|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 27372
|
| Hospital Charge Code |
27372
|
| Min. Negotiated Rate |
$249.64 |
| Max. Negotiated Rate |
$860.25 |
| Rate for Payer: Aetna Commercial |
$533.27
|
| Rate for Payer: Aetna Medicare |
$573.50
|
| Rate for Payer: BCBS Complete |
$262.12
|
| Rate for Payer: BCN Commercial |
$614.51
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Mclaren Medicaid |
$249.64
|
| Rate for Payer: Meridian Medicaid |
$262.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$656.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.90
|
| Rate for Payer: UHC Medicaid |
$249.64
|
| Rate for Payer: UHCCP Medicaid |
$249.64
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
IP
|
$1,147.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$798.31 |
| Max. Negotiated Rate |
$1,032.30 |
| Rate for Payer: Aetna Commercial |
$974.95
|
| Rate for Payer: BCBS Trust/PPO |
$947.31
|
| Rate for Payer: BCN Commercial |
$947.31
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$986.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$917.60
|
| Rate for Payer: Healthscope Commercial |
$1,032.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$974.95
|
| Rate for Payer: Nomi Health Commercial |
$940.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PHP Commercial |
$974.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$997.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$798.31
|
| Rate for Payer: UHC Core |
$957.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.25
|
|
|
PR REMOVAL FOREIGN BODY FOOT COMPLICATED
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 28193
|
| Min. Negotiated Rate |
$217.47 |
| Max. Negotiated Rate |
$727.50 |
| Rate for Payer: Aetna Commercial |
$486.43
|
| Rate for Payer: Aetna Medicare |
$485.00
|
| Rate for Payer: BCBS Complete |
$228.34
|
| Rate for Payer: BCN Commercial |
$552.76
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Mclaren Medicaid |
$217.47
|
| Rate for Payer: Meridian Medicaid |
$228.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$590.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$590.89
|
| Rate for Payer: UHC Medicaid |
$217.47
|
| Rate for Payer: UHCCP Medicaid |
$217.47
|
|
|
PR REMOVAL FOREIGN BODY FOOT DEEP
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 28192
|
| Min. Negotiated Rate |
$187.23 |
| Max. Negotiated Rate |
$591.00 |
| Rate for Payer: Aetna Commercial |
$411.56
|
| Rate for Payer: Aetna Medicare |
$394.00
|
| Rate for Payer: BCBS Complete |
$196.59
|
| Rate for Payer: BCN Commercial |
$473.08
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Mclaren Medicaid |
$187.23
|
| Rate for Payer: Meridian Medicaid |
$196.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$505.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.71
|
| Rate for Payer: UHC Medicaid |
$187.23
|
| Rate for Payer: UHCCP Medicaid |
$187.23
|
|
|
PR REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 28190
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$176.00
|
| Rate for Payer: Aetna Medicare |
$308.00
|
| Rate for Payer: BCBS Complete |
$85.44
|
| Rate for Payer: BCN Commercial |
$200.19
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Mclaren Medicaid |
$81.37
|
| Rate for Payer: Meridian Medicaid |
$85.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$462.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$213.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.99
|
| Rate for Payer: UHC Medicaid |
$81.37
|
| Rate for Payer: UHCCP Medicaid |
$81.37
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 30310
|
| Min. Negotiated Rate |
$121.41 |
| Max. Negotiated Rate |
$309.75 |
| Rate for Payer: Aetna Commercial |
$262.26
|
| Rate for Payer: Aetna Medicare |
$190.00
|
| Rate for Payer: BCBS Complete |
$127.48
|
| Rate for Payer: BCN Commercial |
$309.75
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Mclaren Medicaid |
$121.41
|
| Rate for Payer: Meridian Medicaid |
$127.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$291.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.69
|
| Rate for Payer: UHC Medicaid |
$121.41
|
| Rate for Payer: UHCCP Medicaid |
$121.41
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 30300
|
| Min. Negotiated Rate |
$73.70 |
| Max. Negotiated Rate |
$303.00 |
| Rate for Payer: Aetna Commercial |
$151.15
|
| Rate for Payer: Aetna Medicare |
$202.00
|
| Rate for Payer: BCBS Complete |
$77.39
|
| Rate for Payer: BCN Commercial |
$182.26
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Mclaren Medicaid |
$73.70
|
| Rate for Payer: Meridian Medicaid |
$77.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.64
|
| Rate for Payer: UHC Medicaid |
$73.70
|
| Rate for Payer: UHCCP Medicaid |
$73.70
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$417.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$73.52 |
| Max. Negotiated Rate |
$375.30 |
| Rate for Payer: Aetna Commercial |
$354.45
|
| Rate for Payer: Aetna Medicare |
$108.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.31
|
| Rate for Payer: BCBS Complete |
$77.19
|
| Rate for Payer: BCBS MAPPO |
$104.25
|
| Rate for Payer: BCBS Trust/PPO |
$342.82
|
| Rate for Payer: BCN Commercial |
$342.82
|
| Rate for Payer: BCN Medicare Advantage |
$104.25
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cofinity Commercial |
$358.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.25
|
| Rate for Payer: Healthscope Commercial |
$375.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.75
|
| Rate for Payer: Mclaren Medicaid |
$73.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.46
|
| Rate for Payer: Meridian Medicaid |
$77.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.45
|
| Rate for Payer: Nomi Health Commercial |
$341.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: PACE Senior Care Partners |
$99.04
|
| Rate for Payer: PACE SWMI |
$104.25
|
| Rate for Payer: PHP Commercial |
$354.45
|
| Rate for Payer: PHP Medicare Advantage |
$104.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.79
|
| Rate for Payer: Priority Health Medicare |
$105.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.23
|
| Rate for Payer: Railroad Medicare Medicare |
$104.25
|
| Rate for Payer: UHC Core |
$348.19
|
| Rate for Payer: UHC Exchange |
$104.25
|
| Rate for Payer: UHC Medicaid |
$73.52
|
| Rate for Payer: UHC Medicare Advantage |
$104.25
|
| Rate for Payer: UHCCP Medicaid |
$73.52
|
| Rate for Payer: VA VA |
$104.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.75
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$417.00
|
|
|
Service Code
|
HCPCS 20520
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$312.75 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$208.50
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCN Commercial |
$224.59
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Mclaren Medicaid |
$90.53
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$240.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.08
|
| Rate for Payer: UHC Medicaid |
$90.53
|
| Rate for Payer: UHCCP Medicaid |
$90.53
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$417.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$290.23 |
| Max. Negotiated Rate |
$375.30 |
| Rate for Payer: Aetna Commercial |
$354.45
|
| Rate for Payer: BCBS Trust/PPO |
$344.40
|
| Rate for Payer: BCN Commercial |
$344.40
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cofinity Commercial |
$358.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.60
|
| Rate for Payer: Healthscope Commercial |
$375.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.45
|
| Rate for Payer: Nomi Health Commercial |
$341.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: PHP Commercial |
$354.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.23
|
| Rate for Payer: UHC Core |
$348.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.75
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$417.00
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
20520
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$312.75 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$208.50
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCN Commercial |
$224.59
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Mclaren Medicaid |
$90.53
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$240.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.08
|
| Rate for Payer: UHC Medicaid |
$90.53
|
| Rate for Payer: UHCCP Medicaid |
$90.53
|
|
|
PR REMOVAL FOREIGN BODY PELVIS/HIP DEEP
|
Professional
|
Both
|
$1,408.00
|
|
|
Service Code
|
HCPCS 27087
|
| Min. Negotiated Rate |
$380.42 |
| Max. Negotiated Rate |
$1,056.00 |
| Rate for Payer: Aetna Commercial |
$821.49
|
| Rate for Payer: Aetna Medicare |
$704.00
|
| Rate for Payer: BCBS Complete |
$399.44
|
| Rate for Payer: BCN Commercial |
$938.69
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Mclaren Medicaid |
$380.42
|
| Rate for Payer: Meridian Medicaid |
$399.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,056.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,003.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,003.44
|
| Rate for Payer: UHC Medicaid |
$380.42
|
| Rate for Payer: UHCCP Medicaid |
$380.42
|
|
|
PR REMOVAL FOREIGN BODY PHARYNX
|
Professional
|
Both
|
$312.00
|
|
|
Service Code
|
HCPCS 42809
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$165.73
|
| Rate for Payer: Aetna Medicare |
$156.00
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCN Commercial |
$190.23
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Mclaren Medicaid |
$74.55
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$231.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$231.77
|
| Rate for Payer: UHC Medicaid |
$74.55
|
| Rate for Payer: UHCCP Medicaid |
$74.55
|
|
|
PR REMOVAL FOREIGN BODY SCROTUM
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 55120
|
| Min. Negotiated Rate |
$211.30 |
| Max. Negotiated Rate |
$585.86 |
| Rate for Payer: Aetna Commercial |
$452.80
|
| Rate for Payer: Aetna Medicare |
$344.50
|
| Rate for Payer: BCBS Complete |
$221.87
|
| Rate for Payer: BCN Commercial |
$537.82
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Mclaren Medicaid |
$211.30
|
| Rate for Payer: Meridian Medicaid |
$221.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$585.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.86
|
| Rate for Payer: UHC Medicaid |
$211.30
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
|
|
PR REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 23330
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$348.00 |
| Rate for Payer: Aetna Commercial |
$220.75
|
| Rate for Payer: Aetna Medicare |
$232.00
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCN Commercial |
$256.96
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Mclaren Medicaid |
$106.07
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$348.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.68
|
| Rate for Payer: UHC Medicaid |
$106.07
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
|
|
PR REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 24201
|
| Min. Negotiated Rate |
$250.28 |
| Max. Negotiated Rate |
$700.50 |
| Rate for Payer: Aetna Commercial |
$485.08
|
| Rate for Payer: Aetna Medicare |
$467.00
|
| Rate for Payer: BCBS Complete |
$262.79
|
| Rate for Payer: BCN Commercial |
$617.49
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Mclaren Medicaid |
$250.28
|
| Rate for Payer: Meridian Medicaid |
$262.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$700.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$660.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$660.09
|
| Rate for Payer: UHC Medicaid |
$250.28
|
| Rate for Payer: UHCCP Medicaid |
$250.28
|
|
|
PR REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,168.00
|
|
|
Service Code
|
HCPCS 27090
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$1,106.89
|
| Rate for Payer: Aetna Medicare |
$1,084.00
|
| Rate for Payer: BCBS Complete |
$517.75
|
| Rate for Payer: BCN Commercial |
$1,259.89
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Mclaren Medicaid |
$493.10
|
| Rate for Payer: Meridian Medicaid |
$517.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,626.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,346.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,346.80
|
| Rate for Payer: UHC Medicaid |
$493.10
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
|
|
PR REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$2,584.00
|
|
|
Service Code
|
HCPCS 64584
|
| Min. Negotiated Rate |
$402.78 |
| Max. Negotiated Rate |
$1,938.00 |
| Rate for Payer: Aetna Commercial |
$856.83
|
| Rate for Payer: Aetna Medicare |
$1,292.00
|
| Rate for Payer: BCBS Complete |
$422.92
|
| Rate for Payer: BCN Commercial |
$1,094.56
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Mclaren Medicaid |
$402.78
|
| Rate for Payer: Meridian Medicaid |
$422.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,938.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,271.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,271.32
|
| Rate for Payer: UHC Medicaid |
$402.78
|
| Rate for Payer: UHCCP Medicaid |
$402.78
|
|
|
PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 69210
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$37.88
|
| Rate for Payer: Aetna Medicare |
$50.00
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCN Commercial |
$37.70
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Mclaren Medicaid |
$17.25
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.23
|
| Rate for Payer: UHC Medicaid |
$17.25
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
|
|
PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 69209
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Commercial |
$16.11
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: BCN Commercial |
$23.40
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
|
|
PR REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 57415
|
| Min. Negotiated Rate |
$99.68 |
| Max. Negotiated Rate |
$266.79 |
| Rate for Payer: Aetna Commercial |
$205.66
|
| Rate for Payer: Aetna Medicare |
$171.00
|
| Rate for Payer: BCBS Complete |
$104.66
|
| Rate for Payer: BCN Commercial |
$263.44
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Mclaren Medicaid |
$99.68
|
| Rate for Payer: Meridian Medicaid |
$104.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$266.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.79
|
| Rate for Payer: UHC Medicaid |
$99.68
|
| Rate for Payer: UHCCP Medicaid |
$99.68
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
IP
|
$248.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$172.61 |
| Max. Negotiated Rate |
$223.20 |
| Rate for Payer: Aetna Commercial |
$210.80
|
| Rate for Payer: BCBS Trust/PPO |
$204.82
|
| Rate for Payer: BCN Commercial |
$204.82
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$213.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.40
|
| Rate for Payer: Healthscope Commercial |
$223.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.80
|
| Rate for Payer: Nomi Health Commercial |
$203.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: PHP Commercial |
$210.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.61
|
| Rate for Payer: UHC Core |
$207.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.00
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 11976
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$186.00 |
| Rate for Payer: Aetna Commercial |
$102.24
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCN Commercial |
$137.45
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Mclaren Medicaid |
$51.12
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$125.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.80
|
| Rate for Payer: UHC Medicaid |
$51.12
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 11976
|
| Hospital Charge Code |
11976
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$186.00 |
| Rate for Payer: Aetna Commercial |
$102.24
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCN Commercial |
$137.45
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Mclaren Medicaid |
$51.12
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$125.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.80
|
| Rate for Payer: UHC Medicaid |
$51.12
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
OP
|
$248.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$43.72 |
| Max. Negotiated Rate |
$223.20 |
| Rate for Payer: Aetna Commercial |
$210.80
|
| Rate for Payer: Aetna Medicare |
$64.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.50
|
| Rate for Payer: BCBS Complete |
$45.90
|
| Rate for Payer: BCBS MAPPO |
$62.00
|
| Rate for Payer: BCBS Trust/PPO |
$203.88
|
| Rate for Payer: BCN Commercial |
$203.88
|
| Rate for Payer: BCN Medicare Advantage |
$62.00
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$213.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.00
|
| Rate for Payer: Healthscope Commercial |
$223.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.00
|
| Rate for Payer: Mclaren Medicaid |
$43.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Medicaid |
$45.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.80
|
| Rate for Payer: Nomi Health Commercial |
$203.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: PACE Senior Care Partners |
$58.90
|
| Rate for Payer: PACE SWMI |
$62.00
|
| Rate for Payer: PHP Commercial |
$210.80
|
| Rate for Payer: PHP Medicare Advantage |
$62.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.76
|
| Rate for Payer: Priority Health Medicare |
$62.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.61
|
| Rate for Payer: Railroad Medicare Medicare |
$62.00
|
| Rate for Payer: UHC Core |
$207.08
|
| Rate for Payer: UHC Exchange |
$62.00
|
| Rate for Payer: UHC Medicaid |
$43.72
|
| Rate for Payer: UHC Medicare Advantage |
$62.00
|
| Rate for Payer: UHCCP Medicaid |
$43.72
|
| Rate for Payer: VA VA |
$62.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.00
|
|
