|
PR SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 97535
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$43.99 |
| Rate for Payer: Aetna Commercial |
$40.94
|
| Rate for Payer: Aetna Medicare |
$31.77
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$30.55
|
| Rate for Payer: BCN Medicare Advantage |
$30.55
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$43.99
|
| Rate for Payer: Cofinity Commercial |
$40.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.08
|
| Rate for Payer: Nomi Health Commercial |
$36.66
|
| Rate for Payer: PACE SWMI |
$30.55
|
| Rate for Payer: PHP Medicare Advantage |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.55
|
| Rate for Payer: UHC Exchange |
$30.55
|
| Rate for Payer: UHC Medicare Advantage |
$30.55
|
|
|
PR SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 92060
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$84.15 |
| Rate for Payer: Aetna Commercial |
$78.31
|
| Rate for Payer: Aetna Medicare |
$60.78
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$58.44
|
| Rate for Payer: BCN Medicare Advantage |
$58.44
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$84.15
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.36
|
| Rate for Payer: Nomi Health Commercial |
$70.13
|
| Rate for Payer: PACE SWMI |
$58.44
|
| Rate for Payer: PHP Medicare Advantage |
$58.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Medicare |
$59.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.44
|
| Rate for Payer: UHC Exchange |
$58.44
|
| Rate for Payer: UHC Medicare Advantage |
$58.44
|
|
|
PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF
|
Professional
|
Both
|
$1,820.00
|
|
|
Service Code
|
HCPCS 30520
|
| Min. Negotiated Rate |
$624.37 |
| Max. Negotiated Rate |
$1,183.00 |
| Rate for Payer: Aetna Commercial |
$836.66
|
| Rate for Payer: Aetna Commercial |
$836.66
|
| Rate for Payer: Aetna Medicare |
$649.34
|
| Rate for Payer: Aetna Medicare |
$649.34
|
| Rate for Payer: BCBS Complete |
$728.00
|
| Rate for Payer: BCBS Complete |
$1,264.80
|
| Rate for Payer: BCBS MAPPO |
$624.37
|
| Rate for Payer: BCBS MAPPO |
$624.37
|
| Rate for Payer: BCN Medicare Advantage |
$624.37
|
| Rate for Payer: BCN Medicare Advantage |
$624.37
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cash Price |
$1,456.00
|
| Rate for Payer: Cash Price |
$1,456.00
|
| Rate for Payer: Cofinity Commercial |
$899.09
|
| Rate for Payer: Cofinity Commercial |
$836.66
|
| Rate for Payer: Cofinity Commercial |
$899.09
|
| Rate for Payer: Cofinity Commercial |
$836.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.59
|
| Rate for Payer: Nomi Health Commercial |
$749.24
|
| Rate for Payer: Nomi Health Commercial |
$749.24
|
| Rate for Payer: PACE SWMI |
$624.37
|
| Rate for Payer: PACE SWMI |
$624.37
|
| Rate for Payer: PHP Medicare Advantage |
$624.37
|
| Rate for Payer: PHP Medicare Advantage |
$624.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
| Rate for Payer: Priority Health Medicare |
$630.61
|
| Rate for Payer: Priority Health Medicare |
$630.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.37
|
| Rate for Payer: UHC Exchange |
$624.37
|
| Rate for Payer: UHC Exchange |
$624.37
|
| Rate for Payer: UHC Medicare Advantage |
$624.37
|
| Rate for Payer: UHC Medicare Advantage |
$624.37
|
|
|
PR SEQUESTRECTOMY FOREARM &/WRIST
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
HCPCS 25145
|
| Min. Negotiated Rate |
$505.88 |
| Max. Negotiated Rate |
$1,467.05 |
| Rate for Payer: Aetna Commercial |
$677.88
|
| Rate for Payer: Aetna Medicare |
$526.12
|
| Rate for Payer: BCBS Complete |
$902.80
|
| Rate for Payer: BCBS MAPPO |
$505.88
|
| Rate for Payer: BCN Medicare Advantage |
$505.88
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cofinity Commercial |
$728.47
|
| Rate for Payer: Cofinity Commercial |
$677.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.17
|
| Rate for Payer: Nomi Health Commercial |
$607.06
|
| Rate for Payer: PACE SWMI |
$505.88
|
| Rate for Payer: PHP Medicare Advantage |
$505.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.05
|
| Rate for Payer: Priority Health Medicare |
$510.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.88
|
| Rate for Payer: UHC Exchange |
$505.88
|
| Rate for Payer: UHC Medicare Advantage |
$505.88
|
|
|
PR SEQUESTRECTOMY SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 24134
|
| Min. Negotiated Rate |
$724.18 |
| Max. Negotiated Rate |
$1,443.00 |
| Rate for Payer: Aetna Commercial |
$970.40
|
| Rate for Payer: Aetna Medicare |
$753.15
|
| Rate for Payer: BCBS Complete |
$888.00
|
| Rate for Payer: BCBS MAPPO |
$724.18
|
| Rate for Payer: BCN Medicare Advantage |
$724.18
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$970.40
|
| Rate for Payer: Cofinity Commercial |
$1,042.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$760.39
|
| Rate for Payer: Nomi Health Commercial |
$869.02
|
| Rate for Payer: PACE SWMI |
$724.18
|
| Rate for Payer: PHP Medicare Advantage |
$724.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health Medicare |
$731.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.18
|
| Rate for Payer: UHC Exchange |
$724.18
|
| Rate for Payer: UHC Medicare Advantage |
$724.18
|
|
|
PR SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 99050
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
|
|
PR SESAMOIDECTOMY FIRST TOE SPX
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
HCPCS 28315
|
| Min. Negotiated Rate |
$312.80 |
| Max. Negotiated Rate |
$577.85 |
| Rate for Payer: Aetna Commercial |
$419.15
|
| Rate for Payer: Aetna Medicare |
$325.31
|
| Rate for Payer: BCBS Complete |
$355.60
|
| Rate for Payer: BCBS MAPPO |
$312.80
|
| Rate for Payer: BCN Medicare Advantage |
$312.80
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cofinity Commercial |
$450.43
|
| Rate for Payer: Cofinity Commercial |
$419.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.44
|
| Rate for Payer: Nomi Health Commercial |
$375.36
|
| Rate for Payer: PACE SWMI |
$312.80
|
| Rate for Payer: PHP Medicare Advantage |
$312.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.85
|
| Rate for Payer: Priority Health Medicare |
$315.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.80
|
| Rate for Payer: UHC Exchange |
$312.80
|
| Rate for Payer: UHC Medicare Advantage |
$312.80
|
|
|
PR SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,680.00
|
|
|
Service Code
|
HCPCS 26185
|
| Min. Negotiated Rate |
$540.89 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna Commercial |
$724.79
|
| Rate for Payer: Aetna Medicare |
$562.53
|
| Rate for Payer: BCBS Complete |
$672.00
|
| Rate for Payer: BCBS MAPPO |
$540.89
|
| Rate for Payer: BCN Medicare Advantage |
$540.89
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cofinity Commercial |
$724.79
|
| Rate for Payer: Cofinity Commercial |
$778.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$567.93
|
| Rate for Payer: Nomi Health Commercial |
$649.07
|
| Rate for Payer: PACE SWMI |
$540.89
|
| Rate for Payer: PHP Medicare Advantage |
$540.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.00
|
| Rate for Payer: Priority Health Medicare |
$546.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$540.89
|
| Rate for Payer: UHC Exchange |
$540.89
|
| Rate for Payer: UHC Medicare Advantage |
$540.89
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$422.50 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: BCBS Trust/PPO |
$530.60
|
| Rate for Payer: BCN Commercial |
$502.32
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.50
|
| Rate for Payer: Nomi Health Commercial |
$533.00
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO |
$565.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.00
|
| Rate for Payer: UHC Core |
$542.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 45335
|
| Min. Negotiated Rate |
$63.87 |
| Max. Negotiated Rate |
$422.50 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Nomi Health Commercial |
$76.64
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health Medicare |
$64.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Exchange |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$650.00
|
|
|
Service Code
|
HCPCS 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$63.87 |
| Max. Negotiated Rate |
$422.50 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: BCBS Complete |
$260.00
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Nomi Health Commercial |
$76.64
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health Medicare |
$64.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Exchange |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$154.38 |
| Max. Negotiated Rate |
$692.17 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna Medicare |
$169.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$203.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$203.12
|
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: BCBS MAPPO |
$162.50
|
| Rate for Payer: BCBS Trust/PPO |
$534.37
|
| Rate for Payer: BCN Commercial |
$505.38
|
| Rate for Payer: BCN Medicare Advantage |
$162.50
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.50
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.62
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.50
|
| Rate for Payer: Nomi Health Commercial |
$533.00
|
| Rate for Payer: PACE Senior Care Partners |
$154.38
|
| Rate for Payer: PACE SWMI |
$162.50
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: PHP Medicare Advantage |
$162.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.50
|
| Rate for Payer: Priority Health HMO/PPO |
$565.50
|
| Rate for Payer: Priority Health Medicare |
$164.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.50
|
| Rate for Payer: Railroad Medicare Medicare |
$162.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.00
|
| Rate for Payer: UHC Core |
$542.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.50
|
| Rate for Payer: UHC Exchange |
$162.50
|
| Rate for Payer: UHC Medicare Advantage |
$162.50
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
| Rate for Payer: VA VA |
$162.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$488.15 |
| Max. Negotiated Rate |
$675.90 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: BCBS Trust/PPO |
$613.04
|
| Rate for Payer: BCN Commercial |
$580.37
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$615.82
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$653.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.88
|
| Rate for Payer: UHC Core |
$627.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.25
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45338
|
| Min. Negotiated Rate |
$113.68 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$118.23
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$113.68
|
| Rate for Payer: BCN Medicare Advantage |
$113.68
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$152.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.36
|
| Rate for Payer: Nomi Health Commercial |
$136.42
|
| Rate for Payer: PACE SWMI |
$113.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$114.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.68
|
| Rate for Payer: UHC Exchange |
$113.68
|
| Rate for Payer: UHC Medicare Advantage |
$113.68
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$113.68 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$152.33
|
| Rate for Payer: Aetna Medicare |
$118.23
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$113.68
|
| Rate for Payer: BCN Medicare Advantage |
$113.68
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Commercial |
$152.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.36
|
| Rate for Payer: Nomi Health Commercial |
$136.42
|
| Rate for Payer: PACE SWMI |
$113.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$114.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.68
|
| Rate for Payer: UHC Exchange |
$113.68
|
| Rate for Payer: UHC Medicare Advantage |
$113.68
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$178.36 |
| Max. Negotiated Rate |
$895.16 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna Medicare |
$195.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$234.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$234.69
|
| Rate for Payer: BCBS Complete |
$895.16
|
| Rate for Payer: BCBS MAPPO |
$187.75
|
| Rate for Payer: BCBS Trust/PPO |
$617.40
|
| Rate for Payer: BCN Commercial |
$583.90
|
| Rate for Payer: BCN Medicare Advantage |
$187.75
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.75
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.25
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.14
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$615.82
|
| Rate for Payer: PACE Senior Care Partners |
$178.36
|
| Rate for Payer: PACE SWMI |
$187.75
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: PHP Medicare Advantage |
$187.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$653.37
|
| Rate for Payer: Priority Health Medicare |
$189.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.17
|
| Rate for Payer: Railroad Medicare Medicare |
$187.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.88
|
| Rate for Payer: UHC Core |
$627.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.75
|
| Rate for Payer: UHC Exchange |
$187.75
|
| Rate for Payer: UHC Medicare Advantage |
$187.75
|
| Rate for Payer: UHCCP Medicaid |
$852.47
|
| Rate for Payer: VA VA |
$187.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.25
|
|
|
PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
HCPCS 45337
|
| Min. Negotiated Rate |
$108.23 |
| Max. Negotiated Rate |
$393.90 |
| Rate for Payer: Aetna Commercial |
$145.03
|
| Rate for Payer: Aetna Medicare |
$112.56
|
| Rate for Payer: BCBS Complete |
$242.40
|
| Rate for Payer: BCBS MAPPO |
$108.23
|
| Rate for Payer: BCN Medicare Advantage |
$108.23
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cofinity Commercial |
$155.85
|
| Rate for Payer: Cofinity Commercial |
$145.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.64
|
| Rate for Payer: Nomi Health Commercial |
$129.88
|
| Rate for Payer: PACE SWMI |
$108.23
|
| Rate for Payer: PHP Medicare Advantage |
$108.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.90
|
| Rate for Payer: Priority Health Medicare |
$109.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.23
|
| Rate for Payer: UHC Exchange |
$108.23
|
| Rate for Payer: UHC Medicare Advantage |
$108.23
|
|
|
PR SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 45349
|
| Min. Negotiated Rate |
$146.00 |
| Max. Negotiated Rate |
$268.37 |
| Rate for Payer: Aetna Commercial |
$249.74
|
| Rate for Payer: Aetna Medicare |
$193.82
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCBS MAPPO |
$186.37
|
| Rate for Payer: BCN Medicare Advantage |
$186.37
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$268.37
|
| Rate for Payer: Cofinity Commercial |
$249.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.69
|
| Rate for Payer: Nomi Health Commercial |
$223.64
|
| Rate for Payer: PACE SWMI |
$186.37
|
| Rate for Payer: PHP Medicare Advantage |
$186.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health Medicare |
$188.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.37
|
| Rate for Payer: UHC Exchange |
$186.37
|
| Rate for Payer: UHC Medicare Advantage |
$186.37
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 11310
|
| Min. Negotiated Rate |
$42.76 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Commercial |
$57.30
|
| Rate for Payer: Aetna Medicare |
$44.47
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: BCBS MAPPO |
$42.76
|
| Rate for Payer: BCN Medicare Advantage |
$42.76
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$61.57
|
| Rate for Payer: Cofinity Commercial |
$57.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.90
|
| Rate for Payer: Nomi Health Commercial |
$51.31
|
| Rate for Payer: PACE SWMI |
$42.76
|
| Rate for Payer: PHP Medicare Advantage |
$42.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health Medicare |
$43.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.76
|
| Rate for Payer: UHC Exchange |
$42.76
|
| Rate for Payer: UHC Medicare Advantage |
$42.76
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 11313
|
| Min. Negotiated Rate |
$90.64 |
| Max. Negotiated Rate |
$199.55 |
| Rate for Payer: Aetna Commercial |
$121.46
|
| Rate for Payer: Aetna Medicare |
$94.27
|
| Rate for Payer: BCBS Complete |
$122.80
|
| Rate for Payer: BCBS MAPPO |
$90.64
|
| Rate for Payer: BCN Medicare Advantage |
$90.64
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cofinity Commercial |
$130.52
|
| Rate for Payer: Cofinity Commercial |
$121.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.17
|
| Rate for Payer: Nomi Health Commercial |
$108.77
|
| Rate for Payer: PACE SWMI |
$90.64
|
| Rate for Payer: PHP Medicare Advantage |
$90.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.55
|
| Rate for Payer: Priority Health Medicare |
$91.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.64
|
| Rate for Payer: UHC Exchange |
$90.64
|
| Rate for Payer: UHC Medicare Advantage |
$90.64
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 11305
|
| Min. Negotiated Rate |
$35.52 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$36.94
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: Nomi Health Commercial |
$42.62
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$35.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Exchange |
$35.52
|
| Rate for Payer: UHC Medicare Advantage |
$35.52
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 11306
|
| Min. Negotiated Rate |
$46.17 |
| Max. Negotiated Rate |
$130.00 |
| Rate for Payer: Aetna Commercial |
$61.87
|
| Rate for Payer: Aetna Medicare |
$48.02
|
| Rate for Payer: BCBS Complete |
$80.00
|
| Rate for Payer: BCBS MAPPO |
$46.17
|
| Rate for Payer: BCN Medicare Advantage |
$46.17
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$66.48
|
| Rate for Payer: Cofinity Commercial |
$61.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.48
|
| Rate for Payer: Nomi Health Commercial |
$55.40
|
| Rate for Payer: PACE SWMI |
$46.17
|
| Rate for Payer: PHP Medicare Advantage |
$46.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: Priority Health Medicare |
$46.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.17
|
| Rate for Payer: UHC Exchange |
$46.17
|
| Rate for Payer: UHC Medicare Advantage |
$46.17
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 11307
|
| Min. Negotiated Rate |
$58.69 |
| Max. Negotiated Rate |
$154.05 |
| Rate for Payer: Aetna Commercial |
$78.64
|
| Rate for Payer: Aetna Medicare |
$61.04
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS MAPPO |
$58.69
|
| Rate for Payer: BCN Medicare Advantage |
$58.69
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$84.51
|
| Rate for Payer: Cofinity Commercial |
$78.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.62
|
| Rate for Payer: Nomi Health Commercial |
$70.43
|
| Rate for Payer: PACE SWMI |
$58.69
|
| Rate for Payer: PHP Medicare Advantage |
$58.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health Medicare |
$59.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.69
|
| Rate for Payer: UHC Exchange |
$58.69
|
| Rate for Payer: UHC Medicare Advantage |
$58.69
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 11308
|
| Min. Negotiated Rate |
$66.01 |
| Max. Negotiated Rate |
$163.15 |
| Rate for Payer: Aetna Commercial |
$88.45
|
| Rate for Payer: Aetna Medicare |
$68.65
|
| Rate for Payer: BCBS Complete |
$100.40
|
| Rate for Payer: BCBS MAPPO |
$66.01
|
| Rate for Payer: BCN Medicare Advantage |
$66.01
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$95.05
|
| Rate for Payer: Cofinity Commercial |
$88.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.31
|
| Rate for Payer: Nomi Health Commercial |
$79.21
|
| Rate for Payer: PACE SWMI |
$66.01
|
| Rate for Payer: PHP Medicare Advantage |
$66.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health Medicare |
$66.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.01
|
| Rate for Payer: UHC Exchange |
$66.01
|
| Rate for Payer: UHC Medicare Advantage |
$66.01
|
|
|
PR SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 11300
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna Commercial |
$42.88
|
| Rate for Payer: Aetna Medicare |
$33.28
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$32.00
|
| Rate for Payer: BCN Medicare Advantage |
$32.00
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Cofinity Commercial |
$42.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.60
|
| Rate for Payer: Nomi Health Commercial |
$38.40
|
| Rate for Payer: PACE SWMI |
$32.00
|
| Rate for Payer: PHP Medicare Advantage |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Medicare |
$32.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.00
|
| Rate for Payer: UHC Exchange |
$32.00
|
| Rate for Payer: UHC Medicare Advantage |
$32.00
|
|
