|
PR LIGATION/BIOPSY TEMPORAL ARTERY
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
37609
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$196.64 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$585.00
|
| Rate for Payer: Aetna Commercial |
$765.00
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.00
|
| 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 |
$2,832.84
|
| Rate for Payer: BCN Commercial |
$2,832.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$630.00
|
| Rate for Payer: Cofinity Commercial |
$774.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$630.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$810.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$630.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.00
|
| 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 |
$765.00
|
| 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 |
$765.00
|
| 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 |
$585.00
|
| 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 |
$567.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.30
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$196.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$333.00
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.00
|
|
|
PR LIGATION DIRECT ESOPHAGEAL VARICES
|
Professional
|
Both
|
$3,134.00
|
|
|
Service Code
|
HCPCS 43400
|
| Min. Negotiated Rate |
$977.46 |
| Max. Negotiated Rate |
$2,724.05 |
| Rate for Payer: Aetna Commercial |
$1,984.83
|
| Rate for Payer: Aetna Medicare |
$1,540.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,132.96
|
| Rate for Payer: BCBS Complete |
$1,026.33
|
| Rate for Payer: BCBS MAPPO |
$1,481.22
|
| Rate for Payer: BCBS Trust/PPO |
$986.56
|
| Rate for Payer: BCN Commercial |
$2,221.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,481.22
|
| Rate for Payer: Cash Price |
$2,507.20
|
| Rate for Payer: Cash Price |
$2,507.20
|
| Rate for Payer: Cofinity Commercial |
$1,984.83
|
| Rate for Payer: Cofinity Commercial |
$2,132.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,481.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,555.28
|
| Rate for Payer: Meridian Medicaid |
$1,026.33
|
| Rate for Payer: Nomi Health Commercial |
$1,777.46
|
| Rate for Payer: PACE SWMI |
$1,481.22
|
| Rate for Payer: PHP Commercial |
$2,073.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,481.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$977.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,037.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,724.05
|
| Rate for Payer: Priority Health Medicare |
$1,481.22
|
| Rate for Payer: Priority Health Narrow Network |
$2,724.05
|
| Rate for Payer: Priority Health SBD |
$2,724.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,481.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,481.22
|
| Rate for Payer: UHCCP Medicaid |
$977.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,441.64
|
|
|
PR LIGATION HEMORRHOID BUNDLE W/US
|
Professional
|
Both
|
$2,091.00
|
|
|
Service Code
|
HCPCS 0249T
|
| Min. Negotiated Rate |
$836.40 |
| Max. Negotiated Rate |
$1,359.15 |
| Rate for Payer: Aetna Medicare |
$1,045.50
|
| Rate for Payer: BCBS Complete |
$836.40
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.15
|
| Rate for Payer: UMR Bronson Commercial |
$961.86
|
|
|
PR LIGATION INTERNAL/COMMON CAROTID ARTERY
|
Professional
|
Both
|
$1,996.00
|
|
|
Service Code
|
HCPCS 37605
|
| Min. Negotiated Rate |
$463.49 |
| Max. Negotiated Rate |
$1,342.94 |
| Rate for Payer: Aetna Commercial |
$954.17
|
| Rate for Payer: Aetna Medicare |
$740.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$954.17
|
| Rate for Payer: BCBS Complete |
$486.66
|
| Rate for Payer: BCBS MAPPO |
$712.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.94
|
| Rate for Payer: BCN Commercial |
$1,055.06
|
| Rate for Payer: BCN Medicare Advantage |
$712.07
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cash Price |
$1,596.80
|
| Rate for Payer: Cofinity Commercial |
$954.17
|
| Rate for Payer: Cofinity Commercial |
$1,025.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$747.67
|
| Rate for Payer: Meridian Medicaid |
$486.66
|
| Rate for Payer: Nomi Health Commercial |
$854.48
|
| Rate for Payer: PACE SWMI |
$712.07
|
| Rate for Payer: PHP Commercial |
$996.90
|
| Rate for Payer: PHP Medicare Advantage |
$712.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.59
|
| Rate for Payer: Priority Health Medicare |
$712.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.59
|
| Rate for Payer: Priority Health SBD |
$1,154.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$712.07
|
| Rate for Payer: UHC Medicare Advantage |
$712.07
|
| Rate for Payer: UHCCP Medicaid |
$463.49
|
| Rate for Payer: UMR Bronson Commercial |
$918.16
|
|
|
PR LIGATION INTERNAL JUGULAR VEIN
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 37565
|
| Min. Negotiated Rate |
$463.28 |
| Max. Negotiated Rate |
$1,155.66 |
| Rate for Payer: Aetna Commercial |
$931.89
|
| Rate for Payer: Aetna Medicare |
$723.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.89
|
| Rate for Payer: BCBS Complete |
$486.44
|
| Rate for Payer: BCBS MAPPO |
$695.44
|
| Rate for Payer: BCN Commercial |
$1,057.01
|
| Rate for Payer: BCN Medicare Advantage |
$695.44
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cofinity Commercial |
$1,001.43
|
| Rate for Payer: Cofinity Commercial |
$931.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.21
|
| Rate for Payer: Meridian Medicaid |
$486.44
|
| Rate for Payer: Nomi Health Commercial |
$834.53
|
| Rate for Payer: PACE SWMI |
$695.44
|
| Rate for Payer: PHP Commercial |
$973.62
|
| Rate for Payer: PHP Medicare Advantage |
$695.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,155.66
|
| Rate for Payer: Priority Health Medicare |
$695.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,155.66
|
| Rate for Payer: Priority Health SBD |
$1,155.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.44
|
| Rate for Payer: UHC Medicare Advantage |
$695.44
|
| Rate for Payer: UHCCP Medicaid |
$463.28
|
| Rate for Payer: UMR Bronson Commercial |
$697.36
|
|
|
PR LIGATION MAJOR ARTERY ABDOMEN
|
Professional
|
Both
|
$3,271.00
|
|
|
Service Code
|
HCPCS 37617
|
| Min. Negotiated Rate |
$839.01 |
| Max. Negotiated Rate |
$2,126.15 |
| Rate for Payer: Aetna Commercial |
$1,709.28
|
| Rate for Payer: Aetna Medicare |
$1,326.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,836.84
|
| Rate for Payer: BCBS Complete |
$880.96
|
| Rate for Payer: BCBS MAPPO |
$1,275.58
|
| Rate for Payer: BCBS Trust/PPO |
$999.54
|
| Rate for Payer: BCN Commercial |
$1,902.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.58
|
| Rate for Payer: Cash Price |
$2,616.80
|
| Rate for Payer: Cash Price |
$2,616.80
|
| Rate for Payer: Cofinity Commercial |
$1,709.28
|
| Rate for Payer: Cofinity Commercial |
$1,836.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.36
|
| Rate for Payer: Meridian Medicaid |
$880.96
|
| Rate for Payer: Nomi Health Commercial |
$1,530.70
|
| Rate for Payer: PACE SWMI |
$1,275.58
|
| Rate for Payer: PHP Commercial |
$1,785.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,090.60
|
| Rate for Payer: Priority Health Medicare |
$1,275.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,090.60
|
| Rate for Payer: Priority Health SBD |
$2,090.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,275.58
|
| Rate for Payer: UHCCP Medicaid |
$839.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,504.66
|
|
|
PR LIGATION MAJOR ARTERY CHEST
|
Professional
|
Both
|
$3,387.00
|
|
|
Service Code
|
HCPCS 37616
|
| Min. Negotiated Rate |
$727.40 |
| Max. Negotiated Rate |
$2,201.55 |
| Rate for Payer: Aetna Commercial |
$1,474.23
|
| Rate for Payer: Aetna Medicare |
$1,144.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,474.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,584.24
|
| Rate for Payer: BCBS Complete |
$763.77
|
| Rate for Payer: BCBS MAPPO |
$1,100.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.22
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,100.17
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cash Price |
$2,709.60
|
| Rate for Payer: Cofinity Commercial |
$1,474.23
|
| Rate for Payer: Cofinity Commercial |
$1,584.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,100.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,155.18
|
| Rate for Payer: Meridian Medicaid |
$763.77
|
| Rate for Payer: Nomi Health Commercial |
$1,320.20
|
| Rate for Payer: PACE SWMI |
$1,100.17
|
| Rate for Payer: PHP Commercial |
$1,540.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,100.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$727.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,201.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,781.61
|
| Rate for Payer: Priority Health Medicare |
$1,100.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,781.61
|
| Rate for Payer: Priority Health SBD |
$1,781.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,100.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,100.17
|
| Rate for Payer: UHCCP Medicaid |
$727.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,558.02
|
|
|
PR LIGATION MAJOR ARTERY EXTREMITY
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 37618
|
| Min. Negotiated Rate |
$249.64 |
| Max. Negotiated Rate |
$848.45 |
| Rate for Payer: Aetna Commercial |
$502.06
|
| Rate for Payer: Aetna Medicare |
$389.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.52
|
| Rate for Payer: BCBS Complete |
$262.12
|
| Rate for Payer: BCBS MAPPO |
$374.67
|
| Rate for Payer: BCBS Trust/PPO |
$848.45
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: BCN Medicare Advantage |
$374.67
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$502.06
|
| Rate for Payer: Cofinity Commercial |
$539.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.40
|
| Rate for Payer: Meridian Medicaid |
$262.12
|
| Rate for Payer: Nomi Health Commercial |
$449.60
|
| Rate for Payer: PACE SWMI |
$374.67
|
| Rate for Payer: PHP Commercial |
$524.54
|
| Rate for Payer: PHP Medicare Advantage |
$374.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$699.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$623.83
|
| Rate for Payer: Priority Health Medicare |
$374.67
|
| Rate for Payer: Priority Health Narrow Network |
$623.83
|
| Rate for Payer: Priority Health SBD |
$623.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.67
|
| Rate for Payer: UHC Medicare Advantage |
$374.67
|
| Rate for Payer: UHCCP Medicaid |
$249.64
|
| Rate for Payer: UMR Bronson Commercial |
$494.96
|
|
|
PR LIGATION MAJOR ARTERY NECK
|
Professional
|
Both
|
$1,213.00
|
|
|
Service Code
|
HCPCS 37615
|
| Min. Negotiated Rate |
$331.00 |
| Max. Negotiated Rate |
$1,021.20 |
| Rate for Payer: Aetna Commercial |
$660.74
|
| Rate for Payer: Aetna Medicare |
$512.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$710.05
|
| Rate for Payer: BCBS Complete |
$347.55
|
| Rate for Payer: BCBS MAPPO |
$493.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.20
|
| Rate for Payer: BCN Commercial |
$750.61
|
| Rate for Payer: BCN Medicare Advantage |
$493.09
|
| Rate for Payer: Cash Price |
$970.40
|
| Rate for Payer: Cash Price |
$970.40
|
| Rate for Payer: Cofinity Commercial |
$660.74
|
| Rate for Payer: Cofinity Commercial |
$710.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.74
|
| Rate for Payer: Meridian Medicaid |
$347.55
|
| Rate for Payer: Nomi Health Commercial |
$591.71
|
| Rate for Payer: PACE SWMI |
$493.09
|
| Rate for Payer: PHP Commercial |
$690.33
|
| Rate for Payer: PHP Medicare Advantage |
$493.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.67
|
| Rate for Payer: Priority Health Medicare |
$493.09
|
| Rate for Payer: Priority Health Narrow Network |
$821.67
|
| Rate for Payer: Priority Health SBD |
$821.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$493.09
|
| Rate for Payer: UHC Medicare Advantage |
$493.09
|
| Rate for Payer: UHCCP Medicaid |
$331.00
|
| Rate for Payer: UMR Bronson Commercial |
$557.98
|
|
|
PR LIGATION OF FEMORAL VEIN
|
Professional
|
Both
|
$1,679.00
|
|
|
Service Code
|
HCPCS 37650
|
| Min. Negotiated Rate |
$290.32 |
| Max. Negotiated Rate |
$1,285.88 |
| Rate for Payer: Aetna Commercial |
$594.92
|
| Rate for Payer: Aetna Medicare |
$461.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.32
|
| Rate for Payer: BCBS Complete |
$304.84
|
| Rate for Payer: BCBS MAPPO |
$443.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.88
|
| Rate for Payer: BCN Commercial |
$658.74
|
| Rate for Payer: BCN Medicare Advantage |
$443.97
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cash Price |
$1,343.20
|
| Rate for Payer: Cofinity Commercial |
$594.92
|
| Rate for Payer: Cofinity Commercial |
$639.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$466.17
|
| Rate for Payer: Meridian Medicaid |
$304.84
|
| Rate for Payer: Nomi Health Commercial |
$532.76
|
| Rate for Payer: PACE SWMI |
$443.97
|
| Rate for Payer: PHP Commercial |
$621.56
|
| Rate for Payer: PHP Medicare Advantage |
$443.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,091.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.16
|
| Rate for Payer: Priority Health Medicare |
$443.97
|
| Rate for Payer: Priority Health Narrow Network |
$721.16
|
| Rate for Payer: Priority Health SBD |
$721.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.97
|
| Rate for Payer: UHC Medicare Advantage |
$443.97
|
| Rate for Payer: UHCCP Medicaid |
$290.32
|
| Rate for Payer: UMR Bronson Commercial |
$772.34
|
|
|
PR LIGATION OF INFERIOR VENA CAVA
|
Professional
|
Both
|
$3,441.00
|
|
|
Service Code
|
HCPCS 37619
|
| Min. Negotiated Rate |
$980.00 |
| Max. Negotiated Rate |
$2,739.43 |
| Rate for Payer: Aetna Commercial |
$2,246.43
|
| Rate for Payer: Aetna Medicare |
$1,743.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,246.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,414.07
|
| Rate for Payer: BCBS Complete |
$1,157.61
|
| Rate for Payer: BCBS MAPPO |
$1,676.44
|
| Rate for Payer: BCBS Trust/PPO |
$980.00
|
| Rate for Payer: BCN Commercial |
$2,509.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,676.44
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Cofinity Commercial |
$2,246.43
|
| Rate for Payer: Cofinity Commercial |
$2,414.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,676.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,760.26
|
| Rate for Payer: Meridian Medicaid |
$1,157.61
|
| Rate for Payer: Nomi Health Commercial |
$2,011.73
|
| Rate for Payer: PACE SWMI |
$1,676.44
|
| Rate for Payer: PHP Commercial |
$2,347.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,676.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,102.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,739.43
|
| Rate for Payer: Priority Health Medicare |
$1,676.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,739.43
|
| Rate for Payer: Priority Health SBD |
$2,739.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,676.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,676.44
|
| Rate for Payer: UHCCP Medicaid |
$1,102.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,582.86
|
|
|
PR LIGATION OF SPERM DUCT
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 55450
|
| Min. Negotiated Rate |
$260.40 |
| Max. Negotiated Rate |
$423.15 |
| Rate for Payer: Aetna Medicare |
$325.50
|
| Rate for Payer: BCBS Complete |
$260.40
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.15
|
| Rate for Payer: UMR Bronson Commercial |
$299.46
|
|
|
PR LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 37607
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$929.28 |
| Rate for Payer: Aetna Commercial |
$479.10
|
| Rate for Payer: Aetna Medicare |
$371.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.86
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS MAPPO |
$357.54
|
| Rate for Payer: BCBS Trust/PPO |
$929.28
|
| Rate for Payer: BCN Commercial |
$538.04
|
| Rate for Payer: BCN Medicare Advantage |
$357.54
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$514.86
|
| Rate for Payer: Cofinity Commercial |
$479.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.42
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Nomi Health Commercial |
$429.05
|
| Rate for Payer: PACE SWMI |
$357.54
|
| Rate for Payer: PHP Commercial |
$500.56
|
| Rate for Payer: PHP Medicare Advantage |
$357.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$588.73
|
| Rate for Payer: Priority Health Medicare |
$357.54
|
| Rate for Payer: Priority Health Narrow Network |
$588.73
|
| Rate for Payer: Priority Health SBD |
$588.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.54
|
| Rate for Payer: UHC Medicare Advantage |
$357.54
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
| Rate for Payer: UMR Bronson Commercial |
$505.08
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Professional
|
Both
|
$855.78
|
|
|
Service Code
|
HCPCS 37735
|
| Min. Negotiated Rate |
$366.57 |
| Max. Negotiated Rate |
$913.15 |
| Rate for Payer: Aetna Commercial |
$751.94
|
| Rate for Payer: Aetna Medicare |
$583.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.06
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCBS MAPPO |
$561.15
|
| Rate for Payer: BCN Commercial |
$834.17
|
| Rate for Payer: BCN Medicare Advantage |
$561.15
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cofinity Commercial |
$751.94
|
| Rate for Payer: Cofinity Commercial |
$808.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.21
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Nomi Health Commercial |
$673.38
|
| Rate for Payer: PACE SWMI |
$561.15
|
| Rate for Payer: PHP Commercial |
$785.61
|
| Rate for Payer: PHP Medicare Advantage |
$561.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.15
|
| Rate for Payer: Priority Health Medicare |
$561.15
|
| Rate for Payer: Priority Health Narrow Network |
$913.15
|
| Rate for Payer: Priority Health SBD |
$913.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.15
|
| Rate for Payer: UHC Medicare Advantage |
$561.15
|
| Rate for Payer: UHCCP Medicaid |
$366.57
|
| Rate for Payer: UMR Bronson Commercial |
$393.66
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Facility
|
OP
|
$856.00
|
|
|
Service Code
|
CPT 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$316.72 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$556.40
|
| Rate for Payer: Aetna Commercial |
$727.60
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,317.94
|
| Rate for Payer: BCN Commercial |
$2,317.94
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$736.16
|
| Rate for Payer: Cofinity Commercial |
$599.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$599.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$770.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$599.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$642.00
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.60
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$727.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$539.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.91
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$567.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$316.72
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$642.00
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Facility
|
IP
|
$856.00
|
|
|
Service Code
|
CPT 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$376.64 |
| Max. Negotiated Rate |
$770.40 |
| Rate for Payer: Aetna American Axle |
$556.40
|
| Rate for Payer: Aetna Commercial |
$727.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.40
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$736.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$599.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.80
|
| Rate for Payer: Healthscope Commercial |
$770.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$599.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.60
|
| Rate for Payer: PHP Commercial |
$727.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.40
|
| Rate for Payer: Priority Health SBD |
$539.28
|
| Rate for Payer: UMR Bronson Commercial |
$376.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$642.00
|
|
|
PR LIG&DIV&COMPL STRPG LONG/SHRT SAPHENOUS VN W/EXC
|
Professional
|
Both
|
$855.78
|
|
|
Service Code
|
HCPCS 37735
|
| Hospital Charge Code |
37735
|
| Min. Negotiated Rate |
$366.57 |
| Max. Negotiated Rate |
$913.15 |
| Rate for Payer: Aetna Commercial |
$751.94
|
| Rate for Payer: Aetna Medicare |
$583.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.06
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCBS MAPPO |
$561.15
|
| Rate for Payer: BCN Commercial |
$834.17
|
| Rate for Payer: BCN Medicare Advantage |
$561.15
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cash Price |
$684.62
|
| Rate for Payer: Cofinity Commercial |
$751.94
|
| Rate for Payer: Cofinity Commercial |
$808.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.21
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Nomi Health Commercial |
$673.38
|
| Rate for Payer: PACE SWMI |
$561.15
|
| Rate for Payer: PHP Commercial |
$785.61
|
| Rate for Payer: PHP Medicare Advantage |
$561.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$556.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.15
|
| Rate for Payer: Priority Health Medicare |
$561.15
|
| Rate for Payer: Priority Health Narrow Network |
$913.15
|
| Rate for Payer: Priority Health SBD |
$913.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.15
|
| Rate for Payer: UHC Medicare Advantage |
$561.15
|
| Rate for Payer: UHCCP Medicaid |
$366.57
|
| Rate for Payer: UMR Bronson Commercial |
$393.66
|
|
|
PR LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 37700
|
| Min. Negotiated Rate |
$150.57 |
| Max. Negotiated Rate |
$386.11 |
| Rate for Payer: Aetna Commercial |
$313.67
|
| Rate for Payer: Aetna Medicare |
$243.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.08
|
| Rate for Payer: BCBS Complete |
$163.26
|
| Rate for Payer: BCBS MAPPO |
$234.08
|
| Rate for Payer: BCBS Trust/PPO |
$150.57
|
| Rate for Payer: BCN Commercial |
$353.80
|
| Rate for Payer: BCN Medicare Advantage |
$234.08
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$313.67
|
| Rate for Payer: Cofinity Commercial |
$337.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.78
|
| Rate for Payer: Meridian Medicaid |
$163.26
|
| Rate for Payer: Nomi Health Commercial |
$280.90
|
| Rate for Payer: PACE SWMI |
$234.08
|
| Rate for Payer: PHP Commercial |
$327.71
|
| Rate for Payer: PHP Medicare Advantage |
$234.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.11
|
| Rate for Payer: Priority Health Medicare |
$234.08
|
| Rate for Payer: Priority Health Narrow Network |
$386.11
|
| Rate for Payer: Priority Health SBD |
$386.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.08
|
| Rate for Payer: UHC Medicare Advantage |
$234.08
|
| Rate for Payer: UHCCP Medicaid |
$155.49
|
| Rate for Payer: UMR Bronson Commercial |
$218.04
|
|
|
PR LIG DIV & STRIPPING SHORT SAPHENOUS VEIN
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 37718
|
| Min. Negotiated Rate |
$219.24 |
| Max. Negotiated Rate |
$617.45 |
| Rate for Payer: Aetna Commercial |
$508.81
|
| Rate for Payer: Aetna Medicare |
$394.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$508.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.78
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$379.71
|
| Rate for Payer: BCBS Trust/PPO |
$219.24
|
| Rate for Payer: BCN Commercial |
$564.43
|
| Rate for Payer: BCN Medicare Advantage |
$379.71
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$508.81
|
| Rate for Payer: Cofinity Commercial |
$546.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.70
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Nomi Health Commercial |
$455.65
|
| Rate for Payer: PACE SWMI |
$379.71
|
| Rate for Payer: PHP Commercial |
$531.59
|
| Rate for Payer: PHP Medicare Advantage |
$379.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$534.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.45
|
| Rate for Payer: Priority Health Medicare |
$379.71
|
| Rate for Payer: Priority Health Narrow Network |
$617.45
|
| Rate for Payer: Priority Health SBD |
$617.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.71
|
| Rate for Payer: UHC Medicare Advantage |
$379.71
|
| Rate for Payer: UHCCP Medicaid |
$248.78
|
| Rate for Payer: UMR Bronson Commercial |
$378.12
|
|
|
PR LIG DIV&STRPG LONG SAPH SAPHFEM JUNCT KNE/BELW
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 37722
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$724.88 |
| Rate for Payer: Aetna Commercial |
$590.42
|
| Rate for Payer: Aetna Medicare |
$458.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.48
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$440.61
|
| Rate for Payer: BCBS Trust/PPO |
$407.85
|
| Rate for Payer: BCN Commercial |
$669.00
|
| Rate for Payer: BCN Medicare Advantage |
$440.61
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cofinity Commercial |
$590.42
|
| Rate for Payer: Cofinity Commercial |
$634.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$462.64
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Nomi Health Commercial |
$528.73
|
| Rate for Payer: PACE SWMI |
$440.61
|
| Rate for Payer: PHP Commercial |
$616.85
|
| Rate for Payer: PHP Medicare Advantage |
$440.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$616.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$724.88
|
| Rate for Payer: Priority Health Medicare |
$440.61
|
| Rate for Payer: Priority Health Narrow Network |
$724.88
|
| Rate for Payer: Priority Health SBD |
$724.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.61
|
| Rate for Payer: UHC Medicare Advantage |
$440.61
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
| Rate for Payer: UMR Bronson Commercial |
$436.08
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 37785
|
| Hospital Charge Code |
37785
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$629.85 |
| Rate for Payer: Aetna Commercial |
$322.10
|
| Rate for Payer: Aetna Medicare |
$249.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.13
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$240.37
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$240.37
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$346.13
|
| Rate for Payer: Cofinity Commercial |
$322.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.39
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: Nomi Health Commercial |
$288.44
|
| Rate for Payer: PACE SWMI |
$240.37
|
| Rate for Payer: PHP Commercial |
$336.52
|
| Rate for Payer: PHP Medicare Advantage |
$240.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$403.12
|
| Rate for Payer: Priority Health Medicare |
$240.37
|
| Rate for Payer: Priority Health Narrow Network |
$403.12
|
| Rate for Payer: Priority Health SBD |
$403.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.37
|
| Rate for Payer: UHC Medicare Advantage |
$240.37
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: UMR Bronson Commercial |
$445.74
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Facility
|
IP
|
$969.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
37785
|
| Min. Negotiated Rate |
$426.36 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna American Axle |
$629.85
|
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.85
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$678.30
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$678.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health SBD |
$610.47
|
| Rate for Payer: UMR Bronson Commercial |
$426.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Facility
|
OP
|
$969.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
37785
|
| Min. Negotiated Rate |
$245.89 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$629.85
|
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,986.82
|
| Rate for Payer: BCN Commercial |
$1,986.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$678.30
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$678.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$610.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.48
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$245.89
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$358.53
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
PR LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG
|
Professional
|
Both
|
$969.00
|
|
|
Service Code
|
HCPCS 37785
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$629.85 |
| Rate for Payer: Aetna Commercial |
$322.10
|
| Rate for Payer: Aetna Medicare |
$249.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.13
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$240.37
|
| Rate for Payer: BCBS Trust/PPO |
$583.24
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$240.37
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$322.10
|
| Rate for Payer: Cofinity Commercial |
$346.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.39
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: Nomi Health Commercial |
$288.44
|
| Rate for Payer: PACE SWMI |
$240.37
|
| Rate for Payer: PHP Commercial |
$336.52
|
| Rate for Payer: PHP Medicare Advantage |
$240.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$403.12
|
| Rate for Payer: Priority Health Medicare |
$240.37
|
| Rate for Payer: Priority Health Narrow Network |
$403.12
|
| Rate for Payer: Priority Health SBD |
$403.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.37
|
| Rate for Payer: UHC Medicare Advantage |
$240.37
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: UMR Bronson Commercial |
$445.74
|
|
|
PR LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 37780
|
| Min. Negotiated Rate |
$149.95 |
| Max. Negotiated Rate |
$438.49 |
| Rate for Payer: Aetna Commercial |
$304.17
|
| Rate for Payer: Aetna Medicare |
$236.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.87
|
| Rate for Payer: BCBS Complete |
$157.45
|
| Rate for Payer: BCBS MAPPO |
$226.99
|
| Rate for Payer: BCBS Trust/PPO |
$438.49
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: BCN Medicare Advantage |
$226.99
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cofinity Commercial |
$304.17
|
| Rate for Payer: Cofinity Commercial |
$326.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.34
|
| Rate for Payer: Meridian Medicaid |
$157.45
|
| Rate for Payer: Nomi Health Commercial |
$272.39
|
| Rate for Payer: PACE SWMI |
$226.99
|
| Rate for Payer: PHP Commercial |
$317.79
|
| Rate for Payer: PHP Medicare Advantage |
$226.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.82
|
| Rate for Payer: Priority Health Medicare |
$226.99
|
| Rate for Payer: Priority Health Narrow Network |
$372.82
|
| Rate for Payer: Priority Health SBD |
$372.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.99
|
| Rate for Payer: UHC Medicare Advantage |
$226.99
|
| Rate for Payer: UHCCP Medicaid |
$149.95
|
| Rate for Payer: UMR Bronson Commercial |
$222.18
|
|
