|
Rate for Payer: BCN Medicare Advantage |
$1,734.51
|
Rate for Payer: Cash Price |
$2,516.00
|
Rate for Payer: Cash Price |
$2,516.00
|
Rate for Payer: Cofinity Commercial |
$2,497.69
|
Rate for Payer: Cofinity Commercial |
$2,324.24
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,734.51
|
Rate for Payer: Mclaren Medicaid |
$1,115.91
|
Rate for Payer: Meridian Medicaid |
$1,171.71
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,821.24
|
Rate for Payer: PACE SWMI |
$1,734.51
|
Rate for Payer: PHP Medicare Advantage |
$1,734.51
|
Rate for Payer: Priority Health Choice Medicaid |
$1,115.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,201.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,061.58
|
Rate for Payer: Priority Health Medicare |
$1,734.51
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3,061.58
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,734.51
|
Rate for Payer: UHC Dual Complete DSNP |
$1,734.51
|
Rate for Payer: UHC Medicare Advantage |
$1,786.55
|
|
PR EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX
|
Professional
|
Both
|
$1,030.00
|
|
Service Code
|
HCPCS 42870
|
Min. Negotiated Rate |
$377.65 |
Max. Negotiated Rate |
$1,046.00 |
Rate for Payer: Aetna Commercial |
$764.15
|
Rate for Payer: Aetna Medicare |
$593.07
|
Rate for Payer: BCBS Complete |
$396.53
|
Rate for Payer: BCBS MAPPO |
$570.26
|
Rate for Payer: BCBS Trust/PPO |
$829.43
|
Rate for Payer: BCN Commercial |
$869.36
|
Rate for Payer: BCN Medicare Advantage |
$570.26
|
Rate for Payer: Cash Price |
$824.00
|
Rate for Payer: Cash Price |
$824.00
|
Rate for Payer: Cofinity Commercial |
$821.17
|
Rate for Payer: Cofinity Commercial |
$764.15
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.26
|
Rate for Payer: Mclaren Medicaid |
$377.65
|
Rate for Payer: Meridian Medicaid |
$396.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$598.77
|
Rate for Payer: PACE SWMI |
$570.26
|
Rate for Payer: PHP Medicare Advantage |
$570.26
|
Rate for Payer: Priority Health Choice Medicaid |
$377.65
|
Rate for Payer: Priority Health Cigna Priority Health |
$721.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.00
|
Rate for Payer: Priority Health Medicare |
$570.26
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,046.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$570.26
|
Rate for Payer: UHC Dual Complete DSNP |
$570.26
|
Rate for Payer: UHC Medicare Advantage |
$587.37
|
|
PR EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F
|
Professional
|
Both
|
$2,599.00
|
|
Service Code
|
HCPCS 26390
|
Min. Negotiated Rate |
$153.74 |
Max. Negotiated Rate |
$1,819.30 |
Rate for Payer: Aetna Commercial |
$1,155.70
|
Rate for Payer: Aetna Medicare |
$896.96
|
Rate for Payer: BCBS Complete |
$595.80
|
Rate for Payer: BCBS MAPPO |
$862.46
|
Rate for Payer: BCBS Trust/PPO |
$153.74
|
Rate for Payer: BCN Commercial |
$1,303.31
|
Rate for Payer: BCN Medicare Advantage |
$862.46
|
Rate for Payer: Cash Price |
$2,079.20
|
Rate for Payer: Cash Price |
$2,079.20
|
Rate for Payer: Cofinity Commercial |
$1,241.94
|
Rate for Payer: Cofinity Commercial |
$1,155.70
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.46
|
Rate for Payer: Mclaren Medicaid |
$567.43
|
Rate for Payer: Meridian Medicaid |
$595.80
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$905.58
|
Rate for Payer: PACE SWMI |
$862.46
|
Rate for Payer: PHP Medicare Advantage |
$862.46
|
Rate for Payer: Priority Health Choice Medicaid |
$567.43
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,819.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,361.90
|
Rate for Payer: Priority Health Medicare |
$862.46
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,361.90
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$862.46
|
Rate for Payer: UHC Dual Complete DSNP |
$862.46
|
Rate for Payer: UHC Medicare Advantage |
$888.33
|
|
PR EXC FRENUM LABIAL/BUCCAL
|
Professional
|
Both
|
$500.00
|
|
Service Code
|
HCPCS 40819
|
Min. Negotiated Rate |
$128.01 |
Max. Negotiated Rate |
$760.22 |
Rate for Payer: Aetna Commercial |
$257.17
|
Rate for Payer: Aetna Medicare |
$199.60
|
Rate for Payer: BCBS Complete |
$134.41
|
Rate for Payer: BCBS MAPPO |
$191.92
|
Rate for Payer: BCBS Trust/PPO |
$760.22
|
Rate for Payer: BCN Commercial |
$394.36
|
Rate for Payer: BCN Medicare Advantage |
$191.92
|
Rate for Payer: Cash Price |
$400.00
|
Rate for Payer: Cash Price |
$400.00
|
Rate for Payer: Cofinity Commercial |
$276.36
|
Rate for Payer: Cofinity Commercial |
$257.17
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.92
|
Rate for Payer: Mclaren Medicaid |
$128.01
|
Rate for Payer: Meridian Medicaid |
$134.41
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.52
|
Rate for Payer: PACE SWMI |
$191.92
|
Rate for Payer: PHP Medicare Advantage |
$191.92
|
Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.67
|
Rate for Payer: Priority Health Medicare |
$191.92
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$348.67
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$191.92
|
Rate for Payer: UHC Dual Complete DSNP |
$191.92
|
Rate for Payer: UHC Medicare Advantage |
$197.68
|
|
PR EXC/FULGURATION URETHRAL CARUNCLE
|
Professional
|
Both
|
$404.00
|
|
Service Code
|
HCPCS 53265
|
Min. Negotiated Rate |
$120.77 |
Max. Negotiated Rate |
$1,099.39 |
Rate for Payer: Aetna Commercial |
$248.60
|
Rate for Payer: Aetna Medicare |
$192.94
|
Rate for Payer: BCBS Complete |
$126.81
|
Rate for Payer: BCBS MAPPO |
$185.52
|
Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
Rate for Payer: BCN Commercial |
$334.26
|
Rate for Payer: BCN Medicare Advantage |
$185.52
|
Rate for Payer: Cash Price |
$323.20
|
Rate for Payer: Cash Price |
$323.20
|
Rate for Payer: Cofinity Commercial |
$267.15
|
Rate for Payer: Cofinity Commercial |
$248.60
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.52
|
Rate for Payer: Mclaren Medicaid |
$120.77
|
Rate for Payer: Meridian Medicaid |
$126.81
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$194.80
|
Rate for Payer: PACE SWMI |
$185.52
|
Rate for Payer: PHP Medicare Advantage |
$185.52
|
Rate for Payer: Priority Health Choice Medicaid |
$120.77
|
Rate for Payer: Priority Health Cigna Priority Health |
$282.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.69
|
Rate for Payer: Priority Health Medicare |
$185.52
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$303.69
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$185.52
|
Rate for Payer: UHC Dual Complete DSNP |
$185.52
|
Rate for Payer: UHC Medicare Advantage |
$191.09
|
|
PR EXC/FULGURATION URETHRAL POLYP DSTL URETHRA
|
Professional
|
Both
|
$270.00
|
|
Service Code
|
HCPCS 53260
|
Min. Negotiated Rate |
$116.09 |
Max. Negotiated Rate |
$546.26 |
Rate for Payer: Aetna Commercial |
$238.29
|
Rate for Payer: Aetna Medicare |
$184.94
|
Rate for Payer: BCBS Complete |
$121.89
|
Rate for Payer: BCBS MAPPO |
$177.83
|
Rate for Payer: BCBS Trust/PPO |
$546.26
|
Rate for Payer: BCN Commercial |
$302.00
|
Rate for Payer: BCN Medicare Advantage |
$177.83
|
Rate for Payer: Cash Price |
$216.00
|
Rate for Payer: Cash Price |
$216.00
|
Rate for Payer: Cofinity Commercial |
$238.29
|
Rate for Payer: Cofinity Commercial |
$256.08
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.83
|
Rate for Payer: Mclaren Medicaid |
$116.09
|
Rate for Payer: Meridian Medicaid |
$121.89
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.72
|
Rate for Payer: PACE SWMI |
$177.83
|
Rate for Payer: PHP Medicare Advantage |
$177.83
|
Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
Rate for Payer: Priority Health Cigna Priority Health |
$189.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.25
|
Rate for Payer: Priority Health Medicare |
$177.83
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$291.25
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$177.83
|
Rate for Payer: UHC Dual Complete DSNP |
$177.83
|
Rate for Payer: UHC Medicare Advantage |
$183.16
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,249.00
|
|
Service Code
|
HCPCS 49423
|
Min. Negotiated Rate |
$43.88 |
Max. Negotiated Rate |
$1,009.05 |
Rate for Payer: Aetna Commercial |
$93.22
|
Rate for Payer: Aetna Medicare |
$72.35
|
Rate for Payer: BCBS Complete |
$46.07
|
Rate for Payer: BCBS MAPPO |
$69.57
|
Rate for Payer: BCBS Trust/PPO |
$1,009.05
|
Rate for Payer: BCN Commercial |
$875.23
|
Rate for Payer: BCN Medicare Advantage |
$69.57
|
Rate for Payer: Cash Price |
$999.20
|
Rate for Payer: Cash Price |
$999.20
|
Rate for Payer: Cofinity Commercial |
$93.22
|
Rate for Payer: Cofinity Commercial |
$100.18
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.57
|
Rate for Payer: Mclaren Medicaid |
$43.88
|
Rate for Payer: Meridian Medicaid |
$46.07
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.05
|
Rate for Payer: PACE SWMI |
$69.57
|
Rate for Payer: PHP Medicare Advantage |
$69.57
|
Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
Rate for Payer: Priority Health Cigna Priority Health |
$874.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.31
|
Rate for Payer: Priority Health Medicare |
$69.57
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$122.31
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$69.57
|
Rate for Payer: UHC Dual Complete DSNP |
$69.57
|
Rate for Payer: UHC Medicare Advantage |
$71.66
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$711.00
|
|
Service Code
|
HCPCS 55500
|
Min. Negotiated Rate |
$251.55 |
Max. Negotiated Rate |
$2,419.09 |
Rate for Payer: Aetna Commercial |
$515.12
|
Rate for Payer: Aetna Medicare |
$399.80
|
Rate for Payer: BCBS Complete |
$264.13
|
Rate for Payer: BCBS MAPPO |
$384.42
|
Rate for Payer: BCBS Trust/PPO |
$2,419.09
|
Rate for Payer: BCN Commercial |
$570.77
|
Rate for Payer: BCN Medicare Advantage |
$384.42
|
Rate for Payer: Cash Price |
$568.80
|
Rate for Payer: Cash Price |
$568.80
|
Rate for Payer: Cofinity Commercial |
$553.56
|
Rate for Payer: Cofinity Commercial |
$515.12
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.42
|
Rate for Payer: Mclaren Medicaid |
$251.55
|
Rate for Payer: Meridian Medicaid |
$264.13
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.64
|
Rate for Payer: PACE SWMI |
$384.42
|
Rate for Payer: PHP Medicare Advantage |
$384.42
|
Rate for Payer: Priority Health Choice Medicaid |
$251.55
|
Rate for Payer: Priority Health Cigna Priority Health |
$497.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$631.13
|
Rate for Payer: Priority Health Medicare |
$384.42
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$631.13
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$384.42
|
Rate for Payer: UHC Dual Complete DSNP |
$384.42
|
Rate for Payer: UHC Medicare Advantage |
$395.95
|
|
PR EXC ILEOANAL RSVR W/ILEOSTOMY
|
Professional
|
Both
|
$3,190.00
|
|
Service Code
|
HCPCS 45136
|
Min. Negotiated Rate |
$1,129.33 |
Max. Negotiated Rate |
$3,106.85 |
Rate for Payer: Aetna Commercial |
$2,340.91
|
Rate for Payer: Aetna Medicare |
$1,816.83
|
Rate for Payer: BCBS Complete |
$1,185.80
|
Rate for Payer: BCBS MAPPO |
$1,746.95
|
Rate for Payer: BCBS Trust/PPO |
$1,476.07
|
Rate for Payer: BCN Commercial |
$2,582.17
|
Rate for Payer: BCN Medicare Advantage |
$1,746.95
|
Rate for Payer: Cash Price |
$2,552.00
|
Rate for Payer: Cash Price |
$2,552.00
|
Rate for Payer: Cofinity Commercial |
$2,340.91
|
Rate for Payer: Cofinity Commercial |
$2,515.61
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,746.95
|
Rate for Payer: Mclaren Medicaid |
$1,129.33
|
Rate for Payer: Meridian Medicaid |
$1,185.80
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,834.30
|
Rate for Payer: PACE SWMI |
$1,746.95
|
Rate for Payer: PHP Medicare Advantage |
$1,746.95
|
Rate for Payer: Priority Health Choice Medicaid |
$1,129.33
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,233.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,106.85
|
Rate for Payer: Priority Health Medicare |
$1,746.95
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3,106.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,746.95
|
Rate for Payer: UHC Dual Complete DSNP |
$1,746.95
|
Rate for Payer: UHC Medicare Advantage |
$1,799.36
|
|
PR EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,305.90
|
|
Service Code
|
HCPCS 33120
|
Min. Negotiated Rate |
$1,008.52 |
Max. Negotiated Rate |
$3,256.64 |
Rate for Payer: Aetna Commercial |
$2,754.75
|
Rate for Payer: Aetna Medicare |
$2,138.01
|
Rate for Payer: BCBS Complete |
$1,374.56
|
Rate for Payer: BCBS MAPPO |
$2,055.78
|
Rate for Payer: BCBS Trust/PPO |
$1,008.52
|
Rate for Payer: BCN Commercial |
$2,991.68
|
Rate for Payer: BCN Medicare Advantage |
$2,055.78
|
Rate for Payer: Cash Price |
$3,444.72
|
Rate for Payer: Cash Price |
$3,444.72
|
Rate for Payer: Cofinity Commercial |
$2,754.75
|
Rate for Payer: Cofinity Commercial |
$2,960.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.78
|
Rate for Payer: Mclaren Medicaid |
$1,309.10
|
Rate for Payer: Meridian Medicaid |
$1,374.56
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,158.57
|
Rate for Payer: PACE SWMI |
$2,055.78
|
Rate for Payer: PHP Medicare Advantage |
$2,055.78
|
Rate for Payer: Priority Health Choice Medicaid |
$1,309.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,014.13
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,256.64
|
Rate for Payer: Priority Health Medicare |
$2,055.78
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3,256.64
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,055.78
|
Rate for Payer: UHC Dual Complete DSNP |
$2,055.78
|
Rate for Payer: UHC Medicare Advantage |
$2,117.45
|
|
PR EXCIS CHEST WALL TUMOR/RIBS
|
Professional
|
Both
|
$2,221.00
|
|
Service Code
|
HCPCS 19260
|
Min. Negotiated Rate |
$888.40 |
Max. Negotiated Rate |
$1,554.70 |
Rate for Payer: BCBS Complete |
$888.40
|
Rate for Payer: Cash Price |
$1,776.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,554.70
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,224.00
|
|
Service Code
|
HCPCS 15940
|
Min. Negotiated Rate |
$455.39 |
Max. Negotiated Rate |
$1,038.93 |
Rate for Payer: Aetna Commercial |
$936.87
|
Rate for Payer: Aetna Medicare |
$727.13
|
Rate for Payer: BCBS Complete |
$478.16
|
Rate for Payer: BCBS MAPPO |
$699.16
|
Rate for Payer: BCBS Trust/PPO |
$540.00
|
Rate for Payer: BCN Commercial |
$1,038.93
|
Rate for Payer: BCN Medicare Advantage |
$699.16
|
Rate for Payer: Cash Price |
$979.20
|
Rate for Payer: Cash Price |
$979.20
|
Rate for Payer: Cofinity Commercial |
$936.87
|
Rate for Payer: Cofinity Commercial |
$1,006.79
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.16
|
Rate for Payer: Mclaren Medicaid |
$455.39
|
Rate for Payer: Meridian Medicaid |
$478.16
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$734.12
|
Rate for Payer: PACE SWMI |
$699.16
|
Rate for Payer: PHP Medicare Advantage |
$699.16
|
Rate for Payer: Priority Health Choice Medicaid |
$455.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$856.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$873.87
|
Rate for Payer: Priority Health Medicare |
$699.16
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$873.87
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$699.16
|
Rate for Payer: UHC Dual Complete DSNP |
$699.16
|
Rate for Payer: UHC Medicare Advantage |
$720.13
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,585.00
|
|
Service Code
|
HCPCS 15944
|
Min. Negotiated Rate |
$598.96 |
Max. Negotiated Rate |
$2,275.40 |
Rate for Payer: Aetna Commercial |
$1,226.25
|
Rate for Payer: Aetna Medicare |
$951.71
|
Rate for Payer: BCBS Complete |
$628.91
|
Rate for Payer: BCBS MAPPO |
$915.11
|
Rate for Payer: BCBS Trust/PPO |
$2,275.40
|
Rate for Payer: BCN Commercial |
$1,369.28
|
Rate for Payer: BCN Medicare Advantage |
$915.11
|
Rate for Payer: Cash Price |
$1,268.00
|
Rate for Payer: Cash Price |
$1,268.00
|
Rate for Payer: Cofinity Commercial |
$1,317.76
|
Rate for Payer: Cofinity Commercial |
$1,226.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$915.11
|
Rate for Payer: Mclaren Medicaid |
$598.96
|
Rate for Payer: Meridian Medicaid |
$628.91
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$960.87
|
Rate for Payer: PACE SWMI |
$915.11
|
Rate for Payer: PHP Medicare Advantage |
$915.11
|
Rate for Payer: Priority Health Choice Medicaid |
$598.96
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,109.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,151.73
|
Rate for Payer: Priority Health Medicare |
$915.11
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,151.73
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$915.11
|
Rate for Payer: UHC Dual Complete DSNP |
$915.11
|
Rate for Payer: UHC Medicare Advantage |
$942.56
|
|
PR EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$3,286.00
|
|
Service Code
|
HCPCS 15946
|
Min. Negotiated Rate |
$1,029.64 |
Max. Negotiated Rate |
$2,363.25 |
Rate for Payer: Aetna Commercial |
$2,133.00
|
Rate for Payer: Aetna Medicare |
$1,655.46
|
Rate for Payer: BCBS Complete |
$1,081.12
|
Rate for Payer: BCBS MAPPO |
$1,591.79
|
Rate for Payer: BCBS Trust/PPO |
$1,664.35
|
Rate for Payer: BCN Commercial |
$2,363.25
|
Rate for Payer: BCN Medicare Advantage |
$1,591.79
|
Rate for Payer: Cash Price |
$2,628.80
|
Rate for Payer: Cash Price |
$2,628.80
|
Rate for Payer: Cofinity Commercial |
$2,292.18
|
Rate for Payer: Cofinity Commercial |
$2,133.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,591.79
|
Rate for Payer: Mclaren Medicaid |
$1,029.64
|
Rate for Payer: Meridian Medicaid |
$1,081.12
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,671.38
|
Rate for Payer: PACE SWMI |
$1,591.79
|
Rate for Payer: PHP Medicare Advantage |
$1,591.79
|
Rate for Payer: Priority Health Choice Medicaid |
$1,029.64
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,300.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,987.78
|
Rate for Payer: Priority Health Medicare |
$1,591.79
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,987.78
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,591.79
|
Rate for Payer: UHC Dual Complete DSNP |
$1,591.79
|
Rate for Payer: UHC Medicare Advantage |
$1,639.54
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,584.00
|
|
Service Code
|
HCPCS 15941
|
Min. Negotiated Rate |
$562.50 |
Max. Negotiated Rate |
$1,372.69 |
Rate for Payer: Aetna Commercial |
$1,230.67
|
Rate for Payer: Aetna Medicare |
$955.15
|
Rate for Payer: BCBS Complete |
$624.88
|
Rate for Payer: BCBS MAPPO |
$918.41
|
Rate for Payer: BCBS Trust/PPO |
$562.50
|
Rate for Payer: BCN Commercial |
$1,372.69
|
Rate for Payer: BCN Medicare Advantage |
$918.41
|
Rate for Payer: Cash Price |
$1,267.20
|
Rate for Payer: Cash Price |
$1,267.20
|
Rate for Payer: Cofinity Commercial |
$1,322.51
|
Rate for Payer: Cofinity Commercial |
$1,230.67
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.41
|
Rate for Payer: Mclaren Medicaid |
$595.12
|
Rate for Payer: Meridian Medicaid |
$624.88
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$964.33
|
Rate for Payer: PACE SWMI |
$918.41
|
Rate for Payer: PHP Medicare Advantage |
$918.41
|
Rate for Payer: Priority Health Choice Medicaid |
$595.12
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,108.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.61
|
Rate for Payer: Priority Health Medicare |
$918.41
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,154.61
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$918.41
|
Rate for Payer: UHC Dual Complete DSNP |
$918.41
|
Rate for Payer: UHC Medicare Advantage |
$945.96
|
|
PR EXCISION 1ST &/CERVICAL RIB
|
Professional
|
Both
|
$1,178.00
|
|
Service Code
|
HCPCS 21615
|
Min. Negotiated Rate |
$397.46 |
Max. Negotiated Rate |
$3,350.93 |
Rate for Payer: Aetna Commercial |
$826.53
|
Rate for Payer: Aetna Medicare |
$641.48
|
Rate for Payer: BCBS Complete |
$417.33
|
Rate for Payer: BCBS MAPPO |
$616.81
|
Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
Rate for Payer: BCN Commercial |
$904.54
|
Rate for Payer: BCN Medicare Advantage |
$616.81
|
Rate for Payer: Cash Price |
$942.40
|
Rate for Payer: Cash Price |
$942.40
|
Rate for Payer: Cofinity Commercial |
$888.21
|
Rate for Payer: Cofinity Commercial |
$826.53
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.81
|
Rate for Payer: Mclaren Medicaid |
$397.46
|
Rate for Payer: Meridian Medicaid |
$417.33
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$647.65
|
Rate for Payer: PACE SWMI |
$616.81
|
Rate for Payer: PHP Medicare Advantage |
$616.81
|
Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$824.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$945.21
|
Rate for Payer: Priority Health Medicare |
$616.81
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$945.21
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$616.81
|
Rate for Payer: UHC Dual Complete DSNP |
$616.81
|
Rate for Payer: UHC Medicare Advantage |
$635.31
|
|
PR EXCISION AMPULLA VATER
|
Professional
|
Both
|
$1,811.00
|
|
Service Code
|
HCPCS 48148
|
Min. Negotiated Rate |
$800.24 |
Max. Negotiated Rate |
$2,199.61 |
Rate for Payer: Aetna Commercial |
$1,668.33
|
Rate for Payer: Aetna Medicare |
$1,294.82
|
Rate for Payer: BCBS Complete |
$840.25
|
Rate for Payer: BCBS MAPPO |
$1,245.02
|
Rate for Payer: BCBS Trust/PPO |
$1,258.41
|
Rate for Payer: BCN Commercial |
$1,828.14
|
Rate for Payer: BCN Medicare Advantage |
$1,245.02
|
Rate for Payer: Cash Price |
$1,448.80
|
Rate for Payer: Cash Price |
$1,448.80
|
Rate for Payer: Cofinity Commercial |
$1,792.83
|
Rate for Payer: Cofinity Commercial |
$1,668.33
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,245.02
|
Rate for Payer: Mclaren Medicaid |
$800.24
|
Rate for Payer: Meridian Medicaid |
$840.25
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,307.27
|
Rate for Payer: PACE SWMI |
$1,245.02
|
Rate for Payer: PHP Medicare Advantage |
$1,245.02
|
Rate for Payer: Priority Health Choice Medicaid |
$800.24
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,267.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,199.61
|
Rate for Payer: Priority Health Medicare |
$1,245.02
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,199.61
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,245.02
|
Rate for Payer: UHC Dual Complete DSNP |
$1,245.02
|
Rate for Payer: UHC Medicare Advantage |
$1,282.37
|
|
PR EXCISION AURAL POLYP
|
Professional
|
Both
|
$369.00
|
|
Service Code
|
HCPCS 69540
|
Min. Negotiated Rate |
$84.14 |
Max. Negotiated Rate |
$2,401.65 |
Rate for Payer: Aetna Commercial |
$169.46
|
Rate for Payer: Aetna Medicare |
$131.52
|
Rate for Payer: BCBS Complete |
$88.35
|
Rate for Payer: BCBS MAPPO |
$126.46
|
Rate for Payer: BCBS Trust/PPO |
$2,401.65
|
Rate for Payer: BCN Commercial |
$313.73
|
Rate for Payer: BCN Medicare Advantage |
$126.46
|
Rate for Payer: Cash Price |
$295.20
|
Rate for Payer: Cash Price |
$295.20
|
Rate for Payer: Cofinity Commercial |
$169.46
|
Rate for Payer: Cofinity Commercial |
$182.10
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.46
|
Rate for Payer: Mclaren Medicaid |
$84.14
|
Rate for Payer: Meridian Medicaid |
$88.35
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.78
|
Rate for Payer: PACE SWMI |
$126.46
|
Rate for Payer: PHP Medicare Advantage |
$126.46
|
Rate for Payer: Priority Health Choice Medicaid |
$84.14
|
Rate for Payer: Priority Health Cigna Priority Health |
$258.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.76
|
Rate for Payer: Priority Health Medicare |
$126.46
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$185.76
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$126.46
|
Rate for Payer: UHC Dual Complete DSNP |
$126.46
|
Rate for Payer: UHC Medicare Advantage |
$130.25
|
|
PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT
|
Professional
|
Both
|
$957.00
|
|
Service Code
|
HCPCS 21040
|
Min. Negotiated Rate |
$231.74 |
Max. Negotiated Rate |
$681.71 |
Rate for Payer: Aetna Commercial |
$472.77
|
Rate for Payer: Aetna Medicare |
$366.92
|
Rate for Payer: BCBS Complete |
$243.33
|
Rate for Payer: BCBS MAPPO |
$352.81
|
Rate for Payer: BCBS Trust/PPO |
$332.62
|
Rate for Payer: BCN Commercial |
$681.71
|
Rate for Payer: BCN Medicare Advantage |
$352.81
|
Rate for Payer: Cash Price |
$765.60
|
Rate for Payer: Cash Price |
$765.60
|
Rate for Payer: Cofinity Commercial |
$508.05
|
Rate for Payer: Cofinity Commercial |
$472.77
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.81
|
Rate for Payer: Mclaren Medicaid |
$231.74
|
Rate for Payer: Meridian Medicaid |
$243.33
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$370.45
|
Rate for Payer: PACE SWMI |
$352.81
|
Rate for Payer: PHP Medicare Advantage |
$352.81
|
Rate for Payer: Priority Health Choice Medicaid |
$231.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$669.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.56
|
Rate for Payer: Priority Health Medicare |
$352.81
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$554.56
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$352.81
|
Rate for Payer: UHC Dual Complete DSNP |
$352.81
|
Rate for Payer: UHC Medicare Advantage |
$363.39
|
|
PR EXCISION BONE CYST/BENIGN TUMOR DEEP
|
Professional
|
Both
|
$1,468.00
|
|
Service Code
|
HCPCS 27066
|
Min. Negotiated Rate |
$80.30 |
Max. Negotiated Rate |
$1,261.81 |
Rate for Payer: Aetna Commercial |
$1,084.61
|
Rate for Payer: Aetna Medicare |
$841.79
|
Rate for Payer: BCBS Complete |
$553.76
|
Rate for Payer: BCBS MAPPO |
$809.41
|
Rate for Payer: BCBS Trust/PPO |
$80.30
|
Rate for Payer: BCN Commercial |
$1,207.52
|
Rate for Payer: BCN Medicare Advantage |
$809.41
|
Rate for Payer: Cash Price |
$1,174.40
|
Rate for Payer: Cash Price |
$1,174.40
|
Rate for Payer: Cofinity Commercial |
$1,165.55
|
Rate for Payer: Cofinity Commercial |
$1,084.61
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.41
|
Rate for Payer: Mclaren Medicaid |
$527.39
|
Rate for Payer: Meridian Medicaid |
$553.76
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$849.88
|
Rate for Payer: PACE SWMI |
$809.41
|
Rate for Payer: PHP Medicare Advantage |
$809.41
|
Rate for Payer: Priority Health Choice Medicaid |
$527.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,027.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,261.81
|
Rate for Payer: Priority Health Medicare |
$809.41
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,261.81
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$809.41
|
Rate for Payer: UHC Dual Complete DSNP |
$809.41
|
Rate for Payer: UHC Medicare Advantage |
$833.69
|
|