|
PR EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 42420
|
| Min. Negotiated Rate |
$812.80 |
| Max. Negotiated Rate |
$1,635.11 |
| Rate for Payer: Aetna Commercial |
$1,521.56
|
| Rate for Payer: Aetna Medicare |
$1,180.91
|
| Rate for Payer: BCBS Complete |
$812.80
|
| Rate for Payer: BCBS MAPPO |
$1,135.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,135.49
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,635.11
|
| Rate for Payer: Cofinity Commercial |
$1,521.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,135.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,192.26
|
| Rate for Payer: Nomi Health Commercial |
$1,362.59
|
| Rate for Payer: PACE SWMI |
$1,135.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,135.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.80
|
| Rate for Payer: Priority Health Medicare |
$1,146.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,135.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,135.49
|
| Rate for Payer: UHC Exchange |
$1,135.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,135.49
|
|
|
PR EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH
|
Professional
|
Both
|
$2,703.00
|
|
|
Service Code
|
HCPCS 45135
|
| Min. Negotiated Rate |
$1,081.20 |
| Max. Negotiated Rate |
$1,776.57 |
| Rate for Payer: Aetna Commercial |
$1,653.20
|
| Rate for Payer: Aetna Medicare |
$1,283.08
|
| Rate for Payer: BCBS Complete |
$1,081.20
|
| Rate for Payer: BCBS MAPPO |
$1,233.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,233.73
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,776.57
|
| Rate for Payer: Cofinity Commercial |
$1,653.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,233.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,295.42
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: PACE SWMI |
$1,233.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,233.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,756.95
|
| Rate for Payer: Priority Health Medicare |
$1,246.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,233.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,233.73
|
| Rate for Payer: UHC Exchange |
$1,233.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,233.73
|
|
|
PR EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH
|
Professional
|
Both
|
$2,827.00
|
|
|
Service Code
|
HCPCS 45130
|
| Min. Negotiated Rate |
$1,037.86 |
| Max. Negotiated Rate |
$1,837.55 |
| Rate for Payer: Aetna Commercial |
$1,390.73
|
| Rate for Payer: Aetna Medicare |
$1,079.37
|
| Rate for Payer: BCBS Complete |
$1,130.80
|
| Rate for Payer: BCBS MAPPO |
$1,037.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.86
|
| Rate for Payer: Cash Price |
$2,261.60
|
| Rate for Payer: Cash Price |
$2,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,494.52
|
| Rate for Payer: Cofinity Commercial |
$1,390.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,089.75
|
| Rate for Payer: Nomi Health Commercial |
$1,245.43
|
| Rate for Payer: PACE SWMI |
$1,037.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,837.55
|
| Rate for Payer: Priority Health Medicare |
$1,048.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,037.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.86
|
| Rate for Payer: UHC Exchange |
$1,037.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,037.86
|
|
|
PR EXC RCT TUM INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,883.00
|
|
|
Service Code
|
HCPCS 45172
|
| Min. Negotiated Rate |
$753.20 |
| Max. Negotiated Rate |
$1,223.95 |
| Rate for Payer: Aetna Commercial |
$1,053.01
|
| Rate for Payer: Aetna Medicare |
$817.26
|
| Rate for Payer: BCBS Complete |
$753.20
|
| Rate for Payer: BCBS MAPPO |
$785.83
|
| Rate for Payer: BCN Medicare Advantage |
$785.83
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cofinity Commercial |
$1,131.60
|
| Rate for Payer: Cofinity Commercial |
$1,053.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$825.12
|
| Rate for Payer: Nomi Health Commercial |
$943.00
|
| Rate for Payer: PACE SWMI |
$785.83
|
| Rate for Payer: PHP Medicare Advantage |
$785.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.95
|
| Rate for Payer: Priority Health Medicare |
$793.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.83
|
| Rate for Payer: UHC Exchange |
$785.83
|
| Rate for Payer: UHC Medicare Advantage |
$785.83
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 45171
|
| Min. Negotiated Rate |
$548.00 |
| Max. Negotiated Rate |
$890.50 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$611.31
|
| Rate for Payer: BCBS Complete |
$548.00
|
| Rate for Payer: BCBS MAPPO |
$587.80
|
| Rate for Payer: BCN Medicare Advantage |
$587.80
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$846.43
|
| Rate for Payer: Cofinity Commercial |
$787.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.19
|
| Rate for Payer: Nomi Health Commercial |
$705.36
|
| Rate for Payer: PACE SWMI |
$587.80
|
| Rate for Payer: PHP Medicare Advantage |
$587.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health Medicare |
$593.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.80
|
| Rate for Payer: UHC Exchange |
$587.80
|
| Rate for Payer: UHC Medicare Advantage |
$587.80
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
IP
|
$1,370.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$890.50 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$1,164.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.33
|
| Rate for Payer: BCN Commercial |
$1,058.74
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$1,178.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.00
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,027.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.50
|
| Rate for Payer: Nomi Health Commercial |
$1,123.40
|
| Rate for Payer: PHP Commercial |
$1,164.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,191.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,205.60
|
| Rate for Payer: UHC Core |
$1,143.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,027.50
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$548.00 |
| Max. Negotiated Rate |
$890.50 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$611.31
|
| Rate for Payer: BCBS Complete |
$548.00
|
| Rate for Payer: BCBS MAPPO |
$587.80
|
| Rate for Payer: BCN Medicare Advantage |
$587.80
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$846.43
|
| Rate for Payer: Cofinity Commercial |
$787.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.19
|
| Rate for Payer: Nomi Health Commercial |
$705.36
|
| Rate for Payer: PACE SWMI |
$587.80
|
| Rate for Payer: PHP Medicare Advantage |
$587.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health Medicare |
$593.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.80
|
| Rate for Payer: UHC Exchange |
$587.80
|
| Rate for Payer: UHC Medicare Advantage |
$587.80
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$325.38 |
| Max. Negotiated Rate |
$2,082.02 |
| Rate for Payer: Aetna Commercial |
$1,164.50
|
| Rate for Payer: Aetna Medicare |
$356.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$428.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$428.12
|
| Rate for Payer: BCBS Complete |
$2,082.02
|
| Rate for Payer: BCBS MAPPO |
$342.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.28
|
| Rate for Payer: BCN Commercial |
$1,065.17
|
| Rate for Payer: BCN Medicare Advantage |
$342.50
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$1,178.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.50
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,027.50
|
| Rate for Payer: Mclaren Medicaid |
$1,982.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.62
|
| Rate for Payer: Meridian Medicaid |
$2,082.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.50
|
| Rate for Payer: Nomi Health Commercial |
$1,123.40
|
| Rate for Payer: PACE Senior Care Partners |
$325.38
|
| Rate for Payer: PACE SWMI |
$342.50
|
| Rate for Payer: PHP Commercial |
$1,164.50
|
| Rate for Payer: PHP Medicare Advantage |
$342.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,982.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,191.90
|
| Rate for Payer: Priority Health Medicare |
$345.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.90
|
| Rate for Payer: Railroad Medicare Medicare |
$342.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,205.60
|
| Rate for Payer: UHC Core |
$1,143.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.50
|
| Rate for Payer: UHC Exchange |
$342.50
|
| Rate for Payer: UHC Medicare Advantage |
$342.50
|
| Rate for Payer: UHCCP Medicaid |
$1,982.75
|
| Rate for Payer: VA VA |
$342.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,027.50
|
|
|
PR EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 45160
|
| Min. Negotiated Rate |
$836.80 |
| Max. Negotiated Rate |
$1,438.14 |
| Rate for Payer: Aetna Commercial |
$1,338.27
|
| Rate for Payer: Aetna Medicare |
$1,038.66
|
| Rate for Payer: BCBS Complete |
$836.80
|
| Rate for Payer: BCBS MAPPO |
$998.71
|
| Rate for Payer: BCN Medicare Advantage |
$998.71
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,438.14
|
| Rate for Payer: Cofinity Commercial |
$1,338.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$998.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,048.65
|
| Rate for Payer: Nomi Health Commercial |
$1,198.45
|
| Rate for Payer: PACE SWMI |
$998.71
|
| Rate for Payer: PHP Medicare Advantage |
$998.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health Medicare |
$1,008.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$998.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$998.71
|
| Rate for Payer: UHC Exchange |
$998.71
|
| Rate for Payer: UHC Medicare Advantage |
$998.71
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 15936
|
| Min. Negotiated Rate |
$619.60 |
| Max. Negotiated Rate |
$1,230.91 |
| Rate for Payer: Aetna Commercial |
$1,145.43
|
| Rate for Payer: Aetna Medicare |
$888.99
|
| Rate for Payer: BCBS Complete |
$619.60
|
| Rate for Payer: BCBS MAPPO |
$854.80
|
| Rate for Payer: BCN Medicare Advantage |
$854.80
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,230.91
|
| Rate for Payer: Cofinity Commercial |
$1,145.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.54
|
| Rate for Payer: Nomi Health Commercial |
$1,025.76
|
| Rate for Payer: PACE SWMI |
$854.80
|
| Rate for Payer: PHP Medicare Advantage |
$854.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health Medicare |
$863.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$854.80
|
| Rate for Payer: UHC Exchange |
$854.80
|
| Rate for Payer: UHC Medicare Advantage |
$854.80
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC
|
Professional
|
Both
|
$2,107.00
|
|
|
Service Code
|
HCPCS 15937
|
| Min. Negotiated Rate |
$842.80 |
| Max. Negotiated Rate |
$1,369.55 |
| Rate for Payer: Aetna Commercial |
$1,260.74
|
| Rate for Payer: Aetna Medicare |
$978.48
|
| Rate for Payer: BCBS Complete |
$842.80
|
| Rate for Payer: BCBS MAPPO |
$940.85
|
| Rate for Payer: BCN Medicare Advantage |
$940.85
|
| Rate for Payer: Cash Price |
$1,685.60
|
| Rate for Payer: Cash Price |
$1,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,354.82
|
| Rate for Payer: Cofinity Commercial |
$1,260.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.89
|
| Rate for Payer: Nomi Health Commercial |
$1,129.02
|
| Rate for Payer: PACE SWMI |
$940.85
|
| Rate for Payer: PHP Medicare Advantage |
$940.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.55
|
| Rate for Payer: Priority Health Medicare |
$950.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$940.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.85
|
| Rate for Payer: UHC Exchange |
$940.85
|
| Rate for Payer: UHC Medicare Advantage |
$940.85
|
|
|
PR EXC SUBLINGUAL SALIVARY CYST RANULA
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 42408
|
| Min. Negotiated Rate |
$291.20 |
| Max. Negotiated Rate |
$475.93 |
| Rate for Payer: Aetna Commercial |
$442.88
|
| Rate for Payer: Aetna Medicare |
$343.73
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$330.51
|
| Rate for Payer: BCN Medicare Advantage |
$330.51
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$475.93
|
| Rate for Payer: Cofinity Commercial |
$442.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.04
|
| Rate for Payer: Nomi Health Commercial |
$396.61
|
| Rate for Payer: PACE SWMI |
$330.51
|
| Rate for Payer: PHP Medicare Advantage |
$330.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.20
|
| Rate for Payer: Priority Health Medicare |
$333.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.51
|
| Rate for Payer: UHC Exchange |
$330.51
|
| Rate for Payer: UHC Medicare Advantage |
$330.51
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Min. Negotiated Rate |
$519.99 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$525.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Exchange |
$519.99
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
IP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$1,171.30 |
| Max. Negotiated Rate |
$1,621.80 |
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.97
|
| Rate for Payer: BCN Commercial |
$1,392.59
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,351.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: Nomi Health Commercial |
$1,477.64
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,567.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,207.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,585.76
|
| Rate for Payer: UHC Core |
$1,504.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,351.50
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$519.99 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$525.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Exchange |
$519.99
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
OP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$427.98 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna Medicare |
$468.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$563.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$563.12
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$450.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,481.42
|
| Rate for Payer: BCN Commercial |
$1,401.06
|
| Rate for Payer: BCN Medicare Advantage |
$450.50
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.50
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,351.50
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$473.02
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$518.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: Nomi Health Commercial |
$1,477.64
|
| Rate for Payer: PACE Senior Care Partners |
$427.98
|
| Rate for Payer: PACE SWMI |
$450.50
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: PHP Medicare Advantage |
$450.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,567.74
|
| Rate for Payer: Priority Health Medicare |
$455.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,207.34
|
| Rate for Payer: Railroad Medicare Medicare |
$450.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,585.76
|
| Rate for Payer: UHC Core |
$1,504.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$450.50
|
| Rate for Payer: UHC Exchange |
$450.50
|
| Rate for Payer: UHC Medicare Advantage |
$450.50
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$450.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,351.50
|
|
|
PR EXC THROMBOSED HEMORRHOID XTRNL
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 46320
|
| Min. Negotiated Rate |
$108.46 |
| Max. Negotiated Rate |
$230.75 |
| Rate for Payer: Aetna Commercial |
$145.34
|
| Rate for Payer: Aetna Medicare |
$112.80
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: BCBS MAPPO |
$108.46
|
| Rate for Payer: BCN Medicare Advantage |
$108.46
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cofinity Commercial |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$145.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.88
|
| Rate for Payer: Nomi Health Commercial |
$130.15
|
| Rate for Payer: PACE SWMI |
$108.46
|
| Rate for Payer: PHP Medicare Advantage |
$108.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health Medicare |
$109.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.46
|
| Rate for Payer: UHC Exchange |
$108.46
|
| Rate for Payer: UHC Medicare Advantage |
$108.46
|
|
|
PR EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 15950
|
| Min. Negotiated Rate |
$479.60 |
| Max. Negotiated Rate |
$873.16 |
| Rate for Payer: Aetna Commercial |
$812.52
|
| Rate for Payer: Aetna Medicare |
$630.61
|
| Rate for Payer: BCBS Complete |
$479.60
|
| Rate for Payer: BCBS MAPPO |
$606.36
|
| Rate for Payer: BCN Medicare Advantage |
$606.36
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$873.16
|
| Rate for Payer: Cofinity Commercial |
$812.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.68
|
| Rate for Payer: Nomi Health Commercial |
$727.63
|
| Rate for Payer: PACE SWMI |
$606.36
|
| Rate for Payer: PHP Medicare Advantage |
$606.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.35
|
| Rate for Payer: Priority Health Medicare |
$612.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.36
|
| Rate for Payer: UHC Exchange |
$606.36
|
| Rate for Payer: UHC Medicare Advantage |
$606.36
|
|
|
PR EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$1,995.00
|
|
|
Service Code
|
HCPCS 15956
|
| Min. Negotiated Rate |
$798.00 |
| Max. Negotiated Rate |
$1,606.20 |
| Rate for Payer: Aetna Commercial |
$1,494.66
|
| Rate for Payer: Aetna Medicare |
$1,160.04
|
| Rate for Payer: BCBS Complete |
$798.00
|
| Rate for Payer: BCBS MAPPO |
$1,115.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,115.42
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,606.20
|
| Rate for Payer: Cofinity Commercial |
$1,494.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,115.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,171.19
|
| Rate for Payer: Nomi Health Commercial |
$1,338.50
|
| Rate for Payer: PACE SWMI |
$1,115.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,115.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health Medicare |
$1,126.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,115.42
|
| Rate for Payer: UHC Exchange |
$1,115.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,115.42
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
OP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$529.15 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: Aetna Medicare |
$579.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.25
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$557.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.64
|
| Rate for Payer: BCN Commercial |
$1,732.27
|
| Rate for Payer: BCN Medicare Advantage |
$557.00
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.00
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.00
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$584.85
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: Nomi Health Commercial |
$1,826.96
|
| Rate for Payer: PACE Senior Care Partners |
$529.15
|
| Rate for Payer: PACE SWMI |
$557.00
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: PHP Medicare Advantage |
$557.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,938.36
|
| Rate for Payer: Priority Health Medicare |
$562.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,492.76
|
| Rate for Payer: Railroad Medicare Medicare |
$557.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,960.64
|
| Rate for Payer: UHC Core |
$1,860.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.00
|
| Rate for Payer: UHC Exchange |
$557.00
|
| Rate for Payer: UHC Medicare Advantage |
$557.00
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$557.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.00
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$519.50 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: BCBS Complete |
$891.20
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health Medicare |
$524.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Exchange |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
IP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$1,448.20 |
| Max. Negotiated Rate |
$2,005.20 |
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,818.72
|
| Rate for Payer: BCN Commercial |
$1,721.80
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: Nomi Health Commercial |
$1,826.96
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,938.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,492.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,960.64
|
| Rate for Payer: UHC Core |
$1,860.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.00
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Min. Negotiated Rate |
$519.50 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: BCBS Complete |
$891.20
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health Medicare |
$524.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Exchange |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$433.92 |
| Max. Negotiated Rate |
$801.45 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$451.28
|
| Rate for Payer: BCBS Complete |
$493.20
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health Medicare |
$438.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Exchange |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$801.45 |
| Max. Negotiated Rate |
$1,109.70 |
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.50
|
| Rate for Payer: BCN Commercial |
$952.86
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: Nomi Health Commercial |
$1,011.06
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,072.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,085.04
|
| Rate for Payer: UHC Core |
$1,029.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.75
|
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