|
PR EXCISION EXTERNAL EAR COMPLETE AMPUTATION
|
Professional
|
Both
|
$724.00
|
|
|
Service Code
|
HCPCS 69120
|
| Min. Negotiated Rate |
$289.60 |
| Max. Negotiated Rate |
$519.26 |
| Rate for Payer: Aetna Commercial |
$483.20
|
| Rate for Payer: Aetna Medicare |
$375.02
|
| Rate for Payer: BCBS Complete |
$289.60
|
| Rate for Payer: BCBS MAPPO |
$360.60
|
| Rate for Payer: BCN Medicare Advantage |
$360.60
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$519.26
|
| Rate for Payer: Cofinity Commercial |
$483.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.63
|
| Rate for Payer: Nomi Health Commercial |
$432.72
|
| Rate for Payer: PACE SWMI |
$360.60
|
| Rate for Payer: PHP Medicare Advantage |
$360.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.60
|
| Rate for Payer: Priority Health Medicare |
$364.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$360.60
|
| Rate for Payer: UHC Exchange |
$360.60
|
| Rate for Payer: UHC Medicare Advantage |
$360.60
|
|
|
PR EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Professional
|
Both
|
$624.00
|
|
|
Service Code
|
HCPCS 69110
|
| Min. Negotiated Rate |
$249.60 |
| Max. Negotiated Rate |
$440.77 |
| Rate for Payer: Aetna Commercial |
$410.16
|
| Rate for Payer: Aetna Medicare |
$318.33
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$306.09
|
| Rate for Payer: BCN Medicare Advantage |
$306.09
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cofinity Commercial |
$440.77
|
| Rate for Payer: Cofinity Commercial |
$410.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.39
|
| Rate for Payer: Nomi Health Commercial |
$367.31
|
| Rate for Payer: PACE SWMI |
$306.09
|
| Rate for Payer: PHP Medicare Advantage |
$306.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.60
|
| Rate for Payer: Priority Health Medicare |
$309.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.09
|
| Rate for Payer: UHC Exchange |
$306.09
|
| Rate for Payer: UHC Medicare Advantage |
$306.09
|
|
|
PR EXCISION FACIAL BONE
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 21026
|
| Min. Negotiated Rate |
$399.20 |
| Max. Negotiated Rate |
$648.70 |
| Rate for Payer: Aetna Commercial |
$554.48
|
| Rate for Payer: Aetna Medicare |
$430.34
|
| Rate for Payer: BCBS Complete |
$399.20
|
| Rate for Payer: BCBS MAPPO |
$413.79
|
| Rate for Payer: BCN Medicare Advantage |
$413.79
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$595.86
|
| Rate for Payer: Cofinity Commercial |
$554.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.48
|
| Rate for Payer: Nomi Health Commercial |
$496.55
|
| Rate for Payer: PACE SWMI |
$413.79
|
| Rate for Payer: PHP Medicare Advantage |
$413.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.70
|
| Rate for Payer: Priority Health Medicare |
$417.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.79
|
| Rate for Payer: UHC Exchange |
$413.79
|
| Rate for Payer: UHC Medicare Advantage |
$413.79
|
|
|
PR EXCISION/FULGURATION URETHRAL PROLAPSE
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 53275
|
| Min. Negotiated Rate |
$251.04 |
| Max. Negotiated Rate |
$561.60 |
| Rate for Payer: Aetna Commercial |
$336.39
|
| Rate for Payer: Aetna Medicare |
$261.08
|
| Rate for Payer: BCBS Complete |
$345.60
|
| Rate for Payer: BCBS MAPPO |
$251.04
|
| Rate for Payer: BCN Medicare Advantage |
$251.04
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$361.50
|
| Rate for Payer: Cofinity Commercial |
$336.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.59
|
| Rate for Payer: Nomi Health Commercial |
$301.25
|
| Rate for Payer: PACE SWMI |
$251.04
|
| Rate for Payer: PHP Medicare Advantage |
$251.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health Medicare |
$253.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.04
|
| Rate for Payer: UHC Exchange |
$251.04
|
| Rate for Payer: UHC Medicare Advantage |
$251.04
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY
|
Professional
|
Both
|
$1,106.00
|
|
|
Service Code
|
HCPCS 25111
|
| Min. Negotiated Rate |
$315.15 |
| Max. Negotiated Rate |
$718.90 |
| Rate for Payer: Aetna Commercial |
$422.30
|
| Rate for Payer: Aetna Medicare |
$327.76
|
| Rate for Payer: BCBS Complete |
$442.40
|
| Rate for Payer: BCBS MAPPO |
$315.15
|
| Rate for Payer: BCN Medicare Advantage |
$315.15
|
| Rate for Payer: Cash Price |
$884.80
|
| Rate for Payer: Cash Price |
$884.80
|
| Rate for Payer: Cofinity Commercial |
$453.82
|
| Rate for Payer: Cofinity Commercial |
$422.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.91
|
| Rate for Payer: Nomi Health Commercial |
$378.18
|
| Rate for Payer: PACE SWMI |
$315.15
|
| Rate for Payer: PHP Medicare Advantage |
$315.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.90
|
| Rate for Payer: Priority Health Medicare |
$318.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$315.15
|
| Rate for Payer: UHC Exchange |
$315.15
|
| Rate for Payer: UHC Medicare Advantage |
$315.15
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT
|
Professional
|
Both
|
$1,150.00
|
|
|
Service Code
|
HCPCS 25112
|
| Min. Negotiated Rate |
$379.52 |
| Max. Negotiated Rate |
$747.50 |
| Rate for Payer: Aetna Commercial |
$508.56
|
| Rate for Payer: Aetna Medicare |
$394.70
|
| Rate for Payer: BCBS Complete |
$460.00
|
| Rate for Payer: BCBS MAPPO |
$379.52
|
| Rate for Payer: BCN Medicare Advantage |
$379.52
|
| Rate for Payer: Cash Price |
$920.00
|
| Rate for Payer: Cash Price |
$920.00
|
| Rate for Payer: Cofinity Commercial |
$546.51
|
| Rate for Payer: Cofinity Commercial |
$508.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.50
|
| Rate for Payer: Nomi Health Commercial |
$455.42
|
| Rate for Payer: PACE SWMI |
$379.52
|
| Rate for Payer: PHP Medicare Advantage |
$379.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.50
|
| Rate for Payer: Priority Health Medicare |
$383.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.52
|
| Rate for Payer: UHC Exchange |
$379.52
|
| Rate for Payer: UHC Medicare Advantage |
$379.52
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 11451
|
| Min. Negotiated Rate |
$319.61 |
| Max. Negotiated Rate |
$544.05 |
| Rate for Payer: Aetna Commercial |
$428.28
|
| Rate for Payer: Aetna Medicare |
$332.39
|
| Rate for Payer: BCBS Complete |
$334.80
|
| Rate for Payer: BCBS MAPPO |
$319.61
|
| Rate for Payer: BCN Medicare Advantage |
$319.61
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$460.24
|
| Rate for Payer: Cofinity Commercial |
$428.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.59
|
| Rate for Payer: Nomi Health Commercial |
$383.53
|
| Rate for Payer: PACE SWMI |
$319.61
|
| Rate for Payer: PHP Medicare Advantage |
$319.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health Medicare |
$322.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.61
|
| Rate for Payer: UHC Exchange |
$319.61
|
| Rate for Payer: UHC Medicare Advantage |
$319.61
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Facility
|
OP
|
$837.00
|
|
|
Service Code
|
CPT 11451
|
| Hospital Charge Code |
11451
|
| Min. Negotiated Rate |
$198.79 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$711.45
|
| Rate for Payer: Aetna Medicare |
$217.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$261.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$261.56
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$209.25
|
| Rate for Payer: BCBS Trust/PPO |
$688.10
|
| Rate for Payer: BCN Commercial |
$650.77
|
| Rate for Payer: BCN Medicare Advantage |
$209.25
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$719.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.25
|
| Rate for Payer: Healthscope Commercial |
$753.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$627.75
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.71
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$711.45
|
| Rate for Payer: Nomi Health Commercial |
$686.34
|
| Rate for Payer: PACE Senior Care Partners |
$198.79
|
| Rate for Payer: PACE SWMI |
$209.25
|
| Rate for Payer: PHP Commercial |
$711.45
|
| Rate for Payer: PHP Medicare Advantage |
$209.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health HMO/PPO |
$728.19
|
| Rate for Payer: Priority Health Medicare |
$211.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.79
|
| Rate for Payer: Railroad Medicare Medicare |
$209.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$736.56
|
| Rate for Payer: UHC Core |
$698.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.25
|
| Rate for Payer: UHC Exchange |
$209.25
|
| Rate for Payer: UHC Medicare Advantage |
$209.25
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$209.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$627.75
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 11451
|
| Hospital Charge Code |
11451
|
| Min. Negotiated Rate |
$319.61 |
| Max. Negotiated Rate |
$544.05 |
| Rate for Payer: Aetna Commercial |
$428.28
|
| Rate for Payer: Aetna Medicare |
$332.39
|
| Rate for Payer: BCBS Complete |
$334.80
|
| Rate for Payer: BCBS MAPPO |
$319.61
|
| Rate for Payer: BCN Medicare Advantage |
$319.61
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$460.24
|
| Rate for Payer: Cofinity Commercial |
$428.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.59
|
| Rate for Payer: Nomi Health Commercial |
$383.53
|
| Rate for Payer: PACE SWMI |
$319.61
|
| Rate for Payer: PHP Medicare Advantage |
$319.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health Medicare |
$322.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.61
|
| Rate for Payer: UHC Exchange |
$319.61
|
| Rate for Payer: UHC Medicare Advantage |
$319.61
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Facility
|
IP
|
$837.00
|
|
|
Service Code
|
CPT 11451
|
| Hospital Charge Code |
11451
|
| Min. Negotiated Rate |
$544.05 |
| Max. Negotiated Rate |
$753.30 |
| Rate for Payer: Aetna Commercial |
$711.45
|
| Rate for Payer: BCBS Trust/PPO |
$683.24
|
| Rate for Payer: BCN Commercial |
$646.83
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$719.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.60
|
| Rate for Payer: Healthscope Commercial |
$753.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$627.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$711.45
|
| Rate for Payer: Nomi Health Commercial |
$686.34
|
| Rate for Payer: PHP Commercial |
$711.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health HMO/PPO |
$728.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$736.56
|
| Rate for Payer: UHC Core |
$698.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$627.75
|
|
|
PR EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR
|
Professional
|
Both
|
$733.00
|
|
|
Service Code
|
HCPCS 11450
|
| Min. Negotiated Rate |
$251.79 |
| Max. Negotiated Rate |
$476.45 |
| Rate for Payer: Aetna Commercial |
$337.40
|
| Rate for Payer: Aetna Medicare |
$261.86
|
| Rate for Payer: BCBS Complete |
$293.20
|
| Rate for Payer: BCBS MAPPO |
$251.79
|
| Rate for Payer: BCN Medicare Advantage |
$251.79
|
| Rate for Payer: Cash Price |
$586.40
|
| Rate for Payer: Cash Price |
$586.40
|
| Rate for Payer: Cofinity Commercial |
$362.58
|
| Rate for Payer: Cofinity Commercial |
$337.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$264.38
|
| Rate for Payer: Nomi Health Commercial |
$302.15
|
| Rate for Payer: PACE SWMI |
$251.79
|
| Rate for Payer: PHP Medicare Advantage |
$251.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$476.45
|
| Rate for Payer: Priority Health Medicare |
$254.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.79
|
| Rate for Payer: UHC Exchange |
$251.79
|
| Rate for Payer: UHC Medicare Advantage |
$251.79
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 11463
|
| Min. Negotiated Rate |
$254.00 |
| Max. Negotiated Rate |
$456.84 |
| Rate for Payer: Aetna Commercial |
$425.12
|
| Rate for Payer: Aetna Medicare |
$329.94
|
| Rate for Payer: BCBS Complete |
$254.00
|
| Rate for Payer: BCBS MAPPO |
$317.25
|
| Rate for Payer: BCN Medicare Advantage |
$317.25
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$456.84
|
| Rate for Payer: Cofinity Commercial |
$425.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.11
|
| Rate for Payer: Nomi Health Commercial |
$380.70
|
| Rate for Payer: PACE SWMI |
$317.25
|
| Rate for Payer: PHP Medicare Advantage |
$317.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health Medicare |
$320.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.25
|
| Rate for Payer: UHC Exchange |
$317.25
|
| Rate for Payer: UHC Medicare Advantage |
$317.25
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$254.00 |
| Max. Negotiated Rate |
$456.84 |
| Rate for Payer: Aetna Commercial |
$425.12
|
| Rate for Payer: Aetna Medicare |
$329.94
|
| Rate for Payer: BCBS Complete |
$254.00
|
| Rate for Payer: BCBS MAPPO |
$317.25
|
| Rate for Payer: BCN Medicare Advantage |
$317.25
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$456.84
|
| Rate for Payer: Cofinity Commercial |
$425.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.11
|
| Rate for Payer: Nomi Health Commercial |
$380.70
|
| Rate for Payer: PACE SWMI |
$317.25
|
| Rate for Payer: PHP Medicare Advantage |
$317.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health Medicare |
$320.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.25
|
| Rate for Payer: UHC Exchange |
$317.25
|
| Rate for Payer: UHC Medicare Advantage |
$317.25
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Facility
|
OP
|
$635.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$150.81 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$539.75
|
| Rate for Payer: Aetna Medicare |
$165.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$198.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$198.44
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$158.75
|
| Rate for Payer: BCBS Trust/PPO |
$522.03
|
| Rate for Payer: BCN Commercial |
$493.71
|
| Rate for Payer: BCN Medicare Advantage |
$158.75
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$546.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.75
|
| Rate for Payer: Healthscope Commercial |
$571.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.25
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.69
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.75
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE Senior Care Partners |
$150.81
|
| Rate for Payer: PACE SWMI |
$158.75
|
| Rate for Payer: PHP Commercial |
$539.75
|
| Rate for Payer: PHP Medicare Advantage |
$158.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO |
$552.45
|
| Rate for Payer: Priority Health Medicare |
$160.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.45
|
| Rate for Payer: Railroad Medicare Medicare |
$158.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.80
|
| Rate for Payer: UHC Core |
$530.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.75
|
| Rate for Payer: UHC Exchange |
$158.75
|
| Rate for Payer: UHC Medicare Advantage |
$158.75
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$158.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.25
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Facility
|
IP
|
$635.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$412.75 |
| Max. Negotiated Rate |
$571.50 |
| Rate for Payer: Aetna Commercial |
$539.75
|
| Rate for Payer: BCBS Trust/PPO |
$518.35
|
| Rate for Payer: BCN Commercial |
$490.73
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$546.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.00
|
| Rate for Payer: Healthscope Commercial |
$571.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.75
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PHP Commercial |
$539.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO |
$552.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.80
|
| Rate for Payer: UHC Core |
$530.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.25
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$112.34 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$402.05
|
| Rate for Payer: Aetna Medicare |
$122.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.81
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$118.25
|
| Rate for Payer: BCBS Trust/PPO |
$388.85
|
| Rate for Payer: BCN Commercial |
$367.76
|
| Rate for Payer: BCN Medicare Advantage |
$118.25
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$406.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.25
|
| Rate for Payer: Healthscope Commercial |
$425.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.75
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.16
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.05
|
| Rate for Payer: Nomi Health Commercial |
$387.86
|
| Rate for Payer: PACE Senior Care Partners |
$112.34
|
| Rate for Payer: PACE SWMI |
$118.25
|
| Rate for Payer: PHP Commercial |
$402.05
|
| Rate for Payer: PHP Medicare Advantage |
$118.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO |
$411.51
|
| Rate for Payer: Priority Health Medicare |
$119.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$316.91
|
| Rate for Payer: Railroad Medicare Medicare |
$118.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$416.24
|
| Rate for Payer: UHC Core |
$394.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.25
|
| Rate for Payer: UHC Exchange |
$118.25
|
| Rate for Payer: UHC Medicare Advantage |
$118.25
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$118.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.75
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Facility
|
IP
|
$473.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$307.45 |
| Max. Negotiated Rate |
$425.70 |
| Rate for Payer: Aetna Commercial |
$402.05
|
| Rate for Payer: BCBS Trust/PPO |
$386.11
|
| Rate for Payer: BCN Commercial |
$365.53
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$406.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.40
|
| Rate for Payer: Healthscope Commercial |
$425.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.05
|
| Rate for Payer: Nomi Health Commercial |
$387.86
|
| Rate for Payer: PHP Commercial |
$402.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO |
$411.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$316.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$416.24
|
| Rate for Payer: UHC Core |
$394.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.75
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 11462
|
| Min. Negotiated Rate |
$189.20 |
| Max. Negotiated Rate |
$346.81 |
| Rate for Payer: Aetna Commercial |
$322.73
|
| Rate for Payer: Aetna Medicare |
$250.47
|
| Rate for Payer: BCBS Complete |
$189.20
|
| Rate for Payer: BCBS MAPPO |
$240.84
|
| Rate for Payer: BCN Medicare Advantage |
$240.84
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$346.81
|
| Rate for Payer: Cofinity Commercial |
$322.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.88
|
| Rate for Payer: Nomi Health Commercial |
$289.01
|
| Rate for Payer: PACE SWMI |
$240.84
|
| Rate for Payer: PHP Medicare Advantage |
$240.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health Medicare |
$243.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.84
|
| Rate for Payer: UHC Exchange |
$240.84
|
| Rate for Payer: UHC Medicare Advantage |
$240.84
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$189.20 |
| Max. Negotiated Rate |
$346.81 |
| Rate for Payer: Aetna Commercial |
$322.73
|
| Rate for Payer: Aetna Medicare |
$250.47
|
| Rate for Payer: BCBS Complete |
$189.20
|
| Rate for Payer: BCBS MAPPO |
$240.84
|
| Rate for Payer: BCN Medicare Advantage |
$240.84
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$346.81
|
| Rate for Payer: Cofinity Commercial |
$322.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.88
|
| Rate for Payer: Nomi Health Commercial |
$289.01
|
| Rate for Payer: PACE SWMI |
$240.84
|
| Rate for Payer: PHP Medicare Advantage |
$240.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health Medicare |
$243.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.84
|
| Rate for Payer: UHC Exchange |
$240.84
|
| Rate for Payer: UHC Medicare Advantage |
$240.84
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$640.90 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Aetna Commercial |
$838.10
|
| Rate for Payer: BCBS Trust/PPO |
$804.87
|
| Rate for Payer: BCN Commercial |
$761.98
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$847.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$788.80
|
| Rate for Payer: Healthscope Commercial |
$887.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$739.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.10
|
| Rate for Payer: Nomi Health Commercial |
$808.52
|
| Rate for Payer: PHP Commercial |
$838.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO |
$857.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$660.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$867.68
|
| Rate for Payer: UHC Core |
$823.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$739.50
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11471
|
| Min. Negotiated Rate |
$336.88 |
| Max. Negotiated Rate |
$640.90 |
| Rate for Payer: Aetna Commercial |
$451.42
|
| Rate for Payer: Aetna Medicare |
$350.36
|
| Rate for Payer: BCBS Complete |
$394.40
|
| Rate for Payer: BCBS MAPPO |
$336.88
|
| Rate for Payer: BCN Medicare Advantage |
$336.88
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$485.11
|
| Rate for Payer: Cofinity Commercial |
$451.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.72
|
| Rate for Payer: Nomi Health Commercial |
$404.26
|
| Rate for Payer: PACE SWMI |
$336.88
|
| Rate for Payer: PHP Medicare Advantage |
$336.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health Medicare |
$340.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.88
|
| Rate for Payer: UHC Exchange |
$336.88
|
| Rate for Payer: UHC Medicare Advantage |
$336.88
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$234.18 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$838.10
|
| Rate for Payer: Aetna Medicare |
$256.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$308.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$308.12
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$246.50
|
| Rate for Payer: BCBS Trust/PPO |
$810.59
|
| Rate for Payer: BCN Commercial |
$766.62
|
| Rate for Payer: BCN Medicare Advantage |
$246.50
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$847.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$788.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.50
|
| Rate for Payer: Healthscope Commercial |
$887.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$739.50
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.82
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$283.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.10
|
| Rate for Payer: Nomi Health Commercial |
$808.52
|
| Rate for Payer: PACE Senior Care Partners |
$234.18
|
| Rate for Payer: PACE SWMI |
$246.50
|
| Rate for Payer: PHP Commercial |
$838.10
|
| Rate for Payer: PHP Medicare Advantage |
$246.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO |
$857.82
|
| Rate for Payer: Priority Health Medicare |
$248.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$660.62
|
| Rate for Payer: Railroad Medicare Medicare |
$246.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$867.68
|
| Rate for Payer: UHC Core |
$823.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.50
|
| Rate for Payer: UHC Exchange |
$246.50
|
| Rate for Payer: UHC Medicare Advantage |
$246.50
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$246.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$739.50
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$336.88 |
| Max. Negotiated Rate |
$640.90 |
| Rate for Payer: Aetna Commercial |
$451.42
|
| Rate for Payer: Aetna Medicare |
$350.36
|
| Rate for Payer: BCBS Complete |
$394.40
|
| Rate for Payer: BCBS MAPPO |
$336.88
|
| Rate for Payer: BCN Medicare Advantage |
$336.88
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$485.11
|
| Rate for Payer: Cofinity Commercial |
$451.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.72
|
| Rate for Payer: Nomi Health Commercial |
$404.26
|
| Rate for Payer: PACE SWMI |
$336.88
|
| Rate for Payer: PHP Medicare Advantage |
$336.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health Medicare |
$340.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.88
|
| Rate for Payer: UHC Exchange |
$336.88
|
| Rate for Payer: UHC Medicare Advantage |
$336.88
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$275.43 |
| Max. Negotiated Rate |
$591.50 |
| Rate for Payer: Aetna Commercial |
$369.08
|
| Rate for Payer: Aetna Medicare |
$286.45
|
| Rate for Payer: BCBS Complete |
$364.00
|
| Rate for Payer: BCBS MAPPO |
$275.43
|
| Rate for Payer: BCN Medicare Advantage |
$275.43
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cofinity Commercial |
$396.62
|
| Rate for Payer: Cofinity Commercial |
$369.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.20
|
| Rate for Payer: Nomi Health Commercial |
$330.52
|
| Rate for Payer: PACE SWMI |
$275.43
|
| Rate for Payer: PHP Medicare Advantage |
$275.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$591.50
|
| Rate for Payer: Priority Health Medicare |
$278.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.43
|
| Rate for Payer: UHC Exchange |
$275.43
|
| Rate for Payer: UHC Medicare Advantage |
$275.43
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
IP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$1,197.95 |
| Max. Negotiated Rate |
$1,658.70 |
| Rate for Payer: Aetna Commercial |
$1,566.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,504.44
|
| Rate for Payer: BCN Commercial |
$1,424.27
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,584.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,474.40
|
| Rate for Payer: Healthscope Commercial |
$1,658.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,382.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: Nomi Health Commercial |
$1,511.26
|
| Rate for Payer: PHP Commercial |
$1,566.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,603.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,234.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,621.84
|
| Rate for Payer: UHC Core |
$1,538.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,382.25
|
|
