|
PR SHOE LIFTS ELEVATION HEEL /I
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS L3334
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$66.17 |
| Rate for Payer: Aetna Commercial |
$61.57
|
| Rate for Payer: Aetna Medicare |
$47.79
|
| Rate for Payer: BCBS Complete |
$26.00
|
| Rate for Payer: BCBS MAPPO |
$45.95
|
| Rate for Payer: BCN Medicare Advantage |
$45.95
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$66.17
|
| Rate for Payer: Cofinity Commercial |
$61.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.25
|
| Rate for Payer: Nomi Health Commercial |
$55.14
|
| Rate for Payer: PACE SWMI |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.25
|
| Rate for Payer: Priority Health Medicare |
$46.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.95
|
| Rate for Payer: UHC Exchange |
$45.95
|
| Rate for Payer: UHC Medicare Advantage |
$45.95
|
|
|
PR SHORTENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,208.00
|
|
|
Service Code
|
HCPCS 26477
|
| Min. Negotiated Rate |
$483.20 |
| Max. Negotiated Rate |
$842.49 |
| Rate for Payer: Aetna Commercial |
$783.98
|
| Rate for Payer: Aetna Medicare |
$608.46
|
| Rate for Payer: BCBS Complete |
$483.20
|
| Rate for Payer: BCBS MAPPO |
$585.06
|
| Rate for Payer: BCN Medicare Advantage |
$585.06
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cash Price |
$966.40
|
| Rate for Payer: Cofinity Commercial |
$842.49
|
| Rate for Payer: Cofinity Commercial |
$783.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.31
|
| Rate for Payer: Nomi Health Commercial |
$702.07
|
| Rate for Payer: PACE SWMI |
$585.06
|
| Rate for Payer: PHP Medicare Advantage |
$585.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.20
|
| Rate for Payer: Priority Health Medicare |
$590.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.06
|
| Rate for Payer: UHC Exchange |
$585.06
|
| Rate for Payer: UHC Medicare Advantage |
$585.06
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 95926
|
| Min. Negotiated Rate |
$126.04 |
| Max. Negotiated Rate |
$206.05 |
| Rate for Payer: Aetna Commercial |
$168.89
|
| Rate for Payer: Aetna Medicare |
$131.08
|
| Rate for Payer: BCBS Complete |
$126.80
|
| Rate for Payer: BCBS MAPPO |
$126.04
|
| Rate for Payer: BCN Medicare Advantage |
$126.04
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$181.50
|
| Rate for Payer: Cofinity Commercial |
$168.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.34
|
| Rate for Payer: Nomi Health Commercial |
$151.25
|
| Rate for Payer: PACE SWMI |
$126.04
|
| Rate for Payer: PHP Medicare Advantage |
$126.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health Medicare |
$127.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.04
|
| Rate for Payer: UHC Exchange |
$126.04
|
| Rate for Payer: UHC Medicare Advantage |
$126.04
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 95927
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$227.45 |
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Medicare |
$164.27
|
| Rate for Payer: Aetna Medicare |
$164.27
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS Complete |
$115.20
|
| Rate for Payer: BCBS MAPPO |
$157.95
|
| Rate for Payer: BCBS MAPPO |
$157.95
|
| Rate for Payer: BCN Medicare Advantage |
$157.95
|
| Rate for Payer: BCN Medicare Advantage |
$157.95
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Cofinity Commercial |
$211.65
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Cofinity Commercial |
$211.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.85
|
| Rate for Payer: Nomi Health Commercial |
$189.54
|
| Rate for Payer: Nomi Health Commercial |
$189.54
|
| Rate for Payer: PACE SWMI |
$157.95
|
| Rate for Payer: PACE SWMI |
$157.95
|
| Rate for Payer: PHP Medicare Advantage |
$157.95
|
| Rate for Payer: PHP Medicare Advantage |
$157.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.20
|
| Rate for Payer: Priority Health Medicare |
$159.53
|
| Rate for Payer: Priority Health Medicare |
$159.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.95
|
| Rate for Payer: UHC Exchange |
$157.95
|
| Rate for Payer: UHC Exchange |
$157.95
|
| Rate for Payer: UHC Medicare Advantage |
$157.95
|
| Rate for Payer: UHC Medicare Advantage |
$157.95
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 95925
|
| Min. Negotiated Rate |
$130.80 |
| Max. Negotiated Rate |
$212.55 |
| Rate for Payer: Aetna Commercial |
$184.40
|
| Rate for Payer: Aetna Medicare |
$143.11
|
| Rate for Payer: BCBS Complete |
$130.80
|
| Rate for Payer: BCBS MAPPO |
$137.61
|
| Rate for Payer: BCN Medicare Advantage |
$137.61
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$198.16
|
| Rate for Payer: Cofinity Commercial |
$184.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.49
|
| Rate for Payer: Nomi Health Commercial |
$165.13
|
| Rate for Payer: PACE SWMI |
$137.61
|
| Rate for Payer: PHP Medicare Advantage |
$137.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.55
|
| Rate for Payer: Priority Health Medicare |
$138.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.61
|
| Rate for Payer: UHC Exchange |
$137.61
|
| Rate for Payer: UHC Medicare Advantage |
$137.61
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 95938
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$478.53 |
| Rate for Payer: Aetna Commercial |
$445.30
|
| Rate for Payer: Aetna Medicare |
$345.60
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$332.31
|
| Rate for Payer: BCN Medicare Advantage |
$332.31
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$478.53
|
| Rate for Payer: Cofinity Commercial |
$445.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.93
|
| Rate for Payer: Nomi Health Commercial |
$398.77
|
| Rate for Payer: PACE SWMI |
$332.31
|
| Rate for Payer: PHP Medicare Advantage |
$332.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$335.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.31
|
| Rate for Payer: UHC Exchange |
$332.31
|
| Rate for Payer: UHC Medicare Advantage |
$332.31
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 11311
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$120.25 |
| Rate for Payer: Aetna Commercial |
$79.96
|
| Rate for Payer: Aetna Medicare |
$62.06
|
| Rate for Payer: BCBS Complete |
$74.00
|
| Rate for Payer: BCBS MAPPO |
$59.67
|
| Rate for Payer: BCN Medicare Advantage |
$59.67
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$85.92
|
| Rate for Payer: Cofinity Commercial |
$79.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.65
|
| Rate for Payer: Nomi Health Commercial |
$71.60
|
| Rate for Payer: PACE SWMI |
$59.67
|
| Rate for Payer: PHP Medicare Advantage |
$59.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health Medicare |
$60.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.67
|
| Rate for Payer: UHC Exchange |
$59.67
|
| Rate for Payer: UHC Medicare Advantage |
$59.67
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 11312
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$172.90 |
| Rate for Payer: Aetna Commercial |
$94.78
|
| Rate for Payer: Aetna Medicare |
$73.56
|
| Rate for Payer: BCBS Complete |
$106.40
|
| Rate for Payer: BCBS MAPPO |
$70.73
|
| Rate for Payer: BCN Medicare Advantage |
$70.73
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$94.78
|
| Rate for Payer: Cofinity Commercial |
$101.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.27
|
| Rate for Payer: Nomi Health Commercial |
$84.88
|
| Rate for Payer: PACE SWMI |
$70.73
|
| Rate for Payer: PHP Medicare Advantage |
$70.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health Medicare |
$71.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.73
|
| Rate for Payer: UHC Exchange |
$70.73
|
| Rate for Payer: UHC Medicare Advantage |
$70.73
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$198.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$128.70 |
| Max. Negotiated Rate |
$178.20 |
| Rate for Payer: Aetna Commercial |
$168.30
|
| Rate for Payer: BCBS Trust/PPO |
$161.63
|
| Rate for Payer: BCN Commercial |
$153.01
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$170.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$178.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.30
|
| Rate for Payer: Nomi Health Commercial |
$162.36
|
| Rate for Payer: PHP Commercial |
$168.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health HMO/PPO |
$172.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.24
|
| Rate for Payer: UHC Core |
$165.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.50
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 11301
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Aetna Commercial |
$65.42
|
| Rate for Payer: Aetna Medicare |
$50.77
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$48.82
|
| Rate for Payer: BCN Medicare Advantage |
$48.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$70.30
|
| Rate for Payer: Cofinity Commercial |
$65.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.26
|
| Rate for Payer: Nomi Health Commercial |
$58.58
|
| Rate for Payer: PACE SWMI |
$48.82
|
| Rate for Payer: PHP Medicare Advantage |
$48.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$49.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.82
|
| Rate for Payer: UHC Exchange |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$48.82
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 11301
|
| Hospital Charge Code |
11301
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Aetna Commercial |
$65.42
|
| Rate for Payer: Aetna Medicare |
$50.77
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$48.82
|
| Rate for Payer: BCN Medicare Advantage |
$48.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$70.30
|
| Rate for Payer: Cofinity Commercial |
$65.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.26
|
| Rate for Payer: Nomi Health Commercial |
$58.58
|
| Rate for Payer: PACE SWMI |
$48.82
|
| Rate for Payer: PHP Medicare Advantage |
$48.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$49.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.82
|
| Rate for Payer: UHC Exchange |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$48.82
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$198.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$47.02 |
| Max. Negotiated Rate |
$178.20 |
| Rate for Payer: Aetna Commercial |
$168.30
|
| Rate for Payer: Aetna Medicare |
$51.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.88
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$49.50
|
| Rate for Payer: BCBS Trust/PPO |
$162.78
|
| Rate for Payer: BCN Commercial |
$153.94
|
| Rate for Payer: BCN Medicare Advantage |
$49.50
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$170.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.50
|
| Rate for Payer: Healthscope Commercial |
$178.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.50
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.98
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.30
|
| Rate for Payer: Nomi Health Commercial |
$162.36
|
| Rate for Payer: PACE Senior Care Partners |
$47.02
|
| Rate for Payer: PACE SWMI |
$49.50
|
| Rate for Payer: PHP Commercial |
$168.30
|
| Rate for Payer: PHP Medicare Advantage |
$49.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health HMO/PPO |
$172.26
|
| Rate for Payer: Priority Health Medicare |
$49.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.66
|
| Rate for Payer: Railroad Medicare Medicare |
$49.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.24
|
| Rate for Payer: UHC Core |
$165.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.50
|
| Rate for Payer: UHC Exchange |
$49.50
|
| Rate for Payer: UHC Medicare Advantage |
$49.50
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$49.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.50
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$257.00
|
|
|
Service Code
|
HCPCS 11303
|
| Min. Negotiated Rate |
$67.93 |
| Max. Negotiated Rate |
$167.05 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$70.65
|
| Rate for Payer: BCBS Complete |
$102.80
|
| Rate for Payer: BCBS MAPPO |
$67.93
|
| Rate for Payer: BCN Medicare Advantage |
$67.93
|
| Rate for Payer: Cash Price |
$205.60
|
| Rate for Payer: Cash Price |
$205.60
|
| Rate for Payer: Cofinity Commercial |
$97.82
|
| Rate for Payer: Cofinity Commercial |
$91.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.33
|
| Rate for Payer: Nomi Health Commercial |
$81.52
|
| Rate for Payer: PACE SWMI |
$67.93
|
| Rate for Payer: PHP Medicare Advantage |
$67.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.05
|
| Rate for Payer: Priority Health Medicare |
$68.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.93
|
| Rate for Payer: UHC Exchange |
$67.93
|
| Rate for Payer: UHC Medicare Advantage |
$67.93
|
|
|
PR SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 11302
|
| Min. Negotiated Rate |
$56.79 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Aetna Commercial |
$76.10
|
| Rate for Payer: Aetna Medicare |
$59.06
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: BCBS MAPPO |
$56.79
|
| Rate for Payer: BCN Medicare Advantage |
$56.79
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$81.78
|
| Rate for Payer: Cofinity Commercial |
$76.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.63
|
| Rate for Payer: Nomi Health Commercial |
$68.15
|
| Rate for Payer: PACE SWMI |
$56.79
|
| Rate for Payer: PHP Medicare Advantage |
$56.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
| Rate for Payer: Priority Health Medicare |
$57.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.79
|
| Rate for Payer: UHC Exchange |
$56.79
|
| Rate for Payer: UHC Medicare Advantage |
$56.79
|
|
|
PR SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL
|
Professional
|
Both
|
$782.00
|
|
|
Service Code
|
HCPCS 42340
|
| Min. Negotiated Rate |
$312.80 |
| Max. Negotiated Rate |
$508.30 |
| Rate for Payer: Aetna Commercial |
$440.03
|
| Rate for Payer: Aetna Medicare |
$341.52
|
| Rate for Payer: BCBS Complete |
$312.80
|
| Rate for Payer: BCBS MAPPO |
$328.38
|
| Rate for Payer: BCN Medicare Advantage |
$328.38
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cofinity Commercial |
$472.87
|
| Rate for Payer: Cofinity Commercial |
$440.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.80
|
| Rate for Payer: Nomi Health Commercial |
$394.06
|
| Rate for Payer: PACE SWMI |
$328.38
|
| Rate for Payer: PHP Medicare Advantage |
$328.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.30
|
| Rate for Payer: Priority Health Medicare |
$331.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
| Rate for Payer: UHC Medicare Advantage |
$328.38
|
|
|
PR SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL
|
Professional
|
Both
|
$1,021.00
|
|
|
Service Code
|
HCPCS 42335
|
| Min. Negotiated Rate |
$251.27 |
| Max. Negotiated Rate |
$663.65 |
| Rate for Payer: Aetna Commercial |
$336.70
|
| Rate for Payer: Aetna Medicare |
$261.32
|
| Rate for Payer: BCBS Complete |
$408.40
|
| Rate for Payer: BCBS MAPPO |
$251.27
|
| Rate for Payer: BCN Medicare Advantage |
$251.27
|
| Rate for Payer: Cash Price |
$816.80
|
| Rate for Payer: Cash Price |
$816.80
|
| Rate for Payer: Cofinity Commercial |
$361.83
|
| Rate for Payer: Cofinity Commercial |
$336.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.83
|
| Rate for Payer: Nomi Health Commercial |
$301.52
|
| Rate for Payer: PACE SWMI |
$251.27
|
| Rate for Payer: PHP Medicare Advantage |
$251.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.65
|
| Rate for Payer: Priority Health Medicare |
$253.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.27
|
| Rate for Payer: UHC Exchange |
$251.27
|
| Rate for Payer: UHC Medicare Advantage |
$251.27
|
|
|
PR SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS 42330
|
| Min. Negotiated Rate |
$156.98 |
| Max. Negotiated Rate |
$272.35 |
| Rate for Payer: Aetna Commercial |
$210.35
|
| Rate for Payer: Aetna Medicare |
$163.26
|
| Rate for Payer: BCBS Complete |
$167.60
|
| Rate for Payer: BCBS MAPPO |
$156.98
|
| Rate for Payer: BCN Medicare Advantage |
$156.98
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Cofinity Commercial |
$210.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.83
|
| Rate for Payer: Nomi Health Commercial |
$188.38
|
| Rate for Payer: PACE SWMI |
$156.98
|
| Rate for Payer: PHP Medicare Advantage |
$156.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.35
|
| Rate for Payer: Priority Health Medicare |
$158.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.98
|
| Rate for Payer: UHC Exchange |
$156.98
|
| Rate for Payer: UHC Medicare Advantage |
$156.98
|
|
|
PR SIGMOIDOSCOPY,ABLATE LESN
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45339
|
| Min. Negotiated Rate |
$300.40 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Medicare |
$375.50
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
|
|
PR SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 45346
|
| Min. Negotiated Rate |
$151.03 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Aetna Commercial |
$202.38
|
| Rate for Payer: Aetna Medicare |
$157.07
|
| Rate for Payer: BCBS Complete |
$302.40
|
| Rate for Payer: BCBS MAPPO |
$151.03
|
| Rate for Payer: BCN Medicare Advantage |
$151.03
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$217.48
|
| Rate for Payer: Cofinity Commercial |
$202.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.58
|
| Rate for Payer: Nomi Health Commercial |
$181.24
|
| Rate for Payer: PACE SWMI |
$151.03
|
| Rate for Payer: PHP Medicare Advantage |
$151.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health Medicare |
$152.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.03
|
| Rate for Payer: UHC Exchange |
$151.03
|
| Rate for Payer: UHC Medicare Advantage |
$151.03
|
|
|
PR SIGMOIDOSCOPY FLX CONTROL BLEEDING
|
Professional
|
Both
|
$667.00
|
|
|
Service Code
|
HCPCS 45334
|
| Min. Negotiated Rate |
$110.63 |
| Max. Negotiated Rate |
$433.55 |
| Rate for Payer: Aetna Commercial |
$148.24
|
| Rate for Payer: Aetna Medicare |
$115.06
|
| Rate for Payer: BCBS Complete |
$266.80
|
| Rate for Payer: BCBS MAPPO |
$110.63
|
| Rate for Payer: BCN Medicare Advantage |
$110.63
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$159.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.16
|
| Rate for Payer: Nomi Health Commercial |
$132.76
|
| Rate for Payer: PACE SWMI |
$110.63
|
| Rate for Payer: PHP Medicare Advantage |
$110.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.55
|
| Rate for Payer: Priority Health Medicare |
$111.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.63
|
| Rate for Payer: UHC Exchange |
$110.63
|
| Rate for Payer: UHC Medicare Advantage |
$110.63
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 45330
|
| Hospital Charge Code |
45330
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$161.85 |
| Rate for Payer: Aetna Commercial |
$72.24
|
| Rate for Payer: Aetna Medicare |
$56.07
|
| Rate for Payer: BCBS Complete |
$99.60
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$77.63
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Nomi Health Commercial |
$64.69
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health Medicare |
$54.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.91
|
| Rate for Payer: UHC Exchange |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$59.14 |
| Max. Negotiated Rate |
$692.17 |
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Medicare |
$64.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.81
|
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: BCBS MAPPO |
$62.25
|
| Rate for Payer: BCBS Trust/PPO |
$204.70
|
| Rate for Payer: BCN Commercial |
$193.60
|
| Rate for Payer: BCN Medicare Advantage |
$62.25
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$214.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.25
|
| Rate for Payer: Healthscope Commercial |
$224.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.75
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.36
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.65
|
| Rate for Payer: Nomi Health Commercial |
$204.18
|
| Rate for Payer: PACE Senior Care Partners |
$59.14
|
| Rate for Payer: PACE SWMI |
$62.25
|
| Rate for Payer: PHP Commercial |
$211.65
|
| Rate for Payer: PHP Medicare Advantage |
$62.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health HMO/PPO |
$216.63
|
| Rate for Payer: Priority Health Medicare |
$62.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.83
|
| Rate for Payer: Railroad Medicare Medicare |
$62.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.12
|
| Rate for Payer: UHC Core |
$207.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.25
|
| Rate for Payer: UHC Exchange |
$62.25
|
| Rate for Payer: UHC Medicare Advantage |
$62.25
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
| Rate for Payer: VA VA |
$62.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.75
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
IP
|
$249.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$161.85 |
| Max. Negotiated Rate |
$224.10 |
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: BCBS Trust/PPO |
$203.26
|
| Rate for Payer: BCN Commercial |
$192.43
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$214.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.20
|
| Rate for Payer: Healthscope Commercial |
$224.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.65
|
| Rate for Payer: Nomi Health Commercial |
$204.18
|
| Rate for Payer: PHP Commercial |
$211.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health HMO/PPO |
$216.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.12
|
| Rate for Payer: UHC Core |
$207.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.75
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 45330
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$161.85 |
| Rate for Payer: Aetna Commercial |
$72.24
|
| Rate for Payer: Aetna Medicare |
$56.07
|
| Rate for Payer: BCBS Complete |
$99.60
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$77.63
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Nomi Health Commercial |
$64.69
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health Medicare |
$54.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.91
|
| Rate for Payer: UHC Exchange |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
|
|
PR SIGMOIDOSCOPY FLX NDSC US XM
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 45341
|
| Min. Negotiated Rate |
$116.66 |
| Max. Negotiated Rate |
$193.05 |
| Rate for Payer: Aetna Commercial |
$156.32
|
| Rate for Payer: Aetna Medicare |
$121.33
|
| Rate for Payer: BCBS Complete |
$118.80
|
| Rate for Payer: BCBS MAPPO |
$116.66
|
| Rate for Payer: BCN Medicare Advantage |
$116.66
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$167.99
|
| Rate for Payer: Cofinity Commercial |
$156.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.49
|
| Rate for Payer: Nomi Health Commercial |
$139.99
|
| Rate for Payer: PACE SWMI |
$116.66
|
| Rate for Payer: PHP Medicare Advantage |
$116.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.05
|
| Rate for Payer: Priority Health Medicare |
$117.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.66
|
| Rate for Payer: UHC Exchange |
$116.66
|
| Rate for Payer: UHC Medicare Advantage |
$116.66
|
|
