|
PR R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I
|
Professional
|
Both
|
$2,862.00
|
|
|
Service Code
|
HCPCS 93461
|
| Min. Negotiated Rate |
$567.45 |
| Max. Negotiated Rate |
$2,003.40 |
| Rate for Payer: Aetna Commercial |
$1,897.18
|
| Rate for Payer: BCBS Complete |
$1,144.80
|
| Rate for Payer: BCBS Trust/PPO |
$716.90
|
| Rate for Payer: Cash Price |
$2,289.60
|
| Rate for Payer: Cash Price |
$2,289.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$567.45
|
| Rate for Payer: Priority Health Narrow Network |
$567.45
|
| Rate for Payer: Priority Health SBD |
$1,941.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,316.52
|
|
|
PR R & L HRT CATH WINJX HRT ART& L VENTR IMG
|
Professional
|
Both
|
$1,205.00
|
|
|
Service Code
|
HCPCS 93460
|
| Min. Negotiated Rate |
$482.00 |
| Max. Negotiated Rate |
$1,760.01 |
| Rate for Payer: Aetna Commercial |
$1,711.27
|
| Rate for Payer: BCBS Complete |
$482.00
|
| Rate for Payer: BCBS Trust/PPO |
$728.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.53
|
| Rate for Payer: Priority Health Narrow Network |
$513.53
|
| Rate for Payer: Priority Health SBD |
$1,760.01
|
| Rate for Payer: UMR Bronson Commercial |
$554.30
|
|
|
PR R & L HRT CATH W/NJX L VENTRICULOG IMG S&I
|
Professional
|
Both
|
$659.00
|
|
|
Service Code
|
HCPCS 93453
|
| Min. Negotiated Rate |
$263.60 |
| Max. Negotiated Rate |
$1,623.83 |
| Rate for Payer: Aetna Commercial |
$1,569.84
|
| Rate for Payer: BCBS Complete |
$263.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,507.77
|
| Rate for Payer: Cash Price |
$527.20
|
| Rate for Payer: Cash Price |
$527.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$434.09
|
| Rate for Payer: Priority Health Narrow Network |
$434.09
|
| Rate for Payer: Priority Health SBD |
$1,623.83
|
| Rate for Payer: UMR Bronson Commercial |
$303.14
|
|
|
PR RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ
|
Professional
|
Both
|
$1,761.00
|
|
|
Service Code
|
HCPCS 33244
|
| Min. Negotiated Rate |
$541.87 |
| Max. Negotiated Rate |
$1,361.27 |
| Rate for Payer: Aetna Commercial |
$1,162.22
|
| Rate for Payer: BCBS Complete |
$568.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.68
|
| Rate for Payer: Cash Price |
$1,408.80
|
| Rate for Payer: Cash Price |
$1,408.80
|
| Rate for Payer: Meridian Medicaid |
$568.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,361.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.27
|
| Rate for Payer: Priority Health SBD |
$1,361.27
|
| Rate for Payer: UMR Bronson Commercial |
$810.06
|
|
|
PR RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA
|
Professional
|
Both
|
$2,431.00
|
|
|
Service Code
|
HCPCS 33974
|
| Min. Negotiated Rate |
$560.40 |
| Max. Negotiated Rate |
$2,513.12 |
| Rate for Payer: Aetna Commercial |
$1,191.43
|
| Rate for Payer: BCBS Complete |
$588.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,513.12
|
| Rate for Payer: Cash Price |
$1,944.80
|
| Rate for Payer: Cash Price |
$1,944.80
|
| Rate for Payer: Meridian Medicaid |
$588.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,394.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,394.26
|
| Rate for Payer: Priority Health SBD |
$1,394.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,118.26
|
|
|
PR RMVL BONE FLAP/PROSTHETIC PLATE SKULL
|
Professional
|
Both
|
$3,305.00
|
|
|
Service Code
|
HCPCS 62142
|
| Min. Negotiated Rate |
$581.92 |
| Max. Negotiated Rate |
$2,313.50 |
| Rate for Payer: Aetna Commercial |
$1,142.27
|
| Rate for Payer: BCBS Complete |
$611.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.75
|
| Rate for Payer: Cash Price |
$2,644.00
|
| Rate for Payer: Cash Price |
$2,644.00
|
| Rate for Payer: Meridian Medicaid |
$611.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$581.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,313.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,529.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.36
|
| Rate for Payer: Priority Health SBD |
$1,529.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,520.30
|
|
|
PR RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT
|
Professional
|
Both
|
$2,164.00
|
|
|
Service Code
|
HCPCS 62256
|
| Min. Negotiated Rate |
$87.02 |
| Max. Negotiated Rate |
$1,514.80 |
| Rate for Payer: Aetna Commercial |
$781.13
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS Trust/PPO |
$87.02
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Cash Price |
$1,731.20
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,514.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.21
|
| Rate for Payer: Priority Health SBD |
$1,049.21
|
| Rate for Payer: UMR Bronson Commercial |
$995.44
|
|
|
PR RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT
|
Professional
|
Both
|
$5,026.00
|
|
|
Service Code
|
HCPCS 62258
|
| Min. Negotiated Rate |
$586.41 |
| Max. Negotiated Rate |
$3,518.20 |
| Rate for Payer: Aetna Commercial |
$1,443.38
|
| Rate for Payer: BCBS Complete |
$761.08
|
| Rate for Payer: BCBS Trust/PPO |
$586.41
|
| Rate for Payer: Cash Price |
$4,020.80
|
| Rate for Payer: Cash Price |
$4,020.80
|
| Rate for Payer: Meridian Medicaid |
$761.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$724.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,518.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,906.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,906.47
|
| Rate for Payer: Priority Health SBD |
$1,906.47
|
| Rate for Payer: UMR Bronson Commercial |
$2,311.96
|
|
|
PR RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 97602
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$917.66 |
| Rate for Payer: Aetna Commercial |
$89.75
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCBS Trust/PPO |
$917.66
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.57
|
| Rate for Payer: Priority Health Narrow Network |
$109.57
|
| Rate for Payer: Priority Health SBD |
$109.57
|
| Rate for Payer: UMR Bronson Commercial |
$67.62
|
|
|
PR RMVL EMBEDDED FB VESTIBULE MOUTH COMP
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 40805
|
| Min. Negotiated Rate |
$126.52 |
| Max. Negotiated Rate |
$526.19 |
| Rate for Payer: Aetna Commercial |
$263.54
|
| Rate for Payer: BCBS Complete |
$132.85
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Meridian Medicaid |
$132.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$345.73
|
| Rate for Payer: Priority Health Narrow Network |
$345.73
|
| Rate for Payer: Priority Health SBD |
$345.73
|
| Rate for Payer: UMR Bronson Commercial |
$317.86
|
|
|
PR RMVL EMBEDDED FB VESTIBULE MOUTH SMPL
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 40804
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: Aetna Commercial |
$149.26
|
| Rate for Payer: BCBS Complete |
$76.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.05
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Meridian Medicaid |
$76.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.74
|
| Rate for Payer: Priority Health Narrow Network |
$198.74
|
| Rate for Payer: Priority Health SBD |
$198.74
|
| Rate for Payer: UMR Bronson Commercial |
$153.18
|
|
|
PR RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT
|
Professional
|
Both
|
$1,625.00
|
|
|
Service Code
|
HCPCS 63746
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,137.50 |
| Rate for Payer: Aetna Commercial |
$781.78
|
| Rate for Payer: BCBS Complete |
$420.68
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Meridian Medicaid |
$420.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,051.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,051.48
|
| Rate for Payer: Priority Health SBD |
$1,051.48
|
| Rate for Payer: UMR Bronson Commercial |
$747.50
|
|
|
PR RMVL FB XTRNL AUDITORY CANAL ANES
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 69205
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$1,749.20 |
| Rate for Payer: Aetna Commercial |
$106.72
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,749.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.79
|
| Rate for Payer: Priority Health Narrow Network |
$135.79
|
| Rate for Payer: Priority Health SBD |
$135.79
|
| Rate for Payer: UMR Bronson Commercial |
$84.64
|
|
|
PR RMVL FB XTRNL AUDITORY CANAL W/O ANES
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 69200
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$1,294.34 |
| Rate for Payer: Aetna Commercial |
$53.13
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,294.34
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.47
|
| Rate for Payer: Priority Health Narrow Network |
$66.47
|
| Rate for Payer: Priority Health SBD |
$66.47
|
| Rate for Payer: UMR Bronson Commercial |
$109.48
|
|
|
PR RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 65220
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$303.77 |
| Rate for Payer: Aetna Commercial |
$55.19
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS Trust/PPO |
$303.77
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.00
|
| Rate for Payer: Priority Health Narrow Network |
$72.00
|
| Rate for Payer: Priority Health SBD |
$72.00
|
| Rate for Payer: UMR Bronson Commercial |
$74.52
|
|
|
PR RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 65222
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$260.45 |
| Rate for Payer: Aetna Commercial |
$66.76
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS Trust/PPO |
$260.45
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.05
|
| Rate for Payer: Priority Health Narrow Network |
$86.05
|
| Rate for Payer: Priority Health SBD |
$86.05
|
| Rate for Payer: UMR Bronson Commercial |
$82.34
|
|
|
PR RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 65210
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$264.15 |
| Rate for Payer: Aetna Commercial |
$48.17
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS Trust/PPO |
$264.15
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.05
|
| Rate for Payer: Priority Health Narrow Network |
$62.05
|
| Rate for Payer: Priority Health SBD |
$62.05
|
| Rate for Payer: UMR Bronson Commercial |
$87.86
|
|
|
PR RMVL FECAL IMPACTION/FB SPX UNDER ANES
|
Professional
|
Both
|
$601.00
|
|
|
Service Code
|
HCPCS 45915
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$1,239.39 |
| Rate for Payer: Aetna Commercial |
$308.27
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.39
|
| Rate for Payer: Cash Price |
$480.80
|
| Rate for Payer: Cash Price |
$480.80
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$403.36
|
| Rate for Payer: Priority Health Narrow Network |
$403.36
|
| Rate for Payer: Priority Health SBD |
$403.36
|
| Rate for Payer: UMR Bronson Commercial |
$276.46
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Facility
|
IP
|
$753.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
20525
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$331.32 |
| Max. Negotiated Rate |
$677.70 |
| Rate for Payer: Aetna American Axle |
$489.45
|
| Rate for Payer: Aetna Commercial |
$640.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.45
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$527.10
|
| Rate for Payer: Cofinity Commercial |
$647.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$602.40
|
| Rate for Payer: Healthscope Commercial |
$677.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$527.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$564.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$640.05
|
| Rate for Payer: PHP Commercial |
$640.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.10
|
| Rate for Payer: Priority Health SBD |
$474.39
|
| Rate for Payer: UMR Bronson Commercial |
$331.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$564.75
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 20525
|
| Hospital Charge Code |
20525
|
| Min. Negotiated Rate |
$158.69 |
| Max. Negotiated Rate |
$527.10 |
| Rate for Payer: Aetna Commercial |
$328.41
|
| Rate for Payer: BCBS Complete |
$166.62
|
| Rate for Payer: BCBS Trust/PPO |
$195.38
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Meridian Medicaid |
$166.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.38
|
| Rate for Payer: Priority Health Narrow Network |
$377.38
|
| Rate for Payer: Priority Health SBD |
$377.38
|
| Rate for Payer: UMR Bronson Commercial |
$346.38
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 20525
|
| Min. Negotiated Rate |
$158.69 |
| Max. Negotiated Rate |
$527.10 |
| Rate for Payer: Aetna Commercial |
$328.41
|
| Rate for Payer: BCBS Complete |
$166.62
|
| Rate for Payer: BCBS Trust/PPO |
$195.38
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Meridian Medicaid |
$166.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.38
|
| Rate for Payer: Priority Health Narrow Network |
$377.38
|
| Rate for Payer: Priority Health SBD |
$377.38
|
| Rate for Payer: UMR Bronson Commercial |
$346.38
|
|
|
PR RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP
|
Facility
|
OP
|
$753.00
|
|
|
Service Code
|
CPT 20525
|
| Hospital Charge Code |
20525
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$243.94 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$489.45
|
| Rate for Payer: Aetna Commercial |
$640.05
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$527.10
|
| Rate for Payer: Cofinity Commercial |
$647.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$602.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$677.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$527.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$564.75
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$640.05
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$640.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$474.39
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$243.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$278.61
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$564.75
|
|
|
PR RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 27086
|
| Min. Negotiated Rate |
$109.70 |
| Max. Negotiated Rate |
$278.60 |
| Rate for Payer: Aetna Commercial |
$222.58
|
| Rate for Payer: BCBS Complete |
$115.18
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Meridian Medicaid |
$115.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.90
|
| Rate for Payer: Priority Health Narrow Network |
$258.90
|
| Rate for Payer: Priority Health SBD |
$258.90
|
| Rate for Payer: UMR Bronson Commercial |
$183.08
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 24200
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$225.40 |
| Rate for Payer: Aetna Commercial |
$187.10
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS Trust/PPO |
$116.23
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.97
|
| Rate for Payer: Priority Health Narrow Network |
$213.97
|
| Rate for Payer: Priority Health SBD |
$213.97
|
| Rate for Payer: UMR Bronson Commercial |
$148.12
|
|
|
PR RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS
|
Facility
|
IP
|
$322.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
24200
|
| Min. Negotiated Rate |
$141.68 |
| Max. Negotiated Rate |
$289.80 |
| Rate for Payer: Aetna American Axle |
$209.30
|
| Rate for Payer: Aetna Commercial |
$273.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.30
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$276.92
|
| Rate for Payer: Cofinity Commercial |
$225.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Healthscope Commercial |
$289.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.70
|
| Rate for Payer: PHP Commercial |
$273.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health SBD |
$202.86
|
| Rate for Payer: UMR Bronson Commercial |
$141.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.50
|
|
