|
PR RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$2,108.00
|
|
|
Service Code
|
HCPCS 50382
|
| Min. Negotiated Rate |
$155.92 |
| Max. Negotiated Rate |
$4,259.15 |
| Rate for Payer: Aetna Commercial |
$326.82
|
| Rate for Payer: BCBS Complete |
$163.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,259.15
|
| Rate for Payer: Cash Price |
$1,686.40
|
| Rate for Payer: Cash Price |
$1,686.40
|
| Rate for Payer: Meridian Medicaid |
$163.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,475.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$397.70
|
| Rate for Payer: Priority Health Narrow Network |
$397.70
|
| Rate for Payer: Priority Health SBD |
$397.70
|
| Rate for Payer: UMR Bronson Commercial |
$969.68
|
|
|
PR RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 53448
|
| Min. Negotiated Rate |
$807.77 |
| Max. Negotiated Rate |
$2,027.97 |
| Rate for Payer: Aetna Commercial |
$1,639.79
|
| Rate for Payer: BCBS Complete |
$848.31
|
| Rate for Payer: BCBS Trust/PPO |
$807.77
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Meridian Medicaid |
$848.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$807.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,027.97
|
| Rate for Payer: Priority Health Narrow Network |
$2,027.97
|
| Rate for Payer: Priority Health SBD |
$2,027.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,196.00
|
|
|
PR RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL
|
Professional
|
Both
|
$2,089.00
|
|
|
Service Code
|
HCPCS 54411
|
| Min. Negotiated Rate |
$653.91 |
| Max. Negotiated Rate |
$3,265.16 |
| Rate for Payer: Aetna Commercial |
$1,326.02
|
| Rate for Payer: BCBS Complete |
$686.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,265.16
|
| Rate for Payer: Cash Price |
$1,671.20
|
| Rate for Payer: Cash Price |
$1,671.20
|
| Rate for Payer: Meridian Medicaid |
$686.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,641.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,641.60
|
| Rate for Payer: Priority Health SBD |
$1,641.60
|
| Rate for Payer: UMR Bronson Commercial |
$960.94
|
|
|
PR RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC
|
Professional
|
Both
|
$2,466.00
|
|
|
Service Code
|
HCPCS 53447
|
| Min. Negotiated Rate |
$512.90 |
| Max. Negotiated Rate |
$1,726.20 |
| Rate for Payer: Aetna Commercial |
$1,035.47
|
| Rate for Payer: BCBS Complete |
$538.54
|
| Rate for Payer: BCBS Trust/PPO |
$790.34
|
| Rate for Payer: Cash Price |
$1,972.80
|
| Rate for Payer: Cash Price |
$1,972.80
|
| Rate for Payer: Meridian Medicaid |
$538.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,726.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,285.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,285.52
|
| Rate for Payer: Priority Health SBD |
$1,285.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,134.36
|
|
|
PR RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD
|
Professional
|
Both
|
$2,245.00
|
|
|
Service Code
|
HCPCS 54417
|
| Min. Negotiated Rate |
$571.69 |
| Max. Negotiated Rate |
$2,176.77 |
| Rate for Payer: Aetna Commercial |
$1,152.98
|
| Rate for Payer: BCBS Complete |
$600.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,176.77
|
| Rate for Payer: Cash Price |
$1,796.00
|
| Rate for Payer: Cash Price |
$1,796.00
|
| Rate for Payer: Meridian Medicaid |
$600.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,433.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,433.03
|
| Rate for Payer: Priority Health SBD |
$1,433.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,032.70
|
|
|
PR RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 50387
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$3,379.54 |
| Rate for Payer: Aetna Commercial |
$107.12
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,379.54
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.31
|
| Rate for Payer: Priority Health Narrow Network |
$131.31
|
| Rate for Payer: Priority Health SBD |
$131.31
|
| Rate for Payer: UMR Bronson Commercial |
$540.50
|
|
|
PR RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 69711
|
| Min. Negotiated Rate |
$539.10 |
| Max. Negotiated Rate |
$3,026.10 |
| Rate for Payer: Aetna Commercial |
$960.92
|
| Rate for Payer: BCBS Complete |
$566.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,026.10
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Meridian Medicaid |
$566.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$539.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,165.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,195.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,195.15
|
| Rate for Payer: Priority Health SBD |
$1,195.15
|
| Rate for Payer: UMR Bronson Commercial |
$765.90
|
|
|
PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS
|
Professional
|
Both
|
$1,123.00
|
|
|
Service Code
|
HCPCS 19330
|
| Min. Negotiated Rate |
$414.50 |
| Max. Negotiated Rate |
$797.00 |
| Rate for Payer: Aetna Commercial |
$698.31
|
| Rate for Payer: BCBS Complete |
$435.22
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: Cash Price |
$898.40
|
| Rate for Payer: Cash Price |
$898.40
|
| Rate for Payer: Meridian Medicaid |
$435.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$786.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.00
|
| Rate for Payer: Priority Health Narrow Network |
$797.00
|
| Rate for Payer: Priority Health SBD |
$797.00
|
| Rate for Payer: UMR Bronson Commercial |
$516.58
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$63.64 |
| Max. Negotiated Rate |
$560.20 |
| Rate for Payer: Aetna American Axle |
$111.80
|
| Rate for Payer: Aetna Commercial |
$146.20
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$139.16
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$120.40
|
| Rate for Payer: Cofinity Commercial |
$147.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$154.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$120.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.00
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$146.20
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$146.20
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$448.16
|
| Rate for Payer: Priority Health SBD |
$108.36
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$75.64
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$63.64
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.00
|
|
|
PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
11200
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$75.68 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna American Axle |
$111.80
|
| Rate for Payer: Aetna Commercial |
$146.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.80
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$147.92
|
| Rate for Payer: Cofinity Commercial |
$120.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.60
|
| Rate for Payer: Healthscope Commercial |
$154.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$120.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$146.20
|
| Rate for Payer: PHP Commercial |
$146.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.40
|
| Rate for Payer: Priority Health SBD |
$108.36
|
| Rate for Payer: UMR Bronson Commercial |
$75.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.00
|
|
|
PR RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR
|
Professional
|
Both
|
$3,865.00
|
|
|
Service Code
|
HCPCS 63662
|
| Min. Negotiated Rate |
$553.59 |
| Max. Negotiated Rate |
$2,705.50 |
| Rate for Payer: Aetna Commercial |
$1,089.28
|
| Rate for Payer: BCBS Complete |
$581.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.15
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Meridian Medicaid |
$581.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,705.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,450.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,450.66
|
| Rate for Payer: Priority Health SBD |
$1,450.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,777.90
|
|
|
PR RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 63661
|
| Min. Negotiated Rate |
$211.94 |
| Max. Negotiated Rate |
$1,249.50 |
| Rate for Payer: Aetna Commercial |
$419.58
|
| Rate for Payer: BCBS Complete |
$222.54
|
| Rate for Payer: BCBS Trust/PPO |
$409.43
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Meridian Medicaid |
$222.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,249.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.89
|
| Rate for Payer: Priority Health Narrow Network |
$554.89
|
| Rate for Payer: Priority Health SBD |
$554.89
|
| Rate for Payer: UMR Bronson Commercial |
$821.10
|
|
|
PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS
|
Professional
|
Both
|
$1,486.00
|
|
|
Service Code
|
HCPCS 62365
|
| Min. Negotiated Rate |
$178.57 |
| Max. Negotiated Rate |
$1,040.20 |
| Rate for Payer: Aetna Commercial |
$379.91
|
| Rate for Payer: BCBS Complete |
$202.63
|
| Rate for Payer: BCBS Trust/PPO |
$178.57
|
| Rate for Payer: Cash Price |
$1,188.80
|
| Rate for Payer: Cash Price |
$1,188.80
|
| Rate for Payer: Meridian Medicaid |
$202.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,040.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$503.95
|
| Rate for Payer: Priority Health Narrow Network |
$503.95
|
| Rate for Payer: Priority Health SBD |
$503.95
|
| Rate for Payer: UMR Bronson Commercial |
$683.56
|
|
|
PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
|
Professional
|
Both
|
$1,596.00
|
|
|
Service Code
|
HCPCS 26392
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$1,551.86 |
| Rate for Payer: Aetna Commercial |
$1,339.43
|
| Rate for Payer: BCBS Complete |
$679.00
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Meridian Medicaid |
$679.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$646.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,551.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,551.86
|
| Rate for Payer: Priority Health SBD |
$1,551.86
|
| Rate for Payer: UMR Bronson Commercial |
$734.16
|
|
|
PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL
|
Professional
|
Both
|
$463.00
|
|
|
Service Code
|
HCPCS 46754
|
| Min. Negotiated Rate |
$156.13 |
| Max. Negotiated Rate |
$425.10 |
| Rate for Payer: Aetna Commercial |
$312.54
|
| Rate for Payer: BCBS Complete |
$163.94
|
| Rate for Payer: BCBS Trust/PPO |
$396.75
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Cash Price |
$370.40
|
| Rate for Payer: Meridian Medicaid |
$163.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.10
|
| Rate for Payer: Priority Health Narrow Network |
$425.10
|
| Rate for Payer: Priority Health SBD |
$425.10
|
| Rate for Payer: UMR Bronson Commercial |
$212.98
|
|
|
PR RMVL TRANSVNS PM ELTRD DUAL LEAD SYS
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 33235
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$1,206.11 |
| Rate for Payer: Aetna Commercial |
$854.53
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.11
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,003.27
|
| Rate for Payer: Priority Health SBD |
$1,003.27
|
| Rate for Payer: UMR Bronson Commercial |
$598.46
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 36590
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$1,132.68 |
| Rate for Payer: Aetna Commercial |
$252.86
|
| Rate for Payer: BCBS Complete |
$125.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.68
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Meridian Medicaid |
$125.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.97
|
| Rate for Payer: Priority Health Narrow Network |
$298.97
|
| Rate for Payer: Priority Health SBD |
$298.97
|
| Rate for Payer: UMR Bronson Commercial |
$322.92
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
OP
|
$702.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$184.02 |
| Max. Negotiated Rate |
$4,481.48 |
| Rate for Payer: Aetna American Axle |
$456.30
|
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: Aetna Medicare |
$1,480.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$491.40
|
| Rate for Payer: Cofinity Commercial |
$603.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$631.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$491.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.50
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$596.70
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$596.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,585.18
|
| Rate for Payer: Priority Health SBD |
$442.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.57
|
| Rate for Payer: UHC Exchange |
$184.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: UMR Bronson Commercial |
$259.74
|
| Rate for Payer: VA VA |
$1,423.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.50
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
IP
|
$702.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$308.88 |
| Max. Negotiated Rate |
$631.80 |
| Rate for Payer: Aetna American Axle |
$456.30
|
| Rate for Payer: Aetna Commercial |
$596.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.30
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$491.40
|
| Rate for Payer: Cofinity Commercial |
$603.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.60
|
| Rate for Payer: Healthscope Commercial |
$631.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$491.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$596.70
|
| Rate for Payer: PHP Commercial |
$596.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health SBD |
$442.26
|
| Rate for Payer: UMR Bronson Commercial |
$308.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.50
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 36590
|
| Hospital Charge Code |
36590
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$1,132.68 |
| Rate for Payer: Aetna Commercial |
$252.86
|
| Rate for Payer: BCBS Complete |
$125.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.68
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Meridian Medicaid |
$125.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.97
|
| Rate for Payer: Priority Health Narrow Network |
$298.97
|
| Rate for Payer: Priority Health SBD |
$298.97
|
| Rate for Payer: UMR Bronson Commercial |
$322.92
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$1,048.15 |
| Rate for Payer: Aetna Commercial |
$183.56
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.15
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.90
|
| Rate for Payer: Priority Health Narrow Network |
$214.90
|
| Rate for Payer: Priority Health SBD |
$214.90
|
| Rate for Payer: UMR Bronson Commercial |
$193.66
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
OP
|
$421.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$131.96 |
| Max. Negotiated Rate |
$1,757.86 |
| Rate for Payer: Aetna American Axle |
$273.65
|
| Rate for Payer: Aetna Commercial |
$357.85
|
| Rate for Payer: Aetna Medicare |
$580.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$698.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$698.00
|
| Rate for Payer: BCBS Complete |
$320.74
|
| Rate for Payer: BCBS MAPPO |
$558.40
|
| Rate for Payer: BCBS Trust/PPO |
$812.59
|
| Rate for Payer: BCN Medicare Advantage |
$558.40
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$294.70
|
| Rate for Payer: Cofinity Commercial |
$362.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.40
|
| Rate for Payer: Healthscope Commercial |
$378.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.75
|
| Rate for Payer: Mclaren Medicaid |
$305.44
|
| Rate for Payer: Mclaren Medicare |
$558.40
|
| Rate for Payer: Meridian Medicaid |
$320.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.85
|
| Rate for Payer: PACE Medicare |
$530.48
|
| Rate for Payer: PACE SWMI |
$558.40
|
| Rate for Payer: PHP Commercial |
$357.85
|
| Rate for Payer: PHP Medicare Advantage |
$558.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.86
|
| Rate for Payer: Priority Health Medicare |
$558.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,406.29
|
| Rate for Payer: Priority Health SBD |
$265.23
|
| Rate for Payer: Railroad Medicare Medicare |
$558.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.40
|
| Rate for Payer: UHC Exchange |
$131.96
|
| Rate for Payer: UHC Medicare Advantage |
$575.15
|
| Rate for Payer: UMR Bronson Commercial |
$155.77
|
| Rate for Payer: VA VA |
$558.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.75
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
IP
|
$421.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$185.24 |
| Max. Negotiated Rate |
$378.90 |
| Rate for Payer: Aetna American Axle |
$273.65
|
| Rate for Payer: Aetna Commercial |
$357.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.65
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$294.70
|
| Rate for Payer: Cofinity Commercial |
$362.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.80
|
| Rate for Payer: Healthscope Commercial |
$378.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.85
|
| Rate for Payer: PHP Commercial |
$357.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health SBD |
$265.23
|
| Rate for Payer: UMR Bronson Commercial |
$185.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.75
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 36589
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$1,048.15 |
| Rate for Payer: Aetna Commercial |
$183.56
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.15
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.90
|
| Rate for Payer: Priority Health Narrow Network |
$214.90
|
| Rate for Payer: Priority Health SBD |
$214.90
|
| Rate for Payer: UMR Bronson Commercial |
$193.66
|
|
|
PR RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11983
|
| Min. Negotiated Rate |
$65.60 |
| Max. Negotiated Rate |
$532.50 |
| Rate for Payer: Aetna Commercial |
$113.66
|
| Rate for Payer: BCBS Complete |
$68.88
|
| Rate for Payer: BCBS Trust/PPO |
$532.50
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Meridian Medicaid |
$68.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.60
|
| Rate for Payer: Priority Health Narrow Network |
$126.60
|
| Rate for Payer: Priority Health SBD |
$126.60
|
| Rate for Payer: UMR Bronson Commercial |
$181.24
|
|
