|
PR REMOVAL FOREIGN BODY PELVIS/HIP DEEP
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 27087
|
| Min. Negotiated Rate |
$401.51 |
| Max. Negotiated Rate |
$1,172.30 |
| Rate for Payer: Aetna Commercial |
$801.32
|
| Rate for Payer: Aetna Medicare |
$621.92
|
| Rate for Payer: BCBS Complete |
$421.59
|
| Rate for Payer: BCBS MAPPO |
$598.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,172.30
|
| Rate for Payer: BCN Commercial |
$906.01
|
| 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: Mclaren Medicaid |
$401.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.90
|
| Rate for Payer: Meridian Medicaid |
$421.59
|
| 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 Choice Medicaid |
$401.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.55
|
| Rate for Payer: Priority Health HMO/PPO |
$950.55
|
| Rate for Payer: Priority Health Medicare |
$603.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$950.55
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$401.51
|
|
|
PR REMOVAL FOREIGN BODY PHARYNX
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 42809
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$300.53 |
| Rate for Payer: Aetna Commercial |
$161.31
|
| Rate for Payer: Aetna Medicare |
$125.20
|
| Rate for Payer: BCBS Complete |
$85.44
|
| Rate for Payer: BCBS MAPPO |
$120.38
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$300.53
|
| 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: Mclaren Medicaid |
$81.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.40
|
| Rate for Payer: Meridian Medicaid |
$85.44
|
| 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 Choice Medicaid |
$81.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO |
$229.08
|
| Rate for Payer: Priority Health Medicare |
$121.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$229.08
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$81.37
|
|
|
PR REMOVAL FOREIGN BODY SCROTUM
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 55120
|
| Min. Negotiated Rate |
$230.04 |
| Max. Negotiated Rate |
$3,266.48 |
| Rate for Payer: Aetna Commercial |
$456.36
|
| Rate for Payer: Aetna Medicare |
$354.19
|
| Rate for Payer: BCBS Complete |
$241.54
|
| Rate for Payer: BCBS MAPPO |
$340.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,266.48
|
| Rate for Payer: BCN Commercial |
$514.58
|
| 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: Mclaren Medicaid |
$230.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.60
|
| Rate for Payer: Meridian Medicaid |
$241.54
|
| 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 Choice Medicaid |
$230.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health HMO/PPO |
$570.94
|
| Rate for Payer: Priority Health Medicare |
$343.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$570.94
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$230.04
|
|
|
PR REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 23330
|
| Min. Negotiated Rate |
$64.52 |
| Max. Negotiated Rate |
$444.20 |
| Rate for Payer: Aetna Commercial |
$215.51
|
| Rate for Payer: Aetna Medicare |
$167.26
|
| Rate for Payer: BCBS Complete |
$115.41
|
| Rate for Payer: BCBS MAPPO |
$160.83
|
| Rate for Payer: BCBS Trust/PPO |
$64.52
|
| Rate for Payer: BCN Commercial |
$444.20
|
| 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: Mclaren Medicaid |
$109.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.87
|
| Rate for Payer: Meridian Medicaid |
$115.41
|
| 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 Choice Medicaid |
$109.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health HMO/PPO |
$260.03
|
| Rate for Payer: Priority Health Medicare |
$162.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.03
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$109.91
|
|
|
PR REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP
|
Professional
|
Both
|
$907.00
|
|
|
Service Code
|
HCPCS 24201
|
| Min. Negotiated Rate |
$162.72 |
| Max. Negotiated Rate |
$810.72 |
| Rate for Payer: Aetna Commercial |
$518.78
|
| Rate for Payer: Aetna Medicare |
$402.64
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$387.15
|
| Rate for Payer: BCBS Trust/PPO |
$162.72
|
| Rate for Payer: BCN Commercial |
$810.72
|
| 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: Mclaren Medicaid |
$264.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.51
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| 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 Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.55
|
| Rate for Payer: Priority Health HMO/PPO |
$624.38
|
| Rate for Payer: Priority Health Medicare |
$391.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$624.38
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$264.12
|
|
|
PR REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 27090
|
| Min. Negotiated Rate |
$412.60 |
| 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 |
$565.83
|
| Rate for Payer: BCBS MAPPO |
$799.27
|
| Rate for Payer: BCBS Trust/PPO |
$412.60
|
| Rate for Payer: BCN Commercial |
$1,222.67
|
| 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: Mclaren Medicaid |
$538.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$839.23
|
| Rate for Payer: Meridian Medicaid |
$565.83
|
| 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 Choice Medicaid |
$538.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,368.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,278.76
|
| Rate for Payer: Priority Health Medicare |
$807.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,278.76
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$538.89
|
|
|
PR REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 64584
|
| Min. Negotiated Rate |
$468.17 |
| 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 |
$491.58
|
| Rate for Payer: BCBS MAPPO |
$696.91
|
| Rate for Payer: BCN Commercial |
$1,064.34
|
| 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: Mclaren Medicaid |
$468.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.76
|
| Rate for Payer: Meridian Medicaid |
$491.58
|
| 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 Choice Medicaid |
$468.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,244.91
|
| Rate for Payer: Priority Health Medicare |
$703.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,244.91
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$468.17
|
|
|
PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 69210
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$2,090.48 |
| Rate for Payer: Aetna Commercial |
$41.06
|
| Rate for Payer: Aetna Medicare |
$31.87
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$30.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,090.48
|
| Rate for Payer: BCN Commercial |
$55.76
|
| 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: Mclaren Medicaid |
$20.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.17
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| 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 Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO |
$47.18
|
| Rate for Payer: Priority Health Medicare |
$30.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.18
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
|
|
PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 69209
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$2,108.45 |
| 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: BCBS Trust/PPO |
$2,108.45
|
| Rate for Payer: BCN Commercial |
$22.48
|
| 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 HMO/PPO |
$23.35
|
| Rate for Payer: Priority Health Medicare |
$14.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.35
|
| 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
|
|
|
PR REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 57415
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$1,989.05 |
| Rate for Payer: Aetna Commercial |
$223.03
|
| Rate for Payer: Aetna Medicare |
$173.10
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$166.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.05
|
| Rate for Payer: BCN Commercial |
$257.53
|
| Rate for Payer: BCN Medicare Advantage |
$166.44
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$223.03
|
| Rate for Payer: Cofinity Commercial |
$239.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.44
|
| Rate for Payer: Mclaren Medicaid |
$112.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.76
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Nomi Health Commercial |
$199.73
|
| Rate for Payer: PACE SWMI |
$166.44
|
| Rate for Payer: PHP Medicare Advantage |
$166.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: Priority Health HMO/PPO |
$263.90
|
| Rate for Payer: Priority Health Medicare |
$168.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.44
|
| Rate for Payer: UHC Exchange |
$166.44
|
| Rate for Payer: UHC Medicare Advantage |
$166.44
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 11976
|
| Hospital Charge Code |
11976
|
| Min. Negotiated Rate |
$58.79 |
| Max. Negotiated Rate |
$268.22 |
| Rate for Payer: Aetna Commercial |
$119.14
|
| Rate for Payer: Aetna Medicare |
$92.47
|
| Rate for Payer: BCBS Complete |
$61.73
|
| Rate for Payer: BCBS MAPPO |
$88.91
|
| Rate for Payer: BCBS Trust/PPO |
$268.22
|
| Rate for Payer: BCN Commercial |
$212.08
|
| Rate for Payer: BCN Medicare Advantage |
$88.91
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$128.03
|
| Rate for Payer: Cofinity Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.91
|
| Rate for Payer: Mclaren Medicaid |
$58.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.36
|
| Rate for Payer: Meridian Medicaid |
$61.73
|
| Rate for Payer: Nomi Health Commercial |
$106.69
|
| Rate for Payer: PACE SWMI |
$88.91
|
| Rate for Payer: PHP Medicare Advantage |
$88.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO |
$125.08
|
| Rate for Payer: Priority Health Medicare |
$89.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.91
|
| Rate for Payer: UHC Exchange |
$88.91
|
| Rate for Payer: UHC Medicare Advantage |
$88.91
|
| Rate for Payer: UHCCP Medicaid |
$58.79
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 11976
|
| Min. Negotiated Rate |
$58.79 |
| Max. Negotiated Rate |
$268.22 |
| Rate for Payer: Aetna Commercial |
$119.14
|
| Rate for Payer: Aetna Medicare |
$92.47
|
| Rate for Payer: BCBS Complete |
$61.73
|
| Rate for Payer: BCBS MAPPO |
$88.91
|
| Rate for Payer: BCBS Trust/PPO |
$268.22
|
| Rate for Payer: BCN Commercial |
$212.08
|
| Rate for Payer: BCN Medicare Advantage |
$88.91
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$128.03
|
| Rate for Payer: Cofinity Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.91
|
| Rate for Payer: Mclaren Medicaid |
$58.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.36
|
| Rate for Payer: Meridian Medicaid |
$61.73
|
| Rate for Payer: Nomi Health Commercial |
$106.69
|
| Rate for Payer: PACE SWMI |
$88.91
|
| Rate for Payer: PHP Medicare Advantage |
$88.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO |
$125.08
|
| Rate for Payer: Priority Health Medicare |
$89.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.91
|
| Rate for Payer: UHC Exchange |
$88.91
|
| Rate for Payer: UHC Medicare Advantage |
$88.91
|
| Rate for Payer: UHCCP Medicaid |
$58.79
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$57.24 |
| Max. Negotiated Rate |
$523.36 |
| Rate for Payer: Aetna Commercial |
$204.85
|
| Rate for Payer: Aetna Medicare |
$62.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.31
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$60.25
|
| Rate for Payer: BCBS Trust/PPO |
$198.13
|
| Rate for Payer: BCN Commercial |
$187.38
|
| Rate for Payer: BCN Medicare Advantage |
$60.25
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$207.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.25
|
| Rate for Payer: Healthscope Commercial |
$216.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.75
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.26
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.85
|
| Rate for Payer: Nomi Health Commercial |
$197.62
|
| Rate for Payer: PACE Senior Care Partners |
$57.24
|
| Rate for Payer: PACE SWMI |
$60.25
|
| Rate for Payer: PHP Commercial |
$204.85
|
| Rate for Payer: PHP Medicare Advantage |
$60.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO |
$209.67
|
| Rate for Payer: Priority Health Medicare |
$60.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.47
|
| Rate for Payer: Railroad Medicare Medicare |
$60.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.08
|
| Rate for Payer: UHC Core |
$201.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.25
|
| Rate for Payer: UHC Exchange |
$60.25
|
| Rate for Payer: UHC Medicare Advantage |
$60.25
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$60.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.75
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$156.65 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Aetna Commercial |
$204.85
|
| Rate for Payer: BCBS Trust/PPO |
$196.73
|
| Rate for Payer: BCN Commercial |
$186.24
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$207.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.80
|
| Rate for Payer: Healthscope Commercial |
$216.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.85
|
| Rate for Payer: Nomi Health Commercial |
$197.62
|
| Rate for Payer: PHP Commercial |
$204.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO |
$209.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.08
|
| Rate for Payer: UHC Core |
$201.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.75
|
|
|
PR REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY
|
Professional
|
Both
|
$438.00
|
|
|
Service Code
|
HCPCS 33241
|
| Min. Negotiated Rate |
$136.32 |
| Max. Negotiated Rate |
$1,338.18 |
| Rate for Payer: Aetna Commercial |
$272.27
|
| Rate for Payer: Aetna Medicare |
$211.32
|
| Rate for Payer: BCBS Complete |
$143.14
|
| Rate for Payer: BCBS MAPPO |
$203.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.18
|
| Rate for Payer: BCN Commercial |
$311.29
|
| Rate for Payer: BCN Medicare Advantage |
$203.19
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$292.59
|
| Rate for Payer: Cofinity Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.19
|
| Rate for Payer: Mclaren Medicaid |
$136.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.35
|
| Rate for Payer: Meridian Medicaid |
$143.14
|
| Rate for Payer: Nomi Health Commercial |
$243.83
|
| Rate for Payer: PACE SWMI |
$203.19
|
| Rate for Payer: PHP Medicare Advantage |
$203.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health HMO/PPO |
$338.77
|
| Rate for Payer: Priority Health Medicare |
$205.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$338.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.19
|
| Rate for Payer: UHC Exchange |
$203.19
|
| Rate for Payer: UHC Medicare Advantage |
$203.19
|
| Rate for Payer: UHCCP Medicaid |
$136.32
|
|
|
PR REMOVAL IMPLANT DEEP
|
Facility
|
OP
|
$1,085.00
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
20680
|
| Min. Negotiated Rate |
$257.69 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$922.25
|
| Rate for Payer: Aetna Medicare |
$282.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$339.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$339.06
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$271.25
|
| Rate for Payer: BCBS Trust/PPO |
$891.98
|
| Rate for Payer: BCN Commercial |
$843.59
|
| Rate for Payer: BCN Medicare Advantage |
$271.25
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$933.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.25
|
| Rate for Payer: Healthscope Commercial |
$976.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.75
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$284.81
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$311.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.25
|
| Rate for Payer: Nomi Health Commercial |
$889.70
|
| Rate for Payer: PACE Senior Care Partners |
$257.69
|
| Rate for Payer: PACE SWMI |
$271.25
|
| Rate for Payer: PHP Commercial |
$922.25
|
| Rate for Payer: PHP Medicare Advantage |
$271.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.25
|
| Rate for Payer: Priority Health HMO/PPO |
$943.95
|
| Rate for Payer: Priority Health Medicare |
$273.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.95
|
| Rate for Payer: Railroad Medicare Medicare |
$271.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.80
|
| Rate for Payer: UHC Core |
$905.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.25
|
| Rate for Payer: UHC Exchange |
$271.25
|
| Rate for Payer: UHC Medicare Advantage |
$271.25
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$271.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.75
|
|
|
PR REMOVAL IMPLANT DEEP
|
Facility
|
IP
|
$1,085.00
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
20680
|
| Min. Negotiated Rate |
$705.25 |
| Max. Negotiated Rate |
$976.50 |
| Rate for Payer: Aetna Commercial |
$922.25
|
| Rate for Payer: BCBS Trust/PPO |
$885.69
|
| Rate for Payer: BCN Commercial |
$838.49
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$933.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.00
|
| Rate for Payer: Healthscope Commercial |
$976.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.25
|
| Rate for Payer: Nomi Health Commercial |
$889.70
|
| Rate for Payer: PHP Commercial |
$922.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.25
|
| Rate for Payer: Priority Health HMO/PPO |
$943.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.80
|
| Rate for Payer: UHC Core |
$905.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.75
|
|
|
PR REMOVAL IMPLANT DEEP
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
HCPCS 20680
|
| Hospital Charge Code |
20680
|
| Min. Negotiated Rate |
$272.64 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$540.11
|
| Rate for Payer: Aetna Medicare |
$419.19
|
| Rate for Payer: BCBS Complete |
$286.27
|
| Rate for Payer: BCBS MAPPO |
$403.07
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$883.04
|
| Rate for Payer: BCN Medicare Advantage |
$403.07
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$580.42
|
| Rate for Payer: Cofinity Commercial |
$540.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.07
|
| Rate for Payer: Mclaren Medicaid |
$272.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.22
|
| Rate for Payer: Meridian Medicaid |
$286.27
|
| Rate for Payer: Nomi Health Commercial |
$483.68
|
| Rate for Payer: PACE SWMI |
$403.07
|
| Rate for Payer: PHP Medicare Advantage |
$403.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.25
|
| Rate for Payer: Priority Health HMO/PPO |
$646.76
|
| Rate for Payer: Priority Health Medicare |
$407.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$646.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.07
|
| Rate for Payer: UHC Exchange |
$403.07
|
| Rate for Payer: UHC Medicare Advantage |
$403.07
|
| Rate for Payer: UHCCP Medicaid |
$272.64
|
|
|
PR REMOVAL IMPLANT DEEP
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
HCPCS 20680
|
| Min. Negotiated Rate |
$272.64 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$540.11
|
| Rate for Payer: Aetna Medicare |
$419.19
|
| Rate for Payer: BCBS Complete |
$286.27
|
| Rate for Payer: BCBS MAPPO |
$403.07
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$883.04
|
| Rate for Payer: BCN Medicare Advantage |
$403.07
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$580.42
|
| Rate for Payer: Cofinity Commercial |
$540.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.07
|
| Rate for Payer: Mclaren Medicaid |
$272.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.22
|
| Rate for Payer: Meridian Medicaid |
$286.27
|
| Rate for Payer: Nomi Health Commercial |
$483.68
|
| Rate for Payer: PACE SWMI |
$403.07
|
| Rate for Payer: PHP Medicare Advantage |
$403.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.25
|
| Rate for Payer: Priority Health HMO/PPO |
$646.76
|
| Rate for Payer: Priority Health Medicare |
$407.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$646.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.07
|
| Rate for Payer: UHC Exchange |
$403.07
|
| Rate for Payer: UHC Medicare Advantage |
$403.07
|
| Rate for Payer: UHCCP Medicaid |
$272.64
|
|
|
PR REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 36262
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$541.45 |
| Rate for Payer: Aetna Commercial |
$406.74
|
| Rate for Payer: Aetna Medicare |
$315.68
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$303.54
|
| Rate for Payer: BCBS Trust/PPO |
$244.60
|
| Rate for Payer: BCN Commercial |
$460.83
|
| Rate for Payer: BCN Medicare Advantage |
$303.54
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$437.10
|
| Rate for Payer: Cofinity Commercial |
$406.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.54
|
| Rate for Payer: Mclaren Medicaid |
$204.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.72
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Nomi Health Commercial |
$364.25
|
| Rate for Payer: PACE SWMI |
$303.54
|
| Rate for Payer: PHP Medicare Advantage |
$303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.45
|
| Rate for Payer: Priority Health HMO/PPO |
$507.36
|
| Rate for Payer: Priority Health Medicare |
$306.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.54
|
| Rate for Payer: UHC Exchange |
$303.54
|
| Rate for Payer: UHC Medicare Advantage |
$303.54
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR REMOVAL IMPLANT FROM FINGER/HAND
|
Professional
|
Both
|
$1,044.00
|
|
|
Service Code
|
HCPCS 26320
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Aetna Commercial |
$453.78
|
| Rate for Payer: Aetna Medicare |
$352.19
|
| Rate for Payer: BCBS Complete |
$243.11
|
| Rate for Payer: BCBS MAPPO |
$338.64
|
| Rate for Payer: BCBS Trust/PPO |
$140.00
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$338.64
|
| Rate for Payer: Cash Price |
$835.20
|
| Rate for Payer: Cash Price |
$835.20
|
| Rate for Payer: Cofinity Commercial |
$487.64
|
| Rate for Payer: Cofinity Commercial |
$453.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.64
|
| Rate for Payer: Mclaren Medicaid |
$231.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.57
|
| Rate for Payer: Meridian Medicaid |
$243.11
|
| Rate for Payer: Nomi Health Commercial |
$406.37
|
| Rate for Payer: PACE SWMI |
$338.64
|
| Rate for Payer: PHP Medicare Advantage |
$338.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.60
|
| Rate for Payer: Priority Health HMO/PPO |
$546.52
|
| Rate for Payer: Priority Health Medicare |
$342.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$546.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.64
|
| Rate for Payer: UHC Exchange |
$338.64
|
| Rate for Payer: UHC Medicare Advantage |
$338.64
|
| Rate for Payer: UHCCP Medicaid |
$231.53
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$184.61
|
| Rate for Payer: Aetna Medicare |
$143.28
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$137.77
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$422.50
|
| Rate for Payer: BCN Medicare Advantage |
$137.77
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$198.39
|
| Rate for Payer: Cofinity Commercial |
$184.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.77
|
| Rate for Payer: Mclaren Medicaid |
$94.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.66
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Nomi Health Commercial |
$165.32
|
| Rate for Payer: PACE SWMI |
$137.77
|
| Rate for Payer: PHP Medicare Advantage |
$137.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health HMO/PPO |
$222.88
|
| Rate for Payer: Priority Health Medicare |
$139.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.77
|
| Rate for Payer: UHC Exchange |
$137.77
|
| Rate for Payer: UHC Medicare Advantage |
$137.77
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Facility
|
IP
|
$919.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$597.35 |
| Max. Negotiated Rate |
$827.10 |
| Rate for Payer: Aetna Commercial |
$781.15
|
| Rate for Payer: BCBS Trust/PPO |
$750.18
|
| Rate for Payer: BCN Commercial |
$710.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$790.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.20
|
| Rate for Payer: Healthscope Commercial |
$827.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.15
|
| Rate for Payer: Nomi Health Commercial |
$753.58
|
| Rate for Payer: PHP Commercial |
$781.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health HMO/PPO |
$799.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.72
|
| Rate for Payer: UHC Core |
$767.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.25
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Facility
|
OP
|
$919.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$218.26 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$781.15
|
| Rate for Payer: Aetna Medicare |
$238.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$287.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$287.19
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$229.75
|
| Rate for Payer: BCBS Trust/PPO |
$755.51
|
| Rate for Payer: BCN Commercial |
$714.52
|
| Rate for Payer: BCN Medicare Advantage |
$229.75
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$790.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.75
|
| Rate for Payer: Healthscope Commercial |
$827.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.25
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.24
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$264.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.15
|
| Rate for Payer: Nomi Health Commercial |
$753.58
|
| Rate for Payer: PACE Senior Care Partners |
$218.26
|
| Rate for Payer: PACE SWMI |
$229.75
|
| Rate for Payer: PHP Commercial |
$781.15
|
| Rate for Payer: PHP Medicare Advantage |
$229.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health HMO/PPO |
$799.53
|
| Rate for Payer: Priority Health Medicare |
$232.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.73
|
| Rate for Payer: Railroad Medicare Medicare |
$229.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.72
|
| Rate for Payer: UHC Core |
$767.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.75
|
| Rate for Payer: UHC Exchange |
$229.75
|
| Rate for Payer: UHC Medicare Advantage |
$229.75
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$229.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.25
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 20670
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$184.61
|
| Rate for Payer: Aetna Medicare |
$143.28
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$137.77
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$422.50
|
| Rate for Payer: BCN Medicare Advantage |
$137.77
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$198.39
|
| Rate for Payer: Cofinity Commercial |
$184.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.77
|
| Rate for Payer: Mclaren Medicaid |
$94.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.66
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Nomi Health Commercial |
$165.32
|
| Rate for Payer: PACE SWMI |
$137.77
|
| Rate for Payer: PHP Medicare Advantage |
$137.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health HMO/PPO |
$222.88
|
| Rate for Payer: Priority Health Medicare |
$139.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.77
|
| Rate for Payer: UHC Exchange |
$137.77
|
| Rate for Payer: UHC Medicare Advantage |
$137.77
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
|
