|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 27638
|
| Min. Negotiated Rate |
$485.00 |
| Max. Negotiated Rate |
$1,612.37 |
| Rate for Payer: Aetna Commercial |
$963.08
|
| Rate for Payer: Aetna Medicare |
$747.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.08
|
| Rate for Payer: BCBS Complete |
$509.25
|
| Rate for Payer: BCBS MAPPO |
$718.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.37
|
| Rate for Payer: BCN Commercial |
$1,097.08
|
| Rate for Payer: BCN Medicare Advantage |
$718.72
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cofinity Commercial |
$1,034.96
|
| Rate for Payer: Cofinity Commercial |
$963.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$718.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$754.66
|
| Rate for Payer: Meridian Medicaid |
$509.25
|
| Rate for Payer: Nomi Health Commercial |
$862.46
|
| Rate for Payer: PACE SWMI |
$718.72
|
| Rate for Payer: PHP Commercial |
$1,006.21
|
| Rate for Payer: PHP Medicare Advantage |
$718.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,438.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,144.43
|
| Rate for Payer: Priority Health Medicare |
$718.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,144.43
|
| Rate for Payer: Priority Health SBD |
$1,144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$718.72
|
| Rate for Payer: UHC Medicare Advantage |
$718.72
|
| Rate for Payer: UHCCP Medicaid |
$485.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,017.98
|
|
|
PR EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 28104
|
| Min. Negotiated Rate |
$232.17 |
| Max. Negotiated Rate |
$1,143.77 |
| Rate for Payer: Aetna Commercial |
$457.85
|
| Rate for Payer: Aetna Medicare |
$355.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.02
|
| Rate for Payer: BCBS Complete |
$243.78
|
| Rate for Payer: BCBS MAPPO |
$341.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,143.77
|
| Rate for Payer: BCN Commercial |
$761.85
|
| Rate for Payer: BCN Medicare Advantage |
$341.68
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$457.85
|
| Rate for Payer: Cofinity Commercial |
$492.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.76
|
| Rate for Payer: Meridian Medicaid |
$243.78
|
| Rate for Payer: Nomi Health Commercial |
$410.02
|
| Rate for Payer: PACE SWMI |
$341.68
|
| Rate for Payer: PHP Commercial |
$478.35
|
| Rate for Payer: PHP Medicare Advantage |
$341.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.02
|
| Rate for Payer: Priority Health Medicare |
$341.68
|
| Rate for Payer: Priority Health Narrow Network |
$547.02
|
| Rate for Payer: Priority Health SBD |
$547.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.68
|
| Rate for Payer: UHC Medicare Advantage |
$341.68
|
| Rate for Payer: UHCCP Medicaid |
$232.17
|
| Rate for Payer: UMR Bronson Commercial |
$445.74
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 24116
|
| Min. Negotiated Rate |
$82.41 |
| Max. Negotiated Rate |
$1,327.62 |
| Rate for Payer: Aetna Commercial |
$1,113.06
|
| Rate for Payer: Aetna Medicare |
$863.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,196.12
|
| Rate for Payer: BCBS Complete |
$587.75
|
| Rate for Payer: BCBS MAPPO |
$830.64
|
| Rate for Payer: BCBS Trust/PPO |
$82.41
|
| Rate for Payer: BCN Commercial |
$1,264.70
|
| Rate for Payer: BCN Medicare Advantage |
$830.64
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,113.06
|
| Rate for Payer: Cofinity Commercial |
$1,196.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$830.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$872.17
|
| Rate for Payer: Meridian Medicaid |
$587.75
|
| Rate for Payer: Nomi Health Commercial |
$996.77
|
| Rate for Payer: PACE SWMI |
$830.64
|
| Rate for Payer: PHP Commercial |
$1,162.90
|
| Rate for Payer: PHP Medicare Advantage |
$830.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,327.62
|
| Rate for Payer: Priority Health Medicare |
$830.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,327.62
|
| Rate for Payer: Priority Health SBD |
$1,327.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$830.64
|
| Rate for Payer: UHC Medicare Advantage |
$830.64
|
| Rate for Payer: UHCCP Medicaid |
$559.76
|
| Rate for Payer: UMR Bronson Commercial |
$797.64
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 23140
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$865.07 |
| Rate for Payer: Aetna Commercial |
$721.36
|
| Rate for Payer: Aetna Medicare |
$559.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.20
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS MAPPO |
$538.33
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$821.96
|
| Rate for Payer: BCN Medicare Advantage |
$538.33
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$721.36
|
| Rate for Payer: Cofinity Commercial |
$775.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.25
|
| Rate for Payer: Meridian Medicaid |
$383.56
|
| Rate for Payer: Nomi Health Commercial |
$646.00
|
| Rate for Payer: PACE SWMI |
$538.33
|
| Rate for Payer: PHP Commercial |
$753.66
|
| Rate for Payer: PHP Medicare Advantage |
$538.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$865.07
|
| Rate for Payer: Priority Health Medicare |
$538.33
|
| Rate for Payer: Priority Health Narrow Network |
$865.07
|
| Rate for Payer: Priority Health SBD |
$865.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.33
|
| Rate for Payer: UHC Medicare Advantage |
$538.33
|
| Rate for Payer: UHCCP Medicaid |
$365.30
|
| Rate for Payer: UMR Bronson Commercial |
$432.86
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Facility
|
OP
|
$1,253.00
|
|
|
Service Code
|
CPT 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$463.61 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$814.45
|
| Rate for Payer: Aetna Commercial |
$1,065.05
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.39
|
| Rate for Payer: BCN Commercial |
$1,898.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$1,077.58
|
| Rate for Payer: Cofinity Commercial |
$877.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$877.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,127.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$877.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$939.75
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.05
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,065.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$789.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.78
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$517.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$463.61
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$939.75
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Facility
|
IP
|
$1,253.00
|
|
|
Service Code
|
CPT 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$551.32 |
| Max. Negotiated Rate |
$1,127.70 |
| Rate for Payer: Aetna American Axle |
$814.45
|
| Rate for Payer: Aetna Commercial |
$1,065.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.45
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$1,077.58
|
| Rate for Payer: Cofinity Commercial |
$877.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$877.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.40
|
| Rate for Payer: Healthscope Commercial |
$1,127.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$877.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$939.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.05
|
| Rate for Payer: PHP Commercial |
$1,065.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health SBD |
$789.39
|
| Rate for Payer: UMR Bronson Commercial |
$551.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$939.75
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 24120
|
| Min. Negotiated Rate |
$114.64 |
| Max. Negotiated Rate |
$829.95 |
| Rate for Payer: Aetna Commercial |
$693.57
|
| Rate for Payer: Aetna Medicare |
$538.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.33
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$517.59
|
| Rate for Payer: BCBS Trust/PPO |
$114.64
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$517.59
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$693.57
|
| Rate for Payer: Cofinity Commercial |
$745.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.47
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Nomi Health Commercial |
$621.11
|
| Rate for Payer: PACE SWMI |
$517.59
|
| Rate for Payer: PHP Commercial |
$724.63
|
| Rate for Payer: PHP Medicare Advantage |
$517.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$829.95
|
| Rate for Payer: Priority Health Medicare |
$517.59
|
| Rate for Payer: Priority Health Narrow Network |
$829.95
|
| Rate for Payer: Priority Health SBD |
$829.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.59
|
| Rate for Payer: UHC Medicare Advantage |
$517.59
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
| Rate for Payer: UMR Bronson Commercial |
$576.38
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$114.64 |
| Max. Negotiated Rate |
$829.95 |
| Rate for Payer: Aetna Commercial |
$693.57
|
| Rate for Payer: Aetna Medicare |
$538.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.33
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$517.59
|
| Rate for Payer: BCBS Trust/PPO |
$114.64
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$517.59
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$745.33
|
| Rate for Payer: Cofinity Commercial |
$693.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.47
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Nomi Health Commercial |
$621.11
|
| Rate for Payer: PACE SWMI |
$517.59
|
| Rate for Payer: PHP Commercial |
$724.63
|
| Rate for Payer: PHP Medicare Advantage |
$517.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$829.95
|
| Rate for Payer: Priority Health Medicare |
$517.59
|
| Rate for Payer: Priority Health Narrow Network |
$829.95
|
| Rate for Payer: Priority Health SBD |
$829.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.59
|
| Rate for Payer: UHC Medicare Advantage |
$517.59
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
| Rate for Payer: UMR Bronson Commercial |
$576.38
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
HCPCS 23155
|
| Min. Negotiated Rate |
$59.01 |
| Max. Negotiated Rate |
$1,233.98 |
| Rate for Payer: Aetna Commercial |
$1,033.85
|
| Rate for Payer: Aetna Medicare |
$802.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,111.00
|
| Rate for Payer: BCBS Complete |
$547.49
|
| Rate for Payer: BCBS MAPPO |
$771.53
|
| Rate for Payer: BCBS Trust/PPO |
$59.01
|
| Rate for Payer: BCN Commercial |
$1,175.76
|
| Rate for Payer: BCN Medicare Advantage |
$771.53
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cofinity Commercial |
$1,033.85
|
| Rate for Payer: Cofinity Commercial |
$1,111.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$810.11
|
| Rate for Payer: Meridian Medicaid |
$547.49
|
| Rate for Payer: Nomi Health Commercial |
$925.84
|
| Rate for Payer: PACE SWMI |
$771.53
|
| Rate for Payer: PHP Commercial |
$1,080.14
|
| Rate for Payer: PHP Medicare Advantage |
$771.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.98
|
| Rate for Payer: Priority Health Medicare |
$771.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,233.98
|
| Rate for Payer: Priority Health SBD |
$1,233.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.53
|
| Rate for Payer: UHC Medicare Advantage |
$771.53
|
| Rate for Payer: UHCCP Medicaid |
$521.42
|
| Rate for Payer: UMR Bronson Commercial |
$649.06
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT
|
Professional
|
Both
|
$1,299.00
|
|
|
Service Code
|
HCPCS 23156
|
| Min. Negotiated Rate |
$32.26 |
| Max. Negotiated Rate |
$1,053.34 |
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Aetna Commercial |
$882.55
|
| Rate for Payer: Aetna Medicare |
$684.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.41
|
| Rate for Payer: BCBS Complete |
$467.88
|
| Rate for Payer: BCBS MAPPO |
$658.62
|
| Rate for Payer: BCBS Trust/PPO |
$32.26
|
| Rate for Payer: BCN Commercial |
$1,002.76
|
| Rate for Payer: BCN Medicare Advantage |
$658.62
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cofinity Commercial |
$882.55
|
| Rate for Payer: Cofinity Commercial |
$948.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.55
|
| Rate for Payer: Meridian Medicaid |
$467.88
|
| Rate for Payer: Nomi Health Commercial |
$790.34
|
| Rate for Payer: PACE SWMI |
$658.62
|
| Rate for Payer: PHP Commercial |
$922.07
|
| Rate for Payer: PHP Medicare Advantage |
$658.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.34
|
| Rate for Payer: Priority Health Medicare |
$658.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,053.34
|
| Rate for Payer: Priority Health SBD |
$1,053.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.62
|
| Rate for Payer: UHC Medicare Advantage |
$658.62
|
| Rate for Payer: UHCCP Medicaid |
$445.60
|
| Rate for Payer: UMR Bronson Commercial |
$597.54
|
|
|
PR EXC/CURTG CST/B9 TUM PHALANGES FOOT
|
Professional
|
Both
|
$532.00
|
|
|
Service Code
|
HCPCS 28108
|
| Min. Negotiated Rate |
$188.51 |
| Max. Negotiated Rate |
$630.40 |
| Rate for Payer: Aetna Commercial |
$370.59
|
| Rate for Payer: Aetna Medicare |
$287.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.25
|
| Rate for Payer: BCBS Complete |
$197.94
|
| Rate for Payer: BCBS MAPPO |
$276.56
|
| Rate for Payer: BCBS Trust/PPO |
$252.00
|
| Rate for Payer: BCN Commercial |
$630.40
|
| Rate for Payer: BCN Medicare Advantage |
$276.56
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$370.59
|
| Rate for Payer: Cofinity Commercial |
$398.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$276.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$290.39
|
| Rate for Payer: Meridian Medicaid |
$197.94
|
| Rate for Payer: Nomi Health Commercial |
$331.87
|
| Rate for Payer: PACE SWMI |
$276.56
|
| Rate for Payer: PHP Commercial |
$387.18
|
| Rate for Payer: PHP Medicare Advantage |
$276.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$445.26
|
| Rate for Payer: Priority Health Medicare |
$276.56
|
| Rate for Payer: Priority Health Narrow Network |
$445.26
|
| Rate for Payer: Priority Health SBD |
$445.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$276.56
|
| Rate for Payer: UHC Medicare Advantage |
$276.56
|
| Rate for Payer: UHCCP Medicaid |
$188.51
|
| Rate for Payer: UMR Bronson Commercial |
$244.72
|
|
|
PR EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT
|
Professional
|
Both
|
$961.00
|
|
|
Service Code
|
HCPCS 28106
|
| Min. Negotiated Rate |
$276.05 |
| Max. Negotiated Rate |
$907.62 |
| Rate for Payer: Aetna Commercial |
$546.80
|
| Rate for Payer: Aetna Medicare |
$424.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.61
|
| Rate for Payer: BCBS Complete |
$289.85
|
| Rate for Payer: BCBS MAPPO |
$408.06
|
| Rate for Payer: BCBS Trust/PPO |
$907.62
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: BCN Medicare Advantage |
$408.06
|
| Rate for Payer: Cash Price |
$768.80
|
| Rate for Payer: Cash Price |
$768.80
|
| Rate for Payer: Cofinity Commercial |
$546.80
|
| Rate for Payer: Cofinity Commercial |
$587.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.46
|
| Rate for Payer: Meridian Medicaid |
$289.85
|
| Rate for Payer: Nomi Health Commercial |
$489.67
|
| Rate for Payer: PACE SWMI |
$408.06
|
| Rate for Payer: PHP Commercial |
$571.28
|
| Rate for Payer: PHP Medicare Advantage |
$408.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$653.88
|
| Rate for Payer: Priority Health Medicare |
$408.06
|
| Rate for Payer: Priority Health Narrow Network |
$653.88
|
| Rate for Payer: Priority Health SBD |
$653.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.06
|
| Rate for Payer: UHC Medicare Advantage |
$408.06
|
| Rate for Payer: UHCCP Medicaid |
$276.05
|
| Rate for Payer: UMR Bronson Commercial |
$442.06
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT
|
Professional
|
Both
|
$1,003.00
|
|
|
Service Code
|
HCPCS 25136
|
| Min. Negotiated Rate |
$328.66 |
| Max. Negotiated Rate |
$1,019.62 |
| Rate for Payer: Aetna Commercial |
$647.27
|
| Rate for Payer: Aetna Medicare |
$502.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.58
|
| Rate for Payer: BCBS Complete |
$345.09
|
| Rate for Payer: BCBS MAPPO |
$483.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,019.62
|
| Rate for Payer: BCN Commercial |
$738.88
|
| Rate for Payer: BCN Medicare Advantage |
$483.04
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cofinity Commercial |
$647.27
|
| Rate for Payer: Cofinity Commercial |
$695.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$507.19
|
| Rate for Payer: Meridian Medicaid |
$345.09
|
| Rate for Payer: Nomi Health Commercial |
$579.65
|
| Rate for Payer: PACE SWMI |
$483.04
|
| Rate for Payer: PHP Commercial |
$676.26
|
| Rate for Payer: PHP Medicare Advantage |
$483.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$651.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$777.53
|
| Rate for Payer: Priority Health Medicare |
$483.04
|
| Rate for Payer: Priority Health Narrow Network |
$777.53
|
| Rate for Payer: Priority Health SBD |
$777.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.04
|
| Rate for Payer: UHC Medicare Advantage |
$483.04
|
| Rate for Payer: UHCCP Medicaid |
$328.66
|
| Rate for Payer: UMR Bronson Commercial |
$461.38
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT
|
Professional
|
Both
|
$1,011.00
|
|
|
Service Code
|
HCPCS 25135
|
| Min. Negotiated Rate |
$370.19 |
| Max. Negotiated Rate |
$1,158.03 |
| Rate for Payer: Aetna Commercial |
$730.17
|
| Rate for Payer: Aetna Medicare |
$566.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$730.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$784.66
|
| Rate for Payer: BCBS Complete |
$388.70
|
| Rate for Payer: BCBS MAPPO |
$544.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.03
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$544.90
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cash Price |
$808.80
|
| Rate for Payer: Cofinity Commercial |
$730.17
|
| Rate for Payer: Cofinity Commercial |
$784.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$572.14
|
| Rate for Payer: Meridian Medicaid |
$388.70
|
| Rate for Payer: Nomi Health Commercial |
$653.88
|
| Rate for Payer: PACE SWMI |
$544.90
|
| Rate for Payer: PHP Commercial |
$762.86
|
| Rate for Payer: PHP Medicare Advantage |
$544.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$370.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$875.75
|
| Rate for Payer: Priority Health Medicare |
$544.90
|
| Rate for Payer: Priority Health Narrow Network |
$875.75
|
| Rate for Payer: Priority Health SBD |
$875.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$544.90
|
| Rate for Payer: UHC Medicare Advantage |
$544.90
|
| Rate for Payer: UHCCP Medicaid |
$370.19
|
| Rate for Payer: UMR Bronson Commercial |
$465.06
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT
|
Professional
|
Both
|
$1,216.00
|
|
|
Service Code
|
HCPCS 25126
|
| Min. Negotiated Rate |
$394.48 |
| Max. Negotiated Rate |
$1,153.28 |
| Rate for Payer: Aetna Commercial |
$779.09
|
| Rate for Payer: Aetna Medicare |
$604.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.23
|
| Rate for Payer: BCBS Complete |
$414.20
|
| Rate for Payer: BCBS MAPPO |
$581.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.28
|
| Rate for Payer: BCN Commercial |
$887.44
|
| Rate for Payer: BCN Medicare Advantage |
$581.41
|
| Rate for Payer: Cash Price |
$972.80
|
| Rate for Payer: Cash Price |
$972.80
|
| Rate for Payer: Cofinity Commercial |
$779.09
|
| Rate for Payer: Cofinity Commercial |
$837.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$581.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$610.48
|
| Rate for Payer: Meridian Medicaid |
$414.20
|
| Rate for Payer: Nomi Health Commercial |
$697.69
|
| Rate for Payer: PACE SWMI |
$581.41
|
| Rate for Payer: PHP Commercial |
$813.97
|
| Rate for Payer: PHP Medicare Advantage |
$581.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$790.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$934.27
|
| Rate for Payer: Priority Health Medicare |
$581.41
|
| Rate for Payer: Priority Health Narrow Network |
$934.27
|
| Rate for Payer: Priority Health SBD |
$934.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$581.41
|
| Rate for Payer: UHC Medicare Advantage |
$581.41
|
| Rate for Payer: UHCCP Medicaid |
$394.48
|
| Rate for Payer: UMR Bronson Commercial |
$559.36
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$2,319.00
|
|
|
Service Code
|
HCPCS 25125
|
| Min. Negotiated Rate |
$87.17 |
| Max. Negotiated Rate |
$1,507.35 |
| Rate for Payer: Aetna Commercial |
$773.97
|
| Rate for Payer: Aetna Medicare |
$600.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$773.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.73
|
| Rate for Payer: BCBS Complete |
$411.52
|
| Rate for Payer: BCBS MAPPO |
$577.59
|
| Rate for Payer: BCBS Trust/PPO |
$87.17
|
| Rate for Payer: BCN Commercial |
$881.57
|
| Rate for Payer: BCN Medicare Advantage |
$577.59
|
| Rate for Payer: Cash Price |
$1,855.20
|
| Rate for Payer: Cash Price |
$1,855.20
|
| Rate for Payer: Cofinity Commercial |
$773.97
|
| Rate for Payer: Cofinity Commercial |
$831.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.47
|
| Rate for Payer: Meridian Medicaid |
$411.52
|
| Rate for Payer: Nomi Health Commercial |
$693.11
|
| Rate for Payer: PACE SWMI |
$577.59
|
| Rate for Payer: PHP Commercial |
$808.63
|
| Rate for Payer: PHP Medicare Advantage |
$577.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,507.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.65
|
| Rate for Payer: Priority Health Medicare |
$577.59
|
| Rate for Payer: Priority Health Narrow Network |
$927.65
|
| Rate for Payer: Priority Health SBD |
$927.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$577.59
|
| Rate for Payer: UHC Medicare Advantage |
$577.59
|
| Rate for Payer: UHCCP Medicaid |
$391.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,066.74
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,052.00
|
|
|
Service Code
|
HCPCS 19120
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$762.83 |
| Rate for Payer: Aetna Commercial |
$543.26
|
| Rate for Payer: Aetna Medicare |
$421.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.80
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS MAPPO |
$405.42
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$762.83
|
| Rate for Payer: BCN Medicare Advantage |
$405.42
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$543.26
|
| Rate for Payer: Cofinity Commercial |
$583.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.69
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Nomi Health Commercial |
$486.50
|
| Rate for Payer: PACE SWMI |
$405.42
|
| Rate for Payer: PHP Commercial |
$567.59
|
| Rate for Payer: PHP Medicare Advantage |
$405.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$571.62
|
| Rate for Payer: Priority Health Medicare |
$405.42
|
| Rate for Payer: Priority Health Narrow Network |
$571.62
|
| Rate for Payer: Priority Health SBD |
$571.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$405.42
|
| Rate for Payer: UHC Medicare Advantage |
$405.42
|
| Rate for Payer: UHCCP Medicaid |
$271.79
|
| Rate for Payer: UMR Bronson Commercial |
$483.92
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
OP
|
$1,052.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$389.24 |
| Max. Negotiated Rate |
$11,792.02 |
| Rate for Payer: Aetna American Axle |
$683.80
|
| Rate for Payer: Aetna Commercial |
$894.20
|
| Rate for Payer: Aetna Medicare |
$3,901.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.80
|
| 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 |
$2,787.68
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$2,787.68
|
| Rate for Payer: BCN Medicare Advantage |
$3,751.85
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$904.72
|
| Rate for Payer: Cofinity Commercial |
$736.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$736.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,751.85
|
| Rate for Payer: Healthscope Commercial |
$946.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$736.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.00
|
| 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 |
$894.20
|
| 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 |
$894.20
|
| 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 |
$683.80
|
| 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 |
$662.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,751.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.26
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,751.85
|
| Rate for Payer: UHC Exchange |
$407.51
|
| Rate for Payer: UHC Medicare Advantage |
$3,751.85
|
| Rate for Payer: UHCCP Medicaid |
$2,010.99
|
| Rate for Payer: UMR Bronson Commercial |
$389.24
|
| Rate for Payer: VA VA |
$3,751.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.00
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,052.00
|
|
|
Service Code
|
HCPCS 19120
|
| Hospital Charge Code |
19120
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$762.83 |
| Rate for Payer: Aetna Commercial |
$543.26
|
| Rate for Payer: Aetna Medicare |
$421.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.80
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS MAPPO |
$405.42
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$762.83
|
| Rate for Payer: BCN Medicare Advantage |
$405.42
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$543.26
|
| Rate for Payer: Cofinity Commercial |
$583.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.69
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Nomi Health Commercial |
$486.50
|
| Rate for Payer: PACE SWMI |
$405.42
|
| Rate for Payer: PHP Commercial |
$567.59
|
| Rate for Payer: PHP Medicare Advantage |
$405.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$571.62
|
| Rate for Payer: Priority Health Medicare |
$405.42
|
| Rate for Payer: Priority Health Narrow Network |
$571.62
|
| Rate for Payer: Priority Health SBD |
$571.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$405.42
|
| Rate for Payer: UHC Medicare Advantage |
$405.42
|
| Rate for Payer: UHCCP Medicaid |
$271.79
|
| Rate for Payer: UMR Bronson Commercial |
$483.92
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
IP
|
$1,052.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$462.88 |
| Max. Negotiated Rate |
$946.80 |
| Rate for Payer: Aetna American Axle |
$683.80
|
| Rate for Payer: Aetna Commercial |
$894.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.80
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$736.40
|
| Rate for Payer: Cofinity Commercial |
$904.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$736.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.60
|
| Rate for Payer: Healthscope Commercial |
$946.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$736.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.20
|
| Rate for Payer: PHP Commercial |
$894.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.80
|
| Rate for Payer: Priority Health SBD |
$662.76
|
| Rate for Payer: UMR Bronson Commercial |
$462.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.00
|
|
|
PR EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS
|
Professional
|
Both
|
$1,411.00
|
|
|
Service Code
|
HCPCS 60200
|
| Min. Negotiated Rate |
$217.13 |
| Max. Negotiated Rate |
$1,088.30 |
| Rate for Payer: Aetna Commercial |
$862.38
|
| Rate for Payer: Aetna Medicare |
$669.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$926.74
|
| Rate for Payer: BCBS Complete |
$453.56
|
| Rate for Payer: BCBS MAPPO |
$643.57
|
| Rate for Payer: BCBS Trust/PPO |
$217.13
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$643.57
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cash Price |
$1,128.80
|
| Rate for Payer: Cofinity Commercial |
$926.74
|
| Rate for Payer: Cofinity Commercial |
$862.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$643.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$675.75
|
| Rate for Payer: Meridian Medicaid |
$453.56
|
| Rate for Payer: Nomi Health Commercial |
$772.28
|
| Rate for Payer: PACE SWMI |
$643.57
|
| Rate for Payer: PHP Commercial |
$901.00
|
| Rate for Payer: PHP Medicare Advantage |
$643.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,088.30
|
| Rate for Payer: Priority Health Medicare |
$643.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,088.30
|
| Rate for Payer: Priority Health SBD |
$1,088.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$643.57
|
| Rate for Payer: UHC Medicare Advantage |
$643.57
|
| Rate for Payer: UHCCP Medicaid |
$431.96
|
| Rate for Payer: UMR Bronson Commercial |
$649.06
|
|
|
PR EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM
|
Professional
|
Both
|
$3,970.00
|
|
|
Service Code
|
HCPCS 49204
|
| Min. Negotiated Rate |
$624.45 |
| Max. Negotiated Rate |
$2,580.50 |
| Rate for Payer: Aetna Commercial |
$2,046.13
|
| Rate for Payer: Aetna Medicare |
$1,985.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,046.13
|
| Rate for Payer: BCBS Complete |
$1,588.00
|
| Rate for Payer: BCBS Trust/PPO |
$624.45
|
| Rate for Payer: BCN Commercial |
$2,216.64
|
| Rate for Payer: Cash Price |
$3,176.00
|
| Rate for Payer: Cash Price |
$3,176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,580.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,826.20
|
|
|
PR EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM
|
Professional
|
Both
|
$3,208.00
|
|
|
Service Code
|
HCPCS 49205
|
| Min. Negotiated Rate |
$366.64 |
| Max. Negotiated Rate |
$2,544.55 |
| Rate for Payer: Aetna Commercial |
$2,348.49
|
| Rate for Payer: Aetna Medicare |
$1,604.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,348.49
|
| Rate for Payer: BCBS Complete |
$1,283.20
|
| Rate for Payer: BCBS Trust/PPO |
$366.64
|
| Rate for Payer: BCN Commercial |
$2,544.55
|
| Rate for Payer: Cash Price |
$2,566.40
|
| Rate for Payer: Cash Price |
$2,566.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,085.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,475.68
|
|
|
PR EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX
|
Professional
|
Both
|
$1,051.00
|
|
|
Service Code
|
HCPCS 42870
|
| Min. Negotiated Rate |
$377.01 |
| Max. Negotiated Rate |
$1,057.77 |
| Rate for Payer: Aetna Commercial |
$729.30
|
| Rate for Payer: Aetna Medicare |
$566.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.72
|
| Rate for Payer: BCBS Complete |
$395.86
|
| Rate for Payer: BCBS MAPPO |
$544.25
|
| Rate for Payer: BCBS Trust/PPO |
$829.43
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$544.25
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cofinity Commercial |
$729.30
|
| Rate for Payer: Cofinity Commercial |
$783.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.46
|
| Rate for Payer: Meridian Medicaid |
$395.86
|
| Rate for Payer: Nomi Health Commercial |
$653.10
|
| Rate for Payer: PACE SWMI |
$544.25
|
| Rate for Payer: PHP Commercial |
$761.95
|
| Rate for Payer: PHP Medicare Advantage |
$544.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,057.77
|
| Rate for Payer: Priority Health Medicare |
$544.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,057.77
|
| Rate for Payer: Priority Health SBD |
$1,057.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$544.25
|
| Rate for Payer: UHC Medicare Advantage |
$544.25
|
| Rate for Payer: UHCCP Medicaid |
$377.01
|
| Rate for Payer: UMR Bronson Commercial |
$483.46
|
|
|
PR EXC EXCSV SKN ABD INFRAUMBILICAL PANNICULECTOMY
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 15830
|
| Min. Negotiated Rate |
$226.01 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Commercial |
$1,509.38
|
| Rate for Payer: Aetna Medicare |
$1,171.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.02
|
| Rate for Payer: BCBS Complete |
$795.97
|
| Rate for Payer: BCBS MAPPO |
$1,126.40
|
| Rate for Payer: BCBS Trust/PPO |
$226.01
|
| Rate for Payer: BCN Commercial |
$1,711.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,126.40
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Cofinity Commercial |
$1,509.38
|
| Rate for Payer: Cofinity Commercial |
$1,622.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,126.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,182.72
|
| Rate for Payer: Meridian Medicaid |
$795.97
|
| Rate for Payer: Nomi Health Commercial |
$1,351.68
|
| Rate for Payer: PACE SWMI |
$1,126.40
|
| Rate for Payer: PHP Commercial |
$1,576.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,126.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$758.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,588.89
|
| Rate for Payer: Priority Health Medicare |
$1,126.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,588.89
|
| Rate for Payer: Priority Health SBD |
$1,588.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,126.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,126.40
|
| Rate for Payer: UHCCP Medicaid |
$758.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,219.92
|
|
