|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Facility
|
OP
|
$299.00
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
19100
|
| Min. Negotiated Rate |
$71.01 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$254.15
|
| Rate for Payer: Aetna Medicare |
$77.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.44
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$74.75
|
| Rate for Payer: BCBS Trust/PPO |
$245.81
|
| Rate for Payer: BCCCP Commercial |
$140.71
|
| Rate for Payer: BCN Commercial |
$232.47
|
| Rate for Payer: BCN Medicare Advantage |
$74.75
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$257.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.75
|
| Rate for Payer: Healthscope Commercial |
$269.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.25
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.49
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.15
|
| Rate for Payer: Nomi Health Commercial |
$245.18
|
| Rate for Payer: PACE Senior Care Partners |
$71.01
|
| Rate for Payer: PACE SWMI |
$74.75
|
| Rate for Payer: PHP Commercial |
$254.15
|
| Rate for Payer: PHP Medicare Advantage |
$74.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health HMO/PPO |
$260.13
|
| Rate for Payer: Priority Health Medicare |
$75.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.33
|
| Rate for Payer: Railroad Medicare Medicare |
$74.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.12
|
| Rate for Payer: UHC Core |
$249.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.75
|
| Rate for Payer: UHC Exchange |
$74.75
|
| Rate for Payer: UHC Medicare Advantage |
$74.75
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$74.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.25
|
|
|
PR BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID
|
Professional
|
Both
|
$773.00
|
|
|
Service Code
|
HCPCS 19081
|
| Min. Negotiated Rate |
$102.67 |
| Max. Negotiated Rate |
$1,836.42 |
| Rate for Payer: Aetna Commercial |
$206.76
|
| Rate for Payer: Aetna Medicare |
$160.47
|
| Rate for Payer: BCBS Complete |
$107.80
|
| Rate for Payer: BCBS MAPPO |
$154.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,836.42
|
| Rate for Payer: BCN Commercial |
$741.81
|
| Rate for Payer: BCN Medicare Advantage |
$154.30
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cofinity Commercial |
$222.19
|
| Rate for Payer: Cofinity Commercial |
$206.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.30
|
| Rate for Payer: Mclaren Medicaid |
$102.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.02
|
| Rate for Payer: Meridian Medicaid |
$107.80
|
| Rate for Payer: Nomi Health Commercial |
$185.16
|
| Rate for Payer: PACE SWMI |
$154.30
|
| Rate for Payer: PHP Medicare Advantage |
$154.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$502.45
|
| Rate for Payer: Priority Health HMO/PPO |
$216.28
|
| Rate for Payer: Priority Health Medicare |
$155.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.30
|
| Rate for Payer: UHC Exchange |
$154.30
|
| Rate for Payer: UHC Medicare Advantage |
$154.30
|
| Rate for Payer: UHCCP Medicaid |
$102.67
|
|
|
PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 19083
|
| Min. Negotiated Rate |
$96.49 |
| Max. Negotiated Rate |
$741.81 |
| Rate for Payer: Aetna Commercial |
$194.25
|
| Rate for Payer: Aetna Medicare |
$150.76
|
| Rate for Payer: BCBS Complete |
$101.31
|
| Rate for Payer: BCBS MAPPO |
$144.96
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$741.81
|
| Rate for Payer: BCN Medicare Advantage |
$144.96
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cofinity Commercial |
$208.74
|
| Rate for Payer: Cofinity Commercial |
$194.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.96
|
| Rate for Payer: Mclaren Medicaid |
$96.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.21
|
| Rate for Payer: Meridian Medicaid |
$101.31
|
| Rate for Payer: Nomi Health Commercial |
$173.95
|
| Rate for Payer: PACE SWMI |
$144.96
|
| Rate for Payer: PHP Medicare Advantage |
$144.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.65
|
| Rate for Payer: Priority Health HMO/PPO |
$204.53
|
| Rate for Payer: Priority Health Medicare |
$146.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.96
|
| Rate for Payer: UHC Exchange |
$144.96
|
| Rate for Payer: UHC Medicare Advantage |
$144.96
|
| Rate for Payer: UHCCP Medicaid |
$96.49
|
|
|
PR BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 19084
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$566.87 |
| Rate for Payer: Aetna Commercial |
$97.82
|
| Rate for Payer: Aetna Medicare |
$75.92
|
| Rate for Payer: BCBS Complete |
$50.99
|
| Rate for Payer: BCBS MAPPO |
$73.00
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$566.87
|
| Rate for Payer: BCN Medicare Advantage |
$73.00
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$97.82
|
| Rate for Payer: Cofinity Commercial |
$105.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.00
|
| Rate for Payer: Mclaren Medicaid |
$48.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.65
|
| Rate for Payer: Meridian Medicaid |
$50.99
|
| Rate for Payer: Nomi Health Commercial |
$87.60
|
| Rate for Payer: PACE SWMI |
$73.00
|
| Rate for Payer: PHP Medicare Advantage |
$73.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.45
|
| Rate for Payer: Priority Health HMO/PPO |
$102.04
|
| Rate for Payer: Priority Health Medicare |
$73.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.00
|
| Rate for Payer: UHC Exchange |
$73.00
|
| Rate for Payer: UHC Medicare Advantage |
$73.00
|
| Rate for Payer: UHCCP Medicaid |
$48.56
|
|
|
PR BX/EXC LYMPH NODE NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 38505
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$656.16 |
| Rate for Payer: Aetna Commercial |
$108.65
|
| Rate for Payer: Aetna Medicare |
$84.32
|
| Rate for Payer: BCBS Complete |
$57.04
|
| Rate for Payer: BCBS MAPPO |
$81.08
|
| Rate for Payer: BCBS Trust/PPO |
$656.16
|
| Rate for Payer: BCN Commercial |
$259.00
|
| Rate for Payer: BCN Medicare Advantage |
$81.08
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$116.76
|
| Rate for Payer: Cofinity Commercial |
$108.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.08
|
| Rate for Payer: Mclaren Medicaid |
$54.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.13
|
| Rate for Payer: Meridian Medicaid |
$57.04
|
| Rate for Payer: Nomi Health Commercial |
$97.30
|
| Rate for Payer: PACE SWMI |
$81.08
|
| Rate for Payer: PHP Medicare Advantage |
$81.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health HMO/PPO |
$168.44
|
| Rate for Payer: Priority Health Medicare |
$81.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.08
|
| Rate for Payer: UHC Exchange |
$81.08
|
| Rate for Payer: UHC Medicare Advantage |
$81.08
|
| Rate for Payer: UHCCP Medicaid |
$54.32
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38525
|
| Min. Negotiated Rate |
$286.06 |
| Max. Negotiated Rate |
$1,025.05 |
| Rate for Payer: Aetna Commercial |
$573.17
|
| Rate for Payer: Aetna Medicare |
$444.85
|
| Rate for Payer: BCBS Complete |
$300.36
|
| Rate for Payer: BCBS MAPPO |
$427.74
|
| Rate for Payer: BCBS Trust/PPO |
$486.04
|
| Rate for Payer: BCN Commercial |
$646.03
|
| Rate for Payer: BCN Medicare Advantage |
$427.74
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$615.95
|
| Rate for Payer: Cofinity Commercial |
$573.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.74
|
| Rate for Payer: Mclaren Medicaid |
$286.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.13
|
| Rate for Payer: Meridian Medicaid |
$300.36
|
| Rate for Payer: Nomi Health Commercial |
$513.29
|
| Rate for Payer: PACE SWMI |
$427.74
|
| Rate for Payer: PHP Medicare Advantage |
$427.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO |
$888.12
|
| Rate for Payer: Priority Health Medicare |
$432.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$888.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.74
|
| Rate for Payer: UHC Exchange |
$427.74
|
| Rate for Payer: UHC Medicare Advantage |
$427.74
|
| Rate for Payer: UHCCP Medicaid |
$286.06
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
38525
|
| Min. Negotiated Rate |
$286.06 |
| Max. Negotiated Rate |
$1,025.05 |
| Rate for Payer: Aetna Commercial |
$573.17
|
| Rate for Payer: Aetna Medicare |
$444.85
|
| Rate for Payer: BCBS Complete |
$300.36
|
| Rate for Payer: BCBS MAPPO |
$427.74
|
| Rate for Payer: BCBS Trust/PPO |
$486.04
|
| Rate for Payer: BCN Commercial |
$646.03
|
| Rate for Payer: BCN Medicare Advantage |
$427.74
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$615.95
|
| Rate for Payer: Cofinity Commercial |
$573.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.74
|
| Rate for Payer: Mclaren Medicaid |
$286.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.13
|
| Rate for Payer: Meridian Medicaid |
$300.36
|
| Rate for Payer: Nomi Health Commercial |
$513.29
|
| Rate for Payer: PACE SWMI |
$427.74
|
| Rate for Payer: PHP Medicare Advantage |
$427.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO |
$888.12
|
| Rate for Payer: Priority Health Medicare |
$432.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$888.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.74
|
| Rate for Payer: UHC Exchange |
$427.74
|
| Rate for Payer: UHC Medicare Advantage |
$427.74
|
| Rate for Payer: UHCCP Medicaid |
$286.06
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Facility
|
IP
|
$1,577.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
38525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,025.05 |
| Max. Negotiated Rate |
$1,419.30 |
| Rate for Payer: Aetna Commercial |
$1,340.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.31
|
| Rate for Payer: BCN Commercial |
$1,218.71
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.60
|
| Rate for Payer: Healthscope Commercial |
$1,419.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.45
|
| Rate for Payer: Nomi Health Commercial |
$1,293.14
|
| Rate for Payer: PHP Commercial |
$1,340.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,371.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,387.76
|
| Rate for Payer: UHC Core |
$1,316.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.75
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Facility
|
OP
|
$1,577.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
38525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$374.54 |
| Max. Negotiated Rate |
$2,848.40 |
| Rate for Payer: Aetna Commercial |
$1,340.45
|
| Rate for Payer: Aetna Medicare |
$410.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.81
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$394.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.45
|
| Rate for Payer: BCN Commercial |
$1,226.12
|
| Rate for Payer: BCN Medicare Advantage |
$394.25
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.25
|
| Rate for Payer: Healthscope Commercial |
$1,419.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.75
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.96
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$453.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.45
|
| Rate for Payer: Nomi Health Commercial |
$1,293.14
|
| Rate for Payer: PACE Senior Care Partners |
$374.54
|
| Rate for Payer: PACE SWMI |
$394.25
|
| Rate for Payer: PHP Commercial |
$1,340.45
|
| Rate for Payer: PHP Medicare Advantage |
$394.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,371.99
|
| Rate for Payer: Priority Health Medicare |
$398.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.59
|
| Rate for Payer: Railroad Medicare Medicare |
$394.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,387.76
|
| Rate for Payer: UHC Core |
$1,316.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.25
|
| Rate for Payer: UHC Exchange |
$394.25
|
| Rate for Payer: UHC Medicare Advantage |
$394.25
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$394.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.75
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
38510
|
| Min. Negotiated Rate |
$269.45 |
| Max. Negotiated Rate |
$1,025.05 |
| Rate for Payer: Aetna Commercial |
$540.05
|
| Rate for Payer: Aetna Medicare |
$419.14
|
| Rate for Payer: BCBS Complete |
$282.92
|
| Rate for Payer: BCBS MAPPO |
$403.02
|
| Rate for Payer: BCBS Trust/PPO |
$559.47
|
| Rate for Payer: BCN Commercial |
$777.00
|
| Rate for Payer: BCN Medicare Advantage |
$403.02
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$580.35
|
| Rate for Payer: Cofinity Commercial |
$540.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.02
|
| Rate for Payer: Mclaren Medicaid |
$269.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.17
|
| Rate for Payer: Meridian Medicaid |
$282.92
|
| Rate for Payer: Nomi Health Commercial |
$483.62
|
| Rate for Payer: PACE SWMI |
$403.02
|
| Rate for Payer: PHP Medicare Advantage |
$403.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO |
$837.52
|
| Rate for Payer: Priority Health Medicare |
$407.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$837.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.02
|
| Rate for Payer: UHC Exchange |
$403.02
|
| Rate for Payer: UHC Medicare Advantage |
$403.02
|
| Rate for Payer: UHCCP Medicaid |
$269.45
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Facility
|
IP
|
$1,577.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
38510
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,025.05 |
| Max. Negotiated Rate |
$1,419.30 |
| Rate for Payer: Aetna Commercial |
$1,340.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.31
|
| Rate for Payer: BCN Commercial |
$1,218.71
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.60
|
| Rate for Payer: Healthscope Commercial |
$1,419.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.45
|
| Rate for Payer: Nomi Health Commercial |
$1,293.14
|
| Rate for Payer: PHP Commercial |
$1,340.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,371.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,387.76
|
| Rate for Payer: UHC Core |
$1,316.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.75
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38510
|
| Min. Negotiated Rate |
$269.45 |
| Max. Negotiated Rate |
$1,025.05 |
| Rate for Payer: Aetna Commercial |
$540.05
|
| Rate for Payer: Aetna Medicare |
$419.14
|
| Rate for Payer: BCBS Complete |
$282.92
|
| Rate for Payer: BCBS MAPPO |
$403.02
|
| Rate for Payer: BCBS Trust/PPO |
$559.47
|
| Rate for Payer: BCN Commercial |
$777.00
|
| Rate for Payer: BCN Medicare Advantage |
$403.02
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$580.35
|
| Rate for Payer: Cofinity Commercial |
$540.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.02
|
| Rate for Payer: Mclaren Medicaid |
$269.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.17
|
| Rate for Payer: Meridian Medicaid |
$282.92
|
| Rate for Payer: Nomi Health Commercial |
$483.62
|
| Rate for Payer: PACE SWMI |
$403.02
|
| Rate for Payer: PHP Medicare Advantage |
$403.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO |
$837.52
|
| Rate for Payer: Priority Health Medicare |
$407.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$837.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.02
|
| Rate for Payer: UHC Exchange |
$403.02
|
| Rate for Payer: UHC Medicare Advantage |
$403.02
|
| Rate for Payer: UHCCP Medicaid |
$269.45
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Facility
|
OP
|
$1,577.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
38510
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$374.54 |
| Max. Negotiated Rate |
$2,848.40 |
| Rate for Payer: Aetna Commercial |
$1,340.45
|
| Rate for Payer: Aetna Medicare |
$410.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.81
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$394.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.45
|
| Rate for Payer: BCN Commercial |
$1,226.12
|
| Rate for Payer: BCN Medicare Advantage |
$394.25
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.25
|
| Rate for Payer: Healthscope Commercial |
$1,419.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.75
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.96
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$453.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.45
|
| Rate for Payer: Nomi Health Commercial |
$1,293.14
|
| Rate for Payer: PACE Senior Care Partners |
$374.54
|
| Rate for Payer: PACE SWMI |
$394.25
|
| Rate for Payer: PHP Commercial |
$1,340.45
|
| Rate for Payer: PHP Medicare Advantage |
$394.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,371.99
|
| Rate for Payer: Priority Health Medicare |
$398.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.59
|
| Rate for Payer: Railroad Medicare Medicare |
$394.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,387.76
|
| Rate for Payer: UHC Core |
$1,316.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.25
|
| Rate for Payer: UHC Exchange |
$394.25
|
| Rate for Payer: UHC Medicare Advantage |
$394.25
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$394.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.75
|
|
|
PR BX/EXC LYMPH NODE OPEN INT MAMMARY NODE
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 38530
|
| Min. Negotiated Rate |
$368.70 |
| Max. Negotiated Rate |
$1,136.44 |
| Rate for Payer: Aetna Commercial |
$735.45
|
| Rate for Payer: Aetna Medicare |
$570.79
|
| Rate for Payer: BCBS Complete |
$387.14
|
| Rate for Payer: BCBS MAPPO |
$548.84
|
| Rate for Payer: BCBS Trust/PPO |
$427.39
|
| Rate for Payer: BCN Commercial |
$825.38
|
| Rate for Payer: BCN Medicare Advantage |
$548.84
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$790.33
|
| Rate for Payer: Cofinity Commercial |
$735.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.84
|
| Rate for Payer: Mclaren Medicaid |
$368.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$576.28
|
| Rate for Payer: Meridian Medicaid |
$387.14
|
| Rate for Payer: Nomi Health Commercial |
$658.61
|
| Rate for Payer: PACE SWMI |
$548.84
|
| Rate for Payer: PHP Medicare Advantage |
$548.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,136.44
|
| Rate for Payer: Priority Health Medicare |
$554.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,136.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$548.84
|
| Rate for Payer: UHC Exchange |
$548.84
|
| Rate for Payer: UHC Medicare Advantage |
$548.84
|
| Rate for Payer: UHCCP Medicaid |
$368.70
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Professional
|
Both
|
$947.00
|
|
|
Service Code
|
HCPCS 38500
|
| Min. Negotiated Rate |
$164.65 |
| Max. Negotiated Rate |
$615.55 |
| Rate for Payer: Aetna Commercial |
$329.84
|
| Rate for Payer: Aetna Medicare |
$256.00
|
| Rate for Payer: BCBS Complete |
$172.88
|
| Rate for Payer: BCBS MAPPO |
$246.15
|
| Rate for Payer: BCBS Trust/PPO |
$512.45
|
| Rate for Payer: BCN Commercial |
$495.52
|
| Rate for Payer: BCN Medicare Advantage |
$246.15
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$354.46
|
| Rate for Payer: Cofinity Commercial |
$329.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.15
|
| Rate for Payer: Mclaren Medicaid |
$164.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.46
|
| Rate for Payer: Meridian Medicaid |
$172.88
|
| Rate for Payer: Nomi Health Commercial |
$295.38
|
| Rate for Payer: PACE SWMI |
$246.15
|
| Rate for Payer: PHP Medicare Advantage |
$246.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health HMO/PPO |
$512.62
|
| Rate for Payer: Priority Health Medicare |
$248.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$512.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.15
|
| Rate for Payer: UHC Exchange |
$246.15
|
| Rate for Payer: UHC Medicare Advantage |
$246.15
|
| Rate for Payer: UHCCP Medicaid |
$164.65
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Professional
|
Both
|
$947.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
38500
|
| Min. Negotiated Rate |
$164.65 |
| Max. Negotiated Rate |
$615.55 |
| Rate for Payer: Aetna Commercial |
$329.84
|
| Rate for Payer: Aetna Medicare |
$256.00
|
| Rate for Payer: BCBS Complete |
$172.88
|
| Rate for Payer: BCBS MAPPO |
$246.15
|
| Rate for Payer: BCBS Trust/PPO |
$512.45
|
| Rate for Payer: BCN Commercial |
$495.52
|
| Rate for Payer: BCN Medicare Advantage |
$246.15
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$354.46
|
| Rate for Payer: Cofinity Commercial |
$329.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.15
|
| Rate for Payer: Mclaren Medicaid |
$164.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.46
|
| Rate for Payer: Meridian Medicaid |
$172.88
|
| Rate for Payer: Nomi Health Commercial |
$295.38
|
| Rate for Payer: PACE SWMI |
$246.15
|
| Rate for Payer: PHP Medicare Advantage |
$246.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health HMO/PPO |
$512.62
|
| Rate for Payer: Priority Health Medicare |
$248.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$512.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.15
|
| Rate for Payer: UHC Exchange |
$246.15
|
| Rate for Payer: UHC Medicare Advantage |
$246.15
|
| Rate for Payer: UHCCP Medicaid |
$164.65
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Facility
|
OP
|
$947.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
38500
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$224.91 |
| Max. Negotiated Rate |
$2,848.40 |
| Rate for Payer: Aetna Commercial |
$804.95
|
| Rate for Payer: Aetna Medicare |
$246.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.94
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$236.75
|
| Rate for Payer: BCBS Trust/PPO |
$778.53
|
| Rate for Payer: BCN Commercial |
$736.29
|
| Rate for Payer: BCN Medicare Advantage |
$236.75
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$814.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$757.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.75
|
| Rate for Payer: Healthscope Commercial |
$852.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$710.25
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.59
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$804.95
|
| Rate for Payer: Nomi Health Commercial |
$776.54
|
| Rate for Payer: PACE Senior Care Partners |
$224.91
|
| Rate for Payer: PACE SWMI |
$236.75
|
| Rate for Payer: PHP Commercial |
$804.95
|
| Rate for Payer: PHP Medicare Advantage |
$236.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health HMO/PPO |
$823.89
|
| Rate for Payer: Priority Health Medicare |
$239.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$634.49
|
| Rate for Payer: Railroad Medicare Medicare |
$236.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$833.36
|
| Rate for Payer: UHC Core |
$790.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.75
|
| Rate for Payer: UHC Exchange |
$236.75
|
| Rate for Payer: UHC Medicare Advantage |
$236.75
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$236.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$710.25
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Facility
|
IP
|
$947.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
38500
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$615.55 |
| Max. Negotiated Rate |
$852.30 |
| Rate for Payer: Aetna Commercial |
$804.95
|
| Rate for Payer: BCBS Trust/PPO |
$773.04
|
| Rate for Payer: BCN Commercial |
$731.84
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$814.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$757.60
|
| Rate for Payer: Healthscope Commercial |
$852.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$710.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$804.95
|
| Rate for Payer: Nomi Health Commercial |
$776.54
|
| Rate for Payer: PHP Commercial |
$804.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health HMO/PPO |
$823.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$634.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$833.36
|
| Rate for Payer: UHC Core |
$790.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$710.25
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 38520
|
| Hospital Charge Code |
38520
|
| Min. Negotiated Rate |
$1,200.55 |
| Max. Negotiated Rate |
$1,662.30 |
| Rate for Payer: Aetna Commercial |
$1,569.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,507.71
|
| Rate for Payer: BCN Commercial |
$1,427.36
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,588.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.60
|
| Rate for Payer: Healthscope Commercial |
$1,662.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,385.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.95
|
| Rate for Payer: Nomi Health Commercial |
$1,514.54
|
| Rate for Payer: PHP Commercial |
$1,569.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,606.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,237.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,625.36
|
| Rate for Payer: UHC Core |
$1,542.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,385.25
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 38520
|
| Min. Negotiated Rate |
$303.53 |
| Max. Negotiated Rate |
$1,200.55 |
| Rate for Payer: Aetna Commercial |
$606.50
|
| Rate for Payer: Aetna Medicare |
$470.71
|
| Rate for Payer: BCBS Complete |
$318.71
|
| Rate for Payer: BCBS MAPPO |
$452.61
|
| Rate for Payer: BCBS Trust/PPO |
$460.15
|
| Rate for Payer: BCN Commercial |
$685.61
|
| Rate for Payer: BCN Medicare Advantage |
$452.61
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$651.76
|
| Rate for Payer: Cofinity Commercial |
$606.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.61
|
| Rate for Payer: Mclaren Medicaid |
$303.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$475.24
|
| Rate for Payer: Meridian Medicaid |
$318.71
|
| Rate for Payer: Nomi Health Commercial |
$543.13
|
| Rate for Payer: PACE SWMI |
$452.61
|
| Rate for Payer: PHP Medicare Advantage |
$452.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health HMO/PPO |
$939.38
|
| Rate for Payer: Priority Health Medicare |
$457.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$939.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$452.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$452.61
|
| Rate for Payer: UHC Exchange |
$452.61
|
| Rate for Payer: UHC Medicare Advantage |
$452.61
|
| Rate for Payer: UHCCP Medicaid |
$303.53
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 38520
|
| Hospital Charge Code |
38520
|
| Min. Negotiated Rate |
$303.53 |
| Max. Negotiated Rate |
$1,200.55 |
| Rate for Payer: Aetna Commercial |
$606.50
|
| Rate for Payer: Aetna Medicare |
$470.71
|
| Rate for Payer: BCBS Complete |
$318.71
|
| Rate for Payer: BCBS MAPPO |
$452.61
|
| Rate for Payer: BCBS Trust/PPO |
$460.15
|
| Rate for Payer: BCN Commercial |
$685.61
|
| Rate for Payer: BCN Medicare Advantage |
$452.61
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$651.76
|
| Rate for Payer: Cofinity Commercial |
$606.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.61
|
| Rate for Payer: Mclaren Medicaid |
$303.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$475.24
|
| Rate for Payer: Meridian Medicaid |
$318.71
|
| Rate for Payer: Nomi Health Commercial |
$543.13
|
| Rate for Payer: PACE SWMI |
$452.61
|
| Rate for Payer: PHP Medicare Advantage |
$452.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health HMO/PPO |
$939.38
|
| Rate for Payer: Priority Health Medicare |
$457.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$939.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$452.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$452.61
|
| Rate for Payer: UHC Exchange |
$452.61
|
| Rate for Payer: UHC Medicare Advantage |
$452.61
|
| Rate for Payer: UHCCP Medicaid |
$303.53
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 38520
|
| Hospital Charge Code |
38520
|
| Min. Negotiated Rate |
$438.66 |
| Max. Negotiated Rate |
$2,848.40 |
| Rate for Payer: Aetna Commercial |
$1,569.95
|
| Rate for Payer: Aetna Medicare |
$480.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$577.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$577.19
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$461.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.42
|
| Rate for Payer: BCN Commercial |
$1,436.04
|
| Rate for Payer: BCN Medicare Advantage |
$461.75
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,588.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$461.75
|
| Rate for Payer: Healthscope Commercial |
$1,662.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,385.25
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$484.84
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$531.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.95
|
| Rate for Payer: Nomi Health Commercial |
$1,514.54
|
| Rate for Payer: PACE Senior Care Partners |
$438.66
|
| Rate for Payer: PACE SWMI |
$461.75
|
| Rate for Payer: PHP Commercial |
$1,569.95
|
| Rate for Payer: PHP Medicare Advantage |
$461.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,606.89
|
| Rate for Payer: Priority Health Medicare |
$466.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,237.49
|
| Rate for Payer: Railroad Medicare Medicare |
$461.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,625.36
|
| Rate for Payer: UHC Core |
$1,542.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$461.75
|
| Rate for Payer: UHC Exchange |
$461.75
|
| Rate for Payer: UHC Medicare Advantage |
$461.75
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$461.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,385.25
|
|
|
PR BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 44100
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$2,539.54 |
| Rate for Payer: Aetna Commercial |
$134.35
|
| Rate for Payer: Aetna Medicare |
$104.27
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: BCBS MAPPO |
$100.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$152.96
|
| Rate for Payer: BCN Medicare Advantage |
$100.26
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$144.37
|
| Rate for Payer: Cofinity Commercial |
$134.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.26
|
| Rate for Payer: Mclaren Medicaid |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.27
|
| Rate for Payer: Meridian Medicaid |
$70.22
|
| Rate for Payer: Nomi Health Commercial |
$120.31
|
| Rate for Payer: PACE SWMI |
$100.26
|
| Rate for Payer: PHP Medicare Advantage |
$100.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health HMO/PPO |
$187.93
|
| Rate for Payer: Priority Health Medicare |
$101.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.26
|
| Rate for Payer: UHC Exchange |
$100.26
|
| Rate for Payer: UHC Medicare Advantage |
$100.26
|
| Rate for Payer: UHCCP Medicaid |
$66.88
|
|
|
PR BX LVR NDL DONE PURPOSE TM OTH MAJOR PX
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 47001
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$1,355.62 |
| Rate for Payer: Aetna Commercial |
$135.70
|
| Rate for Payer: Aetna Medicare |
$105.32
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$101.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,355.62
|
| Rate for Payer: BCN Commercial |
$150.03
|
| Rate for Payer: BCN Medicare Advantage |
$101.27
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$145.83
|
| Rate for Payer: Cofinity Commercial |
$135.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.27
|
| Rate for Payer: Mclaren Medicaid |
$66.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.33
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: PACE SWMI |
$101.27
|
| Rate for Payer: PHP Medicare Advantage |
$101.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health HMO/PPO |
$183.15
|
| Rate for Payer: Priority Health Medicare |
$102.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.27
|
| Rate for Payer: UHC Exchange |
$101.27
|
| Rate for Payer: UHC Medicare Advantage |
$101.27
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
|
|
PR BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 42806
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$355.76 |
| Rate for Payer: Aetna Commercial |
$178.69
|
| Rate for Payer: Aetna Medicare |
$138.68
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$133.35
|
| Rate for Payer: BCBS Trust/PPO |
$314.34
|
| Rate for Payer: BCN Commercial |
$355.76
|
| Rate for Payer: BCN Medicare Advantage |
$133.35
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$192.02
|
| Rate for Payer: Cofinity Commercial |
$178.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.35
|
| Rate for Payer: Mclaren Medicaid |
$91.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.02
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Nomi Health Commercial |
$160.02
|
| Rate for Payer: PACE SWMI |
$133.35
|
| Rate for Payer: PHP Medicare Advantage |
$133.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.60
|
| Rate for Payer: Priority Health HMO/PPO |
$256.54
|
| Rate for Payer: Priority Health Medicare |
$134.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.35
|
| Rate for Payer: UHC Exchange |
$133.35
|
| Rate for Payer: UHC Medicare Advantage |
$133.35
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
|
