|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$2,319.00
|
|
|
Service Code
|
HCPCS 25125
|
| Min. Negotiated Rate |
$87.17 |
| Max. Negotiated Rate |
$1,507.35 |
| Rate for Payer: Aetna Commercial |
$773.97
|
| Rate for Payer: Aetna Medicare |
$600.69
|
| Rate for Payer: BCBS Complete |
$411.52
|
| Rate for Payer: BCBS MAPPO |
$577.59
|
| Rate for Payer: BCBS Trust/PPO |
$87.17
|
| Rate for Payer: BCN Commercial |
$881.57
|
| Rate for Payer: BCN Medicare Advantage |
$577.59
|
| Rate for Payer: Cash Price |
$1,855.20
|
| Rate for Payer: Cash Price |
$1,855.20
|
| Rate for Payer: Cofinity Commercial |
$831.73
|
| Rate for Payer: Cofinity Commercial |
$773.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.59
|
| Rate for Payer: Mclaren Medicaid |
$391.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.47
|
| Rate for Payer: Meridian Medicaid |
$411.52
|
| Rate for Payer: Nomi Health Commercial |
$693.11
|
| Rate for Payer: PACE SWMI |
$577.59
|
| Rate for Payer: PHP Medicare Advantage |
$577.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,507.35
|
| Rate for Payer: Priority Health HMO/PPO |
$927.65
|
| Rate for Payer: Priority Health Medicare |
$583.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$927.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$577.59
|
| Rate for Payer: UHC Exchange |
$577.59
|
| Rate for Payer: UHC Medicare Advantage |
$577.59
|
| Rate for Payer: UHCCP Medicaid |
$391.92
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
IP
|
$1,052.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$683.80 |
| Max. Negotiated Rate |
$946.80 |
| Rate for Payer: Aetna Commercial |
$894.20
|
| Rate for Payer: BCBS Trust/PPO |
$858.75
|
| Rate for Payer: BCN Commercial |
$812.99
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$904.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.60
|
| Rate for Payer: Healthscope Commercial |
$946.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.20
|
| Rate for Payer: Nomi Health Commercial |
$862.64
|
| Rate for Payer: PHP Commercial |
$894.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.80
|
| Rate for Payer: Priority Health HMO/PPO |
$915.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$704.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.76
|
| Rate for Payer: UHC Core |
$878.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.00
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,052.00
|
|
|
Service Code
|
HCPCS 19120
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$762.83 |
| Rate for Payer: Aetna Commercial |
$543.26
|
| Rate for Payer: Aetna Medicare |
$421.64
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS MAPPO |
$405.42
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$762.83
|
| Rate for Payer: BCN Medicare Advantage |
$405.42
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$583.80
|
| Rate for Payer: Cofinity Commercial |
$543.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.42
|
| Rate for Payer: Mclaren Medicaid |
$271.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.69
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Nomi Health Commercial |
$486.50
|
| Rate for Payer: PACE SWMI |
$405.42
|
| Rate for Payer: PHP Medicare Advantage |
$405.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.80
|
| Rate for Payer: Priority Health HMO/PPO |
$571.62
|
| Rate for Payer: Priority Health Medicare |
$409.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$571.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$405.42
|
| Rate for Payer: UHC Exchange |
$405.42
|
| Rate for Payer: UHC Medicare Advantage |
$405.42
|
| Rate for Payer: UHCCP Medicaid |
$271.79
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
OP
|
$1,052.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$2,848.40 |
| Rate for Payer: Aetna Commercial |
$894.20
|
| Rate for Payer: Aetna Medicare |
$273.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$328.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$328.75
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$263.00
|
| Rate for Payer: BCBS Trust/PPO |
$864.85
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$817.93
|
| Rate for Payer: BCN Medicare Advantage |
$263.00
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$904.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.00
|
| Rate for Payer: Healthscope Commercial |
$946.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.00
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.15
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.20
|
| Rate for Payer: Nomi Health Commercial |
$862.64
|
| Rate for Payer: PACE Senior Care Partners |
$249.85
|
| Rate for Payer: PACE SWMI |
$263.00
|
| Rate for Payer: PHP Commercial |
$894.20
|
| Rate for Payer: PHP Medicare Advantage |
$263.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.80
|
| Rate for Payer: Priority Health HMO/PPO |
$915.24
|
| Rate for Payer: Priority Health Medicare |
$265.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$704.84
|
| Rate for Payer: Railroad Medicare Medicare |
$263.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.76
|
| Rate for Payer: UHC Core |
$878.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.00
|
| Rate for Payer: UHC Exchange |
$263.00
|
| Rate for Payer: UHC Medicare Advantage |
$263.00
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$263.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.00
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,052.00
|
|
|
Service Code
|
HCPCS 19120
|
| Hospital Charge Code |
19120
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$762.83 |
| Rate for Payer: Aetna Commercial |
$543.26
|
| Rate for Payer: Aetna Medicare |
$421.64
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS MAPPO |
$405.42
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$762.83
|
| Rate for Payer: BCN Medicare Advantage |
$405.42
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$583.80
|
| Rate for Payer: Cofinity Commercial |
$543.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.42
|
| Rate for Payer: Mclaren Medicaid |
$271.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.69
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Nomi Health Commercial |
$486.50
|
| Rate for Payer: PACE SWMI |
$405.42
|
| Rate for Payer: PHP Medicare Advantage |
$405.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.80
|
| Rate for Payer: Priority Health HMO/PPO |
$571.62
|
| Rate for Payer: Priority Health Medicare |
$409.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$571.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$405.42
|
| Rate for Payer: UHC Exchange |
$405.42
|
| Rate for Payer: UHC Medicare Advantage |
$405.42
|
| Rate for Payer: UHCCP Medicaid |
$271.79
|
|
|
PR EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
HCPCS 60200
|
| Min. Negotiated Rate |
$217.13 |
| Max. Negotiated Rate |
$1,088.30 |
| Rate for Payer: Aetna Commercial |
$862.38
|
| Rate for Payer: Aetna Medicare |
$669.31
|
| Rate for Payer: BCBS Complete |
$453.56
|
| Rate for Payer: BCBS MAPPO |
$643.57
|
| Rate for Payer: BCBS Trust/PPO |
$217.13
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$643.57
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cofinity Commercial |
$862.38
|
| Rate for Payer: Cofinity Commercial |
$926.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$643.57
|
| Rate for Payer: Mclaren Medicaid |
$431.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$675.75
|
| Rate for Payer: Meridian Medicaid |
$453.56
|
| Rate for Payer: Nomi Health Commercial |
$772.28
|
| Rate for Payer: PACE SWMI |
$643.57
|
| Rate for Payer: PHP Medicare Advantage |
$643.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,088.30
|
| Rate for Payer: Priority Health Medicare |
$650.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,088.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$643.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$643.57
|
| Rate for Payer: UHC Exchange |
$643.57
|
| Rate for Payer: UHC Medicare Advantage |
$643.57
|
| Rate for Payer: UHCCP Medicaid |
$431.96
|
|
|
PR EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM
|
Professional
|
Both
|
$3,970.00
|
|
|
Service Code
|
HCPCS 49204
|
| Min. Negotiated Rate |
$624.45 |
| Max. Negotiated Rate |
$2,580.50 |
| Rate for Payer: Aetna Commercial |
$2,046.13
|
| Rate for Payer: Aetna Medicare |
$1,985.00
|
| Rate for Payer: BCBS Complete |
$1,588.00
|
| Rate for Payer: BCBS Trust/PPO |
$624.45
|
| Rate for Payer: BCN Commercial |
$2,216.64
|
| Rate for Payer: Cash Price |
$3,176.00
|
| Rate for Payer: Cash Price |
$3,176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,580.50
|
|
|
PR EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM
|
Professional
|
Both
|
$3,208.00
|
|
|
Service Code
|
HCPCS 49205
|
| Min. Negotiated Rate |
$366.64 |
| Max. Negotiated Rate |
$2,544.55 |
| Rate for Payer: Aetna Commercial |
$2,348.49
|
| Rate for Payer: Aetna Medicare |
$1,604.00
|
| Rate for Payer: BCBS Complete |
$1,283.20
|
| Rate for Payer: BCBS Trust/PPO |
$366.64
|
| Rate for Payer: BCN Commercial |
$2,544.55
|
| Rate for Payer: Cash Price |
$2,566.40
|
| Rate for Payer: Cash Price |
$2,566.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,085.20
|
|
|
PR EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX
|
Professional
|
Both
|
$1,051.00
|
|
|
Service Code
|
HCPCS 42870
|
| Min. Negotiated Rate |
$377.01 |
| Max. Negotiated Rate |
$1,057.77 |
| Rate for Payer: Aetna Commercial |
$729.30
|
| Rate for Payer: Aetna Medicare |
$566.02
|
| Rate for Payer: BCBS Complete |
$395.86
|
| Rate for Payer: BCBS MAPPO |
$544.25
|
| Rate for Payer: BCBS Trust/PPO |
$829.43
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$544.25
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cofinity Commercial |
$729.30
|
| Rate for Payer: Cofinity Commercial |
$783.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.25
|
| Rate for Payer: Mclaren Medicaid |
$377.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.46
|
| Rate for Payer: Meridian Medicaid |
$395.86
|
| Rate for Payer: Nomi Health Commercial |
$653.10
|
| Rate for Payer: PACE SWMI |
$544.25
|
| Rate for Payer: PHP Medicare Advantage |
$544.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,057.77
|
| Rate for Payer: Priority Health Medicare |
$549.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,057.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$544.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$544.25
|
| Rate for Payer: UHC Exchange |
$544.25
|
| Rate for Payer: UHC Medicare Advantage |
$544.25
|
| Rate for Payer: UHCCP Medicaid |
$377.01
|
|
|
PR EXC EXCSV SKN ABD INFRAUMBILICAL PANNICULECTOMY
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 15830
|
| Min. Negotiated Rate |
$226.01 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Commercial |
$1,509.38
|
| Rate for Payer: Aetna Medicare |
$1,171.46
|
| Rate for Payer: BCBS Complete |
$795.97
|
| Rate for Payer: BCBS MAPPO |
$1,126.40
|
| Rate for Payer: BCBS Trust/PPO |
$226.01
|
| Rate for Payer: BCN Commercial |
$1,711.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,126.40
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cofinity Commercial |
$1,622.02
|
| Rate for Payer: Cofinity Commercial |
$1,509.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,126.40
|
| Rate for Payer: Mclaren Medicaid |
$758.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,182.72
|
| Rate for Payer: Meridian Medicaid |
$795.97
|
| Rate for Payer: Nomi Health Commercial |
$1,351.68
|
| Rate for Payer: PACE SWMI |
$1,126.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,126.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$758.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,588.89
|
| Rate for Payer: Priority Health Medicare |
$1,137.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,588.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,126.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,126.40
|
| Rate for Payer: UHC Exchange |
$1,126.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,126.40
|
| Rate for Payer: UHCCP Medicaid |
$758.07
|
|
|
PR EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F
|
Professional
|
Both
|
$2,651.00
|
|
|
Service Code
|
HCPCS 26390
|
| Min. Negotiated Rate |
$153.74 |
| Max. Negotiated Rate |
$1,723.15 |
| Rate for Payer: Aetna Commercial |
$1,106.95
|
| Rate for Payer: Aetna Medicare |
$859.12
|
| Rate for Payer: BCBS Complete |
$594.02
|
| Rate for Payer: BCBS MAPPO |
$826.08
|
| Rate for Payer: BCBS Trust/PPO |
$153.74
|
| Rate for Payer: BCN Commercial |
$1,303.31
|
| Rate for Payer: BCN Medicare Advantage |
$826.08
|
| Rate for Payer: Cash Price |
$2,120.80
|
| Rate for Payer: Cash Price |
$2,120.80
|
| Rate for Payer: Cofinity Commercial |
$1,189.56
|
| Rate for Payer: Cofinity Commercial |
$1,106.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$826.08
|
| Rate for Payer: Mclaren Medicaid |
$565.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$867.38
|
| Rate for Payer: Meridian Medicaid |
$594.02
|
| Rate for Payer: Nomi Health Commercial |
$991.30
|
| Rate for Payer: PACE SWMI |
$826.08
|
| Rate for Payer: PHP Medicare Advantage |
$826.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$565.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,355.61
|
| Rate for Payer: Priority Health Medicare |
$834.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,355.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$826.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$826.08
|
| Rate for Payer: UHC Exchange |
$826.08
|
| Rate for Payer: UHC Medicare Advantage |
$826.08
|
| Rate for Payer: UHCCP Medicaid |
$565.73
|
|
|
PR EXC FRENUM LABIAL/BUCCAL
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 40819
|
| Min. Negotiated Rate |
$130.57 |
| Max. Negotiated Rate |
$760.22 |
| Rate for Payer: Aetna Commercial |
$254.35
|
| Rate for Payer: Aetna Medicare |
$197.40
|
| Rate for Payer: BCBS Complete |
$137.10
|
| Rate for Payer: BCBS MAPPO |
$189.81
|
| Rate for Payer: BCBS Trust/PPO |
$760.22
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Medicare Advantage |
$189.81
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$273.33
|
| Rate for Payer: Cofinity Commercial |
$254.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.81
|
| Rate for Payer: Mclaren Medicaid |
$130.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.30
|
| Rate for Payer: Meridian Medicaid |
$137.10
|
| Rate for Payer: Nomi Health Commercial |
$227.77
|
| Rate for Payer: PACE SWMI |
$189.81
|
| Rate for Payer: PHP Medicare Advantage |
$189.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: Priority Health HMO/PPO |
$358.56
|
| Rate for Payer: Priority Health Medicare |
$191.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.81
|
| Rate for Payer: UHC Exchange |
$189.81
|
| Rate for Payer: UHC Medicare Advantage |
$189.81
|
| Rate for Payer: UHCCP Medicaid |
$130.57
|
|
|
PR EXC/FULGURATION URETHRAL CARUNCLE
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 53265
|
| Min. Negotiated Rate |
$122.05 |
| Max. Negotiated Rate |
$1,099.39 |
| Rate for Payer: Aetna Commercial |
$243.93
|
| Rate for Payer: Aetna Medicare |
$189.32
|
| Rate for Payer: BCBS Complete |
$128.15
|
| Rate for Payer: BCBS MAPPO |
$182.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
| Rate for Payer: BCN Commercial |
$334.26
|
| Rate for Payer: BCN Medicare Advantage |
$182.04
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$262.14
|
| Rate for Payer: Cofinity Commercial |
$243.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.04
|
| Rate for Payer: Mclaren Medicaid |
$122.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.14
|
| Rate for Payer: Meridian Medicaid |
$128.15
|
| Rate for Payer: Nomi Health Commercial |
$218.45
|
| Rate for Payer: PACE SWMI |
$182.04
|
| Rate for Payer: PHP Medicare Advantage |
$182.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO |
$301.98
|
| Rate for Payer: Priority Health Medicare |
$183.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.04
|
| Rate for Payer: UHC Exchange |
$182.04
|
| Rate for Payer: UHC Medicare Advantage |
$182.04
|
| Rate for Payer: UHCCP Medicaid |
$122.05
|
|
|
PR EXC/FULGURATION URETHRAL POLYP DSTL URETHRA
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 53260
|
| Min. Negotiated Rate |
$116.94 |
| Max. Negotiated Rate |
$546.26 |
| Rate for Payer: Aetna Commercial |
$233.24
|
| Rate for Payer: Aetna Medicare |
$181.02
|
| Rate for Payer: BCBS Complete |
$122.79
|
| Rate for Payer: BCBS MAPPO |
$174.06
|
| Rate for Payer: BCBS Trust/PPO |
$546.26
|
| Rate for Payer: BCN Commercial |
$302.00
|
| Rate for Payer: BCN Medicare Advantage |
$174.06
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$233.24
|
| Rate for Payer: Cofinity Commercial |
$250.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.06
|
| Rate for Payer: Mclaren Medicaid |
$116.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.76
|
| Rate for Payer: Meridian Medicaid |
$122.79
|
| Rate for Payer: Nomi Health Commercial |
$208.87
|
| Rate for Payer: PACE SWMI |
$174.06
|
| Rate for Payer: PHP Medicare Advantage |
$174.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.75
|
| Rate for Payer: Priority Health HMO/PPO |
$290.27
|
| Rate for Payer: Priority Health Medicare |
$175.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.06
|
| Rate for Payer: UHC Exchange |
$174.06
|
| Rate for Payer: UHC Medicare Advantage |
$174.06
|
| Rate for Payer: UHCCP Medicaid |
$116.94
|
|
|
PR EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Professional
|
Both
|
$1,274.00
|
|
|
Service Code
|
HCPCS 50435
|
| Min. Negotiated Rate |
$62.62 |
| Max. Negotiated Rate |
$888.91 |
| Rate for Payer: Aetna Commercial |
$125.16
|
| Rate for Payer: Aetna Medicare |
$97.14
|
| Rate for Payer: BCBS Complete |
$65.75
|
| Rate for Payer: BCBS MAPPO |
$93.40
|
| Rate for Payer: BCN Commercial |
$888.91
|
| Rate for Payer: BCN Medicare Advantage |
$93.40
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cofinity Commercial |
$134.50
|
| Rate for Payer: Cofinity Commercial |
$125.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.40
|
| Rate for Payer: Mclaren Medicaid |
$62.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.07
|
| Rate for Payer: Meridian Medicaid |
$65.75
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PACE SWMI |
$93.40
|
| Rate for Payer: PHP Medicare Advantage |
$93.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.10
|
| Rate for Payer: Priority Health HMO/PPO |
$155.52
|
| Rate for Payer: Priority Health Medicare |
$94.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.40
|
| Rate for Payer: UHC Exchange |
$93.40
|
| Rate for Payer: UHC Medicare Advantage |
$93.40
|
| Rate for Payer: UHCCP Medicaid |
$62.62
|
|
|
PR EXCHNG ABSC/CST DRG CATH RAD GID SPX
|
Professional
|
Both
|
$1,274.00
|
|
|
Service Code
|
HCPCS 49423
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$1,009.05 |
| Rate for Payer: Aetna Commercial |
$89.19
|
| Rate for Payer: Aetna Medicare |
$69.22
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$66.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.05
|
| Rate for Payer: BCN Commercial |
$875.23
|
| Rate for Payer: BCN Medicare Advantage |
$66.56
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cofinity Commercial |
$95.85
|
| Rate for Payer: Cofinity Commercial |
$89.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.56
|
| Rate for Payer: Mclaren Medicaid |
$44.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.89
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Nomi Health Commercial |
$79.87
|
| Rate for Payer: PACE SWMI |
$66.56
|
| Rate for Payer: PHP Medicare Advantage |
$66.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.10
|
| Rate for Payer: Priority Health HMO/PPO |
$122.89
|
| Rate for Payer: Priority Health Medicare |
$67.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.56
|
| Rate for Payer: UHC Exchange |
$66.56
|
| Rate for Payer: UHC Medicare Advantage |
$66.56
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR EXC HYDROCELE SPRMATIC CORD UNI SPX
|
Professional
|
Both
|
$725.00
|
|
|
Service Code
|
HCPCS 55500
|
| Min. Negotiated Rate |
$252.83 |
| Max. Negotiated Rate |
$2,419.09 |
| Rate for Payer: Aetna Commercial |
$502.81
|
| Rate for Payer: Aetna Medicare |
$390.24
|
| Rate for Payer: BCBS Complete |
$265.47
|
| Rate for Payer: BCBS MAPPO |
$375.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.09
|
| Rate for Payer: BCN Commercial |
$570.77
|
| Rate for Payer: BCN Medicare Advantage |
$375.23
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cash Price |
$580.00
|
| Rate for Payer: Cofinity Commercial |
$540.33
|
| Rate for Payer: Cofinity Commercial |
$502.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.23
|
| Rate for Payer: Mclaren Medicaid |
$252.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.99
|
| Rate for Payer: Meridian Medicaid |
$265.47
|
| Rate for Payer: Nomi Health Commercial |
$450.28
|
| Rate for Payer: PACE SWMI |
$375.23
|
| Rate for Payer: PHP Medicare Advantage |
$375.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.25
|
| Rate for Payer: Priority Health HMO/PPO |
$629.01
|
| Rate for Payer: Priority Health Medicare |
$378.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$629.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$375.23
|
| Rate for Payer: UHC Exchange |
$375.23
|
| Rate for Payer: UHC Medicare Advantage |
$375.23
|
| Rate for Payer: UHCCP Medicaid |
$252.83
|
|
|
PR EXC ILEOANAL RSVR W/ILEOSTOMY
|
Professional
|
Both
|
$3,254.00
|
|
|
Service Code
|
HCPCS 45136
|
| Min. Negotiated Rate |
$1,131.88 |
| Max. Negotiated Rate |
$3,163.14 |
| Rate for Payer: Aetna Commercial |
$2,264.35
|
| Rate for Payer: Aetna Medicare |
$1,757.40
|
| Rate for Payer: BCBS Complete |
$1,188.47
|
| Rate for Payer: BCBS MAPPO |
$1,689.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.07
|
| Rate for Payer: BCN Commercial |
$2,582.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,689.81
|
| Rate for Payer: Cash Price |
$2,603.20
|
| Rate for Payer: Cash Price |
$2,603.20
|
| Rate for Payer: Cofinity Commercial |
$2,433.33
|
| Rate for Payer: Cofinity Commercial |
$2,264.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,689.81
|
| Rate for Payer: Mclaren Medicaid |
$1,131.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,774.30
|
| Rate for Payer: Meridian Medicaid |
$1,188.47
|
| Rate for Payer: Nomi Health Commercial |
$2,027.77
|
| Rate for Payer: PACE SWMI |
$1,689.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,689.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,131.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,115.10
|
| Rate for Payer: Priority Health HMO/PPO |
$3,163.14
|
| Rate for Payer: Priority Health Medicare |
$1,706.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,163.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,689.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,689.81
|
| Rate for Payer: UHC Exchange |
$1,689.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,689.81
|
| Rate for Payer: UHCCP Medicaid |
$1,131.88
|
|
|
PR EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP
|
Professional
|
Both
|
$4,392.00
|
|
|
Service Code
|
HCPCS 33120
|
| Min. Negotiated Rate |
$1,008.52 |
| Max. Negotiated Rate |
$3,268.59 |
| Rate for Payer: Aetna Commercial |
$2,687.72
|
| Rate for Payer: Aetna Medicare |
$2,085.99
|
| Rate for Payer: BCBS Complete |
$1,379.70
|
| Rate for Payer: BCBS MAPPO |
$2,005.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.52
|
| Rate for Payer: BCN Commercial |
$2,991.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,005.76
|
| Rate for Payer: Cash Price |
$3,513.60
|
| Rate for Payer: Cash Price |
$3,513.60
|
| Rate for Payer: Cofinity Commercial |
$2,888.29
|
| Rate for Payer: Cofinity Commercial |
$2,687.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,005.76
|
| Rate for Payer: Mclaren Medicaid |
$1,314.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,106.05
|
| Rate for Payer: Meridian Medicaid |
$1,379.70
|
| Rate for Payer: Nomi Health Commercial |
$2,406.91
|
| Rate for Payer: PACE SWMI |
$2,005.76
|
| Rate for Payer: PHP Medicare Advantage |
$2,005.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,314.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,854.80
|
| Rate for Payer: Priority Health HMO/PPO |
$3,268.59
|
| Rate for Payer: Priority Health Medicare |
$2,025.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,268.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,005.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,005.76
|
| Rate for Payer: UHC Exchange |
$2,005.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,005.76
|
| Rate for Payer: UHCCP Medicaid |
$1,314.00
|
|
|
PR EXCIS CHEST WALL TUMOR/RIBS
|
Professional
|
Both
|
$2,265.00
|
|
|
Service Code
|
HCPCS 19260
|
| Min. Negotiated Rate |
$906.00 |
| Max. Negotiated Rate |
$1,472.25 |
| Rate for Payer: Aetna Medicare |
$1,132.50
|
| Rate for Payer: BCBS Complete |
$906.00
|
| Rate for Payer: Cash Price |
$1,812.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.25
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,248.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$459.65 |
| Max. Negotiated Rate |
$1,038.93 |
| Rate for Payer: Aetna Commercial |
$916.57
|
| Rate for Payer: Aetna Medicare |
$711.37
|
| Rate for Payer: BCBS Complete |
$482.63
|
| Rate for Payer: BCBS MAPPO |
$684.01
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$1,038.93
|
| Rate for Payer: BCN Medicare Advantage |
$684.01
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cofinity Commercial |
$984.97
|
| Rate for Payer: Cofinity Commercial |
$916.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.01
|
| Rate for Payer: Mclaren Medicaid |
$459.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.21
|
| Rate for Payer: Meridian Medicaid |
$482.63
|
| Rate for Payer: Nomi Health Commercial |
$820.81
|
| Rate for Payer: PACE SWMI |
$684.01
|
| Rate for Payer: PHP Medicare Advantage |
$684.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$459.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.20
|
| Rate for Payer: Priority Health HMO/PPO |
$965.35
|
| Rate for Payer: Priority Health Medicare |
$690.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$965.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$684.01
|
| Rate for Payer: UHC Exchange |
$684.01
|
| Rate for Payer: UHC Medicare Advantage |
$684.01
|
| Rate for Payer: UHCCP Medicaid |
$459.65
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$604.28 |
| Max. Negotiated Rate |
$2,275.40 |
| Rate for Payer: Aetna Commercial |
$1,194.11
|
| Rate for Payer: Aetna Medicare |
$926.78
|
| Rate for Payer: BCBS Complete |
$634.49
|
| Rate for Payer: BCBS MAPPO |
$891.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,275.40
|
| Rate for Payer: BCN Commercial |
$1,369.28
|
| Rate for Payer: BCN Medicare Advantage |
$891.13
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,283.23
|
| Rate for Payer: Cofinity Commercial |
$1,194.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$891.13
|
| Rate for Payer: Mclaren Medicaid |
$604.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$935.69
|
| Rate for Payer: Meridian Medicaid |
$634.49
|
| Rate for Payer: Nomi Health Commercial |
$1,069.36
|
| Rate for Payer: PACE SWMI |
$891.13
|
| Rate for Payer: PHP Medicare Advantage |
$891.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$604.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,269.66
|
| Rate for Payer: Priority Health Medicare |
$900.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,269.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$891.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$891.13
|
| Rate for Payer: UHC Exchange |
$891.13
|
| Rate for Payer: UHC Medicare Advantage |
$891.13
|
| Rate for Payer: UHCCP Medicaid |
$604.28
|
|
|
PR EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$3,352.00
|
|
|
Service Code
|
HCPCS 15946
|
| Min. Negotiated Rate |
$1,030.92 |
| Max. Negotiated Rate |
$2,363.25 |
| Rate for Payer: Aetna Commercial |
$2,058.15
|
| Rate for Payer: Aetna Medicare |
$1,597.37
|
| Rate for Payer: BCBS Complete |
$1,082.47
|
| Rate for Payer: BCBS MAPPO |
$1,535.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.35
|
| Rate for Payer: BCN Commercial |
$2,363.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,535.93
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cofinity Commercial |
$2,211.74
|
| Rate for Payer: Cofinity Commercial |
$2,058.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,535.93
|
| Rate for Payer: Mclaren Medicaid |
$1,030.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,612.73
|
| Rate for Payer: Meridian Medicaid |
$1,082.47
|
| Rate for Payer: Nomi Health Commercial |
$1,843.12
|
| Rate for Payer: PACE SWMI |
$1,535.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,535.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,030.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,182.63
|
| Rate for Payer: Priority Health Medicare |
$1,551.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,182.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,535.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,535.93
|
| Rate for Payer: UHC Exchange |
$1,535.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,535.93
|
| Rate for Payer: UHCCP Medicaid |
$1,030.92
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,616.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$1,372.69 |
| Rate for Payer: Aetna Commercial |
$1,209.28
|
| Rate for Payer: Aetna Medicare |
$938.55
|
| Rate for Payer: BCBS Complete |
$643.22
|
| Rate for Payer: BCBS MAPPO |
$902.45
|
| Rate for Payer: BCBS Trust/PPO |
$562.50
|
| Rate for Payer: BCN Commercial |
$1,372.69
|
| Rate for Payer: BCN Medicare Advantage |
$902.45
|
| Rate for Payer: Cash Price |
$1,292.80
|
| Rate for Payer: Cash Price |
$1,292.80
|
| Rate for Payer: Cofinity Commercial |
$1,299.53
|
| Rate for Payer: Cofinity Commercial |
$1,209.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.45
|
| Rate for Payer: Mclaren Medicaid |
$612.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$947.57
|
| Rate for Payer: Meridian Medicaid |
$643.22
|
| Rate for Payer: Nomi Health Commercial |
$1,082.94
|
| Rate for Payer: PACE SWMI |
$902.45
|
| Rate for Payer: PHP Medicare Advantage |
$902.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$612.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,261.53
|
| Rate for Payer: Priority Health Medicare |
$911.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,261.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$902.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.45
|
| Rate for Payer: UHC Exchange |
$902.45
|
| Rate for Payer: UHC Medicare Advantage |
$902.45
|
| Rate for Payer: UHCCP Medicaid |
$612.59
|
|
|
PR EXCISION 1ST &/CERVICAL RIB
|
Professional
|
Both
|
$1,202.00
|
|
|
Service Code
|
HCPCS 21615
|
| Min. Negotiated Rate |
$400.23 |
| Max. Negotiated Rate |
$3,350.93 |
| Rate for Payer: Aetna Commercial |
$810.99
|
| Rate for Payer: Aetna Medicare |
$629.43
|
| Rate for Payer: BCBS Complete |
$420.24
|
| Rate for Payer: BCBS MAPPO |
$605.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$904.54
|
| Rate for Payer: BCN Medicare Advantage |
$605.22
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cofinity Commercial |
$871.52
|
| Rate for Payer: Cofinity Commercial |
$810.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.22
|
| Rate for Payer: Mclaren Medicaid |
$400.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.48
|
| Rate for Payer: Meridian Medicaid |
$420.24
|
| Rate for Payer: Nomi Health Commercial |
$726.26
|
| Rate for Payer: PACE SWMI |
$605.22
|
| Rate for Payer: PHP Medicare Advantage |
$605.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.30
|
| Rate for Payer: Priority Health HMO/PPO |
$949.53
|
| Rate for Payer: Priority Health Medicare |
$611.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$949.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$605.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.22
|
| Rate for Payer: UHC Exchange |
$605.22
|
| Rate for Payer: UHC Medicare Advantage |
$605.22
|
| Rate for Payer: UHCCP Medicaid |
$400.23
|
|
