|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
HCPCS 11603
|
| Hospital Charge Code |
11603
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$409.03 |
| Rate for Payer: Aetna Commercial |
$244.55
|
| Rate for Payer: Aetna Medicare |
$189.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.80
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$182.50
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$409.03
|
| Rate for Payer: BCN Medicare Advantage |
$182.50
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$262.80
|
| Rate for Payer: Cofinity Commercial |
$244.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.62
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$219.00
|
| Rate for Payer: PACE SWMI |
$182.50
|
| Rate for Payer: PHP Commercial |
$255.50
|
| Rate for Payer: PHP Medicare Advantage |
$182.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.53
|
| Rate for Payer: Priority Health Medicare |
$182.50
|
| Rate for Payer: Priority Health Narrow Network |
$260.53
|
| Rate for Payer: Priority Health SBD |
$260.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.50
|
| Rate for Payer: UHC Medicare Advantage |
$182.50
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
| Rate for Payer: UMR Bronson Commercial |
$214.82
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Facility
|
IP
|
$467.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
11603
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$205.48 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna American Axle |
$303.55
|
| Rate for Payer: Aetna Commercial |
$396.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.55
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$326.90
|
| Rate for Payer: Cofinity Commercial |
$401.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$326.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$373.60
|
| Rate for Payer: Healthscope Commercial |
$420.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$326.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$350.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$396.95
|
| Rate for Payer: PHP Commercial |
$396.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health SBD |
$294.21
|
| Rate for Payer: UMR Bronson Commercial |
$205.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$350.25
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
HCPCS 11603
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$409.03 |
| Rate for Payer: Aetna Commercial |
$244.55
|
| Rate for Payer: Aetna Medicare |
$189.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.80
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$182.50
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$409.03
|
| Rate for Payer: BCN Medicare Advantage |
$182.50
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$244.55
|
| Rate for Payer: Cofinity Commercial |
$262.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.62
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$219.00
|
| Rate for Payer: PACE SWMI |
$182.50
|
| Rate for Payer: PHP Commercial |
$255.50
|
| Rate for Payer: PHP Medicare Advantage |
$182.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.53
|
| Rate for Payer: Priority Health Medicare |
$182.50
|
| Rate for Payer: Priority Health Narrow Network |
$260.53
|
| Rate for Payer: Priority Health SBD |
$260.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.50
|
| Rate for Payer: UHC Medicare Advantage |
$182.50
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
| Rate for Payer: UMR Bronson Commercial |
$214.82
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 11604
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$5,686.65 |
| Rate for Payer: Aetna Commercial |
$270.22
|
| Rate for Payer: Aetna Medicare |
$209.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: BCBS Complete |
$143.36
|
| Rate for Payer: BCBS MAPPO |
$201.66
|
| Rate for Payer: BCBS Trust/PPO |
$5,686.65
|
| Rate for Payer: BCN Commercial |
$455.45
|
| Rate for Payer: BCN Medicare Advantage |
$201.66
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$270.22
|
| Rate for Payer: Cofinity Commercial |
$290.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.74
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Nomi Health Commercial |
$241.99
|
| Rate for Payer: PACE SWMI |
$201.66
|
| Rate for Payer: PHP Commercial |
$282.32
|
| Rate for Payer: PHP Medicare Advantage |
$201.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.72
|
| Rate for Payer: Priority Health Medicare |
$201.66
|
| Rate for Payer: Priority Health Narrow Network |
$286.72
|
| Rate for Payer: Priority Health SBD |
$286.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$201.66
|
| Rate for Payer: UHC Medicare Advantage |
$201.66
|
| Rate for Payer: UHCCP Medicaid |
$136.53
|
| Rate for Payer: UMR Bronson Commercial |
$239.66
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Facility
|
OP
|
$521.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
11604
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$192.77 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$338.65
|
| Rate for Payer: Aetna Commercial |
$442.85
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.65
|
| 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 |
$1,152.62
|
| Rate for Payer: BCN Commercial |
$1,152.62
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$364.70
|
| Rate for Payer: Cofinity Commercial |
$448.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$468.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.75
|
| 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 |
$442.85
|
| 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 |
$442.85
|
| 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 |
$338.65
|
| 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 |
$328.23
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.49
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$202.26
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$192.77
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.75
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 11604
|
| Hospital Charge Code |
11604
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$5,686.65 |
| Rate for Payer: Aetna Commercial |
$270.22
|
| Rate for Payer: Aetna Medicare |
$209.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: BCBS Complete |
$143.36
|
| Rate for Payer: BCBS MAPPO |
$201.66
|
| Rate for Payer: BCBS Trust/PPO |
$5,686.65
|
| Rate for Payer: BCN Commercial |
$455.45
|
| Rate for Payer: BCN Medicare Advantage |
$201.66
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$290.39
|
| Rate for Payer: Cofinity Commercial |
$270.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.74
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Nomi Health Commercial |
$241.99
|
| Rate for Payer: PACE SWMI |
$201.66
|
| Rate for Payer: PHP Commercial |
$282.32
|
| Rate for Payer: PHP Medicare Advantage |
$201.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.72
|
| Rate for Payer: Priority Health Medicare |
$201.66
|
| Rate for Payer: Priority Health Narrow Network |
$286.72
|
| Rate for Payer: Priority Health SBD |
$286.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$201.66
|
| Rate for Payer: UHC Medicare Advantage |
$201.66
|
| Rate for Payer: UHCCP Medicaid |
$136.53
|
| Rate for Payer: UMR Bronson Commercial |
$239.66
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Facility
|
IP
|
$521.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
11604
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$229.24 |
| Max. Negotiated Rate |
$468.90 |
| Rate for Payer: Aetna American Axle |
$338.65
|
| Rate for Payer: Aetna Commercial |
$442.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.65
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$364.70
|
| Rate for Payer: Cofinity Commercial |
$448.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.80
|
| Rate for Payer: Healthscope Commercial |
$468.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.85
|
| Rate for Payer: PHP Commercial |
$442.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health SBD |
$328.23
|
| Rate for Payer: UMR Bronson Commercial |
$229.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.75
|
|
|
PR EXCISION MAXILLARY TORUS PALATINUS
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 21032
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$542.92 |
| Rate for Payer: Aetna Commercial |
$332.08
|
| Rate for Payer: Aetna Medicare |
$257.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$356.86
|
| Rate for Payer: BCBS Complete |
$178.47
|
| Rate for Payer: BCBS MAPPO |
$247.82
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$542.92
|
| Rate for Payer: BCN Medicare Advantage |
$247.82
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$332.08
|
| Rate for Payer: Cofinity Commercial |
$356.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.21
|
| Rate for Payer: Meridian Medicaid |
$178.47
|
| Rate for Payer: Nomi Health Commercial |
$297.38
|
| Rate for Payer: PACE SWMI |
$247.82
|
| Rate for Payer: PHP Commercial |
$346.95
|
| Rate for Payer: PHP Medicare Advantage |
$247.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$399.46
|
| Rate for Payer: Priority Health Medicare |
$247.82
|
| Rate for Payer: Priority Health Narrow Network |
$399.46
|
| Rate for Payer: Priority Health SBD |
$399.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.82
|
| Rate for Payer: UHC Medicare Advantage |
$247.82
|
| Rate for Payer: UHCCP Medicaid |
$169.97
|
| Rate for Payer: UMR Bronson Commercial |
$364.78
|
|
|
PR EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 46230
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$1,777.73 |
| Rate for Payer: Aetna Commercial |
$224.56
|
| Rate for Payer: Aetna Medicare |
$174.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.32
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$167.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,777.73
|
| Rate for Payer: BCN Commercial |
$459.85
|
| Rate for Payer: BCN Medicare Advantage |
$167.58
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cofinity Commercial |
$224.56
|
| Rate for Payer: Cofinity Commercial |
$241.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.96
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Nomi Health Commercial |
$201.10
|
| Rate for Payer: PACE SWMI |
$167.58
|
| Rate for Payer: PHP Commercial |
$234.61
|
| Rate for Payer: PHP Medicare Advantage |
$167.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.62
|
| Rate for Payer: Priority Health Medicare |
$167.58
|
| Rate for Payer: Priority Health Narrow Network |
$312.62
|
| Rate for Payer: Priority Health SBD |
$312.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.58
|
| Rate for Payer: UHC Medicare Advantage |
$167.58
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
| Rate for Payer: UMR Bronson Commercial |
$312.34
|
|
|
PR EXCISION NAIL MATRIX PERMANENT REMOVAL
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 11750
|
| Min. Negotiated Rate |
$20.33 |
| Max. Negotiated Rate |
$313.95 |
| Rate for Payer: Aetna Commercial |
$128.80
|
| Rate for Payer: Aetna Medicare |
$99.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.41
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$96.12
|
| Rate for Payer: BCBS Trust/PPO |
$20.33
|
| Rate for Payer: BCN Commercial |
$187.30
|
| Rate for Payer: BCN Medicare Advantage |
$96.12
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cofinity Commercial |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$138.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.93
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Nomi Health Commercial |
$115.34
|
| Rate for Payer: PACE SWMI |
$96.12
|
| Rate for Payer: PHP Commercial |
$134.57
|
| Rate for Payer: PHP Medicare Advantage |
$96.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.16
|
| Rate for Payer: Priority Health Medicare |
$96.12
|
| Rate for Payer: Priority Health Narrow Network |
$138.16
|
| Rate for Payer: Priority Health SBD |
$138.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.12
|
| Rate for Payer: UHC Medicare Advantage |
$96.12
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
| Rate for Payer: UMR Bronson Commercial |
$222.18
|
|
|
PR EXCISION NASAL POLYP EXTENSIVE
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 30115
|
| Min. Negotiated Rate |
$298.41 |
| Max. Negotiated Rate |
$893.36 |
| Rate for Payer: Aetna Commercial |
$577.49
|
| Rate for Payer: Aetna Medicare |
$448.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.58
|
| Rate for Payer: BCBS Complete |
$313.33
|
| Rate for Payer: BCBS MAPPO |
$430.96
|
| Rate for Payer: BCBS Trust/PPO |
$893.36
|
| Rate for Payer: BCN Commercial |
$693.93
|
| Rate for Payer: BCN Medicare Advantage |
$430.96
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$577.49
|
| Rate for Payer: Cofinity Commercial |
$620.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.51
|
| Rate for Payer: Meridian Medicaid |
$313.33
|
| Rate for Payer: Nomi Health Commercial |
$517.15
|
| Rate for Payer: PACE SWMI |
$430.96
|
| Rate for Payer: PHP Commercial |
$603.34
|
| Rate for Payer: PHP Medicare Advantage |
$430.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$653.96
|
| Rate for Payer: Priority Health Medicare |
$430.96
|
| Rate for Payer: Priority Health Narrow Network |
$653.96
|
| Rate for Payer: Priority Health SBD |
$653.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.96
|
| Rate for Payer: UHC Medicare Advantage |
$430.96
|
| Rate for Payer: UHCCP Medicaid |
$298.41
|
| Rate for Payer: UMR Bronson Commercial |
$373.98
|
|
|
PR EXCISION NASAL POLYP SIMPLE
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 30110
|
| Min. Negotiated Rate |
$86.27 |
| Max. Negotiated Rate |
$937.20 |
| Rate for Payer: Aetna Commercial |
$169.12
|
| Rate for Payer: Aetna Medicare |
$131.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.74
|
| Rate for Payer: BCBS Complete |
$90.58
|
| Rate for Payer: BCBS MAPPO |
$126.21
|
| Rate for Payer: BCBS Trust/PPO |
$937.20
|
| Rate for Payer: BCN Commercial |
$367.97
|
| Rate for Payer: BCN Medicare Advantage |
$126.21
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$169.12
|
| Rate for Payer: Cofinity Commercial |
$181.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.52
|
| Rate for Payer: Meridian Medicaid |
$90.58
|
| Rate for Payer: Nomi Health Commercial |
$151.45
|
| Rate for Payer: PACE SWMI |
$126.21
|
| Rate for Payer: PHP Commercial |
$176.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$323.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.78
|
| Rate for Payer: Priority Health Medicare |
$126.21
|
| Rate for Payer: Priority Health Narrow Network |
$186.78
|
| Rate for Payer: Priority Health SBD |
$186.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.21
|
| Rate for Payer: UHC Medicare Advantage |
$126.21
|
| Rate for Payer: UHCCP Medicaid |
$86.27
|
| Rate for Payer: UMR Bronson Commercial |
$228.62
|
|
|
PR EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 64778
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$304.27 |
| Rate for Payer: Aetna Commercial |
$231.59
|
| Rate for Payer: Aetna Medicare |
$179.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.88
|
| Rate for Payer: BCBS Complete |
$120.32
|
| Rate for Payer: BCBS MAPPO |
$172.83
|
| Rate for Payer: BCBS Trust/PPO |
$291.09
|
| Rate for Payer: BCN Commercial |
$261.93
|
| Rate for Payer: BCN Medicare Advantage |
$172.83
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$231.59
|
| Rate for Payer: Cofinity Commercial |
$248.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.47
|
| Rate for Payer: Meridian Medicaid |
$120.32
|
| Rate for Payer: Nomi Health Commercial |
$207.40
|
| Rate for Payer: PACE SWMI |
$172.83
|
| Rate for Payer: PHP Commercial |
$241.96
|
| Rate for Payer: PHP Medicare Advantage |
$172.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.27
|
| Rate for Payer: Priority Health Medicare |
$172.83
|
| Rate for Payer: Priority Health Narrow Network |
$304.27
|
| Rate for Payer: Priority Health SBD |
$304.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.83
|
| Rate for Payer: UHC Medicare Advantage |
$172.83
|
| Rate for Payer: UHCCP Medicaid |
$114.59
|
| Rate for Payer: UMR Bronson Commercial |
$153.18
|
|
|
PR EXCISION NEUROMA SCIATIC NERVE
|
Professional
|
Both
|
$3,548.00
|
|
|
Service Code
|
HCPCS 64786
|
| Min. Negotiated Rate |
$154.26 |
| Max. Negotiated Rate |
$2,306.20 |
| Rate for Payer: Aetna Commercial |
$1,310.88
|
| Rate for Payer: Aetna Medicare |
$1,017.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,408.71
|
| Rate for Payer: BCBS Complete |
$680.35
|
| Rate for Payer: BCBS MAPPO |
$978.27
|
| Rate for Payer: BCBS Trust/PPO |
$154.26
|
| Rate for Payer: BCN Commercial |
$1,470.43
|
| Rate for Payer: BCN Medicare Advantage |
$978.27
|
| Rate for Payer: Cash Price |
$2,838.40
|
| Rate for Payer: Cash Price |
$2,838.40
|
| Rate for Payer: Cofinity Commercial |
$1,310.88
|
| Rate for Payer: Cofinity Commercial |
$1,408.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$978.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,027.18
|
| Rate for Payer: Meridian Medicaid |
$680.35
|
| Rate for Payer: Nomi Health Commercial |
$1,173.92
|
| Rate for Payer: PACE SWMI |
$978.27
|
| Rate for Payer: PHP Commercial |
$1,369.58
|
| Rate for Payer: PHP Medicare Advantage |
$978.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$647.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,306.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,720.37
|
| Rate for Payer: Priority Health Medicare |
$978.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,720.37
|
| Rate for Payer: Priority Health SBD |
$1,720.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$978.27
|
| Rate for Payer: UHC Medicare Advantage |
$978.27
|
| Rate for Payer: UHCCP Medicaid |
$647.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,632.08
|
|
|
PR EXCISION OF BULBOURETHRAL GLAND
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 53250
|
| Min. Negotiated Rate |
$256.24 |
| Max. Negotiated Rate |
$739.05 |
| Rate for Payer: Aetna Commercial |
$509.27
|
| Rate for Payer: Aetna Medicare |
$395.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.27
|
| Rate for Payer: BCBS Complete |
$269.05
|
| Rate for Payer: BCBS MAPPO |
$380.05
|
| Rate for Payer: BCBS Trust/PPO |
$419.47
|
| Rate for Payer: BCN Commercial |
$574.19
|
| Rate for Payer: BCN Medicare Advantage |
$380.05
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$509.27
|
| Rate for Payer: Cofinity Commercial |
$547.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.05
|
| Rate for Payer: Meridian Medicaid |
$269.05
|
| Rate for Payer: Nomi Health Commercial |
$456.06
|
| Rate for Payer: PACE SWMI |
$380.05
|
| Rate for Payer: PHP Commercial |
$532.07
|
| Rate for Payer: PHP Medicare Advantage |
$380.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$634.86
|
| Rate for Payer: Priority Health Medicare |
$380.05
|
| Rate for Payer: Priority Health Narrow Network |
$634.86
|
| Rate for Payer: Priority Health SBD |
$634.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.05
|
| Rate for Payer: UHC Medicare Advantage |
$380.05
|
| Rate for Payer: UHCCP Medicaid |
$256.24
|
| Rate for Payer: UMR Bronson Commercial |
$523.02
|
|
|
PR EXCISION OF PENILE PLAQUE
|
Professional
|
Both
|
$1,186.00
|
|
|
Service Code
|
HCPCS 54110
|
| Min. Negotiated Rate |
$400.87 |
| Max. Negotiated Rate |
$2,843.84 |
| Rate for Payer: Aetna Commercial |
$800.14
|
| Rate for Payer: Aetna Medicare |
$621.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.85
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS MAPPO |
$597.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,843.84
|
| Rate for Payer: BCN Commercial |
$901.13
|
| Rate for Payer: BCN Medicare Advantage |
$597.12
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cofinity Commercial |
$800.14
|
| Rate for Payer: Cofinity Commercial |
$859.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.98
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Nomi Health Commercial |
$716.54
|
| Rate for Payer: PACE SWMI |
$597.12
|
| Rate for Payer: PHP Commercial |
$835.97
|
| Rate for Payer: PHP Medicare Advantage |
$597.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$995.97
|
| Rate for Payer: Priority Health Medicare |
$597.12
|
| Rate for Payer: Priority Health Narrow Network |
$995.97
|
| Rate for Payer: Priority Health SBD |
$995.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.12
|
| Rate for Payer: UHC Medicare Advantage |
$597.12
|
| Rate for Payer: UHCCP Medicaid |
$400.87
|
| Rate for Payer: UMR Bronson Commercial |
$545.56
|
|
|
PR EXCISION OLECRANON BURSA
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$269.28 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna American Axle |
$397.80
|
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: UMR Bronson Commercial |
$269.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$206.04 |
| Max. Negotiated Rate |
$565.86 |
| Rate for Payer: Aetna Commercial |
$466.43
|
| Rate for Payer: Aetna Medicare |
$362.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.24
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$348.08
|
| Rate for Payer: BCBS Trust/PPO |
$206.04
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: BCN Medicare Advantage |
$348.08
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$501.24
|
| Rate for Payer: Cofinity Commercial |
$466.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.48
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Nomi Health Commercial |
$417.70
|
| Rate for Payer: PACE SWMI |
$348.08
|
| Rate for Payer: PHP Commercial |
$487.31
|
| Rate for Payer: PHP Medicare Advantage |
$348.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.86
|
| Rate for Payer: Priority Health Medicare |
$348.08
|
| Rate for Payer: Priority Health Narrow Network |
$565.86
|
| Rate for Payer: Priority Health SBD |
$565.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.08
|
| Rate for Payer: UHC Medicare Advantage |
$348.08
|
| Rate for Payer: UHCCP Medicaid |
$239.20
|
| Rate for Payer: UMR Bronson Commercial |
$281.52
|
|
|
PR EXCISION OLECRANON BURSA
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 24105
|
| Hospital Charge Code |
24105
|
| Min. Negotiated Rate |
$226.44 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.40
|
| Rate for Payer: BCN Commercial |
$2,945.70
|
| Rate for Payer: Aetna American Axle |
$397.80
|
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| 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 |
$2,945.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| 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 |
$520.20
|
| 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 |
$520.20
|
| 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 |
$397.80
|
| 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 |
$385.56
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.08
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$349.16
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$226.44
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 24105
|
| Min. Negotiated Rate |
$206.04 |
| Max. Negotiated Rate |
$565.86 |
| Rate for Payer: Aetna Commercial |
$466.43
|
| Rate for Payer: Aetna Medicare |
$362.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.24
|
| Rate for Payer: BCBS Complete |
$251.16
|
| Rate for Payer: BCBS MAPPO |
$348.08
|
| Rate for Payer: BCBS Trust/PPO |
$206.04
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: BCN Medicare Advantage |
$348.08
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$466.43
|
| Rate for Payer: Cofinity Commercial |
$501.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.48
|
| Rate for Payer: Meridian Medicaid |
$251.16
|
| Rate for Payer: Nomi Health Commercial |
$417.70
|
| Rate for Payer: PACE SWMI |
$348.08
|
| Rate for Payer: PHP Commercial |
$487.31
|
| Rate for Payer: PHP Medicare Advantage |
$348.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.86
|
| Rate for Payer: Priority Health Medicare |
$348.08
|
| Rate for Payer: Priority Health Narrow Network |
$565.86
|
| Rate for Payer: Priority Health SBD |
$565.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.08
|
| Rate for Payer: UHC Medicare Advantage |
$348.08
|
| Rate for Payer: UHCCP Medicaid |
$239.20
|
| Rate for Payer: UMR Bronson Commercial |
$281.52
|
|
|
PR EXCISION OR FULGURATION SKENES GLANDS
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 53270
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$772.90 |
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Aetna Commercial |
$238.06
|
| Rate for Payer: Aetna Medicare |
$184.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.83
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$177.66
|
| Rate for Payer: BCBS Trust/PPO |
$772.90
|
| Rate for Payer: BCN Commercial |
$307.38
|
| Rate for Payer: BCN Medicare Advantage |
$177.66
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$238.06
|
| Rate for Payer: Cofinity Commercial |
$255.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.54
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Nomi Health Commercial |
$213.19
|
| Rate for Payer: PACE SWMI |
$177.66
|
| Rate for Payer: PHP Commercial |
$248.72
|
| Rate for Payer: PHP Medicare Advantage |
$177.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.60
|
| Rate for Payer: Priority Health Medicare |
$177.66
|
| Rate for Payer: Priority Health Narrow Network |
$295.60
|
| Rate for Payer: Priority Health SBD |
$295.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.66
|
| Rate for Payer: UHC Medicare Advantage |
$177.66
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
| Rate for Payer: UMR Bronson Commercial |
$184.92
|
|
|
PR EXCISION PILONIDAL CYST/SINUS COMPLICATED
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 11772
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$1,453.51 |
| Rate for Payer: Aetna Commercial |
$742.63
|
| Rate for Payer: Aetna Medicare |
$576.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.05
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$554.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.51
|
| Rate for Payer: BCN Commercial |
$1,137.15
|
| Rate for Payer: BCN Medicare Advantage |
$554.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$742.63
|
| Rate for Payer: Cofinity Commercial |
$798.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$581.91
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Nomi Health Commercial |
$665.04
|
| Rate for Payer: PACE SWMI |
$554.20
|
| Rate for Payer: PHP Commercial |
$775.88
|
| Rate for Payer: PHP Medicare Advantage |
$554.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$790.60
|
| Rate for Payer: Priority Health Medicare |
$554.20
|
| Rate for Payer: Priority Health Narrow Network |
$790.60
|
| Rate for Payer: Priority Health SBD |
$790.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.20
|
| Rate for Payer: UHC Medicare Advantage |
$554.20
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
| Rate for Payer: UMR Bronson Commercial |
$530.84
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 11771
|
| Hospital Charge Code |
11771
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$925.56 |
| Rate for Payer: Aetna Commercial |
$580.47
|
| Rate for Payer: Aetna Medicare |
$450.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.79
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$433.19
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$925.56
|
| Rate for Payer: BCN Medicare Advantage |
$433.19
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$623.79
|
| Rate for Payer: Cofinity Commercial |
$580.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.85
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Nomi Health Commercial |
$519.83
|
| Rate for Payer: PACE SWMI |
$433.19
|
| Rate for Payer: PHP Commercial |
$606.47
|
| Rate for Payer: PHP Medicare Advantage |
$433.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.97
|
| Rate for Payer: Priority Health Medicare |
$433.19
|
| Rate for Payer: Priority Health Narrow Network |
$614.97
|
| Rate for Payer: Priority Health SBD |
$614.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.19
|
| Rate for Payer: UHC Medicare Advantage |
$433.19
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
| Rate for Payer: UMR Bronson Commercial |
$617.78
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 11771
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$925.56 |
| Rate for Payer: Aetna Commercial |
$580.47
|
| Rate for Payer: Aetna Medicare |
$450.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.79
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$433.19
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$925.56
|
| Rate for Payer: BCN Medicare Advantage |
$433.19
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$580.47
|
| Rate for Payer: Cofinity Commercial |
$623.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.85
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Nomi Health Commercial |
$519.83
|
| Rate for Payer: PACE SWMI |
$433.19
|
| Rate for Payer: PHP Commercial |
$606.47
|
| Rate for Payer: PHP Medicare Advantage |
$433.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.97
|
| Rate for Payer: Priority Health Medicare |
$433.19
|
| Rate for Payer: Priority Health Narrow Network |
$614.97
|
| Rate for Payer: Priority Health SBD |
$614.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.19
|
| Rate for Payer: UHC Medicare Advantage |
$433.19
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
| Rate for Payer: UMR Bronson Commercial |
$617.78
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Facility
|
IP
|
$1,343.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
11771
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$590.92 |
| Max. Negotiated Rate |
$1,208.70 |
| Rate for Payer: Aetna American Axle |
$872.95
|
| Rate for Payer: Aetna Commercial |
$1,141.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.95
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.98
|
| Rate for Payer: Cofinity Commercial |
$940.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$940.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.40
|
| Rate for Payer: Healthscope Commercial |
$1,208.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$940.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,007.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.55
|
| Rate for Payer: PHP Commercial |
$1,141.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.95
|
| Rate for Payer: Priority Health SBD |
$846.09
|
| Rate for Payer: UMR Bronson Commercial |
$590.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,007.25
|
|
