|
PR RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 50387
|
| Min. Negotiated Rate |
$78.46 |
| Max. Negotiated Rate |
$779.35 |
| Rate for Payer: Aetna Commercial |
$105.14
|
| Rate for Payer: Aetna Medicare |
$81.60
|
| Rate for Payer: BCBS Complete |
$479.60
|
| Rate for Payer: BCBS MAPPO |
$78.46
|
| Rate for Payer: BCN Medicare Advantage |
$78.46
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$112.98
|
| Rate for Payer: Cofinity Commercial |
$105.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.38
|
| Rate for Payer: Nomi Health Commercial |
$94.15
|
| Rate for Payer: PACE SWMI |
$78.46
|
| Rate for Payer: PHP Medicare Advantage |
$78.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.35
|
| Rate for Payer: Priority Health Medicare |
$79.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.46
|
| Rate for Payer: UHC Exchange |
$78.46
|
| Rate for Payer: UHC Medicare Advantage |
$78.46
|
|
|
PR RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE
|
Professional
|
Both
|
$1,698.00
|
|
|
Service Code
|
HCPCS 69711
|
| Min. Negotiated Rate |
$679.20 |
| Max. Negotiated Rate |
$1,129.59 |
| Rate for Payer: Aetna Commercial |
$1,051.15
|
| Rate for Payer: Aetna Medicare |
$815.82
|
| Rate for Payer: BCBS Complete |
$679.20
|
| Rate for Payer: BCBS MAPPO |
$784.44
|
| Rate for Payer: BCN Medicare Advantage |
$784.44
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Cofinity Commercial |
$1,129.59
|
| Rate for Payer: Cofinity Commercial |
$1,051.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$784.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$823.66
|
| Rate for Payer: Nomi Health Commercial |
$941.33
|
| Rate for Payer: PACE SWMI |
$784.44
|
| Rate for Payer: PHP Medicare Advantage |
$784.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.70
|
| Rate for Payer: Priority Health Medicare |
$792.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$784.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$784.44
|
| Rate for Payer: UHC Exchange |
$784.44
|
| Rate for Payer: UHC Medicare Advantage |
$784.44
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 19330
|
| Min. Negotiated Rate |
$458.00 |
| Max. Negotiated Rate |
$891.88 |
| Rate for Payer: Aetna Commercial |
$829.94
|
| Rate for Payer: Aetna Medicare |
$644.13
|
| Rate for Payer: BCBS Complete |
$458.00
|
| Rate for Payer: BCBS MAPPO |
$619.36
|
| Rate for Payer: BCN Medicare Advantage |
$619.36
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$891.88
|
| Rate for Payer: Cofinity Commercial |
$829.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.33
|
| Rate for Payer: Nomi Health Commercial |
$743.23
|
| Rate for Payer: PACE SWMI |
$619.36
|
| Rate for Payer: PHP Medicare Advantage |
$619.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health Medicare |
$625.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.36
|
| Rate for Payer: UHC Exchange |
$619.36
|
| Rate for Payer: UHC Medicare Advantage |
$619.36
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Facility
|
IP
|
$1,145.00
|
|
|
Service Code
|
CPT 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$744.25 |
| Max. Negotiated Rate |
$1,030.50 |
| Rate for Payer: Aetna Commercial |
$973.25
|
| Rate for Payer: BCBS Trust/PPO |
$934.66
|
| Rate for Payer: BCN Commercial |
$884.86
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$984.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.00
|
| Rate for Payer: Healthscope Commercial |
$1,030.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.25
|
| Rate for Payer: Nomi Health Commercial |
$938.90
|
| Rate for Payer: PHP Commercial |
$973.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO |
$996.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$767.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.60
|
| Rate for Payer: UHC Core |
$956.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.75
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Facility
|
OP
|
$1,145.00
|
|
|
Service Code
|
CPT 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$271.94 |
| Max. Negotiated Rate |
$2,907.19 |
| Rate for Payer: Aetna Commercial |
$973.25
|
| Rate for Payer: Aetna Medicare |
$297.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.81
|
| Rate for Payer: BCBS Complete |
$2,907.19
|
| Rate for Payer: BCBS MAPPO |
$286.25
|
| Rate for Payer: BCBS Trust/PPO |
$941.30
|
| Rate for Payer: BCN Commercial |
$890.24
|
| Rate for Payer: BCN Medicare Advantage |
$286.25
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$984.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.25
|
| Rate for Payer: Healthscope Commercial |
$1,030.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.75
|
| Rate for Payer: Mclaren Medicaid |
$2,768.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.56
|
| Rate for Payer: Meridian Medicaid |
$2,907.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.25
|
| Rate for Payer: Nomi Health Commercial |
$938.90
|
| Rate for Payer: PACE Senior Care Partners |
$271.94
|
| Rate for Payer: PACE SWMI |
$286.25
|
| Rate for Payer: PHP Commercial |
$973.25
|
| Rate for Payer: PHP Medicare Advantage |
$286.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,768.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health HMO/PPO |
$996.15
|
| Rate for Payer: Priority Health Medicare |
$289.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$767.15
|
| Rate for Payer: Railroad Medicare Medicare |
$286.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.60
|
| Rate for Payer: UHC Core |
$956.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.25
|
| Rate for Payer: UHC Exchange |
$286.25
|
| Rate for Payer: UHC Medicare Advantage |
$286.25
|
| Rate for Payer: UHCCP Medicaid |
$2,768.57
|
| Rate for Payer: VA VA |
$286.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.75
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 19330
|
| Hospital Charge Code |
19330
|
| Min. Negotiated Rate |
$458.00 |
| Max. Negotiated Rate |
$891.88 |
| Rate for Payer: Aetna Commercial |
$829.94
|
| Rate for Payer: Aetna Medicare |
$644.13
|
| Rate for Payer: BCBS Complete |
$458.00
|
| Rate for Payer: BCBS MAPPO |
$619.36
|
| Rate for Payer: BCN Medicare Advantage |
$619.36
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$891.88
|
| Rate for Payer: Cofinity Commercial |
$829.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.33
|
| Rate for Payer: Nomi Health Commercial |
$743.23
|
| Rate for Payer: PACE SWMI |
$619.36
|
| Rate for Payer: PHP Medicare Advantage |
$619.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health Medicare |
$625.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.36
|
| Rate for Payer: UHC Exchange |
$619.36
|
| Rate for Payer: UHC Medicare Advantage |
$619.36
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY EA ADDL 10
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 11201
|
| Min. Negotiated Rate |
$15.23 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$20.41
|
| Rate for Payer: Aetna Medicare |
$15.84
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$15.23
|
| Rate for Payer: BCN Medicare Advantage |
$15.23
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.99
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: PACE SWMI |
$15.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Medicare |
$15.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.23
|
| Rate for Payer: UHC Exchange |
$15.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.23
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 11200
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$113.75 |
| Rate for Payer: Aetna Commercial |
$96.08
|
| Rate for Payer: Aetna Medicare |
$74.57
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$71.70
|
| Rate for Payer: BCN Medicare Advantage |
$71.70
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$96.08
|
| Rate for Payer: Cofinity Commercial |
$103.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.28
|
| Rate for Payer: Nomi Health Commercial |
$86.04
|
| Rate for Payer: PACE SWMI |
$71.70
|
| Rate for Payer: PHP Medicare Advantage |
$71.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health Medicare |
$72.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.70
|
| Rate for Payer: UHC Exchange |
$71.70
|
| Rate for Payer: UHC Medicare Advantage |
$71.70
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$41.56 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$148.75
|
| Rate for Payer: Aetna Medicare |
$45.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.69
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$43.75
|
| Rate for Payer: BCBS Trust/PPO |
$143.87
|
| Rate for Payer: BCN Commercial |
$136.06
|
| Rate for Payer: BCN Medicare Advantage |
$43.75
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.75
|
| Rate for Payer: Healthscope Commercial |
$157.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.25
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.94
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.75
|
| Rate for Payer: Nomi Health Commercial |
$143.50
|
| Rate for Payer: PACE Senior Care Partners |
$41.56
|
| Rate for Payer: PACE SWMI |
$43.75
|
| Rate for Payer: PHP Commercial |
$148.75
|
| Rate for Payer: PHP Medicare Advantage |
$43.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO |
$152.25
|
| Rate for Payer: Priority Health Medicare |
$44.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.25
|
| Rate for Payer: Railroad Medicare Medicare |
$43.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.00
|
| Rate for Payer: UHC Core |
$146.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.75
|
| Rate for Payer: UHC Exchange |
$43.75
|
| Rate for Payer: UHC Medicare Advantage |
$43.75
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$43.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.25
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 11200
|
| Hospital Charge Code |
11200
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$113.75 |
| Rate for Payer: Aetna Commercial |
$96.08
|
| Rate for Payer: Aetna Medicare |
$74.57
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$71.70
|
| Rate for Payer: BCN Medicare Advantage |
$71.70
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$96.08
|
| Rate for Payer: Cofinity Commercial |
$103.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.28
|
| Rate for Payer: Nomi Health Commercial |
$86.04
|
| Rate for Payer: PACE SWMI |
$71.70
|
| Rate for Payer: PHP Medicare Advantage |
$71.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health Medicare |
$72.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.70
|
| Rate for Payer: UHC Exchange |
$71.70
|
| Rate for Payer: UHC Medicare Advantage |
$71.70
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$113.75 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$148.75
|
| Rate for Payer: BCBS Trust/PPO |
$142.85
|
| Rate for Payer: BCN Commercial |
$135.24
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.00
|
| Rate for Payer: Healthscope Commercial |
$157.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.75
|
| Rate for Payer: Nomi Health Commercial |
$143.50
|
| Rate for Payer: PHP Commercial |
$148.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO |
$152.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.00
|
| Rate for Payer: UHC Core |
$146.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.25
|
|
|
PR RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR
|
Professional
|
Both
|
$3,942.00
|
|
|
Service Code
|
HCPCS 63662
|
| Min. Negotiated Rate |
$834.37 |
| Max. Negotiated Rate |
$2,562.30 |
| Rate for Payer: Aetna Commercial |
$1,118.06
|
| Rate for Payer: Aetna Medicare |
$867.74
|
| Rate for Payer: BCBS Complete |
$1,576.80
|
| Rate for Payer: BCBS MAPPO |
$834.37
|
| Rate for Payer: BCN Medicare Advantage |
$834.37
|
| Rate for Payer: Cash Price |
$3,153.60
|
| Rate for Payer: Cash Price |
$3,153.60
|
| Rate for Payer: Cofinity Commercial |
$1,201.49
|
| Rate for Payer: Cofinity Commercial |
$1,118.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$834.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.09
|
| Rate for Payer: Nomi Health Commercial |
$1,001.24
|
| Rate for Payer: PACE SWMI |
$834.37
|
| Rate for Payer: PHP Medicare Advantage |
$834.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,562.30
|
| Rate for Payer: Priority Health Medicare |
$842.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$834.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$834.37
|
| Rate for Payer: UHC Exchange |
$834.37
|
| Rate for Payer: UHC Medicare Advantage |
$834.37
|
|
|
PR RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR
|
Professional
|
Both
|
$1,821.00
|
|
|
Service Code
|
HCPCS 63661
|
| Min. Negotiated Rate |
$318.16 |
| Max. Negotiated Rate |
$1,183.65 |
| Rate for Payer: Aetna Commercial |
$426.33
|
| Rate for Payer: Aetna Medicare |
$330.89
|
| Rate for Payer: BCBS Complete |
$728.40
|
| Rate for Payer: BCBS MAPPO |
$318.16
|
| Rate for Payer: BCN Medicare Advantage |
$318.16
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cofinity Commercial |
$458.15
|
| Rate for Payer: Cofinity Commercial |
$426.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.07
|
| Rate for Payer: Nomi Health Commercial |
$381.79
|
| Rate for Payer: PACE SWMI |
$318.16
|
| Rate for Payer: PHP Medicare Advantage |
$318.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.65
|
| Rate for Payer: Priority Health Medicare |
$321.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.16
|
| Rate for Payer: UHC Exchange |
$318.16
|
| Rate for Payer: UHC Medicare Advantage |
$318.16
|
|
|
PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 62365
|
| Min. Negotiated Rate |
$288.07 |
| Max. Negotiated Rate |
$985.40 |
| Rate for Payer: Aetna Commercial |
$386.01
|
| Rate for Payer: Aetna Medicare |
$299.59
|
| Rate for Payer: BCBS Complete |
$606.40
|
| Rate for Payer: BCBS MAPPO |
$288.07
|
| Rate for Payer: BCN Medicare Advantage |
$288.07
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cofinity Commercial |
$414.82
|
| Rate for Payer: Cofinity Commercial |
$386.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.47
|
| Rate for Payer: Nomi Health Commercial |
$345.68
|
| Rate for Payer: PACE SWMI |
$288.07
|
| Rate for Payer: PHP Medicare Advantage |
$288.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health Medicare |
$290.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.07
|
| Rate for Payer: UHC Exchange |
$288.07
|
| Rate for Payer: UHC Medicare Advantage |
$288.07
|
|
|
PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 26392
|
| Min. Negotiated Rate |
$651.20 |
| Max. Negotiated Rate |
$1,351.99 |
| Rate for Payer: Aetna Commercial |
$1,258.10
|
| Rate for Payer: Aetna Medicare |
$976.44
|
| Rate for Payer: BCBS Complete |
$651.20
|
| Rate for Payer: BCBS MAPPO |
$938.88
|
| Rate for Payer: BCN Medicare Advantage |
$938.88
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,351.99
|
| Rate for Payer: Cofinity Commercial |
$1,258.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.82
|
| Rate for Payer: Nomi Health Commercial |
$1,126.66
|
| Rate for Payer: PACE SWMI |
$938.88
|
| Rate for Payer: PHP Medicare Advantage |
$938.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health Medicare |
$948.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$938.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$938.88
|
| Rate for Payer: UHC Exchange |
$938.88
|
| Rate for Payer: UHC Medicare Advantage |
$938.88
|
|
|
PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 46754
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$330.52 |
| Rate for Payer: Aetna Commercial |
$307.57
|
| Rate for Payer: Aetna Medicare |
$238.71
|
| Rate for Payer: BCBS Complete |
$188.80
|
| Rate for Payer: BCBS MAPPO |
$229.53
|
| Rate for Payer: BCN Medicare Advantage |
$229.53
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$330.52
|
| Rate for Payer: Cofinity Commercial |
$307.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.01
|
| Rate for Payer: Nomi Health Commercial |
$275.44
|
| Rate for Payer: PACE SWMI |
$229.53
|
| Rate for Payer: PHP Medicare Advantage |
$229.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.80
|
| Rate for Payer: Priority Health Medicare |
$231.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.53
|
| Rate for Payer: UHC Exchange |
$229.53
|
| Rate for Payer: UHC Medicare Advantage |
$229.53
|
|
|
PR RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 33234
|
| Min. Negotiated Rate |
$459.28 |
| Max. Negotiated Rate |
$1,090.70 |
| Rate for Payer: Aetna Commercial |
$615.44
|
| Rate for Payer: Aetna Medicare |
$477.65
|
| Rate for Payer: BCBS Complete |
$671.20
|
| Rate for Payer: BCBS MAPPO |
$459.28
|
| Rate for Payer: BCN Medicare Advantage |
$459.28
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cofinity Commercial |
$661.36
|
| Rate for Payer: Cofinity Commercial |
$615.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$482.24
|
| Rate for Payer: Nomi Health Commercial |
$551.14
|
| Rate for Payer: PACE SWMI |
$459.28
|
| Rate for Payer: PHP Medicare Advantage |
$459.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.70
|
| Rate for Payer: Priority Health Medicare |
$463.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$459.28
|
| Rate for Payer: UHC Exchange |
$459.28
|
| Rate for Payer: UHC Medicare Advantage |
$459.28
|
|
|
PR RMVL TRANSVNS PM ELTRD DUAL LEAD SYS
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 33235
|
| Min. Negotiated Rate |
$530.80 |
| Max. Negotiated Rate |
$867.82 |
| Rate for Payer: Aetna Commercial |
$807.55
|
| Rate for Payer: Aetna Medicare |
$626.76
|
| Rate for Payer: BCBS Complete |
$530.80
|
| Rate for Payer: BCBS MAPPO |
$602.65
|
| Rate for Payer: BCN Medicare Advantage |
$602.65
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$867.82
|
| Rate for Payer: Cofinity Commercial |
$807.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.78
|
| Rate for Payer: Nomi Health Commercial |
$723.18
|
| Rate for Payer: PACE SWMI |
$602.65
|
| Rate for Payer: PHP Medicare Advantage |
$602.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.55
|
| Rate for Payer: Priority Health Medicare |
$608.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.65
|
| Rate for Payer: UHC Exchange |
$602.65
|
| Rate for Payer: UHC Medicare Advantage |
$602.65
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
OP
|
$716.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$170.05 |
| Max. Negotiated Rate |
$1,179.37 |
| Rate for Payer: Aetna Commercial |
$608.60
|
| Rate for Payer: Aetna Medicare |
$186.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.75
|
| Rate for Payer: BCBS Complete |
$1,179.37
|
| Rate for Payer: BCBS MAPPO |
$179.00
|
| Rate for Payer: BCBS Trust/PPO |
$588.62
|
| Rate for Payer: BCN Commercial |
$556.69
|
| Rate for Payer: BCN Medicare Advantage |
$179.00
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$615.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.00
|
| Rate for Payer: Healthscope Commercial |
$644.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$537.00
|
| Rate for Payer: Mclaren Medicaid |
$1,123.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.95
|
| Rate for Payer: Meridian Medicaid |
$1,179.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.60
|
| Rate for Payer: Nomi Health Commercial |
$587.12
|
| Rate for Payer: PACE Senior Care Partners |
$170.05
|
| Rate for Payer: PACE SWMI |
$179.00
|
| Rate for Payer: PHP Commercial |
$608.60
|
| Rate for Payer: PHP Medicare Advantage |
$179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,123.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO |
$622.92
|
| Rate for Payer: Priority Health Medicare |
$180.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$479.72
|
| Rate for Payer: Railroad Medicare Medicare |
$179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$630.08
|
| Rate for Payer: UHC Core |
$597.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.00
|
| Rate for Payer: UHC Exchange |
$179.00
|
| Rate for Payer: UHC Medicare Advantage |
$179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,123.14
|
| Rate for Payer: VA VA |
$179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$537.00
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
IP
|
$716.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$644.40 |
| Rate for Payer: Aetna Commercial |
$608.60
|
| Rate for Payer: BCBS Trust/PPO |
$584.47
|
| Rate for Payer: BCN Commercial |
$553.32
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$615.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.80
|
| Rate for Payer: Healthscope Commercial |
$644.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$537.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.60
|
| Rate for Payer: Nomi Health Commercial |
$587.12
|
| Rate for Payer: PHP Commercial |
$608.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO |
$622.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$479.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$630.08
|
| Rate for Payer: UHC Core |
$597.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$537.00
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 36590
|
| Min. Negotiated Rate |
$179.91 |
| Max. Negotiated Rate |
$465.40 |
| Rate for Payer: Aetna Commercial |
$241.08
|
| Rate for Payer: Aetna Medicare |
$187.11
|
| Rate for Payer: BCBS Complete |
$286.40
|
| Rate for Payer: BCBS MAPPO |
$179.91
|
| Rate for Payer: BCN Medicare Advantage |
$179.91
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$259.07
|
| Rate for Payer: Cofinity Commercial |
$241.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.91
|
| Rate for Payer: Nomi Health Commercial |
$215.89
|
| Rate for Payer: PACE SWMI |
$179.91
|
| Rate for Payer: PHP Medicare Advantage |
$179.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$181.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.91
|
| Rate for Payer: UHC Exchange |
$179.91
|
| Rate for Payer: UHC Medicare Advantage |
$179.91
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 36590
|
| Hospital Charge Code |
36590
|
| Min. Negotiated Rate |
$179.91 |
| Max. Negotiated Rate |
$465.40 |
| Rate for Payer: Aetna Commercial |
$241.08
|
| Rate for Payer: Aetna Medicare |
$187.11
|
| Rate for Payer: BCBS Complete |
$286.40
|
| Rate for Payer: BCBS MAPPO |
$179.91
|
| Rate for Payer: BCN Medicare Advantage |
$179.91
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$259.07
|
| Rate for Payer: Cofinity Commercial |
$241.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.91
|
| Rate for Payer: Nomi Health Commercial |
$215.89
|
| Rate for Payer: PACE SWMI |
$179.91
|
| Rate for Payer: PHP Medicare Advantage |
$179.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$181.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.91
|
| Rate for Payer: UHC Exchange |
$179.91
|
| Rate for Payer: UHC Medicare Advantage |
$179.91
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
IP
|
$429.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$278.85 |
| Max. Negotiated Rate |
$386.10 |
| Rate for Payer: Aetna Commercial |
$364.65
|
| Rate for Payer: BCBS Trust/PPO |
$350.19
|
| Rate for Payer: BCN Commercial |
$331.53
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$368.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.20
|
| Rate for Payer: Healthscope Commercial |
$386.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.65
|
| Rate for Payer: Nomi Health Commercial |
$351.78
|
| Rate for Payer: PHP Commercial |
$364.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health HMO/PPO |
$373.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.52
|
| Rate for Payer: UHC Core |
$358.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.75
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
OP
|
$429.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$101.89 |
| Max. Negotiated Rate |
$469.38 |
| Rate for Payer: Aetna Commercial |
$364.65
|
| Rate for Payer: Aetna Medicare |
$111.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.06
|
| Rate for Payer: BCBS Complete |
$469.38
|
| Rate for Payer: BCBS MAPPO |
$107.25
|
| Rate for Payer: BCBS Trust/PPO |
$352.68
|
| Rate for Payer: BCN Commercial |
$333.55
|
| Rate for Payer: BCN Medicare Advantage |
$107.25
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$368.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.25
|
| Rate for Payer: Healthscope Commercial |
$386.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.75
|
| Rate for Payer: Mclaren Medicaid |
$447.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.61
|
| Rate for Payer: Meridian Medicaid |
$469.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.65
|
| Rate for Payer: Nomi Health Commercial |
$351.78
|
| Rate for Payer: PACE Senior Care Partners |
$101.89
|
| Rate for Payer: PACE SWMI |
$107.25
|
| Rate for Payer: PHP Commercial |
$364.65
|
| Rate for Payer: PHP Medicare Advantage |
$107.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health HMO/PPO |
$373.23
|
| Rate for Payer: Priority Health Medicare |
$108.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.43
|
| Rate for Payer: Railroad Medicare Medicare |
$107.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.52
|
| Rate for Payer: UHC Core |
$358.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.25
|
| Rate for Payer: UHC Exchange |
$107.25
|
| Rate for Payer: UHC Medicare Advantage |
$107.25
|
| Rate for Payer: UHCCP Medicaid |
$447.00
|
| Rate for Payer: VA VA |
$107.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.75
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$429.00
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$278.85 |
| Rate for Payer: Aetna Commercial |
$172.97
|
| Rate for Payer: Aetna Medicare |
$134.24
|
| Rate for Payer: BCBS Complete |
$171.60
|
| Rate for Payer: BCBS MAPPO |
$129.08
|
| Rate for Payer: BCN Medicare Advantage |
$129.08
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$185.88
|
| Rate for Payer: Cofinity Commercial |
$172.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.53
|
| Rate for Payer: Nomi Health Commercial |
$154.90
|
| Rate for Payer: PACE SWMI |
$129.08
|
| Rate for Payer: PHP Medicare Advantage |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health Medicare |
$130.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.08
|
| Rate for Payer: UHC Exchange |
$129.08
|
| Rate for Payer: UHC Medicare Advantage |
$129.08
|
|
