|
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 |
$2,172.87 |
| 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 |
$2,172.87
|
| 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 |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.54
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| 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 |
$2,069.26
|
| 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 |
$2,069.26
|
| 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 |
$433.19 |
| Max. Negotiated Rate |
$872.95 |
| Rate for Payer: Aetna Commercial |
$580.47
|
| Rate for Payer: Aetna Medicare |
$450.52
|
| Rate for Payer: BCBS Complete |
$537.20
|
| Rate for Payer: BCBS MAPPO |
$433.19
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.85
|
| 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 Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health Medicare |
$437.52
|
| 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
|
|
|
PR EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 11770
|
| Min. Negotiated Rate |
$177.76 |
| Max. Negotiated Rate |
$338.00 |
| Rate for Payer: Aetna Commercial |
$238.20
|
| Rate for Payer: Aetna Medicare |
$184.87
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: BCBS MAPPO |
$177.76
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.65
|
| 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 Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$179.54
|
| 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
|
|
|
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 |
$2,172.87 |
| 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 |
$2,172.87
|
| 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 |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.50
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| 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 |
$2,069.26
|
| 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 |
$2,069.26
|
| 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
|
| Hospital Charge Code |
11770
|
| Min. Negotiated Rate |
$177.76 |
| Max. Negotiated Rate |
$338.00 |
| Rate for Payer: Aetna Commercial |
$238.20
|
| Rate for Payer: Aetna Medicare |
$184.87
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: BCBS MAPPO |
$177.76
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.65
|
| 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 Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$179.54
|
| 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
|
|
|
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 PREPATELLAR BURSA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27340
|
| Min. Negotiated Rate |
$363.02 |
| Max. Negotiated Rate |
$845.65 |
| Rate for Payer: Aetna Commercial |
$486.45
|
| Rate for Payer: Aetna Medicare |
$377.54
|
| Rate for Payer: BCBS Complete |
$520.40
|
| Rate for Payer: BCBS MAPPO |
$363.02
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.17
|
| 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 Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$366.65
|
| 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
|
|
|
PR EXCISION PREPATELLAR BURSA
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$363.02 |
| Max. Negotiated Rate |
$845.65 |
| Rate for Payer: Aetna Commercial |
$486.45
|
| Rate for Payer: Aetna Medicare |
$377.54
|
| Rate for Payer: BCBS Complete |
$520.40
|
| Rate for Payer: BCBS MAPPO |
$363.02
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.17
|
| 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 Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health Medicare |
$366.65
|
| 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
|
|
|
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
|
Facility
|
OP
|
$1,301.00
|
|
|
Service Code
|
CPT 27340
|
| Hospital Charge Code |
27340
|
| Min. Negotiated Rate |
$308.99 |
| Max. Negotiated Rate |
$2,463.31 |
| 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 |
$2,463.31
|
| 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 |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.51
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| 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 |
$2,345.85
|
| 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 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 |
$2,345.85
|
| 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 |
$497.11 |
| Max. Negotiated Rate |
$816.40 |
| Rate for Payer: Aetna Commercial |
$666.13
|
| Rate for Payer: Aetna Medicare |
$516.99
|
| Rate for Payer: BCBS Complete |
$502.40
|
| Rate for Payer: BCBS MAPPO |
$497.11
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.97
|
| 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 Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health Medicare |
$502.08
|
| 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
|
|
|
PR EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 67961
|
| Min. Negotiated Rate |
$420.10 |
| Max. Negotiated Rate |
$748.80 |
| Rate for Payer: Aetna Commercial |
$562.93
|
| Rate for Payer: Aetna Medicare |
$436.90
|
| Rate for Payer: BCBS Complete |
$460.80
|
| Rate for Payer: BCBS MAPPO |
$420.10
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.11
|
| 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 Cigna Priority Health |
$748.80
|
| Rate for Payer: Priority Health Medicare |
$424.30
|
| 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
|
|
|
PR EXCISION RIB PARTIAL
|
Professional
|
Both
|
$1,625.00
|
|
|
Service Code
|
HCPCS 21600
|
| Min. Negotiated Rate |
$550.70 |
| 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 |
$650.00
|
| Rate for Payer: BCBS MAPPO |
$550.70
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.24
|
| 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 Cigna Priority Health |
$1,056.25
|
| Rate for Payer: Priority Health Medicare |
$556.21
|
| 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
|
|
|
PR EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 15931
|
| Min. Negotiated Rate |
$469.60 |
| Max. Negotiated Rate |
$979.72 |
| Rate for Payer: Aetna Commercial |
$911.68
|
| Rate for Payer: Aetna Medicare |
$707.57
|
| Rate for Payer: BCBS Complete |
$469.60
|
| Rate for Payer: BCBS MAPPO |
$680.36
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.38
|
| 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 Cigna Priority Health |
$763.10
|
| Rate for Payer: Priority Health Medicare |
$687.16
|
| 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
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$440.00
|
|
|
Service Code
|
HCPCS 46220
|
| Min. Negotiated Rate |
$116.12 |
| Max. Negotiated Rate |
$286.00 |
| Rate for Payer: Aetna Commercial |
$155.60
|
| Rate for Payer: Aetna Medicare |
$120.76
|
| Rate for Payer: BCBS Complete |
$176.00
|
| Rate for Payer: BCBS MAPPO |
$116.12
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.93
|
| 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 Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health Medicare |
$117.28
|
| 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
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Professional
|
Both
|
$440.00
|
|
|
Service Code
|
HCPCS 46220
|
| Hospital Charge Code |
46220
|
| Min. Negotiated Rate |
$116.12 |
| Max. Negotiated Rate |
$286.00 |
| Rate for Payer: Aetna Commercial |
$155.60
|
| Rate for Payer: Aetna Medicare |
$120.76
|
| Rate for Payer: BCBS Complete |
$176.00
|
| Rate for Payer: BCBS MAPPO |
$116.12
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.93
|
| 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 Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health Medicare |
$117.28
|
| 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
|
|
|
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
|
Facility
|
OP
|
$440.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$104.50 |
| Max. Negotiated Rate |
$895.16 |
| Rate for Payer: Aetna Commercial |
$374.00
|
| Rate for Payer: Aetna Medicare |
$114.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.50
|
| Rate for Payer: BCBS Complete |
$895.16
|
| Rate for Payer: BCBS MAPPO |
$110.00
|
| Rate for Payer: BCBS Trust/PPO |
$361.72
|
| Rate for Payer: BCN Commercial |
$342.10
|
| Rate for Payer: BCN Medicare Advantage |
$110.00
|
| Rate for Payer: Cash Price |
$352.00
|
| 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: Health Alliance Plan Medicare Advantage |
$110.00
|
| Rate for Payer: Healthscope Commercial |
$396.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.00
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.50
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.00
|
| Rate for Payer: Nomi Health Commercial |
$360.80
|
| Rate for Payer: PACE Senior Care Partners |
$104.50
|
| Rate for Payer: PACE SWMI |
$110.00
|
| Rate for Payer: PHP Commercial |
$374.00
|
| Rate for Payer: PHP Medicare Advantage |
$110.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.00
|
| Rate for Payer: Priority Health HMO/PPO |
$382.80
|
| Rate for Payer: Priority Health Medicare |
$111.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.80
|
| Rate for Payer: Railroad Medicare Medicare |
$110.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.20
|
| Rate for Payer: UHC Core |
$367.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.00
|
| Rate for Payer: UHC Exchange |
$110.00
|
| Rate for Payer: UHC Medicare Advantage |
$110.00
|
| Rate for Payer: UHCCP Medicaid |
$852.47
|
| Rate for Payer: VA VA |
$110.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.00
|
|
|
PR EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$676.00
|
|
|
Service Code
|
HCPCS 69145
|
| Min. Negotiated Rate |
$239.75 |
| Max. Negotiated Rate |
$439.40 |
| Rate for Payer: Aetna Commercial |
$321.26
|
| Rate for Payer: Aetna Medicare |
$249.34
|
| Rate for Payer: BCBS Complete |
$270.40
|
| Rate for Payer: BCBS MAPPO |
$239.75
|
| Rate for Payer: BCN Medicare Advantage |
$239.75
|
| Rate for Payer: Cash Price |
$540.80
|
| Rate for Payer: Cash Price |
$540.80
|
| Rate for Payer: Cofinity Commercial |
$345.24
|
| Rate for Payer: Cofinity Commercial |
$321.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.74
|
| Rate for Payer: Nomi Health Commercial |
$287.70
|
| Rate for Payer: PACE SWMI |
$239.75
|
| Rate for Payer: PHP Medicare Advantage |
$239.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.40
|
| Rate for Payer: Priority Health Medicare |
$242.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.75
|
| Rate for Payer: UHC Exchange |
$239.75
|
| Rate for Payer: UHC Medicare Advantage |
$239.75
|
|
|
PR EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 54840
|
| Min. Negotiated Rate |
$239.20 |
| Max. Negotiated Rate |
$443.68 |
| Rate for Payer: Aetna Commercial |
$412.87
|
| Rate for Payer: Aetna Medicare |
$320.43
|
| Rate for Payer: BCBS Complete |
$239.20
|
| Rate for Payer: BCBS MAPPO |
$308.11
|
| Rate for Payer: BCN Medicare Advantage |
$308.11
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$443.68
|
| Rate for Payer: Cofinity Commercial |
$412.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.52
|
| Rate for Payer: Nomi Health Commercial |
$369.73
|
| Rate for Payer: PACE SWMI |
$308.11
|
| Rate for Payer: PHP Medicare Advantage |
$308.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.70
|
| Rate for Payer: Priority Health Medicare |
$311.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.11
|
| Rate for Payer: UHC Exchange |
$308.11
|
| Rate for Payer: UHC Medicare Advantage |
$308.11
|
|
|
PR EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND
|
Professional
|
Both
|
$2,272.00
|
|
|
Service Code
|
HCPCS 42440
|
| Min. Negotiated Rate |
$397.31 |
| Max. Negotiated Rate |
$1,476.80 |
| Rate for Payer: Aetna Commercial |
$532.40
|
| Rate for Payer: Aetna Medicare |
$413.20
|
| Rate for Payer: BCBS Complete |
$908.80
|
| Rate for Payer: BCBS MAPPO |
$397.31
|
| Rate for Payer: BCN Medicare Advantage |
$397.31
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cash Price |
$1,817.60
|
| Rate for Payer: Cofinity Commercial |
$572.13
|
| Rate for Payer: Cofinity Commercial |
$532.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.18
|
| Rate for Payer: Nomi Health Commercial |
$476.77
|
| Rate for Payer: PACE SWMI |
$397.31
|
| Rate for Payer: PHP Medicare Advantage |
$397.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,476.80
|
| Rate for Payer: Priority Health Medicare |
$401.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.31
|
| Rate for Payer: UHC Exchange |
$397.31
|
| Rate for Payer: UHC Medicare Advantage |
$397.31
|
|
|
PR EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA
|
Professional
|
Both
|
$1,035.00
|
|
|
Service Code
|
HCPCS 30120
|
| Min. Negotiated Rate |
$397.71 |
| Max. Negotiated Rate |
$672.75 |
| Rate for Payer: Aetna Commercial |
$532.93
|
| Rate for Payer: Aetna Medicare |
$413.62
|
| Rate for Payer: BCBS Complete |
$414.00
|
| Rate for Payer: BCBS MAPPO |
$397.71
|
| Rate for Payer: BCN Medicare Advantage |
$397.71
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cofinity Commercial |
$572.70
|
| Rate for Payer: Cofinity Commercial |
$532.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.60
|
| Rate for Payer: Nomi Health Commercial |
$477.25
|
| Rate for Payer: PACE SWMI |
$397.71
|
| Rate for Payer: PHP Medicare Advantage |
$397.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.75
|
| Rate for Payer: Priority Health Medicare |
$401.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.71
|
| Rate for Payer: UHC Exchange |
$397.71
|
| Rate for Payer: UHC Medicare Advantage |
$397.71
|
|
|
PR EXCISION SYNOVIAL CYST POPLITEAL SPACE
|
Professional
|
Both
|
$1,640.00
|
|
|
Service Code
|
HCPCS 27345
|
| Min. Negotiated Rate |
$472.92 |
| Max. Negotiated Rate |
$1,066.00 |
| Rate for Payer: Aetna Commercial |
$633.71
|
| Rate for Payer: Aetna Medicare |
$491.84
|
| Rate for Payer: BCBS Complete |
$656.00
|
| Rate for Payer: BCBS MAPPO |
$472.92
|
| Rate for Payer: BCN Medicare Advantage |
$472.92
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cofinity Commercial |
$681.00
|
| Rate for Payer: Cofinity Commercial |
$633.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.57
|
| Rate for Payer: Nomi Health Commercial |
$567.50
|
| Rate for Payer: PACE SWMI |
$472.92
|
| Rate for Payer: PHP Medicare Advantage |
$472.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.00
|
| Rate for Payer: Priority Health Medicare |
$477.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$472.92
|
| Rate for Payer: UHC Exchange |
$472.92
|
| Rate for Payer: UHC Medicare Advantage |
$472.92
|
|
|
PR EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 26180
|
| Min. Negotiated Rate |
$436.63 |
| Max. Negotiated Rate |
$826.80 |
| Rate for Payer: Aetna Commercial |
$585.08
|
| Rate for Payer: Aetna Medicare |
$454.10
|
| Rate for Payer: BCBS Complete |
$508.80
|
| Rate for Payer: BCBS MAPPO |
$436.63
|
| Rate for Payer: BCN Medicare Advantage |
$436.63
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$628.75
|
| Rate for Payer: Cofinity Commercial |
$585.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.46
|
| Rate for Payer: Nomi Health Commercial |
$523.96
|
| Rate for Payer: PACE SWMI |
$436.63
|
| Rate for Payer: PHP Medicare Advantage |
$436.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.80
|
| Rate for Payer: Priority Health Medicare |
$441.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.63
|
| Rate for Payer: UHC Exchange |
$436.63
|
| Rate for Payer: UHC Medicare Advantage |
$436.63
|
|
|
PR EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 26170
|
| Min. Negotiated Rate |
$394.74 |
| Max. Negotiated Rate |
$724.10 |
| Rate for Payer: Aetna Commercial |
$528.95
|
| Rate for Payer: Aetna Medicare |
$410.53
|
| Rate for Payer: BCBS Complete |
$445.60
|
| Rate for Payer: BCBS MAPPO |
$394.74
|
| Rate for Payer: BCN Medicare Advantage |
$394.74
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$568.43
|
| Rate for Payer: Cofinity Commercial |
$528.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.48
|
| Rate for Payer: Nomi Health Commercial |
$473.69
|
| Rate for Payer: PACE SWMI |
$394.74
|
| Rate for Payer: PHP Medicare Advantage |
$394.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health Medicare |
$398.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.74
|
| Rate for Payer: UHC Exchange |
$394.74
|
| Rate for Payer: UHC Medicare Advantage |
$394.74
|
|
