|
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 |
$2,128.93 |
| 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 |
$2,128.93
|
| 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 |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.16
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| 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 |
$2,027.42
|
| 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 |
$394.96
|
| 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 |
$2,027.42
|
| 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 |
$394.96
|
| 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
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$615.25 |
| Rate for Payer: Aetna Commercial |
$322.73
|
| Rate for Payer: Aetna Medicare |
$250.47
|
| Rate for Payer: BCBS Complete |
$171.99
|
| Rate for Payer: BCBS MAPPO |
$240.84
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$615.25
|
| 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: Mclaren Medicaid |
$163.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.88
|
| Rate for Payer: Meridian Medicaid |
$171.99
|
| 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 Choice Medicaid |
$163.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.45
|
| Rate for Payer: Priority Health HMO/PPO |
$341.34
|
| Rate for Payer: Priority Health Medicare |
$243.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.34
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$163.80
|
|
|
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 |
$2,128.93 |
| 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 |
$2,128.93
|
| 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 |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.82
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| 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 |
$2,027.42
|
| 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 |
$248.96
|
| 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 |
$2,027.42
|
| 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
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$796.55 |
| Rate for Payer: Aetna Commercial |
$451.42
|
| Rate for Payer: Aetna Medicare |
$350.36
|
| Rate for Payer: BCBS Complete |
$239.08
|
| Rate for Payer: BCBS MAPPO |
$336.88
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$796.55
|
| 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: Mclaren Medicaid |
$227.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.72
|
| Rate for Payer: Meridian Medicaid |
$239.08
|
| 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 Choice Medicaid |
$227.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO |
$479.51
|
| Rate for Payer: Priority Health Medicare |
$340.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$479.51
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$227.70
|
|
|
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
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$796.55 |
| Rate for Payer: Aetna Commercial |
$451.42
|
| Rate for Payer: Aetna Medicare |
$350.36
|
| Rate for Payer: BCBS Complete |
$239.08
|
| Rate for Payer: BCBS MAPPO |
$336.88
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$796.55
|
| 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: Mclaren Medicaid |
$227.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.72
|
| Rate for Payer: Meridian Medicaid |
$239.08
|
| 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 Choice Medicaid |
$227.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO |
$479.51
|
| Rate for Payer: Priority Health Medicare |
$340.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$479.51
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$227.70
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$673.89 |
| Rate for Payer: Aetna Commercial |
$369.08
|
| Rate for Payer: Aetna Medicare |
$286.45
|
| Rate for Payer: BCBS Complete |
$195.92
|
| Rate for Payer: BCBS MAPPO |
$275.43
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$673.89
|
| 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: Mclaren Medicaid |
$186.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.20
|
| Rate for Payer: Meridian Medicaid |
$195.92
|
| 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 Choice Medicaid |
$186.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$591.50
|
| Rate for Payer: Priority Health HMO/PPO |
$391.92
|
| Rate for Payer: Priority Health Medicare |
$278.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.92
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$186.59
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$1,449.66 |
| Rate for Payer: Aetna Commercial |
$655.22
|
| Rate for Payer: Aetna Medicare |
$508.53
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS MAPPO |
$488.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: BCN Commercial |
$740.83
|
| Rate for Payer: BCN Medicare Advantage |
$488.97
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$704.12
|
| Rate for Payer: Cofinity Commercial |
$655.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.97
|
| Rate for Payer: Mclaren Medicaid |
$329.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.42
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Nomi Health Commercial |
$586.76
|
| Rate for Payer: PACE SWMI |
$488.97
|
| Rate for Payer: PHP Medicare Advantage |
$488.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO |
$819.66
|
| Rate for Payer: Priority Health Medicare |
$493.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$819.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$488.97
|
| Rate for Payer: UHC Exchange |
$488.97
|
| Rate for Payer: UHC Medicare Advantage |
$488.97
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$1,449.66 |
| Rate for Payer: Aetna Commercial |
$655.22
|
| Rate for Payer: Aetna Medicare |
$508.53
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS MAPPO |
$488.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: BCN Commercial |
$740.83
|
| Rate for Payer: BCN Medicare Advantage |
$488.97
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$704.12
|
| Rate for Payer: Cofinity Commercial |
$655.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.97
|
| Rate for Payer: Mclaren Medicaid |
$329.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.42
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Nomi Health Commercial |
$586.76
|
| Rate for Payer: PACE SWMI |
$488.97
|
| Rate for Payer: PHP Medicare Advantage |
$488.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO |
$819.66
|
| Rate for Payer: Priority Health Medicare |
$493.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$819.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$488.97
|
| Rate for Payer: UHC Exchange |
$488.97
|
| Rate for Payer: UHC Medicare Advantage |
$488.97
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
|
|
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
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
OP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$437.71 |
| Max. Negotiated Rate |
$2,625.09 |
| Rate for Payer: Aetna Commercial |
$1,566.55
|
| Rate for Payer: Aetna Medicare |
$479.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$575.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$575.94
|
| Rate for Payer: BCBS Complete |
$2,625.09
|
| Rate for Payer: BCBS MAPPO |
$460.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,515.13
|
| Rate for Payer: BCN Commercial |
$1,432.93
|
| Rate for Payer: BCN Medicare Advantage |
$460.75
|
| Rate for Payer: Cash Price |
$1,474.40
|
| 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: Health Alliance Plan Medicare Advantage |
$460.75
|
| Rate for Payer: Healthscope Commercial |
$1,658.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,382.25
|
| Rate for Payer: Mclaren Medicaid |
$2,499.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.79
|
| Rate for Payer: Meridian Medicaid |
$2,625.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$529.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: Nomi Health Commercial |
$1,511.26
|
| Rate for Payer: PACE Senior Care Partners |
$437.71
|
| Rate for Payer: PACE SWMI |
$460.75
|
| Rate for Payer: PHP Commercial |
$1,566.55
|
| Rate for Payer: PHP Medicare Advantage |
$460.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.92
|
| 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 Medicare |
$465.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,234.81
|
| Rate for Payer: Railroad Medicare Medicare |
$460.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,621.84
|
| Rate for Payer: UHC Core |
$1,538.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.75
|
| Rate for Payer: UHC Exchange |
$460.75
|
| Rate for Payer: UHC Medicare Advantage |
$460.75
|
| Rate for Payer: UHCCP Medicaid |
$2,499.92
|
| Rate for Payer: VA VA |
$460.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,382.25
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
55040
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,183.92 |
| Rate for Payer: Aetna Commercial |
$434.39
|
| Rate for Payer: Aetna Medicare |
$337.14
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS MAPPO |
$324.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$324.17
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$466.80
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.17
|
| Rate for Payer: Mclaren Medicaid |
$218.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.38
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| Rate for Payer: Nomi Health Commercial |
$389.00
|
| Rate for Payer: PACE SWMI |
$324.17
|
| Rate for Payer: PHP Medicare Advantage |
$324.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO |
$543.79
|
| Rate for Payer: Priority Health Medicare |
$327.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.17
|
| Rate for Payer: UHC Exchange |
$324.17
|
| Rate for Payer: UHC Medicare Advantage |
$324.17
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
IP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$816.40 |
| Max. Negotiated Rate |
$1,130.40 |
| Rate for Payer: Aetna Commercial |
$1,067.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,025.27
|
| Rate for Payer: BCN Commercial |
$970.64
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,080.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Healthscope Commercial |
$1,130.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: Nomi Health Commercial |
$1,029.92
|
| Rate for Payer: PHP Commercial |
$1,067.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,092.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$841.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,105.28
|
| Rate for Payer: UHC Core |
$1,048.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.00
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
OP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$298.30 |
| Max. Negotiated Rate |
$2,625.09 |
| Rate for Payer: Aetna Commercial |
$1,067.60
|
| Rate for Payer: Aetna Medicare |
$326.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$392.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$392.50
|
| Rate for Payer: BCBS Complete |
$2,625.09
|
| Rate for Payer: BCBS MAPPO |
$314.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,032.56
|
| Rate for Payer: BCN Commercial |
$976.54
|
| Rate for Payer: BCN Medicare Advantage |
$314.00
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,080.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.00
|
| Rate for Payer: Healthscope Commercial |
$1,130.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.00
|
| Rate for Payer: Mclaren Medicaid |
$2,499.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$329.70
|
| Rate for Payer: Meridian Medicaid |
$2,625.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$361.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: Nomi Health Commercial |
$1,029.92
|
| Rate for Payer: PACE Senior Care Partners |
$298.30
|
| Rate for Payer: PACE SWMI |
$314.00
|
| Rate for Payer: PHP Commercial |
$1,067.60
|
| Rate for Payer: PHP Medicare Advantage |
$314.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,092.72
|
| Rate for Payer: Priority Health Medicare |
$317.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$841.52
|
| Rate for Payer: Railroad Medicare Medicare |
$314.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,105.28
|
| Rate for Payer: UHC Core |
$1,048.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.00
|
| Rate for Payer: UHC Exchange |
$314.00
|
| Rate for Payer: UHC Medicare Advantage |
$314.00
|
| Rate for Payer: UHCCP Medicaid |
$2,499.92
|
| Rate for Payer: VA VA |
$314.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.00
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,183.92 |
| Rate for Payer: Aetna Commercial |
$434.39
|
| Rate for Payer: Aetna Medicare |
$337.14
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS MAPPO |
$324.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$324.17
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$466.80
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.17
|
| Rate for Payer: Mclaren Medicaid |
$218.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.38
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| Rate for Payer: Nomi Health Commercial |
$389.00
|
| Rate for Payer: PACE SWMI |
$324.17
|
| Rate for Payer: PHP Medicare Advantage |
$324.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO |
$543.79
|
| Rate for Payer: Priority Health Medicare |
$327.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.17
|
| Rate for Payer: UHC Exchange |
$324.17
|
| Rate for Payer: UHC Medicare Advantage |
$324.17
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$1,120.00 |
| Max. Negotiated Rate |
$2,971.84 |
| Rate for Payer: Aetna Commercial |
$2,461.98
|
| Rate for Payer: Aetna Medicare |
$1,910.79
|
| Rate for Payer: BCBS Complete |
$1,253.78
|
| Rate for Payer: BCBS MAPPO |
$1,837.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.00
|
| Rate for Payer: BCN Commercial |
$2,709.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,837.30
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cofinity Commercial |
$2,645.71
|
| Rate for Payer: Cofinity Commercial |
$2,461.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,837.30
|
| Rate for Payer: Mclaren Medicaid |
$1,194.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,929.16
|
| Rate for Payer: Meridian Medicaid |
$1,253.78
|
| Rate for Payer: Nomi Health Commercial |
$2,204.76
|
| Rate for Payer: PACE SWMI |
$1,837.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,837.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,194.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,627.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,971.84
|
| Rate for Payer: Priority Health Medicare |
$1,855.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,971.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,837.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,837.30
|
| Rate for Payer: UHC Exchange |
$1,837.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,837.30
|
| Rate for Payer: UHCCP Medicaid |
$1,194.08
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$2,005.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,303.25 |
| Rate for Payer: Aetna Commercial |
$718.70
|
| Rate for Payer: Aetna Medicare |
$557.79
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$536.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.68
|
| Rate for Payer: BCN Commercial |
$810.72
|
| Rate for Payer: BCN Medicare Advantage |
$536.34
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cofinity Commercial |
$772.33
|
| Rate for Payer: Cofinity Commercial |
$718.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.34
|
| Rate for Payer: Mclaren Medicaid |
$353.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.16
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Nomi Health Commercial |
$643.61
|
| Rate for Payer: PACE SWMI |
$536.34
|
| Rate for Payer: PHP Medicare Advantage |
$536.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.25
|
| Rate for Payer: Priority Health HMO/PPO |
$884.95
|
| Rate for Payer: Priority Health Medicare |
$541.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$884.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$536.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.34
|
| Rate for Payer: UHC Exchange |
$536.34
|
| Rate for Payer: UHC Medicare Advantage |
$536.34
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$266.68 |
| Max. Negotiated Rate |
$674.64 |
| Rate for Payer: Aetna Commercial |
$513.43
|
| Rate for Payer: Aetna Medicare |
$398.49
|
| Rate for Payer: BCBS Complete |
$280.01
|
| Rate for Payer: BCBS MAPPO |
$383.16
|
| Rate for Payer: BCBS Trust/PPO |
$674.64
|
| Rate for Payer: BCN Commercial |
$619.16
|
| Rate for Payer: BCN Medicare Advantage |
$383.16
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$551.75
|
| Rate for Payer: Cofinity Commercial |
$513.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.16
|
| Rate for Payer: Mclaren Medicaid |
$266.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.32
|
| Rate for Payer: Meridian Medicaid |
$280.01
|
| Rate for Payer: Nomi Health Commercial |
$459.79
|
| Rate for Payer: PACE SWMI |
$383.16
|
| Rate for Payer: PHP Medicare Advantage |
$383.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.25
|
| Rate for Payer: Priority Health HMO/PPO |
$583.96
|
| Rate for Payer: Priority Health Medicare |
$386.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$383.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.16
|
| Rate for Payer: UHC Exchange |
$383.16
|
| Rate for Payer: UHC Medicare Advantage |
$383.16
|
| Rate for Payer: UHCCP Medicaid |
$266.68
|
|
|
PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 28080
|
| Min. Negotiated Rate |
$249.21 |
| Max. Negotiated Rate |
$1,100.45 |
| Rate for Payer: Aetna Commercial |
$486.76
|
| Rate for Payer: Aetna Medicare |
$377.78
|
| Rate for Payer: BCBS Complete |
$261.67
|
| Rate for Payer: BCBS MAPPO |
$363.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.45
|
| Rate for Payer: BCN Commercial |
$853.39
|
| Rate for Payer: BCN Medicare Advantage |
$363.25
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cofinity Commercial |
$523.08
|
| Rate for Payer: Cofinity Commercial |
$486.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.25
|
| Rate for Payer: Mclaren Medicaid |
$249.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.41
|
| Rate for Payer: Meridian Medicaid |
$261.67
|
| Rate for Payer: Nomi Health Commercial |
$435.90
|
| Rate for Payer: PACE SWMI |
$363.25
|
| Rate for Payer: PHP Medicare Advantage |
$363.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.90
|
| Rate for Payer: Priority Health HMO/PPO |
$584.68
|
| Rate for Payer: Priority Health Medicare |
$366.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$584.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.25
|
| Rate for Payer: UHC Exchange |
$363.25
|
| Rate for Payer: UHC Medicare Advantage |
$363.25
|
| Rate for Payer: UHCCP Medicaid |
$249.21
|
|
|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$678.77 |
| Rate for Payer: Aetna Commercial |
$417.53
|
| Rate for Payer: Aetna Medicare |
$324.05
|
| Rate for Payer: BCBS Complete |
$221.86
|
| Rate for Payer: BCBS MAPPO |
$311.59
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$678.77
|
| Rate for Payer: BCN Medicare Advantage |
$311.59
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cofinity Commercial |
$448.69
|
| Rate for Payer: Cofinity Commercial |
$417.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.59
|
| Rate for Payer: Mclaren Medicaid |
$211.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.17
|
| Rate for Payer: Meridian Medicaid |
$221.86
|
| Rate for Payer: Nomi Health Commercial |
$373.91
|
| Rate for Payer: PACE SWMI |
$311.59
|
| Rate for Payer: PHP Medicare Advantage |
$311.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$516.10
|
| Rate for Payer: Priority Health HMO/PPO |
$443.39
|
| Rate for Payer: Priority Health Medicare |
$314.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$443.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.59
|
| Rate for Payer: UHC Exchange |
$311.59
|
| Rate for Payer: UHC Medicare Advantage |
$311.59
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$916.07 |
| Rate for Payer: Aetna Commercial |
$273.40
|
| Rate for Payer: Aetna Medicare |
$212.19
|
| Rate for Payer: BCBS Complete |
$147.16
|
| Rate for Payer: BCBS MAPPO |
$204.03
|
| Rate for Payer: BCBS Trust/PPO |
$916.07
|
| Rate for Payer: BCN Commercial |
$494.05
|
| Rate for Payer: BCN Medicare Advantage |
$204.03
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cofinity Commercial |
$293.80
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.03
|
| Rate for Payer: Mclaren Medicaid |
$140.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.23
|
| Rate for Payer: Meridian Medicaid |
$147.16
|
| Rate for Payer: Nomi Health Commercial |
$244.84
|
| Rate for Payer: PACE SWMI |
$204.03
|
| Rate for Payer: PHP Medicare Advantage |
$204.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.20
|
| Rate for Payer: Priority Health HMO/PPO |
$390.17
|
| Rate for Payer: Priority Health Medicare |
$206.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.03
|
| Rate for Payer: UHC Exchange |
$204.03
|
| Rate for Payer: UHC Medicare Advantage |
$204.03
|
| Rate for Payer: UHCCP Medicaid |
$140.15
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$347.19 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$684.93
|
| Rate for Payer: Aetna Medicare |
$531.59
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS MAPPO |
$511.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.67
|
| Rate for Payer: BCN Commercial |
$780.90
|
| Rate for Payer: BCN Medicare Advantage |
$511.14
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cofinity Commercial |
$736.04
|
| Rate for Payer: Cofinity Commercial |
$684.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.14
|
| Rate for Payer: Mclaren Medicaid |
$347.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.70
|
| Rate for Payer: Meridian Medicaid |
$364.55
|
| Rate for Payer: Nomi Health Commercial |
$613.37
|
| Rate for Payer: PACE SWMI |
$511.14
|
| Rate for Payer: PHP Medicare Advantage |
$511.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.00
|
| Rate for Payer: Priority Health HMO/PPO |
$821.30
|
| Rate for Payer: Priority Health Medicare |
$516.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$511.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$511.14
|
| Rate for Payer: UHC Exchange |
$511.14
|
| Rate for Payer: UHC Medicare Advantage |
$511.14
|
| Rate for Payer: UHCCP Medicaid |
$347.19
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$1,529.66 |
| Rate for Payer: Aetna Commercial |
$1,110.95
|
| Rate for Payer: Aetna Medicare |
$862.23
|
| Rate for Payer: BCBS Complete |
$576.80
|
| Rate for Payer: BCBS MAPPO |
$829.07
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$1,245.15
|
| Rate for Payer: BCN Medicare Advantage |
$829.07
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cofinity Commercial |
$1,193.86
|
| Rate for Payer: Cofinity Commercial |
$1,110.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.07
|
| Rate for Payer: Mclaren Medicaid |
$549.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.52
|
| Rate for Payer: Meridian Medicaid |
$576.80
|
| Rate for Payer: Nomi Health Commercial |
$994.88
|
| Rate for Payer: PACE SWMI |
$829.07
|
| Rate for Payer: PHP Medicare Advantage |
$829.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,529.66
|
| Rate for Payer: Priority Health Medicare |
$837.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,529.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$829.07
|
| Rate for Payer: UHC Exchange |
$829.07
|
| Rate for Payer: UHC Medicare Advantage |
$829.07
|
| Rate for Payer: UHCCP Medicaid |
$549.33
|
|
|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,275.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$1,995.61 |
| Rate for Payer: Aetna Commercial |
$1,451.70
|
| Rate for Payer: Aetna Medicare |
$1,126.69
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS MAPPO |
$1,083.36
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$1,628.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.36
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cofinity Commercial |
$1,560.04
|
| Rate for Payer: Cofinity Commercial |
$1,451.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.36
|
| Rate for Payer: Mclaren Medicaid |
$716.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.53
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Nomi Health Commercial |
$1,300.03
|
| Rate for Payer: PACE SWMI |
$1,083.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,995.61
|
| Rate for Payer: Priority Health Medicare |
$1,094.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,995.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,083.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.36
|
| Rate for Payer: UHC Exchange |
$1,083.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.36
|
| Rate for Payer: UHCCP Medicaid |
$716.11
|
|
