|
PR REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
HCPCS 20694
|
| Min. Negotiated Rate |
$329.90 |
| Max. Negotiated Rate |
$620.10 |
| Rate for Payer: Aetna Commercial |
$442.07
|
| Rate for Payer: Aetna Medicare |
$343.10
|
| Rate for Payer: BCBS Complete |
$381.60
|
| Rate for Payer: BCBS MAPPO |
$329.90
|
| Rate for Payer: BCN Medicare Advantage |
$329.90
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cofinity Commercial |
$475.06
|
| Rate for Payer: Cofinity Commercial |
$442.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.39
|
| Rate for Payer: Nomi Health Commercial |
$395.88
|
| Rate for Payer: PACE SWMI |
$329.90
|
| Rate for Payer: PHP Medicare Advantage |
$329.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.10
|
| Rate for Payer: Priority Health Medicare |
$333.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.90
|
| Rate for Payer: UHC Exchange |
$329.90
|
| Rate for Payer: UHC Medicare Advantage |
$329.90
|
|
|
PR REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 65205
|
| Min. Negotiated Rate |
$27.01 |
| Max. Negotiated Rate |
$126.10 |
| Rate for Payer: Aetna Commercial |
$36.19
|
| Rate for Payer: Aetna Medicare |
$28.09
|
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: BCBS MAPPO |
$27.01
|
| Rate for Payer: BCN Medicare Advantage |
$27.01
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$38.89
|
| Rate for Payer: Cofinity Commercial |
$36.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.36
|
| Rate for Payer: Nomi Health Commercial |
$32.41
|
| Rate for Payer: PACE SWMI |
$27.01
|
| Rate for Payer: PHP Medicare Advantage |
$27.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health Medicare |
$27.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.01
|
| Rate for Payer: UHC Exchange |
$27.01
|
| Rate for Payer: UHC Medicare Advantage |
$27.01
|
|
|
PR REMOVAL FOREIGN BODY DEEP PENILE TISSUE
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 54115
|
| Min. Negotiated Rate |
$340.00 |
| Max. Negotiated Rate |
$588.02 |
| Rate for Payer: Aetna Commercial |
$547.19
|
| Rate for Payer: Aetna Medicare |
$424.68
|
| Rate for Payer: BCBS Complete |
$340.00
|
| Rate for Payer: BCBS MAPPO |
$408.35
|
| Rate for Payer: BCN Medicare Advantage |
$408.35
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cofinity Commercial |
$588.02
|
| Rate for Payer: Cofinity Commercial |
$547.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.77
|
| Rate for Payer: Nomi Health Commercial |
$490.02
|
| Rate for Payer: PACE SWMI |
$408.35
|
| Rate for Payer: PHP Medicare Advantage |
$408.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$552.50
|
| Rate for Payer: Priority Health Medicare |
$412.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$408.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.35
|
| Rate for Payer: UHC Exchange |
$408.35
|
| Rate for Payer: UHC Medicare Advantage |
$408.35
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
IP
|
$1,114.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$724.10 |
| Max. Negotiated Rate |
$1,002.60 |
| Rate for Payer: Aetna Commercial |
$946.90
|
| Rate for Payer: BCBS Trust/PPO |
$909.36
|
| Rate for Payer: BCN Commercial |
$860.90
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$958.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.20
|
| Rate for Payer: Healthscope Commercial |
$1,002.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.90
|
| Rate for Payer: Nomi Health Commercial |
$913.48
|
| Rate for Payer: PHP Commercial |
$946.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO |
$969.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.32
|
| Rate for Payer: UHC Core |
$930.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.50
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 27372
|
| Min. Negotiated Rate |
$387.70 |
| Max. Negotiated Rate |
$724.10 |
| Rate for Payer: Aetna Commercial |
$519.52
|
| Rate for Payer: Aetna Medicare |
$403.21
|
| Rate for Payer: BCBS Complete |
$445.60
|
| Rate for Payer: BCBS MAPPO |
$387.70
|
| Rate for Payer: BCN Medicare Advantage |
$387.70
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$558.29
|
| Rate for Payer: Cofinity Commercial |
$519.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.08
|
| Rate for Payer: Nomi Health Commercial |
$465.24
|
| Rate for Payer: PACE SWMI |
$387.70
|
| Rate for Payer: PHP Medicare Advantage |
$387.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health Medicare |
$391.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.70
|
| Rate for Payer: UHC Exchange |
$387.70
|
| Rate for Payer: UHC Medicare Advantage |
$387.70
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 27372
|
| Hospital Charge Code |
27372
|
| Min. Negotiated Rate |
$387.70 |
| Max. Negotiated Rate |
$724.10 |
| Rate for Payer: Aetna Commercial |
$519.52
|
| Rate for Payer: Aetna Medicare |
$403.21
|
| Rate for Payer: BCBS Complete |
$445.60
|
| Rate for Payer: BCBS MAPPO |
$387.70
|
| Rate for Payer: BCN Medicare Advantage |
$387.70
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$558.29
|
| Rate for Payer: Cofinity Commercial |
$519.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.08
|
| Rate for Payer: Nomi Health Commercial |
$465.24
|
| Rate for Payer: PACE SWMI |
$387.70
|
| Rate for Payer: PHP Medicare Advantage |
$387.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health Medicare |
$391.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.70
|
| Rate for Payer: UHC Exchange |
$387.70
|
| Rate for Payer: UHC Medicare Advantage |
$387.70
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
OP
|
$1,114.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$264.57 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$946.90
|
| Rate for Payer: Aetna Medicare |
$289.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.12
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$278.50
|
| Rate for Payer: BCBS Trust/PPO |
$915.82
|
| Rate for Payer: BCN Commercial |
$866.13
|
| Rate for Payer: BCN Medicare Advantage |
$278.50
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$958.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.50
|
| Rate for Payer: Healthscope Commercial |
$1,002.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.50
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.43
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.90
|
| Rate for Payer: Nomi Health Commercial |
$913.48
|
| Rate for Payer: PACE Senior Care Partners |
$264.57
|
| Rate for Payer: PACE SWMI |
$278.50
|
| Rate for Payer: PHP Commercial |
$946.90
|
| Rate for Payer: PHP Medicare Advantage |
$278.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO |
$969.18
|
| Rate for Payer: Priority Health Medicare |
$281.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.38
|
| Rate for Payer: Railroad Medicare Medicare |
$278.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.32
|
| Rate for Payer: UHC Core |
$930.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.50
|
| Rate for Payer: UHC Exchange |
$278.50
|
| Rate for Payer: UHC Medicare Advantage |
$278.50
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$278.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.50
|
|
|
PR REMOVAL FOREIGN BODY FOOT COMPLICATED
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 28193
|
| Min. Negotiated Rate |
$348.40 |
| Max. Negotiated Rate |
$612.30 |
| Rate for Payer: Aetna Commercial |
$466.86
|
| Rate for Payer: Aetna Medicare |
$362.34
|
| Rate for Payer: BCBS Complete |
$376.80
|
| Rate for Payer: BCBS MAPPO |
$348.40
|
| Rate for Payer: BCN Medicare Advantage |
$348.40
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$501.70
|
| Rate for Payer: Cofinity Commercial |
$466.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.82
|
| Rate for Payer: Nomi Health Commercial |
$418.08
|
| Rate for Payer: PACE SWMI |
$348.40
|
| Rate for Payer: PHP Medicare Advantage |
$348.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health Medicare |
$351.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.40
|
| Rate for Payer: UHC Exchange |
$348.40
|
| Rate for Payer: UHC Medicare Advantage |
$348.40
|
|
|
PR REMOVAL FOREIGN BODY FOOT DEEP
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 28192
|
| Min. Negotiated Rate |
$297.77 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: Aetna Commercial |
$399.01
|
| Rate for Payer: Aetna Medicare |
$309.68
|
| Rate for Payer: BCBS Complete |
$306.00
|
| Rate for Payer: BCBS MAPPO |
$297.77
|
| Rate for Payer: BCN Medicare Advantage |
$297.77
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$428.79
|
| Rate for Payer: Cofinity Commercial |
$399.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.66
|
| Rate for Payer: Nomi Health Commercial |
$357.32
|
| Rate for Payer: PACE SWMI |
$297.77
|
| Rate for Payer: PHP Medicare Advantage |
$297.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health Medicare |
$300.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.77
|
| Rate for Payer: UHC Exchange |
$297.77
|
| Rate for Payer: UHC Medicare Advantage |
$297.77
|
|
|
PR REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 28190
|
| Min. Negotiated Rate |
$125.94 |
| Max. Negotiated Rate |
$388.70 |
| Rate for Payer: Aetna Commercial |
$168.76
|
| Rate for Payer: Aetna Medicare |
$130.98
|
| Rate for Payer: BCBS Complete |
$239.20
|
| Rate for Payer: BCBS MAPPO |
$125.94
|
| Rate for Payer: BCN Medicare Advantage |
$125.94
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$181.35
|
| Rate for Payer: Cofinity Commercial |
$168.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.24
|
| Rate for Payer: Nomi Health Commercial |
$151.13
|
| Rate for Payer: PACE SWMI |
$125.94
|
| Rate for Payer: PHP Medicare Advantage |
$125.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.70
|
| Rate for Payer: Priority Health Medicare |
$127.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.94
|
| Rate for Payer: UHC Exchange |
$125.94
|
| Rate for Payer: UHC Medicare Advantage |
$125.94
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES
|
Professional
|
Both
|
$369.00
|
|
|
Service Code
|
HCPCS 30310
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$275.80 |
| Rate for Payer: Aetna Commercial |
$256.65
|
| Rate for Payer: Aetna Medicare |
$199.19
|
| Rate for Payer: BCBS Complete |
$147.60
|
| Rate for Payer: BCBS MAPPO |
$191.53
|
| Rate for Payer: BCN Medicare Advantage |
$191.53
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Commercial |
$256.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.11
|
| Rate for Payer: Nomi Health Commercial |
$229.84
|
| Rate for Payer: PACE SWMI |
$191.53
|
| Rate for Payer: PHP Medicare Advantage |
$191.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.85
|
| Rate for Payer: Priority Health Medicare |
$193.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.53
|
| Rate for Payer: UHC Exchange |
$191.53
|
| Rate for Payer: UHC Medicare Advantage |
$191.53
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 30300
|
| Min. Negotiated Rate |
$112.35 |
| Max. Negotiated Rate |
$254.80 |
| Rate for Payer: Aetna Commercial |
$150.55
|
| Rate for Payer: Aetna Medicare |
$116.84
|
| Rate for Payer: BCBS Complete |
$156.80
|
| Rate for Payer: BCBS MAPPO |
$112.35
|
| Rate for Payer: BCN Medicare Advantage |
$112.35
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$161.78
|
| Rate for Payer: Cofinity Commercial |
$150.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.97
|
| Rate for Payer: Nomi Health Commercial |
$134.82
|
| Rate for Payer: PACE SWMI |
$112.35
|
| Rate for Payer: PHP Medicare Advantage |
$112.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health Medicare |
$113.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.35
|
| Rate for Payer: UHC Exchange |
$112.35
|
| Rate for Payer: UHC Medicare Advantage |
$112.35
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 20520
|
| Min. Negotiated Rate |
$140.83 |
| Max. Negotiated Rate |
$263.25 |
| Rate for Payer: Aetna Commercial |
$188.71
|
| Rate for Payer: Aetna Medicare |
$146.46
|
| Rate for Payer: BCBS Complete |
$162.00
|
| Rate for Payer: BCBS MAPPO |
$140.83
|
| Rate for Payer: BCN Medicare Advantage |
$140.83
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$202.80
|
| Rate for Payer: Cofinity Commercial |
$188.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.87
|
| Rate for Payer: Nomi Health Commercial |
$169.00
|
| Rate for Payer: PACE SWMI |
$140.83
|
| Rate for Payer: PHP Medicare Advantage |
$140.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health Medicare |
$142.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.83
|
| Rate for Payer: UHC Exchange |
$140.83
|
| Rate for Payer: UHC Medicare Advantage |
$140.83
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$405.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$96.19 |
| Max. Negotiated Rate |
$1,230.09 |
| Rate for Payer: Aetna Commercial |
$344.25
|
| Rate for Payer: Aetna Medicare |
$105.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.56
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$101.25
|
| Rate for Payer: BCBS Trust/PPO |
$332.95
|
| Rate for Payer: BCN Commercial |
$314.89
|
| Rate for Payer: BCN Medicare Advantage |
$101.25
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$348.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.25
|
| Rate for Payer: Healthscope Commercial |
$364.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.75
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.31
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.25
|
| Rate for Payer: Nomi Health Commercial |
$332.10
|
| Rate for Payer: PACE Senior Care Partners |
$96.19
|
| Rate for Payer: PACE SWMI |
$101.25
|
| Rate for Payer: PHP Commercial |
$344.25
|
| Rate for Payer: PHP Medicare Advantage |
$101.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO |
$352.35
|
| Rate for Payer: Priority Health Medicare |
$102.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.35
|
| Rate for Payer: Railroad Medicare Medicare |
$101.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.40
|
| Rate for Payer: UHC Core |
$338.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.25
|
| Rate for Payer: UHC Exchange |
$101.25
|
| Rate for Payer: UHC Medicare Advantage |
$101.25
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$101.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.75
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
20520
|
| Min. Negotiated Rate |
$140.83 |
| Max. Negotiated Rate |
$263.25 |
| Rate for Payer: Aetna Commercial |
$188.71
|
| Rate for Payer: Aetna Medicare |
$146.46
|
| Rate for Payer: BCBS Complete |
$162.00
|
| Rate for Payer: BCBS MAPPO |
$140.83
|
| Rate for Payer: BCN Medicare Advantage |
$140.83
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$202.80
|
| Rate for Payer: Cofinity Commercial |
$188.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.87
|
| Rate for Payer: Nomi Health Commercial |
$169.00
|
| Rate for Payer: PACE SWMI |
$140.83
|
| Rate for Payer: PHP Medicare Advantage |
$140.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health Medicare |
$142.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.83
|
| Rate for Payer: UHC Exchange |
$140.83
|
| Rate for Payer: UHC Medicare Advantage |
$140.83
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$405.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$263.25 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna Commercial |
$344.25
|
| Rate for Payer: BCBS Trust/PPO |
$330.60
|
| Rate for Payer: BCN Commercial |
$312.98
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$348.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.00
|
| Rate for Payer: Healthscope Commercial |
$364.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.25
|
| Rate for Payer: Nomi Health Commercial |
$332.10
|
| Rate for Payer: PHP Commercial |
$344.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO |
$352.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.40
|
| Rate for Payer: UHC Core |
$338.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.75
|
|
|
PR REMOVAL FOREIGN BODY PELVIS/HIP DEEP
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 27087
|
| Min. Negotiated Rate |
$546.80 |
| Max. Negotiated Rate |
$888.55 |
| Rate for Payer: Aetna Commercial |
$801.32
|
| Rate for Payer: Aetna Medicare |
$621.92
|
| Rate for Payer: BCBS Complete |
$546.80
|
| Rate for Payer: BCBS MAPPO |
$598.00
|
| Rate for Payer: BCN Medicare Advantage |
$598.00
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$861.12
|
| Rate for Payer: Cofinity Commercial |
$801.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.90
|
| Rate for Payer: Nomi Health Commercial |
$717.60
|
| Rate for Payer: PACE SWMI |
$598.00
|
| Rate for Payer: PHP Medicare Advantage |
$598.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.55
|
| Rate for Payer: Priority Health Medicare |
$603.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$598.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.00
|
| Rate for Payer: UHC Exchange |
$598.00
|
| Rate for Payer: UHC Medicare Advantage |
$598.00
|
|
|
PR REMOVAL FOREIGN BODY PHARYNX
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 42809
|
| Min. Negotiated Rate |
$120.38 |
| Max. Negotiated Rate |
$196.95 |
| Rate for Payer: Aetna Commercial |
$161.31
|
| Rate for Payer: Aetna Medicare |
$125.20
|
| Rate for Payer: BCBS Complete |
$121.20
|
| Rate for Payer: BCBS MAPPO |
$120.38
|
| Rate for Payer: BCN Medicare Advantage |
$120.38
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$173.35
|
| Rate for Payer: Cofinity Commercial |
$161.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.40
|
| Rate for Payer: Nomi Health Commercial |
$144.46
|
| Rate for Payer: PACE SWMI |
$120.38
|
| Rate for Payer: PHP Medicare Advantage |
$120.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health Medicare |
$121.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.38
|
| Rate for Payer: UHC Exchange |
$120.38
|
| Rate for Payer: UHC Medicare Advantage |
$120.38
|
|
|
PR REMOVAL FOREIGN BODY SCROTUM
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 55120
|
| Min. Negotiated Rate |
$267.60 |
| Max. Negotiated Rate |
$490.42 |
| Rate for Payer: Aetna Commercial |
$456.36
|
| Rate for Payer: Aetna Medicare |
$354.19
|
| Rate for Payer: BCBS Complete |
$267.60
|
| Rate for Payer: BCBS MAPPO |
$340.57
|
| Rate for Payer: BCN Medicare Advantage |
$340.57
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cofinity Commercial |
$490.42
|
| Rate for Payer: Cofinity Commercial |
$456.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.60
|
| Rate for Payer: Nomi Health Commercial |
$408.68
|
| Rate for Payer: PACE SWMI |
$340.57
|
| Rate for Payer: PHP Medicare Advantage |
$340.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health Medicare |
$343.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.57
|
| Rate for Payer: UHC Exchange |
$340.57
|
| Rate for Payer: UHC Medicare Advantage |
$340.57
|
|
|
PR REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 23330
|
| Min. Negotiated Rate |
$160.83 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$215.51
|
| Rate for Payer: Aetna Medicare |
$167.26
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: BCBS MAPPO |
$160.83
|
| Rate for Payer: BCN Medicare Advantage |
$160.83
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$231.60
|
| Rate for Payer: Cofinity Commercial |
$215.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.87
|
| Rate for Payer: Nomi Health Commercial |
$193.00
|
| Rate for Payer: PACE SWMI |
$160.83
|
| Rate for Payer: PHP Medicare Advantage |
$160.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health Medicare |
$162.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.83
|
| Rate for Payer: UHC Exchange |
$160.83
|
| Rate for Payer: UHC Medicare Advantage |
$160.83
|
|
|
PR REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP
|
Professional
|
Both
|
$907.00
|
|
|
Service Code
|
HCPCS 24201
|
| Min. Negotiated Rate |
$362.80 |
| Max. Negotiated Rate |
$589.55 |
| Rate for Payer: Aetna Commercial |
$518.78
|
| Rate for Payer: Aetna Medicare |
$402.64
|
| Rate for Payer: BCBS Complete |
$362.80
|
| Rate for Payer: BCBS MAPPO |
$387.15
|
| Rate for Payer: BCN Medicare Advantage |
$387.15
|
| Rate for Payer: Cash Price |
$725.60
|
| Rate for Payer: Cash Price |
$725.60
|
| Rate for Payer: Cofinity Commercial |
$557.50
|
| Rate for Payer: Cofinity Commercial |
$518.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.51
|
| Rate for Payer: Nomi Health Commercial |
$464.58
|
| Rate for Payer: PACE SWMI |
$387.15
|
| Rate for Payer: PHP Medicare Advantage |
$387.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.55
|
| Rate for Payer: Priority Health Medicare |
$391.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.15
|
| Rate for Payer: UHC Exchange |
$387.15
|
| Rate for Payer: UHC Medicare Advantage |
$387.15
|
|
|
PR REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 27090
|
| Min. Negotiated Rate |
$799.27 |
| Max. Negotiated Rate |
$1,368.25 |
| Rate for Payer: Aetna Commercial |
$1,071.02
|
| Rate for Payer: Aetna Medicare |
$831.24
|
| Rate for Payer: BCBS Complete |
$842.00
|
| Rate for Payer: BCBS MAPPO |
$799.27
|
| Rate for Payer: BCN Medicare Advantage |
$799.27
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,150.95
|
| Rate for Payer: Cofinity Commercial |
$1,071.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$799.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$839.23
|
| Rate for Payer: Nomi Health Commercial |
$959.12
|
| Rate for Payer: PACE SWMI |
$799.27
|
| Rate for Payer: PHP Medicare Advantage |
$799.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,368.25
|
| Rate for Payer: Priority Health Medicare |
$807.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$799.27
|
| Rate for Payer: UHC Exchange |
$799.27
|
| Rate for Payer: UHC Medicare Advantage |
$799.27
|
|
|
PR REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 64584
|
| Min. Negotiated Rate |
$696.91 |
| Max. Negotiated Rate |
$1,630.85 |
| Rate for Payer: Aetna Commercial |
$933.86
|
| Rate for Payer: Aetna Medicare |
$724.79
|
| Rate for Payer: BCBS Complete |
$1,003.60
|
| Rate for Payer: BCBS MAPPO |
$696.91
|
| Rate for Payer: BCN Medicare Advantage |
$696.91
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$933.86
|
| Rate for Payer: Cofinity Commercial |
$1,003.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.76
|
| Rate for Payer: Nomi Health Commercial |
$836.29
|
| Rate for Payer: PACE SWMI |
$696.91
|
| Rate for Payer: PHP Medicare Advantage |
$696.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health Medicare |
$703.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$696.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$696.91
|
| Rate for Payer: UHC Exchange |
$696.91
|
| Rate for Payer: UHC Medicare Advantage |
$696.91
|
|
|
PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 69210
|
| Min. Negotiated Rate |
$30.64 |
| Max. Negotiated Rate |
$63.05 |
| Rate for Payer: Aetna Commercial |
$41.06
|
| Rate for Payer: Aetna Medicare |
$31.87
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCBS MAPPO |
$30.64
|
| Rate for Payer: BCN Medicare Advantage |
$30.64
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$44.12
|
| Rate for Payer: Cofinity Commercial |
$41.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.17
|
| Rate for Payer: Nomi Health Commercial |
$36.77
|
| Rate for Payer: PACE SWMI |
$30.64
|
| Rate for Payer: PHP Medicare Advantage |
$30.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health Medicare |
$30.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.64
|
| Rate for Payer: UHC Exchange |
$30.64
|
| Rate for Payer: UHC Medicare Advantage |
$30.64
|
|
|
PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 69209
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$20.06 |
| Rate for Payer: Aetna Commercial |
$18.67
|
| Rate for Payer: Aetna Medicare |
$14.49
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$13.93
|
| Rate for Payer: BCN Medicare Advantage |
$13.93
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$18.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.63
|
| Rate for Payer: Nomi Health Commercial |
$16.72
|
| Rate for Payer: PACE SWMI |
$13.93
|
| Rate for Payer: PHP Medicare Advantage |
$13.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health Medicare |
$14.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.93
|
| Rate for Payer: UHC Exchange |
$13.93
|
| Rate for Payer: UHC Medicare Advantage |
$13.93
|
|
