|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,516.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$2,206.40 |
| Max. Negotiated Rate |
$3,585.40 |
| Rate for Payer: Aetna Medicare |
$2,758.00
|
| Rate for Payer: BCBS Complete |
$2,206.40
|
| Rate for Payer: Cash Price |
$4,412.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,585.40
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: Aetna Medicare |
$217.00
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$173.60
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$933.20 |
| Max. Negotiated Rate |
$1,570.36 |
| Rate for Payer: Aetna Commercial |
$1,461.31
|
| Rate for Payer: Aetna Medicare |
$1,134.15
|
| Rate for Payer: BCBS Complete |
$933.20
|
| Rate for Payer: BCBS MAPPO |
$1,090.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.53
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,570.36
|
| Rate for Payer: Cofinity Commercial |
$1,461.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.06
|
| Rate for Payer: Nomi Health Commercial |
$1,308.64
|
| Rate for Payer: PACE SWMI |
$1,090.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health Medicare |
$1,101.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,090.53
|
| Rate for Payer: UHC Exchange |
$1,090.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,090.53
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$697.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$255.44 |
| Max. Negotiated Rate |
$453.05 |
| Rate for Payer: Aetna Commercial |
$342.29
|
| Rate for Payer: Aetna Medicare |
$265.66
|
| Rate for Payer: BCBS Complete |
$278.80
|
| Rate for Payer: BCBS MAPPO |
$255.44
|
| Rate for Payer: BCN Medicare Advantage |
$255.44
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cash Price |
$557.60
|
| Rate for Payer: Cofinity Commercial |
$367.83
|
| Rate for Payer: Cofinity Commercial |
$342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.21
|
| Rate for Payer: Nomi Health Commercial |
$306.53
|
| Rate for Payer: PACE SWMI |
$255.44
|
| Rate for Payer: PHP Medicare Advantage |
$255.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$453.05
|
| Rate for Payer: Priority Health Medicare |
$257.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.44
|
| Rate for Payer: UHC Exchange |
$255.44
|
| Rate for Payer: UHC Medicare Advantage |
$255.44
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$96.22 |
| Rate for Payer: Aetna Commercial |
$89.54
|
| Rate for Payer: Aetna Medicare |
$69.49
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$66.82
|
| Rate for Payer: BCN Medicare Advantage |
$66.82
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$96.22
|
| Rate for Payer: Cofinity Commercial |
$89.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.16
|
| Rate for Payer: Nomi Health Commercial |
$80.18
|
| Rate for Payer: PACE SWMI |
$66.82
|
| Rate for Payer: PHP Medicare Advantage |
$66.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health Medicare |
$67.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.82
|
| Rate for Payer: UHC Exchange |
$66.82
|
| Rate for Payer: UHC Medicare Advantage |
$66.82
|
|
|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$129.66
|
| Rate for Payer: Aetna Medicare |
$100.63
|
| Rate for Payer: BCBS Complete |
$238.40
|
| Rate for Payer: BCBS MAPPO |
$96.76
|
| Rate for Payer: BCN Medicare Advantage |
$96.76
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$139.33
|
| Rate for Payer: Cofinity Commercial |
$129.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.60
|
| Rate for Payer: Nomi Health Commercial |
$116.11
|
| Rate for Payer: PACE SWMI |
$96.76
|
| Rate for Payer: PHP Medicare Advantage |
$96.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health Medicare |
$97.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.76
|
| Rate for Payer: UHC Exchange |
$96.76
|
| Rate for Payer: UHC Medicare Advantage |
$96.76
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$166.00 |
| Max. Negotiated Rate |
$269.75 |
| Rate for Payer: Aetna Commercial |
$245.77
|
| Rate for Payer: Aetna Medicare |
$190.75
|
| Rate for Payer: BCBS Complete |
$166.00
|
| Rate for Payer: BCBS MAPPO |
$183.41
|
| Rate for Payer: BCN Medicare Advantage |
$183.41
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$264.11
|
| Rate for Payer: Cofinity Commercial |
$245.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.58
|
| Rate for Payer: Nomi Health Commercial |
$220.09
|
| Rate for Payer: PACE SWMI |
$183.41
|
| Rate for Payer: PHP Medicare Advantage |
$183.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health Medicare |
$185.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.41
|
| Rate for Payer: UHC Exchange |
$183.41
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$692.17 |
| Rate for Payer: Aetna Commercial |
$352.75
|
| Rate for Payer: Aetna Medicare |
$107.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.69
|
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: BCBS MAPPO |
$103.75
|
| Rate for Payer: BCBS Trust/PPO |
$341.17
|
| Rate for Payer: BCN Commercial |
$322.66
|
| Rate for Payer: BCN Medicare Advantage |
$103.75
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$356.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.75
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.25
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.94
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: Nomi Health Commercial |
$340.30
|
| Rate for Payer: PACE Senior Care Partners |
$98.56
|
| Rate for Payer: PACE SWMI |
$103.75
|
| Rate for Payer: PHP Commercial |
$352.75
|
| Rate for Payer: PHP Medicare Advantage |
$103.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO |
$361.05
|
| Rate for Payer: Priority Health Medicare |
$104.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.05
|
| Rate for Payer: Railroad Medicare Medicare |
$103.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.20
|
| Rate for Payer: UHC Core |
$346.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.75
|
| Rate for Payer: UHC Exchange |
$103.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.75
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
| Rate for Payer: VA VA |
$103.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.25
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$269.75 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Aetna Commercial |
$352.75
|
| Rate for Payer: BCBS Trust/PPO |
$338.76
|
| Rate for Payer: BCN Commercial |
$320.71
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$356.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.00
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.75
|
| Rate for Payer: Nomi Health Commercial |
$340.30
|
| Rate for Payer: PHP Commercial |
$352.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO |
$361.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.20
|
| Rate for Payer: UHC Core |
$346.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.25
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$166.00 |
| Max. Negotiated Rate |
$269.75 |
| Rate for Payer: Aetna Commercial |
$245.77
|
| Rate for Payer: Aetna Medicare |
$190.75
|
| Rate for Payer: BCBS Complete |
$166.00
|
| Rate for Payer: BCBS MAPPO |
$183.41
|
| Rate for Payer: BCN Medicare Advantage |
$183.41
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$264.11
|
| Rate for Payer: Cofinity Commercial |
$245.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.58
|
| Rate for Payer: Nomi Health Commercial |
$220.09
|
| Rate for Payer: PACE SWMI |
$183.41
|
| Rate for Payer: PHP Medicare Advantage |
$183.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health Medicare |
$185.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.41
|
| Rate for Payer: UHC Exchange |
$183.41
|
| Rate for Payer: UHC Medicare Advantage |
$183.41
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$462.98 |
| Max. Negotiated Rate |
$1,049.10 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$481.50
|
| Rate for Payer: BCBS Complete |
$645.60
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health Medicare |
$467.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Exchange |
$462.98
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,049.10 |
| Max. Negotiated Rate |
$1,452.60 |
| Rate for Payer: Aetna Commercial |
$1,371.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.51
|
| Rate for Payer: BCN Commercial |
$1,247.30
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,388.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Healthscope Commercial |
$1,452.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: Nomi Health Commercial |
$1,323.48
|
| Rate for Payer: PHP Commercial |
$1,371.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,404.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.32
|
| Rate for Payer: UHC Core |
$1,347.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.50
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,614.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$462.98 |
| Max. Negotiated Rate |
$1,049.10 |
| Rate for Payer: Aetna Commercial |
$620.39
|
| Rate for Payer: Aetna Medicare |
$481.50
|
| Rate for Payer: BCBS Complete |
$645.60
|
| Rate for Payer: BCBS MAPPO |
$462.98
|
| Rate for Payer: BCN Medicare Advantage |
$462.98
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$666.69
|
| Rate for Payer: Cofinity Commercial |
$620.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$486.13
|
| Rate for Payer: Nomi Health Commercial |
$555.58
|
| Rate for Payer: PACE SWMI |
$462.98
|
| Rate for Payer: PHP Medicare Advantage |
$462.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health Medicare |
$467.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.98
|
| Rate for Payer: UHC Exchange |
$462.98
|
| Rate for Payer: UHC Medicare Advantage |
$462.98
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
OP
|
$1,614.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$383.32 |
| Max. Negotiated Rate |
$2,082.02 |
| Rate for Payer: Aetna Commercial |
$1,371.90
|
| Rate for Payer: Aetna Medicare |
$419.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$504.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$504.38
|
| Rate for Payer: BCBS Complete |
$2,082.02
|
| Rate for Payer: BCBS MAPPO |
$403.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.87
|
| Rate for Payer: BCN Commercial |
$1,254.88
|
| Rate for Payer: BCN Medicare Advantage |
$403.50
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cash Price |
$1,291.20
|
| Rate for Payer: Cofinity Commercial |
$1,388.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.50
|
| Rate for Payer: Healthscope Commercial |
$1,452.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.50
|
| Rate for Payer: Mclaren Medicaid |
$1,982.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.68
|
| Rate for Payer: Meridian Medicaid |
$2,082.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$464.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,371.90
|
| Rate for Payer: Nomi Health Commercial |
$1,323.48
|
| Rate for Payer: PACE Senior Care Partners |
$383.32
|
| Rate for Payer: PACE SWMI |
$403.50
|
| Rate for Payer: PHP Commercial |
$1,371.90
|
| Rate for Payer: PHP Medicare Advantage |
$403.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,982.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,404.18
|
| Rate for Payer: Priority Health Medicare |
$407.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.38
|
| Rate for Payer: Railroad Medicare Medicare |
$403.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.32
|
| Rate for Payer: UHC Core |
$1,347.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.50
|
| Rate for Payer: UHC Exchange |
$403.50
|
| Rate for Payer: UHC Medicare Advantage |
$403.50
|
| Rate for Payer: UHCCP Medicaid |
$1,982.75
|
| Rate for Payer: VA VA |
$403.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.50
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$260.77 |
| Max. Negotiated Rate |
$2,082.02 |
| Rate for Payer: Aetna Commercial |
$933.30
|
| Rate for Payer: Aetna Medicare |
$285.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$343.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$343.12
|
| Rate for Payer: BCBS Complete |
$2,082.02
|
| Rate for Payer: BCBS MAPPO |
$274.50
|
| Rate for Payer: BCBS Trust/PPO |
$902.67
|
| Rate for Payer: BCN Commercial |
$853.70
|
| Rate for Payer: BCN Medicare Advantage |
$274.50
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$944.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.50
|
| Rate for Payer: Healthscope Commercial |
$988.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.50
|
| Rate for Payer: Mclaren Medicaid |
$1,982.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.23
|
| Rate for Payer: Meridian Medicaid |
$2,082.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: Nomi Health Commercial |
$900.36
|
| Rate for Payer: PACE Senior Care Partners |
$260.77
|
| Rate for Payer: PACE SWMI |
$274.50
|
| Rate for Payer: PHP Commercial |
$933.30
|
| Rate for Payer: PHP Medicare Advantage |
$274.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,982.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO |
$955.26
|
| Rate for Payer: Priority Health Medicare |
$277.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$735.66
|
| Rate for Payer: Railroad Medicare Medicare |
$274.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$966.24
|
| Rate for Payer: UHC Core |
$916.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.50
|
| Rate for Payer: UHC Exchange |
$274.50
|
| Rate for Payer: UHC Medicare Advantage |
$274.50
|
| Rate for Payer: UHCCP Medicaid |
$1,982.75
|
| Rate for Payer: VA VA |
$274.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.50
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$339.69 |
| Max. Negotiated Rate |
$713.70 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$353.28
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$343.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Exchange |
$339.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$339.69 |
| Max. Negotiated Rate |
$713.70 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$353.28
|
| Rate for Payer: BCBS Complete |
$439.20
|
| Rate for Payer: BCBS MAPPO |
$339.69
|
| Rate for Payer: BCN Medicare Advantage |
$339.69
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.67
|
| Rate for Payer: Nomi Health Commercial |
$407.63
|
| Rate for Payer: PACE SWMI |
$339.69
|
| Rate for Payer: PHP Medicare Advantage |
$339.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health Medicare |
$343.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.69
|
| Rate for Payer: UHC Exchange |
$339.69
|
| Rate for Payer: UHC Medicare Advantage |
$339.69
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,098.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$713.70 |
| Max. Negotiated Rate |
$988.20 |
| Rate for Payer: Aetna Commercial |
$933.30
|
| Rate for Payer: BCBS Trust/PPO |
$896.30
|
| Rate for Payer: BCN Commercial |
$848.53
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$944.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.40
|
| Rate for Payer: Healthscope Commercial |
$988.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$933.30
|
| Rate for Payer: Nomi Health Commercial |
$900.36
|
| Rate for Payer: PHP Commercial |
$933.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO |
$955.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$735.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$966.24
|
| Rate for Payer: UHC Core |
$916.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.50
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$306.79 |
| Max. Negotiated Rate |
$733.85 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$319.06
|
| Rate for Payer: BCBS Complete |
$451.60
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health Medicare |
$309.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Exchange |
$306.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,129.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$306.79 |
| Max. Negotiated Rate |
$733.85 |
| Rate for Payer: Aetna Commercial |
$411.10
|
| Rate for Payer: Aetna Medicare |
$319.06
|
| Rate for Payer: BCBS Complete |
$451.60
|
| Rate for Payer: BCBS MAPPO |
$306.79
|
| Rate for Payer: BCN Medicare Advantage |
$306.79
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Cofinity Commercial |
$411.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.13
|
| Rate for Payer: Nomi Health Commercial |
$368.15
|
| Rate for Payer: PACE SWMI |
$306.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health Medicare |
$309.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.79
|
| Rate for Payer: UHC Exchange |
$306.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.79
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
OP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$268.14 |
| Max. Negotiated Rate |
$2,082.02 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: Aetna Medicare |
$293.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$352.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$352.81
|
| Rate for Payer: BCBS Complete |
$2,082.02
|
| Rate for Payer: BCBS MAPPO |
$282.25
|
| Rate for Payer: BCBS Trust/PPO |
$928.15
|
| Rate for Payer: BCN Commercial |
$877.80
|
| Rate for Payer: BCN Medicare Advantage |
$282.25
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.25
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.75
|
| Rate for Payer: Mclaren Medicaid |
$1,982.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.36
|
| Rate for Payer: Meridian Medicaid |
$2,082.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$324.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: Nomi Health Commercial |
$925.78
|
| Rate for Payer: PACE Senior Care Partners |
$268.14
|
| Rate for Payer: PACE SWMI |
$282.25
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: PHP Medicare Advantage |
$282.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,982.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO |
$982.23
|
| Rate for Payer: Priority Health Medicare |
$285.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.43
|
| Rate for Payer: Railroad Medicare Medicare |
$282.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$993.52
|
| Rate for Payer: UHC Core |
$942.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.25
|
| Rate for Payer: UHC Exchange |
$282.25
|
| Rate for Payer: UHC Medicare Advantage |
$282.25
|
| Rate for Payer: UHCCP Medicaid |
$1,982.75
|
| Rate for Payer: VA VA |
$282.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.75
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
IP
|
$1,129.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$733.85 |
| Max. Negotiated Rate |
$1,016.10 |
| Rate for Payer: Aetna Commercial |
$959.65
|
| Rate for Payer: BCBS Trust/PPO |
$921.60
|
| Rate for Payer: BCN Commercial |
$872.49
|
| Rate for Payer: Cash Price |
$903.20
|
| Rate for Payer: Cofinity Commercial |
$970.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.20
|
| Rate for Payer: Healthscope Commercial |
$1,016.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.65
|
| Rate for Payer: Nomi Health Commercial |
$925.78
|
| Rate for Payer: PHP Commercial |
$959.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.85
|
| Rate for Payer: Priority Health HMO/PPO |
$982.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$993.52
|
| Rate for Payer: UHC Core |
$942.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.75
|
|
|
PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO
|
Professional
|
Both
|
$743.00
|
|
|
Service Code
|
HCPCS 46257
|
| Min. Negotiated Rate |
$297.20 |
| Max. Negotiated Rate |
$572.43 |
| Rate for Payer: Aetna Commercial |
$532.68
|
| Rate for Payer: Aetna Medicare |
$413.42
|
| Rate for Payer: BCBS Complete |
$297.20
|
| Rate for Payer: BCBS MAPPO |
$397.52
|
| Rate for Payer: BCN Medicare Advantage |
$397.52
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cash Price |
$594.40
|
| Rate for Payer: Cofinity Commercial |
$572.43
|
| Rate for Payer: Cofinity Commercial |
$532.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.40
|
| Rate for Payer: Nomi Health Commercial |
$477.02
|
| Rate for Payer: PACE SWMI |
$397.52
|
| Rate for Payer: PHP Medicare Advantage |
$397.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.95
|
| Rate for Payer: Priority Health Medicare |
$401.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.52
|
| Rate for Payer: UHC Exchange |
$397.52
|
| Rate for Payer: UHC Medicare Advantage |
$397.52
|
|
