|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$296.12 |
| Max. Negotiated Rate |
$605.70 |
| Rate for Payer: Aetna American Axle |
$437.45
|
| Rate for Payer: Aetna Commercial |
$572.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.45
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$471.10
|
| Rate for Payer: Cofinity Commercial |
$578.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.40
|
| Rate for Payer: Healthscope Commercial |
$605.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.05
|
| Rate for Payer: PHP Commercial |
$572.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health SBD |
$423.99
|
| Rate for Payer: UMR Bronson Commercial |
$296.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.75
|
|
|
PR INCISION & DRAINAGE FOREARM&/WRIST BURSA
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
HCPCS 25031
|
| Min. Negotiated Rate |
$244.31 |
| Max. Negotiated Rate |
$942.49 |
| Rate for Payer: Aetna Commercial |
$479.22
|
| Rate for Payer: Aetna Medicare |
$371.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.99
|
| Rate for Payer: BCBS Complete |
$256.53
|
| Rate for Payer: BCBS MAPPO |
$357.63
|
| Rate for Payer: BCBS Trust/PPO |
$942.49
|
| Rate for Payer: BCN Commercial |
$547.32
|
| Rate for Payer: BCN Medicare Advantage |
$357.63
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cofinity Commercial |
$479.22
|
| Rate for Payer: Cofinity Commercial |
$514.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.51
|
| Rate for Payer: Meridian Medicaid |
$256.53
|
| Rate for Payer: Nomi Health Commercial |
$429.16
|
| Rate for Payer: PACE SWMI |
$357.63
|
| Rate for Payer: PHP Commercial |
$500.68
|
| Rate for Payer: PHP Medicare Advantage |
$357.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$577.55
|
| Rate for Payer: Priority Health Medicare |
$357.63
|
| Rate for Payer: Priority Health Narrow Network |
$577.55
|
| Rate for Payer: Priority Health SBD |
$577.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.63
|
| Rate for Payer: UHC Medicare Advantage |
$357.63
|
| Rate for Payer: UHCCP Medicaid |
$244.31
|
| Rate for Payer: UMR Bronson Commercial |
$335.34
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,140.00
|
|
|
Service Code
|
HCPCS 27603
|
| Min. Negotiated Rate |
$252.19 |
| Max. Negotiated Rate |
$1,557.43 |
| Rate for Payer: Aetna Commercial |
$497.81
|
| Rate for Payer: Aetna Medicare |
$386.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.96
|
| Rate for Payer: BCBS Complete |
$264.80
|
| Rate for Payer: BCBS MAPPO |
$371.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,557.43
|
| Rate for Payer: BCN Commercial |
$777.97
|
| Rate for Payer: BCN Medicare Advantage |
$371.50
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cofinity Commercial |
$497.81
|
| Rate for Payer: Cofinity Commercial |
$534.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.08
|
| Rate for Payer: Meridian Medicaid |
$264.80
|
| Rate for Payer: Nomi Health Commercial |
$445.80
|
| Rate for Payer: PACE SWMI |
$371.50
|
| Rate for Payer: PHP Commercial |
$520.10
|
| Rate for Payer: PHP Medicare Advantage |
$371.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.48
|
| Rate for Payer: Priority Health Medicare |
$371.50
|
| Rate for Payer: Priority Health Narrow Network |
$601.48
|
| Rate for Payer: Priority Health SBD |
$601.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.50
|
| Rate for Payer: UHC Medicare Advantage |
$371.50
|
| Rate for Payer: UHCCP Medicaid |
$252.19
|
| Rate for Payer: UMR Bronson Commercial |
$524.40
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 27604
|
| Min. Negotiated Rate |
$216.41 |
| Max. Negotiated Rate |
$661.18 |
| Rate for Payer: Aetna Commercial |
$428.09
|
| Rate for Payer: Aetna Medicare |
$332.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.04
|
| Rate for Payer: BCBS Complete |
$227.23
|
| Rate for Payer: BCBS MAPPO |
$319.47
|
| Rate for Payer: BCBS Trust/PPO |
$557.88
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$319.47
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cofinity Commercial |
$428.09
|
| Rate for Payer: Cofinity Commercial |
$460.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.44
|
| Rate for Payer: Meridian Medicaid |
$227.23
|
| Rate for Payer: Nomi Health Commercial |
$383.36
|
| Rate for Payer: PACE SWMI |
$319.47
|
| Rate for Payer: PHP Commercial |
$447.26
|
| Rate for Payer: PHP Medicare Advantage |
$319.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.69
|
| Rate for Payer: Priority Health Medicare |
$319.47
|
| Rate for Payer: Priority Health Narrow Network |
$498.69
|
| Rate for Payer: Priority Health SBD |
$498.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.47
|
| Rate for Payer: UHC Medicare Advantage |
$319.47
|
| Rate for Payer: UHCCP Medicaid |
$216.41
|
| Rate for Payer: UMR Bronson Commercial |
$408.48
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 10081
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$406.41 |
| Rate for Payer: Aetna Commercial |
$219.87
|
| Rate for Payer: Aetna Medicare |
$170.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.28
|
| Rate for Payer: BCBS Complete |
$115.85
|
| Rate for Payer: BCBS MAPPO |
$164.08
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$406.41
|
| Rate for Payer: BCN Medicare Advantage |
$164.08
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cofinity Commercial |
$219.87
|
| Rate for Payer: Cofinity Commercial |
$236.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.28
|
| Rate for Payer: Meridian Medicaid |
$115.85
|
| Rate for Payer: Nomi Health Commercial |
$196.90
|
| Rate for Payer: PACE SWMI |
$164.08
|
| Rate for Payer: PHP Commercial |
$229.71
|
| Rate for Payer: PHP Medicare Advantage |
$164.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.53
|
| Rate for Payer: Priority Health Medicare |
$164.08
|
| Rate for Payer: Priority Health Narrow Network |
$232.53
|
| Rate for Payer: Priority Health SBD |
$232.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.08
|
| Rate for Payer: UHC Medicare Advantage |
$164.08
|
| Rate for Payer: UHCCP Medicaid |
$110.33
|
| Rate for Payer: UMR Bronson Commercial |
$208.84
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 10080
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$297.64 |
| Rate for Payer: Aetna Commercial |
$132.94
|
| Rate for Payer: Aetna Medicare |
$103.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.86
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$99.21
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$297.64
|
| Rate for Payer: BCN Medicare Advantage |
$99.21
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cofinity Commercial |
$132.94
|
| Rate for Payer: Cofinity Commercial |
$142.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.17
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Nomi Health Commercial |
$119.05
|
| Rate for Payer: PACE SWMI |
$99.21
|
| Rate for Payer: PHP Commercial |
$138.89
|
| Rate for Payer: PHP Medicare Advantage |
$99.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.58
|
| Rate for Payer: Priority Health Medicare |
$99.21
|
| Rate for Payer: Priority Health Narrow Network |
$143.58
|
| Rate for Payer: Priority Health SBD |
$143.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.21
|
| Rate for Payer: UHC Medicare Advantage |
$99.21
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
| Rate for Payer: UMR Bronson Commercial |
$143.98
|
|
|
PR INCISION&DRAINAGE UPPER ARM/ELBOW BURSA
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
HCPCS 23931
|
| Min. Negotiated Rate |
$29.72 |
| Max. Negotiated Rate |
$482.30 |
| Rate for Payer: Aetna Commercial |
$206.13
|
| Rate for Payer: Aetna Medicare |
$159.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.52
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS MAPPO |
$153.83
|
| Rate for Payer: BCBS Trust/PPO |
$29.72
|
| Rate for Payer: BCN Commercial |
$448.61
|
| Rate for Payer: BCN Medicare Advantage |
$153.83
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cofinity Commercial |
$206.13
|
| Rate for Payer: Cofinity Commercial |
$221.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.52
|
| Rate for Payer: Meridian Medicaid |
$110.48
|
| Rate for Payer: Nomi Health Commercial |
$184.60
|
| Rate for Payer: PACE SWMI |
$153.83
|
| Rate for Payer: PHP Commercial |
$215.36
|
| Rate for Payer: PHP Medicare Advantage |
$153.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$250.35
|
| Rate for Payer: Priority Health Medicare |
$153.83
|
| Rate for Payer: Priority Health Narrow Network |
$250.35
|
| Rate for Payer: Priority Health SBD |
$250.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.83
|
| Rate for Payer: UHC Medicare Advantage |
$153.83
|
| Rate for Payer: UHCCP Medicaid |
$105.22
|
| Rate for Payer: UMR Bronson Commercial |
$341.32
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Facility
|
OP
|
$1,175.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
25000
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$334.76 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna American Axle |
$763.75
|
| Rate for Payer: Aetna Commercial |
$998.75
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,792.62
|
| Rate for Payer: BCN Commercial |
$1,792.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,010.50
|
| Rate for Payer: Cofinity Commercial |
$822.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$822.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,057.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$881.25
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$998.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$740.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.24
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$334.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: UMR Bronson Commercial |
$434.75
|
| Rate for Payer: VA VA |
$1,568.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$881.25
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25000
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$763.75 |
| Rate for Payer: Aetna Commercial |
$447.25
|
| Rate for Payer: Aetna Medicare |
$347.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.63
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS MAPPO |
$333.77
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$514.58
|
| Rate for Payer: BCN Medicare Advantage |
$333.77
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$447.25
|
| Rate for Payer: Cofinity Commercial |
$480.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.46
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Nomi Health Commercial |
$400.52
|
| Rate for Payer: PACE SWMI |
$333.77
|
| Rate for Payer: PHP Commercial |
$467.28
|
| Rate for Payer: PHP Medicare Advantage |
$333.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.46
|
| Rate for Payer: Priority Health Medicare |
$333.77
|
| Rate for Payer: Priority Health Narrow Network |
$543.46
|
| Rate for Payer: Priority Health SBD |
$543.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.77
|
| Rate for Payer: UHC Medicare Advantage |
$333.77
|
| Rate for Payer: UHCCP Medicaid |
$229.83
|
| Rate for Payer: UMR Bronson Commercial |
$540.50
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25000
|
| Hospital Charge Code |
25000
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$763.75 |
| Rate for Payer: Aetna Commercial |
$447.25
|
| Rate for Payer: Aetna Medicare |
$347.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.63
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS MAPPO |
$333.77
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$514.58
|
| Rate for Payer: BCN Medicare Advantage |
$333.77
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$480.63
|
| Rate for Payer: Cofinity Commercial |
$447.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.46
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Nomi Health Commercial |
$400.52
|
| Rate for Payer: PACE SWMI |
$333.77
|
| Rate for Payer: PHP Commercial |
$467.28
|
| Rate for Payer: PHP Medicare Advantage |
$333.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.46
|
| Rate for Payer: Priority Health Medicare |
$333.77
|
| Rate for Payer: Priority Health Narrow Network |
$543.46
|
| Rate for Payer: Priority Health SBD |
$543.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.77
|
| Rate for Payer: UHC Medicare Advantage |
$333.77
|
| Rate for Payer: UHCCP Medicaid |
$229.83
|
| Rate for Payer: UMR Bronson Commercial |
$540.50
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Facility
|
IP
|
$1,175.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
25000
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$517.00 |
| Max. Negotiated Rate |
$1,057.50 |
| Rate for Payer: Aetna American Axle |
$763.75
|
| Rate for Payer: Aetna Commercial |
$998.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.75
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,010.50
|
| Rate for Payer: Cofinity Commercial |
$822.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$822.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Healthscope Commercial |
$1,057.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$881.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: PHP Commercial |
$998.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health SBD |
$740.25
|
| Rate for Payer: UMR Bronson Commercial |
$517.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$881.25
|
|
|
PR INCISION FLEXOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25001
|
| Min. Negotiated Rate |
$232.17 |
| Max. Negotiated Rate |
$1,124.75 |
| Rate for Payer: Aetna Commercial |
$453.09
|
| Rate for Payer: Aetna Medicare |
$351.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.91
|
| Rate for Payer: BCBS Complete |
$243.78
|
| Rate for Payer: BCBS MAPPO |
$338.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.75
|
| Rate for Payer: BCN Commercial |
$515.07
|
| Rate for Payer: BCN Medicare Advantage |
$338.13
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$453.09
|
| Rate for Payer: Cofinity Commercial |
$486.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.04
|
| Rate for Payer: Meridian Medicaid |
$243.78
|
| Rate for Payer: Nomi Health Commercial |
$405.76
|
| Rate for Payer: PACE SWMI |
$338.13
|
| Rate for Payer: PHP Commercial |
$473.38
|
| Rate for Payer: PHP Medicare Advantage |
$338.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.00
|
| Rate for Payer: Priority Health Medicare |
$338.13
|
| Rate for Payer: Priority Health Narrow Network |
$546.00
|
| Rate for Payer: Priority Health SBD |
$546.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.13
|
| Rate for Payer: UHC Medicare Advantage |
$338.13
|
| Rate for Payer: UHCCP Medicaid |
$232.17
|
| Rate for Payer: UMR Bronson Commercial |
$540.50
|
|
|
PR INCISION LABIAL FRENUM FRENOTOMY
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 40806
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$393.58 |
| Rate for Payer: Aetna Commercial |
$37.59
|
| Rate for Payer: Aetna Medicare |
$29.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.39
|
| Rate for Payer: BCBS Complete |
$20.35
|
| Rate for Payer: BCBS MAPPO |
$28.05
|
| Rate for Payer: BCBS Trust/PPO |
$393.58
|
| Rate for Payer: BCN Commercial |
$146.11
|
| Rate for Payer: BCN Medicare Advantage |
$28.05
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cofinity Commercial |
$37.59
|
| Rate for Payer: Cofinity Commercial |
$40.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.45
|
| Rate for Payer: Meridian Medicaid |
$20.35
|
| Rate for Payer: Nomi Health Commercial |
$33.66
|
| Rate for Payer: PACE SWMI |
$28.05
|
| Rate for Payer: PHP Commercial |
$39.27
|
| Rate for Payer: PHP Medicare Advantage |
$28.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.10
|
| Rate for Payer: Priority Health Medicare |
$28.05
|
| Rate for Payer: Priority Health Narrow Network |
$53.10
|
| Rate for Payer: Priority Health SBD |
$53.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.05
|
| Rate for Payer: UHC Medicare Advantage |
$28.05
|
| Rate for Payer: UHCCP Medicaid |
$19.38
|
| Rate for Payer: UMR Bronson Commercial |
$163.76
|
|
|
PR INCISION LEG/ANKLE
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 27607
|
| Min. Negotiated Rate |
$388.73 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$771.60
|
| Rate for Payer: Aetna Medicare |
$598.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$829.18
|
| Rate for Payer: BCBS Complete |
$408.17
|
| Rate for Payer: BCBS MAPPO |
$575.82
|
| Rate for Payer: BCBS Trust/PPO |
$864.83
|
| Rate for Payer: BCN Commercial |
$876.69
|
| Rate for Payer: BCN Medicare Advantage |
$575.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$771.60
|
| Rate for Payer: Cofinity Commercial |
$829.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.61
|
| Rate for Payer: Meridian Medicaid |
$408.17
|
| Rate for Payer: Nomi Health Commercial |
$690.98
|
| Rate for Payer: PACE SWMI |
$575.82
|
| Rate for Payer: PHP Commercial |
$806.15
|
| Rate for Payer: PHP Medicare Advantage |
$575.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$924.09
|
| Rate for Payer: Priority Health Medicare |
$575.82
|
| Rate for Payer: Priority Health Narrow Network |
$924.09
|
| Rate for Payer: Priority Health SBD |
$924.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.82
|
| Rate for Payer: UHC Medicare Advantage |
$575.82
|
| Rate for Payer: UHCCP Medicaid |
$388.73
|
| Rate for Payer: UMR Bronson Commercial |
$797.64
|
|
|
PR INCISION LINGUAL FRENUM FRENOTOMY
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS 41010
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$971.54 |
| Rate for Payer: Aetna Commercial |
$137.19
|
| Rate for Payer: Aetna Medicare |
$106.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.43
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$102.38
|
| Rate for Payer: BCBS Trust/PPO |
$971.54
|
| Rate for Payer: BCN Commercial |
$322.04
|
| Rate for Payer: BCN Medicare Advantage |
$102.38
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cofinity Commercial |
$137.19
|
| Rate for Payer: Cofinity Commercial |
$147.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.50
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Nomi Health Commercial |
$122.86
|
| Rate for Payer: PACE SWMI |
$102.38
|
| Rate for Payer: PHP Commercial |
$143.33
|
| Rate for Payer: PHP Medicare Advantage |
$102.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.67
|
| Rate for Payer: Priority Health Medicare |
$102.38
|
| Rate for Payer: Priority Health Narrow Network |
$198.67
|
| Rate for Payer: Priority Health SBD |
$198.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.38
|
| Rate for Payer: UHC Medicare Advantage |
$102.38
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
| Rate for Payer: UMR Bronson Commercial |
$168.36
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMP
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 10121
|
| Min. Negotiated Rate |
$118.22 |
| Max. Negotiated Rate |
$387.52 |
| Rate for Payer: Aetna Commercial |
$234.15
|
| Rate for Payer: Aetna Medicare |
$181.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.63
|
| Rate for Payer: BCBS Complete |
$124.13
|
| Rate for Payer: BCBS MAPPO |
$174.74
|
| Rate for Payer: BCBS Trust/PPO |
$234.52
|
| Rate for Payer: BCN Commercial |
$387.52
|
| Rate for Payer: BCN Medicare Advantage |
$174.74
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$234.15
|
| Rate for Payer: Cofinity Commercial |
$251.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.48
|
| Rate for Payer: Meridian Medicaid |
$124.13
|
| Rate for Payer: Nomi Health Commercial |
$209.69
|
| Rate for Payer: PACE SWMI |
$174.74
|
| Rate for Payer: PHP Commercial |
$244.64
|
| Rate for Payer: PHP Medicare Advantage |
$174.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.24
|
| Rate for Payer: Priority Health Medicare |
$174.74
|
| Rate for Payer: Priority Health Narrow Network |
$249.24
|
| Rate for Payer: Priority Health SBD |
$249.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.74
|
| Rate for Payer: UHC Medicare Advantage |
$174.74
|
| Rate for Payer: UHCCP Medicaid |
$118.22
|
| Rate for Payer: UMR Bronson Commercial |
$230.00
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 10120
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$132.77
|
| Rate for Payer: Aetna Medicare |
$103.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.68
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCBS MAPPO |
$99.08
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: BCN Medicare Advantage |
$99.08
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$132.77
|
| Rate for Payer: Cofinity Commercial |
$142.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.03
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Nomi Health Commercial |
$118.90
|
| Rate for Payer: PACE SWMI |
$99.08
|
| Rate for Payer: PHP Commercial |
$138.71
|
| Rate for Payer: PHP Medicare Advantage |
$99.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.04
|
| Rate for Payer: Priority Health Medicare |
$99.08
|
| Rate for Payer: Priority Health Narrow Network |
$144.04
|
| Rate for Payer: Priority Health SBD |
$144.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.08
|
| Rate for Payer: UHC Medicare Advantage |
$99.08
|
| Rate for Payer: UHCCP Medicaid |
$68.16
|
| Rate for Payer: UMR Bronson Commercial |
$115.46
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
10120
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$92.87 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna American Axle |
$163.15
|
| Rate for Payer: Aetna Commercial |
$213.35
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$418.44
|
| Rate for Payer: BCN Commercial |
$418.44
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$175.70
|
| Rate for Payer: Cofinity Commercial |
$215.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$225.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.25
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.35
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$213.35
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$158.13
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$100.00
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: UMR Bronson Commercial |
$92.87
|
| Rate for Payer: VA VA |
$391.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.25
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Facility
|
IP
|
$251.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
10120
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$110.44 |
| Max. Negotiated Rate |
$225.90 |
| Rate for Payer: Aetna American Axle |
$163.15
|
| Rate for Payer: Aetna Commercial |
$213.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.15
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$175.70
|
| Rate for Payer: Cofinity Commercial |
$215.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.80
|
| Rate for Payer: Healthscope Commercial |
$225.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.35
|
| Rate for Payer: PHP Commercial |
$213.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health SBD |
$158.13
|
| Rate for Payer: UMR Bronson Commercial |
$110.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.25
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 10120
|
| Hospital Charge Code |
10120
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$132.77
|
| Rate for Payer: Aetna Medicare |
$103.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.68
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCBS MAPPO |
$99.08
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: BCN Medicare Advantage |
$99.08
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$142.68
|
| Rate for Payer: Cofinity Commercial |
$132.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.03
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Nomi Health Commercial |
$118.90
|
| Rate for Payer: PACE SWMI |
$99.08
|
| Rate for Payer: PHP Commercial |
$138.71
|
| Rate for Payer: PHP Medicare Advantage |
$99.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.04
|
| Rate for Payer: Priority Health Medicare |
$99.08
|
| Rate for Payer: Priority Health Narrow Network |
$144.04
|
| Rate for Payer: Priority Health SBD |
$144.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.08
|
| Rate for Payer: UHC Medicare Advantage |
$99.08
|
| Rate for Payer: UHCCP Medicaid |
$68.16
|
| Rate for Payer: UMR Bronson Commercial |
$115.46
|
|
|
PR INCISION&SUBCUTANEOUS PLMT CRANIAL BONE GRAFT
|
Professional
|
Both
|
$1,593.00
|
|
|
Service Code
|
HCPCS 61316
|
| Min. Negotiated Rate |
$56.45 |
| Max. Negotiated Rate |
$1,035.45 |
| Rate for Payer: Aetna Commercial |
$116.59
|
| Rate for Payer: Aetna Medicare |
$90.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.29
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS MAPPO |
$87.01
|
| Rate for Payer: BCBS Trust/PPO |
$305.36
|
| Rate for Payer: BCN Commercial |
$177.62
|
| Rate for Payer: BCN Medicare Advantage |
$87.01
|
| Rate for Payer: Cash Price |
$1,274.40
|
| Rate for Payer: Cash Price |
$1,274.40
|
| Rate for Payer: Cofinity Commercial |
$116.59
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.36
|
| Rate for Payer: Meridian Medicaid |
$59.27
|
| Rate for Payer: Nomi Health Commercial |
$104.41
|
| Rate for Payer: PACE SWMI |
$87.01
|
| Rate for Payer: PHP Commercial |
$121.81
|
| Rate for Payer: PHP Medicare Advantage |
$87.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,035.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.58
|
| Rate for Payer: Priority Health Medicare |
$87.01
|
| Rate for Payer: Priority Health Narrow Network |
$149.58
|
| Rate for Payer: Priority Health SBD |
$149.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.01
|
| Rate for Payer: UHC Medicare Advantage |
$87.01
|
| Rate for Payer: UHCCP Medicaid |
$56.45
|
| Rate for Payer: UMR Bronson Commercial |
$732.78
|
|
|
PR INCISION THROMBOSED HEMORRHOID EXTERNAL
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 46083
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$2,366.78 |
| Rate for Payer: Aetna Commercial |
$141.45
|
| Rate for Payer: Aetna Medicare |
$109.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.01
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$105.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,366.78
|
| Rate for Payer: BCN Commercial |
$306.40
|
| Rate for Payer: BCN Medicare Advantage |
$105.56
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$152.01
|
| Rate for Payer: Cofinity Commercial |
$141.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.84
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Nomi Health Commercial |
$126.67
|
| Rate for Payer: PACE SWMI |
$105.56
|
| Rate for Payer: PHP Commercial |
$147.78
|
| Rate for Payer: PHP Medicare Advantage |
$105.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.67
|
| Rate for Payer: Priority Health Medicare |
$105.56
|
| Rate for Payer: Priority Health Narrow Network |
$198.67
|
| Rate for Payer: Priority Health SBD |
$198.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.56
|
| Rate for Payer: UHC Medicare Advantage |
$105.56
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
| Rate for Payer: UMR Bronson Commercial |
$165.14
|
|
|
PR INCOBOTULINUMTOXIN A
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS J0588
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$7.64 |
| Rate for Payer: Aetna Commercial |
$7.11
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$5.19
|
| Rate for Payer: BCN Commercial |
$5.21
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$7.11
|
| Rate for Payer: Cofinity Commercial |
$7.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Nomi Health Commercial |
$6.37
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$7.43
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.20
|
| Rate for Payer: Priority Health Medicare |
$5.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.31
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UMR Bronson Commercial |
$3.68
|
|
|
PR INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 99340
|
| Min. Negotiated Rate |
$87.20 |
| Max. Negotiated Rate |
$141.70 |
| Rate for Payer: Aetna Medicare |
$109.00
|
| Rate for Payer: BCBS Complete |
$87.20
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: UMR Bronson Commercial |
$100.28
|
|
|
PR INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 59856
|
| Min. Negotiated Rate |
$320.99 |
| Max. Negotiated Rate |
$1,248.90 |
| Rate for Payer: Aetna Commercial |
$651.91
|
| Rate for Payer: Aetna Medicare |
$505.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.56
|
| Rate for Payer: BCBS Complete |
$337.04
|
| Rate for Payer: BCBS MAPPO |
$486.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.90
|
| Rate for Payer: BCN Commercial |
$733.51
|
| Rate for Payer: BCN Medicare Advantage |
$486.50
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cofinity Commercial |
$700.56
|
| Rate for Payer: Cofinity Commercial |
$651.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.82
|
| Rate for Payer: Meridian Medicaid |
$337.04
|
| Rate for Payer: Nomi Health Commercial |
$583.80
|
| Rate for Payer: PACE SWMI |
$486.50
|
| Rate for Payer: PHP Commercial |
$681.10
|
| Rate for Payer: PHP Medicare Advantage |
$486.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.30
|
| Rate for Payer: Priority Health Medicare |
$486.50
|
| Rate for Payer: Priority Health Narrow Network |
$703.30
|
| Rate for Payer: Priority Health SBD |
$703.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.50
|
| Rate for Payer: UHC Medicare Advantage |
$486.50
|
| Rate for Payer: UHCCP Medicaid |
$320.99
|
| Rate for Payer: UMR Bronson Commercial |
$422.28
|
|
