|
PR INCISION BONE CORTEX FOOT
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 28005
|
| Min. Negotiated Rate |
$367.00 |
| Max. Negotiated Rate |
$3,691.76 |
| Rate for Payer: Aetna Commercial |
$748.40
|
| Rate for Payer: Aetna Medicare |
$580.85
|
| Rate for Payer: BCBS Complete |
$385.35
|
| Rate for Payer: BCBS MAPPO |
$558.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,691.76
|
| Rate for Payer: BCN Commercial |
$831.24
|
| Rate for Payer: BCN Medicare Advantage |
$558.51
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$748.40
|
| Rate for Payer: Cofinity Commercial |
$804.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.51
|
| Rate for Payer: Mclaren Medicaid |
$367.00
|
| Rate for Payer: Meridian Medicaid |
$385.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.44
|
| Rate for Payer: PACE SWMI |
$558.51
|
| Rate for Payer: PHP Medicare Advantage |
$558.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$790.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$868.61
|
| Rate for Payer: Priority Health Medicare |
$558.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$868.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.51
|
| Rate for Payer: UHC Medicare Advantage |
$575.27
|
|
|
PR INCISION BONE CORTEX HAND/FINGER
|
Professional
|
Both
|
$933.00
|
|
|
Service Code
|
HCPCS 26034
|
| Min. Negotiated Rate |
$58.64 |
| Max. Negotiated Rate |
$852.79 |
| Rate for Payer: Aetna Commercial |
$726.99
|
| Rate for Payer: Aetna Medicare |
$564.23
|
| Rate for Payer: BCBS Complete |
$377.52
|
| Rate for Payer: BCBS MAPPO |
$542.53
|
| Rate for Payer: BCBS Trust/PPO |
$58.64
|
| Rate for Payer: BCN Commercial |
$816.09
|
| Rate for Payer: BCN Medicare Advantage |
$542.53
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cash Price |
$746.40
|
| Rate for Payer: Cofinity Commercial |
$781.24
|
| Rate for Payer: Cofinity Commercial |
$726.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.53
|
| Rate for Payer: Mclaren Medicaid |
$359.54
|
| Rate for Payer: Meridian Medicaid |
$377.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$569.66
|
| Rate for Payer: PACE SWMI |
$542.53
|
| Rate for Payer: PHP Medicare Advantage |
$542.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$852.79
|
| Rate for Payer: Priority Health Medicare |
$542.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$852.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.53
|
| Rate for Payer: UHC Medicare Advantage |
$558.81
|
|
|
PR INCISION BONE CORTEX PELVIS&/HIP JOINT
|
Professional
|
Both
|
$2,029.00
|
|
|
Service Code
|
HCPCS 26992
|
| Min. Negotiated Rate |
$651.57 |
| Max. Negotiated Rate |
$1,547.27 |
| Rate for Payer: Aetna Commercial |
$1,328.37
|
| Rate for Payer: Aetna Medicare |
$1,030.97
|
| Rate for Payer: BCBS Complete |
$684.15
|
| Rate for Payer: BCBS MAPPO |
$991.32
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$1,480.69
|
| Rate for Payer: BCN Medicare Advantage |
$991.32
|
| Rate for Payer: Cash Price |
$1,623.20
|
| Rate for Payer: Cash Price |
$1,623.20
|
| Rate for Payer: Cofinity Commercial |
$1,328.37
|
| Rate for Payer: Cofinity Commercial |
$1,427.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$991.32
|
| Rate for Payer: Mclaren Medicaid |
$651.57
|
| Rate for Payer: Meridian Medicaid |
$684.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,040.89
|
| Rate for Payer: PACE SWMI |
$991.32
|
| Rate for Payer: PHP Medicare Advantage |
$991.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$651.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,420.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,547.27
|
| Rate for Payer: Priority Health Medicare |
$991.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,547.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$991.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$991.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,021.06
|
|
|
PR INCISION BONE CORTEX SHOULDER AREA
|
Professional
|
Both
|
$1,332.00
|
|
|
Service Code
|
HCPCS 23035
|
| Min. Negotiated Rate |
$438.99 |
| Max. Negotiated Rate |
$1,050.92 |
| Rate for Payer: Aetna Commercial |
$902.14
|
| Rate for Payer: Aetna Medicare |
$700.17
|
| Rate for Payer: BCBS Complete |
$460.94
|
| Rate for Payer: BCBS MAPPO |
$673.24
|
| Rate for Payer: BCBS Trust/PPO |
$887.54
|
| Rate for Payer: BCN Commercial |
$1,005.70
|
| Rate for Payer: BCN Medicare Advantage |
$673.24
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cofinity Commercial |
$902.14
|
| Rate for Payer: Cofinity Commercial |
$969.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.24
|
| Rate for Payer: Mclaren Medicaid |
$438.99
|
| Rate for Payer: Meridian Medicaid |
$460.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$706.90
|
| Rate for Payer: PACE SWMI |
$673.24
|
| Rate for Payer: PHP Medicare Advantage |
$673.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$932.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,050.92
|
| Rate for Payer: Priority Health Medicare |
$673.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$673.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$673.24
|
| Rate for Payer: UHC Medicare Advantage |
$693.44
|
|
|
PR INCISION DEEP BONE CORTEX FOREARM&/WRIST
|
Professional
|
Both
|
$1,600.00
|
|
|
Service Code
|
HCPCS 25035
|
| Min. Negotiated Rate |
$140.53 |
| Max. Negotiated Rate |
$1,120.00 |
| Rate for Payer: Aetna Commercial |
$775.65
|
| Rate for Payer: Aetna Medicare |
$601.99
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS MAPPO |
$578.84
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: BCN Commercial |
$866.91
|
| Rate for Payer: BCN Medicare Advantage |
$578.84
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cofinity Commercial |
$833.53
|
| Rate for Payer: Cofinity Commercial |
$775.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.84
|
| Rate for Payer: Mclaren Medicaid |
$384.04
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$607.78
|
| Rate for Payer: PACE SWMI |
$578.84
|
| Rate for Payer: PHP Medicare Advantage |
$578.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$905.89
|
| Rate for Payer: Priority Health Medicare |
$578.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$905.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$578.84
|
| Rate for Payer: UHC Medicare Advantage |
$596.21
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Facility
|
OP
|
$360.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
10061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$324.00 |
| Rate for Payer: Aetna Commercial |
$306.00
|
| Rate for Payer: Aetna Medicare |
$93.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.50
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$90.00
|
| Rate for Payer: BCBS Trust/PPO |
$279.90
|
| Rate for Payer: BCN Commercial |
$279.90
|
| Rate for Payer: BCN Medicare Advantage |
$90.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$309.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.00
|
| Rate for Payer: Healthscope Commercial |
$324.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.00
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.00
|
| Rate for Payer: PACE Senior Care Partners |
$85.50
|
| Rate for Payer: PACE SWMI |
$90.00
|
| Rate for Payer: PHP Commercial |
$306.00
|
| Rate for Payer: PHP Medicare Advantage |
$90.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.20
|
| Rate for Payer: Priority Health Medicare |
$90.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.56
|
| Rate for Payer: Railroad Medicare Medicare |
$90.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.80
|
| Rate for Payer: UHC Core |
$300.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.00
|
| Rate for Payer: UHC Medicare Advantage |
$92.70
|
| Rate for Payer: VA VA |
$90.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.00
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
10061
|
| Min. Negotiated Rate |
$118.43 |
| Max. Negotiated Rate |
$307.43 |
| Rate for Payer: Aetna Commercial |
$238.43
|
| Rate for Payer: Aetna Medicare |
$185.05
|
| Rate for Payer: BCBS Complete |
$124.35
|
| Rate for Payer: BCBS MAPPO |
$177.93
|
| Rate for Payer: BCBS Trust/PPO |
$307.43
|
| Rate for Payer: BCN Commercial |
$250.13
|
| Rate for Payer: BCN Medicare Advantage |
$177.93
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$256.22
|
| Rate for Payer: Cofinity Commercial |
$238.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.93
|
| Rate for Payer: Mclaren Medicaid |
$118.43
|
| Rate for Payer: Meridian Medicaid |
$124.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.83
|
| Rate for Payer: PACE SWMI |
$177.93
|
| Rate for Payer: PHP Medicare Advantage |
$177.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.83
|
| Rate for Payer: Priority Health Medicare |
$177.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.93
|
| Rate for Payer: UHC Medicare Advantage |
$183.27
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Facility
|
IP
|
$360.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
10061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$219.56 |
| Max. Negotiated Rate |
$324.00 |
| Rate for Payer: Aetna Commercial |
$306.00
|
| Rate for Payer: BCBS Trust/PPO |
$278.21
|
| Rate for Payer: BCN Commercial |
$278.21
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$309.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.00
|
| Rate for Payer: Healthscope Commercial |
$324.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.00
|
| Rate for Payer: PHP Commercial |
$306.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.80
|
| Rate for Payer: UHC Core |
$300.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.00
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 10061
|
| Min. Negotiated Rate |
$118.43 |
| Max. Negotiated Rate |
$307.43 |
| Rate for Payer: Aetna Commercial |
$238.43
|
| Rate for Payer: Aetna Medicare |
$185.05
|
| Rate for Payer: BCBS Complete |
$124.35
|
| Rate for Payer: BCBS MAPPO |
$177.93
|
| Rate for Payer: BCBS Trust/PPO |
$307.43
|
| Rate for Payer: BCN Commercial |
$250.13
|
| Rate for Payer: BCN Medicare Advantage |
$177.93
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$238.43
|
| Rate for Payer: Cofinity Commercial |
$256.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.93
|
| Rate for Payer: Mclaren Medicaid |
$118.43
|
| Rate for Payer: Meridian Medicaid |
$124.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.83
|
| Rate for Payer: PACE SWMI |
$177.93
|
| Rate for Payer: PHP Medicare Advantage |
$177.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.83
|
| Rate for Payer: Priority Health Medicare |
$177.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.93
|
| Rate for Payer: UHC Medicare Advantage |
$183.27
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
10060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$109.78 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Aetna Commercial |
$153.00
|
| Rate for Payer: BCBS Trust/PPO |
$139.10
|
| Rate for Payer: BCN Commercial |
$139.10
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$154.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.00
|
| Rate for Payer: Healthscope Commercial |
$162.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.00
|
| Rate for Payer: PHP Commercial |
$153.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.40
|
| Rate for Payer: UHC Core |
$150.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.00
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
10060
|
| Min. Negotiated Rate |
$10.31 |
| Max. Negotiated Rate |
$147.64 |
| Rate for Payer: Aetna Commercial |
$135.73
|
| Rate for Payer: Aetna Medicare |
$105.34
|
| Rate for Payer: BCBS Complete |
$72.02
|
| Rate for Payer: BCBS MAPPO |
$101.29
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Commercial |
$147.64
|
| Rate for Payer: BCN Medicare Advantage |
$101.29
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$135.73
|
| Rate for Payer: Cofinity Commercial |
$145.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.29
|
| Rate for Payer: Mclaren Medicaid |
$68.59
|
| Rate for Payer: Meridian Medicaid |
$72.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.35
|
| Rate for Payer: PACE SWMI |
$101.29
|
| Rate for Payer: PHP Medicare Advantage |
$101.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.07
|
| Rate for Payer: Priority Health Medicare |
$101.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.29
|
| Rate for Payer: UHC Medicare Advantage |
$104.33
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 10060
|
| Min. Negotiated Rate |
$10.31 |
| Max. Negotiated Rate |
$147.64 |
| Rate for Payer: Aetna Commercial |
$135.73
|
| Rate for Payer: Aetna Medicare |
$105.34
|
| Rate for Payer: BCBS Complete |
$72.02
|
| Rate for Payer: BCBS MAPPO |
$101.29
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Commercial |
$147.64
|
| Rate for Payer: BCN Medicare Advantage |
$101.29
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$145.86
|
| Rate for Payer: Cofinity Commercial |
$135.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.29
|
| Rate for Payer: Mclaren Medicaid |
$68.59
|
| Rate for Payer: Meridian Medicaid |
$72.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.35
|
| Rate for Payer: PACE SWMI |
$101.29
|
| Rate for Payer: PHP Medicare Advantage |
$101.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.07
|
| Rate for Payer: Priority Health Medicare |
$101.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.29
|
| Rate for Payer: UHC Medicare Advantage |
$104.33
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
10060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$42.75 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Aetna Commercial |
$153.00
|
| Rate for Payer: Aetna Medicare |
$46.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.25
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$45.00
|
| Rate for Payer: BCBS Trust/PPO |
$139.95
|
| Rate for Payer: BCN Commercial |
$139.95
|
| Rate for Payer: BCN Medicare Advantage |
$45.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$154.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.00
|
| Rate for Payer: Healthscope Commercial |
$162.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.00
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.00
|
| Rate for Payer: PACE Senior Care Partners |
$42.75
|
| Rate for Payer: PACE SWMI |
$45.00
|
| Rate for Payer: PHP Commercial |
$153.00
|
| Rate for Payer: PHP Medicare Advantage |
$45.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.60
|
| Rate for Payer: Priority Health Medicare |
$45.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.78
|
| Rate for Payer: Railroad Medicare Medicare |
$45.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.40
|
| Rate for Payer: UHC Core |
$150.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.00
|
| Rate for Payer: UHC Medicare Advantage |
$46.35
|
| Rate for Payer: VA VA |
$45.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.00
|
|
|
PR INCISION&DRAINAGE BURSA FOOT
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
HCPCS 28001
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$795.62 |
| Rate for Payer: Aetna Commercial |
$127.33
|
| Rate for Payer: Aetna Medicare |
$98.82
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$95.02
|
| Rate for Payer: BCBS Trust/PPO |
$795.62
|
| Rate for Payer: BCN Commercial |
$249.71
|
| Rate for Payer: BCN Medicare Advantage |
$95.02
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Cofinity Commercial |
$136.83
|
| Rate for Payer: Cofinity Commercial |
$127.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.02
|
| Rate for Payer: Mclaren Medicaid |
$60.92
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.77
|
| Rate for Payer: PACE SWMI |
$95.02
|
| Rate for Payer: PHP Medicare Advantage |
$95.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.54
|
| Rate for Payer: Priority Health Medicare |
$95.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.02
|
| Rate for Payer: UHC Medicare Advantage |
$97.87
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 10180
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$234.02
|
| Rate for Payer: Aetna Medicare |
$181.63
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS MAPPO |
$174.64
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$386.55
|
| Rate for Payer: BCN Medicare Advantage |
$174.64
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$251.48
|
| Rate for Payer: Cofinity Commercial |
$234.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.64
|
| Rate for Payer: Mclaren Medicaid |
$114.81
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$183.37
|
| Rate for Payer: PACE SWMI |
$174.64
|
| Rate for Payer: PHP Medicare Advantage |
$174.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$219.50
|
| Rate for Payer: Priority Health Medicare |
$174.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.64
|
| Rate for Payer: UHC Medicare Advantage |
$179.88
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 10180
|
| Hospital Charge Code |
10180
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$234.02
|
| Rate for Payer: Aetna Medicare |
$181.63
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS MAPPO |
$174.64
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$386.55
|
| Rate for Payer: BCN Medicare Advantage |
$174.64
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$251.48
|
| Rate for Payer: Cofinity Commercial |
$234.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.64
|
| Rate for Payer: Mclaren Medicaid |
$114.81
|
| Rate for Payer: Meridian Medicaid |
$120.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$183.37
|
| Rate for Payer: PACE SWMI |
$174.64
|
| Rate for Payer: PHP Medicare Advantage |
$174.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$219.50
|
| Rate for Payer: Priority Health Medicare |
$174.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.64
|
| Rate for Payer: UHC Medicare Advantage |
$179.88
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$402.53 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$561.00
|
| Rate for Payer: BCBS Trust/PPO |
$510.05
|
| Rate for Payer: BCN Commercial |
$510.05
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$567.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.00
|
| Rate for Payer: Healthscope Commercial |
$594.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.00
|
| Rate for Payer: PHP Commercial |
$561.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.80
|
| Rate for Payer: UHC Core |
$551.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.00
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$561.00
|
| Rate for Payer: Aetna Medicare |
$171.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$206.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$206.25
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$165.00
|
| Rate for Payer: BCBS Trust/PPO |
$513.15
|
| Rate for Payer: BCN Commercial |
$513.15
|
| Rate for Payer: BCN Medicare Advantage |
$165.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$567.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.00
|
| Rate for Payer: Healthscope Commercial |
$594.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.00
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$173.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.00
|
| Rate for Payer: PACE Senior Care Partners |
$156.75
|
| Rate for Payer: PACE SWMI |
$165.00
|
| Rate for Payer: PHP Commercial |
$561.00
|
| Rate for Payer: PHP Medicare Advantage |
$165.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.20
|
| Rate for Payer: Priority Health Medicare |
$165.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.53
|
| Rate for Payer: Railroad Medicare Medicare |
$165.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.80
|
| Rate for Payer: UHC Core |
$551.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.00
|
| Rate for Payer: UHC Medicare Advantage |
$169.95
|
| Rate for Payer: VA VA |
$165.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.00
|
|
|
PR INCISION & DRAINAGE FOREARM&/WRIST BURSA
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 25031
|
| Min. Negotiated Rate |
$241.76 |
| Max. Negotiated Rate |
$942.49 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$377.89
|
| Rate for Payer: BCBS Complete |
$253.85
|
| Rate for Payer: BCBS MAPPO |
$363.36
|
| Rate for Payer: BCBS Trust/PPO |
$942.49
|
| Rate for Payer: BCN Commercial |
$547.32
|
| Rate for Payer: BCN Medicare Advantage |
$363.36
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$523.24
|
| Rate for Payer: Cofinity Commercial |
$486.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.36
|
| Rate for Payer: Mclaren Medicaid |
$241.76
|
| Rate for Payer: Meridian Medicaid |
$253.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$381.53
|
| Rate for Payer: PACE SWMI |
$363.36
|
| Rate for Payer: PHP Medicare Advantage |
$363.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$571.93
|
| Rate for Payer: Priority Health Medicare |
$363.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$571.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.36
|
| Rate for Payer: UHC Medicare Advantage |
$374.26
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,118.00
|
|
|
Service Code
|
HCPCS 27603
|
| Min. Negotiated Rate |
$251.77 |
| Max. Negotiated Rate |
$1,557.43 |
| Rate for Payer: Aetna Commercial |
$515.30
|
| Rate for Payer: Aetna Medicare |
$399.93
|
| Rate for Payer: BCBS Complete |
$264.36
|
| Rate for Payer: BCBS MAPPO |
$384.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,557.43
|
| Rate for Payer: BCN Commercial |
$777.97
|
| Rate for Payer: BCN Medicare Advantage |
$384.55
|
| Rate for Payer: Cash Price |
$894.40
|
| Rate for Payer: Cash Price |
$894.40
|
| Rate for Payer: Cofinity Commercial |
$553.75
|
| Rate for Payer: Cofinity Commercial |
$515.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.55
|
| Rate for Payer: Mclaren Medicaid |
$251.77
|
| Rate for Payer: Meridian Medicaid |
$264.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.78
|
| Rate for Payer: PACE SWMI |
$384.55
|
| Rate for Payer: PHP Medicare Advantage |
$384.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.03
|
| Rate for Payer: Priority Health Medicare |
$384.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$601.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.55
|
| Rate for Payer: UHC Medicare Advantage |
$396.09
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA
|
Professional
|
Both
|
$871.00
|
|
|
Service Code
|
HCPCS 27604
|
| Min. Negotiated Rate |
$208.74 |
| Max. Negotiated Rate |
$661.18 |
| Rate for Payer: Aetna Commercial |
$423.75
|
| Rate for Payer: Aetna Medicare |
$328.88
|
| Rate for Payer: BCBS Complete |
$219.18
|
| Rate for Payer: BCBS MAPPO |
$316.23
|
| Rate for Payer: BCBS Trust/PPO |
$557.88
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$316.23
|
| Rate for Payer: Cash Price |
$696.80
|
| Rate for Payer: Cash Price |
$696.80
|
| Rate for Payer: Cofinity Commercial |
$455.37
|
| Rate for Payer: Cofinity Commercial |
$423.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.23
|
| Rate for Payer: Mclaren Medicaid |
$208.74
|
| Rate for Payer: Meridian Medicaid |
$219.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$332.04
|
| Rate for Payer: PACE SWMI |
$316.23
|
| Rate for Payer: PHP Medicare Advantage |
$316.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$609.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$493.80
|
| Rate for Payer: Priority Health Medicare |
$316.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.23
|
| Rate for Payer: UHC Medicare Advantage |
$325.72
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$445.00
|
|
|
Service Code
|
HCPCS 10081
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$406.41 |
| Rate for Payer: Aetna Commercial |
$224.37
|
| Rate for Payer: Aetna Medicare |
$174.14
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS MAPPO |
$167.44
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$406.41
|
| Rate for Payer: BCN Medicare Advantage |
$167.44
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$224.37
|
| Rate for Payer: Cofinity Commercial |
$241.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.44
|
| Rate for Payer: Mclaren Medicaid |
$109.70
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$175.81
|
| Rate for Payer: PACE SWMI |
$167.44
|
| Rate for Payer: PHP Medicare Advantage |
$167.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.62
|
| Rate for Payer: Priority Health Medicare |
$167.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.44
|
| Rate for Payer: UHC Medicare Advantage |
$172.46
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 10080
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$297.64 |
| Rate for Payer: Aetna Commercial |
$135.42
|
| Rate for Payer: Aetna Medicare |
$105.10
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS MAPPO |
$101.06
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$297.64
|
| Rate for Payer: BCN Medicare Advantage |
$101.06
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cofinity Commercial |
$145.53
|
| Rate for Payer: Cofinity Commercial |
$135.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.06
|
| Rate for Payer: Mclaren Medicaid |
$67.73
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.11
|
| Rate for Payer: PACE SWMI |
$101.06
|
| Rate for Payer: PHP Medicare Advantage |
$101.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.25
|
| Rate for Payer: Priority Health Medicare |
$101.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.06
|
| Rate for Payer: UHC Medicare Advantage |
$104.09
|
|
|
PR INCISION&DRAINAGE UPPER ARM/ELBOW BURSA
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 23931
|
| Min. Negotiated Rate |
$29.72 |
| Max. Negotiated Rate |
$508.90 |
| Rate for Payer: Aetna Commercial |
$211.10
|
| Rate for Payer: Aetna Medicare |
$163.84
|
| Rate for Payer: BCBS Complete |
$110.04
|
| Rate for Payer: BCBS MAPPO |
$157.54
|
| Rate for Payer: BCBS Trust/PPO |
$29.72
|
| Rate for Payer: BCN Commercial |
$448.61
|
| Rate for Payer: BCN Medicare Advantage |
$157.54
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$226.86
|
| Rate for Payer: Cofinity Commercial |
$211.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.54
|
| Rate for Payer: Mclaren Medicaid |
$104.80
|
| Rate for Payer: Meridian Medicaid |
$110.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.42
|
| Rate for Payer: PACE SWMI |
$157.54
|
| Rate for Payer: PHP Medicare Advantage |
$157.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.17
|
| Rate for Payer: Priority Health Medicare |
$157.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.54
|
| Rate for Payer: UHC Medicare Advantage |
$162.27
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 25000
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$806.40 |
| Rate for Payer: Aetna Commercial |
$454.89
|
| Rate for Payer: Aetna Medicare |
$353.05
|
| Rate for Payer: BCBS Complete |
$238.85
|
| Rate for Payer: BCBS MAPPO |
$339.47
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$514.58
|
| Rate for Payer: BCN Medicare Advantage |
$339.47
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$488.84
|
| Rate for Payer: Cofinity Commercial |
$454.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.47
|
| Rate for Payer: Mclaren Medicaid |
$227.48
|
| Rate for Payer: Meridian Medicaid |
$238.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$356.44
|
| Rate for Payer: PACE SWMI |
$339.47
|
| Rate for Payer: PHP Medicare Advantage |
$339.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$537.71
|
| Rate for Payer: Priority Health Medicare |
$339.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$537.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.47
|
| Rate for Payer: UHC Medicare Advantage |
$349.65
|
|
