|
PR CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 98941
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$583.77 |
| Rate for Payer: Aetna Commercial |
$42.73
|
| Rate for Payer: Aetna Medicare |
$33.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.92
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$31.89
|
| Rate for Payer: BCBS Trust/PPO |
$583.77
|
| Rate for Payer: BCN Commercial |
$38.50
|
| Rate for Payer: BCN Medicare Advantage |
$31.89
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$42.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.48
|
| Rate for Payer: Nomi Health Commercial |
$38.27
|
| Rate for Payer: PACE SWMI |
$31.89
|
| Rate for Payer: PHP Commercial |
$44.65
|
| Rate for Payer: PHP Medicare Advantage |
$31.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.23
|
| Rate for Payer: Priority Health Medicare |
$31.89
|
| Rate for Payer: Priority Health Narrow Network |
$45.23
|
| Rate for Payer: Priority Health SBD |
$45.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.89
|
| Rate for Payer: UHC Medicare Advantage |
$31.89
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
PR CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 50688
|
| Min. Negotiated Rate |
$50.06 |
| Max. Negotiated Rate |
$2,900.37 |
| Rate for Payer: Aetna Commercial |
$98.91
|
| Rate for Payer: Aetna Medicare |
$76.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.29
|
| Rate for Payer: BCBS Complete |
$52.56
|
| Rate for Payer: BCBS MAPPO |
$73.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.37
|
| Rate for Payer: BCN Commercial |
$111.42
|
| Rate for Payer: BCN Medicare Advantage |
$73.81
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$98.91
|
| Rate for Payer: Cofinity Commercial |
$106.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.50
|
| Rate for Payer: Meridian Medicaid |
$52.56
|
| Rate for Payer: Nomi Health Commercial |
$88.57
|
| Rate for Payer: PACE SWMI |
$73.81
|
| Rate for Payer: PHP Commercial |
$103.33
|
| Rate for Payer: PHP Medicare Advantage |
$73.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.02
|
| Rate for Payer: Priority Health Medicare |
$73.81
|
| Rate for Payer: Priority Health Narrow Network |
$123.02
|
| Rate for Payer: Priority Health SBD |
$123.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.81
|
| Rate for Payer: UHC Medicare Advantage |
$73.81
|
| Rate for Payer: UHCCP Medicaid |
$50.06
|
| Rate for Payer: UMR Bronson Commercial |
$69.00
|
|
|
PR CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,120.00
|
|
|
Service Code
|
HCPCS 47620
|
| Min. Negotiated Rate |
$521.43 |
| Max. Negotiated Rate |
$2,459.75 |
| Rate for Payer: Aetna Commercial |
$1,790.91
|
| Rate for Payer: Aetna Medicare |
$1,389.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,790.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,924.56
|
| Rate for Payer: BCBS Complete |
$926.13
|
| Rate for Payer: BCBS MAPPO |
$1,336.50
|
| Rate for Payer: BCBS Trust/PPO |
$521.43
|
| Rate for Payer: BCN Commercial |
$2,007.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,336.50
|
| Rate for Payer: Cash Price |
$1,696.00
|
| Rate for Payer: Cash Price |
$1,696.00
|
| Rate for Payer: Cofinity Commercial |
$1,790.91
|
| Rate for Payer: Cofinity Commercial |
$1,924.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,336.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,403.32
|
| Rate for Payer: Meridian Medicaid |
$926.13
|
| Rate for Payer: Nomi Health Commercial |
$1,603.80
|
| Rate for Payer: PACE SWMI |
$1,336.50
|
| Rate for Payer: PHP Commercial |
$1,871.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,336.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$882.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,378.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,459.75
|
| Rate for Payer: Priority Health Medicare |
$1,336.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,459.75
|
| Rate for Payer: Priority Health SBD |
$2,459.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,336.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,336.50
|
| Rate for Payer: UHCCP Medicaid |
$882.03
|
| Rate for Payer: UMR Bronson Commercial |
$975.20
|
|
|
PR CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM
|
Professional
|
Both
|
$2,644.00
|
|
|
Service Code
|
HCPCS 47741
|
| Min. Negotiated Rate |
$446.41 |
| Max. Negotiated Rate |
$2,641.72 |
| Rate for Payer: Aetna Commercial |
$1,919.83
|
| Rate for Payer: Aetna Medicare |
$1,490.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,919.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,063.10
|
| Rate for Payer: BCBS Complete |
$994.79
|
| Rate for Payer: BCBS MAPPO |
$1,432.71
|
| Rate for Payer: BCBS Trust/PPO |
$446.41
|
| Rate for Payer: BCN Commercial |
$2,155.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,432.71
|
| Rate for Payer: Cash Price |
$2,115.20
|
| Rate for Payer: Cash Price |
$2,115.20
|
| Rate for Payer: Cofinity Commercial |
$1,919.83
|
| Rate for Payer: Cofinity Commercial |
$2,063.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,432.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,504.35
|
| Rate for Payer: Meridian Medicaid |
$994.79
|
| Rate for Payer: Nomi Health Commercial |
$1,719.25
|
| Rate for Payer: PACE SWMI |
$1,432.71
|
| Rate for Payer: PHP Commercial |
$2,005.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,432.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$947.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,718.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,641.72
|
| Rate for Payer: Priority Health Medicare |
$1,432.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.72
|
| Rate for Payer: Priority Health SBD |
$2,641.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,432.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,432.71
|
| Rate for Payer: UHCCP Medicaid |
$947.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,216.24
|
|
|
PR CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX
|
Professional
|
Both
|
$2,623.00
|
|
|
Service Code
|
HCPCS 47480
|
| Min. Negotiated Rate |
$566.79 |
| Max. Negotiated Rate |
$1,704.95 |
| Rate for Payer: Aetna Commercial |
$1,138.30
|
| Rate for Payer: Aetna Medicare |
$883.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,138.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,223.25
|
| Rate for Payer: BCBS Complete |
$595.13
|
| Rate for Payer: BCBS MAPPO |
$849.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.28
|
| Rate for Payer: BCN Commercial |
$1,283.75
|
| Rate for Payer: BCN Medicare Advantage |
$849.48
|
| Rate for Payer: Cash Price |
$2,098.40
|
| Rate for Payer: Cash Price |
$2,098.40
|
| Rate for Payer: Cofinity Commercial |
$1,138.30
|
| Rate for Payer: Cofinity Commercial |
$1,223.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.95
|
| Rate for Payer: Meridian Medicaid |
$595.13
|
| Rate for Payer: Nomi Health Commercial |
$1,019.38
|
| Rate for Payer: PACE SWMI |
$849.48
|
| Rate for Payer: PHP Commercial |
$1,189.27
|
| Rate for Payer: PHP Medicare Advantage |
$849.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,704.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,572.62
|
| Rate for Payer: Priority Health Medicare |
$849.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,572.62
|
| Rate for Payer: Priority Health SBD |
$1,572.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$849.48
|
| Rate for Payer: UHC Medicare Advantage |
$849.48
|
| Rate for Payer: UHCCP Medicaid |
$566.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,206.58
|
|
|
PR CHOLECYSTECTOMY
|
Facility
|
IP
|
$2,617.00
|
|
|
Service Code
|
CPT 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$1,151.48 |
| Max. Negotiated Rate |
$2,355.30 |
| Rate for Payer: Aetna American Axle |
$1,701.05
|
| Rate for Payer: Aetna Commercial |
$2,224.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,701.05
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cofinity Commercial |
$1,831.90
|
| Rate for Payer: Cofinity Commercial |
$2,250.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,831.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,093.60
|
| Rate for Payer: Healthscope Commercial |
$2,355.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,831.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,224.45
|
| Rate for Payer: PHP Commercial |
$2,224.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.05
|
| Rate for Payer: Priority Health SBD |
$1,648.71
|
| Rate for Payer: UMR Bronson Commercial |
$1,151.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.75
|
|
|
PR CHOLECYSTECTOMY
|
Professional
|
Both
|
$2,617.00
|
|
|
Service Code
|
HCPCS 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$690.12 |
| Max. Negotiated Rate |
$2,558.03 |
| Rate for Payer: Aetna Commercial |
$1,395.74
|
| Rate for Payer: Aetna Medicare |
$1,083.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,499.90
|
| Rate for Payer: BCBS Complete |
$724.63
|
| Rate for Payer: BCBS MAPPO |
$1,041.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,558.03
|
| Rate for Payer: BCN Commercial |
$1,562.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.60
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cofinity Commercial |
$1,499.90
|
| Rate for Payer: Cofinity Commercial |
$1,395.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,093.68
|
| Rate for Payer: Meridian Medicaid |
$724.63
|
| Rate for Payer: Nomi Health Commercial |
$1,249.92
|
| Rate for Payer: PACE SWMI |
$1,041.60
|
| Rate for Payer: PHP Commercial |
$1,458.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,919.24
|
| Rate for Payer: Priority Health Medicare |
$1,041.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,919.24
|
| Rate for Payer: Priority Health SBD |
$1,919.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,041.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,041.60
|
| Rate for Payer: UHCCP Medicaid |
$690.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,203.82
|
|
|
PR CHOLECYSTECTOMY
|
Facility
|
OP
|
$2,617.00
|
|
|
Service Code
|
CPT 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$968.29 |
| Max. Negotiated Rate |
$3,904.13 |
| Rate for Payer: Aetna American Axle |
$1,701.05
|
| Rate for Payer: Aetna Commercial |
$2,224.45
|
| Rate for Payer: Aetna Medicare |
$1,308.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,701.05
|
| Rate for Payer: BCBS Complete |
$1,046.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,904.13
|
| Rate for Payer: BCN Commercial |
$3,904.13
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cofinity Commercial |
$2,250.62
|
| Rate for Payer: Cofinity Commercial |
$1,831.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,831.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,093.60
|
| Rate for Payer: Healthscope Commercial |
$2,355.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,831.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,224.45
|
| Rate for Payer: PHP Commercial |
$2,224.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.05
|
| Rate for Payer: Priority Health SBD |
$1,648.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,152.58
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$1,047.80
|
| Rate for Payer: UMR Bronson Commercial |
$968.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.75
|
|
|
PR CHOLECYSTECTOMY
|
Professional
|
Both
|
$2,617.00
|
|
|
Service Code
|
HCPCS 47600
|
| Min. Negotiated Rate |
$690.12 |
| Max. Negotiated Rate |
$2,558.03 |
| Rate for Payer: Aetna Commercial |
$1,395.74
|
| Rate for Payer: Aetna Medicare |
$1,083.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,499.90
|
| Rate for Payer: BCBS Complete |
$724.63
|
| Rate for Payer: BCBS MAPPO |
$1,041.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,558.03
|
| Rate for Payer: BCN Commercial |
$1,562.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,041.60
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cash Price |
$2,093.60
|
| Rate for Payer: Cofinity Commercial |
$1,395.74
|
| Rate for Payer: Cofinity Commercial |
$1,499.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,041.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,093.68
|
| Rate for Payer: Meridian Medicaid |
$724.63
|
| Rate for Payer: Nomi Health Commercial |
$1,249.92
|
| Rate for Payer: PACE SWMI |
$1,041.60
|
| Rate for Payer: PHP Commercial |
$1,458.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,041.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$690.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,701.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,919.24
|
| Rate for Payer: Priority Health Medicare |
$1,041.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,919.24
|
| Rate for Payer: Priority Health SBD |
$1,919.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,041.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,041.60
|
| Rate for Payer: UHCCP Medicaid |
$690.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,203.82
|
|
|
PR CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY
|
Professional
|
Both
|
$4,710.00
|
|
|
Service Code
|
HCPCS 47612
|
| Min. Negotiated Rate |
$676.22 |
| Max. Negotiated Rate |
$3,061.50 |
| Rate for Payer: Aetna Commercial |
$1,658.25
|
| Rate for Payer: Aetna Medicare |
$1,287.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,658.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,782.00
|
| Rate for Payer: BCBS Complete |
$858.14
|
| Rate for Payer: BCBS MAPPO |
$1,237.50
|
| Rate for Payer: BCBS Trust/PPO |
$676.22
|
| Rate for Payer: BCN Commercial |
$1,858.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.50
|
| Rate for Payer: Cash Price |
$3,768.00
|
| Rate for Payer: Cash Price |
$3,768.00
|
| Rate for Payer: Cofinity Commercial |
$1,658.25
|
| Rate for Payer: Cofinity Commercial |
$1,782.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.38
|
| Rate for Payer: Meridian Medicaid |
$858.14
|
| Rate for Payer: Nomi Health Commercial |
$1,485.00
|
| Rate for Payer: PACE SWMI |
$1,237.50
|
| Rate for Payer: PHP Commercial |
$1,732.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$817.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,061.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,278.98
|
| Rate for Payer: Priority Health Medicare |
$1,237.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,278.98
|
| Rate for Payer: Priority Health SBD |
$2,278.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,237.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,237.50
|
| Rate for Payer: UHCCP Medicaid |
$817.28
|
| Rate for Payer: UMR Bronson Commercial |
$2,166.60
|
|
|
PR CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$3,009.00
|
|
|
Service Code
|
HCPCS 47605
|
| Min. Negotiated Rate |
$725.69 |
| Max. Negotiated Rate |
$2,020.67 |
| Rate for Payer: Aetna Commercial |
$1,468.84
|
| Rate for Payer: Aetna Medicare |
$1,140.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,468.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.46
|
| Rate for Payer: BCBS Complete |
$761.97
|
| Rate for Payer: BCBS MAPPO |
$1,096.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.79
|
| Rate for Payer: BCN Commercial |
$1,648.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.15
|
| Rate for Payer: Cash Price |
$2,407.20
|
| Rate for Payer: Cash Price |
$2,407.20
|
| Rate for Payer: Cofinity Commercial |
$1,468.84
|
| Rate for Payer: Cofinity Commercial |
$1,578.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.96
|
| Rate for Payer: Meridian Medicaid |
$761.97
|
| Rate for Payer: Nomi Health Commercial |
$1,315.38
|
| Rate for Payer: PACE SWMI |
$1,096.15
|
| Rate for Payer: PHP Commercial |
$1,534.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,955.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,020.67
|
| Rate for Payer: Priority Health Medicare |
$1,096.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,020.67
|
| Rate for Payer: Priority Health SBD |
$2,020.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,096.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,096.15
|
| Rate for Payer: UHCCP Medicaid |
$725.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,384.14
|
|
|
PR CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT
|
Professional
|
Both
|
$3,310.00
|
|
|
Service Code
|
HCPCS 47610
|
| Min. Negotiated Rate |
$141.58 |
| Max. Negotiated Rate |
$2,235.43 |
| Rate for Payer: Aetna Commercial |
$1,634.95
|
| Rate for Payer: Aetna Medicare |
$1,268.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,634.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,756.96
|
| Rate for Payer: BCBS Complete |
$846.74
|
| Rate for Payer: BCBS MAPPO |
$1,220.11
|
| Rate for Payer: BCBS Trust/PPO |
$141.58
|
| Rate for Payer: BCN Commercial |
$1,829.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,220.11
|
| Rate for Payer: Cash Price |
$2,648.00
|
| Rate for Payer: Cash Price |
$2,648.00
|
| Rate for Payer: Cofinity Commercial |
$1,634.95
|
| Rate for Payer: Cofinity Commercial |
$1,756.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,220.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,281.12
|
| Rate for Payer: Meridian Medicaid |
$846.74
|
| Rate for Payer: Nomi Health Commercial |
$1,464.13
|
| Rate for Payer: PACE SWMI |
$1,220.11
|
| Rate for Payer: PHP Commercial |
$1,708.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,220.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$806.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,151.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,235.43
|
| Rate for Payer: Priority Health Medicare |
$1,220.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,235.43
|
| Rate for Payer: Priority Health SBD |
$2,235.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,220.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,220.11
|
| Rate for Payer: UHCCP Medicaid |
$806.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,522.60
|
|
|
PR CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 47490
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$4,357.95 |
| Rate for Payer: Aetna Commercial |
$413.66
|
| Rate for Payer: Aetna Medicare |
$321.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.53
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$308.70
|
| Rate for Payer: BCBS Trust/PPO |
$4,357.95
|
| Rate for Payer: BCN Commercial |
$480.37
|
| Rate for Payer: BCN Medicare Advantage |
$308.70
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$413.66
|
| Rate for Payer: Cofinity Commercial |
$444.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.14
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Nomi Health Commercial |
$370.44
|
| Rate for Payer: PACE SWMI |
$308.70
|
| Rate for Payer: PHP Commercial |
$432.18
|
| Rate for Payer: PHP Medicare Advantage |
$308.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.06
|
| Rate for Payer: Priority Health Medicare |
$308.70
|
| Rate for Payer: Priority Health Narrow Network |
$584.06
|
| Rate for Payer: Priority Health SBD |
$584.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.70
|
| Rate for Payer: UHC Medicare Advantage |
$308.70
|
| Rate for Payer: UHCCP Medicaid |
$210.23
|
| Rate for Payer: UMR Bronson Commercial |
$311.42
|
|
|
PR CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,405.00
|
|
|
Service Code
|
HCPCS 47420
|
| Min. Negotiated Rate |
$856.69 |
| Max. Negotiated Rate |
$2,396.52 |
| Rate for Payer: Aetna Commercial |
$1,734.58
|
| Rate for Payer: Aetna Medicare |
$1,346.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,734.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,864.02
|
| Rate for Payer: BCBS Complete |
$899.52
|
| Rate for Payer: BCBS MAPPO |
$1,294.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.71
|
| Rate for Payer: BCN Commercial |
$1,943.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,294.46
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cash Price |
$1,924.00
|
| Rate for Payer: Cofinity Commercial |
$1,734.58
|
| Rate for Payer: Cofinity Commercial |
$1,864.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,294.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,359.18
|
| Rate for Payer: Meridian Medicaid |
$899.52
|
| Rate for Payer: Nomi Health Commercial |
$1,553.35
|
| Rate for Payer: PACE SWMI |
$1,294.46
|
| Rate for Payer: PHP Commercial |
$1,812.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,294.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,563.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,396.52
|
| Rate for Payer: Priority Health Medicare |
$1,294.46
|
| Rate for Payer: Priority Health Narrow Network |
$2,396.52
|
| Rate for Payer: Priority Health SBD |
$2,396.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,294.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,294.46
|
| Rate for Payer: UHCCP Medicaid |
$856.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,106.30
|
|
|
PR CHOLERA IMMUNIZATION,INJECTABLE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 90725
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: UMR Bronson Commercial |
$5.52
|
|
|
PR CHOLINESTERASE INHIBITOR CHALLENGE TEST
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 95857
|
| Min. Negotiated Rate |
$17.89 |
| Max. Negotiated Rate |
$220.30 |
| Rate for Payer: Aetna Commercial |
$35.67
|
| Rate for Payer: Aetna Medicare |
$27.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.33
|
| Rate for Payer: BCBS Complete |
$18.78
|
| Rate for Payer: BCBS MAPPO |
$26.62
|
| Rate for Payer: BCBS Trust/PPO |
$220.30
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.62
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$35.67
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.95
|
| Rate for Payer: Meridian Medicaid |
$18.78
|
| Rate for Payer: Nomi Health Commercial |
$31.94
|
| Rate for Payer: PACE SWMI |
$26.62
|
| Rate for Payer: PHP Commercial |
$37.27
|
| Rate for Payer: PHP Medicare Advantage |
$26.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.99
|
| Rate for Payer: Priority Health Medicare |
$26.62
|
| Rate for Payer: Priority Health Narrow Network |
$37.99
|
| Rate for Payer: Priority Health SBD |
$37.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.62
|
| Rate for Payer: UHC Medicare Advantage |
$26.62
|
| Rate for Payer: UHCCP Medicaid |
$17.89
|
| Rate for Payer: UMR Bronson Commercial |
$74.06
|
|
|
PR CHORIONIC VILLUS SAMPLING
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 59015
|
| Min. Negotiated Rate |
$83.92 |
| Max. Negotiated Rate |
$258.70 |
| Rate for Payer: Aetna Commercial |
$171.56
|
| Rate for Payer: Aetna Medicare |
$133.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.36
|
| Rate for Payer: BCBS Complete |
$88.12
|
| Rate for Payer: BCBS MAPPO |
$128.03
|
| Rate for Payer: BCBS Trust/PPO |
$143.17
|
| Rate for Payer: BCN Commercial |
$231.15
|
| Rate for Payer: BCN Medicare Advantage |
$128.03
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$171.56
|
| Rate for Payer: Cofinity Commercial |
$184.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.43
|
| Rate for Payer: Meridian Medicaid |
$88.12
|
| Rate for Payer: Nomi Health Commercial |
$153.64
|
| Rate for Payer: PACE SWMI |
$128.03
|
| Rate for Payer: PHP Commercial |
$179.24
|
| Rate for Payer: PHP Medicare Advantage |
$128.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.98
|
| Rate for Payer: Priority Health Medicare |
$128.03
|
| Rate for Payer: Priority Health Narrow Network |
$183.98
|
| Rate for Payer: Priority Health SBD |
$183.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.03
|
| Rate for Payer: UHC Medicare Advantage |
$128.03
|
| Rate for Payer: UHCCP Medicaid |
$83.92
|
| Rate for Payer: UMR Bronson Commercial |
$183.08
|
|
|
PR CHROMOTUBATION OVIDUCT W/MATERIALS
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 58350
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$508.22 |
| Rate for Payer: Aetna Commercial |
$118.56
|
| Rate for Payer: Aetna Medicare |
$92.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.41
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS MAPPO |
$88.48
|
| Rate for Payer: BCBS Trust/PPO |
$508.22
|
| Rate for Payer: BCN Commercial |
$228.22
|
| Rate for Payer: BCN Medicare Advantage |
$88.48
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$127.41
|
| Rate for Payer: Cofinity Commercial |
$118.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.90
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Nomi Health Commercial |
$106.18
|
| Rate for Payer: PACE SWMI |
$88.48
|
| Rate for Payer: PHP Commercial |
$123.87
|
| Rate for Payer: PHP Medicare Advantage |
$88.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.86
|
| Rate for Payer: Priority Health Medicare |
$88.48
|
| Rate for Payer: Priority Health Narrow Network |
$142.86
|
| Rate for Payer: Priority Health SBD |
$142.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.48
|
| Rate for Payer: UHC Medicare Advantage |
$88.48
|
| Rate for Payer: UHCCP Medicaid |
$60.71
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE
|
Professional
|
Both
|
$3,535.00
|
|
|
Service Code
|
HCPCS 24940
|
| Min. Negotiated Rate |
$602.42 |
| Max. Negotiated Rate |
$11,675.93 |
| Rate for Payer: Aetna Commercial |
$1,439.82
|
| Rate for Payer: Aetna Medicare |
$1,767.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,439.82
|
| Rate for Payer: BCBS Complete |
$632.54
|
| Rate for Payer: BCBS Trust/PPO |
$730.11
|
| Rate for Payer: BCN Commercial |
$11,675.93
|
| Rate for Payer: Cash Price |
$2,828.00
|
| Rate for Payer: Cash Price |
$2,828.00
|
| Rate for Payer: Meridian Medicaid |
$632.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,680.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,680.25
|
| Rate for Payer: Priority Health SBD |
$1,680.25
|
| Rate for Payer: UHCCP Medicaid |
$602.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,626.10
|
|
|
PR CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT
|
Professional
|
Both
|
$646.00
|
|
|
Service Code
|
HCPCS 94772
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$544.82 |
| Rate for Payer: Aetna Commercial |
$318.52
|
| Rate for Payer: Aetna Medicare |
$323.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.52
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS Trust/PPO |
$518.79
|
| Rate for Payer: BCN Commercial |
$544.82
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Cash Price |
$516.80
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.44
|
| Rate for Payer: Priority Health Narrow Network |
$427.44
|
| Rate for Payer: Priority Health SBD |
$170.98
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
| Rate for Payer: UMR Bronson Commercial |
$297.16
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,543.00
|
|
|
Service Code
|
HCPCS 54161
|
| Min. Negotiated Rate |
$127.16 |
| Max. Negotiated Rate |
$1,002.95 |
| Rate for Payer: Aetna Commercial |
$253.09
|
| Rate for Payer: Aetna Medicare |
$196.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.97
|
| Rate for Payer: BCBS Complete |
$133.52
|
| Rate for Payer: BCBS MAPPO |
$188.87
|
| Rate for Payer: BCBS Trust/PPO |
$496.07
|
| Rate for Payer: BCN Commercial |
$285.39
|
| Rate for Payer: BCN Medicare Advantage |
$188.87
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cofinity Commercial |
$271.97
|
| Rate for Payer: Cofinity Commercial |
$253.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.31
|
| Rate for Payer: Meridian Medicaid |
$133.52
|
| Rate for Payer: Nomi Health Commercial |
$226.64
|
| Rate for Payer: PACE SWMI |
$188.87
|
| Rate for Payer: PHP Commercial |
$264.42
|
| Rate for Payer: PHP Medicare Advantage |
$188.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.30
|
| Rate for Payer: Priority Health Medicare |
$188.87
|
| Rate for Payer: Priority Health Narrow Network |
$315.30
|
| Rate for Payer: Priority Health SBD |
$315.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.87
|
| Rate for Payer: UHC Medicare Advantage |
$188.87
|
| Rate for Payer: UHCCP Medicaid |
$127.16
|
| Rate for Payer: UMR Bronson Commercial |
$709.78
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
IP
|
$1,543.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$678.92 |
| Max. Negotiated Rate |
$1,388.70 |
| Rate for Payer: Aetna American Axle |
$1,002.95
|
| Rate for Payer: Aetna Commercial |
$1,311.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,002.95
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cofinity Commercial |
$1,080.10
|
| Rate for Payer: Cofinity Commercial |
$1,326.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,080.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,234.40
|
| Rate for Payer: Healthscope Commercial |
$1,388.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,080.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,157.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,311.55
|
| Rate for Payer: PHP Commercial |
$1,311.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.95
|
| Rate for Payer: Priority Health SBD |
$972.09
|
| Rate for Payer: UMR Bronson Commercial |
$678.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,157.25
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Professional
|
Both
|
$1,543.00
|
|
|
Service Code
|
HCPCS 54161
|
| Hospital Charge Code |
54161
|
| Min. Negotiated Rate |
$127.16 |
| Max. Negotiated Rate |
$1,002.95 |
| Rate for Payer: Aetna Commercial |
$253.09
|
| Rate for Payer: Aetna Medicare |
$196.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.97
|
| Rate for Payer: BCBS Complete |
$133.52
|
| Rate for Payer: BCBS MAPPO |
$188.87
|
| Rate for Payer: BCBS Trust/PPO |
$496.07
|
| Rate for Payer: BCN Commercial |
$285.39
|
| Rate for Payer: BCN Medicare Advantage |
$188.87
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cofinity Commercial |
$271.97
|
| Rate for Payer: Cofinity Commercial |
$253.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.31
|
| Rate for Payer: Meridian Medicaid |
$133.52
|
| Rate for Payer: Nomi Health Commercial |
$226.64
|
| Rate for Payer: PACE SWMI |
$188.87
|
| Rate for Payer: PHP Commercial |
$264.42
|
| Rate for Payer: PHP Medicare Advantage |
$188.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.30
|
| Rate for Payer: Priority Health Medicare |
$188.87
|
| Rate for Payer: Priority Health Narrow Network |
$315.30
|
| Rate for Payer: Priority Health SBD |
$315.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.87
|
| Rate for Payer: UHC Medicare Advantage |
$188.87
|
| Rate for Payer: UHCCP Medicaid |
$127.16
|
| Rate for Payer: UMR Bronson Commercial |
$709.78
|
|
|
PR CIRCUMCISION AGE >28 DAYS
|
Facility
|
OP
|
$1,543.00
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
54161
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna American Axle |
$1,002.95
|
| Rate for Payer: Aetna Commercial |
$1,311.55
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,002.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,979.42
|
| Rate for Payer: BCN Commercial |
$2,979.42
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cash Price |
$1,234.40
|
| Rate for Payer: Cofinity Commercial |
$1,080.10
|
| Rate for Payer: Cofinity Commercial |
$1,326.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,080.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,234.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$1,388.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,080.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,157.25
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,311.55
|
| Rate for Payer: Nomi Health Commercial |
$4,214.89
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$1,311.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Priority Health SBD |
$972.09
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.67
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$189.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: UMR Bronson Commercial |
$570.91
|
| Rate for Payer: VA VA |
$2,007.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,157.25
|
|
|
PR CIRCUMCISION NEONATE
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
HCPCS 54160
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$2,797.35 |
| Rate for Payer: Aetna Commercial |
$185.60
|
| Rate for Payer: Aetna Medicare |
$144.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.45
|
| Rate for Payer: BCBS Complete |
$97.73
|
| Rate for Payer: BCBS MAPPO |
$138.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,797.35
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: BCN Medicare Advantage |
$138.51
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cofinity Commercial |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$199.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.44
|
| Rate for Payer: Meridian Medicaid |
$97.73
|
| Rate for Payer: Nomi Health Commercial |
$166.21
|
| Rate for Payer: PACE SWMI |
$138.51
|
| Rate for Payer: PHP Commercial |
$193.91
|
| Rate for Payer: PHP Medicare Advantage |
$138.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.21
|
| Rate for Payer: Priority Health Medicare |
$138.51
|
| Rate for Payer: Priority Health Narrow Network |
$232.21
|
| Rate for Payer: Priority Health SBD |
$232.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.51
|
| Rate for Payer: UHC Medicare Advantage |
$138.51
|
| Rate for Payer: UHCCP Medicaid |
$93.08
|
| Rate for Payer: UMR Bronson Commercial |
$278.76
|
|
