|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL
|
Professional
|
Both
|
$629.00
|
|
|
Service Code
|
HCPCS 34711
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$1,060.83 |
| Rate for Payer: Aetna Commercial |
$379.70
|
| Rate for Payer: Aetna Medicare |
$294.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.04
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$283.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,060.83
|
| Rate for Payer: BCN Commercial |
$418.30
|
| Rate for Payer: BCN Medicare Advantage |
$283.36
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cofinity Commercial |
$379.70
|
| Rate for Payer: Cofinity Commercial |
$408.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$297.53
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Nomi Health Commercial |
$340.03
|
| Rate for Payer: PACE SWMI |
$283.36
|
| Rate for Payer: PHP Commercial |
$396.70
|
| Rate for Payer: PHP Medicare Advantage |
$283.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.31
|
| Rate for Payer: Priority Health Medicare |
$283.36
|
| Rate for Payer: Priority Health Narrow Network |
$456.31
|
| Rate for Payer: Priority Health SBD |
$456.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.36
|
| Rate for Payer: UHC Medicare Advantage |
$283.36
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
| Rate for Payer: UMR Bronson Commercial |
$289.34
|
|
|
PR DOG EAR REVISION
|
Professional
|
Both
|
$1,845.00
|
|
|
Service Code
|
HCPCS 00565
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$738.00 |
| Max. Negotiated Rate |
$1,199.25 |
| Rate for Payer: Aetna Medicare |
$922.50
|
| Rate for Payer: BCBS Complete |
$738.00
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,199.25
|
| Rate for Payer: UMR Bronson Commercial |
$848.70
|
|
|
PR DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 99324
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
|
|
PR DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 99335
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: UMR Bronson Commercial |
$65.78
|
|
|
PR DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 99336
|
| Min. Negotiated Rate |
$80.80 |
| Max. Negotiated Rate |
$131.30 |
| Rate for Payer: Aetna Medicare |
$101.00
|
| Rate for Payer: BCBS Complete |
$80.80
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
| Rate for Payer: UMR Bronson Commercial |
$92.92
|
|
|
PR DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 99334
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$59.15 |
| Rate for Payer: Aetna Medicare |
$45.50
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: UMR Bronson Commercial |
$41.86
|
|
|
PR DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 99337
|
| Min. Negotiated Rate |
$115.60 |
| Max. Negotiated Rate |
$187.85 |
| Rate for Payer: Aetna Medicare |
$144.50
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.85
|
| Rate for Payer: UMR Bronson Commercial |
$132.94
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$2,792.59 |
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Medicare |
$21.05
|
| Rate for Payer: Aetna Medicare |
$21.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.12
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Meridian Medicaid |
$2.02
|
| Rate for Payer: Meridian Medicaid |
$2.02
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PHP Commercial |
$28.34
|
| Rate for Payer: PHP Commercial |
$28.34
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.96
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: Priority Health Narrow Network |
$32.96
|
| Rate for Payer: Priority Health Narrow Network |
$32.96
|
| Rate for Payer: Priority Health SBD |
$4.24
|
| Rate for Payer: Priority Health SBD |
$4.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
| Rate for Payer: UMR Bronson Commercial |
$151.80
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 93325
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$2,792.59 |
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Medicare |
$21.05
|
| Rate for Payer: Aetna Medicare |
$21.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.12
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Meridian Medicaid |
$2.02
|
| Rate for Payer: Meridian Medicaid |
$2.02
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PHP Commercial |
$28.34
|
| Rate for Payer: PHP Commercial |
$28.34
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.96
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: Priority Health Narrow Network |
$32.96
|
| Rate for Payer: Priority Health Narrow Network |
$32.96
|
| Rate for Payer: Priority Health SBD |
$4.24
|
| Rate for Payer: Priority Health SBD |
$4.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
| Rate for Payer: UMR Bronson Commercial |
$151.80
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$88.44 |
| Max. Negotiated Rate |
$180.90 |
| Rate for Payer: Aetna American Axle |
$130.65
|
| Rate for Payer: Aetna American Axle |
$214.50
|
| Rate for Payer: Aetna Commercial |
$170.85
|
| Rate for Payer: Aetna Commercial |
$280.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.50
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$283.80
|
| Rate for Payer: Cofinity Commercial |
$231.00
|
| Rate for Payer: Cofinity Commercial |
$140.70
|
| Rate for Payer: Cofinity Commercial |
$172.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.00
|
| Rate for Payer: Healthscope Commercial |
$180.90
|
| Rate for Payer: Healthscope Commercial |
$297.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.85
|
| Rate for Payer: PHP Commercial |
$280.50
|
| Rate for Payer: PHP Commercial |
$170.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health SBD |
$126.63
|
| Rate for Payer: Priority Health SBD |
$207.90
|
| Rate for Payer: UMR Bronson Commercial |
$88.44
|
| Rate for Payer: UMR Bronson Commercial |
$145.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.50
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Facility
|
OP
|
$330.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$21.08 |
| Max. Negotiated Rate |
$297.00 |
| Rate for Payer: Aetna American Axle |
$214.50
|
| Rate for Payer: Aetna American Axle |
$130.65
|
| Rate for Payer: Aetna Commercial |
$170.85
|
| Rate for Payer: Aetna Commercial |
$280.50
|
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.65
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS Trust/PPO |
$85.98
|
| Rate for Payer: BCBS Trust/PPO |
$85.98
|
| Rate for Payer: BCN Commercial |
$85.98
|
| Rate for Payer: BCN Commercial |
$85.98
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$172.86
|
| Rate for Payer: Cofinity Commercial |
$231.00
|
| Rate for Payer: Cofinity Commercial |
$283.80
|
| Rate for Payer: Cofinity Commercial |
$140.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.80
|
| Rate for Payer: Healthscope Commercial |
$180.90
|
| Rate for Payer: Healthscope Commercial |
$297.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.85
|
| Rate for Payer: PHP Commercial |
$280.50
|
| Rate for Payer: PHP Commercial |
$170.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health SBD |
$126.63
|
| Rate for Payer: Priority Health SBD |
$207.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.19
|
| Rate for Payer: UHC Exchange |
$21.08
|
| Rate for Payer: UHC Exchange |
$21.08
|
| Rate for Payer: UMR Bronson Commercial |
$74.37
|
| Rate for Payer: UMR Bronson Commercial |
$122.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.50
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
IP
|
$176.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$77.44 |
| Max. Negotiated Rate |
$158.40 |
| Rate for Payer: Aetna American Axle |
$114.40
|
| Rate for Payer: Aetna American Axle |
$168.35
|
| Rate for Payer: Aetna Commercial |
$220.15
|
| Rate for Payer: Aetna Commercial |
$149.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.35
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$151.36
|
| Rate for Payer: Cofinity Commercial |
$123.20
|
| Rate for Payer: Cofinity Commercial |
$181.30
|
| Rate for Payer: Cofinity Commercial |
$222.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Healthscope Commercial |
$233.10
|
| Rate for Payer: Healthscope Commercial |
$158.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: PHP Commercial |
$149.60
|
| Rate for Payer: PHP Commercial |
$220.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health SBD |
$163.17
|
| Rate for Payer: Priority Health SBD |
$110.88
|
| Rate for Payer: UMR Bronson Commercial |
$113.96
|
| Rate for Payer: UMR Bronson Commercial |
$77.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.25
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$46.62 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Aetna American Axle |
$168.35
|
| Rate for Payer: Aetna American Axle |
$114.40
|
| Rate for Payer: Aetna Commercial |
$149.60
|
| Rate for Payer: Aetna Commercial |
$220.15
|
| Rate for Payer: Aetna Medicare |
$129.50
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.40
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS Trust/PPO |
$140.95
|
| Rate for Payer: BCBS Trust/PPO |
$140.95
|
| Rate for Payer: BCN Commercial |
$140.95
|
| Rate for Payer: BCN Commercial |
$140.95
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$151.36
|
| Rate for Payer: Cofinity Commercial |
$181.30
|
| Rate for Payer: Cofinity Commercial |
$222.74
|
| Rate for Payer: Cofinity Commercial |
$123.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Healthscope Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$233.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: PHP Commercial |
$220.15
|
| Rate for Payer: PHP Commercial |
$149.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health SBD |
$110.88
|
| Rate for Payer: Priority Health SBD |
$163.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.28
|
| Rate for Payer: UHC Exchange |
$46.62
|
| Rate for Payer: UHC Exchange |
$46.62
|
| Rate for Payer: UMR Bronson Commercial |
$65.12
|
| Rate for Payer: UMR Bronson Commercial |
$95.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.25
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 93320
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$1,902.94 |
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.92
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PHP Commercial |
$63.64
|
| Rate for Payer: PHP Commercial |
$63.64
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.57
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: Priority Health Narrow Network |
$71.57
|
| Rate for Payer: Priority Health Narrow Network |
$71.57
|
| Rate for Payer: Priority Health SBD |
$24.48
|
| Rate for Payer: Priority Health SBD |
$24.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UMR Bronson Commercial |
$80.96
|
| Rate for Payer: UMR Bronson Commercial |
$119.14
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$1,902.94 |
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.92
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PHP Commercial |
$63.64
|
| Rate for Payer: PHP Commercial |
$63.64
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.57
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: Priority Health Narrow Network |
$71.57
|
| Rate for Payer: Priority Health Narrow Network |
$71.57
|
| Rate for Payer: Priority Health SBD |
$24.48
|
| Rate for Payer: Priority Health SBD |
$24.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UMR Bronson Commercial |
$80.96
|
| Rate for Payer: UMR Bronson Commercial |
$119.14
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93321
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$2,553.80 |
| Rate for Payer: Aetna Commercial |
$29.91
|
| Rate for Payer: Aetna Medicare |
$23.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.14
|
| Rate for Payer: BCBS Complete |
$4.69
|
| Rate for Payer: BCBS MAPPO |
$22.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,553.80
|
| Rate for Payer: BCN Commercial |
$36.65
|
| Rate for Payer: BCN Medicare Advantage |
$22.32
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$29.91
|
| Rate for Payer: Cofinity Commercial |
$32.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.44
|
| Rate for Payer: Meridian Medicaid |
$4.69
|
| Rate for Payer: Nomi Health Commercial |
$26.78
|
| Rate for Payer: PACE SWMI |
$22.32
|
| Rate for Payer: PHP Commercial |
$31.25
|
| Rate for Payer: PHP Medicare Advantage |
$22.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.32
|
| Rate for Payer: Priority Health Medicare |
$22.32
|
| Rate for Payer: Priority Health Narrow Network |
$35.32
|
| Rate for Payer: Priority Health SBD |
$9.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.32
|
| Rate for Payer: UHC Medicare Advantage |
$22.32
|
| Rate for Payer: UHCCP Medicaid |
$4.47
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
|
PR DRAIN ABD ABSCESS PERCUTANEOUS
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
HCPCS 49021
|
| Min. Negotiated Rate |
$247.60 |
| Max. Negotiated Rate |
$402.35 |
| Rate for Payer: Aetna Medicare |
$309.50
|
| Rate for Payer: BCBS Complete |
$247.60
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.35
|
| Rate for Payer: UMR Bronson Commercial |
$284.74
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 30000
|
| Min. Negotiated Rate |
$79.02 |
| Max. Negotiated Rate |
$1,942.56 |
| Rate for Payer: Aetna Commercial |
$154.70
|
| Rate for Payer: Aetna Medicare |
$120.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.25
|
| Rate for Payer: BCBS Complete |
$82.97
|
| Rate for Payer: BCBS MAPPO |
$115.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,942.56
|
| Rate for Payer: BCN Commercial |
$396.81
|
| Rate for Payer: BCN Medicare Advantage |
$115.45
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$154.70
|
| Rate for Payer: Cofinity Commercial |
$166.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.22
|
| Rate for Payer: Meridian Medicaid |
$82.97
|
| Rate for Payer: Nomi Health Commercial |
$138.54
|
| Rate for Payer: PACE SWMI |
$115.45
|
| Rate for Payer: PHP Commercial |
$161.63
|
| Rate for Payer: PHP Medicare Advantage |
$115.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.10
|
| Rate for Payer: Priority Health Medicare |
$115.45
|
| Rate for Payer: Priority Health Narrow Network |
$170.10
|
| Rate for Payer: Priority Health SBD |
$170.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.45
|
| Rate for Payer: UHC Medicare Advantage |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$79.02
|
| Rate for Payer: UMR Bronson Commercial |
$172.04
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS 30020
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$1,109.43 |
| Rate for Payer: Aetna Commercial |
$154.98
|
| Rate for Payer: Aetna Medicare |
$120.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.55
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$115.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.43
|
| Rate for Payer: BCN Commercial |
$401.20
|
| Rate for Payer: BCN Medicare Advantage |
$115.66
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cofinity Commercial |
$154.98
|
| Rate for Payer: Cofinity Commercial |
$166.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.44
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Nomi Health Commercial |
$138.79
|
| Rate for Payer: PACE SWMI |
$115.66
|
| Rate for Payer: PHP Commercial |
$161.92
|
| Rate for Payer: PHP Medicare Advantage |
$115.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.41
|
| Rate for Payer: Priority Health Medicare |
$115.66
|
| Rate for Payer: Priority Health Narrow Network |
$172.41
|
| Rate for Payer: Priority Health SBD |
$172.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.66
|
| Rate for Payer: UHC Medicare Advantage |
$115.66
|
| Rate for Payer: UHCCP Medicaid |
$79.24
|
| Rate for Payer: UMR Bronson Commercial |
$139.84
|
|
|
PR DRAINAGE ABSCESS PALATE UVULA
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 42000
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$237.98 |
| Rate for Payer: Aetna Commercial |
$138.07
|
| Rate for Payer: Aetna Medicare |
$107.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.38
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$103.04
|
| Rate for Payer: BCN Commercial |
$237.98
|
| Rate for Payer: BCN Medicare Advantage |
$103.04
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$138.07
|
| Rate for Payer: Cofinity Commercial |
$148.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.19
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Nomi Health Commercial |
$123.65
|
| Rate for Payer: PACE SWMI |
$103.04
|
| Rate for Payer: PHP Commercial |
$144.26
|
| Rate for Payer: PHP Medicare Advantage |
$103.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.47
|
| Rate for Payer: Priority Health Medicare |
$103.04
|
| Rate for Payer: Priority Health Narrow Network |
$197.47
|
| Rate for Payer: Priority Health SBD |
$197.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.04
|
| Rate for Payer: UHC Medicare Advantage |
$103.04
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
| Rate for Payer: UMR Bronson Commercial |
$154.56
|
|
|
PR DRAINAGE ABSCESS PAROTID COMPLICATED
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 42305
|
| Min. Negotiated Rate |
$200.75 |
| Max. Negotiated Rate |
$783.32 |
| Rate for Payer: Aetna Commercial |
$554.21
|
| Rate for Payer: Aetna Medicare |
$430.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.57
|
| Rate for Payer: BCBS Complete |
$294.33
|
| Rate for Payer: BCBS MAPPO |
$413.59
|
| Rate for Payer: BCBS Trust/PPO |
$200.75
|
| Rate for Payer: BCN Commercial |
$621.60
|
| Rate for Payer: BCN Medicare Advantage |
$413.59
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$554.21
|
| Rate for Payer: Cofinity Commercial |
$595.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.27
|
| Rate for Payer: Meridian Medicaid |
$294.33
|
| Rate for Payer: Nomi Health Commercial |
$496.31
|
| Rate for Payer: PACE SWMI |
$413.59
|
| Rate for Payer: PHP Commercial |
$579.03
|
| Rate for Payer: PHP Medicare Advantage |
$413.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$280.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.32
|
| Rate for Payer: Priority Health Medicare |
$413.59
|
| Rate for Payer: Priority Health Narrow Network |
$783.32
|
| Rate for Payer: Priority Health SBD |
$783.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.59
|
| Rate for Payer: UHC Medicare Advantage |
$413.59
|
| Rate for Payer: UHCCP Medicaid |
$280.31
|
| Rate for Payer: UMR Bronson Commercial |
$360.18
|
|
|
PR DRAINAGE ABSCESS PAROTID SIMPLE
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 42300
|
| Min. Negotiated Rate |
$101.18 |
| Max. Negotiated Rate |
$891.77 |
| Rate for Payer: Aetna Commercial |
$198.37
|
| Rate for Payer: Aetna Medicare |
$153.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.18
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS MAPPO |
$148.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.77
|
| Rate for Payer: BCN Commercial |
$319.11
|
| Rate for Payer: BCN Medicare Advantage |
$148.04
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$198.37
|
| Rate for Payer: Cofinity Commercial |
$213.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.44
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Nomi Health Commercial |
$177.65
|
| Rate for Payer: PACE SWMI |
$148.04
|
| Rate for Payer: PHP Commercial |
$207.26
|
| Rate for Payer: PHP Medicare Advantage |
$148.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.78
|
| Rate for Payer: Priority Health Medicare |
$148.04
|
| Rate for Payer: Priority Health Narrow Network |
$282.78
|
| Rate for Payer: Priority Health SBD |
$282.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.04
|
| Rate for Payer: UHC Medicare Advantage |
$148.04
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
| Rate for Payer: UMR Bronson Commercial |
$160.54
|
|
|
PR DRAINAGE DEEP PERIURETHRAL ABSCESS
|
Professional
|
Both
|
$815.00
|
|
|
Service Code
|
HCPCS 53040
|
| Min. Negotiated Rate |
$253.26 |
| Max. Negotiated Rate |
$758.64 |
| Rate for Payer: Aetna Commercial |
$503.85
|
| Rate for Payer: Aetna Medicare |
$391.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.45
|
| Rate for Payer: BCBS Complete |
$265.92
|
| Rate for Payer: BCBS MAPPO |
$376.01
|
| Rate for Payer: BCBS Trust/PPO |
$758.64
|
| Rate for Payer: BCN Commercial |
$568.33
|
| Rate for Payer: BCN Medicare Advantage |
$376.01
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cofinity Commercial |
$503.85
|
| Rate for Payer: Cofinity Commercial |
$541.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.81
|
| Rate for Payer: Meridian Medicaid |
$265.92
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: PACE SWMI |
$376.01
|
| Rate for Payer: PHP Commercial |
$526.41
|
| Rate for Payer: PHP Medicare Advantage |
$376.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.94
|
| Rate for Payer: Priority Health Medicare |
$376.01
|
| Rate for Payer: Priority Health Narrow Network |
$627.94
|
| Rate for Payer: Priority Health SBD |
$627.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.01
|
| Rate for Payer: UHC Medicare Advantage |
$376.01
|
| Rate for Payer: UHCCP Medicaid |
$253.26
|
| Rate for Payer: UMR Bronson Commercial |
$374.90
|
|
|
PR DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 69020
|
| Min. Negotiated Rate |
$92.66 |
| Max. Negotiated Rate |
$346.96 |
| Rate for Payer: Aetna Commercial |
$180.06
|
| Rate for Payer: Aetna Medicare |
$139.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.49
|
| Rate for Payer: BCBS Complete |
$97.29
|
| Rate for Payer: BCBS MAPPO |
$134.37
|
| Rate for Payer: BCBS Trust/PPO |
$282.64
|
| Rate for Payer: BCN Commercial |
$346.96
|
| Rate for Payer: BCN Medicare Advantage |
$134.37
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cofinity Commercial |
$180.06
|
| Rate for Payer: Cofinity Commercial |
$193.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.09
|
| Rate for Payer: Meridian Medicaid |
$97.29
|
| Rate for Payer: Nomi Health Commercial |
$161.24
|
| Rate for Payer: PACE SWMI |
$134.37
|
| Rate for Payer: PHP Commercial |
$188.12
|
| Rate for Payer: PHP Medicare Advantage |
$134.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.05
|
| Rate for Payer: Priority Health Medicare |
$134.37
|
| Rate for Payer: Priority Health Narrow Network |
$212.05
|
| Rate for Payer: Priority Health SBD |
$212.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.37
|
| Rate for Payer: UHC Medicare Advantage |
$134.37
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
| Rate for Payer: UMR Bronson Commercial |
$174.80
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA COMP
|
Professional
|
Both
|
$385.00
|
|
|
Service Code
|
HCPCS 69005
|
| Min. Negotiated Rate |
$104.37 |
| Max. Negotiated Rate |
$5,834.02 |
| Rate for Payer: Aetna Commercial |
$205.57
|
| Rate for Payer: Aetna Medicare |
$159.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.91
|
| Rate for Payer: BCBS Complete |
$109.59
|
| Rate for Payer: BCBS MAPPO |
$153.41
|
| Rate for Payer: BCBS Trust/PPO |
$5,834.02
|
| Rate for Payer: BCN Commercial |
$323.02
|
| Rate for Payer: BCN Medicare Advantage |
$153.41
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cofinity Commercial |
$205.57
|
| Rate for Payer: Cofinity Commercial |
$220.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.08
|
| Rate for Payer: Meridian Medicaid |
$109.59
|
| Rate for Payer: Nomi Health Commercial |
$184.09
|
| Rate for Payer: PACE SWMI |
$153.41
|
| Rate for Payer: PHP Commercial |
$214.77
|
| Rate for Payer: PHP Medicare Advantage |
$153.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.84
|
| Rate for Payer: Priority Health Medicare |
$153.41
|
| Rate for Payer: Priority Health Narrow Network |
$237.84
|
| Rate for Payer: Priority Health SBD |
$237.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.41
|
| Rate for Payer: UHC Medicare Advantage |
$153.41
|
| Rate for Payer: UHCCP Medicaid |
$104.37
|
| Rate for Payer: UMR Bronson Commercial |
$177.10
|
|
