|
PR DRUG SCREEN MULTIP CLASS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS G0431
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$40.30 |
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
PR DRUG SCREEN PANEL 10 WITH BATH SALTS
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 00124
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$50.05 |
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
|
|
PR DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS
|
Professional
|
Both
|
$2,434.00
|
|
|
Service Code
|
HCPCS 36838
|
| Min. Negotiated Rate |
$713.55 |
| Max. Negotiated Rate |
$1,776.29 |
| Rate for Payer: Aetna Commercial |
$1,466.88
|
| Rate for Payer: Aetna Medicare |
$1,138.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,466.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,576.35
|
| Rate for Payer: BCBS Complete |
$749.23
|
| Rate for Payer: BCBS MAPPO |
$1,094.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.13
|
| Rate for Payer: BCN Commercial |
$1,629.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,094.69
|
| Rate for Payer: Cash Price |
$1,947.20
|
| Rate for Payer: Cash Price |
$1,947.20
|
| Rate for Payer: Cofinity Commercial |
$1,576.35
|
| Rate for Payer: Cofinity Commercial |
$1,466.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,094.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,149.42
|
| Rate for Payer: Meridian Medicaid |
$749.23
|
| Rate for Payer: Nomi Health Commercial |
$1,313.63
|
| Rate for Payer: PACE SWMI |
$1,094.69
|
| Rate for Payer: PHP Commercial |
$1,532.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,094.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,582.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,776.29
|
| Rate for Payer: Priority Health Medicare |
$1,094.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,776.29
|
| Rate for Payer: Priority Health SBD |
$1,776.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,094.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,094.69
|
| Rate for Payer: UHCCP Medicaid |
$713.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,119.64
|
|
|
PR DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 17107
|
| Min. Negotiated Rate |
$233.02 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Aetna Commercial |
$456.48
|
| Rate for Payer: Aetna Medicare |
$354.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$490.55
|
| Rate for Payer: BCBS Complete |
$244.67
|
| Rate for Payer: BCBS MAPPO |
$340.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,712.50
|
| Rate for Payer: BCN Commercial |
$523.42
|
| Rate for Payer: BCN Medicare Advantage |
$340.66
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cofinity Commercial |
$456.48
|
| Rate for Payer: Cofinity Commercial |
$490.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.69
|
| Rate for Payer: Meridian Medicaid |
$244.67
|
| Rate for Payer: Nomi Health Commercial |
$408.79
|
| Rate for Payer: PACE SWMI |
$340.66
|
| Rate for Payer: PHP Commercial |
$476.92
|
| Rate for Payer: PHP Medicare Advantage |
$340.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.09
|
| Rate for Payer: Priority Health Medicare |
$340.66
|
| Rate for Payer: Priority Health Narrow Network |
$488.09
|
| Rate for Payer: Priority Health SBD |
$488.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.66
|
| Rate for Payer: UHC Medicare Advantage |
$340.66
|
| Rate for Payer: UHCCP Medicaid |
$233.02
|
| Rate for Payer: UMR Bronson Commercial |
$376.28
|
|
|
PR DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 17108
|
| Min. Negotiated Rate |
$340.59 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$671.65
|
| Rate for Payer: Aetna Medicare |
$521.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.77
|
| Rate for Payer: BCBS Complete |
$357.62
|
| Rate for Payer: BCBS MAPPO |
$501.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.00
|
| Rate for Payer: BCN Commercial |
$742.53
|
| Rate for Payer: BCN Medicare Advantage |
$501.23
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$671.65
|
| Rate for Payer: Cofinity Commercial |
$721.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$526.29
|
| Rate for Payer: Meridian Medicaid |
$357.62
|
| Rate for Payer: Nomi Health Commercial |
$601.48
|
| Rate for Payer: PACE SWMI |
$501.23
|
| Rate for Payer: PHP Commercial |
$701.72
|
| Rate for Payer: PHP Medicare Advantage |
$501.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$340.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.11
|
| Rate for Payer: Priority Health Medicare |
$501.23
|
| Rate for Payer: Priority Health Narrow Network |
$716.11
|
| Rate for Payer: Priority Health SBD |
$716.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$501.23
|
| Rate for Payer: UHC Medicare Advantage |
$501.23
|
| Rate for Payer: UHCCP Medicaid |
$340.59
|
| Rate for Payer: UMR Bronson Commercial |
$538.20
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 46924
|
| Min. Negotiated Rate |
$118.00 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$234.47
|
| Rate for Payer: Aetna Medicare |
$181.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.97
|
| Rate for Payer: BCBS Complete |
$123.90
|
| Rate for Payer: BCBS MAPPO |
$174.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$809.25
|
| Rate for Payer: BCN Medicare Advantage |
$174.98
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$234.47
|
| Rate for Payer: Cofinity Commercial |
$251.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.73
|
| Rate for Payer: Meridian Medicaid |
$123.90
|
| Rate for Payer: Nomi Health Commercial |
$209.98
|
| Rate for Payer: PACE SWMI |
$174.98
|
| Rate for Payer: PHP Commercial |
$244.97
|
| Rate for Payer: PHP Medicare Advantage |
$174.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.74
|
| Rate for Payer: Priority Health Medicare |
$174.98
|
| Rate for Payer: Priority Health Narrow Network |
$325.74
|
| Rate for Payer: Priority Health SBD |
$325.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.98
|
| Rate for Payer: UHC Medicare Advantage |
$174.98
|
| Rate for Payer: UHCCP Medicaid |
$118.00
|
| Rate for Payer: UMR Bronson Commercial |
$397.90
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
IP
|
$865.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$380.60 |
| Max. Negotiated Rate |
$778.50 |
| Rate for Payer: Aetna American Axle |
$562.25
|
| Rate for Payer: Aetna Commercial |
$735.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.25
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$605.50
|
| Rate for Payer: Cofinity Commercial |
$743.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$605.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.00
|
| Rate for Payer: Healthscope Commercial |
$778.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$605.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.25
|
| Rate for Payer: PHP Commercial |
$735.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health SBD |
$544.95
|
| Rate for Payer: UMR Bronson Commercial |
$380.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.75
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 46924
|
| Hospital Charge Code |
46924
|
| Min. Negotiated Rate |
$118.00 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$234.47
|
| Rate for Payer: Aetna Medicare |
$181.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.97
|
| Rate for Payer: BCBS Complete |
$123.90
|
| Rate for Payer: BCBS MAPPO |
$174.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$809.25
|
| Rate for Payer: BCN Medicare Advantage |
$174.98
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$251.97
|
| Rate for Payer: Cofinity Commercial |
$234.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.73
|
| Rate for Payer: Meridian Medicaid |
$123.90
|
| Rate for Payer: Nomi Health Commercial |
$209.98
|
| Rate for Payer: PACE SWMI |
$174.98
|
| Rate for Payer: PHP Commercial |
$244.97
|
| Rate for Payer: PHP Medicare Advantage |
$174.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.74
|
| Rate for Payer: Priority Health Medicare |
$174.98
|
| Rate for Payer: Priority Health Narrow Network |
$325.74
|
| Rate for Payer: Priority Health SBD |
$325.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.98
|
| Rate for Payer: UHC Medicare Advantage |
$174.98
|
| Rate for Payer: UHCCP Medicaid |
$118.00
|
| Rate for Payer: UMR Bronson Commercial |
$397.90
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
OP
|
$865.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$174.75 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna American Axle |
$562.25
|
| Rate for Payer: Aetna Commercial |
$735.25
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,892.53
|
| Rate for Payer: BCN Commercial |
$2,892.53
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$605.50
|
| Rate for Payer: Cofinity Commercial |
$743.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$605.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$778.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$605.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.75
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.25
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$735.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$544.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.22
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$174.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: UMR Bronson Commercial |
$320.05
|
| Rate for Payer: VA VA |
$2,686.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.75
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$176.28
|
| Rate for Payer: Aetna Medicare |
$136.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.43
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$131.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$131.55
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$176.28
|
| Rate for Payer: Cofinity Commercial |
$189.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.13
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Nomi Health Commercial |
$157.86
|
| Rate for Payer: PACE SWMI |
$131.55
|
| Rate for Payer: PHP Commercial |
$184.17
|
| Rate for Payer: PHP Medicare Advantage |
$131.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.58
|
| Rate for Payer: Priority Health Medicare |
$131.55
|
| Rate for Payer: Priority Health Narrow Network |
$247.58
|
| Rate for Payer: Priority Health SBD |
$247.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.55
|
| Rate for Payer: UHC Medicare Advantage |
$131.55
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
| Rate for Payer: UMR Bronson Commercial |
$176.18
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
OP
|
$383.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$131.59 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna American Axle |
$248.95
|
| Rate for Payer: Aetna Commercial |
$325.55
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$209.34
|
| Rate for Payer: BCN Commercial |
$209.34
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$329.38
|
| Rate for Payer: Cofinity Commercial |
$268.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$268.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$344.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.25
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.55
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$325.55
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$241.29
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.75
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$131.59
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: UMR Bronson Commercial |
$141.71
|
| Rate for Payer: VA VA |
$391.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.25
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
IP
|
$383.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$168.52 |
| Max. Negotiated Rate |
$344.70 |
| Rate for Payer: Aetna American Axle |
$248.95
|
| Rate for Payer: Aetna Commercial |
$325.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.95
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$268.10
|
| Rate for Payer: Cofinity Commercial |
$329.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$268.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.40
|
| Rate for Payer: Healthscope Commercial |
$344.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.55
|
| Rate for Payer: PHP Commercial |
$325.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health SBD |
$241.29
|
| Rate for Payer: UMR Bronson Commercial |
$168.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.25
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 46900
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$176.28
|
| Rate for Payer: Aetna Medicare |
$136.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.43
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$131.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$131.55
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$176.28
|
| Rate for Payer: Cofinity Commercial |
$189.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.13
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Nomi Health Commercial |
$157.86
|
| Rate for Payer: PACE SWMI |
$131.55
|
| Rate for Payer: PHP Commercial |
$184.17
|
| Rate for Payer: PHP Medicare Advantage |
$131.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.58
|
| Rate for Payer: Priority Health Medicare |
$131.55
|
| Rate for Payer: Priority Health Narrow Network |
$247.58
|
| Rate for Payer: Priority Health SBD |
$247.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.55
|
| Rate for Payer: UHC Medicare Advantage |
$131.55
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
| Rate for Payer: UMR Bronson Commercial |
$176.18
|
|
|
PR DSTRJ LESION ANUS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 46916
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$1,647.77 |
| Rate for Payer: Aetna Commercial |
$179.55
|
| Rate for Payer: Aetna Medicare |
$139.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.95
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$133.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.77
|
| Rate for Payer: BCN Commercial |
$383.13
|
| Rate for Payer: BCN Medicare Advantage |
$133.99
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$179.55
|
| Rate for Payer: Cofinity Commercial |
$192.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.69
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Nomi Health Commercial |
$160.79
|
| Rate for Payer: PACE SWMI |
$133.99
|
| Rate for Payer: PHP Commercial |
$187.59
|
| Rate for Payer: PHP Medicare Advantage |
$133.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.34
|
| Rate for Payer: Priority Health Medicare |
$133.99
|
| Rate for Payer: Priority Health Narrow Network |
$255.34
|
| Rate for Payer: Priority Health SBD |
$255.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.99
|
| Rate for Payer: UHC Medicare Advantage |
$133.99
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
| Rate for Payer: UMR Bronson Commercial |
$189.52
|
|
|
PR DSTRJ LESION ANUS SIMPLE LASER SURG
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 46917
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$1,832.14 |
| Rate for Payer: Aetna Commercial |
$165.45
|
| Rate for Payer: Aetna Medicare |
$128.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.80
|
| Rate for Payer: BCBS Complete |
$87.68
|
| Rate for Payer: BCBS MAPPO |
$123.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.14
|
| Rate for Payer: BCN Commercial |
$659.72
|
| Rate for Payer: BCN Medicare Advantage |
$123.47
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$165.45
|
| Rate for Payer: Cofinity Commercial |
$177.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.64
|
| Rate for Payer: Meridian Medicaid |
$87.68
|
| Rate for Payer: Nomi Health Commercial |
$148.16
|
| Rate for Payer: PACE SWMI |
$123.47
|
| Rate for Payer: PHP Commercial |
$172.86
|
| Rate for Payer: PHP Medicare Advantage |
$123.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.67
|
| Rate for Payer: Priority Health Medicare |
$123.47
|
| Rate for Payer: Priority Health Narrow Network |
$232.67
|
| Rate for Payer: Priority Health SBD |
$232.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.47
|
| Rate for Payer: UHC Medicare Advantage |
$123.47
|
| Rate for Payer: UHCCP Medicaid |
$83.50
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 46922
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$177.30
|
| Rate for Payer: Aetna Medicare |
$137.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.53
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$132.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: BCN Medicare Advantage |
$132.31
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$177.30
|
| Rate for Payer: Cofinity Commercial |
$190.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.93
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Nomi Health Commercial |
$158.77
|
| Rate for Payer: PACE SWMI |
$132.31
|
| Rate for Payer: PHP Commercial |
$185.23
|
| Rate for Payer: PHP Medicare Advantage |
$132.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.78
|
| Rate for Payer: Priority Health Medicare |
$132.31
|
| Rate for Payer: Priority Health Narrow Network |
$248.78
|
| Rate for Payer: Priority Health SBD |
$248.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.31
|
| Rate for Payer: UHC Medicare Advantage |
$132.31
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
| Rate for Payer: UMR Bronson Commercial |
$237.82
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
IP
|
$517.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$227.48 |
| Max. Negotiated Rate |
$465.30 |
| Rate for Payer: Aetna American Axle |
$336.05
|
| Rate for Payer: Aetna Commercial |
$439.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.05
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$361.90
|
| Rate for Payer: Cofinity Commercial |
$444.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$361.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.60
|
| Rate for Payer: Healthscope Commercial |
$465.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$361.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.45
|
| Rate for Payer: PHP Commercial |
$439.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health SBD |
$325.71
|
| Rate for Payer: UMR Bronson Commercial |
$227.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.75
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 46922
|
| Hospital Charge Code |
46922
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$177.30
|
| Rate for Payer: Aetna Medicare |
$137.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.53
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$132.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: BCN Medicare Advantage |
$132.31
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$177.30
|
| Rate for Payer: Cofinity Commercial |
$190.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.93
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Nomi Health Commercial |
$158.77
|
| Rate for Payer: PACE SWMI |
$132.31
|
| Rate for Payer: PHP Commercial |
$185.23
|
| Rate for Payer: PHP Medicare Advantage |
$132.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.78
|
| Rate for Payer: Priority Health Medicare |
$132.31
|
| Rate for Payer: Priority Health Narrow Network |
$248.78
|
| Rate for Payer: Priority Health SBD |
$248.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.31
|
| Rate for Payer: UHC Medicare Advantage |
$132.31
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
| Rate for Payer: UMR Bronson Commercial |
$237.82
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
OP
|
$517.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$133.05 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna American Axle |
$336.05
|
| Rate for Payer: Aetna Commercial |
$439.45
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,406.74
|
| Rate for Payer: BCN Commercial |
$2,406.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$444.62
|
| Rate for Payer: Cofinity Commercial |
$361.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$361.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$465.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$361.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.75
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.45
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$439.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$325.71
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.36
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$133.05
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: UMR Bronson Commercial |
$191.29
|
| Rate for Payer: VA VA |
$2,686.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.75
|
|
|
PR DSTRJ LESION ANUS SMPL ELTRDSICCATION
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 46910
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$2,583.92 |
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Aetna Commercial |
$172.16
|
| Rate for Payer: Aetna Medicare |
$133.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.01
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$128.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,583.92
|
| Rate for Payer: BCN Commercial |
$387.03
|
| Rate for Payer: BCN Medicare Advantage |
$128.48
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$172.16
|
| Rate for Payer: Cofinity Commercial |
$185.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.90
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Nomi Health Commercial |
$154.18
|
| Rate for Payer: PACE SWMI |
$128.48
|
| Rate for Payer: PHP Commercial |
$179.87
|
| Rate for Payer: PHP Medicare Advantage |
$128.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.01
|
| Rate for Payer: Priority Health Medicare |
$128.48
|
| Rate for Payer: Priority Health Narrow Network |
$244.01
|
| Rate for Payer: Priority Health SBD |
$244.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.48
|
| Rate for Payer: UHC Medicare Advantage |
$128.48
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
| Rate for Payer: UMR Bronson Commercial |
$190.90
|
|
|
PR DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM
|
Professional
|
Both
|
$430.00
|
|
|
Service Code
|
HCPCS 42160
|
| Min. Negotiated Rate |
$90.31 |
| Max. Negotiated Rate |
$342.56 |
| Rate for Payer: Aetna Commercial |
$177.05
|
| Rate for Payer: Aetna Medicare |
$137.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.27
|
| Rate for Payer: BCBS Complete |
$94.83
|
| Rate for Payer: BCBS MAPPO |
$132.13
|
| Rate for Payer: BCBS Trust/PPO |
$264.46
|
| Rate for Payer: BCN Commercial |
$342.56
|
| Rate for Payer: BCN Medicare Advantage |
$132.13
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$177.05
|
| Rate for Payer: Cofinity Commercial |
$190.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.74
|
| Rate for Payer: Meridian Medicaid |
$94.83
|
| Rate for Payer: Nomi Health Commercial |
$158.56
|
| Rate for Payer: PACE SWMI |
$132.13
|
| Rate for Payer: PHP Commercial |
$184.98
|
| Rate for Payer: PHP Medicare Advantage |
$132.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.55
|
| Rate for Payer: Priority Health Medicare |
$132.13
|
| Rate for Payer: Priority Health Narrow Network |
$253.55
|
| Rate for Payer: Priority Health SBD |
$253.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.13
|
| Rate for Payer: UHC Medicare Advantage |
$132.13
|
| Rate for Payer: UHCCP Medicaid |
$90.31
|
| Rate for Payer: UMR Bronson Commercial |
$197.80
|
|
|
PR DSTRJ LESION PENIS EXTENSIVE
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
HCPCS 54065
|
| Min. Negotiated Rate |
$112.25 |
| Max. Negotiated Rate |
$1,527.84 |
| Rate for Payer: Aetna Commercial |
$220.68
|
| Rate for Payer: Aetna Medicare |
$171.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.15
|
| Rate for Payer: BCBS Complete |
$117.86
|
| Rate for Payer: BCBS MAPPO |
$164.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.84
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: BCN Medicare Advantage |
$164.69
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cofinity Commercial |
$220.68
|
| Rate for Payer: Cofinity Commercial |
$237.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.92
|
| Rate for Payer: Meridian Medicaid |
$117.86
|
| Rate for Payer: Nomi Health Commercial |
$197.63
|
| Rate for Payer: PACE SWMI |
$164.69
|
| Rate for Payer: PHP Commercial |
$230.57
|
| Rate for Payer: PHP Medicare Advantage |
$164.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.36
|
| Rate for Payer: Priority Health Medicare |
$164.69
|
| Rate for Payer: Priority Health Narrow Network |
$275.36
|
| Rate for Payer: Priority Health SBD |
$275.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.69
|
| Rate for Payer: UHC Medicare Advantage |
$164.69
|
| Rate for Payer: UHCCP Medicaid |
$112.25
|
| Rate for Payer: UMR Bronson Commercial |
$213.90
|
|
|
PR DSTRJ LESION PENIS SIMPLE CHEMICAL
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 54050
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$1,664.67 |
| Rate for Payer: Aetna Commercial |
$135.92
|
| Rate for Payer: Aetna Medicare |
$105.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.06
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS MAPPO |
$101.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.67
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: BCN Medicare Advantage |
$101.43
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$135.92
|
| Rate for Payer: Cofinity Commercial |
$146.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.50
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Nomi Health Commercial |
$121.72
|
| Rate for Payer: PACE SWMI |
$101.43
|
| Rate for Payer: PHP Commercial |
$142.00
|
| Rate for Payer: PHP Medicare Advantage |
$101.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Medicare |
$101.43
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: Priority Health SBD |
$172.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.43
|
| Rate for Payer: UHC Medicare Advantage |
$101.43
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
| Rate for Payer: UMR Bronson Commercial |
$103.04
|
|
|
PR DSTRJ LESION PENIS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$270.00
|
|
|
Service Code
|
HCPCS 54056
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$1,380.45 |
| Rate for Payer: Aetna Commercial |
$142.51
|
| Rate for Payer: Aetna Medicare |
$110.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.14
|
| Rate for Payer: BCBS Complete |
$76.93
|
| Rate for Payer: BCBS MAPPO |
$106.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.45
|
| Rate for Payer: BCN Commercial |
$169.24
|
| Rate for Payer: BCN Medicare Advantage |
$106.35
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cofinity Commercial |
$142.51
|
| Rate for Payer: Cofinity Commercial |
$153.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.67
|
| Rate for Payer: Meridian Medicaid |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$127.62
|
| Rate for Payer: PACE SWMI |
$106.35
|
| Rate for Payer: PHP Commercial |
$148.89
|
| Rate for Payer: PHP Medicare Advantage |
$106.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.02
|
| Rate for Payer: Priority Health Medicare |
$106.35
|
| Rate for Payer: Priority Health Narrow Network |
$180.02
|
| Rate for Payer: Priority Health SBD |
$180.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.35
|
| Rate for Payer: UHC Medicare Advantage |
$106.35
|
| Rate for Payer: UHCCP Medicaid |
$73.27
|
| Rate for Payer: UMR Bronson Commercial |
$124.20
|
|
|
PR DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 54055
|
| Min. Negotiated Rate |
$62.84 |
| Max. Negotiated Rate |
$1,009.58 |
| Rate for Payer: Aetna Commercial |
$123.01
|
| Rate for Payer: Aetna Medicare |
$95.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.19
|
| Rate for Payer: BCBS Complete |
$65.98
|
| Rate for Payer: BCBS MAPPO |
$91.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
| Rate for Payer: BCN Commercial |
$201.34
|
| Rate for Payer: BCN Medicare Advantage |
$91.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$123.01
|
| Rate for Payer: Cofinity Commercial |
$132.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.39
|
| Rate for Payer: Meridian Medicaid |
$65.98
|
| Rate for Payer: Nomi Health Commercial |
$110.16
|
| Rate for Payer: PACE SWMI |
$91.80
|
| Rate for Payer: PHP Commercial |
$128.52
|
| Rate for Payer: PHP Medicare Advantage |
$91.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.45
|
| Rate for Payer: Priority Health Medicare |
$91.80
|
| Rate for Payer: Priority Health Narrow Network |
$154.45
|
| Rate for Payer: Priority Health SBD |
$154.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.80
|
| Rate for Payer: UHC Medicare Advantage |
$91.80
|
| Rate for Payer: UHCCP Medicaid |
$62.84
|
| Rate for Payer: UMR Bronson Commercial |
$97.06
|
|
