|
PR HYSTEROTOMY ABDOMINAL
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 59100
|
| Min. Negotiated Rate |
$130.49 |
| Max. Negotiated Rate |
$1,260.30 |
| Rate for Payer: Aetna Commercial |
$1,119.72
|
| Rate for Payer: Aetna Medicare |
$869.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,203.28
|
| Rate for Payer: BCBS Complete |
$578.80
|
| Rate for Payer: BCBS MAPPO |
$835.61
|
| Rate for Payer: BCBS Trust/PPO |
$130.49
|
| Rate for Payer: BCN Commercial |
$1,260.30
|
| Rate for Payer: BCN Medicare Advantage |
$835.61
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,119.72
|
| Rate for Payer: Cofinity Commercial |
$1,203.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.39
|
| Rate for Payer: Meridian Medicaid |
$578.80
|
| Rate for Payer: Nomi Health Commercial |
$1,002.73
|
| Rate for Payer: PACE SWMI |
$835.61
|
| Rate for Payer: PHP Commercial |
$1,169.85
|
| Rate for Payer: PHP Medicare Advantage |
$835.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,208.65
|
| Rate for Payer: Priority Health Medicare |
$835.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,208.65
|
| Rate for Payer: Priority Health SBD |
$1,208.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.61
|
| Rate for Payer: UHC Medicare Advantage |
$835.61
|
| Rate for Payer: UHCCP Medicaid |
$551.24
|
| Rate for Payer: UMR Bronson Commercial |
$703.80
|
|
|
PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM USE
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 90750
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$187.08 |
| Rate for Payer: Aetna Commercial |
$187.08
|
| Rate for Payer: Aetna Medicare |
$85.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.08
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: BCBS Trust/PPO |
$175.26
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: UMR Bronson Commercial |
$78.66
|
|
|
PR I131 IODIDE CAP, RX
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS A9517
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$2,124.29 |
| Rate for Payer: Aetna Commercial |
$40.43
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.43
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.29
|
| Rate for Payer: BCN Commercial |
$23.73
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
PR ICAR CATH ABLATION DISCRETE MECHANISM ARRHYTHMIA
|
Professional
|
Both
|
$1,492.00
|
|
|
Service Code
|
HCPCS 93655
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$2,991.76 |
| Rate for Payer: Aetna Commercial |
$390.01
|
| Rate for Payer: Aetna Medicare |
$302.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.11
|
| Rate for Payer: BCBS Complete |
$200.83
|
| Rate for Payer: BCBS MAPPO |
$291.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,991.76
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$291.05
|
| Rate for Payer: Cash Price |
$1,193.60
|
| Rate for Payer: Cash Price |
$1,193.60
|
| Rate for Payer: Cofinity Commercial |
$419.11
|
| Rate for Payer: Cofinity Commercial |
$390.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.60
|
| Rate for Payer: Meridian Medicaid |
$200.83
|
| Rate for Payer: Nomi Health Commercial |
$349.26
|
| Rate for Payer: PACE SWMI |
$291.05
|
| Rate for Payer: PHP Commercial |
$407.47
|
| Rate for Payer: PHP Medicare Advantage |
$291.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.39
|
| Rate for Payer: Priority Health Medicare |
$291.05
|
| Rate for Payer: Priority Health Narrow Network |
$421.39
|
| Rate for Payer: Priority Health SBD |
$421.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.05
|
| Rate for Payer: UHC Medicare Advantage |
$291.05
|
| Rate for Payer: UHCCP Medicaid |
$191.27
|
| Rate for Payer: UMR Bronson Commercial |
$686.32
|
|
|
PR ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 93650
|
| Min. Negotiated Rate |
$363.17 |
| Max. Negotiated Rate |
$2,821.65 |
| Rate for Payer: Aetna Commercial |
$738.98
|
| Rate for Payer: Aetna Medicare |
$573.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$794.13
|
| Rate for Payer: BCBS Complete |
$381.33
|
| Rate for Payer: BCBS MAPPO |
$551.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,821.65
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$551.48
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cofinity Commercial |
$738.98
|
| Rate for Payer: Cofinity Commercial |
$794.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.05
|
| Rate for Payer: Meridian Medicaid |
$381.33
|
| Rate for Payer: Nomi Health Commercial |
$661.78
|
| Rate for Payer: PACE SWMI |
$551.48
|
| Rate for Payer: PHP Commercial |
$772.07
|
| Rate for Payer: PHP Medicare Advantage |
$551.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,196.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$800.43
|
| Rate for Payer: Priority Health Medicare |
$551.48
|
| Rate for Payer: Priority Health Narrow Network |
$800.43
|
| Rate for Payer: Priority Health SBD |
$800.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.48
|
| Rate for Payer: UHC Medicare Advantage |
$551.48
|
| Rate for Payer: UHCCP Medicaid |
$363.17
|
| Rate for Payer: UMR Bronson Commercial |
$846.40
|
|
|
PR I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 42700
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$492.38 |
| Rate for Payer: Aetna Commercial |
$173.38
|
| Rate for Payer: Aetna Medicare |
$134.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.32
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$129.39
|
| Rate for Payer: BCBS Trust/PPO |
$492.38
|
| Rate for Payer: BCN Commercial |
$284.90
|
| Rate for Payer: BCN Medicare Advantage |
$129.39
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$173.38
|
| Rate for Payer: Cofinity Commercial |
$186.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.86
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Nomi Health Commercial |
$155.27
|
| Rate for Payer: PACE SWMI |
$129.39
|
| Rate for Payer: PHP Commercial |
$181.15
|
| Rate for Payer: PHP Medicare Advantage |
$129.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.79
|
| Rate for Payer: Priority Health Medicare |
$129.39
|
| Rate for Payer: Priority Health Narrow Network |
$245.79
|
| Rate for Payer: Priority Health SBD |
$245.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.39
|
| Rate for Payer: UHC Medicare Advantage |
$129.39
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
| Rate for Payer: UMR Bronson Commercial |
$141.68
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 42720
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$692.06 |
| Rate for Payer: Aetna Commercial |
$494.58
|
| Rate for Payer: Aetna Medicare |
$383.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.49
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS MAPPO |
$369.09
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: BCN Commercial |
$657.27
|
| Rate for Payer: BCN Medicare Advantage |
$369.09
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$494.58
|
| Rate for Payer: Cofinity Commercial |
$531.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.54
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Nomi Health Commercial |
$442.91
|
| Rate for Payer: PACE SWMI |
$369.09
|
| Rate for Payer: PHP Commercial |
$516.73
|
| Rate for Payer: PHP Medicare Advantage |
$369.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$692.06
|
| Rate for Payer: Priority Health Medicare |
$369.09
|
| Rate for Payer: Priority Health Narrow Network |
$692.06
|
| Rate for Payer: Priority Health SBD |
$692.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$369.09
|
| Rate for Payer: UHC Medicare Advantage |
$369.09
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
| Rate for Payer: UMR Bronson Commercial |
$380.42
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 42725
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$1,436.59 |
| Rate for Payer: Aetna Commercial |
$1,025.14
|
| Rate for Payer: Aetna Medicare |
$795.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,101.64
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS MAPPO |
$765.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.83
|
| Rate for Payer: BCN Commercial |
$1,165.98
|
| Rate for Payer: BCN Medicare Advantage |
$765.03
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cofinity Commercial |
$1,025.14
|
| Rate for Payer: Cofinity Commercial |
$1,101.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.28
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Nomi Health Commercial |
$918.04
|
| Rate for Payer: PACE SWMI |
$765.03
|
| Rate for Payer: PHP Commercial |
$1,071.04
|
| Rate for Payer: PHP Medicare Advantage |
$765.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$960.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,436.59
|
| Rate for Payer: Priority Health Medicare |
$765.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,436.59
|
| Rate for Payer: Priority Health SBD |
$1,436.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.03
|
| Rate for Payer: UHC Medicare Advantage |
$765.03
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
| Rate for Payer: UMR Bronson Commercial |
$679.88
|
|
|
PR I&D BELOW FASCIA FOOT 1 BURSAL SPACE
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 28002
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$564.20 |
| Rate for Payer: Aetna Commercial |
$179.72
|
| Rate for Payer: Aetna Medicare |
$139.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.13
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$134.12
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$359.18
|
| Rate for Payer: BCN Medicare Advantage |
$134.12
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cofinity Commercial |
$179.72
|
| Rate for Payer: Cofinity Commercial |
$193.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.83
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Nomi Health Commercial |
$160.94
|
| Rate for Payer: PACE SWMI |
$134.12
|
| Rate for Payer: PHP Commercial |
$187.77
|
| Rate for Payer: PHP Medicare Advantage |
$134.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.21
|
| Rate for Payer: Priority Health Medicare |
$134.12
|
| Rate for Payer: Priority Health Narrow Network |
$213.21
|
| Rate for Payer: Priority Health SBD |
$213.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.12
|
| Rate for Payer: UHC Medicare Advantage |
$134.12
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
| Rate for Payer: UMR Bronson Commercial |
$399.28
|
|
|
PR I&D BELOW FASCIA FOOT MULTIPLE AREAS
|
Professional
|
Both
|
$1,243.00
|
|
|
Service Code
|
HCPCS 28003
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$3,691.76 |
| Rate for Payer: Aetna Commercial |
$330.94
|
| Rate for Payer: Aetna Medicare |
$256.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.64
|
| Rate for Payer: BCBS Complete |
$172.43
|
| Rate for Payer: BCBS MAPPO |
$246.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,691.76
|
| Rate for Payer: BCN Commercial |
$554.65
|
| Rate for Payer: BCN Medicare Advantage |
$246.97
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cofinity Commercial |
$330.94
|
| Rate for Payer: Cofinity Commercial |
$355.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.32
|
| Rate for Payer: Meridian Medicaid |
$172.43
|
| Rate for Payer: Nomi Health Commercial |
$296.36
|
| Rate for Payer: PACE SWMI |
$246.97
|
| Rate for Payer: PHP Commercial |
$345.76
|
| Rate for Payer: PHP Medicare Advantage |
$246.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.34
|
| Rate for Payer: Priority Health Medicare |
$246.97
|
| Rate for Payer: Priority Health Narrow Network |
$392.34
|
| Rate for Payer: Priority Health SBD |
$392.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.97
|
| Rate for Payer: UHC Medicare Advantage |
$246.97
|
| Rate for Payer: UHCCP Medicaid |
$164.22
|
| Rate for Payer: UMR Bronson Commercial |
$571.78
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
|
IP
|
$1,665.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$732.60 |
| Max. Negotiated Rate |
$1,498.50 |
| Rate for Payer: Aetna American Axle |
$1,082.25
|
| Rate for Payer: Aetna Commercial |
$1,415.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,165.50
|
| Rate for Payer: Cofinity Commercial |
$1,431.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,165.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Healthscope Commercial |
$1,498.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,165.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,248.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: PHP Commercial |
$1,415.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health SBD |
$1,048.95
|
| Rate for Payer: UMR Bronson Commercial |
$732.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,248.75
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
|
OP
|
$1,665.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$494.26 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$1,082.25
|
| Rate for Payer: Aetna Commercial |
$1,415.25
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.25
|
| 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 |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,165.50
|
| Rate for Payer: Cofinity Commercial |
$1,431.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,165.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,498.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,165.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,248.75
|
| 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 |
$1,415.25
|
| 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 |
$1,415.25
|
| 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 |
$1,082.25
|
| 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 |
$1,048.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$543.69
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$494.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$616.05
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,248.75
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 27301
|
| Min. Negotiated Rate |
$332.71 |
| Max. Negotiated Rate |
$3,899.38 |
| Rate for Payer: Aetna Commercial |
$659.17
|
| Rate for Payer: Aetna Medicare |
$511.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.36
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS MAPPO |
$491.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.38
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$491.92
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$659.17
|
| Rate for Payer: Cofinity Commercial |
$708.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.52
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Nomi Health Commercial |
$590.30
|
| Rate for Payer: PACE SWMI |
$491.92
|
| Rate for Payer: PHP Commercial |
$688.69
|
| Rate for Payer: PHP Medicare Advantage |
$491.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.22
|
| Rate for Payer: Priority Health Medicare |
$491.92
|
| Rate for Payer: Priority Health Narrow Network |
$788.22
|
| Rate for Payer: Priority Health SBD |
$788.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.92
|
| Rate for Payer: UHC Medicare Advantage |
$491.92
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
| Rate for Payer: UMR Bronson Commercial |
$765.90
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$332.71 |
| Max. Negotiated Rate |
$3,899.38 |
| Rate for Payer: PACE SWMI |
$491.92
|
| Rate for Payer: PHP Commercial |
$688.69
|
| Rate for Payer: PHP Medicare Advantage |
$491.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.22
|
| Rate for Payer: Priority Health Medicare |
$491.92
|
| Rate for Payer: Priority Health Narrow Network |
$788.22
|
| Rate for Payer: Priority Health SBD |
$788.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.92
|
| Rate for Payer: UHC Medicare Advantage |
$491.92
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
| Rate for Payer: UMR Bronson Commercial |
$765.90
|
| Rate for Payer: Aetna Commercial |
$659.17
|
| Rate for Payer: Aetna Medicare |
$511.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.36
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS MAPPO |
$491.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.38
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$491.92
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$708.36
|
| Rate for Payer: Cofinity Commercial |
$659.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.52
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Nomi Health Commercial |
$590.30
|
|
|
PR I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR
|
Professional
|
Both
|
$2,460.00
|
|
|
Service Code
|
HCPCS 22010
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,599.00 |
| Rate for Payer: Aetna Commercial |
$1,273.05
|
| Rate for Payer: Aetna Medicare |
$988.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.06
|
| Rate for Payer: BCBS Complete |
$667.60
|
| Rate for Payer: BCBS MAPPO |
$950.04
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$1,424.01
|
| Rate for Payer: BCN Medicare Advantage |
$950.04
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$1,273.05
|
| Rate for Payer: Cofinity Commercial |
$1,368.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.54
|
| Rate for Payer: Meridian Medicaid |
$667.60
|
| Rate for Payer: Nomi Health Commercial |
$1,140.05
|
| Rate for Payer: PACE SWMI |
$950.04
|
| Rate for Payer: PHP Commercial |
$1,330.06
|
| Rate for Payer: PHP Medicare Advantage |
$950.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$635.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,599.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,503.69
|
| Rate for Payer: Priority Health Medicare |
$950.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,503.69
|
| Rate for Payer: Priority Health SBD |
$1,503.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.04
|
| Rate for Payer: UHC Medicare Advantage |
$950.04
|
| Rate for Payer: UHCCP Medicaid |
$635.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,131.60
|
|
|
PR I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC
|
Professional
|
Both
|
$1,725.00
|
|
|
Service Code
|
HCPCS 22015
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,467.05 |
| Rate for Payer: Aetna Commercial |
$1,237.24
|
| Rate for Payer: Aetna Medicare |
$960.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,329.57
|
| Rate for Payer: BCBS Complete |
$650.37
|
| Rate for Payer: BCBS MAPPO |
$923.31
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$1,399.57
|
| Rate for Payer: BCN Medicare Advantage |
$923.31
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cofinity Commercial |
$1,237.24
|
| Rate for Payer: Cofinity Commercial |
$1,329.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.48
|
| Rate for Payer: Meridian Medicaid |
$650.37
|
| Rate for Payer: Nomi Health Commercial |
$1,107.97
|
| Rate for Payer: PACE SWMI |
$923.31
|
| Rate for Payer: PHP Commercial |
$1,292.63
|
| Rate for Payer: PHP Medicare Advantage |
$923.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,121.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.05
|
| Rate for Payer: Priority Health Medicare |
$923.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,467.05
|
| Rate for Payer: Priority Health SBD |
$1,467.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.31
|
| Rate for Payer: UHC Medicare Advantage |
$923.31
|
| Rate for Payer: UHCCP Medicaid |
$619.40
|
| Rate for Payer: UMR Bronson Commercial |
$793.50
|
|
|
PR I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$1,168.00
|
|
|
Service Code
|
HCPCS 21501
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$759.20 |
| Rate for Payer: Aetna Commercial |
$433.74
|
| Rate for Payer: Aetna Medicare |
$336.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.11
|
| Rate for Payer: BCBS Complete |
$231.70
|
| Rate for Payer: BCBS MAPPO |
$323.69
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$718.85
|
| Rate for Payer: BCN Medicare Advantage |
$323.69
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cofinity Commercial |
$433.74
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.87
|
| Rate for Payer: Meridian Medicaid |
$231.70
|
| Rate for Payer: Nomi Health Commercial |
$388.43
|
| Rate for Payer: PACE SWMI |
$323.69
|
| Rate for Payer: PHP Commercial |
$453.17
|
| Rate for Payer: PHP Medicare Advantage |
$323.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.59
|
| Rate for Payer: Priority Health Medicare |
$323.69
|
| Rate for Payer: Priority Health Narrow Network |
$521.59
|
| Rate for Payer: Priority Health SBD |
$521.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.69
|
| Rate for Payer: UHC Medicare Advantage |
$323.69
|
| Rate for Payer: UHCCP Medicaid |
$220.67
|
| Rate for Payer: UMR Bronson Commercial |
$537.28
|
|
|
PR I&D DP ABSC/HMTMA SFT TIS NCK/THRX PRTL RIB OSTC
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 21502
|
| Min. Negotiated Rate |
$328.23 |
| Max. Negotiated Rate |
$779.06 |
| Rate for Payer: Aetna Commercial |
$658.85
|
| Rate for Payer: Aetna Medicare |
$511.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.02
|
| Rate for Payer: BCBS Complete |
$344.64
|
| Rate for Payer: BCBS MAPPO |
$491.68
|
| Rate for Payer: BCBS Trust/PPO |
$483.43
|
| Rate for Payer: BCN Commercial |
$742.79
|
| Rate for Payer: BCN Medicare Advantage |
$491.68
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$658.85
|
| Rate for Payer: Cofinity Commercial |
$708.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.26
|
| Rate for Payer: Meridian Medicaid |
$344.64
|
| Rate for Payer: Nomi Health Commercial |
$590.02
|
| Rate for Payer: PACE SWMI |
$491.68
|
| Rate for Payer: PHP Commercial |
$688.35
|
| Rate for Payer: PHP Medicare Advantage |
$491.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$779.06
|
| Rate for Payer: Priority Health Medicare |
$491.68
|
| Rate for Payer: Priority Health Narrow Network |
$779.06
|
| Rate for Payer: Priority Health SBD |
$779.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.68
|
| Rate for Payer: UHC Medicare Advantage |
$491.68
|
| Rate for Payer: UHCCP Medicaid |
$328.23
|
| Rate for Payer: UMR Bronson Commercial |
$440.22
|
|
|
PR I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC
|
Professional
|
Both
|
$1,637.00
|
|
|
Service Code
|
HCPCS 45020
|
| Min. Negotiated Rate |
$371.26 |
| Max. Negotiated Rate |
$1,064.05 |
| Rate for Payer: Aetna Commercial |
$740.02
|
| Rate for Payer: Aetna Medicare |
$574.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$740.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.24
|
| Rate for Payer: BCBS Complete |
$389.82
|
| Rate for Payer: BCBS MAPPO |
$552.25
|
| Rate for Payer: BCBS Trust/PPO |
$489.21
|
| Rate for Payer: BCN Commercial |
$841.99
|
| Rate for Payer: BCN Medicare Advantage |
$552.25
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cofinity Commercial |
$740.02
|
| Rate for Payer: Cofinity Commercial |
$795.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.86
|
| Rate for Payer: Meridian Medicaid |
$389.82
|
| Rate for Payer: Nomi Health Commercial |
$662.70
|
| Rate for Payer: PACE SWMI |
$552.25
|
| Rate for Payer: PHP Commercial |
$773.15
|
| Rate for Payer: PHP Medicare Advantage |
$552.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,064.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.96
|
| Rate for Payer: Priority Health Medicare |
$552.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,021.96
|
| Rate for Payer: Priority Health SBD |
$1,021.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.25
|
| Rate for Payer: UHC Medicare Advantage |
$552.25
|
| Rate for Payer: UHCCP Medicaid |
$371.26
|
| Rate for Payer: UMR Bronson Commercial |
$753.02
|
|
|
PR I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 54700
|
| Min. Negotiated Rate |
$138.02 |
| Max. Negotiated Rate |
$2,037.12 |
| Rate for Payer: Aetna Commercial |
$274.82
|
| Rate for Payer: Aetna Medicare |
$213.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.33
|
| Rate for Payer: BCBS Complete |
$144.92
|
| Rate for Payer: BCBS MAPPO |
$205.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,037.12
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Medicare Advantage |
$205.09
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$274.82
|
| Rate for Payer: Cofinity Commercial |
$295.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.34
|
| Rate for Payer: Meridian Medicaid |
$144.92
|
| Rate for Payer: Nomi Health Commercial |
$246.11
|
| Rate for Payer: PACE SWMI |
$205.09
|
| Rate for Payer: PHP Commercial |
$287.13
|
| Rate for Payer: PHP Medicare Advantage |
$205.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.39
|
| Rate for Payer: Priority Health Medicare |
$205.09
|
| Rate for Payer: Priority Health Narrow Network |
$341.39
|
| Rate for Payer: Priority Health SBD |
$341.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.09
|
| Rate for Payer: UHC Medicare Advantage |
$205.09
|
| Rate for Payer: UHCCP Medicaid |
$138.02
|
| Rate for Payer: UMR Bronson Commercial |
$186.30
|
|
|
PR I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$931.00
|
|
|
Service Code
|
HCPCS 25028
|
| Min. Negotiated Rate |
$209.74 |
| Max. Negotiated Rate |
$1,068.61 |
| Rate for Payer: Aetna Commercial |
$853.47
|
| Rate for Payer: Aetna Medicare |
$662.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$853.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.16
|
| Rate for Payer: BCBS Complete |
$464.74
|
| Rate for Payer: BCBS MAPPO |
$636.92
|
| Rate for Payer: BCBS Trust/PPO |
$209.74
|
| Rate for Payer: BCN Commercial |
$1,026.22
|
| Rate for Payer: BCN Medicare Advantage |
$636.92
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Cofinity Commercial |
$853.47
|
| Rate for Payer: Cofinity Commercial |
$917.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.77
|
| Rate for Payer: Meridian Medicaid |
$464.74
|
| Rate for Payer: Nomi Health Commercial |
$764.30
|
| Rate for Payer: PACE SWMI |
$636.92
|
| Rate for Payer: PHP Commercial |
$891.69
|
| Rate for Payer: PHP Medicare Advantage |
$636.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,068.61
|
| Rate for Payer: Priority Health Medicare |
$636.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.61
|
| Rate for Payer: Priority Health SBD |
$1,068.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$636.92
|
| Rate for Payer: UHC Medicare Advantage |
$636.92
|
| Rate for Payer: UHCCP Medicaid |
$442.61
|
| Rate for Payer: UMR Bronson Commercial |
$428.26
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$199.08 |
| Rate for Payer: Aetna Commercial |
$150.63
|
| Rate for Payer: Aetna Medicare |
$116.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.87
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$112.41
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$112.41
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Cofinity Commercial |
$150.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.03
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: PACE SWMI |
$112.41
|
| Rate for Payer: PHP Commercial |
$157.37
|
| Rate for Payer: PHP Medicare Advantage |
$112.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.20
|
| Rate for Payer: Priority Health Medicare |
$112.41
|
| Rate for Payer: Priority Health Narrow Network |
$161.20
|
| Rate for Payer: Priority Health SBD |
$161.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.41
|
| Rate for Payer: UHC Medicare Advantage |
$112.41
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
| Rate for Payer: UMR Bronson Commercial |
$123.74
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$118.36 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Aetna American Axle |
$174.85
|
| Rate for Payer: Aetna Commercial |
$228.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.85
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$188.30
|
| Rate for Payer: Cofinity Commercial |
$231.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$188.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Healthscope Commercial |
$242.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.65
|
| Rate for Payer: PHP Commercial |
$228.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health SBD |
$169.47
|
| Rate for Payer: UMR Bronson Commercial |
$118.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.75
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$99.53 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$174.85
|
| Rate for Payer: Aetna Commercial |
$228.65
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.85
|
| 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 |
$1,681.90
|
| Rate for Payer: BCN Commercial |
$1,681.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$188.30
|
| Rate for Payer: Cofinity Commercial |
$231.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$188.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$242.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.75
|
| 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 |
$228.65
|
| 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 |
$228.65
|
| 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 |
$174.85
|
| 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 |
$169.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.19
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$112.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$99.53
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.75
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$199.08 |
| Rate for Payer: Aetna Commercial |
$150.63
|
| Rate for Payer: Aetna Medicare |
$116.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.87
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$112.41
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$112.41
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$150.63
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.03
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: PACE SWMI |
$112.41
|
| Rate for Payer: PHP Commercial |
$157.37
|
| Rate for Payer: PHP Medicare Advantage |
$112.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.20
|
| Rate for Payer: Priority Health Medicare |
$112.41
|
| Rate for Payer: Priority Health Narrow Network |
$161.20
|
| Rate for Payer: Priority Health SBD |
$161.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.41
|
| Rate for Payer: UHC Medicare Advantage |
$112.41
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
| Rate for Payer: UMR Bronson Commercial |
$123.74
|
|
