|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
10140
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$174.85 |
| Rate for Payer: Aetna Commercial |
$150.63
|
| Rate for Payer: Aetna Medicare |
$116.91
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCBS MAPPO |
$112.41
|
| Rate for Payer: BCN Medicare Advantage |
$112.41
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Cofinity Commercial |
$150.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.03
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: PACE SWMI |
$112.41
|
| Rate for Payer: PHP Medicare Advantage |
$112.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Medicare |
$113.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.41
|
| Rate for Payer: UHC Exchange |
$112.41
|
| Rate for Payer: UHC Medicare Advantage |
$112.41
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 46045
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$564.94
|
| Rate for Payer: Aetna Medicare |
$438.46
|
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: BCBS MAPPO |
$421.60
|
| Rate for Payer: BCN Medicare Advantage |
$421.60
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$607.10
|
| Rate for Payer: Cofinity Commercial |
$564.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.68
|
| Rate for Payer: Nomi Health Commercial |
$505.92
|
| Rate for Payer: PACE SWMI |
$421.60
|
| Rate for Payer: PHP Medicare Advantage |
$421.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Medicare |
$425.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.60
|
| Rate for Payer: UHC Exchange |
$421.60
|
| Rate for Payer: UHC Medicare Advantage |
$421.60
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$478.40 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Aetna Commercial |
$625.60
|
| Rate for Payer: BCBS Trust/PPO |
$600.80
|
| Rate for Payer: BCN Commercial |
$568.78
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$632.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Healthscope Commercial |
$662.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.60
|
| Rate for Payer: Nomi Health Commercial |
$603.52
|
| Rate for Payer: PHP Commercial |
$625.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health HMO/PPO |
$640.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.68
|
| Rate for Payer: UHC Core |
$614.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.00
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$2,082.02 |
| Rate for Payer: Aetna Commercial |
$625.60
|
| Rate for Payer: Aetna Medicare |
$191.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$230.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$230.00
|
| Rate for Payer: BCBS Complete |
$2,082.02
|
| Rate for Payer: BCBS MAPPO |
$184.00
|
| Rate for Payer: BCBS Trust/PPO |
$605.07
|
| Rate for Payer: BCN Commercial |
$572.24
|
| Rate for Payer: BCN Medicare Advantage |
$184.00
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$632.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.00
|
| Rate for Payer: Healthscope Commercial |
$662.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.00
|
| Rate for Payer: Mclaren Medicaid |
$1,982.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.20
|
| Rate for Payer: Meridian Medicaid |
$2,082.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.60
|
| Rate for Payer: Nomi Health Commercial |
$603.52
|
| Rate for Payer: PACE Senior Care Partners |
$174.80
|
| Rate for Payer: PACE SWMI |
$184.00
|
| Rate for Payer: PHP Commercial |
$625.60
|
| Rate for Payer: PHP Medicare Advantage |
$184.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,982.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health HMO/PPO |
$640.32
|
| Rate for Payer: Priority Health Medicare |
$185.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.12
|
| Rate for Payer: Railroad Medicare Medicare |
$184.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.68
|
| Rate for Payer: UHC Core |
$614.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.00
|
| Rate for Payer: UHC Exchange |
$184.00
|
| Rate for Payer: UHC Medicare Advantage |
$184.00
|
| Rate for Payer: UHCCP Medicaid |
$1,982.75
|
| Rate for Payer: VA VA |
$184.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.00
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$564.94
|
| Rate for Payer: Aetna Medicare |
$438.46
|
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: BCBS MAPPO |
$421.60
|
| Rate for Payer: BCN Medicare Advantage |
$421.60
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$607.10
|
| Rate for Payer: Cofinity Commercial |
$564.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.68
|
| Rate for Payer: Nomi Health Commercial |
$505.92
|
| Rate for Payer: PACE SWMI |
$421.60
|
| Rate for Payer: PHP Medicare Advantage |
$421.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Medicare |
$425.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.60
|
| Rate for Payer: UHC Exchange |
$421.60
|
| Rate for Payer: UHC Medicare Advantage |
$421.60
|
|
|
PR I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$2,127.00
|
|
|
Service Code
|
HCPCS 46060
|
| Min. Negotiated Rate |
$466.27 |
| Max. Negotiated Rate |
$1,382.55 |
| Rate for Payer: Aetna Commercial |
$624.80
|
| Rate for Payer: Aetna Medicare |
$484.92
|
| Rate for Payer: BCBS Complete |
$850.80
|
| Rate for Payer: BCBS MAPPO |
$466.27
|
| Rate for Payer: BCN Medicare Advantage |
$466.27
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cofinity Commercial |
$671.43
|
| Rate for Payer: Cofinity Commercial |
$624.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.58
|
| Rate for Payer: Nomi Health Commercial |
$559.52
|
| Rate for Payer: PACE SWMI |
$466.27
|
| Rate for Payer: PHP Medicare Advantage |
$466.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.55
|
| Rate for Payer: Priority Health Medicare |
$470.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.27
|
| Rate for Payer: UHC Exchange |
$466.27
|
| Rate for Payer: UHC Medicare Advantage |
$466.27
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 46040
|
| Min. Negotiated Rate |
$369.60 |
| Max. Negotiated Rate |
$600.60 |
| Rate for Payer: Aetna Commercial |
$549.47
|
| Rate for Payer: Aetna Medicare |
$426.45
|
| Rate for Payer: BCBS Complete |
$369.60
|
| Rate for Payer: BCBS MAPPO |
$410.05
|
| Rate for Payer: BCN Medicare Advantage |
$410.05
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$590.47
|
| Rate for Payer: Cofinity Commercial |
$549.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.55
|
| Rate for Payer: Nomi Health Commercial |
$492.06
|
| Rate for Payer: PACE SWMI |
$410.05
|
| Rate for Payer: PHP Medicare Advantage |
$410.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health Medicare |
$414.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.05
|
| Rate for Payer: UHC Exchange |
$410.05
|
| Rate for Payer: UHC Medicare Advantage |
$410.05
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
OP
|
$924.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$219.45 |
| Max. Negotiated Rate |
$895.16 |
| Rate for Payer: Aetna Commercial |
$785.40
|
| Rate for Payer: Aetna Medicare |
$240.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.75
|
| Rate for Payer: BCBS Complete |
$895.16
|
| Rate for Payer: BCBS MAPPO |
$231.00
|
| Rate for Payer: BCBS Trust/PPO |
$759.62
|
| Rate for Payer: BCN Commercial |
$718.41
|
| Rate for Payer: BCN Medicare Advantage |
$231.00
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$794.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.00
|
| Rate for Payer: Healthscope Commercial |
$831.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.00
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.55
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.40
|
| Rate for Payer: Nomi Health Commercial |
$757.68
|
| Rate for Payer: PACE Senior Care Partners |
$219.45
|
| Rate for Payer: PACE SWMI |
$231.00
|
| Rate for Payer: PHP Commercial |
$785.40
|
| Rate for Payer: PHP Medicare Advantage |
$231.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO |
$803.88
|
| Rate for Payer: Priority Health Medicare |
$233.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.08
|
| Rate for Payer: Railroad Medicare Medicare |
$231.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.12
|
| Rate for Payer: UHC Core |
$771.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.00
|
| Rate for Payer: UHC Exchange |
$231.00
|
| Rate for Payer: UHC Medicare Advantage |
$231.00
|
| Rate for Payer: UHCCP Medicaid |
$852.47
|
| Rate for Payer: VA VA |
$231.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.00
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
46040
|
| Min. Negotiated Rate |
$369.60 |
| Max. Negotiated Rate |
$600.60 |
| Rate for Payer: Aetna Commercial |
$549.47
|
| Rate for Payer: Aetna Medicare |
$426.45
|
| Rate for Payer: BCBS Complete |
$369.60
|
| Rate for Payer: BCBS MAPPO |
$410.05
|
| Rate for Payer: BCN Medicare Advantage |
$410.05
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$590.47
|
| Rate for Payer: Cofinity Commercial |
$549.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.55
|
| Rate for Payer: Nomi Health Commercial |
$492.06
|
| Rate for Payer: PACE SWMI |
$410.05
|
| Rate for Payer: PHP Medicare Advantage |
$410.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health Medicare |
$414.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.05
|
| Rate for Payer: UHC Exchange |
$410.05
|
| Rate for Payer: UHC Medicare Advantage |
$410.05
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
IP
|
$924.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$600.60 |
| Max. Negotiated Rate |
$831.60 |
| Rate for Payer: Aetna Commercial |
$785.40
|
| Rate for Payer: BCBS Trust/PPO |
$754.26
|
| Rate for Payer: BCN Commercial |
$714.07
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$794.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.20
|
| Rate for Payer: Healthscope Commercial |
$831.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.40
|
| Rate for Payer: Nomi Health Commercial |
$757.68
|
| Rate for Payer: PHP Commercial |
$785.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO |
$803.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.12
|
| Rate for Payer: UHC Core |
$771.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.00
|
|
|
PR I&D OF BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
HCPCS 56420
|
| Min. Negotiated Rate |
$104.01 |
| Max. Negotiated Rate |
$250.90 |
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna Medicare |
$108.17
|
| Rate for Payer: BCBS Complete |
$154.40
|
| Rate for Payer: BCBS MAPPO |
$104.01
|
| Rate for Payer: BCN Medicare Advantage |
$104.01
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cofinity Commercial |
$149.77
|
| Rate for Payer: Cofinity Commercial |
$139.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.21
|
| Rate for Payer: Nomi Health Commercial |
$124.81
|
| Rate for Payer: PACE SWMI |
$104.01
|
| Rate for Payer: PHP Medicare Advantage |
$104.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.90
|
| Rate for Payer: Priority Health Medicare |
$105.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.01
|
| Rate for Payer: UHC Exchange |
$104.01
|
| Rate for Payer: UHC Medicare Advantage |
$104.01
|
|
|
PR I&D PELVIS/HIP JOINT AREA INFECTED BURSA
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 26991
|
| Min. Negotiated Rate |
$497.60 |
| Max. Negotiated Rate |
$808.60 |
| Rate for Payer: Aetna Commercial |
$677.12
|
| Rate for Payer: Aetna Medicare |
$525.52
|
| Rate for Payer: BCBS Complete |
$497.60
|
| Rate for Payer: BCBS MAPPO |
$505.31
|
| Rate for Payer: BCN Medicare Advantage |
$505.31
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cofinity Commercial |
$727.65
|
| Rate for Payer: Cofinity Commercial |
$677.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.58
|
| Rate for Payer: Nomi Health Commercial |
$606.37
|
| Rate for Payer: PACE SWMI |
$505.31
|
| Rate for Payer: PHP Medicare Advantage |
$505.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$808.60
|
| Rate for Payer: Priority Health Medicare |
$510.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.31
|
| Rate for Payer: UHC Exchange |
$505.31
|
| Rate for Payer: UHC Medicare Advantage |
$505.31
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 26990
|
| Min. Negotiated Rate |
$605.20 |
| Max. Negotiated Rate |
$983.45 |
| Rate for Payer: Aetna Commercial |
$867.40
|
| Rate for Payer: Aetna Medicare |
$673.20
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: BCBS MAPPO |
$647.31
|
| Rate for Payer: BCN Medicare Advantage |
$647.31
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$932.13
|
| Rate for Payer: Cofinity Commercial |
$867.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.68
|
| Rate for Payer: Nomi Health Commercial |
$776.77
|
| Rate for Payer: PACE SWMI |
$647.31
|
| Rate for Payer: PHP Medicare Advantage |
$647.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health Medicare |
$653.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.31
|
| Rate for Payer: UHC Exchange |
$647.31
|
| Rate for Payer: UHC Medicare Advantage |
$647.31
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$605.20 |
| Max. Negotiated Rate |
$983.45 |
| Rate for Payer: Aetna Commercial |
$867.40
|
| Rate for Payer: Aetna Medicare |
$673.20
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: BCBS MAPPO |
$647.31
|
| Rate for Payer: BCN Medicare Advantage |
$647.31
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$932.13
|
| Rate for Payer: Cofinity Commercial |
$867.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.68
|
| Rate for Payer: Nomi Health Commercial |
$776.77
|
| Rate for Payer: PACE SWMI |
$647.31
|
| Rate for Payer: PHP Medicare Advantage |
$647.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health Medicare |
$653.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.31
|
| Rate for Payer: UHC Exchange |
$647.31
|
| Rate for Payer: UHC Medicare Advantage |
$647.31
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$983.45 |
| Max. Negotiated Rate |
$1,361.70 |
| Rate for Payer: Aetna Commercial |
$1,286.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.06
|
| Rate for Payer: BCN Commercial |
$1,169.25
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,301.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,210.40
|
| Rate for Payer: Healthscope Commercial |
$1,361.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,134.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.05
|
| Rate for Payer: Nomi Health Commercial |
$1,240.66
|
| Rate for Payer: PHP Commercial |
$1,286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,316.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,013.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,331.44
|
| Rate for Payer: UHC Core |
$1,263.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,134.75
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$359.34 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: Aetna Commercial |
$1,286.05
|
| Rate for Payer: Aetna Medicare |
$393.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$472.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$472.81
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$378.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,243.84
|
| Rate for Payer: BCN Commercial |
$1,176.36
|
| Rate for Payer: BCN Medicare Advantage |
$378.25
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,301.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,210.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.25
|
| Rate for Payer: Healthscope Commercial |
$1,361.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,134.75
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.16
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$434.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.05
|
| Rate for Payer: Nomi Health Commercial |
$1,240.66
|
| Rate for Payer: PACE Senior Care Partners |
$359.34
|
| Rate for Payer: PACE SWMI |
$378.25
|
| Rate for Payer: PHP Commercial |
$1,286.05
|
| Rate for Payer: PHP Medicare Advantage |
$378.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,316.31
|
| Rate for Payer: Priority Health Medicare |
$382.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,013.71
|
| Rate for Payer: Railroad Medicare Medicare |
$378.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,331.44
|
| Rate for Payer: UHC Core |
$1,263.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$378.25
|
| Rate for Payer: UHC Exchange |
$378.25
|
| Rate for Payer: UHC Medicare Advantage |
$378.25
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$378.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,134.75
|
|
|
PR I&D PENIS DEEP
|
Professional
|
Both
|
$766.00
|
|
|
Service Code
|
HCPCS 54015
|
| Min. Negotiated Rate |
$290.78 |
| Max. Negotiated Rate |
$497.90 |
| Rate for Payer: Aetna Commercial |
$389.65
|
| Rate for Payer: Aetna Medicare |
$302.41
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$290.78
|
| Rate for Payer: BCN Medicare Advantage |
$290.78
|
| Rate for Payer: Cash Price |
$612.80
|
| Rate for Payer: Cash Price |
$612.80
|
| Rate for Payer: Cofinity Commercial |
$418.72
|
| Rate for Payer: Cofinity Commercial |
$389.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.32
|
| Rate for Payer: Nomi Health Commercial |
$348.94
|
| Rate for Payer: PACE SWMI |
$290.78
|
| Rate for Payer: PHP Medicare Advantage |
$290.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.90
|
| Rate for Payer: Priority Health Medicare |
$293.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.78
|
| Rate for Payer: UHC Exchange |
$290.78
|
| Rate for Payer: UHC Medicare Advantage |
$290.78
|
|
|
PR I&D PERIANAL ABSCESS SUPERFICIAL
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 46050
|
| Min. Negotiated Rate |
$96.95 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$129.91
|
| Rate for Payer: Aetna Medicare |
$100.83
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: BCBS MAPPO |
$96.95
|
| Rate for Payer: BCN Medicare Advantage |
$96.95
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$139.61
|
| Rate for Payer: Cofinity Commercial |
$129.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.80
|
| Rate for Payer: Nomi Health Commercial |
$116.34
|
| Rate for Payer: PACE SWMI |
$96.95
|
| Rate for Payer: PHP Medicare Advantage |
$96.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health Medicare |
$97.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.95
|
| Rate for Payer: UHC Exchange |
$96.95
|
| Rate for Payer: UHC Medicare Advantage |
$96.95
|
|
|
PR I&D SHOULDER DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 23030
|
| Min. Negotiated Rate |
$245.68 |
| Max. Negotiated Rate |
$465.40 |
| Rate for Payer: Aetna Commercial |
$329.21
|
| Rate for Payer: Aetna Medicare |
$255.51
|
| Rate for Payer: BCBS Complete |
$286.40
|
| Rate for Payer: BCBS MAPPO |
$245.68
|
| Rate for Payer: BCN Medicare Advantage |
$245.68
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$353.78
|
| Rate for Payer: Cofinity Commercial |
$329.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.96
|
| Rate for Payer: Nomi Health Commercial |
$294.82
|
| Rate for Payer: PACE SWMI |
$245.68
|
| Rate for Payer: PHP Medicare Advantage |
$245.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$248.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$245.68
|
| Rate for Payer: UHC Exchange |
$245.68
|
| Rate for Payer: UHC Medicare Advantage |
$245.68
|
|
|
PR I&D SHOULDER INFECTED BURSA
|
Professional
|
Both
|
$720.00
|
|
|
Service Code
|
HCPCS 23031
|
| Min. Negotiated Rate |
$214.80 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$287.83
|
| Rate for Payer: Aetna Medicare |
$223.39
|
| Rate for Payer: BCBS Complete |
$288.00
|
| Rate for Payer: BCBS MAPPO |
$214.80
|
| Rate for Payer: BCN Medicare Advantage |
$214.80
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cofinity Commercial |
$309.31
|
| Rate for Payer: Cofinity Commercial |
$287.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.54
|
| Rate for Payer: Nomi Health Commercial |
$257.76
|
| Rate for Payer: PACE SWMI |
$214.80
|
| Rate for Payer: PHP Medicare Advantage |
$214.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.00
|
| Rate for Payer: Priority Health Medicare |
$216.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.80
|
| Rate for Payer: UHC Exchange |
$214.80
|
| Rate for Payer: UHC Medicare Advantage |
$214.80
|
|
|
PR I&D SOFT TISSUE ABSCESS SUBFASCIAL
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 20005
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$334.75 |
| Rate for Payer: Aetna Medicare |
$257.50
|
| Rate for Payer: BCBS Complete |
$206.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$334.75
|
|
|
PR I&D SUBMUCOSAL ABSCESS RECTUM
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 45005
|
| Min. Negotiated Rate |
$161.01 |
| Max. Negotiated Rate |
$342.55 |
| Rate for Payer: Aetna Commercial |
$215.75
|
| Rate for Payer: Aetna Medicare |
$167.45
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$161.01
|
| Rate for Payer: BCN Medicare Advantage |
$161.01
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$231.85
|
| Rate for Payer: Cofinity Commercial |
$215.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$193.21
|
| Rate for Payer: PACE SWMI |
$161.01
|
| Rate for Payer: PHP Medicare Advantage |
$161.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health Medicare |
$162.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.01
|
| Rate for Payer: UHC Exchange |
$161.01
|
| Rate for Payer: UHC Medicare Advantage |
$161.01
|
|
|
PR I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$620.00
|
|
|
Service Code
|
HCPCS 23930
|
| Min. Negotiated Rate |
$208.73 |
| Max. Negotiated Rate |
$403.00 |
| Rate for Payer: Aetna Commercial |
$279.70
|
| Rate for Payer: Aetna Medicare |
$217.08
|
| Rate for Payer: BCBS Complete |
$248.00
|
| Rate for Payer: BCBS MAPPO |
$208.73
|
| Rate for Payer: BCN Medicare Advantage |
$208.73
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cofinity Commercial |
$300.57
|
| Rate for Payer: Cofinity Commercial |
$279.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.17
|
| Rate for Payer: Nomi Health Commercial |
$250.48
|
| Rate for Payer: PACE SWMI |
$208.73
|
| Rate for Payer: PHP Medicare Advantage |
$208.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$403.00
|
| Rate for Payer: Priority Health Medicare |
$210.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.73
|
| Rate for Payer: UHC Exchange |
$208.73
|
| Rate for Payer: UHC Medicare Advantage |
$208.73
|
|
|
PR I&D VAGINAL HEMATOMA NON-OBSTETRICAL
|
Professional
|
Both
|
$526.00
|
|
|
Service Code
|
HCPCS 57023
|
| Min. Negotiated Rate |
$210.40 |
| Max. Negotiated Rate |
$441.03 |
| Rate for Payer: Aetna Commercial |
$410.40
|
| Rate for Payer: Aetna Medicare |
$318.52
|
| Rate for Payer: BCBS Complete |
$210.40
|
| Rate for Payer: BCBS MAPPO |
$306.27
|
| Rate for Payer: BCN Medicare Advantage |
$306.27
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cofinity Commercial |
$441.03
|
| Rate for Payer: Cofinity Commercial |
$410.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.58
|
| Rate for Payer: Nomi Health Commercial |
$367.52
|
| Rate for Payer: PACE SWMI |
$306.27
|
| Rate for Payer: PHP Medicare Advantage |
$306.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.90
|
| Rate for Payer: Priority Health Medicare |
$309.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.27
|
| Rate for Payer: UHC Exchange |
$306.27
|
| Rate for Payer: UHC Medicare Advantage |
$306.27
|
|
|
PR I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM
|
Professional
|
Both
|
$458.00
|
|
|
Service Code
|
HCPCS 57022
|
| Min. Negotiated Rate |
$173.41 |
| Max. Negotiated Rate |
$297.70 |
| Rate for Payer: Aetna Commercial |
$232.37
|
| Rate for Payer: Aetna Medicare |
$180.35
|
| Rate for Payer: BCBS Complete |
$183.20
|
| Rate for Payer: BCBS MAPPO |
$173.41
|
| Rate for Payer: BCN Medicare Advantage |
$173.41
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cofinity Commercial |
$249.71
|
| Rate for Payer: Cofinity Commercial |
$232.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.08
|
| Rate for Payer: Nomi Health Commercial |
$208.09
|
| Rate for Payer: PACE SWMI |
$173.41
|
| Rate for Payer: PHP Medicare Advantage |
$173.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.70
|
| Rate for Payer: Priority Health Medicare |
$175.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.41
|
| Rate for Payer: UHC Exchange |
$173.41
|
| Rate for Payer: UHC Medicare Advantage |
$173.41
|
|
