|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$1,297.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$319.87 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$843.05
|
| Rate for Payer: Aetna Commercial |
$1,102.45
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.80
|
| Rate for Payer: BCN Commercial |
$1,338.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,115.42
|
| Rate for Payer: Cofinity Commercial |
$907.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$907.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,167.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$907.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.75
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.45
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,102.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$817.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.86
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$319.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$479.89
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.75
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.68 |
| Max. Negotiated Rate |
$1,167.30 |
| Rate for Payer: Aetna American Axle |
$843.05
|
| Rate for Payer: Aetna Commercial |
$1,102.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.05
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,115.42
|
| Rate for Payer: Cofinity Commercial |
$907.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$907.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Healthscope Commercial |
$1,167.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$907.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.45
|
| Rate for Payer: PHP Commercial |
$1,102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health SBD |
$817.11
|
| Rate for Payer: UMR Bronson Commercial |
$570.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.75
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
IP
|
$1,693.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$744.92 |
| Max. Negotiated Rate |
$1,523.70 |
| Rate for Payer: Aetna American Axle |
$1,100.45
|
| Rate for Payer: Aetna Commercial |
$1,439.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.45
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$1,185.10
|
| Rate for Payer: Cofinity Commercial |
$1,455.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,185.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,354.40
|
| Rate for Payer: Healthscope Commercial |
$1,523.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,185.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,269.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,439.05
|
| Rate for Payer: PHP Commercial |
$1,439.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: Priority Health SBD |
$1,066.59
|
| Rate for Payer: UMR Bronson Commercial |
$744.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,269.75
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,693.00
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
24073
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$1,100.45 |
| Rate for Payer: Aetna Commercial |
$900.84
|
| Rate for Payer: Aetna Medicare |
$699.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.07
|
| Rate for Payer: BCBS Complete |
$473.69
|
| Rate for Payer: BCBS MAPPO |
$672.27
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$672.27
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$968.07
|
| Rate for Payer: Cofinity Commercial |
$900.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.88
|
| Rate for Payer: Meridian Medicaid |
$473.69
|
| Rate for Payer: Nomi Health Commercial |
$806.72
|
| Rate for Payer: PACE SWMI |
$672.27
|
| Rate for Payer: PHP Commercial |
$941.18
|
| Rate for Payer: PHP Medicare Advantage |
$672.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.59
|
| Rate for Payer: Priority Health Medicare |
$672.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,067.59
|
| Rate for Payer: Priority Health SBD |
$1,067.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.27
|
| Rate for Payer: UHC Medicare Advantage |
$672.27
|
| Rate for Payer: UHCCP Medicaid |
$451.13
|
| Rate for Payer: UMR Bronson Commercial |
$778.78
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,693.00
|
|
|
Service Code
|
HCPCS 24073
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$1,100.45 |
| Rate for Payer: Aetna Commercial |
$900.84
|
| Rate for Payer: Aetna Medicare |
$699.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.07
|
| Rate for Payer: BCBS Complete |
$473.69
|
| Rate for Payer: BCBS MAPPO |
$672.27
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$672.27
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$900.84
|
| Rate for Payer: Cofinity Commercial |
$968.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.88
|
| Rate for Payer: Meridian Medicaid |
$473.69
|
| Rate for Payer: Nomi Health Commercial |
$806.72
|
| Rate for Payer: PACE SWMI |
$672.27
|
| Rate for Payer: PHP Commercial |
$941.18
|
| Rate for Payer: PHP Medicare Advantage |
$672.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.59
|
| Rate for Payer: Priority Health Medicare |
$672.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,067.59
|
| Rate for Payer: Priority Health SBD |
$1,067.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.27
|
| Rate for Payer: UHC Medicare Advantage |
$672.27
|
| Rate for Payer: UHCCP Medicaid |
$451.13
|
| Rate for Payer: UMR Bronson Commercial |
$778.78
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
OP
|
$1,693.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$626.41 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: BCN Commercial |
$1,874.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$1,185.10
|
| Rate for Payer: Cofinity Commercial |
$1,455.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,185.10
|
| Rate for Payer: Aetna American Axle |
$1,100.45
|
| Rate for Payer: Aetna Commercial |
$1,439.05
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.45
|
| 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 |
$1,874.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,354.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,523.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,185.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,269.75
|
| 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 |
$1,439.05
|
| 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 |
$1,439.05
|
| 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 |
$1,100.45
|
| 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 |
$1,066.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.03
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$674.57
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$626.41
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,269.75
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 24076
|
| Hospital Charge Code |
24076
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$846.74 |
| Rate for Payer: Aetna Commercial |
$709.45
|
| Rate for Payer: Aetna Medicare |
$550.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.39
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS MAPPO |
$529.44
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$806.80
|
| Rate for Payer: BCN Medicare Advantage |
$529.44
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$762.39
|
| Rate for Payer: Cofinity Commercial |
$709.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.91
|
| Rate for Payer: Meridian Medicaid |
$375.73
|
| Rate for Payer: Nomi Health Commercial |
$635.33
|
| Rate for Payer: PACE SWMI |
$529.44
|
| Rate for Payer: PHP Commercial |
$741.22
|
| Rate for Payer: PHP Medicare Advantage |
$529.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.74
|
| Rate for Payer: Priority Health Medicare |
$529.44
|
| Rate for Payer: Priority Health Narrow Network |
$846.74
|
| Rate for Payer: Priority Health SBD |
$846.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.44
|
| Rate for Payer: UHC Medicare Advantage |
$529.44
|
| Rate for Payer: UHCCP Medicaid |
$357.84
|
| Rate for Payer: UMR Bronson Commercial |
$531.30
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 24076
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$846.74 |
| Rate for Payer: Aetna Commercial |
$709.45
|
| Rate for Payer: Aetna Medicare |
$550.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.39
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS MAPPO |
$529.44
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$806.80
|
| Rate for Payer: BCN Medicare Advantage |
$529.44
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$709.45
|
| Rate for Payer: Cofinity Commercial |
$762.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.91
|
| Rate for Payer: Meridian Medicaid |
$375.73
|
| Rate for Payer: Nomi Health Commercial |
$635.33
|
| Rate for Payer: PACE SWMI |
$529.44
|
| Rate for Payer: PHP Commercial |
$741.22
|
| Rate for Payer: PHP Medicare Advantage |
$529.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.74
|
| Rate for Payer: Priority Health Medicare |
$529.44
|
| Rate for Payer: Priority Health Narrow Network |
$846.74
|
| Rate for Payer: Priority Health SBD |
$846.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.44
|
| Rate for Payer: UHC Medicare Advantage |
$529.44
|
| Rate for Payer: UHCCP Medicaid |
$357.84
|
| Rate for Payer: UMR Bronson Commercial |
$531.30
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$1,155.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$508.20 |
| Max. Negotiated Rate |
$1,039.50 |
| Rate for Payer: Aetna American Axle |
$750.75
|
| Rate for Payer: Aetna Commercial |
$981.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.75
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$808.50
|
| Rate for Payer: Cofinity Commercial |
$993.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$808.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$924.00
|
| Rate for Payer: Healthscope Commercial |
$1,039.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$808.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$866.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$981.75
|
| Rate for Payer: PHP Commercial |
$981.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health SBD |
$727.65
|
| Rate for Payer: UMR Bronson Commercial |
$508.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$866.25
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$1,155.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$427.35 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$750.75
|
| Rate for Payer: Aetna Commercial |
$981.75
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.75
|
| 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 |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$808.50
|
| Rate for Payer: Cofinity Commercial |
$993.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$808.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$924.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,039.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$808.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$866.25
|
| 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 |
$981.75
|
| 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 |
$981.75
|
| 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 |
$750.75
|
| 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 |
$727.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$584.39
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$531.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$427.35
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$866.25
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,089.00
|
|
|
Service Code
|
HCPCS 26115
|
| Hospital Charge Code |
26115
|
| Min. Negotiated Rate |
$108.67 |
| Max. Negotiated Rate |
$814.14 |
| Rate for Payer: Aetna Commercial |
$431.57
|
| Rate for Payer: Aetna Medicare |
$334.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.78
|
| Rate for Payer: BCBS Complete |
$231.03
|
| Rate for Payer: BCBS MAPPO |
$322.07
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: BCN Commercial |
$814.14
|
| Rate for Payer: BCN Medicare Advantage |
$322.07
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$463.78
|
| Rate for Payer: Cofinity Commercial |
$431.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.17
|
| Rate for Payer: Meridian Medicaid |
$231.03
|
| Rate for Payer: Nomi Health Commercial |
$386.48
|
| Rate for Payer: PACE SWMI |
$322.07
|
| Rate for Payer: PHP Commercial |
$450.90
|
| Rate for Payer: PHP Medicare Advantage |
$322.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.03
|
| Rate for Payer: Priority Health Medicare |
$322.07
|
| Rate for Payer: Priority Health Narrow Network |
$519.03
|
| Rate for Payer: Priority Health SBD |
$519.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.07
|
| Rate for Payer: UHC Medicare Advantage |
$322.07
|
| Rate for Payer: UHCCP Medicaid |
$220.03
|
| Rate for Payer: UMR Bronson Commercial |
$500.94
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,089.00
|
|
|
Service Code
|
HCPCS 26115
|
| Min. Negotiated Rate |
$108.67 |
| Max. Negotiated Rate |
$814.14 |
| Rate for Payer: Aetna Commercial |
$431.57
|
| Rate for Payer: Aetna Medicare |
$334.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.78
|
| Rate for Payer: BCBS Complete |
$231.03
|
| Rate for Payer: BCBS MAPPO |
$322.07
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: BCN Commercial |
$814.14
|
| Rate for Payer: BCN Medicare Advantage |
$322.07
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$431.57
|
| Rate for Payer: Cofinity Commercial |
$463.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.17
|
| Rate for Payer: Meridian Medicaid |
$231.03
|
| Rate for Payer: Nomi Health Commercial |
$386.48
|
| Rate for Payer: PACE SWMI |
$322.07
|
| Rate for Payer: PHP Commercial |
$450.90
|
| Rate for Payer: PHP Medicare Advantage |
$322.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.03
|
| Rate for Payer: Priority Health Medicare |
$322.07
|
| Rate for Payer: Priority Health Narrow Network |
$519.03
|
| Rate for Payer: Priority Health SBD |
$519.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.07
|
| Rate for Payer: UHC Medicare Advantage |
$322.07
|
| Rate for Payer: UHCCP Medicaid |
$220.03
|
| Rate for Payer: UMR Bronson Commercial |
$500.94
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
OP
|
$1,089.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$322.24 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Cofinity Commercial |
$936.54
|
| Rate for Payer: Cofinity Commercial |
$762.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$762.30
|
| Rate for Payer: Aetna American Axle |
$707.85
|
| Rate for Payer: Aetna Commercial |
$925.65
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.44
|
| Rate for Payer: BCN Commercial |
$1,523.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$980.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$762.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.75
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.65
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$925.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$686.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.46
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$322.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$402.93
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.75
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
IP
|
$1,089.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$479.16 |
| Max. Negotiated Rate |
$980.10 |
| Rate for Payer: Aetna American Axle |
$707.85
|
| Rate for Payer: Aetna Commercial |
$925.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.85
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$762.30
|
| Rate for Payer: Cofinity Commercial |
$936.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$762.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.20
|
| Rate for Payer: Healthscope Commercial |
$980.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$762.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.65
|
| Rate for Payer: PHP Commercial |
$925.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health SBD |
$686.07
|
| Rate for Payer: UMR Bronson Commercial |
$479.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.75
|
|
|
PR EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM
|
Professional
|
Both
|
$1,680.00
|
|
|
Service Code
|
HCPCS 26116
|
| Min. Negotiated Rate |
$149.00 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna Commercial |
$681.97
|
| Rate for Payer: Aetna Medicare |
$529.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.86
|
| Rate for Payer: BCBS Complete |
$363.44
|
| Rate for Payer: BCBS MAPPO |
$508.93
|
| Rate for Payer: BCBS Trust/PPO |
$149.00
|
| Rate for Payer: BCN Commercial |
$776.51
|
| Rate for Payer: BCN Medicare Advantage |
$508.93
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cash Price |
$1,344.00
|
| Rate for Payer: Cofinity Commercial |
$681.97
|
| Rate for Payer: Cofinity Commercial |
$732.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.38
|
| Rate for Payer: Meridian Medicaid |
$363.44
|
| Rate for Payer: Nomi Health Commercial |
$610.72
|
| Rate for Payer: PACE SWMI |
$508.93
|
| Rate for Payer: PHP Commercial |
$712.50
|
| Rate for Payer: PHP Medicare Advantage |
$508.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.71
|
| Rate for Payer: Priority Health Medicare |
$508.93
|
| Rate for Payer: Priority Health Narrow Network |
$816.71
|
| Rate for Payer: Priority Health SBD |
$816.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.93
|
| Rate for Payer: UHC Medicare Advantage |
$508.93
|
| Rate for Payer: UHCCP Medicaid |
$346.13
|
| Rate for Payer: UMR Bronson Commercial |
$772.80
|
|
|
PR EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR
|
Professional
|
Both
|
$5,537.00
|
|
|
Service Code
|
HCPCS 51500
|
| Min. Negotiated Rate |
$409.81 |
| Max. Negotiated Rate |
$3,599.05 |
| Rate for Payer: Aetna Commercial |
$817.68
|
| Rate for Payer: Aetna Medicare |
$634.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$817.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$878.70
|
| Rate for Payer: BCBS Complete |
$430.30
|
| Rate for Payer: BCBS MAPPO |
$610.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,025.57
|
| Rate for Payer: BCN Commercial |
$920.67
|
| Rate for Payer: BCN Medicare Advantage |
$610.21
|
| Rate for Payer: Cash Price |
$4,429.60
|
| Rate for Payer: Cash Price |
$4,429.60
|
| Rate for Payer: Cofinity Commercial |
$817.68
|
| Rate for Payer: Cofinity Commercial |
$878.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.72
|
| Rate for Payer: Meridian Medicaid |
$430.30
|
| Rate for Payer: Nomi Health Commercial |
$732.25
|
| Rate for Payer: PACE SWMI |
$610.21
|
| Rate for Payer: PHP Commercial |
$854.29
|
| Rate for Payer: PHP Medicare Advantage |
$610.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,599.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,016.74
|
| Rate for Payer: Priority Health Medicare |
$610.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,016.74
|
| Rate for Payer: Priority Health SBD |
$1,016.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.21
|
| Rate for Payer: UHC Medicare Advantage |
$610.21
|
| Rate for Payer: UHCCP Medicaid |
$409.81
|
| Rate for Payer: UMR Bronson Commercial |
$2,547.02
|
|
|
PR EXC URETHRAL DIVERTICULUM SPX FEMALE
|
Professional
|
Both
|
$1,149.00
|
|
|
Service Code
|
HCPCS 53230
|
| Min. Negotiated Rate |
$52.30 |
| Max. Negotiated Rate |
$974.66 |
| Rate for Payer: Aetna Commercial |
$782.95
|
| Rate for Payer: Aetna Medicare |
$607.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$841.38
|
| Rate for Payer: BCBS Complete |
$411.52
|
| Rate for Payer: BCBS MAPPO |
$584.29
|
| Rate for Payer: BCBS Trust/PPO |
$52.30
|
| Rate for Payer: BCN Commercial |
$882.06
|
| Rate for Payer: BCN Medicare Advantage |
$584.29
|
| Rate for Payer: Cash Price |
$919.20
|
| Rate for Payer: Cash Price |
$919.20
|
| Rate for Payer: Cofinity Commercial |
$782.95
|
| Rate for Payer: Cofinity Commercial |
$841.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$584.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$613.50
|
| Rate for Payer: Meridian Medicaid |
$411.52
|
| Rate for Payer: Nomi Health Commercial |
$701.15
|
| Rate for Payer: PACE SWMI |
$584.29
|
| Rate for Payer: PHP Commercial |
$818.01
|
| Rate for Payer: PHP Medicare Advantage |
$584.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.66
|
| Rate for Payer: Priority Health Medicare |
$584.29
|
| Rate for Payer: Priority Health Narrow Network |
$974.66
|
| Rate for Payer: Priority Health SBD |
$974.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$584.29
|
| Rate for Payer: UHC Medicare Advantage |
$584.29
|
| Rate for Payer: UHCCP Medicaid |
$391.92
|
| Rate for Payer: UMR Bronson Commercial |
$528.54
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL
|
Professional
|
Both
|
$2,143.00
|
|
|
Service Code
|
HCPCS 55535
|
| Min. Negotiated Rate |
$277.54 |
| Max. Negotiated Rate |
$1,511.99 |
| Rate for Payer: Aetna Commercial |
$552.01
|
| Rate for Payer: Aetna Medicare |
$428.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.21
|
| Rate for Payer: BCBS Complete |
$291.42
|
| Rate for Payer: BCBS MAPPO |
$411.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,511.99
|
| Rate for Payer: BCN Commercial |
$623.55
|
| Rate for Payer: BCN Medicare Advantage |
$411.95
|
| Rate for Payer: Cash Price |
$1,714.40
|
| Rate for Payer: Cash Price |
$1,714.40
|
| Rate for Payer: Cofinity Commercial |
$552.01
|
| Rate for Payer: Cofinity Commercial |
$593.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$432.55
|
| Rate for Payer: Meridian Medicaid |
$291.42
|
| Rate for Payer: Nomi Health Commercial |
$494.34
|
| Rate for Payer: PACE SWMI |
$411.95
|
| Rate for Payer: PHP Commercial |
$576.73
|
| Rate for Payer: PHP Medicare Advantage |
$411.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.71
|
| Rate for Payer: Priority Health Medicare |
$411.95
|
| Rate for Payer: Priority Health Narrow Network |
$689.71
|
| Rate for Payer: Priority Health SBD |
$689.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.95
|
| Rate for Payer: UHC Medicare Advantage |
$411.95
|
| Rate for Payer: UHCCP Medicaid |
$277.54
|
| Rate for Payer: UMR Bronson Commercial |
$985.78
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX
|
Professional
|
Both
|
$655.00
|
|
|
Service Code
|
HCPCS 55530
|
| Min. Negotiated Rate |
$227.48 |
| Max. Negotiated Rate |
$1,577.50 |
| Rate for Payer: Aetna Commercial |
$451.97
|
| Rate for Payer: Aetna Medicare |
$350.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.70
|
| Rate for Payer: BCBS Complete |
$238.85
|
| Rate for Payer: BCBS MAPPO |
$337.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.50
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$337.29
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cofinity Commercial |
$451.97
|
| Rate for Payer: Cofinity Commercial |
$485.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.15
|
| Rate for Payer: Meridian Medicaid |
$238.85
|
| Rate for Payer: Nomi Health Commercial |
$404.75
|
| Rate for Payer: PACE SWMI |
$337.29
|
| Rate for Payer: PHP Commercial |
$472.21
|
| Rate for Payer: PHP Medicare Advantage |
$337.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.09
|
| Rate for Payer: Priority Health Medicare |
$337.29
|
| Rate for Payer: Priority Health Narrow Network |
$565.09
|
| Rate for Payer: Priority Health SBD |
$565.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.29
|
| Rate for Payer: UHC Medicare Advantage |
$337.29
|
| Rate for Payer: UHCCP Medicaid |
$227.48
|
| Rate for Payer: UMR Bronson Commercial |
$301.30
|
|
|
PR EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 55540
|
| Min. Negotiated Rate |
$360.40 |
| Max. Negotiated Rate |
$1,332.37 |
| Rate for Payer: Aetna Commercial |
$724.32
|
| Rate for Payer: Aetna Medicare |
$562.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.38
|
| Rate for Payer: BCBS Complete |
$378.42
|
| Rate for Payer: BCBS MAPPO |
$540.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,332.37
|
| Rate for Payer: BCN Commercial |
$814.14
|
| Rate for Payer: BCN Medicare Advantage |
$540.54
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$724.32
|
| Rate for Payer: Cofinity Commercial |
$778.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$567.57
|
| Rate for Payer: Meridian Medicaid |
$378.42
|
| Rate for Payer: Nomi Health Commercial |
$648.65
|
| Rate for Payer: PACE SWMI |
$540.54
|
| Rate for Payer: PHP Commercial |
$756.76
|
| Rate for Payer: PHP Medicare Advantage |
$540.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.24
|
| Rate for Payer: Priority Health Medicare |
$540.54
|
| Rate for Payer: Priority Health Narrow Network |
$894.24
|
| Rate for Payer: Priority Health SBD |
$894.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$540.54
|
| Rate for Payer: UHC Medicare Advantage |
$540.54
|
| Rate for Payer: UHCCP Medicaid |
$360.40
|
| Rate for Payer: UMR Bronson Commercial |
$364.32
|
|
|
PR EXC XTRPARENCHYMAL LESION TESTIS
|
Professional
|
Both
|
$1,112.00
|
|
|
Service Code
|
HCPCS 54512
|
| Min. Negotiated Rate |
$346.55 |
| Max. Negotiated Rate |
$1,954.18 |
| Rate for Payer: Aetna Commercial |
$691.49
|
| Rate for Payer: Aetna Medicare |
$536.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.10
|
| Rate for Payer: BCBS Complete |
$363.88
|
| Rate for Payer: BCBS MAPPO |
$516.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,954.18
|
| Rate for Payer: BCN Commercial |
$776.51
|
| Rate for Payer: BCN Medicare Advantage |
$516.04
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cofinity Commercial |
$691.49
|
| Rate for Payer: Cofinity Commercial |
$743.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$541.84
|
| Rate for Payer: Meridian Medicaid |
$363.88
|
| Rate for Payer: Nomi Health Commercial |
$619.25
|
| Rate for Payer: PACE SWMI |
$516.04
|
| Rate for Payer: PHP Commercial |
$722.46
|
| Rate for Payer: PHP Medicare Advantage |
$516.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$859.09
|
| Rate for Payer: Priority Health Medicare |
$516.04
|
| Rate for Payer: Priority Health Narrow Network |
$859.09
|
| Rate for Payer: Priority Health SBD |
$859.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.04
|
| Rate for Payer: UHC Medicare Advantage |
$516.04
|
| Rate for Payer: UHCCP Medicaid |
$346.55
|
| Rate for Payer: UMR Bronson Commercial |
$511.52
|
|
|
PR EXERCISE EQUIPMENT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS A9300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR EXISION OF SUBLINGUAL GLAND
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 42450
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$696.86 |
| Rate for Payer: Aetna Commercial |
$464.42
|
| Rate for Payer: Aetna Medicare |
$360.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.08
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS MAPPO |
$346.58
|
| Rate for Payer: BCBS Trust/PPO |
$563.70
|
| Rate for Payer: BCN Commercial |
$696.86
|
| Rate for Payer: BCN Medicare Advantage |
$346.58
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$499.08
|
| Rate for Payer: Cofinity Commercial |
$464.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.91
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Nomi Health Commercial |
$415.90
|
| Rate for Payer: PACE SWMI |
$346.58
|
| Rate for Payer: PHP Commercial |
$485.21
|
| Rate for Payer: PHP Medicare Advantage |
$346.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.24
|
| Rate for Payer: Priority Health Medicare |
$346.58
|
| Rate for Payer: Priority Health Narrow Network |
$659.24
|
| Rate for Payer: Priority Health SBD |
$659.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.58
|
| Rate for Payer: UHC Medicare Advantage |
$346.58
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
| Rate for Payer: UMR Bronson Commercial |
$352.82
|
|
|
PR EXPL CONGENITAL ATRESIA BILE DUCTS
|
Professional
|
Both
|
$2,902.00
|
|
|
Service Code
|
HCPCS 47700
|
| Min. Negotiated Rate |
$678.34 |
| Max. Negotiated Rate |
$1,901.95 |
| Rate for Payer: Aetna Commercial |
$1,375.31
|
| Rate for Payer: Aetna Medicare |
$1,067.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,375.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,477.94
|
| Rate for Payer: BCBS Complete |
$715.90
|
| Rate for Payer: BCBS MAPPO |
$1,026.35
|
| Rate for Payer: BCBS Trust/PPO |
$678.34
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,026.35
|
| Rate for Payer: Cash Price |
$2,321.60
|
| Rate for Payer: Cash Price |
$2,321.60
|
| Rate for Payer: Cofinity Commercial |
$1,375.31
|
| Rate for Payer: Cofinity Commercial |
$1,477.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,026.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,077.67
|
| Rate for Payer: Meridian Medicaid |
$715.90
|
| Rate for Payer: Nomi Health Commercial |
$1,231.62
|
| Rate for Payer: PACE SWMI |
$1,026.35
|
| Rate for Payer: PHP Commercial |
$1,436.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,026.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$681.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,886.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,901.95
|
| Rate for Payer: Priority Health Medicare |
$1,026.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,901.95
|
| Rate for Payer: Priority Health SBD |
$1,901.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,026.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,026.35
|
| Rate for Payer: UHCCP Medicaid |
$681.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,334.92
|
|
|
PR EXPLORATION EPIDIDYMIS W/WO BIOPSY
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 54865
|
| Min. Negotiated Rate |
$233.24 |
| Max. Negotiated Rate |
$1,488.22 |
| Rate for Payer: Aetna Commercial |
$462.70
|
| Rate for Payer: Aetna Medicare |
$359.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.23
|
| Rate for Payer: BCBS Complete |
$244.90
|
| Rate for Payer: BCBS MAPPO |
$345.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,488.22
|
| Rate for Payer: BCN Commercial |
$522.39
|
| Rate for Payer: BCN Medicare Advantage |
$345.30
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$462.70
|
| Rate for Payer: Cofinity Commercial |
$497.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.56
|
| Rate for Payer: Meridian Medicaid |
$244.90
|
| Rate for Payer: Nomi Health Commercial |
$414.36
|
| Rate for Payer: PACE SWMI |
$345.30
|
| Rate for Payer: PHP Commercial |
$483.42
|
| Rate for Payer: PHP Medicare Advantage |
$345.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$578.40
|
| Rate for Payer: Priority Health Medicare |
$345.30
|
| Rate for Payer: Priority Health Narrow Network |
$578.40
|
| Rate for Payer: Priority Health SBD |
$578.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.30
|
| Rate for Payer: UHC Medicare Advantage |
$345.30
|
| Rate for Payer: UHCCP Medicaid |
$233.24
|
| Rate for Payer: UMR Bronson Commercial |
$309.58
|
|
