|
PR EXCISION OF PENILE PLAQUE
|
Professional
|
Both
|
$1,186.00
|
|
|
Service Code
|
HCPCS 54110
|
| Min. Negotiated Rate |
$400.87 |
| Max. Negotiated Rate |
$2,843.84 |
| Rate for Payer: Aetna Commercial |
$800.14
|
| Rate for Payer: Aetna Medicare |
$621.00
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS MAPPO |
$597.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,843.84
|
| Rate for Payer: BCN Commercial |
$901.13
|
| Rate for Payer: BCN Medicare Advantage |
$597.12
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cofinity Commercial |
$859.85
|
| Rate for Payer: Cofinity Commercial |
$800.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.12
|
| Rate for Payer: Mclaren Medicaid |
$400.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.98
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Nomi Health Commercial |
$716.54
|
| Rate for Payer: PACE SWMI |
$597.12
|
| Rate for Payer: PHP Medicare Advantage |
$597.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.90
|
| Rate for Payer: Priority Health HMO/PPO |
$995.97
|
| Rate for Payer: Priority Health Medicare |
$603.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$995.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.12
|
| Rate for Payer: UHC Exchange |
$597.12
|
| Rate for Payer: UHC Medicare Advantage |
$597.12
|
| Rate for Payer: UHCCP Medicaid |
$400.87
|
|
|
PR EXCISION OLECRANON BURSA
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$145.35 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$159.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.25
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$153.00
|
| Rate for Payer: BCBS Trust/PPO |
$503.13
|
| Rate for Payer: BCN Commercial |
$475.83
|
| Rate for Payer: BCN Medicare Advantage |
$153.00
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.00
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.65
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: Nomi Health Commercial |
$501.84
|
| Rate for Payer: PACE Senior Care Partners |
$145.35
|
| Rate for Payer: PACE SWMI |
$153.00
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$153.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO |
$532.44
|
| Rate for Payer: Priority Health Medicare |
$154.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.04
|
| Rate for Payer: Railroad Medicare Medicare |
$153.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.56
|
| Rate for Payer: UHC Core |
$511.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.00
|
| Rate for Payer: UHC Exchange |
$153.00
|
| Rate for Payer: UHC Medicare Advantage |
$153.00
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$153.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 24105
|
| Min. Negotiated Rate |
$206.04 |
| Max. Negotiated Rate |
$565.86 |
| Rate for Payer: Aetna Commercial |
$466.43
|
| Rate for Payer: Aetna Medicare |
$362.00
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$348.08
|
| Rate for Payer: BCBS Trust/PPO |
$206.04
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: BCN Medicare Advantage |
$348.08
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$501.24
|
| Rate for Payer: Cofinity Commercial |
$466.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.08
|
| Rate for Payer: Mclaren Medicaid |
$239.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.48
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Nomi Health Commercial |
$417.70
|
| Rate for Payer: PACE SWMI |
$348.08
|
| Rate for Payer: PHP Medicare Advantage |
$348.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO |
$565.86
|
| Rate for Payer: Priority Health Medicare |
$351.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$565.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.08
|
| Rate for Payer: UHC Exchange |
$348.08
|
| Rate for Payer: UHC Medicare Advantage |
$348.08
|
| Rate for Payer: UHCCP Medicaid |
$239.20
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$206.04 |
| Max. Negotiated Rate |
$565.86 |
| Rate for Payer: Aetna Commercial |
$466.43
|
| Rate for Payer: Aetna Medicare |
$362.00
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$348.08
|
| Rate for Payer: BCBS Trust/PPO |
$206.04
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: BCN Medicare Advantage |
$348.08
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$501.24
|
| Rate for Payer: Cofinity Commercial |
$466.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.08
|
| Rate for Payer: Mclaren Medicaid |
$239.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.48
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Nomi Health Commercial |
$417.70
|
| Rate for Payer: PACE SWMI |
$348.08
|
| Rate for Payer: PHP Medicare Advantage |
$348.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO |
$565.86
|
| Rate for Payer: Priority Health Medicare |
$351.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$565.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.08
|
| Rate for Payer: UHC Exchange |
$348.08
|
| Rate for Payer: UHC Medicare Advantage |
$348.08
|
| Rate for Payer: UHCCP Medicaid |
$239.20
|
|
|
PR EXCISION OLECRANON BURSA
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$397.80 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: BCBS Trust/PPO |
$499.58
|
| Rate for Payer: BCN Commercial |
$472.95
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: Nomi Health Commercial |
$501.84
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO |
$532.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.56
|
| Rate for Payer: UHC Core |
$511.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
PR EXCISION OR FULGURATION SKENES GLANDS
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 53270
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$772.90 |
| Rate for Payer: Aetna Commercial |
$238.06
|
| Rate for Payer: Aetna Medicare |
$184.77
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$177.66
|
| Rate for Payer: BCBS Trust/PPO |
$772.90
|
| Rate for Payer: BCN Commercial |
$307.38
|
| Rate for Payer: BCN Medicare Advantage |
$177.66
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$255.83
|
| Rate for Payer: Cofinity Commercial |
$238.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.66
|
| Rate for Payer: Mclaren Medicaid |
$119.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.54
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Nomi Health Commercial |
$213.19
|
| Rate for Payer: PACE SWMI |
$177.66
|
| Rate for Payer: PHP Medicare Advantage |
$177.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health HMO/PPO |
$295.60
|
| Rate for Payer: Priority Health Medicare |
$179.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.66
|
| Rate for Payer: UHC Exchange |
$177.66
|
| Rate for Payer: UHC Medicare Advantage |
$177.66
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
|
|
PR EXCISION PILONIDAL CYST/SINUS COMPLICATED
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 11772
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$1,453.51 |
| Rate for Payer: Aetna Commercial |
$742.63
|
| Rate for Payer: Aetna Medicare |
$576.37
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$554.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.51
|
| Rate for Payer: BCN Commercial |
$1,137.15
|
| Rate for Payer: BCN Medicare Advantage |
$554.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$798.05
|
| Rate for Payer: Cofinity Commercial |
$742.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.20
|
| Rate for Payer: Mclaren Medicaid |
$374.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$581.91
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Nomi Health Commercial |
$665.04
|
| Rate for Payer: PACE SWMI |
$554.20
|
| Rate for Payer: PHP Medicare Advantage |
$554.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.10
|
| Rate for Payer: Priority Health HMO/PPO |
$790.60
|
| Rate for Payer: Priority Health Medicare |
$559.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$790.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.20
|
| Rate for Payer: UHC Exchange |
$554.20
|
| Rate for Payer: UHC Medicare Advantage |
$554.20
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 11771
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$925.56 |
| Rate for Payer: Aetna Commercial |
$580.47
|
| Rate for Payer: Aetna Medicare |
$450.52
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$433.19
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$925.56
|
| Rate for Payer: BCN Medicare Advantage |
$433.19
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$623.79
|
| Rate for Payer: Cofinity Commercial |
$580.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.19
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.85
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Nomi Health Commercial |
$519.83
|
| Rate for Payer: PACE SWMI |
$433.19
|
| Rate for Payer: PHP Medicare Advantage |
$433.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO |
$614.97
|
| Rate for Payer: Priority Health Medicare |
$437.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$614.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.19
|
| Rate for Payer: UHC Exchange |
$433.19
|
| Rate for Payer: UHC Medicare Advantage |
$433.19
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Facility
|
OP
|
$1,343.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
11771
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$318.96 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,141.55
|
| Rate for Payer: Aetna Medicare |
$349.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$419.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$419.69
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$335.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.08
|
| Rate for Payer: BCN Commercial |
$1,044.18
|
| Rate for Payer: BCN Medicare Advantage |
$335.75
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.75
|
| Rate for Payer: Healthscope Commercial |
$1,208.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,007.25
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.54
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$386.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.55
|
| Rate for Payer: Nomi Health Commercial |
$1,101.26
|
| Rate for Payer: PACE Senior Care Partners |
$318.96
|
| Rate for Payer: PACE SWMI |
$335.75
|
| Rate for Payer: PHP Commercial |
$1,141.55
|
| Rate for Payer: PHP Medicare Advantage |
$335.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,168.41
|
| Rate for Payer: Priority Health Medicare |
$339.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.81
|
| Rate for Payer: Railroad Medicare Medicare |
$335.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,181.84
|
| Rate for Payer: UHC Core |
$1,121.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.75
|
| Rate for Payer: UHC Exchange |
$335.75
|
| Rate for Payer: UHC Medicare Advantage |
$335.75
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$335.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,007.25
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 11771
|
| Hospital Charge Code |
11771
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$925.56 |
| Rate for Payer: Aetna Commercial |
$580.47
|
| Rate for Payer: Aetna Medicare |
$450.52
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$433.19
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$925.56
|
| Rate for Payer: BCN Medicare Advantage |
$433.19
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$623.79
|
| Rate for Payer: Cofinity Commercial |
$580.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.19
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.85
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Nomi Health Commercial |
$519.83
|
| Rate for Payer: PACE SWMI |
$433.19
|
| Rate for Payer: PHP Medicare Advantage |
$433.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO |
$614.97
|
| Rate for Payer: Priority Health Medicare |
$437.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$614.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.19
|
| Rate for Payer: UHC Exchange |
$433.19
|
| Rate for Payer: UHC Medicare Advantage |
$433.19
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Facility
|
IP
|
$1,343.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
11771
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$872.95 |
| Max. Negotiated Rate |
$1,208.70 |
| Rate for Payer: Aetna Commercial |
$1,141.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.29
|
| Rate for Payer: BCN Commercial |
$1,037.87
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.40
|
| Rate for Payer: Healthscope Commercial |
$1,208.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,007.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.55
|
| Rate for Payer: Nomi Health Commercial |
$1,101.26
|
| Rate for Payer: PHP Commercial |
$1,141.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,168.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,181.84
|
| Rate for Payer: UHC Core |
$1,121.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,007.25
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
IP
|
$520.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
11770
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$338.00 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: BCBS Trust/PPO |
$424.48
|
| Rate for Payer: BCN Commercial |
$401.86
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: Nomi Health Commercial |
$426.40
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO |
$452.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.60
|
| Rate for Payer: UHC Core |
$434.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.00
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
OP
|
$520.00
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
11770
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$123.50 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: Aetna Medicare |
$135.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.50
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$130.00
|
| Rate for Payer: BCBS Trust/PPO |
$427.49
|
| Rate for Payer: BCN Commercial |
$404.30
|
| Rate for Payer: BCN Medicare Advantage |
$130.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.00
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.00
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.50
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: Nomi Health Commercial |
$426.40
|
| Rate for Payer: PACE Senior Care Partners |
$123.50
|
| Rate for Payer: PACE SWMI |
$130.00
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: PHP Medicare Advantage |
$130.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO |
$452.40
|
| Rate for Payer: Priority Health Medicare |
$131.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.40
|
| Rate for Payer: Railroad Medicare Medicare |
$130.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.60
|
| Rate for Payer: UHC Core |
$434.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.00
|
| Rate for Payer: UHC Exchange |
$130.00
|
| Rate for Payer: UHC Medicare Advantage |
$130.00
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$130.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.00
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 11770
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$523.86 |
| Rate for Payer: Aetna Commercial |
$238.20
|
| Rate for Payer: Aetna Medicare |
$184.87
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$177.76
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$523.86
|
| Rate for Payer: BCN Medicare Advantage |
$177.76
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$255.97
|
| Rate for Payer: Cofinity Commercial |
$238.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.76
|
| Rate for Payer: Mclaren Medicaid |
$119.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.65
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Nomi Health Commercial |
$213.31
|
| Rate for Payer: PACE SWMI |
$177.76
|
| Rate for Payer: PHP Medicare Advantage |
$177.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO |
$252.85
|
| Rate for Payer: Priority Health Medicare |
$179.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.76
|
| Rate for Payer: UHC Exchange |
$177.76
|
| Rate for Payer: UHC Medicare Advantage |
$177.76
|
| Rate for Payer: UHCCP Medicaid |
$119.28
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 11770
|
| Hospital Charge Code |
11770
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$523.86 |
| Rate for Payer: Aetna Commercial |
$238.20
|
| Rate for Payer: Aetna Medicare |
$184.87
|
| Rate for Payer: BCBS Complete |
$125.24
|
| Rate for Payer: BCBS MAPPO |
$177.76
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$523.86
|
| Rate for Payer: BCN Medicare Advantage |
$177.76
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$255.97
|
| Rate for Payer: Cofinity Commercial |
$238.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.76
|
| Rate for Payer: Mclaren Medicaid |
$119.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.65
|
| Rate for Payer: Meridian Medicaid |
$125.24
|
| Rate for Payer: Nomi Health Commercial |
$213.31
|
| Rate for Payer: PACE SWMI |
$177.76
|
| Rate for Payer: PHP Medicare Advantage |
$177.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO |
$252.85
|
| Rate for Payer: Priority Health Medicare |
$179.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.76
|
| Rate for Payer: UHC Exchange |
$177.76
|
| Rate for Payer: UHC Medicare Advantage |
$177.76
|
| Rate for Payer: UHCCP Medicaid |
$119.28
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27340
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$2,642.03 |
| Rate for Payer: Aetna Commercial |
$486.45
|
| Rate for Payer: Aetna Medicare |
$377.54
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS MAPPO |
$363.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.03
|
| Rate for Payer: BCN Commercial |
$556.12
|
| Rate for Payer: BCN Medicare Advantage |
$363.02
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$522.75
|
| Rate for Payer: Cofinity Commercial |
$486.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.02
|
| Rate for Payer: Mclaren Medicaid |
$248.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.17
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Nomi Health Commercial |
$435.62
|
| Rate for Payer: PACE SWMI |
$363.02
|
| Rate for Payer: PHP Medicare Advantage |
$363.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO |
$587.73
|
| Rate for Payer: Priority Health Medicare |
$366.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$587.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.02
|
| Rate for Payer: UHC Exchange |
$363.02
|
| Rate for Payer: UHC Medicare Advantage |
$363.02
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Facility
|
IP
|
$1,301.00
|
|
|
Service Code
|
CPT 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$845.65 |
| Max. Negotiated Rate |
$1,170.90 |
| Rate for Payer: Aetna Commercial |
$1,105.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.01
|
| Rate for Payer: BCN Commercial |
$1,005.41
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$1,118.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.80
|
| Rate for Payer: Healthscope Commercial |
$1,170.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$975.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,105.85
|
| Rate for Payer: Nomi Health Commercial |
$1,066.82
|
| Rate for Payer: PHP Commercial |
$1,105.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,131.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$871.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,144.88
|
| Rate for Payer: UHC Core |
$1,086.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$975.75
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$2,642.03 |
| Rate for Payer: Aetna Commercial |
$486.45
|
| Rate for Payer: Aetna Medicare |
$377.54
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS MAPPO |
$363.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.03
|
| Rate for Payer: BCN Commercial |
$556.12
|
| Rate for Payer: BCN Medicare Advantage |
$363.02
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$522.75
|
| Rate for Payer: Cofinity Commercial |
$486.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.02
|
| Rate for Payer: Mclaren Medicaid |
$248.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.17
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Nomi Health Commercial |
$435.62
|
| Rate for Payer: PACE SWMI |
$363.02
|
| Rate for Payer: PHP Medicare Advantage |
$363.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO |
$587.73
|
| Rate for Payer: Priority Health Medicare |
$366.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$587.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.02
|
| Rate for Payer: UHC Exchange |
$363.02
|
| Rate for Payer: UHC Medicare Advantage |
$363.02
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Facility
|
OP
|
$1,301.00
|
|
|
Service Code
|
CPT 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$308.99 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$1,105.85
|
| Rate for Payer: Aetna Medicare |
$338.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.56
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$325.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.55
|
| Rate for Payer: BCN Commercial |
$1,011.53
|
| Rate for Payer: BCN Medicare Advantage |
$325.25
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$1,118.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.25
|
| Rate for Payer: Healthscope Commercial |
$1,170.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$975.75
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.51
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$374.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,105.85
|
| Rate for Payer: Nomi Health Commercial |
$1,066.82
|
| Rate for Payer: PACE Senior Care Partners |
$308.99
|
| Rate for Payer: PACE SWMI |
$325.25
|
| Rate for Payer: PHP Commercial |
$1,105.85
|
| Rate for Payer: PHP Medicare Advantage |
$325.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,131.87
|
| Rate for Payer: Priority Health Medicare |
$328.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$871.67
|
| Rate for Payer: Railroad Medicare Medicare |
$325.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,144.88
|
| Rate for Payer: UHC Core |
$1,086.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$325.25
|
| Rate for Payer: UHC Exchange |
$325.25
|
| Rate for Payer: UHC Medicare Advantage |
$325.25
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$325.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$975.75
|
|
|
PR EXCISION RADIAL HEAD
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 24130
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$816.40 |
| Rate for Payer: Aetna Commercial |
$666.13
|
| Rate for Payer: Aetna Medicare |
$516.99
|
| Rate for Payer: BCBS Complete |
$355.15
|
| Rate for Payer: BCBS MAPPO |
$497.11
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$760.38
|
| Rate for Payer: BCN Medicare Advantage |
$497.11
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$715.84
|
| Rate for Payer: Cofinity Commercial |
$666.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$497.11
|
| Rate for Payer: Mclaren Medicaid |
$338.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.97
|
| Rate for Payer: Meridian Medicaid |
$355.15
|
| Rate for Payer: Nomi Health Commercial |
$596.53
|
| Rate for Payer: PACE SWMI |
$497.11
|
| Rate for Payer: PHP Medicare Advantage |
$497.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO |
$796.37
|
| Rate for Payer: Priority Health Medicare |
$502.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$796.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$497.11
|
| Rate for Payer: UHC Exchange |
$497.11
|
| Rate for Payer: UHC Medicare Advantage |
$497.11
|
| Rate for Payer: UHCCP Medicaid |
$338.24
|
|
|
PR EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 67961
|
| Min. Negotiated Rate |
$288.40 |
| Max. Negotiated Rate |
$2,721.27 |
| Rate for Payer: Aetna Commercial |
$562.93
|
| Rate for Payer: Aetna Medicare |
$436.90
|
| Rate for Payer: BCBS Complete |
$302.82
|
| Rate for Payer: BCBS MAPPO |
$420.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,721.27
|
| Rate for Payer: BCN Commercial |
$854.21
|
| Rate for Payer: BCN Medicare Advantage |
$420.10
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$604.94
|
| Rate for Payer: Cofinity Commercial |
$562.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.10
|
| Rate for Payer: Mclaren Medicaid |
$288.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.10
|
| Rate for Payer: Meridian Medicaid |
$302.82
|
| Rate for Payer: Nomi Health Commercial |
$504.12
|
| Rate for Payer: PACE SWMI |
$420.10
|
| Rate for Payer: PHP Medicare Advantage |
$420.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.80
|
| Rate for Payer: Priority Health HMO/PPO |
$789.62
|
| Rate for Payer: Priority Health Medicare |
$424.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$789.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$420.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.10
|
| Rate for Payer: UHC Exchange |
$420.10
|
| Rate for Payer: UHC Medicare Advantage |
$420.10
|
| Rate for Payer: UHCCP Medicaid |
$288.40
|
|
|
PR EXCISION RIB PARTIAL
|
Professional
|
Both
|
$1,625.00
|
|
|
Service Code
|
HCPCS 21600
|
| Min. Negotiated Rate |
$57.05 |
| Max. Negotiated Rate |
$1,056.25 |
| Rate for Payer: Aetna Commercial |
$737.94
|
| Rate for Payer: Aetna Medicare |
$572.73
|
| Rate for Payer: BCBS Complete |
$391.17
|
| Rate for Payer: BCBS MAPPO |
$550.70
|
| Rate for Payer: BCBS Trust/PPO |
$57.05
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$550.70
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cofinity Commercial |
$793.01
|
| Rate for Payer: Cofinity Commercial |
$737.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.70
|
| Rate for Payer: Mclaren Medicaid |
$372.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.24
|
| Rate for Payer: Meridian Medicaid |
$391.17
|
| Rate for Payer: Nomi Health Commercial |
$660.84
|
| Rate for Payer: PACE SWMI |
$550.70
|
| Rate for Payer: PHP Medicare Advantage |
$550.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,056.25
|
| Rate for Payer: Priority Health HMO/PPO |
$874.22
|
| Rate for Payer: Priority Health Medicare |
$556.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$874.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.70
|
| Rate for Payer: UHC Exchange |
$550.70
|
| Rate for Payer: UHC Medicare Advantage |
$550.70
|
| Rate for Payer: UHCCP Medicaid |
$372.54
|
|
|
PR EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 15931
|
| Min. Negotiated Rate |
$48.31 |
| Max. Negotiated Rate |
$1,034.04 |
| Rate for Payer: Aetna Commercial |
$911.68
|
| Rate for Payer: Aetna Medicare |
$707.57
|
| Rate for Payer: BCBS Complete |
$479.06
|
| Rate for Payer: BCBS MAPPO |
$680.36
|
| Rate for Payer: BCBS Trust/PPO |
$48.31
|
| Rate for Payer: BCN Commercial |
$1,034.04
|
| Rate for Payer: BCN Medicare Advantage |
$680.36
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cofinity Commercial |
$979.72
|
| Rate for Payer: Cofinity Commercial |
$911.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.36
|
| Rate for Payer: Mclaren Medicaid |
$456.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.38
|
| Rate for Payer: Meridian Medicaid |
$479.06
|
| Rate for Payer: Nomi Health Commercial |
$816.43
|
| Rate for Payer: PACE SWMI |
$680.36
|
| Rate for Payer: PHP Medicare Advantage |
$680.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.10
|
| Rate for Payer: Priority Health HMO/PPO |
$959.47
|
| Rate for Payer: Priority Health Medicare |
$687.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$959.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.36
|
| Rate for Payer: UHC Exchange |
$680.36
|
| Rate for Payer: UHC Medicare Advantage |
$680.36
|
| Rate for Payer: UHCCP Medicaid |
$456.25
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
IP
|
$440.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Aetna Commercial |
$374.00
|
| Rate for Payer: BCBS Trust/PPO |
$359.17
|
| Rate for Payer: BCN Commercial |
$340.03
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cofinity Commercial |
$378.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.00
|
| Rate for Payer: Healthscope Commercial |
$396.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.00
|
| Rate for Payer: Nomi Health Commercial |
$360.80
|
| Rate for Payer: PHP Commercial |
$374.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health HMO/PPO |
$382.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.20
|
| Rate for Payer: UHC Core |
$367.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.00
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$440.00
|
|
|
Service Code
|
HCPCS 46220
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$1,565.88 |
| Rate for Payer: Aetna Commercial |
$155.60
|
| Rate for Payer: Aetna Medicare |
$120.76
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$116.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,565.88
|
| Rate for Payer: BCN Commercial |
$370.42
|
| Rate for Payer: BCN Medicare Advantage |
$116.12
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cofinity Commercial |
$167.21
|
| Rate for Payer: Cofinity Commercial |
$155.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.12
|
| Rate for Payer: Mclaren Medicaid |
$78.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.93
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Nomi Health Commercial |
$139.34
|
| Rate for Payer: PACE SWMI |
$116.12
|
| Rate for Payer: PHP Medicare Advantage |
$116.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health HMO/PPO |
$219.55
|
| Rate for Payer: Priority Health Medicare |
$117.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.12
|
| Rate for Payer: UHC Exchange |
$116.12
|
| Rate for Payer: UHC Medicare Advantage |
$116.12
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
