|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$1,449.66 |
| Rate for Payer: Aetna Commercial |
$655.22
|
| Rate for Payer: Aetna Medicare |
$508.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$655.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.12
|
| Rate for Payer: BCBS Complete |
$345.76
|
| Rate for Payer: BCBS MAPPO |
$488.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: BCN Commercial |
$740.83
|
| Rate for Payer: BCN Medicare Advantage |
$488.97
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$655.22
|
| Rate for Payer: Cofinity Commercial |
$704.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.42
|
| Rate for Payer: Meridian Medicaid |
$345.76
|
| Rate for Payer: Nomi Health Commercial |
$586.76
|
| Rate for Payer: PACE SWMI |
$488.97
|
| Rate for Payer: PHP Commercial |
$684.56
|
| Rate for Payer: PHP Medicare Advantage |
$488.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.66
|
| Rate for Payer: Priority Health Medicare |
$488.97
|
| Rate for Payer: Priority Health Narrow Network |
$819.66
|
| Rate for Payer: Priority Health SBD |
$819.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$488.97
|
| Rate for Payer: UHC Medicare Advantage |
$488.97
|
| Rate for Payer: UHCCP Medicaid |
$329.30
|
| Rate for Payer: UMR Bronson Commercial |
$847.78
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
OP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$493.24 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna American Axle |
$1,197.95
|
| Rate for Payer: Aetna Commercial |
$1,566.55
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,197.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.09
|
| Rate for Payer: BCN Commercial |
$2,642.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,584.98
|
| Rate for Payer: Cofinity Commercial |
$1,290.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,290.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,474.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,658.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,290.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,382.25
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$1,566.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$1,161.09
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.56
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$493.24
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: UMR Bronson Commercial |
$681.91
|
| Rate for Payer: VA VA |
$3,457.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,382.25
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
55040
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,183.92 |
| Rate for Payer: Aetna Commercial |
$434.39
|
| Rate for Payer: Aetna Medicare |
$337.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.80
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS MAPPO |
$324.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$324.17
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$466.80
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.38
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| Rate for Payer: Nomi Health Commercial |
$389.00
|
| Rate for Payer: PACE SWMI |
$324.17
|
| Rate for Payer: PHP Commercial |
$453.84
|
| Rate for Payer: PHP Medicare Advantage |
$324.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.79
|
| Rate for Payer: Priority Health Medicare |
$324.17
|
| Rate for Payer: Priority Health Narrow Network |
$543.79
|
| Rate for Payer: Priority Health SBD |
$543.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.17
|
| Rate for Payer: UHC Medicare Advantage |
$324.17
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
| Rate for Payer: UMR Bronson Commercial |
$577.76
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
OP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$326.45 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna American Axle |
$816.40
|
| Rate for Payer: Aetna Commercial |
$1,067.60
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,124.09
|
| Rate for Payer: BCN Commercial |
$3,124.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,080.16
|
| Rate for Payer: Cofinity Commercial |
$879.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$879.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,130.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$879.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.00
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$1,067.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$791.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.10
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$326.45
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: UMR Bronson Commercial |
$464.72
|
| Rate for Payer: VA VA |
$3,457.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.00
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,183.92 |
| Rate for Payer: Aetna Commercial |
$434.39
|
| Rate for Payer: Aetna Medicare |
$337.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.80
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS MAPPO |
$324.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$324.17
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Cofinity Commercial |
$466.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.38
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| Rate for Payer: Nomi Health Commercial |
$389.00
|
| Rate for Payer: PACE SWMI |
$324.17
|
| Rate for Payer: PHP Commercial |
$453.84
|
| Rate for Payer: PHP Medicare Advantage |
$324.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.79
|
| Rate for Payer: Priority Health Medicare |
$324.17
|
| Rate for Payer: Priority Health Narrow Network |
$543.79
|
| Rate for Payer: Priority Health SBD |
$543.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.17
|
| Rate for Payer: UHC Medicare Advantage |
$324.17
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
| Rate for Payer: UMR Bronson Commercial |
$577.76
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
IP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$552.64 |
| Max. Negotiated Rate |
$1,130.40 |
| Rate for Payer: Aetna American Axle |
$816.40
|
| Rate for Payer: Aetna Commercial |
$1,067.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.40
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,080.16
|
| Rate for Payer: Cofinity Commercial |
$879.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$879.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Healthscope Commercial |
$1,130.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$879.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: PHP Commercial |
$1,067.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health SBD |
$791.28
|
| Rate for Payer: UMR Bronson Commercial |
$552.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.00
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$1,120.00 |
| Max. Negotiated Rate |
$2,971.84 |
| Rate for Payer: Aetna Commercial |
$2,461.98
|
| Rate for Payer: Aetna Medicare |
$1,910.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,461.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,645.71
|
| Rate for Payer: BCBS Complete |
$1,253.78
|
| Rate for Payer: BCBS MAPPO |
$1,837.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.00
|
| Rate for Payer: BCN Commercial |
$2,709.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,837.30
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cofinity Commercial |
$2,461.98
|
| Rate for Payer: Cofinity Commercial |
$2,645.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,837.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,929.16
|
| Rate for Payer: Meridian Medicaid |
$1,253.78
|
| Rate for Payer: Nomi Health Commercial |
$2,204.76
|
| Rate for Payer: PACE SWMI |
$1,837.30
|
| Rate for Payer: PHP Commercial |
$2,572.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,837.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,194.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,627.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,971.84
|
| Rate for Payer: Priority Health Medicare |
$1,837.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,971.84
|
| Rate for Payer: Priority Health SBD |
$2,971.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,837.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,837.30
|
| Rate for Payer: UHCCP Medicaid |
$1,194.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,859.78
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$2,005.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,303.25 |
| Rate for Payer: Aetna Commercial |
$718.70
|
| Rate for Payer: Aetna Medicare |
$557.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$718.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.33
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$536.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.68
|
| Rate for Payer: BCN Commercial |
$810.72
|
| Rate for Payer: BCN Medicare Advantage |
$536.34
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cofinity Commercial |
$718.70
|
| Rate for Payer: Cofinity Commercial |
$772.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.16
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Nomi Health Commercial |
$643.61
|
| Rate for Payer: PACE SWMI |
$536.34
|
| Rate for Payer: PHP Commercial |
$750.88
|
| Rate for Payer: PHP Medicare Advantage |
$536.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.95
|
| Rate for Payer: Priority Health Medicare |
$536.34
|
| Rate for Payer: Priority Health Narrow Network |
$884.95
|
| Rate for Payer: Priority Health SBD |
$884.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.34
|
| Rate for Payer: UHC Medicare Advantage |
$536.34
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
| Rate for Payer: UMR Bronson Commercial |
$922.30
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$266.68 |
| Max. Negotiated Rate |
$674.64 |
| Rate for Payer: Aetna Commercial |
$513.43
|
| Rate for Payer: Aetna Medicare |
$398.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.75
|
| Rate for Payer: BCBS Complete |
$280.01
|
| Rate for Payer: BCBS MAPPO |
$383.16
|
| Rate for Payer: BCBS Trust/PPO |
$674.64
|
| Rate for Payer: BCN Commercial |
$619.16
|
| Rate for Payer: BCN Medicare Advantage |
$383.16
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$513.43
|
| Rate for Payer: Cofinity Commercial |
$551.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.32
|
| Rate for Payer: Meridian Medicaid |
$280.01
|
| Rate for Payer: Nomi Health Commercial |
$459.79
|
| Rate for Payer: PACE SWMI |
$383.16
|
| Rate for Payer: PHP Commercial |
$536.42
|
| Rate for Payer: PHP Medicare Advantage |
$383.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$583.96
|
| Rate for Payer: Priority Health Medicare |
$383.16
|
| Rate for Payer: Priority Health Narrow Network |
$583.96
|
| Rate for Payer: Priority Health SBD |
$583.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.16
|
| Rate for Payer: UHC Medicare Advantage |
$383.16
|
| Rate for Payer: UHCCP Medicaid |
$266.68
|
| Rate for Payer: UMR Bronson Commercial |
$370.30
|
|
|
PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 28080
|
| Min. Negotiated Rate |
$249.21 |
| Max. Negotiated Rate |
$1,100.45 |
| Rate for Payer: Aetna Commercial |
$486.76
|
| Rate for Payer: Aetna Medicare |
$377.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.08
|
| Rate for Payer: BCBS Complete |
$261.67
|
| Rate for Payer: BCBS MAPPO |
$363.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.45
|
| Rate for Payer: BCN Commercial |
$853.39
|
| Rate for Payer: BCN Medicare Advantage |
$363.25
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cofinity Commercial |
$486.76
|
| Rate for Payer: Cofinity Commercial |
$523.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.41
|
| Rate for Payer: Meridian Medicaid |
$261.67
|
| Rate for Payer: Nomi Health Commercial |
$435.90
|
| Rate for Payer: PACE SWMI |
$363.25
|
| Rate for Payer: PHP Commercial |
$508.55
|
| Rate for Payer: PHP Medicare Advantage |
$363.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.68
|
| Rate for Payer: Priority Health Medicare |
$363.25
|
| Rate for Payer: Priority Health Narrow Network |
$584.68
|
| Rate for Payer: Priority Health SBD |
$584.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.25
|
| Rate for Payer: UHC Medicare Advantage |
$363.25
|
| Rate for Payer: UHCCP Medicaid |
$249.21
|
| Rate for Payer: UMR Bronson Commercial |
$407.56
|
|
|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$678.77 |
| Rate for Payer: Aetna Commercial |
$417.53
|
| Rate for Payer: Aetna Medicare |
$324.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.69
|
| Rate for Payer: BCBS Complete |
$221.86
|
| Rate for Payer: BCBS MAPPO |
$311.59
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$678.77
|
| Rate for Payer: BCN Medicare Advantage |
$311.59
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cofinity Commercial |
$417.53
|
| Rate for Payer: Cofinity Commercial |
$448.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.17
|
| Rate for Payer: Meridian Medicaid |
$221.86
|
| Rate for Payer: Nomi Health Commercial |
$373.91
|
| Rate for Payer: PACE SWMI |
$311.59
|
| Rate for Payer: PHP Commercial |
$436.23
|
| Rate for Payer: PHP Medicare Advantage |
$311.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$516.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$443.39
|
| Rate for Payer: Priority Health Medicare |
$311.59
|
| Rate for Payer: Priority Health Narrow Network |
$443.39
|
| Rate for Payer: Priority Health SBD |
$443.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.59
|
| Rate for Payer: UHC Medicare Advantage |
$311.59
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
| Rate for Payer: UMR Bronson Commercial |
$365.24
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$916.07 |
| Rate for Payer: Aetna Commercial |
$273.40
|
| Rate for Payer: Aetna Medicare |
$212.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.80
|
| Rate for Payer: BCBS Complete |
$147.16
|
| Rate for Payer: BCBS MAPPO |
$204.03
|
| Rate for Payer: BCBS Trust/PPO |
$916.07
|
| Rate for Payer: BCN Commercial |
$494.05
|
| Rate for Payer: BCN Medicare Advantage |
$204.03
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Cofinity Commercial |
$293.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.23
|
| Rate for Payer: Meridian Medicaid |
$147.16
|
| Rate for Payer: Nomi Health Commercial |
$244.84
|
| Rate for Payer: PACE SWMI |
$204.03
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: PHP Medicare Advantage |
$204.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.17
|
| Rate for Payer: Priority Health Medicare |
$204.03
|
| Rate for Payer: Priority Health Narrow Network |
$390.17
|
| Rate for Payer: Priority Health SBD |
$390.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.03
|
| Rate for Payer: UHC Medicare Advantage |
$204.03
|
| Rate for Payer: UHCCP Medicaid |
$140.15
|
| Rate for Payer: UMR Bronson Commercial |
$270.48
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$347.19 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$684.93
|
| Rate for Payer: Aetna Medicare |
$531.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.04
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS MAPPO |
$511.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.67
|
| Rate for Payer: BCN Commercial |
$780.90
|
| Rate for Payer: BCN Medicare Advantage |
$511.14
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cofinity Commercial |
$684.93
|
| Rate for Payer: Cofinity Commercial |
$736.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.70
|
| Rate for Payer: Meridian Medicaid |
$364.55
|
| Rate for Payer: Nomi Health Commercial |
$613.37
|
| Rate for Payer: PACE SWMI |
$511.14
|
| Rate for Payer: PHP Commercial |
$715.60
|
| Rate for Payer: PHP Medicare Advantage |
$511.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.30
|
| Rate for Payer: Priority Health Medicare |
$511.14
|
| Rate for Payer: Priority Health Narrow Network |
$821.30
|
| Rate for Payer: Priority Health SBD |
$821.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$511.14
|
| Rate for Payer: UHC Medicare Advantage |
$511.14
|
| Rate for Payer: UHCCP Medicaid |
$347.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,076.40
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$1,529.66 |
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Aetna Commercial |
$1,110.95
|
| Rate for Payer: Aetna Medicare |
$862.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,193.86
|
| Rate for Payer: BCBS Complete |
$576.80
|
| Rate for Payer: BCBS MAPPO |
$829.07
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$1,245.15
|
| Rate for Payer: BCN Medicare Advantage |
$829.07
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cofinity Commercial |
$1,110.95
|
| Rate for Payer: Cofinity Commercial |
$1,193.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.52
|
| Rate for Payer: Meridian Medicaid |
$576.80
|
| Rate for Payer: Nomi Health Commercial |
$994.88
|
| Rate for Payer: PACE SWMI |
$829.07
|
| Rate for Payer: PHP Commercial |
$1,160.70
|
| Rate for Payer: PHP Medicare Advantage |
$829.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,529.66
|
| Rate for Payer: Priority Health Medicare |
$829.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.66
|
| Rate for Payer: Priority Health SBD |
$1,529.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$829.07
|
| Rate for Payer: UHC Medicare Advantage |
$829.07
|
| Rate for Payer: UHCCP Medicaid |
$549.33
|
| Rate for Payer: UMR Bronson Commercial |
$693.68
|
|
|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,275.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$1,995.61 |
| Rate for Payer: Aetna Commercial |
$1,451.70
|
| Rate for Payer: Aetna Medicare |
$1,126.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,560.04
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS MAPPO |
$1,083.36
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$1,628.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.36
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cofinity Commercial |
$1,451.70
|
| Rate for Payer: Cofinity Commercial |
$1,560.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.53
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Nomi Health Commercial |
$1,300.03
|
| Rate for Payer: PACE SWMI |
$1,083.36
|
| Rate for Payer: PHP Commercial |
$1,516.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,995.61
|
| Rate for Payer: Priority Health Medicare |
$1,083.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,995.61
|
| Rate for Payer: Priority Health SBD |
$1,995.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.36
|
| Rate for Payer: UHCCP Medicaid |
$716.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,046.50
|
|
|
PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
HCPCS 27630
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$873.60 |
| Rate for Payer: Aetna Commercial |
$462.66
|
| Rate for Payer: Aetna Medicare |
$359.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.19
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS MAPPO |
$345.27
|
| Rate for Payer: BCBS Trust/PPO |
$600.15
|
| Rate for Payer: BCN Commercial |
$785.31
|
| Rate for Payer: BCN Medicare Advantage |
$345.27
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cofinity Commercial |
$462.66
|
| Rate for Payer: Cofinity Commercial |
$497.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.53
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Nomi Health Commercial |
$414.32
|
| Rate for Payer: PACE SWMI |
$345.27
|
| Rate for Payer: PHP Commercial |
$483.38
|
| Rate for Payer: PHP Medicare Advantage |
$345.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$873.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.64
|
| Rate for Payer: Priority Health Medicare |
$345.27
|
| Rate for Payer: Priority Health Narrow Network |
$553.64
|
| Rate for Payer: Priority Health SBD |
$553.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.27
|
| Rate for Payer: UHC Medicare Advantage |
$345.27
|
| Rate for Payer: UHCCP Medicaid |
$234.94
|
| Rate for Payer: UMR Bronson Commercial |
$618.24
|
|
|
PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 25110
|
| Min. Negotiated Rate |
$212.38 |
| Max. Negotiated Rate |
$750.75 |
| Rate for Payer: Aetna Commercial |
$449.60
|
| Rate for Payer: Aetna Medicare |
$348.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.15
|
| Rate for Payer: BCBS Complete |
$240.87
|
| Rate for Payer: BCBS MAPPO |
$335.52
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$516.04
|
| Rate for Payer: BCN Medicare Advantage |
$335.52
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$483.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.30
|
| Rate for Payer: Meridian Medicaid |
$240.87
|
| Rate for Payer: Nomi Health Commercial |
$402.62
|
| Rate for Payer: PACE SWMI |
$335.52
|
| Rate for Payer: PHP Commercial |
$469.73
|
| Rate for Payer: PHP Medicare Advantage |
$335.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.44
|
| Rate for Payer: Priority Health Medicare |
$335.52
|
| Rate for Payer: Priority Health Narrow Network |
$542.44
|
| Rate for Payer: Priority Health SBD |
$542.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.52
|
| Rate for Payer: UHC Medicare Advantage |
$335.52
|
| Rate for Payer: UHCCP Medicaid |
$229.40
|
| Rate for Payer: UMR Bronson Commercial |
$531.30
|
|
|
PR EXCISION LESION TONGUE W/O CLOSURE
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 41110
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$569.51 |
| Rate for Payer: Aetna Commercial |
$163.19
|
| Rate for Payer: Aetna Medicare |
$126.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.36
|
| Rate for Payer: BCBS Complete |
$87.68
|
| Rate for Payer: BCBS MAPPO |
$121.78
|
| Rate for Payer: BCBS Trust/PPO |
$569.51
|
| Rate for Payer: BCN Commercial |
$340.12
|
| Rate for Payer: BCN Medicare Advantage |
$121.78
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$163.19
|
| Rate for Payer: Cofinity Commercial |
$175.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.87
|
| Rate for Payer: Meridian Medicaid |
$87.68
|
| Rate for Payer: Nomi Health Commercial |
$146.14
|
| Rate for Payer: PACE SWMI |
$121.78
|
| Rate for Payer: PHP Commercial |
$170.49
|
| Rate for Payer: PHP Medicare Advantage |
$121.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.46
|
| Rate for Payer: Priority Health Medicare |
$121.78
|
| Rate for Payer: Priority Health Narrow Network |
$234.46
|
| Rate for Payer: Priority Health SBD |
$234.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.78
|
| Rate for Payer: UHC Medicare Advantage |
$121.78
|
| Rate for Payer: UHCCP Medicaid |
$83.50
|
| Rate for Payer: UMR Bronson Commercial |
$175.26
|
|
|
PR EXCISION LINGUAL FRENUM FRENECTOMY
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
HCPCS 41115
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$967.85 |
| Rate for Payer: Aetna Commercial |
$184.28
|
| Rate for Payer: Aetna Medicare |
$143.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.03
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$137.52
|
| Rate for Payer: BCBS Trust/PPO |
$967.85
|
| Rate for Payer: BCN Commercial |
$387.03
|
| Rate for Payer: BCN Medicare Advantage |
$137.52
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cofinity Commercial |
$184.28
|
| Rate for Payer: Cofinity Commercial |
$198.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.40
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Nomi Health Commercial |
$165.02
|
| Rate for Payer: PACE SWMI |
$137.52
|
| Rate for Payer: PHP Commercial |
$192.53
|
| Rate for Payer: PHP Medicare Advantage |
$137.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.69
|
| Rate for Payer: Priority Health Medicare |
$137.52
|
| Rate for Payer: Priority Health Narrow Network |
$263.69
|
| Rate for Payer: Priority Health SBD |
$263.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.52
|
| Rate for Payer: UHC Medicare Advantage |
$137.52
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
| Rate for Payer: UMR Bronson Commercial |
$205.62
|
|
|
PR EXCISION LOCAL LESION EPIDIDYMIS
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
HCPCS 54830
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$1,910.86 |
| Rate for Payer: Aetna Commercial |
$477.67
|
| Rate for Payer: Aetna Medicare |
$370.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.32
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS MAPPO |
$356.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,910.86
|
| Rate for Payer: BCN Commercial |
$539.99
|
| Rate for Payer: BCN Medicare Advantage |
$356.47
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cofinity Commercial |
$477.67
|
| Rate for Payer: Cofinity Commercial |
$513.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.29
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Nomi Health Commercial |
$427.76
|
| Rate for Payer: PACE SWMI |
$356.47
|
| Rate for Payer: PHP Commercial |
$499.06
|
| Rate for Payer: PHP Medicare Advantage |
$356.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$598.11
|
| Rate for Payer: Priority Health Medicare |
$356.47
|
| Rate for Payer: Priority Health Narrow Network |
$598.11
|
| Rate for Payer: Priority Health SBD |
$598.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.47
|
| Rate for Payer: UHC Medicare Advantage |
$356.47
|
| Rate for Payer: UHCCP Medicaid |
$240.69
|
| Rate for Payer: UMR Bronson Commercial |
$283.82
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 11640
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$977.96 |
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna Medicare |
$124.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.01
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS MAPPO |
$119.45
|
| Rate for Payer: BCBS Trust/PPO |
$977.96
|
| Rate for Payer: BCN Commercial |
$239.53
|
| Rate for Payer: BCN Medicare Advantage |
$119.45
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$160.06
|
| Rate for Payer: Cofinity Commercial |
$172.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.42
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Nomi Health Commercial |
$143.34
|
| Rate for Payer: PACE SWMI |
$119.45
|
| Rate for Payer: PHP Commercial |
$167.23
|
| Rate for Payer: PHP Medicare Advantage |
$119.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Medicare |
$119.45
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: Priority Health SBD |
$172.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.45
|
| Rate for Payer: UHC Medicare Advantage |
$119.45
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
| Rate for Payer: UMR Bronson Commercial |
$153.18
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
IP
|
$333.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$146.52 |
| Max. Negotiated Rate |
$299.70 |
| Rate for Payer: Aetna American Axle |
$216.45
|
| Rate for Payer: Aetna Commercial |
$283.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.45
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$233.10
|
| Rate for Payer: Cofinity Commercial |
$286.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$233.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.40
|
| Rate for Payer: Healthscope Commercial |
$299.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.05
|
| Rate for Payer: PHP Commercial |
$283.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health SBD |
$209.79
|
| Rate for Payer: UMR Bronson Commercial |
$146.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.75
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
11640
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$977.96 |
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna Medicare |
$124.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.01
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS MAPPO |
$119.45
|
| Rate for Payer: BCBS Trust/PPO |
$977.96
|
| Rate for Payer: BCN Commercial |
$239.53
|
| Rate for Payer: BCN Medicare Advantage |
$119.45
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$172.01
|
| Rate for Payer: Cofinity Commercial |
$160.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.42
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Nomi Health Commercial |
$143.34
|
| Rate for Payer: PACE SWMI |
$119.45
|
| Rate for Payer: PHP Commercial |
$167.23
|
| Rate for Payer: PHP Medicare Advantage |
$119.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Medicare |
$119.45
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: Priority Health SBD |
$172.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.45
|
| Rate for Payer: UHC Medicare Advantage |
$119.45
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
| Rate for Payer: UMR Bronson Commercial |
$153.18
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
OP
|
$333.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$120.32 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$216.45
|
| Rate for Payer: Aetna Commercial |
$283.05
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$179.04
|
| Rate for Payer: BCN Commercial |
$179.04
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$233.10
|
| Rate for Payer: Cofinity Commercial |
$286.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$233.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$299.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.75
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.05
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$283.05
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$209.79
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.35
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$120.32
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$123.21
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.75
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$145.78 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$256.10
|
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$202.29
|
| Rate for Payer: BCN Commercial |
$202.29
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$275.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$275.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.50
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$248.22
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.42
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$147.65
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$145.78
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.50
|
|
