|
PR SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 92060
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$970.49 |
| Rate for Payer: Aetna Commercial |
$66.75
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$970.49
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.12
|
| Rate for Payer: Priority Health Narrow Network |
$32.12
|
| Rate for Payer: Priority Health SBD |
$75.48
|
| Rate for Payer: UMR Bronson Commercial |
$46.00
|
|
|
PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF
|
Professional
|
Both
|
$1,784.00
|
|
|
Service Code
|
HCPCS 30520
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,248.80 |
| Rate for Payer: Aetna Commercial |
$848.68
|
| Rate for Payer: Aetna Commercial |
$848.68
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: Cash Price |
$1,427.20
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$1,427.20
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,248.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$947.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$947.39
|
| Rate for Payer: Priority Health Narrow Network |
$947.39
|
| Rate for Payer: Priority Health Narrow Network |
$947.39
|
| Rate for Payer: Priority Health SBD |
$947.39
|
| Rate for Payer: Priority Health SBD |
$947.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,426.00
|
| Rate for Payer: UMR Bronson Commercial |
$820.64
|
|
|
PR SEQUESTRECTOMY FOREARM &/WRIST
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 25145
|
| Min. Negotiated Rate |
$334.94 |
| Max. Negotiated Rate |
$1,549.10 |
| Rate for Payer: Aetna Commercial |
$694.20
|
| Rate for Payer: BCBS Complete |
$357.62
|
| Rate for Payer: BCBS Trust/PPO |
$334.94
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Meridian Medicaid |
$357.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$340.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,549.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.34
|
| Rate for Payer: Priority Health Narrow Network |
$807.34
|
| Rate for Payer: Priority Health SBD |
$807.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,017.98
|
|
|
PR SEQUESTRECTOMY SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,176.00
|
|
|
Service Code
|
HCPCS 24134
|
| Min. Negotiated Rate |
$175.92 |
| Max. Negotiated Rate |
$1,523.20 |
| Rate for Payer: Aetna Commercial |
$998.19
|
| Rate for Payer: BCBS Complete |
$508.81
|
| Rate for Payer: BCBS Trust/PPO |
$175.92
|
| Rate for Payer: Cash Price |
$1,740.80
|
| Rate for Payer: Cash Price |
$1,740.80
|
| Rate for Payer: Meridian Medicaid |
$508.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,523.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,151.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,151.52
|
| Rate for Payer: Priority Health SBD |
$1,151.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,000.96
|
|
|
PR SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 99050
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$608.60 |
| Rate for Payer: Aetna Commercial |
$23.50
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$608.60
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.25
|
| Rate for Payer: Priority Health Narrow Network |
$24.25
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
PR SESAMOIDECTOMY FIRST TOE SPX
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 28315
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$1,893.96 |
| Rate for Payer: Aetna Commercial |
$432.42
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.96
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.88
|
| Rate for Payer: Priority Health Narrow Network |
$497.88
|
| Rate for Payer: Priority Health SBD |
$497.88
|
| Rate for Payer: UMR Bronson Commercial |
$401.12
|
|
|
PR SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 26185
|
| Min. Negotiated Rate |
$364.87 |
| Max. Negotiated Rate |
$1,152.90 |
| Rate for Payer: Aetna Commercial |
$737.45
|
| Rate for Payer: BCBS Complete |
$383.11
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Meridian Medicaid |
$383.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,152.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.99
|
| Rate for Payer: Priority Health Narrow Network |
$862.99
|
| Rate for Payer: Priority Health SBD |
$862.99
|
| Rate for Payer: UMR Bronson Commercial |
$757.62
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
OP
|
$637.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$65.16 |
| Max. Negotiated Rate |
$2,557.47 |
| Rate for Payer: Aetna American Axle |
$414.05
|
| Rate for Payer: Aetna Commercial |
$541.45
|
| Rate for Payer: Aetna Medicare |
$844.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$535.79
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cofinity Commercial |
$445.90
|
| Rate for Payer: Cofinity Commercial |
$547.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$573.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$445.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.75
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.45
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$541.45
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,557.47
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,045.98
|
| Rate for Payer: Priority Health SBD |
$401.31
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.40
|
| Rate for Payer: UHC Exchange |
$65.16
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: UMR Bronson Commercial |
$235.69
|
| Rate for Payer: VA VA |
$812.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.75
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$637.00
|
|
|
Service Code
|
HCPCS 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$445.90 |
| Rate for Payer: Aetna Commercial |
$88.06
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.83
|
| Rate for Payer: Priority Health Narrow Network |
$115.83
|
| Rate for Payer: Priority Health SBD |
$115.83
|
| Rate for Payer: UMR Bronson Commercial |
$293.02
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
IP
|
$637.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$280.28 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Aetna American Axle |
$414.05
|
| Rate for Payer: Aetna Commercial |
$541.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.05
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cofinity Commercial |
$445.90
|
| Rate for Payer: Cofinity Commercial |
$547.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.60
|
| Rate for Payer: Healthscope Commercial |
$573.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$445.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.45
|
| Rate for Payer: PHP Commercial |
$541.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health SBD |
$401.31
|
| Rate for Payer: UMR Bronson Commercial |
$280.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.75
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$637.00
|
|
|
Service Code
|
HCPCS 45335
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$445.90 |
| Rate for Payer: Aetna Commercial |
$88.06
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.83
|
| Rate for Payer: Priority Health Narrow Network |
$115.83
|
| Rate for Payer: Priority Health SBD |
$115.83
|
| Rate for Payer: UMR Bronson Commercial |
$293.02
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$323.84 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Aetna American Axle |
$478.40
|
| Rate for Payer: Aetna Commercial |
$625.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.40
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$632.96
|
| Rate for Payer: Cofinity Commercial |
$515.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Healthscope Commercial |
$662.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$515.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.60
|
| Rate for Payer: PHP Commercial |
$625.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: Priority Health SBD |
$463.68
|
| Rate for Payer: UMR Bronson Commercial |
$323.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.00
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 45338
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$515.20 |
| Rate for Payer: Aetna Commercial |
$159.59
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS Trust/PPO |
$76.08
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.55
|
| Rate for Payer: Priority Health Narrow Network |
$207.55
|
| Rate for Payer: Priority Health SBD |
$207.55
|
| Rate for Payer: UMR Bronson Commercial |
$338.56
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$515.20 |
| Rate for Payer: Aetna Commercial |
$159.59
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS Trust/PPO |
$76.08
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.55
|
| Rate for Payer: Priority Health Narrow Network |
$207.55
|
| Rate for Payer: Priority Health SBD |
$207.55
|
| Rate for Payer: UMR Bronson Commercial |
$338.56
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$116.57 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$478.40
|
| Rate for Payer: Aetna Commercial |
$625.60
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,414.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$632.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$662.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$515.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.00
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.60
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$625.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$463.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$116.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$272.32
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.00
|
|
|
PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE
|
Professional
|
Both
|
$594.00
|
|
|
Service Code
|
HCPCS 45337
|
| Min. Negotiated Rate |
$71.99 |
| Max. Negotiated Rate |
$415.80 |
| Rate for Payer: Aetna Commercial |
$153.40
|
| Rate for Payer: BCBS Complete |
$75.59
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Meridian Medicaid |
$75.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$415.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.56
|
| Rate for Payer: Priority Health Narrow Network |
$197.56
|
| Rate for Payer: Priority Health SBD |
$197.56
|
| Rate for Payer: UMR Bronson Commercial |
$273.24
|
|
|
PR SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 45349
|
| Min. Negotiated Rate |
$124.39 |
| Max. Negotiated Rate |
$380.90 |
| Rate for Payer: Aetna Commercial |
$263.62
|
| Rate for Payer: BCBS Complete |
$130.61
|
| Rate for Payer: BCBS Trust/PPO |
$380.90
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Meridian Medicaid |
$130.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$342.19
|
| Rate for Payer: Priority Health Narrow Network |
$342.19
|
| Rate for Payer: Priority Health SBD |
$342.19
|
| Rate for Payer: UMR Bronson Commercial |
$164.68
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 11310
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$128.80 |
| Rate for Payer: Aetna Commercial |
$49.47
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.91
|
| Rate for Payer: Priority Health Narrow Network |
$55.91
|
| Rate for Payer: Priority Health SBD |
$55.91
|
| Rate for Payer: UMR Bronson Commercial |
$84.64
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 11313
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$103.74
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.32
|
| Rate for Payer: Priority Health Narrow Network |
$116.32
|
| Rate for Payer: Priority Health SBD |
$116.32
|
| Rate for Payer: UMR Bronson Commercial |
$138.46
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 11305
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$41.35
|
| Rate for Payer: BCBS Complete |
$24.82
|
| Rate for Payer: BCBS Trust/PPO |
$450.00
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Meridian Medicaid |
$24.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.62
|
| Rate for Payer: Priority Health Narrow Network |
$45.62
|
| Rate for Payer: Priority Health SBD |
$45.62
|
| Rate for Payer: UMR Bronson Commercial |
$72.68
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 11306
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$137.20 |
| Rate for Payer: Aetna Commercial |
$53.87
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.02
|
| Rate for Payer: Priority Health Narrow Network |
$60.02
|
| Rate for Payer: Priority Health SBD |
$60.02
|
| Rate for Payer: UMR Bronson Commercial |
$90.16
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 11307
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$2,827.44 |
| Rate for Payer: Aetna Commercial |
$69.07
|
| Rate for Payer: BCBS Complete |
$41.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.44
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Meridian Medicaid |
$41.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.45
|
| Rate for Payer: Priority Health Narrow Network |
$76.45
|
| Rate for Payer: Priority Health SBD |
$76.45
|
| Rate for Payer: UMR Bronson Commercial |
$106.72
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 11308
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$78.76
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.09
|
| Rate for Payer: Priority Health Narrow Network |
$85.09
|
| Rate for Payer: Priority Health SBD |
$85.09
|
| Rate for Payer: UMR Bronson Commercial |
$113.16
|
|
|
PR SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 11300
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$36.45
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS Trust/PPO |
$285.00
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.52
|
| Rate for Payer: Priority Health Narrow Network |
$41.52
|
| Rate for Payer: Priority Health SBD |
$41.52
|
| Rate for Payer: UMR Bronson Commercial |
$72.68
|
|
|
PR SHOE LIFTS ELEVATION HEEL /I
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS L3334
|
| Min. Negotiated Rate |
$22.97 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.80
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
|
