|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Facility
|
IP
|
$299.00
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
19100
|
| Min. Negotiated Rate |
$131.56 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Aetna American Axle |
$194.35
|
| Rate for Payer: Aetna Commercial |
$254.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.35
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$209.30
|
| Rate for Payer: Cofinity Commercial |
$257.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.20
|
| Rate for Payer: Healthscope Commercial |
$269.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.15
|
| Rate for Payer: PHP Commercial |
$254.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health SBD |
$188.37
|
| Rate for Payer: UMR Bronson Commercial |
$131.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.25
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Facility
|
OP
|
$299.00
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
19100
|
| Min. Negotiated Rate |
$110.63 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$194.35
|
| Rate for Payer: Aetna Commercial |
$254.15
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$257.14
|
| Rate for Payer: Cofinity Commercial |
$209.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$269.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.25
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.15
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$254.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$188.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$110.63
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.25
|
|
|
PR BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID
|
Professional
|
Both
|
$773.00
|
|
|
Service Code
|
HCPCS 19081
|
| Min. Negotiated Rate |
$154.30 |
| Max. Negotiated Rate |
$502.45 |
| Rate for Payer: Aetna Commercial |
$206.76
|
| Rate for Payer: Aetna Medicare |
$160.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.76
|
| Rate for Payer: BCBS Complete |
$309.20
|
| Rate for Payer: BCBS MAPPO |
$154.30
|
| Rate for Payer: BCN Medicare Advantage |
$154.30
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cofinity Commercial |
$222.19
|
| Rate for Payer: Cofinity Commercial |
$206.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.01
|
| Rate for Payer: Nomi Health Commercial |
$185.16
|
| Rate for Payer: PACE SWMI |
$154.30
|
| Rate for Payer: PHP Commercial |
$216.02
|
| Rate for Payer: PHP Medicare Advantage |
$154.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$502.45
|
| Rate for Payer: Priority Health Medicare |
$154.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.30
|
| Rate for Payer: UHC Medicare Advantage |
$154.30
|
| Rate for Payer: UMR Bronson Commercial |
$355.58
|
|
|
PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 19083
|
| Min. Negotiated Rate |
$144.96 |
| Max. Negotiated Rate |
$286.65 |
| Rate for Payer: Aetna Commercial |
$194.25
|
| Rate for Payer: Aetna Medicare |
$150.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.25
|
| Rate for Payer: BCBS Complete |
$176.40
|
| Rate for Payer: BCBS MAPPO |
$144.96
|
| Rate for Payer: BCN Medicare Advantage |
$144.96
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cofinity Commercial |
$208.74
|
| Rate for Payer: Cofinity Commercial |
$194.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.21
|
| Rate for Payer: Nomi Health Commercial |
$173.95
|
| Rate for Payer: PACE SWMI |
$144.96
|
| Rate for Payer: PHP Commercial |
$202.94
|
| Rate for Payer: PHP Medicare Advantage |
$144.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.65
|
| Rate for Payer: Priority Health Medicare |
$144.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.96
|
| Rate for Payer: UHC Medicare Advantage |
$144.96
|
| Rate for Payer: UMR Bronson Commercial |
$202.86
|
|
|
PR BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 19084
|
| Min. Negotiated Rate |
$73.00 |
| Max. Negotiated Rate |
$515.45 |
| Rate for Payer: Aetna Commercial |
$97.82
|
| Rate for Payer: Aetna Medicare |
$75.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.12
|
| Rate for Payer: BCBS Complete |
$317.20
|
| Rate for Payer: BCBS MAPPO |
$73.00
|
| Rate for Payer: BCN Medicare Advantage |
$73.00
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$97.82
|
| Rate for Payer: Cofinity Commercial |
$105.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.65
|
| Rate for Payer: Nomi Health Commercial |
$87.60
|
| Rate for Payer: PACE SWMI |
$73.00
|
| Rate for Payer: PHP Commercial |
$102.20
|
| Rate for Payer: PHP Medicare Advantage |
$73.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.45
|
| Rate for Payer: Priority Health Medicare |
$73.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.00
|
| Rate for Payer: UHC Medicare Advantage |
$73.00
|
| Rate for Payer: UMR Bronson Commercial |
$364.78
|
|
|
PR BX/EXC LYMPH NODE NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 38505
|
| Min. Negotiated Rate |
$81.08 |
| Max. Negotiated Rate |
$148.20 |
| Rate for Payer: Aetna Commercial |
$108.65
|
| Rate for Payer: Aetna Medicare |
$84.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.65
|
| Rate for Payer: BCBS Complete |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$81.08
|
| Rate for Payer: BCN Medicare Advantage |
$81.08
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$116.76
|
| Rate for Payer: Cofinity Commercial |
$108.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.13
|
| Rate for Payer: Nomi Health Commercial |
$97.30
|
| Rate for Payer: PACE SWMI |
$81.08
|
| Rate for Payer: PHP Commercial |
$113.51
|
| Rate for Payer: PHP Medicare Advantage |
$81.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health Medicare |
$81.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.08
|
| Rate for Payer: UHC Medicare Advantage |
$81.08
|
| Rate for Payer: UMR Bronson Commercial |
$104.88
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38525
|
| Min. Negotiated Rate |
$427.74 |
| Max. Negotiated Rate |
$1,025.05 |
| Rate for Payer: Aetna Commercial |
$573.17
|
| Rate for Payer: Aetna Medicare |
$444.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.17
|
| Rate for Payer: BCBS Complete |
$630.80
|
| Rate for Payer: BCBS MAPPO |
$427.74
|
| Rate for Payer: BCN Medicare Advantage |
$427.74
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$615.95
|
| Rate for Payer: Cofinity Commercial |
$573.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.13
|
| Rate for Payer: Nomi Health Commercial |
$513.29
|
| Rate for Payer: PACE SWMI |
$427.74
|
| Rate for Payer: PHP Commercial |
$598.84
|
| Rate for Payer: PHP Medicare Advantage |
$427.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health Medicare |
$427.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.74
|
| Rate for Payer: UHC Medicare Advantage |
$427.74
|
| Rate for Payer: UMR Bronson Commercial |
$725.42
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
38525
|
| Min. Negotiated Rate |
$427.74 |
| Max. Negotiated Rate |
$1,025.05 |
| Rate for Payer: Aetna Commercial |
$573.17
|
| Rate for Payer: Aetna Medicare |
$444.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.17
|
| Rate for Payer: BCBS Complete |
$630.80
|
| Rate for Payer: BCBS MAPPO |
$427.74
|
| Rate for Payer: BCN Medicare Advantage |
$427.74
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$615.95
|
| Rate for Payer: Cofinity Commercial |
$573.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.13
|
| Rate for Payer: Nomi Health Commercial |
$513.29
|
| Rate for Payer: PACE SWMI |
$427.74
|
| Rate for Payer: PHP Commercial |
$598.84
|
| Rate for Payer: PHP Medicare Advantage |
$427.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health Medicare |
$427.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.74
|
| Rate for Payer: UHC Medicare Advantage |
$427.74
|
| Rate for Payer: UMR Bronson Commercial |
$725.42
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Facility
|
OP
|
$1,577.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
38525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$583.49 |
| Max. Negotiated Rate |
$10,512.58 |
| Rate for Payer: Aetna American Axle |
$1,025.05
|
| Rate for Payer: Aetna Commercial |
$1,340.45
|
| Rate for Payer: Aetna Medicare |
$3,884.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,668.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,668.27
|
| Rate for Payer: BCBS Complete |
$2,101.84
|
| Rate for Payer: BCBS MAPPO |
$3,734.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,734.62
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.22
|
| Rate for Payer: Cofinity Commercial |
$1,103.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,103.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,734.62
|
| Rate for Payer: Healthscope Commercial |
$1,419.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,103.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.75
|
| Rate for Payer: Mclaren Medicaid |
$2,001.76
|
| Rate for Payer: Mclaren Medicare |
$3,734.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,921.35
|
| Rate for Payer: Meridian Medicaid |
$2,101.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,294.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.45
|
| Rate for Payer: PACE Medicare |
$3,547.89
|
| Rate for Payer: PACE SWMI |
$3,734.62
|
| Rate for Payer: PHP Commercial |
$1,340.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,734.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,001.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health Medicare |
$3,734.62
|
| Rate for Payer: Priority Health SBD |
$993.51
|
| Rate for Payer: Railroad Medicare Medicare |
$3,734.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,512.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,734.62
|
| Rate for Payer: UHC Exchange |
$7,137.23
|
| Rate for Payer: UHC Medicare Advantage |
$3,734.62
|
| Rate for Payer: UHCCP Medicaid |
$2,001.76
|
| Rate for Payer: UMR Bronson Commercial |
$583.49
|
| Rate for Payer: VA VA |
$3,734.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.75
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Facility
|
IP
|
$1,577.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
38525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$693.88 |
| Max. Negotiated Rate |
$1,419.30 |
| Rate for Payer: Aetna American Axle |
$1,025.05
|
| Rate for Payer: Aetna Commercial |
$1,340.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.05
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,103.90
|
| Rate for Payer: Cofinity Commercial |
$1,356.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,103.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.60
|
| Rate for Payer: Healthscope Commercial |
$1,419.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,103.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.45
|
| Rate for Payer: PHP Commercial |
$1,340.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health SBD |
$993.51
|
| Rate for Payer: UMR Bronson Commercial |
$693.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.75
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Facility
|
OP
|
$1,577.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
38510
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$583.49 |
| Max. Negotiated Rate |
$10,512.58 |
| Rate for Payer: Aetna American Axle |
$1,025.05
|
| Rate for Payer: Aetna Commercial |
$1,340.45
|
| Rate for Payer: Aetna Medicare |
$3,884.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,668.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,668.27
|
| Rate for Payer: BCBS Complete |
$2,101.84
|
| Rate for Payer: BCBS MAPPO |
$3,734.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,734.62
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,103.90
|
| Rate for Payer: Cofinity Commercial |
$1,356.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,103.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,734.62
|
| Rate for Payer: Healthscope Commercial |
$1,419.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,103.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.75
|
| Rate for Payer: Mclaren Medicaid |
$2,001.76
|
| Rate for Payer: Mclaren Medicare |
$3,734.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,921.35
|
| Rate for Payer: Meridian Medicaid |
$2,101.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,294.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.45
|
| Rate for Payer: PACE Medicare |
$3,547.89
|
| Rate for Payer: PACE SWMI |
$3,734.62
|
| Rate for Payer: PHP Commercial |
$1,340.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,734.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,001.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health Medicare |
$3,734.62
|
| Rate for Payer: Priority Health SBD |
$993.51
|
| Rate for Payer: Railroad Medicare Medicare |
$3,734.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,512.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,734.62
|
| Rate for Payer: UHC Exchange |
$7,137.23
|
| Rate for Payer: UHC Medicare Advantage |
$3,734.62
|
| Rate for Payer: UHCCP Medicaid |
$2,001.76
|
| Rate for Payer: UMR Bronson Commercial |
$583.49
|
| Rate for Payer: VA VA |
$3,734.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.75
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Facility
|
IP
|
$1,577.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
38510
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$693.88 |
| Max. Negotiated Rate |
$1,419.30 |
| Rate for Payer: Aetna American Axle |
$1,025.05
|
| Rate for Payer: Aetna Commercial |
$1,340.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.05
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,103.90
|
| Rate for Payer: Cofinity Commercial |
$1,356.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,103.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.60
|
| Rate for Payer: Healthscope Commercial |
$1,419.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,103.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.45
|
| Rate for Payer: PHP Commercial |
$1,340.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health SBD |
$993.51
|
| Rate for Payer: UMR Bronson Commercial |
$693.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.75
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
38510
|
| Min. Negotiated Rate |
$403.02 |
| Max. Negotiated Rate |
$1,025.05 |
| Rate for Payer: Aetna Commercial |
$540.05
|
| Rate for Payer: Aetna Medicare |
$419.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.05
|
| Rate for Payer: BCBS Complete |
$630.80
|
| Rate for Payer: BCBS MAPPO |
$403.02
|
| Rate for Payer: BCN Medicare Advantage |
$403.02
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$540.05
|
| Rate for Payer: Cofinity Commercial |
$580.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.17
|
| Rate for Payer: Nomi Health Commercial |
$483.62
|
| Rate for Payer: PACE SWMI |
$403.02
|
| Rate for Payer: PHP Commercial |
$564.23
|
| Rate for Payer: PHP Medicare Advantage |
$403.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health Medicare |
$403.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.02
|
| Rate for Payer: UHC Medicare Advantage |
$403.02
|
| Rate for Payer: UMR Bronson Commercial |
$725.42
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38510
|
| Min. Negotiated Rate |
$403.02 |
| Max. Negotiated Rate |
$1,025.05 |
| Rate for Payer: Aetna Commercial |
$540.05
|
| Rate for Payer: Aetna Medicare |
$419.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.05
|
| Rate for Payer: BCBS Complete |
$630.80
|
| Rate for Payer: BCBS MAPPO |
$403.02
|
| Rate for Payer: BCN Medicare Advantage |
$403.02
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$580.35
|
| Rate for Payer: Cofinity Commercial |
$540.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.17
|
| Rate for Payer: Nomi Health Commercial |
$483.62
|
| Rate for Payer: PACE SWMI |
$403.02
|
| Rate for Payer: PHP Commercial |
$564.23
|
| Rate for Payer: PHP Medicare Advantage |
$403.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health Medicare |
$403.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.02
|
| Rate for Payer: UHC Medicare Advantage |
$403.02
|
| Rate for Payer: UMR Bronson Commercial |
$725.42
|
|
|
PR BX/EXC LYMPH NODE OPEN INT MAMMARY NODE
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 38530
|
| Min. Negotiated Rate |
$548.84 |
| Max. Negotiated Rate |
$1,105.65 |
| Rate for Payer: Aetna Commercial |
$735.45
|
| Rate for Payer: Aetna Medicare |
$570.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.45
|
| Rate for Payer: BCBS Complete |
$680.40
|
| Rate for Payer: BCBS MAPPO |
$548.84
|
| Rate for Payer: BCN Medicare Advantage |
$548.84
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$790.33
|
| Rate for Payer: Cofinity Commercial |
$735.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$576.28
|
| Rate for Payer: Nomi Health Commercial |
$658.61
|
| Rate for Payer: PACE SWMI |
$548.84
|
| Rate for Payer: PHP Commercial |
$768.38
|
| Rate for Payer: PHP Medicare Advantage |
$548.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health Medicare |
$548.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$548.84
|
| Rate for Payer: UHC Medicare Advantage |
$548.84
|
| Rate for Payer: UMR Bronson Commercial |
$782.46
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Professional
|
Both
|
$947.00
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
38500
|
| Min. Negotiated Rate |
$246.15 |
| Max. Negotiated Rate |
$615.55 |
| Rate for Payer: Aetna Commercial |
$329.84
|
| Rate for Payer: Aetna Medicare |
$256.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.84
|
| Rate for Payer: BCBS Complete |
$378.80
|
| Rate for Payer: BCBS MAPPO |
$246.15
|
| Rate for Payer: BCN Medicare Advantage |
$246.15
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$329.84
|
| Rate for Payer: Cofinity Commercial |
$354.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.46
|
| Rate for Payer: Nomi Health Commercial |
$295.38
|
| Rate for Payer: PACE SWMI |
$246.15
|
| Rate for Payer: PHP Commercial |
$344.61
|
| Rate for Payer: PHP Medicare Advantage |
$246.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health Medicare |
$246.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.15
|
| Rate for Payer: UHC Medicare Advantage |
$246.15
|
| Rate for Payer: UMR Bronson Commercial |
$435.62
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Facility
|
OP
|
$947.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
38500
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$350.39 |
| Max. Negotiated Rate |
$10,512.58 |
| Rate for Payer: Aetna American Axle |
$615.55
|
| Rate for Payer: Aetna Commercial |
$804.95
|
| Rate for Payer: Aetna Medicare |
$3,884.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,668.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,668.27
|
| Rate for Payer: BCBS Complete |
$2,101.84
|
| Rate for Payer: BCBS MAPPO |
$3,734.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,734.62
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$662.90
|
| Rate for Payer: Cofinity Commercial |
$814.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$662.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$757.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,734.62
|
| Rate for Payer: Healthscope Commercial |
$852.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$662.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$710.25
|
| Rate for Payer: Mclaren Medicaid |
$2,001.76
|
| Rate for Payer: Mclaren Medicare |
$3,734.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,921.35
|
| Rate for Payer: Meridian Medicaid |
$2,101.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,294.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$804.95
|
| Rate for Payer: PACE Medicare |
$3,547.89
|
| Rate for Payer: PACE SWMI |
$3,734.62
|
| Rate for Payer: PHP Commercial |
$804.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,734.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,001.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health Medicare |
$3,734.62
|
| Rate for Payer: Priority Health SBD |
$596.61
|
| Rate for Payer: Railroad Medicare Medicare |
$3,734.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,512.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,734.62
|
| Rate for Payer: UHC Exchange |
$7,137.23
|
| Rate for Payer: UHC Medicare Advantage |
$3,734.62
|
| Rate for Payer: UHCCP Medicaid |
$2,001.76
|
| Rate for Payer: UMR Bronson Commercial |
$350.39
|
| Rate for Payer: VA VA |
$3,734.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$710.25
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Facility
|
IP
|
$947.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
38500
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$416.68 |
| Max. Negotiated Rate |
$852.30 |
| Rate for Payer: Aetna American Axle |
$615.55
|
| Rate for Payer: Aetna Commercial |
$804.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.55
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$662.90
|
| Rate for Payer: Cofinity Commercial |
$814.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$662.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$757.60
|
| Rate for Payer: Healthscope Commercial |
$852.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$662.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$710.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$804.95
|
| Rate for Payer: PHP Commercial |
$804.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health SBD |
$596.61
|
| Rate for Payer: UMR Bronson Commercial |
$416.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$710.25
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Professional
|
Both
|
$947.00
|
|
|
Service Code
|
HCPCS 38500
|
| Min. Negotiated Rate |
$246.15 |
| Max. Negotiated Rate |
$615.55 |
| Rate for Payer: Aetna Commercial |
$329.84
|
| Rate for Payer: Aetna Medicare |
$256.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.84
|
| Rate for Payer: BCBS Complete |
$378.80
|
| Rate for Payer: BCBS MAPPO |
$246.15
|
| Rate for Payer: BCN Medicare Advantage |
$246.15
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$354.46
|
| Rate for Payer: Cofinity Commercial |
$329.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.46
|
| Rate for Payer: Nomi Health Commercial |
$295.38
|
| Rate for Payer: PACE SWMI |
$246.15
|
| Rate for Payer: PHP Commercial |
$344.61
|
| Rate for Payer: PHP Medicare Advantage |
$246.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health Medicare |
$246.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.15
|
| Rate for Payer: UHC Medicare Advantage |
$246.15
|
| Rate for Payer: UMR Bronson Commercial |
$435.62
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 38520
|
| Min. Negotiated Rate |
$452.61 |
| Max. Negotiated Rate |
$1,200.55 |
| Rate for Payer: Aetna Commercial |
$606.50
|
| Rate for Payer: Aetna Medicare |
$470.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.50
|
| Rate for Payer: BCBS Complete |
$738.80
|
| Rate for Payer: BCBS MAPPO |
$452.61
|
| Rate for Payer: BCN Medicare Advantage |
$452.61
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$651.76
|
| Rate for Payer: Cofinity Commercial |
$606.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$475.24
|
| Rate for Payer: Nomi Health Commercial |
$543.13
|
| Rate for Payer: PACE SWMI |
$452.61
|
| Rate for Payer: PHP Commercial |
$633.65
|
| Rate for Payer: PHP Medicare Advantage |
$452.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health Medicare |
$452.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$452.61
|
| Rate for Payer: UHC Medicare Advantage |
$452.61
|
| Rate for Payer: UMR Bronson Commercial |
$849.62
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 38520
|
| Hospital Charge Code |
38520
|
| Min. Negotiated Rate |
$452.61 |
| Max. Negotiated Rate |
$1,200.55 |
| Rate for Payer: Aetna Commercial |
$606.50
|
| Rate for Payer: Aetna Medicare |
$470.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.50
|
| Rate for Payer: BCBS Complete |
$738.80
|
| Rate for Payer: BCBS MAPPO |
$452.61
|
| Rate for Payer: BCN Medicare Advantage |
$452.61
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$651.76
|
| Rate for Payer: Cofinity Commercial |
$606.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$475.24
|
| Rate for Payer: Nomi Health Commercial |
$543.13
|
| Rate for Payer: PACE SWMI |
$452.61
|
| Rate for Payer: PHP Commercial |
$633.65
|
| Rate for Payer: PHP Medicare Advantage |
$452.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health Medicare |
$452.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$452.61
|
| Rate for Payer: UHC Medicare Advantage |
$452.61
|
| Rate for Payer: UMR Bronson Commercial |
$849.62
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 38520
|
| Hospital Charge Code |
38520
|
| Min. Negotiated Rate |
$683.39 |
| Max. Negotiated Rate |
$10,512.58 |
| Rate for Payer: Aetna American Axle |
$1,200.55
|
| Rate for Payer: Aetna Commercial |
$1,569.95
|
| Rate for Payer: Aetna Medicare |
$3,884.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,668.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,668.27
|
| Rate for Payer: BCBS Complete |
$2,101.84
|
| Rate for Payer: BCBS MAPPO |
$3,734.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,734.62
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,588.42
|
| Rate for Payer: Cofinity Commercial |
$1,292.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,292.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,734.62
|
| Rate for Payer: Healthscope Commercial |
$1,662.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,292.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,385.25
|
| Rate for Payer: Mclaren Medicaid |
$2,001.76
|
| Rate for Payer: Mclaren Medicare |
$3,734.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,921.35
|
| Rate for Payer: Meridian Medicaid |
$2,101.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,294.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.95
|
| Rate for Payer: PACE Medicare |
$3,547.89
|
| Rate for Payer: PACE SWMI |
$3,734.62
|
| Rate for Payer: PHP Commercial |
$1,569.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,734.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,001.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health Medicare |
$3,734.62
|
| Rate for Payer: Priority Health SBD |
$1,163.61
|
| Rate for Payer: Railroad Medicare Medicare |
$3,734.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,512.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,734.62
|
| Rate for Payer: UHC Exchange |
$7,137.23
|
| Rate for Payer: UHC Medicare Advantage |
$3,734.62
|
| Rate for Payer: UHCCP Medicaid |
$2,001.76
|
| Rate for Payer: UMR Bronson Commercial |
$683.39
|
| Rate for Payer: VA VA |
$3,734.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,385.25
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 38520
|
| Hospital Charge Code |
38520
|
| Min. Negotiated Rate |
$812.68 |
| Max. Negotiated Rate |
$1,662.30 |
| Rate for Payer: Aetna American Axle |
$1,200.55
|
| Rate for Payer: Aetna Commercial |
$1,569.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.55
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,292.90
|
| Rate for Payer: Cofinity Commercial |
$1,588.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,292.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.60
|
| Rate for Payer: Healthscope Commercial |
$1,662.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,292.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,385.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,569.95
|
| Rate for Payer: PHP Commercial |
$1,569.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health SBD |
$1,163.61
|
| Rate for Payer: UMR Bronson Commercial |
$812.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,385.25
|
|
|
PR BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 44100
|
| Min. Negotiated Rate |
$100.26 |
| Max. Negotiated Rate |
$237.25 |
| Rate for Payer: Aetna Commercial |
$134.35
|
| Rate for Payer: Aetna Medicare |
$104.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.35
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCBS MAPPO |
$100.26
|
| Rate for Payer: BCN Medicare Advantage |
$100.26
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$144.37
|
| Rate for Payer: Cofinity Commercial |
$134.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.27
|
| Rate for Payer: Nomi Health Commercial |
$120.31
|
| Rate for Payer: PACE SWMI |
$100.26
|
| Rate for Payer: PHP Commercial |
$140.36
|
| Rate for Payer: PHP Medicare Advantage |
$100.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health Medicare |
$100.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.26
|
| Rate for Payer: UHC Medicare Advantage |
$100.26
|
| Rate for Payer: UMR Bronson Commercial |
$167.90
|
|
|
PR BX LVR NDL DONE PURPOSE TM OTH MAJOR PX
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 47001
|
| Min. Negotiated Rate |
$91.20 |
| Max. Negotiated Rate |
$148.20 |
| Rate for Payer: Aetna Commercial |
$135.70
|
| Rate for Payer: Aetna Medicare |
$105.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.70
|
| Rate for Payer: BCBS Complete |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$101.27
|
| Rate for Payer: BCN Medicare Advantage |
$101.27
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$145.83
|
| Rate for Payer: Cofinity Commercial |
$135.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.33
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: PACE SWMI |
$101.27
|
| Rate for Payer: PHP Commercial |
$141.78
|
| Rate for Payer: PHP Medicare Advantage |
$101.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health Medicare |
$101.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.27
|
| Rate for Payer: UHC Medicare Advantage |
$101.27
|
| Rate for Payer: UMR Bronson Commercial |
$104.88
|
|
