|
PR EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT
|
Professional
|
Both
|
$1,835.00
|
|
|
Service Code
|
HCPCS 26215
|
| Min. Negotiated Rate |
$346.34 |
| Max. Negotiated Rate |
$1,376.25 |
| Rate for Payer: Aetna Commercial |
$756.96
|
| Rate for Payer: Aetna Medicare |
$917.50
|
| Rate for Payer: BCBS Complete |
$363.66
|
| Rate for Payer: BCN Commercial |
$870.97
|
| Rate for Payer: Cash Price |
$1,468.00
|
| Rate for Payer: Cash Price |
$1,468.00
|
| Rate for Payer: Mclaren Medicaid |
$346.34
|
| Rate for Payer: Meridian Medicaid |
$363.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,376.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$931.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$931.04
|
| Rate for Payer: UHC Medicaid |
$346.34
|
| Rate for Payer: UHCCP Medicaid |
$346.34
|
|
|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT
|
Professional
|
Both
|
$2,858.00
|
|
|
Service Code
|
HCPCS 27637
|
| Min. Negotiated Rate |
$451.35 |
| Max. Negotiated Rate |
$2,143.50 |
| Rate for Payer: Aetna Commercial |
$989.60
|
| Rate for Payer: Aetna Medicare |
$1,429.00
|
| Rate for Payer: BCBS Complete |
$473.92
|
| Rate for Payer: BCN Commercial |
$1,143.36
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Cash Price |
$2,286.40
|
| Rate for Payer: Mclaren Medicaid |
$451.35
|
| Rate for Payer: Meridian Medicaid |
$473.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,143.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,222.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,222.23
|
| Rate for Payer: UHC Medicaid |
$451.35
|
| Rate for Payer: UHCCP Medicaid |
$451.35
|
|
|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT
|
Professional
|
Both
|
$2,279.00
|
|
|
Service Code
|
HCPCS 27638
|
| Min. Negotiated Rate |
$445.60 |
| Max. Negotiated Rate |
$1,709.25 |
| Rate for Payer: Aetna Commercial |
$1,011.80
|
| Rate for Payer: Aetna Medicare |
$1,139.50
|
| Rate for Payer: BCBS Complete |
$467.88
|
| Rate for Payer: BCN Commercial |
$1,133.90
|
| Rate for Payer: Cash Price |
$1,823.20
|
| Rate for Payer: Cash Price |
$1,823.20
|
| Rate for Payer: Mclaren Medicaid |
$445.60
|
| Rate for Payer: Meridian Medicaid |
$467.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,709.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,212.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,212.11
|
| Rate for Payer: UHC Medicaid |
$445.60
|
| Rate for Payer: UHCCP Medicaid |
$445.60
|
|
|
PR EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 28104
|
| Min. Negotiated Rate |
$216.41 |
| Max. Negotiated Rate |
$748.50 |
| Rate for Payer: Aetna Commercial |
$469.02
|
| Rate for Payer: Aetna Medicare |
$499.00
|
| Rate for Payer: BCBS Complete |
$227.23
|
| Rate for Payer: BCN Commercial |
$542.80
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Mclaren Medicaid |
$216.41
|
| Rate for Payer: Meridian Medicaid |
$227.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$748.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$580.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.24
|
| Rate for Payer: UHC Medicaid |
$216.41
|
| Rate for Payer: UHCCP Medicaid |
$216.41
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 24116
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$1,398.96 |
| Rate for Payer: Aetna Commercial |
$1,149.88
|
| Rate for Payer: Aetna Medicare |
$893.00
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCN Commercial |
$1,308.69
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Mclaren Medicaid |
$508.86
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,398.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,398.96
|
| Rate for Payer: UHC Medicaid |
$508.86
|
| Rate for Payer: UHCCP Medicaid |
$508.86
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 23140
|
| Min. Negotiated Rate |
$338.88 |
| Max. Negotiated Rate |
$912.94 |
| Rate for Payer: Aetna Commercial |
$740.39
|
| Rate for Payer: Aetna Medicare |
$484.50
|
| Rate for Payer: BCBS Complete |
$355.82
|
| Rate for Payer: BCN Commercial |
$854.04
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Mclaren Medicaid |
$338.88
|
| Rate for Payer: Meridian Medicaid |
$355.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$726.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$912.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$912.94
|
| Rate for Payer: UHC Medicaid |
$338.88
|
| Rate for Payer: UHCCP Medicaid |
$338.88
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Professional
|
Both
|
$1,291.00
|
|
|
Service Code
|
HCPCS 24120
|
| Min. Negotiated Rate |
$323.55 |
| Max. Negotiated Rate |
$968.25 |
| Rate for Payer: Aetna Commercial |
$709.53
|
| Rate for Payer: Aetna Medicare |
$645.50
|
| Rate for Payer: BCBS Complete |
$339.73
|
| Rate for Payer: BCN Commercial |
$822.16
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Cash Price |
$1,032.80
|
| Rate for Payer: Mclaren Medicaid |
$323.55
|
| Rate for Payer: Meridian Medicaid |
$339.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$968.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$878.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$878.87
|
| Rate for Payer: UHC Medicaid |
$323.55
|
| Rate for Payer: UHCCP Medicaid |
$323.55
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS
|
Professional
|
Both
|
$1,452.00
|
|
|
Service Code
|
HCPCS 23150
|
| Min. Negotiated Rate |
$403.42 |
| Max. Negotiated Rate |
$1,092.86 |
| Rate for Payer: Aetna Commercial |
$879.24
|
| Rate for Payer: Aetna Medicare |
$726.00
|
| Rate for Payer: BCBS Complete |
$423.59
|
| Rate for Payer: BCN Commercial |
$1,022.36
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Mclaren Medicaid |
$403.42
|
| Rate for Payer: Meridian Medicaid |
$423.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,092.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,092.86
|
| Rate for Payer: UHC Medicaid |
$403.42
|
| Rate for Payer: UHCCP Medicaid |
$403.42
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 23155
|
| Min. Negotiated Rate |
$477.33 |
| Max. Negotiated Rate |
$1,303.13 |
| Rate for Payer: Aetna Commercial |
$1,063.91
|
| Rate for Payer: Aetna Medicare |
$726.50
|
| Rate for Payer: BCBS Complete |
$501.20
|
| Rate for Payer: BCN Commercial |
$1,219.05
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Mclaren Medicaid |
$477.33
|
| Rate for Payer: Meridian Medicaid |
$501.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,303.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,303.13
|
| Rate for Payer: UHC Medicaid |
$477.33
|
| Rate for Payer: UHCCP Medicaid |
$477.33
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT
|
Professional
|
Both
|
$1,338.00
|
|
|
Service Code
|
HCPCS 23156
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$1,113.63 |
| Rate for Payer: Aetna Commercial |
$906.58
|
| Rate for Payer: Aetna Medicare |
$669.00
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCN Commercial |
$1,041.78
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Cash Price |
$1,070.40
|
| Rate for Payer: Mclaren Medicaid |
$409.81
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,003.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,113.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.63
|
| Rate for Payer: UHC Medicaid |
$409.81
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
|
|
PR EXC/CURTG CST/B9 TUM PHALANGES FOOT
|
Professional
|
Both
|
$548.00
|
|
|
Service Code
|
HCPCS 28108
|
| Min. Negotiated Rate |
$174.87 |
| Max. Negotiated Rate |
$471.12 |
| Rate for Payer: Aetna Commercial |
$378.46
|
| Rate for Payer: Aetna Medicare |
$274.00
|
| Rate for Payer: BCBS Complete |
$183.61
|
| Rate for Payer: BCN Commercial |
$440.71
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Mclaren Medicaid |
$174.87
|
| Rate for Payer: Meridian Medicaid |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$471.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.12
|
| Rate for Payer: UHC Medicaid |
$174.87
|
| Rate for Payer: UHCCP Medicaid |
$174.87
|
|
|
PR EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT
|
Professional
|
Both
|
$990.00
|
|
|
Service Code
|
HCPCS 28106
|
| Min. Negotiated Rate |
$253.04 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna Commercial |
$566.51
|
| Rate for Payer: Aetna Medicare |
$495.00
|
| Rate for Payer: BCBS Complete |
$265.69
|
| Rate for Payer: BCN Commercial |
$645.38
|
| Rate for Payer: Cash Price |
$792.00
|
| Rate for Payer: Cash Price |
$792.00
|
| Rate for Payer: Mclaren Medicaid |
$253.04
|
| Rate for Payer: Meridian Medicaid |
$265.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$689.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$689.90
|
| Rate for Payer: UHC Medicaid |
$253.04
|
| Rate for Payer: UHCCP Medicaid |
$253.04
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 25136
|
| Min. Negotiated Rate |
$308.21 |
| Max. Negotiated Rate |
$821.39 |
| Rate for Payer: Aetna Commercial |
$663.57
|
| Rate for Payer: Aetna Medicare |
$516.50
|
| Rate for Payer: BCBS Complete |
$323.62
|
| Rate for Payer: BCN Commercial |
$768.38
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Mclaren Medicaid |
$308.21
|
| Rate for Payer: Meridian Medicaid |
$323.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$774.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$821.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.39
|
| Rate for Payer: UHC Medicaid |
$308.21
|
| Rate for Payer: UHCCP Medicaid |
$308.21
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT
|
Professional
|
Both
|
$1,041.00
|
|
|
Service Code
|
HCPCS 25135
|
| Min. Negotiated Rate |
$345.06 |
| Max. Negotiated Rate |
$925.18 |
| Rate for Payer: Aetna Commercial |
$747.91
|
| Rate for Payer: Aetna Medicare |
$520.50
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCN Commercial |
$865.49
|
| Rate for Payer: Cash Price |
$832.80
|
| Rate for Payer: Cash Price |
$832.80
|
| Rate for Payer: Mclaren Medicaid |
$345.06
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$925.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$925.18
|
| Rate for Payer: UHC Medicaid |
$345.06
|
| Rate for Payer: UHCCP Medicaid |
$345.06
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT
|
Professional
|
Both
|
$1,252.00
|
|
|
Service Code
|
HCPCS 25126
|
| Min. Negotiated Rate |
$366.36 |
| Max. Negotiated Rate |
$985.88 |
| Rate for Payer: Aetna Commercial |
$799.55
|
| Rate for Payer: Aetna Medicare |
$626.00
|
| Rate for Payer: BCBS Complete |
$384.68
|
| Rate for Payer: BCN Commercial |
$922.27
|
| Rate for Payer: Cash Price |
$1,001.60
|
| Rate for Payer: Cash Price |
$1,001.60
|
| Rate for Payer: Mclaren Medicaid |
$366.36
|
| Rate for Payer: Meridian Medicaid |
$384.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$939.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$985.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$985.88
|
| Rate for Payer: UHC Medicaid |
$366.36
|
| Rate for Payer: UHCCP Medicaid |
$366.36
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$2,389.00
|
|
|
Service Code
|
HCPCS 25125
|
| Min. Negotiated Rate |
$364.02 |
| Max. Negotiated Rate |
$1,791.75 |
| Rate for Payer: Aetna Commercial |
$793.59
|
| Rate for Payer: Aetna Medicare |
$1,194.50
|
| Rate for Payer: BCBS Complete |
$382.22
|
| Rate for Payer: BCN Commercial |
$916.28
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Mclaren Medicaid |
$364.02
|
| Rate for Payer: Meridian Medicaid |
$382.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,791.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$979.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$979.49
|
| Rate for Payer: UHC Medicaid |
$364.02
|
| Rate for Payer: UHCCP Medicaid |
$364.02
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$191.11 |
| Max. Negotiated Rate |
$975.60 |
| Rate for Payer: Aetna Commercial |
$921.40
|
| Rate for Payer: Aetna Medicare |
$281.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$338.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$338.75
|
| Rate for Payer: BCBS Complete |
$200.65
|
| Rate for Payer: BCBS MAPPO |
$271.00
|
| Rate for Payer: BCBS Trust/PPO |
$891.16
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$891.16
|
| Rate for Payer: BCN Medicare Advantage |
$271.00
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$932.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.00
|
| Rate for Payer: Healthscope Commercial |
$975.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.00
|
| Rate for Payer: Mclaren Medicaid |
$191.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$284.55
|
| Rate for Payer: Meridian Medicaid |
$200.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$311.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$298.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$888.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PACE Senior Care Partners |
$257.45
|
| Rate for Payer: PACE SWMI |
$271.00
|
| Rate for Payer: PHP Commercial |
$921.40
|
| Rate for Payer: PHP Medicare Advantage |
$271.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$943.08
|
| Rate for Payer: Priority Health Medicare |
$273.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.46
|
| Rate for Payer: Railroad Medicare Medicare |
$271.00
|
| Rate for Payer: UHC Core |
$905.14
|
| Rate for Payer: UHC Exchange |
$271.00
|
| Rate for Payer: UHC Medicaid |
$191.11
|
| Rate for Payer: UHC Medicare Advantage |
$271.00
|
| Rate for Payer: UHCCP Medicaid |
$191.11
|
| Rate for Payer: VA VA |
$271.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.00
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
IP
|
$1,084.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$754.46 |
| Max. Negotiated Rate |
$975.60 |
| Rate for Payer: Aetna Commercial |
$921.40
|
| Rate for Payer: BCBS Trust/PPO |
$895.28
|
| Rate for Payer: BCN Commercial |
$895.28
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$932.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Healthscope Commercial |
$975.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$888.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: PHP Commercial |
$921.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$943.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.46
|
| Rate for Payer: UHC Core |
$905.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.00
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 19120
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$813.00 |
| Rate for Payer: Aetna Commercial |
$453.99
|
| Rate for Payer: Aetna Medicare |
$542.00
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCN Commercial |
$635.43
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Mclaren Medicaid |
$260.07
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$581.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$581.58
|
| Rate for Payer: UHC Medicaid |
$260.07
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 19120
|
| Hospital Charge Code |
19120
|
| Min. Negotiated Rate |
$260.07 |
| Max. Negotiated Rate |
$813.00 |
| Rate for Payer: Aetna Commercial |
$453.99
|
| Rate for Payer: Aetna Medicare |
$542.00
|
| Rate for Payer: BCBS Complete |
$273.07
|
| Rate for Payer: BCN Commercial |
$635.43
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Mclaren Medicaid |
$260.07
|
| Rate for Payer: Meridian Medicaid |
$273.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$581.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$581.58
|
| Rate for Payer: UHC Medicaid |
$260.07
|
| Rate for Payer: UHCCP Medicaid |
$260.07
|
|
|
PR EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 60200
|
| Min. Negotiated Rate |
$396.39 |
| Max. Negotiated Rate |
$1,095.09 |
| Rate for Payer: Aetna Commercial |
$855.88
|
| Rate for Payer: Aetna Medicare |
$726.50
|
| Rate for Payer: BCBS Complete |
$416.21
|
| Rate for Payer: BCN Commercial |
$1,009.90
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Mclaren Medicaid |
$396.39
|
| Rate for Payer: Meridian Medicaid |
$416.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,089.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,095.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,095.09
|
| Rate for Payer: UHC Medicaid |
$396.39
|
| Rate for Payer: UHCCP Medicaid |
$396.39
|
|
|
PR EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM
|
Professional
|
Both
|
$4,089.00
|
|
|
Service Code
|
HCPCS 49204
|
| Min. Negotiated Rate |
$1,635.60 |
| Max. Negotiated Rate |
$3,066.75 |
| Rate for Payer: Aetna Commercial |
$2,046.13
|
| Rate for Payer: Aetna Medicare |
$2,044.50
|
| Rate for Payer: BCBS Complete |
$1,635.60
|
| Rate for Payer: BCN Commercial |
$2,249.95
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Cash Price |
$3,271.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,066.75
|
|
|
PR EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM
|
Professional
|
Both
|
$3,304.00
|
|
|
Service Code
|
HCPCS 49205
|
| Min. Negotiated Rate |
$1,321.60 |
| Max. Negotiated Rate |
$2,581.02 |
| Rate for Payer: Aetna Commercial |
$2,348.49
|
| Rate for Payer: Aetna Medicare |
$1,652.00
|
| Rate for Payer: BCBS Complete |
$1,321.60
|
| Rate for Payer: BCN Commercial |
$2,581.02
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,478.00
|
|
|
PR EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX
|
Professional
|
Both
|
$1,083.00
|
|
|
Service Code
|
HCPCS 42870
|
| Min. Negotiated Rate |
$349.75 |
| Max. Negotiated Rate |
$1,073.95 |
| Rate for Payer: Aetna Commercial |
$780.39
|
| Rate for Payer: Aetna Medicare |
$541.50
|
| Rate for Payer: BCBS Complete |
$367.24
|
| Rate for Payer: BCN Commercial |
$881.42
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Cash Price |
$866.40
|
| Rate for Payer: Mclaren Medicaid |
$349.75
|
| Rate for Payer: Meridian Medicaid |
$367.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$812.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,073.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,073.95
|
| Rate for Payer: UHC Medicaid |
$349.75
|
| Rate for Payer: UHCCP Medicaid |
$349.75
|
|
|
PR EXC EXCSV SKN ABD INFRAUMBILICAL PANNICULECTOMY
|
Professional
|
Both
|
$2,732.00
|
|
|
Service Code
|
HCPCS 15830
|
| Min. Negotiated Rate |
$680.54 |
| Max. Negotiated Rate |
$2,049.00 |
| Rate for Payer: Aetna Commercial |
$1,270.12
|
| Rate for Payer: Aetna Medicare |
$1,366.00
|
| Rate for Payer: BCBS Complete |
$714.57
|
| Rate for Payer: BCN Commercial |
$1,772.31
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Mclaren Medicaid |
$680.54
|
| Rate for Payer: Meridian Medicaid |
$714.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,049.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,622.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,622.12
|
| Rate for Payer: UHC Medicaid |
$680.54
|
| Rate for Payer: UHCCP Medicaid |
$680.54
|
|
