|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM
|
Facility
|
OP
|
$449.00
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
11443
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$166.13 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$291.85
|
| Rate for Payer: Aetna Commercial |
$381.65
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.90
|
| Rate for Payer: BCN Commercial |
$1,681.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$314.30
|
| Rate for Payer: Cofinity Commercial |
$386.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$314.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$404.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$314.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.75
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.65
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$381.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$282.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.72
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$170.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$166.13
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 11443
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$291.85 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$176.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.99
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$170.13
|
| Rate for Payer: BCBS Trust/PPO |
$125.51
|
| Rate for Payer: BCN Commercial |
$268.97
|
| Rate for Payer: BCN Medicare Advantage |
$170.13
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$227.97
|
| Rate for Payer: Cofinity Commercial |
$244.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.64
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Nomi Health Commercial |
$204.16
|
| Rate for Payer: PACE SWMI |
$170.13
|
| Rate for Payer: PHP Commercial |
$238.18
|
| Rate for Payer: PHP Medicare Advantage |
$170.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$243.82
|
| Rate for Payer: Priority Health Medicare |
$170.13
|
| Rate for Payer: Priority Health Narrow Network |
$243.82
|
| Rate for Payer: Priority Health SBD |
$243.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.13
|
| Rate for Payer: UHC Medicare Advantage |
$170.13
|
| Rate for Payer: UHCCP Medicaid |
$116.09
|
| Rate for Payer: UMR Bronson Commercial |
$206.54
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 11443
|
| Hospital Charge Code |
11443
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$291.85 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$176.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.99
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$170.13
|
| Rate for Payer: BCBS Trust/PPO |
$125.51
|
| Rate for Payer: BCN Commercial |
$268.97
|
| Rate for Payer: BCN Medicare Advantage |
$170.13
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$244.99
|
| Rate for Payer: Cofinity Commercial |
$227.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.64
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Nomi Health Commercial |
$204.16
|
| Rate for Payer: PACE SWMI |
$170.13
|
| Rate for Payer: PHP Commercial |
$238.18
|
| Rate for Payer: PHP Medicare Advantage |
$170.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$243.82
|
| Rate for Payer: Priority Health Medicare |
$170.13
|
| Rate for Payer: Priority Health Narrow Network |
$243.82
|
| Rate for Payer: Priority Health SBD |
$243.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.13
|
| Rate for Payer: UHC Medicare Advantage |
$170.13
|
| Rate for Payer: UHCCP Medicaid |
$116.09
|
| Rate for Payer: UMR Bronson Commercial |
$206.54
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM
|
Facility
|
OP
|
$577.00
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
11444
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$213.49 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$375.05
|
| Rate for Payer: Aetna Commercial |
$490.45
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$947.36
|
| Rate for Payer: BCN Commercial |
$947.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cofinity Commercial |
$403.90
|
| Rate for Payer: Cofinity Commercial |
$496.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$519.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.75
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.45
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$490.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$363.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.18
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$215.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$213.49
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
HCPCS 11444
|
| Hospital Charge Code |
11444
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$540.00 |
| Rate for Payer: Aetna Commercial |
$289.82
|
| Rate for Payer: Aetna Medicare |
$224.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.44
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS MAPPO |
$216.28
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$333.37
|
| Rate for Payer: BCN Medicare Advantage |
$216.28
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cofinity Commercial |
$311.44
|
| Rate for Payer: Cofinity Commercial |
$289.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.09
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Nomi Health Commercial |
$259.54
|
| Rate for Payer: PACE SWMI |
$216.28
|
| Rate for Payer: PHP Commercial |
$302.79
|
| Rate for Payer: PHP Medicare Advantage |
$216.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.58
|
| Rate for Payer: Priority Health Medicare |
$216.28
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: Priority Health SBD |
$306.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.28
|
| Rate for Payer: UHC Medicare Advantage |
$216.28
|
| Rate for Payer: UHCCP Medicaid |
$146.76
|
| Rate for Payer: UMR Bronson Commercial |
$265.42
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
HCPCS 11444
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$540.00 |
| Rate for Payer: Aetna Commercial |
$289.82
|
| Rate for Payer: Aetna Medicare |
$224.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.44
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS MAPPO |
$216.28
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$333.37
|
| Rate for Payer: BCN Medicare Advantage |
$216.28
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cofinity Commercial |
$289.82
|
| Rate for Payer: Cofinity Commercial |
$311.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.09
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Nomi Health Commercial |
$259.54
|
| Rate for Payer: PACE SWMI |
$216.28
|
| Rate for Payer: PHP Commercial |
$302.79
|
| Rate for Payer: PHP Medicare Advantage |
$216.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.58
|
| Rate for Payer: Priority Health Medicare |
$216.28
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: Priority Health SBD |
$306.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.28
|
| Rate for Payer: UHC Medicare Advantage |
$216.28
|
| Rate for Payer: UHCCP Medicaid |
$146.76
|
| Rate for Payer: UMR Bronson Commercial |
$265.42
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM
|
Facility
|
IP
|
$577.00
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
11444
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$253.88 |
| Max. Negotiated Rate |
$519.30 |
| Rate for Payer: Aetna American Axle |
$375.05
|
| Rate for Payer: Aetna Commercial |
$490.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.05
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cofinity Commercial |
$403.90
|
| Rate for Payer: Cofinity Commercial |
$496.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.60
|
| Rate for Payer: Healthscope Commercial |
$519.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.45
|
| Rate for Payer: PHP Commercial |
$490.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.05
|
| Rate for Payer: Priority Health SBD |
$363.51
|
| Rate for Payer: UMR Bronson Commercial |
$253.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.75
|
|
|
PR EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN
|
Professional
|
Both
|
$7,984.00
|
|
|
Service Code
|
HCPCS 61563
|
| Min. Negotiated Rate |
$382.49 |
| Max. Negotiated Rate |
$5,189.60 |
| Rate for Payer: Aetna Commercial |
$2,636.54
|
| Rate for Payer: Aetna Medicare |
$2,046.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,636.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,833.30
|
| Rate for Payer: BCBS Complete |
$1,355.99
|
| Rate for Payer: BCBS MAPPO |
$1,967.57
|
| Rate for Payer: BCBS Trust/PPO |
$382.49
|
| Rate for Payer: BCN Commercial |
$4,057.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,967.57
|
| Rate for Payer: Cash Price |
$6,387.20
|
| Rate for Payer: Cash Price |
$6,387.20
|
| Rate for Payer: Cofinity Commercial |
$2,636.54
|
| Rate for Payer: Cofinity Commercial |
$2,833.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,967.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,065.95
|
| Rate for Payer: Meridian Medicaid |
$1,355.99
|
| Rate for Payer: Nomi Health Commercial |
$2,361.08
|
| Rate for Payer: PACE SWMI |
$1,967.57
|
| Rate for Payer: PHP Commercial |
$2,754.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,967.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,291.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,189.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,434.47
|
| Rate for Payer: Priority Health Medicare |
$1,967.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,434.47
|
| Rate for Payer: Priority Health SBD |
$3,434.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,967.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,967.57
|
| Rate for Payer: UHCCP Medicaid |
$1,291.42
|
| Rate for Payer: UMR Bronson Commercial |
$3,672.64
|
|
|
PR EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT
|
Professional
|
Both
|
$2,311.00
|
|
|
Service Code
|
HCPCS 21048
|
| Min. Negotiated Rate |
$642.62 |
| Max. Negotiated Rate |
$3,701.02 |
| Rate for Payer: Aetna Commercial |
$1,265.09
|
| Rate for Payer: Aetna Medicare |
$981.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,265.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.50
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$944.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,701.02
|
| Rate for Payer: BCN Commercial |
$1,452.35
|
| Rate for Payer: BCN Medicare Advantage |
$944.10
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cofinity Commercial |
$1,265.09
|
| Rate for Payer: Cofinity Commercial |
$1,359.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$991.30
|
| Rate for Payer: Meridian Medicaid |
$674.75
|
| Rate for Payer: Nomi Health Commercial |
$1,132.92
|
| Rate for Payer: PACE SWMI |
$944.10
|
| Rate for Payer: PHP Commercial |
$1,321.74
|
| Rate for Payer: PHP Medicare Advantage |
$944.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,517.94
|
| Rate for Payer: Priority Health Medicare |
$944.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,517.94
|
| Rate for Payer: Priority Health SBD |
$1,517.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$944.10
|
| Rate for Payer: UHC Medicare Advantage |
$944.10
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,063.06
|
|
|
PR EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG
|
Professional
|
Both
|
$1,024.00
|
|
|
Service Code
|
HCPCS 21030
|
| Min. Negotiated Rate |
$234.73 |
| Max. Negotiated Rate |
$998.90 |
| Rate for Payer: Aetna Commercial |
$459.77
|
| Rate for Payer: Aetna Medicare |
$356.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.08
|
| Rate for Payer: BCBS Complete |
$246.47
|
| Rate for Payer: BCBS MAPPO |
$343.11
|
| Rate for Payer: BCBS Trust/PPO |
$998.90
|
| Rate for Payer: BCN Commercial |
$672.42
|
| Rate for Payer: BCN Medicare Advantage |
$343.11
|
| Rate for Payer: Cash Price |
$819.20
|
| Rate for Payer: Cash Price |
$819.20
|
| Rate for Payer: Cofinity Commercial |
$459.77
|
| Rate for Payer: Cofinity Commercial |
$494.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.27
|
| Rate for Payer: Meridian Medicaid |
$246.47
|
| Rate for Payer: Nomi Health Commercial |
$411.73
|
| Rate for Payer: PACE SWMI |
$343.11
|
| Rate for Payer: PHP Commercial |
$480.35
|
| Rate for Payer: PHP Medicare Advantage |
$343.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$551.61
|
| Rate for Payer: Priority Health Medicare |
$343.11
|
| Rate for Payer: Priority Health Narrow Network |
$551.61
|
| Rate for Payer: Priority Health SBD |
$551.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.11
|
| Rate for Payer: UHC Medicare Advantage |
$343.11
|
| Rate for Payer: UHCCP Medicaid |
$234.73
|
| Rate for Payer: UMR Bronson Commercial |
$471.04
|
|
|
PR EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 42815
|
| Min. Negotiated Rate |
$278.41 |
| Max. Negotiated Rate |
$1,075.75 |
| Rate for Payer: Aetna Commercial |
$684.15
|
| Rate for Payer: Aetna Medicare |
$530.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.21
|
| Rate for Payer: BCBS Complete |
$364.33
|
| Rate for Payer: BCBS MAPPO |
$510.56
|
| Rate for Payer: BCBS Trust/PPO |
$278.41
|
| Rate for Payer: BCN Commercial |
$796.55
|
| Rate for Payer: BCN Medicare Advantage |
$510.56
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cofinity Commercial |
$684.15
|
| Rate for Payer: Cofinity Commercial |
$735.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.09
|
| Rate for Payer: Meridian Medicaid |
$364.33
|
| Rate for Payer: Nomi Health Commercial |
$612.67
|
| Rate for Payer: PACE SWMI |
$510.56
|
| Rate for Payer: PHP Commercial |
$714.78
|
| Rate for Payer: PHP Medicare Advantage |
$510.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$971.85
|
| Rate for Payer: Priority Health Medicare |
$510.56
|
| Rate for Payer: Priority Health Narrow Network |
$971.85
|
| Rate for Payer: Priority Health SBD |
$971.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.56
|
| Rate for Payer: UHC Medicare Advantage |
$510.56
|
| Rate for Payer: UHCCP Medicaid |
$346.98
|
| Rate for Payer: UMR Bronson Commercial |
$761.30
|
|
|
PR EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 42810
|
| Min. Negotiated Rate |
$183.82 |
| Max. Negotiated Rate |
$575.66 |
| Rate for Payer: Aetna Commercial |
$359.48
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.31
|
| Rate for Payer: BCBS Complete |
$193.01
|
| Rate for Payer: BCBS MAPPO |
$268.27
|
| Rate for Payer: BCBS Trust/PPO |
$196.53
|
| Rate for Payer: BCN Commercial |
$575.66
|
| Rate for Payer: BCN Medicare Advantage |
$268.27
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$359.48
|
| Rate for Payer: Cofinity Commercial |
$386.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.68
|
| Rate for Payer: Meridian Medicaid |
$193.01
|
| Rate for Payer: Nomi Health Commercial |
$321.92
|
| Rate for Payer: PACE SWMI |
$268.27
|
| Rate for Payer: PHP Commercial |
$375.58
|
| Rate for Payer: PHP Medicare Advantage |
$268.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.07
|
| Rate for Payer: Priority Health Medicare |
$268.27
|
| Rate for Payer: Priority Health Narrow Network |
$513.07
|
| Rate for Payer: Priority Health SBD |
$513.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.27
|
| Rate for Payer: UHC Medicare Advantage |
$268.27
|
| Rate for Payer: UHCCP Medicaid |
$183.82
|
| Rate for Payer: UMR Bronson Commercial |
$398.82
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Facility
|
OP
|
$1,263.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
19125
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$451.61 |
| Max. Negotiated Rate |
$11,792.02 |
| Rate for Payer: Aetna American Axle |
$820.95
|
| Rate for Payer: Aetna Commercial |
$1,073.55
|
| Rate for Payer: Aetna Medicare |
$3,901.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,689.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,689.81
|
| Rate for Payer: BCBS Complete |
$2,111.54
|
| Rate for Payer: BCBS MAPPO |
$3,751.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,713.49
|
| Rate for Payer: BCCCP Commercial |
$569.78
|
| Rate for Payer: BCN Commercial |
$2,713.49
|
| Rate for Payer: BCN Medicare Advantage |
$3,751.85
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$1,086.18
|
| Rate for Payer: Cofinity Commercial |
$884.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$884.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,010.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,751.85
|
| Rate for Payer: Healthscope Commercial |
$1,136.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$884.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$947.25
|
| Rate for Payer: Mclaren Medicaid |
$2,010.99
|
| Rate for Payer: Mclaren Medicare |
$3,751.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,939.44
|
| Rate for Payer: Meridian Medicaid |
$2,111.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,314.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,073.55
|
| Rate for Payer: Nomi Health Commercial |
$7,878.88
|
| Rate for Payer: PACE Medicare |
$3,564.26
|
| Rate for Payer: PACE SWMI |
$3,751.85
|
| Rate for Payer: PHP Commercial |
$1,073.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,751.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,010.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,792.02
|
| Rate for Payer: Priority Health Medicare |
$3,751.85
|
| Rate for Payer: Priority Health Narrow Network |
$9,433.62
|
| Rate for Payer: Priority Health SBD |
$795.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,751.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.77
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,751.85
|
| Rate for Payer: UHC Exchange |
$451.61
|
| Rate for Payer: UHC Medicare Advantage |
$3,751.85
|
| Rate for Payer: UHCCP Medicaid |
$2,010.99
|
| Rate for Payer: UMR Bronson Commercial |
$467.31
|
| Rate for Payer: VA VA |
$3,751.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$947.25
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Facility
|
IP
|
$1,263.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
19125
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$555.72 |
| Max. Negotiated Rate |
$1,136.70 |
| Rate for Payer: Aetna American Axle |
$820.95
|
| Rate for Payer: Aetna Commercial |
$1,073.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.95
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$1,086.18
|
| Rate for Payer: Cofinity Commercial |
$884.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$884.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,010.40
|
| Rate for Payer: Healthscope Commercial |
$1,136.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$884.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$947.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,073.55
|
| Rate for Payer: PHP Commercial |
$1,073.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health SBD |
$795.69
|
| Rate for Payer: UMR Bronson Commercial |
$555.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$947.25
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 19125
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$840.53 |
| Rate for Payer: Aetna Commercial |
$602.16
|
| Rate for Payer: Aetna Medicare |
$467.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.09
|
| Rate for Payer: BCBS Complete |
$315.57
|
| Rate for Payer: BCBS MAPPO |
$449.37
|
| Rate for Payer: BCBS Trust/PPO |
$13.80
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$449.37
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$602.16
|
| Rate for Payer: Cofinity Commercial |
$647.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.84
|
| Rate for Payer: Meridian Medicaid |
$315.57
|
| Rate for Payer: Nomi Health Commercial |
$539.24
|
| Rate for Payer: PACE SWMI |
$449.37
|
| Rate for Payer: PHP Commercial |
$629.12
|
| Rate for Payer: PHP Medicare Advantage |
$449.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.13
|
| Rate for Payer: Priority Health Medicare |
$449.37
|
| Rate for Payer: Priority Health Narrow Network |
$632.13
|
| Rate for Payer: Priority Health SBD |
$632.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.37
|
| Rate for Payer: UHC Medicare Advantage |
$449.37
|
| Rate for Payer: UHCCP Medicaid |
$300.54
|
| Rate for Payer: UMR Bronson Commercial |
$580.98
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 19125
|
| Hospital Charge Code |
19125
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$840.53 |
| Rate for Payer: Aetna Commercial |
$602.16
|
| Rate for Payer: Aetna Medicare |
$467.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.09
|
| Rate for Payer: BCBS Complete |
$315.57
|
| Rate for Payer: BCBS MAPPO |
$449.37
|
| Rate for Payer: BCBS Trust/PPO |
$13.80
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$449.37
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$647.09
|
| Rate for Payer: Cofinity Commercial |
$602.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.84
|
| Rate for Payer: Meridian Medicaid |
$315.57
|
| Rate for Payer: Nomi Health Commercial |
$539.24
|
| Rate for Payer: PACE SWMI |
$449.37
|
| Rate for Payer: PHP Commercial |
$629.12
|
| Rate for Payer: PHP Medicare Advantage |
$449.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.13
|
| Rate for Payer: Priority Health Medicare |
$449.37
|
| Rate for Payer: Priority Health Narrow Network |
$632.13
|
| Rate for Payer: Priority Health SBD |
$632.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.37
|
| Rate for Payer: UHC Medicare Advantage |
$449.37
|
| Rate for Payer: UHCCP Medicaid |
$300.54
|
| Rate for Payer: UMR Bronson Commercial |
$580.98
|
|
|
PR EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 19126
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$232.12 |
| Rate for Payer: Aetna Commercial |
$208.22
|
| Rate for Payer: Aetna Medicare |
$161.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.76
|
| Rate for Payer: BCBS Complete |
$106.90
|
| Rate for Payer: BCBS MAPPO |
$155.39
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$232.12
|
| Rate for Payer: BCN Medicare Advantage |
$155.39
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$208.22
|
| Rate for Payer: Cofinity Commercial |
$223.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.16
|
| Rate for Payer: Meridian Medicaid |
$106.90
|
| Rate for Payer: Nomi Health Commercial |
$186.47
|
| Rate for Payer: PACE SWMI |
$155.39
|
| Rate for Payer: PHP Commercial |
$217.55
|
| Rate for Payer: PHP Medicare Advantage |
$155.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.37
|
| Rate for Payer: Priority Health Medicare |
$155.39
|
| Rate for Payer: Priority Health Narrow Network |
$215.37
|
| Rate for Payer: Priority Health SBD |
$215.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.39
|
| Rate for Payer: UHC Medicare Advantage |
$155.39
|
| Rate for Payer: UHCCP Medicaid |
$101.81
|
| Rate for Payer: UMR Bronson Commercial |
$125.12
|
|
|
PR EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY
|
Professional
|
Both
|
$2,765.00
|
|
|
Service Code
|
HCPCS 60600
|
| Min. Negotiated Rate |
$529.36 |
| Max. Negotiated Rate |
$2,189.00 |
| Rate for Payer: Aetna Commercial |
$1,754.35
|
| Rate for Payer: Aetna Medicare |
$1,361.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,754.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,885.28
|
| Rate for Payer: BCBS Complete |
$902.43
|
| Rate for Payer: BCBS MAPPO |
$1,309.22
|
| Rate for Payer: BCBS Trust/PPO |
$529.36
|
| Rate for Payer: BCN Commercial |
$1,977.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,309.22
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Cofinity Commercial |
$1,754.35
|
| Rate for Payer: Cofinity Commercial |
$1,885.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,309.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,374.68
|
| Rate for Payer: Meridian Medicaid |
$902.43
|
| Rate for Payer: Nomi Health Commercial |
$1,571.06
|
| Rate for Payer: PACE SWMI |
$1,309.22
|
| Rate for Payer: PHP Commercial |
$1,832.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,309.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$859.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,189.00
|
| Rate for Payer: Priority Health Medicare |
$1,309.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,189.00
|
| Rate for Payer: Priority Health SBD |
$2,189.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,309.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,309.22
|
| Rate for Payer: UHCCP Medicaid |
$859.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,271.90
|
|
|
PR EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 26596
|
| Min. Negotiated Rate |
$72.17 |
| Max. Negotiated Rate |
$1,265.54 |
| Rate for Payer: Aetna Commercial |
$1,039.55
|
| Rate for Payer: Aetna Medicare |
$806.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,117.12
|
| Rate for Payer: BCBS Complete |
$556.67
|
| Rate for Payer: BCBS MAPPO |
$775.78
|
| Rate for Payer: BCBS Trust/PPO |
$72.17
|
| Rate for Payer: BCN Commercial |
$1,213.39
|
| Rate for Payer: BCN Medicare Advantage |
$775.78
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$1,039.55
|
| Rate for Payer: Cofinity Commercial |
$1,117.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.57
|
| Rate for Payer: Meridian Medicaid |
$556.67
|
| Rate for Payer: Nomi Health Commercial |
$930.94
|
| Rate for Payer: PACE SWMI |
$775.78
|
| Rate for Payer: PHP Commercial |
$1,086.09
|
| Rate for Payer: PHP Medicare Advantage |
$775.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,265.54
|
| Rate for Payer: Priority Health Medicare |
$775.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,265.54
|
| Rate for Payer: Priority Health SBD |
$1,265.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.78
|
| Rate for Payer: UHC Medicare Advantage |
$775.78
|
| Rate for Payer: UHCCP Medicaid |
$530.16
|
| Rate for Payer: UMR Bronson Commercial |
$610.42
|
|
|
PR EXC CRV STUMP VAG APPR W/RPR NTRCL
|
Professional
|
Both
|
$1,282.00
|
|
|
Service Code
|
HCPCS 57556
|
| Min. Negotiated Rate |
$377.44 |
| Max. Negotiated Rate |
$1,301.73 |
| Rate for Payer: Aetna Commercial |
$753.64
|
| Rate for Payer: Aetna Medicare |
$584.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$809.88
|
| Rate for Payer: BCBS Complete |
$396.31
|
| Rate for Payer: BCBS MAPPO |
$562.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,301.73
|
| Rate for Payer: BCN Commercial |
$864.96
|
| Rate for Payer: BCN Medicare Advantage |
$562.42
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cofinity Commercial |
$753.64
|
| Rate for Payer: Cofinity Commercial |
$809.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.54
|
| Rate for Payer: Meridian Medicaid |
$396.31
|
| Rate for Payer: Nomi Health Commercial |
$674.90
|
| Rate for Payer: PACE SWMI |
$562.42
|
| Rate for Payer: PHP Commercial |
$787.39
|
| Rate for Payer: PHP Medicare Advantage |
$562.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$833.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$881.48
|
| Rate for Payer: Priority Health Medicare |
$562.42
|
| Rate for Payer: Priority Health Narrow Network |
$881.48
|
| Rate for Payer: Priority Health SBD |
$881.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$562.42
|
| Rate for Payer: UHC Medicare Advantage |
$562.42
|
| Rate for Payer: UHCCP Medicaid |
$377.44
|
| Rate for Payer: UMR Bronson Commercial |
$589.72
|
|
|
PR EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ
|
Professional
|
Both
|
$4,205.00
|
|
|
Service Code
|
HCPCS 38555
|
| Min. Negotiated Rate |
$556.83 |
| Max. Negotiated Rate |
$2,733.25 |
| Rate for Payer: Aetna Commercial |
$1,333.77
|
| Rate for Payer: Aetna Medicare |
$1,035.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.30
|
| Rate for Payer: BCBS Complete |
$695.77
|
| Rate for Payer: BCBS MAPPO |
$995.35
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: BCN Commercial |
$1,501.71
|
| Rate for Payer: BCN Medicare Advantage |
$995.35
|
| Rate for Payer: Cash Price |
$3,364.00
|
| Rate for Payer: Cash Price |
$3,364.00
|
| Rate for Payer: Cofinity Commercial |
$1,333.77
|
| Rate for Payer: Cofinity Commercial |
$1,433.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$995.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,045.12
|
| Rate for Payer: Meridian Medicaid |
$695.77
|
| Rate for Payer: Nomi Health Commercial |
$1,194.42
|
| Rate for Payer: PACE SWMI |
$995.35
|
| Rate for Payer: PHP Commercial |
$1,393.49
|
| Rate for Payer: PHP Medicare Advantage |
$995.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,733.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,057.84
|
| Rate for Payer: Priority Health Medicare |
$995.35
|
| Rate for Payer: Priority Health Narrow Network |
$2,057.84
|
| Rate for Payer: Priority Health SBD |
$2,057.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$995.35
|
| Rate for Payer: UHC Medicare Advantage |
$995.35
|
| Rate for Payer: UHCCP Medicaid |
$662.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,934.30
|
|
|
PR EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ
|
Professional
|
Both
|
$1,577.00
|
|
|
Service Code
|
HCPCS 38550
|
| Min. Negotiated Rate |
$339.95 |
| Max. Negotiated Rate |
$1,053.88 |
| Rate for Payer: Aetna Commercial |
$678.08
|
| Rate for Payer: Aetna Medicare |
$526.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.68
|
| Rate for Payer: BCBS Complete |
$356.95
|
| Rate for Payer: BCBS MAPPO |
$506.03
|
| Rate for Payer: BCBS Trust/PPO |
$608.07
|
| Rate for Payer: BCN Commercial |
$766.24
|
| Rate for Payer: BCN Medicare Advantage |
$506.03
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cash Price |
$1,261.60
|
| Rate for Payer: Cofinity Commercial |
$678.08
|
| Rate for Payer: Cofinity Commercial |
$728.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.33
|
| Rate for Payer: Meridian Medicaid |
$356.95
|
| Rate for Payer: Nomi Health Commercial |
$607.24
|
| Rate for Payer: PACE SWMI |
$506.03
|
| Rate for Payer: PHP Commercial |
$708.44
|
| Rate for Payer: PHP Medicare Advantage |
$506.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.88
|
| Rate for Payer: Priority Health Medicare |
$506.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,053.88
|
| Rate for Payer: Priority Health SBD |
$1,053.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.03
|
| Rate for Payer: UHC Medicare Advantage |
$506.03
|
| Rate for Payer: UHCCP Medicaid |
$339.95
|
| Rate for Payer: UMR Bronson Commercial |
$725.42
|
|
|
PR EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT
|
Professional
|
Both
|
$2,361.00
|
|
|
Service Code
|
HCPCS 26205
|
| Min. Negotiated Rate |
$32.23 |
| Max. Negotiated Rate |
$1,534.65 |
| Rate for Payer: Aetna Commercial |
$785.92
|
| Rate for Payer: Aetna Medicare |
$609.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.57
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$586.51
|
| Rate for Payer: BCBS Trust/PPO |
$32.23
|
| Rate for Payer: BCN Commercial |
$895.26
|
| Rate for Payer: BCN Medicare Advantage |
$586.51
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cofinity Commercial |
$785.92
|
| Rate for Payer: Cofinity Commercial |
$844.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.84
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Nomi Health Commercial |
$703.81
|
| Rate for Payer: PACE SWMI |
$586.51
|
| Rate for Payer: PHP Commercial |
$821.11
|
| Rate for Payer: PHP Medicare Advantage |
$586.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$940.89
|
| Rate for Payer: Priority Health Medicare |
$586.51
|
| Rate for Payer: Priority Health Narrow Network |
$940.89
|
| Rate for Payer: Priority Health SBD |
$940.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.51
|
| Rate for Payer: UHC Medicare Advantage |
$586.51
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,086.06
|
|
|
PR EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT
|
Professional
|
Both
|
$1,782.00
|
|
|
Service Code
|
HCPCS 26215
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$1,158.30 |
| Rate for Payer: Aetna Commercial |
$735.37
|
| Rate for Payer: Aetna Medicare |
$570.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.24
|
| Rate for Payer: BCBS Complete |
$391.17
|
| Rate for Payer: BCBS MAPPO |
$548.78
|
| Rate for Payer: BCBS Trust/PPO |
$119.40
|
| Rate for Payer: BCN Commercial |
$841.01
|
| Rate for Payer: BCN Medicare Advantage |
$548.78
|
| Rate for Payer: Cash Price |
$1,425.60
|
| Rate for Payer: Cash Price |
$1,425.60
|
| Rate for Payer: Cofinity Commercial |
$735.37
|
| Rate for Payer: Cofinity Commercial |
$790.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$576.22
|
| Rate for Payer: Meridian Medicaid |
$391.17
|
| Rate for Payer: Nomi Health Commercial |
$658.54
|
| Rate for Payer: PACE SWMI |
$548.78
|
| Rate for Payer: PHP Commercial |
$768.29
|
| Rate for Payer: PHP Medicare Advantage |
$548.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,158.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$883.89
|
| Rate for Payer: Priority Health Medicare |
$548.78
|
| Rate for Payer: Priority Health Narrow Network |
$883.89
|
| Rate for Payer: Priority Health SBD |
$883.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$548.78
|
| Rate for Payer: UHC Medicare Advantage |
$548.78
|
| Rate for Payer: UHCCP Medicaid |
$372.54
|
| Rate for Payer: UMR Bronson Commercial |
$819.72
|
|
|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT
|
Professional
|
Both
|
$2,775.00
|
|
|
Service Code
|
HCPCS 27637
|
| Min. Negotiated Rate |
$489.05 |
| Max. Negotiated Rate |
$1,803.75 |
| Rate for Payer: Aetna Commercial |
$968.65
|
| Rate for Payer: Aetna Medicare |
$751.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.65
|
| Rate for Payer: BCBS Complete |
$513.50
|
| Rate for Payer: BCBS MAPPO |
$722.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.18
|
| Rate for Payer: BCN Commercial |
$1,089.26
|
| Rate for Payer: BCN Medicare Advantage |
$722.87
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cash Price |
$2,220.00
|
| Rate for Payer: Cofinity Commercial |
$1,040.93
|
| Rate for Payer: Cofinity Commercial |
$968.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$759.01
|
| Rate for Payer: Meridian Medicaid |
$513.50
|
| Rate for Payer: Nomi Health Commercial |
$867.44
|
| Rate for Payer: PACE SWMI |
$722.87
|
| Rate for Payer: PHP Commercial |
$1,012.02
|
| Rate for Payer: PHP Medicare Advantage |
$722.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.10
|
| Rate for Payer: Priority Health Medicare |
$722.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.10
|
| Rate for Payer: Priority Health SBD |
$1,154.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.87
|
| Rate for Payer: UHC Medicare Advantage |
$722.87
|
| Rate for Payer: UHCCP Medicaid |
$489.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,276.50
|
|
