|
PR EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH
|
Professional
|
Both
|
$2,703.00
|
|
|
Service Code
|
HCPCS 45135
|
| Min. Negotiated Rate |
$826.87 |
| Max. Negotiated Rate |
$2,305.83 |
| Rate for Payer: Aetna Commercial |
$1,653.20
|
| Rate for Payer: Aetna Medicare |
$1,283.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,653.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,776.57
|
| Rate for Payer: BCBS Complete |
$868.21
|
| Rate for Payer: BCBS MAPPO |
$1,233.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,920.90
|
| Rate for Payer: BCN Commercial |
$1,878.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,233.73
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,653.20
|
| Rate for Payer: Cofinity Commercial |
$1,776.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,233.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,295.42
|
| Rate for Payer: Meridian Medicaid |
$868.21
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: PACE SWMI |
$1,233.73
|
| Rate for Payer: PHP Commercial |
$1,727.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,233.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$826.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,756.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,305.83
|
| Rate for Payer: Priority Health Medicare |
$1,233.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,305.83
|
| Rate for Payer: Priority Health SBD |
$2,305.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,233.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,233.73
|
| Rate for Payer: UHCCP Medicaid |
$826.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,243.38
|
|
|
PR EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH
|
Professional
|
Both
|
$2,827.00
|
|
|
Service Code
|
HCPCS 45130
|
| Min. Negotiated Rate |
$692.46 |
| Max. Negotiated Rate |
$2,249.50 |
| Rate for Payer: Aetna Commercial |
$1,390.73
|
| Rate for Payer: Aetna Medicare |
$1,079.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,390.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.52
|
| Rate for Payer: BCBS Complete |
$727.08
|
| Rate for Payer: BCBS MAPPO |
$1,037.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,249.50
|
| Rate for Payer: BCN Commercial |
$1,574.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.86
|
| Rate for Payer: Cash Price |
$2,261.60
|
| Rate for Payer: Cash Price |
$2,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,390.73
|
| Rate for Payer: Cofinity Commercial |
$1,494.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,089.75
|
| Rate for Payer: Meridian Medicaid |
$727.08
|
| Rate for Payer: Nomi Health Commercial |
$1,245.43
|
| Rate for Payer: PACE SWMI |
$1,037.86
|
| Rate for Payer: PHP Commercial |
$1,453.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,837.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,930.57
|
| Rate for Payer: Priority Health Medicare |
$1,037.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,930.57
|
| Rate for Payer: Priority Health SBD |
$1,930.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,037.86
|
| Rate for Payer: UHCCP Medicaid |
$692.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,300.42
|
|
|
PR EXC RCT TUM INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,883.00
|
|
|
Service Code
|
HCPCS 45172
|
| Min. Negotiated Rate |
$478.64 |
| Max. Negotiated Rate |
$1,476.58 |
| Rate for Payer: Aetna Commercial |
$1,053.01
|
| Rate for Payer: Aetna Medicare |
$817.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,053.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,131.60
|
| Rate for Payer: BCBS Complete |
$556.22
|
| Rate for Payer: BCBS MAPPO |
$785.83
|
| Rate for Payer: BCBS Trust/PPO |
$478.64
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$785.83
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cofinity Commercial |
$1,053.01
|
| Rate for Payer: Cofinity Commercial |
$1,131.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$825.12
|
| Rate for Payer: Meridian Medicaid |
$556.22
|
| Rate for Payer: Nomi Health Commercial |
$943.00
|
| Rate for Payer: PACE SWMI |
$785.83
|
| Rate for Payer: PHP Commercial |
$1,100.16
|
| Rate for Payer: PHP Medicare Advantage |
$785.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,476.58
|
| Rate for Payer: Priority Health Medicare |
$785.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,476.58
|
| Rate for Payer: Priority Health SBD |
$1,476.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.83
|
| Rate for Payer: UHC Medicare Advantage |
$785.83
|
| Rate for Payer: UHCCP Medicaid |
$529.73
|
| Rate for Payer: UMR Bronson Commercial |
$866.18
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$2,751.91 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$611.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.43
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$587.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.91
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$587.80
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$846.43
|
| Rate for Payer: Cofinity Commercial |
$787.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.19
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Nomi Health Commercial |
$705.36
|
| Rate for Payer: PACE SWMI |
$587.80
|
| Rate for Payer: PHP Commercial |
$822.92
|
| Rate for Payer: PHP Medicare Advantage |
$587.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.06
|
| Rate for Payer: Priority Health Medicare |
$587.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.06
|
| Rate for Payer: Priority Health SBD |
$1,109.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.80
|
| Rate for Payer: UHC Medicare Advantage |
$587.80
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
| Rate for Payer: UMR Bronson Commercial |
$630.20
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
IP
|
$1,370.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$602.80 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna American Axle |
$890.50
|
| Rate for Payer: Aetna Commercial |
$1,164.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$890.50
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$1,178.20
|
| Rate for Payer: Cofinity Commercial |
$959.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$959.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.00
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$959.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,027.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.50
|
| Rate for Payer: PHP Commercial |
$1,164.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health SBD |
$863.10
|
| Rate for Payer: UMR Bronson Commercial |
$602.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,027.50
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$506.90 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna American Axle |
$890.50
|
| Rate for Payer: Aetna Commercial |
$1,164.50
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$890.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,858.61
|
| Rate for Payer: BCN Commercial |
$2,858.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$959.00
|
| Rate for Payer: Cofinity Commercial |
$1,178.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$959.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$959.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,027.50
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.50
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$1,164.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$863.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.68
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$591.53
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: UMR Bronson Commercial |
$506.90
|
| Rate for Payer: VA VA |
$2,686.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,027.50
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 45171
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$2,751.91 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$611.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.43
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$587.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.91
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$587.80
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$787.65
|
| Rate for Payer: Cofinity Commercial |
$846.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.19
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Nomi Health Commercial |
$705.36
|
| Rate for Payer: PACE SWMI |
$587.80
|
| Rate for Payer: PHP Commercial |
$822.92
|
| Rate for Payer: PHP Medicare Advantage |
$587.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.06
|
| Rate for Payer: Priority Health Medicare |
$587.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.06
|
| Rate for Payer: Priority Health SBD |
$1,109.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.80
|
| Rate for Payer: UHC Medicare Advantage |
$587.80
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
| Rate for Payer: UMR Bronson Commercial |
$630.20
|
|
|
PR EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 45160
|
| Min. Negotiated Rate |
$662.43 |
| Max. Negotiated Rate |
$1,843.47 |
| Rate for Payer: Aetna Commercial |
$1,338.27
|
| Rate for Payer: Aetna Medicare |
$1,038.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,338.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,438.14
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS MAPPO |
$998.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.43
|
| Rate for Payer: BCN Commercial |
$1,500.73
|
| Rate for Payer: BCN Medicare Advantage |
$998.71
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,338.27
|
| Rate for Payer: Cofinity Commercial |
$1,438.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$998.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,048.65
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Nomi Health Commercial |
$1,198.45
|
| Rate for Payer: PACE SWMI |
$998.71
|
| Rate for Payer: PHP Commercial |
$1,398.19
|
| Rate for Payer: PHP Medicare Advantage |
$998.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,843.47
|
| Rate for Payer: Priority Health Medicare |
$998.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,843.47
|
| Rate for Payer: Priority Health SBD |
$1,843.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$998.71
|
| Rate for Payer: UHC Medicare Advantage |
$998.71
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
| Rate for Payer: UMR Bronson Commercial |
$962.32
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 15936
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$2,625.00 |
| Rate for Payer: Aetna Commercial |
$1,145.43
|
| Rate for Payer: Aetna Medicare |
$888.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,230.91
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$854.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,625.00
|
| Rate for Payer: BCN Commercial |
$1,319.92
|
| Rate for Payer: BCN Medicare Advantage |
$854.80
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,145.43
|
| Rate for Payer: Cofinity Commercial |
$1,230.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.54
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Nomi Health Commercial |
$1,025.76
|
| Rate for Payer: PACE SWMI |
$854.80
|
| Rate for Payer: PHP Commercial |
$1,196.72
|
| Rate for Payer: PHP Medicare Advantage |
$854.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,219.55
|
| Rate for Payer: Priority Health Medicare |
$854.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,219.55
|
| Rate for Payer: Priority Health SBD |
$1,219.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$854.80
|
| Rate for Payer: UHC Medicare Advantage |
$854.80
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
| Rate for Payer: UMR Bronson Commercial |
$712.54
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC
|
Professional
|
Both
|
$2,107.00
|
|
|
Service Code
|
HCPCS 15937
|
| Min. Negotiated Rate |
$632.82 |
| Max. Negotiated Rate |
$1,527.61 |
| Rate for Payer: Aetna Commercial |
$1,260.74
|
| Rate for Payer: Aetna Medicare |
$978.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,354.82
|
| Rate for Payer: BCBS Complete |
$664.46
|
| Rate for Payer: BCBS MAPPO |
$940.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.07
|
| Rate for Payer: BCN Commercial |
$1,527.61
|
| Rate for Payer: BCN Medicare Advantage |
$940.85
|
| Rate for Payer: Cash Price |
$1,685.60
|
| Rate for Payer: Cash Price |
$1,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,260.74
|
| Rate for Payer: Cofinity Commercial |
$1,354.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.89
|
| Rate for Payer: Meridian Medicaid |
$664.46
|
| Rate for Payer: Nomi Health Commercial |
$1,129.02
|
| Rate for Payer: PACE SWMI |
$940.85
|
| Rate for Payer: PHP Commercial |
$1,317.19
|
| Rate for Payer: PHP Medicare Advantage |
$940.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$632.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,406.48
|
| Rate for Payer: Priority Health Medicare |
$940.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,406.48
|
| Rate for Payer: Priority Health SBD |
$1,406.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.85
|
| Rate for Payer: UHC Medicare Advantage |
$940.85
|
| Rate for Payer: UHCCP Medicaid |
$632.82
|
| Rate for Payer: UMR Bronson Commercial |
$969.22
|
|
|
PR EXC SUBLINGUAL SALIVARY CYST RANULA
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 42408
|
| Min. Negotiated Rate |
$226.21 |
| Max. Negotiated Rate |
$801.43 |
| Rate for Payer: Aetna Commercial |
$442.88
|
| Rate for Payer: Aetna Medicare |
$343.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$475.93
|
| Rate for Payer: BCBS Complete |
$237.52
|
| Rate for Payer: BCBS MAPPO |
$330.51
|
| Rate for Payer: BCBS Trust/PPO |
$229.28
|
| Rate for Payer: BCN Commercial |
$801.43
|
| Rate for Payer: BCN Medicare Advantage |
$330.51
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$442.88
|
| Rate for Payer: Cofinity Commercial |
$475.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.04
|
| Rate for Payer: Meridian Medicaid |
$237.52
|
| Rate for Payer: Nomi Health Commercial |
$396.61
|
| Rate for Payer: PACE SWMI |
$330.51
|
| Rate for Payer: PHP Commercial |
$462.71
|
| Rate for Payer: PHP Medicare Advantage |
$330.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$625.83
|
| Rate for Payer: Priority Health Medicare |
$330.51
|
| Rate for Payer: Priority Health Narrow Network |
$625.83
|
| Rate for Payer: Priority Health SBD |
$625.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.51
|
| Rate for Payer: UHC Medicare Advantage |
$330.51
|
| Rate for Payer: UHCCP Medicaid |
$226.21
|
| Rate for Payer: UMR Bronson Commercial |
$334.88
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
OP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$520.89 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$1,171.30
|
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.39
|
| Rate for Payer: BCN Commercial |
$1,898.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,261.40
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,261.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,261.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,351.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| 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 |
$1,171.30
|
| 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 |
$1,135.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.98
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$520.89
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$666.74
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,351.50
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,326.56 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.79
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Commercial |
$727.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.04
|
| Rate for Payer: Priority Health Medicare |
$519.99
|
| Rate for Payer: Priority Health Narrow Network |
$835.04
|
| Rate for Payer: Priority Health SBD |
$835.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
| Rate for Payer: UMR Bronson Commercial |
$828.92
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,326.56 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.79
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Commercial |
$727.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.04
|
| Rate for Payer: Priority Health Medicare |
$519.99
|
| Rate for Payer: Priority Health Narrow Network |
$835.04
|
| Rate for Payer: Priority Health SBD |
$835.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
| Rate for Payer: UMR Bronson Commercial |
$828.92
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
IP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$792.88 |
| Max. Negotiated Rate |
$1,621.80 |
| Rate for Payer: Aetna American Axle |
$1,171.30
|
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.30
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,261.40
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,261.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,261.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,351.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health SBD |
$1,135.26
|
| Rate for Payer: UMR Bronson Commercial |
$792.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,351.50
|
|
|
PR EXC THROMBOSED HEMORRHOID XTRNL
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 46320
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$2,226.78 |
| Rate for Payer: Aetna Commercial |
$145.34
|
| Rate for Payer: Aetna Medicare |
$112.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.18
|
| Rate for Payer: BCBS Complete |
$76.93
|
| Rate for Payer: BCBS MAPPO |
$108.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,226.78
|
| Rate for Payer: BCN Commercial |
$314.22
|
| Rate for Payer: BCN Medicare Advantage |
$108.46
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cofinity Commercial |
$145.34
|
| Rate for Payer: Cofinity Commercial |
$156.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.88
|
| Rate for Payer: Meridian Medicaid |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$130.15
|
| Rate for Payer: PACE SWMI |
$108.46
|
| Rate for Payer: PHP Commercial |
$151.84
|
| Rate for Payer: PHP Medicare Advantage |
$108.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.64
|
| Rate for Payer: Priority Health Medicare |
$108.46
|
| Rate for Payer: Priority Health Narrow Network |
$204.64
|
| Rate for Payer: Priority Health SBD |
$204.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.46
|
| Rate for Payer: UHC Medicare Advantage |
$108.46
|
| Rate for Payer: UHCCP Medicaid |
$73.27
|
| Rate for Payer: UMR Bronson Commercial |
$163.30
|
|
|
PR EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 15950
|
| Min. Negotiated Rate |
$412.58 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$812.52
|
| Rate for Payer: Aetna Medicare |
$630.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.16
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS MAPPO |
$606.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$933.86
|
| Rate for Payer: BCN Medicare Advantage |
$606.36
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$812.52
|
| Rate for Payer: Cofinity Commercial |
$873.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.68
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Nomi Health Commercial |
$727.63
|
| Rate for Payer: PACE SWMI |
$606.36
|
| Rate for Payer: PHP Commercial |
$848.90
|
| Rate for Payer: PHP Medicare Advantage |
$606.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.36
|
| Rate for Payer: Priority Health Medicare |
$606.36
|
| Rate for Payer: Priority Health Narrow Network |
$867.36
|
| Rate for Payer: Priority Health SBD |
$867.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.36
|
| Rate for Payer: UHC Medicare Advantage |
$606.36
|
| Rate for Payer: UHCCP Medicaid |
$412.58
|
| Rate for Payer: UMR Bronson Commercial |
$551.54
|
|
|
PR EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$1,995.00
|
|
|
Service Code
|
HCPCS 15956
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$1,702.06 |
| Rate for Payer: Aetna Commercial |
$1,494.66
|
| Rate for Payer: Aetna Medicare |
$1,160.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,606.20
|
| Rate for Payer: BCBS Complete |
$788.14
|
| Rate for Payer: BCBS MAPPO |
$1,115.42
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$1,702.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,115.42
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,494.66
|
| Rate for Payer: Cofinity Commercial |
$1,606.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,115.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,171.19
|
| Rate for Payer: Meridian Medicaid |
$788.14
|
| Rate for Payer: Nomi Health Commercial |
$1,338.50
|
| Rate for Payer: PACE SWMI |
$1,115.42
|
| Rate for Payer: PHP Commercial |
$1,561.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,115.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$750.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,611.01
|
| Rate for Payer: Priority Health Medicare |
$1,115.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,611.01
|
| Rate for Payer: Priority Health SBD |
$1,611.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,115.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,115.42
|
| Rate for Payer: UHCCP Medicaid |
$750.61
|
| Rate for Payer: UMR Bronson Commercial |
$917.70
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.08
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Commercial |
$727.30
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$830.96
|
| Rate for Payer: Priority Health Medicare |
$519.50
|
| Rate for Payer: Priority Health Narrow Network |
$830.96
|
| Rate for Payer: Priority Health SBD |
$830.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.88
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
IP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$980.32 |
| Max. Negotiated Rate |
$2,005.20 |
| Rate for Payer: Aetna American Axle |
$1,448.20
|
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.20
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,559.60
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,559.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,559.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health SBD |
$1,403.64
|
| Rate for Payer: UMR Bronson Commercial |
$980.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.00
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.08
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Commercial |
$727.30
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$830.96
|
| Rate for Payer: Priority Health Medicare |
$519.50
|
| Rate for Payer: Priority Health Narrow Network |
$830.96
|
| Rate for Payer: Priority Health SBD |
$830.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.88
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
OP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$520.51 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Cofinity Commercial |
$1,559.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,559.60
|
| Rate for Payer: Aetna American Axle |
$1,448.20
|
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,874.25
|
| Rate for Payer: BCN Commercial |
$1,874.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,559.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.00
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$1,403.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.56
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$520.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$824.36
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.00
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$801.45 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$451.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.84
|
| Rate for Payer: BCBS Complete |
$305.51
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Meridian Medicaid |
$305.51
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Commercial |
$607.49
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$690.02
|
| Rate for Payer: Priority Health Medicare |
$433.92
|
| Rate for Payer: Priority Health Narrow Network |
$690.02
|
| Rate for Payer: Priority Health SBD |
$690.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UHCCP Medicaid |
$290.96
|
| Rate for Payer: UMR Bronson Commercial |
$567.18
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$436.36 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$801.45
|
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,739.10
|
| Rate for Payer: BCN Commercial |
$2,739.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$863.10
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$863.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$863.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.75
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$776.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.00
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$436.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$456.21
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.75
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$542.52 |
| Max. Negotiated Rate |
$1,109.70 |
| Rate for Payer: Aetna American Axle |
$801.45
|
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.45
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Cofinity Commercial |
$863.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$863.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$863.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health SBD |
$776.79
|
| Rate for Payer: UMR Bronson Commercial |
$542.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.75
|
|
