|
PR LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 31573
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$877.51 |
| Rate for Payer: Aetna Commercial |
$189.85
|
| Rate for Payer: Aetna Medicare |
$147.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.02
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$141.68
|
| Rate for Payer: BCBS Trust/PPO |
$877.51
|
| Rate for Payer: BCN Commercial |
$423.69
|
| Rate for Payer: BCN Medicare Advantage |
$141.68
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$189.85
|
| Rate for Payer: Cofinity Commercial |
$204.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.76
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: Nomi Health Commercial |
$170.02
|
| Rate for Payer: PACE SWMI |
$141.68
|
| Rate for Payer: PHP Commercial |
$198.35
|
| Rate for Payer: PHP Medicare Advantage |
$141.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.24
|
| Rate for Payer: Priority Health Medicare |
$141.68
|
| Rate for Payer: Priority Health Narrow Network |
$206.24
|
| Rate for Payer: Priority Health SBD |
$206.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.68
|
| Rate for Payer: UHC Medicare Advantage |
$141.68
|
| Rate for Payer: UHCCP Medicaid |
$95.21
|
| Rate for Payer: UMR Bronson Commercial |
$259.90
|
|
|
PR LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES)
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 31576
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$1,520.98 |
| Rate for Payer: Aetna Commercial |
$153.01
|
| Rate for Payer: Aetna Medicare |
$118.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.43
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$114.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,520.98
|
| Rate for Payer: BCN Commercial |
$396.81
|
| Rate for Payer: BCN Medicare Advantage |
$114.19
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cofinity Commercial |
$153.01
|
| Rate for Payer: Cofinity Commercial |
$164.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.90
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Nomi Health Commercial |
$137.03
|
| Rate for Payer: PACE SWMI |
$114.19
|
| Rate for Payer: PHP Commercial |
$159.87
|
| Rate for Payer: PHP Medicare Advantage |
$114.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.92
|
| Rate for Payer: Priority Health Medicare |
$114.19
|
| Rate for Payer: Priority Health Narrow Network |
$165.92
|
| Rate for Payer: Priority Health SBD |
$165.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.19
|
| Rate for Payer: UHC Medicare Advantage |
$114.19
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
| Rate for Payer: UMR Bronson Commercial |
$185.38
|
|
|
PR LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
HCPCS 31579
|
| Min. Negotiated Rate |
$94.58 |
| Max. Negotiated Rate |
$739.09 |
| Rate for Payer: Aetna Commercial |
$152.64
|
| Rate for Payer: Aetna Medicare |
$118.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.03
|
| Rate for Payer: BCBS Complete |
$99.31
|
| Rate for Payer: BCBS MAPPO |
$113.91
|
| Rate for Payer: BCBS Trust/PPO |
$739.09
|
| Rate for Payer: BCN Commercial |
$291.75
|
| Rate for Payer: BCN Medicare Advantage |
$113.91
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cofinity Commercial |
$152.64
|
| Rate for Payer: Cofinity Commercial |
$164.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.61
|
| Rate for Payer: Meridian Medicaid |
$99.31
|
| Rate for Payer: Nomi Health Commercial |
$136.69
|
| Rate for Payer: PACE SWMI |
$113.91
|
| Rate for Payer: PHP Commercial |
$159.47
|
| Rate for Payer: PHP Medicare Advantage |
$113.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.92
|
| Rate for Payer: Priority Health Medicare |
$113.91
|
| Rate for Payer: Priority Health Narrow Network |
$165.92
|
| Rate for Payer: Priority Health SBD |
$165.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.91
|
| Rate for Payer: UHC Medicare Advantage |
$113.91
|
| Rate for Payer: UHCCP Medicaid |
$94.58
|
| Rate for Payer: UMR Bronson Commercial |
$176.64
|
|
|
PR LARYNGOSCOPY FLX RMVL FOREIGN BODY(S)
|
Professional
|
Both
|
$411.00
|
|
|
Service Code
|
HCPCS 31577
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$408.05 |
| Rate for Payer: Aetna Commercial |
$170.93
|
| Rate for Payer: Aetna Medicare |
$132.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.69
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$127.56
|
| Rate for Payer: BCBS Trust/PPO |
$395.70
|
| Rate for Payer: BCN Commercial |
$408.05
|
| Rate for Payer: BCN Medicare Advantage |
$127.56
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cofinity Commercial |
$170.93
|
| Rate for Payer: Cofinity Commercial |
$183.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.94
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Nomi Health Commercial |
$153.07
|
| Rate for Payer: PACE SWMI |
$127.56
|
| Rate for Payer: PHP Commercial |
$178.58
|
| Rate for Payer: PHP Medicare Advantage |
$127.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.93
|
| Rate for Payer: Priority Health Medicare |
$127.56
|
| Rate for Payer: Priority Health Narrow Network |
$184.93
|
| Rate for Payer: Priority Health SBD |
$184.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.56
|
| Rate for Payer: UHC Medicare Advantage |
$127.56
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
| Rate for Payer: UMR Bronson Commercial |
$189.06
|
|
|
PR LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 31531
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,325.50 |
| Rate for Payer: Aetna Commercial |
$268.87
|
| Rate for Payer: Aetna Medicare |
$208.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.94
|
| Rate for Payer: BCBS Complete |
$141.12
|
| Rate for Payer: BCBS MAPPO |
$200.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,325.50
|
| Rate for Payer: BCN Commercial |
$307.38
|
| Rate for Payer: BCN Medicare Advantage |
$200.65
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cofinity Commercial |
$268.87
|
| Rate for Payer: Cofinity Commercial |
$288.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.68
|
| Rate for Payer: Meridian Medicaid |
$141.12
|
| Rate for Payer: Nomi Health Commercial |
$240.78
|
| Rate for Payer: PACE SWMI |
$200.65
|
| Rate for Payer: PHP Commercial |
$280.91
|
| Rate for Payer: PHP Medicare Advantage |
$200.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.52
|
| Rate for Payer: Priority Health Medicare |
$200.65
|
| Rate for Payer: Priority Health Narrow Network |
$291.52
|
| Rate for Payer: Priority Health SBD |
$291.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.65
|
| Rate for Payer: UHC Medicare Advantage |
$200.65
|
| Rate for Payer: UHCCP Medicaid |
$134.40
|
| Rate for Payer: UMR Bronson Commercial |
$213.44
|
|
|
PR LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 31505
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$1,167.54 |
| Rate for Payer: Aetna Commercial |
$62.38
|
| Rate for Payer: Aetna Medicare |
$48.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.03
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCBS MAPPO |
$46.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.54
|
| Rate for Payer: BCN Commercial |
$133.41
|
| Rate for Payer: BCN Medicare Advantage |
$46.55
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$67.03
|
| Rate for Payer: Cofinity Commercial |
$62.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.88
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Nomi Health Commercial |
$55.86
|
| Rate for Payer: PACE SWMI |
$46.55
|
| Rate for Payer: PHP Commercial |
$65.17
|
| Rate for Payer: PHP Medicare Advantage |
$46.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.06
|
| Rate for Payer: Priority Health Medicare |
$46.55
|
| Rate for Payer: Priority Health Narrow Network |
$69.06
|
| Rate for Payer: Priority Health SBD |
$69.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.55
|
| Rate for Payer: UHC Medicare Advantage |
$46.55
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
| Rate for Payer: UMR Bronson Commercial |
$97.06
|
|
|
PR LARYNGOSCOPY INDIRECT W/BIOPSY
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 31510
|
| Min. Negotiated Rate |
$115.75 |
| Max. Negotiated Rate |
$1,254.71 |
| Rate for Payer: Aetna Commercial |
$155.10
|
| Rate for Payer: Aetna Medicare |
$120.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.68
|
| Rate for Payer: BCBS Complete |
$177.20
|
| Rate for Payer: BCBS MAPPO |
$115.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.71
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$115.75
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cofinity Commercial |
$166.68
|
| Rate for Payer: Cofinity Commercial |
$155.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.54
|
| Rate for Payer: Nomi Health Commercial |
$138.90
|
| Rate for Payer: PACE SWMI |
$115.75
|
| Rate for Payer: PHP Commercial |
$162.05
|
| Rate for Payer: PHP Medicare Advantage |
$115.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.23
|
| Rate for Payer: Priority Health Medicare |
$115.75
|
| Rate for Payer: Priority Health Narrow Network |
$168.23
|
| Rate for Payer: Priority Health SBD |
$168.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.75
|
| Rate for Payer: UHC Medicare Advantage |
$115.75
|
| Rate for Payer: UMR Bronson Commercial |
$203.78
|
|
|
PR LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 31511
|
| Min. Negotiated Rate |
$127.52 |
| Max. Negotiated Rate |
$1,223.54 |
| Rate for Payer: Aetna Commercial |
$170.88
|
| Rate for Payer: Aetna Medicare |
$132.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.63
|
| Rate for Payer: BCBS Complete |
$228.00
|
| Rate for Payer: BCBS MAPPO |
$127.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,223.54
|
| Rate for Payer: BCN Commercial |
$309.82
|
| Rate for Payer: BCN Medicare Advantage |
$127.52
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$183.63
|
| Rate for Payer: Cofinity Commercial |
$170.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.90
|
| Rate for Payer: Nomi Health Commercial |
$153.02
|
| Rate for Payer: PACE SWMI |
$127.52
|
| Rate for Payer: PHP Commercial |
$178.53
|
| Rate for Payer: PHP Medicare Advantage |
$127.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$370.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.78
|
| Rate for Payer: Priority Health Medicare |
$127.52
|
| Rate for Payer: Priority Health Narrow Network |
$186.78
|
| Rate for Payer: Priority Health SBD |
$186.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.52
|
| Rate for Payer: UHC Medicare Advantage |
$127.52
|
| Rate for Payer: UMR Bronson Commercial |
$262.20
|
|
|
PR LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 31536
|
| Min. Negotiated Rate |
$133.98 |
| Max. Negotiated Rate |
$987.92 |
| Rate for Payer: Aetna Commercial |
$267.85
|
| Rate for Payer: Aetna Medicare |
$207.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.85
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS MAPPO |
$199.89
|
| Rate for Payer: BCBS Trust/PPO |
$987.92
|
| Rate for Payer: BCN Commercial |
$305.43
|
| Rate for Payer: BCN Medicare Advantage |
$199.89
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cofinity Commercial |
$287.84
|
| Rate for Payer: Cofinity Commercial |
$267.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.88
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Nomi Health Commercial |
$239.87
|
| Rate for Payer: PACE SWMI |
$199.89
|
| Rate for Payer: PHP Commercial |
$279.85
|
| Rate for Payer: PHP Medicare Advantage |
$199.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$617.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.13
|
| Rate for Payer: Priority Health Medicare |
$199.89
|
| Rate for Payer: Priority Health Narrow Network |
$290.13
|
| Rate for Payer: Priority Health SBD |
$290.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.89
|
| Rate for Payer: UHC Medicare Advantage |
$199.89
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
| Rate for Payer: UMR Bronson Commercial |
$437.00
|
|
|
PR LARYNGOSCOPY W/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 31530
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$1,856.45 |
| Rate for Payer: Aetna Commercial |
$254.28
|
| Rate for Payer: Aetna Medicare |
$197.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.25
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$189.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,856.45
|
| Rate for Payer: BCN Commercial |
$288.81
|
| Rate for Payer: BCN Medicare Advantage |
$189.76
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$254.28
|
| Rate for Payer: Cofinity Commercial |
$273.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.25
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Nomi Health Commercial |
$227.71
|
| Rate for Payer: PACE SWMI |
$189.76
|
| Rate for Payer: PHP Commercial |
$265.66
|
| Rate for Payer: PHP Medicare Advantage |
$189.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.83
|
| Rate for Payer: Priority Health Medicare |
$189.76
|
| Rate for Payer: Priority Health Narrow Network |
$274.83
|
| Rate for Payer: Priority Health SBD |
$274.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.76
|
| Rate for Payer: UHC Medicare Advantage |
$189.76
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
| Rate for Payer: UMR Bronson Commercial |
$167.44
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 31515
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$142.29
|
| Rate for Payer: Aetna Medicare |
$110.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.91
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS MAPPO |
$106.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$316.66
|
| Rate for Payer: BCN Medicare Advantage |
$106.19
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$142.29
|
| Rate for Payer: Cofinity Commercial |
$152.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.50
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Nomi Health Commercial |
$127.43
|
| Rate for Payer: PACE SWMI |
$106.19
|
| Rate for Payer: PHP Commercial |
$148.67
|
| Rate for Payer: PHP Medicare Advantage |
$106.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.86
|
| Rate for Payer: Priority Health Medicare |
$106.19
|
| Rate for Payer: Priority Health Narrow Network |
$153.86
|
| Rate for Payer: Priority Health SBD |
$153.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.19
|
| Rate for Payer: UHC Medicare Advantage |
$106.19
|
| Rate for Payer: UHCCP Medicaid |
$71.36
|
| Rate for Payer: UMR Bronson Commercial |
$171.12
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 31529
|
| Min. Negotiated Rate |
$102.88 |
| Max. Negotiated Rate |
$1,150.11 |
| Rate for Payer: Aetna Commercial |
$205.49
|
| Rate for Payer: Aetna Medicare |
$159.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.82
|
| Rate for Payer: BCBS Complete |
$108.02
|
| Rate for Payer: BCBS MAPPO |
$153.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,150.11
|
| Rate for Payer: BCN Commercial |
$233.10
|
| Rate for Payer: BCN Medicare Advantage |
$153.35
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$205.49
|
| Rate for Payer: Cofinity Commercial |
$220.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.02
|
| Rate for Payer: Meridian Medicaid |
$108.02
|
| Rate for Payer: Nomi Health Commercial |
$184.02
|
| Rate for Payer: PACE SWMI |
$153.35
|
| Rate for Payer: PHP Commercial |
$214.69
|
| Rate for Payer: PHP Medicare Advantage |
$153.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.92
|
| Rate for Payer: Priority Health Medicare |
$153.35
|
| Rate for Payer: Priority Health Narrow Network |
$222.92
|
| Rate for Payer: Priority Health SBD |
$222.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.35
|
| Rate for Payer: UHC Medicare Advantage |
$153.35
|
| Rate for Payer: UHCCP Medicaid |
$102.88
|
| Rate for Payer: UMR Bronson Commercial |
$150.88
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN
|
Professional
|
Both
|
$624.00
|
|
|
Service Code
|
HCPCS 31525
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$1,289.05 |
| Rate for Payer: Aetna Commercial |
$204.51
|
| Rate for Payer: Aetna Medicare |
$158.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.77
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$152.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.05
|
| Rate for Payer: BCN Commercial |
$367.97
|
| Rate for Payer: BCN Medicare Advantage |
$152.62
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cofinity Commercial |
$204.51
|
| Rate for Payer: Cofinity Commercial |
$219.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.25
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Nomi Health Commercial |
$183.14
|
| Rate for Payer: PACE SWMI |
$152.62
|
| Rate for Payer: PHP Commercial |
$213.67
|
| Rate for Payer: PHP Medicare Advantage |
$152.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.00
|
| Rate for Payer: Priority Health Medicare |
$152.62
|
| Rate for Payer: Priority Health Narrow Network |
$222.00
|
| Rate for Payer: Priority Health SBD |
$222.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.62
|
| Rate for Payer: UHC Medicare Advantage |
$152.62
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
| Rate for Payer: UMR Bronson Commercial |
$287.04
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 31528
|
| Min. Negotiated Rate |
$92.44 |
| Max. Negotiated Rate |
$1,317.05 |
| Rate for Payer: Aetna Commercial |
$184.49
|
| Rate for Payer: Aetna Medicare |
$143.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.26
|
| Rate for Payer: BCBS Complete |
$97.06
|
| Rate for Payer: BCBS MAPPO |
$137.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| Rate for Payer: BCN Commercial |
$209.64
|
| Rate for Payer: BCN Medicare Advantage |
$137.68
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$184.49
|
| Rate for Payer: Cofinity Commercial |
$198.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.56
|
| Rate for Payer: Meridian Medicaid |
$97.06
|
| Rate for Payer: Nomi Health Commercial |
$165.22
|
| Rate for Payer: PACE SWMI |
$137.68
|
| Rate for Payer: PHP Commercial |
$192.75
|
| Rate for Payer: PHP Medicare Advantage |
$137.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.76
|
| Rate for Payer: Priority Health Medicare |
$137.68
|
| Rate for Payer: Priority Health Narrow Network |
$199.76
|
| Rate for Payer: Priority Health SBD |
$199.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.68
|
| Rate for Payer: UHC Medicare Advantage |
$137.68
|
| Rate for Payer: UHCCP Medicaid |
$92.44
|
| Rate for Payer: UMR Bronson Commercial |
$364.32
|
|
|
PR LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 31526
|
| Min. Negotiated Rate |
$100.75 |
| Max. Negotiated Rate |
$1,251.54 |
| Rate for Payer: Aetna Commercial |
$201.12
|
| Rate for Payer: Aetna Medicare |
$156.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.13
|
| Rate for Payer: BCBS Complete |
$105.79
|
| Rate for Payer: BCBS MAPPO |
$150.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.54
|
| Rate for Payer: BCN Commercial |
$227.73
|
| Rate for Payer: BCN Medicare Advantage |
$150.09
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$201.12
|
| Rate for Payer: Cofinity Commercial |
$216.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.59
|
| Rate for Payer: Meridian Medicaid |
$105.79
|
| Rate for Payer: Nomi Health Commercial |
$180.11
|
| Rate for Payer: PACE SWMI |
$150.09
|
| Rate for Payer: PHP Commercial |
$210.13
|
| Rate for Payer: PHP Medicare Advantage |
$150.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.37
|
| Rate for Payer: Priority Health Medicare |
$150.09
|
| Rate for Payer: Priority Health Narrow Network |
$217.37
|
| Rate for Payer: Priority Health SBD |
$217.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.09
|
| Rate for Payer: UHC Medicare Advantage |
$150.09
|
| Rate for Payer: UHCCP Medicaid |
$100.75
|
| Rate for Payer: UMR Bronson Commercial |
$148.12
|
|
|
PR LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY
|
Professional
|
Both
|
$2,271.00
|
|
|
Service Code
|
HCPCS 31300
|
| Min. Negotiated Rate |
$800.24 |
| Max. Negotiated Rate |
$1,841.33 |
| Rate for Payer: Aetna Commercial |
$1,571.12
|
| Rate for Payer: Aetna Medicare |
$1,219.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,688.37
|
| Rate for Payer: BCBS Complete |
$840.25
|
| Rate for Payer: BCBS MAPPO |
$1,172.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,537.35
|
| Rate for Payer: BCN Commercial |
$1,841.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,172.48
|
| Rate for Payer: Cash Price |
$1,816.80
|
| Rate for Payer: Cash Price |
$1,816.80
|
| Rate for Payer: Cofinity Commercial |
$1,571.12
|
| Rate for Payer: Cofinity Commercial |
$1,688.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,172.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,231.10
|
| Rate for Payer: Meridian Medicaid |
$840.25
|
| Rate for Payer: Nomi Health Commercial |
$1,406.98
|
| Rate for Payer: PACE SWMI |
$1,172.48
|
| Rate for Payer: PHP Commercial |
$1,641.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,172.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$800.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,476.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,743.57
|
| Rate for Payer: Priority Health Medicare |
$1,172.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,743.57
|
| Rate for Payer: Priority Health SBD |
$1,743.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,172.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,172.48
|
| Rate for Payer: UHCCP Medicaid |
$800.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,044.66
|
|
|
PR LASER CO2 - FULL FACE
|
Professional
|
Both
|
$2,805.00
|
|
|
Service Code
|
HCPCS 00263
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,122.00 |
| Max. Negotiated Rate |
$1,823.25 |
| Rate for Payer: Aetna Medicare |
$1,402.50
|
| Rate for Payer: BCBS Complete |
$1,122.00
|
| Rate for Payer: Cash Price |
$2,244.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,823.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,290.30
|
|
|
PR LASER CO2 - ONE AREA
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 00181
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$1,160.25 |
| Rate for Payer: Aetna Medicare |
$892.50
|
| Rate for Payer: BCBS Complete |
$714.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.25
|
| Rate for Payer: UMR Bronson Commercial |
$821.10
|
|
|
PR LASER CO2 - TWO AREAS
|
Professional
|
Both
|
$2,295.00
|
|
|
Service Code
|
HCPCS 00182
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$918.00 |
| Max. Negotiated Rate |
$1,491.75 |
| Rate for Payer: Aetna Medicare |
$1,147.50
|
| Rate for Payer: BCBS Complete |
$918.00
|
| Rate for Payer: Cash Price |
$1,836.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,491.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,055.70
|
|
|
PR LASER ENUCLEATION PROSTATE W/MORCELLATION
|
Professional
|
Both
|
$1,709.00
|
|
|
Service Code
|
HCPCS 52649
|
| Min. Negotiated Rate |
$528.03 |
| Max. Negotiated Rate |
$1,312.32 |
| Rate for Payer: Aetna Commercial |
$1,055.14
|
| Rate for Payer: Aetna Medicare |
$818.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.88
|
| Rate for Payer: BCBS Complete |
$554.43
|
| Rate for Payer: BCBS MAPPO |
$787.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.05
|
| Rate for Payer: BCN Commercial |
$1,189.93
|
| Rate for Payer: BCN Medicare Advantage |
$787.42
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cofinity Commercial |
$1,055.14
|
| Rate for Payer: Cofinity Commercial |
$1,133.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.79
|
| Rate for Payer: Meridian Medicaid |
$554.43
|
| Rate for Payer: Nomi Health Commercial |
$944.90
|
| Rate for Payer: PACE SWMI |
$787.42
|
| Rate for Payer: PHP Commercial |
$1,102.39
|
| Rate for Payer: PHP Medicare Advantage |
$787.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,312.32
|
| Rate for Payer: Priority Health Medicare |
$787.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,312.32
|
| Rate for Payer: Priority Health SBD |
$1,312.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.42
|
| Rate for Payer: UHC Medicare Advantage |
$787.42
|
| Rate for Payer: UHCCP Medicaid |
$528.03
|
| Rate for Payer: UMR Bronson Commercial |
$786.14
|
|
|
PR LASER VAPORIZATION OF PROSTATE FOR URINE FLOW
|
Professional
|
Both
|
$3,308.00
|
|
|
Service Code
|
HCPCS 52648
|
| Min. Negotiated Rate |
$444.32 |
| Max. Negotiated Rate |
$2,363.74 |
| Rate for Payer: Aetna Commercial |
$887.25
|
| Rate for Payer: Aetna Medicare |
$688.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$887.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$953.47
|
| Rate for Payer: BCBS Complete |
$466.54
|
| Rate for Payer: BCBS MAPPO |
$662.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,272.67
|
| Rate for Payer: BCN Commercial |
$2,363.74
|
| Rate for Payer: BCN Medicare Advantage |
$662.13
|
| Rate for Payer: Cash Price |
$2,646.40
|
| Rate for Payer: Cash Price |
$2,646.40
|
| Rate for Payer: Cofinity Commercial |
$887.25
|
| Rate for Payer: Cofinity Commercial |
$953.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$662.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$695.24
|
| Rate for Payer: Meridian Medicaid |
$466.54
|
| Rate for Payer: Nomi Health Commercial |
$794.56
|
| Rate for Payer: PACE SWMI |
$662.13
|
| Rate for Payer: PHP Commercial |
$926.98
|
| Rate for Payer: PHP Medicare Advantage |
$662.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,150.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,103.55
|
| Rate for Payer: Priority Health Medicare |
$662.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,103.55
|
| Rate for Payer: Priority Health SBD |
$1,103.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$662.13
|
| Rate for Payer: UHC Medicare Advantage |
$662.13
|
| Rate for Payer: UHCCP Medicaid |
$444.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,521.68
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Facility
|
IP
|
$1,697.00
|
|
|
Service Code
|
CPT 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$746.68 |
| Max. Negotiated Rate |
$1,527.30 |
| Rate for Payer: Aetna American Axle |
$1,103.05
|
| Rate for Payer: Aetna Commercial |
$1,442.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.05
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cofinity Commercial |
$1,187.90
|
| Rate for Payer: Cofinity Commercial |
$1,459.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,187.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,357.60
|
| Rate for Payer: Healthscope Commercial |
$1,527.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,187.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,272.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,442.45
|
| Rate for Payer: PHP Commercial |
$1,442.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.05
|
| Rate for Payer: Priority Health SBD |
$1,069.11
|
| Rate for Payer: UMR Bronson Commercial |
$746.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,272.75
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Professional
|
Both
|
$1,697.00
|
|
|
Service Code
|
HCPCS 27425
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,208.75 |
| Rate for Payer: Aetna Commercial |
$589.65
|
| Rate for Payer: Aetna Medicare |
$457.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.66
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$440.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.75
|
| Rate for Payer: BCN Commercial |
$741.46
|
| Rate for Payer: BCN Medicare Advantage |
$440.04
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cofinity Commercial |
$589.65
|
| Rate for Payer: Cofinity Commercial |
$633.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.04
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Nomi Health Commercial |
$528.05
|
| Rate for Payer: PACE SWMI |
$440.04
|
| Rate for Payer: PHP Commercial |
$616.06
|
| Rate for Payer: PHP Medicare Advantage |
$440.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$710.36
|
| Rate for Payer: Priority Health Medicare |
$440.04
|
| Rate for Payer: Priority Health Narrow Network |
$710.36
|
| Rate for Payer: Priority Health SBD |
$710.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.04
|
| Rate for Payer: UHC Medicare Advantage |
$440.04
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
| Rate for Payer: UMR Bronson Commercial |
$780.62
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Professional
|
Both
|
$1,697.00
|
|
|
Service Code
|
HCPCS 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,208.75 |
| Rate for Payer: Aetna Commercial |
$589.65
|
| Rate for Payer: Aetna Medicare |
$457.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$633.66
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$440.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.75
|
| Rate for Payer: BCN Commercial |
$741.46
|
| Rate for Payer: BCN Medicare Advantage |
$440.04
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cofinity Commercial |
$633.66
|
| Rate for Payer: Cofinity Commercial |
$589.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.04
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Nomi Health Commercial |
$528.05
|
| Rate for Payer: PACE SWMI |
$440.04
|
| Rate for Payer: PHP Commercial |
$616.06
|
| Rate for Payer: PHP Medicare Advantage |
$440.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$710.36
|
| Rate for Payer: Priority Health Medicare |
$440.04
|
| Rate for Payer: Priority Health Narrow Network |
$710.36
|
| Rate for Payer: Priority Health SBD |
$710.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.04
|
| Rate for Payer: UHC Medicare Advantage |
$440.04
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
| Rate for Payer: UMR Bronson Commercial |
$780.62
|
|
|
PR LATERAL RETINACULAR RELEASE OPEN
|
Facility
|
OP
|
$1,697.00
|
|
|
Service Code
|
CPT 27425
|
| Hospital Charge Code |
27425
|
| Min. Negotiated Rate |
$441.66 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna American Axle |
$1,103.05
|
| Rate for Payer: Aetna Commercial |
$1,442.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,214.78
|
| Rate for Payer: BCN Commercial |
$2,214.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cash Price |
$1,357.60
|
| Rate for Payer: Cofinity Commercial |
$1,459.42
|
| Rate for Payer: Cofinity Commercial |
$1,187.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,187.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,357.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,527.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,187.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,272.75
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,442.45
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,442.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$1,069.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.83
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$441.66
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$627.89
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,272.75
|
|
