|
PR REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 28190
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$165.76
|
| Rate for Payer: Aetna Medicare |
$128.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.13
|
| Rate for Payer: BCBS Complete |
$85.44
|
| Rate for Payer: BCBS MAPPO |
$123.70
|
| Rate for Payer: BCN Commercial |
$200.19
|
| Rate for Payer: BCN Medicare Advantage |
$123.70
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$165.76
|
| Rate for Payer: Cofinity Commercial |
$178.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.88
|
| Rate for Payer: Meridian Medicaid |
$85.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.07
|
| Rate for Payer: Nomi Health Commercial |
$148.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$462.00
|
| Rate for Payer: PACE SWMI |
$123.70
|
| Rate for Payer: PHP Commercial |
$173.18
|
| Rate for Payer: PHP Medicare Advantage |
$123.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$213.99
|
| Rate for Payer: Priority Health Medicare |
$123.70
|
| Rate for Payer: Priority Health SBD |
$213.99
|
| Rate for Payer: Priority Health Tiered Network |
$213.99
|
| Rate for Payer: Railroad Medicare Medicare |
$123.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.06
|
| Rate for Payer: UHC Core |
$233.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.70
|
| Rate for Payer: UHC Exchange |
$233.06
|
| Rate for Payer: UHC Medicaid |
$81.37
|
| Rate for Payer: UHCCP Medicaid |
$81.37
|
| Rate for Payer: UMR Bronson Commercial |
$283.36
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 30310
|
| Min. Negotiated Rate |
$121.41 |
| Max. Negotiated Rate |
$345.46 |
| Rate for Payer: Aetna Commercial |
$243.26
|
| Rate for Payer: Aetna Medicare |
$188.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.42
|
| Rate for Payer: BCBS Complete |
$127.48
|
| Rate for Payer: BCBS MAPPO |
$181.54
|
| Rate for Payer: BCN Commercial |
$309.75
|
| Rate for Payer: BCN Medicare Advantage |
$181.54
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cofinity Commercial |
$243.26
|
| Rate for Payer: Cofinity Commercial |
$261.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.62
|
| Rate for Payer: Meridian Medicaid |
$127.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$199.69
|
| Rate for Payer: Nomi Health Commercial |
$217.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.00
|
| Rate for Payer: PACE SWMI |
$181.54
|
| Rate for Payer: PHP Commercial |
$254.16
|
| Rate for Payer: PHP Medicare Advantage |
$181.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$291.69
|
| Rate for Payer: Priority Health Medicare |
$181.54
|
| Rate for Payer: Priority Health SBD |
$291.69
|
| Rate for Payer: Priority Health Tiered Network |
$291.69
|
| Rate for Payer: Railroad Medicare Medicare |
$181.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.46
|
| Rate for Payer: UHC Core |
$345.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.54
|
| Rate for Payer: UHC Exchange |
$345.46
|
| Rate for Payer: UHC Medicaid |
$121.41
|
| Rate for Payer: UHCCP Medicaid |
$121.41
|
| Rate for Payer: UMR Bronson Commercial |
$174.80
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 30300
|
| Min. Negotiated Rate |
$73.70 |
| Max. Negotiated Rate |
$303.00 |
| Rate for Payer: Aetna Commercial |
$147.06
|
| Rate for Payer: Aetna Medicare |
$114.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.04
|
| Rate for Payer: BCBS Complete |
$77.39
|
| Rate for Payer: BCBS MAPPO |
$109.75
|
| Rate for Payer: BCN Commercial |
$182.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.75
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$147.06
|
| Rate for Payer: Cofinity Commercial |
$158.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.24
|
| Rate for Payer: Meridian Medicaid |
$77.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.72
|
| Rate for Payer: Nomi Health Commercial |
$131.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.00
|
| Rate for Payer: PACE SWMI |
$109.75
|
| Rate for Payer: PHP Commercial |
$153.65
|
| Rate for Payer: PHP Medicare Advantage |
$109.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$171.64
|
| Rate for Payer: Priority Health Medicare |
$109.75
|
| Rate for Payer: Priority Health SBD |
$171.64
|
| Rate for Payer: Priority Health Tiered Network |
$171.64
|
| Rate for Payer: Railroad Medicare Medicare |
$109.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.10
|
| Rate for Payer: UHC Core |
$192.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.75
|
| Rate for Payer: UHC Exchange |
$192.10
|
| Rate for Payer: UHC Medicaid |
$73.70
|
| Rate for Payer: UHCCP Medicaid |
$73.70
|
| Rate for Payer: UMR Bronson Commercial |
$185.84
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$417.00
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
20520
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$312.75 |
| Rate for Payer: Aetna Commercial |
$183.49
|
| Rate for Payer: Aetna Medicare |
$142.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.18
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$136.93
|
| Rate for Payer: BCN Commercial |
$224.59
|
| Rate for Payer: BCN Medicare Advantage |
$136.93
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cofinity Commercial |
$183.49
|
| Rate for Payer: Cofinity Commercial |
$197.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.78
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.62
|
| Rate for Payer: Nomi Health Commercial |
$164.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: PACE SWMI |
$136.93
|
| Rate for Payer: PHP Commercial |
$191.70
|
| Rate for Payer: PHP Medicare Advantage |
$136.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$240.08
|
| Rate for Payer: Priority Health Medicare |
$136.93
|
| Rate for Payer: Priority Health SBD |
$240.08
|
| Rate for Payer: Priority Health Tiered Network |
$240.08
|
| Rate for Payer: Railroad Medicare Medicare |
$136.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.09
|
| Rate for Payer: UHC Core |
$254.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.93
|
| Rate for Payer: UHC Exchange |
$254.09
|
| Rate for Payer: UHC Medicaid |
$90.53
|
| Rate for Payer: UHCCP Medicaid |
$90.53
|
| Rate for Payer: UMR Bronson Commercial |
$191.82
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$417.00
|
|
|
Service Code
|
HCPCS 20520
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$312.75 |
| Rate for Payer: Aetna Commercial |
$183.49
|
| Rate for Payer: Aetna Medicare |
$142.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.18
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$136.93
|
| Rate for Payer: BCN Commercial |
$224.59
|
| Rate for Payer: BCN Medicare Advantage |
$136.93
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cofinity Commercial |
$183.49
|
| Rate for Payer: Cofinity Commercial |
$197.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.78
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.62
|
| Rate for Payer: Nomi Health Commercial |
$164.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: PACE SWMI |
$136.93
|
| Rate for Payer: PHP Commercial |
$191.70
|
| Rate for Payer: PHP Medicare Advantage |
$136.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$240.08
|
| Rate for Payer: Priority Health Medicare |
$136.93
|
| Rate for Payer: Priority Health SBD |
$240.08
|
| Rate for Payer: Priority Health Tiered Network |
$240.08
|
| Rate for Payer: Railroad Medicare Medicare |
$136.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.09
|
| Rate for Payer: UHC Core |
$254.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.93
|
| Rate for Payer: UHC Exchange |
$254.09
|
| Rate for Payer: UHC Medicaid |
$90.53
|
| Rate for Payer: UHCCP Medicaid |
$90.53
|
| Rate for Payer: UMR Bronson Commercial |
$191.82
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$417.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$183.48 |
| Max. Negotiated Rate |
$375.30 |
| Rate for Payer: Aetna American Axle |
$271.05
|
| Rate for Payer: Aetna Commercial |
$354.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.05
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cofinity Advantage |
$291.90
|
| Rate for Payer: Cofinity Commercial |
$358.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.60
|
| Rate for Payer: Healthscope Commercial |
$375.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: PHP Commercial |
$354.45
|
| Rate for Payer: Priority Health SBD |
$262.71
|
| Rate for Payer: UMR Bronson Commercial |
$183.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.75
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$417.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$154.29 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$271.05
|
| Rate for Payer: Aetna Commercial |
$354.45
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.89
|
| Rate for Payer: BCN Commercial |
$2,031.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cofinity Advantage |
$291.90
|
| Rate for Payer: Cofinity Commercial |
$358.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$375.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.75
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.45
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.75
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$354.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$262.71
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$154.29
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.75
|
|
|
PR REMOVAL FOREIGN BODY PELVIS/HIP DEEP
|
Professional
|
Both
|
$1,408.00
|
|
|
Service Code
|
HCPCS 27087
|
| Min. Negotiated Rate |
$380.42 |
| Max. Negotiated Rate |
$1,078.87 |
| Rate for Payer: Aetna Commercial |
$782.59
|
| Rate for Payer: Aetna Medicare |
$607.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.99
|
| Rate for Payer: BCBS Complete |
$399.44
|
| Rate for Payer: BCBS MAPPO |
$584.02
|
| Rate for Payer: BCN Commercial |
$938.69
|
| Rate for Payer: BCN Medicare Advantage |
$584.02
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cash Price |
$1,126.40
|
| Rate for Payer: Cofinity Commercial |
$782.59
|
| Rate for Payer: Cofinity Commercial |
$840.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$584.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$613.22
|
| Rate for Payer: Meridian Medicaid |
$399.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$642.42
|
| Rate for Payer: Nomi Health Commercial |
$700.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,056.00
|
| Rate for Payer: PACE SWMI |
$584.02
|
| Rate for Payer: PHP Commercial |
$817.63
|
| Rate for Payer: PHP Medicare Advantage |
$584.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,003.44
|
| Rate for Payer: Priority Health Medicare |
$584.02
|
| Rate for Payer: Priority Health SBD |
$1,003.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,003.44
|
| Rate for Payer: Railroad Medicare Medicare |
$584.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,078.87
|
| Rate for Payer: UHC Core |
$1,078.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$584.02
|
| Rate for Payer: UHC Exchange |
$1,078.87
|
| Rate for Payer: UHC Medicaid |
$380.42
|
| Rate for Payer: UHCCP Medicaid |
$380.42
|
| Rate for Payer: UMR Bronson Commercial |
$647.68
|
|
|
PR REMOVAL FOREIGN BODY PHARYNX
|
Professional
|
Both
|
$312.00
|
|
|
Service Code
|
HCPCS 42809
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$152.77
|
| Rate for Payer: Aetna Medicare |
$118.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.17
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$114.01
|
| Rate for Payer: BCN Commercial |
$190.23
|
| Rate for Payer: BCN Medicare Advantage |
$114.01
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Commercial |
$152.77
|
| Rate for Payer: Cofinity Commercial |
$164.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.71
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.41
|
| Rate for Payer: Nomi Health Commercial |
$136.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: PACE SWMI |
$114.01
|
| Rate for Payer: PHP Commercial |
$159.61
|
| Rate for Payer: PHP Medicare Advantage |
$114.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$231.77
|
| Rate for Payer: Priority Health Medicare |
$114.01
|
| Rate for Payer: Priority Health SBD |
$231.77
|
| Rate for Payer: Priority Health Tiered Network |
$231.77
|
| Rate for Payer: Railroad Medicare Medicare |
$114.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.95
|
| Rate for Payer: UHC Core |
$215.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.01
|
| Rate for Payer: UHC Exchange |
$215.95
|
| Rate for Payer: UHC Medicaid |
$74.55
|
| Rate for Payer: UHCCP Medicaid |
$74.55
|
| Rate for Payer: UMR Bronson Commercial |
$143.52
|
|
|
PR REMOVAL FOREIGN BODY SCROTUM
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 55120
|
| Min. Negotiated Rate |
$211.30 |
| Max. Negotiated Rate |
$619.41 |
| Rate for Payer: Aetna Commercial |
$433.96
|
| Rate for Payer: Aetna Medicare |
$336.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.34
|
| Rate for Payer: BCBS Complete |
$221.87
|
| Rate for Payer: BCBS MAPPO |
$323.85
|
| Rate for Payer: BCN Commercial |
$537.82
|
| Rate for Payer: BCN Medicare Advantage |
$323.85
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cofinity Commercial |
$433.96
|
| Rate for Payer: Cofinity Commercial |
$466.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.04
|
| Rate for Payer: Meridian Medicaid |
$221.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$356.24
|
| Rate for Payer: Nomi Health Commercial |
$388.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.75
|
| Rate for Payer: PACE SWMI |
$323.85
|
| Rate for Payer: PHP Commercial |
$453.39
|
| Rate for Payer: PHP Medicare Advantage |
$323.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$585.86
|
| Rate for Payer: Priority Health Medicare |
$323.85
|
| Rate for Payer: Priority Health SBD |
$585.86
|
| Rate for Payer: Priority Health Tiered Network |
$585.86
|
| Rate for Payer: Railroad Medicare Medicare |
$323.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.41
|
| Rate for Payer: UHC Core |
$619.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$323.85
|
| Rate for Payer: UHC Exchange |
$619.41
|
| Rate for Payer: UHC Medicaid |
$211.30
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
| Rate for Payer: UMR Bronson Commercial |
$316.94
|
|
|
PR REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 23330
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$348.00 |
| Rate for Payer: Aetna Commercial |
$214.57
|
| Rate for Payer: Aetna Medicare |
$166.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.59
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCBS MAPPO |
$160.13
|
| Rate for Payer: BCN Commercial |
$256.96
|
| Rate for Payer: BCN Medicare Advantage |
$160.13
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cofinity Commercial |
$214.57
|
| Rate for Payer: Cofinity Commercial |
$230.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.14
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.14
|
| Rate for Payer: Nomi Health Commercial |
$192.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$348.00
|
| Rate for Payer: PACE SWMI |
$160.13
|
| Rate for Payer: PHP Commercial |
$224.18
|
| Rate for Payer: PHP Medicare Advantage |
$160.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$274.68
|
| Rate for Payer: Priority Health Medicare |
$160.13
|
| Rate for Payer: Priority Health SBD |
$274.68
|
| Rate for Payer: Priority Health Tiered Network |
$274.68
|
| Rate for Payer: Railroad Medicare Medicare |
$160.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.80
|
| Rate for Payer: UHC Core |
$286.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$160.13
|
| Rate for Payer: UHC Exchange |
$286.80
|
| Rate for Payer: UHC Medicaid |
$106.07
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
| Rate for Payer: UMR Bronson Commercial |
$213.44
|
|
|
PR REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 24201
|
| Min. Negotiated Rate |
$250.28 |
| Max. Negotiated Rate |
$700.50 |
| Rate for Payer: Aetna Commercial |
$507.55
|
| Rate for Payer: Aetna Medicare |
$393.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.43
|
| Rate for Payer: BCBS Complete |
$262.79
|
| Rate for Payer: BCBS MAPPO |
$378.77
|
| Rate for Payer: BCN Commercial |
$617.49
|
| Rate for Payer: BCN Medicare Advantage |
$378.77
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$507.55
|
| Rate for Payer: Cofinity Commercial |
$545.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.71
|
| Rate for Payer: Meridian Medicaid |
$262.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.65
|
| Rate for Payer: Nomi Health Commercial |
$454.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$700.50
|
| Rate for Payer: PACE SWMI |
$378.77
|
| Rate for Payer: PHP Commercial |
$530.28
|
| Rate for Payer: PHP Medicare Advantage |
$378.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$660.09
|
| Rate for Payer: Priority Health Medicare |
$378.77
|
| Rate for Payer: Priority Health SBD |
$660.09
|
| Rate for Payer: Priority Health Tiered Network |
$660.09
|
| Rate for Payer: Railroad Medicare Medicare |
$378.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$630.80
|
| Rate for Payer: UHC Core |
$630.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.77
|
| Rate for Payer: UHC Exchange |
$630.80
|
| Rate for Payer: UHC Medicaid |
$250.28
|
| Rate for Payer: UHCCP Medicaid |
$250.28
|
| Rate for Payer: UMR Bronson Commercial |
$429.64
|
|
|
PR REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,168.00
|
|
|
Service Code
|
HCPCS 27090
|
| Min. Negotiated Rate |
$493.10 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$1,013.48
|
| Rate for Payer: Aetna Medicare |
$786.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,013.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.12
|
| Rate for Payer: BCBS Complete |
$517.75
|
| Rate for Payer: BCBS MAPPO |
$756.33
|
| Rate for Payer: BCN Commercial |
$1,259.89
|
| Rate for Payer: BCN Medicare Advantage |
$756.33
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cofinity Commercial |
$1,013.48
|
| Rate for Payer: Cofinity Commercial |
$1,089.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.15
|
| Rate for Payer: Meridian Medicaid |
$517.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$831.96
|
| Rate for Payer: Nomi Health Commercial |
$907.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,626.00
|
| Rate for Payer: PACE SWMI |
$756.33
|
| Rate for Payer: PHP Commercial |
$1,058.86
|
| Rate for Payer: PHP Medicare Advantage |
$756.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$493.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,346.80
|
| Rate for Payer: Priority Health Medicare |
$756.33
|
| Rate for Payer: Priority Health SBD |
$1,346.80
|
| Rate for Payer: Priority Health Tiered Network |
$1,346.80
|
| Rate for Payer: Railroad Medicare Medicare |
$756.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,454.21
|
| Rate for Payer: UHC Core |
$1,454.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$756.33
|
| Rate for Payer: UHC Exchange |
$1,454.21
|
| Rate for Payer: UHC Medicaid |
$493.10
|
| Rate for Payer: UHCCP Medicaid |
$493.10
|
| Rate for Payer: UMR Bronson Commercial |
$997.28
|
|
|
PR REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$2,584.00
|
|
|
Service Code
|
HCPCS 64584
|
| Min. Negotiated Rate |
$402.78 |
| Max. Negotiated Rate |
$1,938.00 |
| Rate for Payer: Aetna Commercial |
$834.71
|
| Rate for Payer: Aetna Medicare |
$647.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.00
|
| Rate for Payer: BCBS Complete |
$422.92
|
| Rate for Payer: BCBS MAPPO |
$622.92
|
| Rate for Payer: BCN Commercial |
$1,094.56
|
| Rate for Payer: BCN Medicare Advantage |
$622.92
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Cofinity Commercial |
$834.71
|
| Rate for Payer: Cofinity Commercial |
$897.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.07
|
| Rate for Payer: Meridian Medicaid |
$422.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$685.21
|
| Rate for Payer: Nomi Health Commercial |
$747.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,938.00
|
| Rate for Payer: PACE SWMI |
$622.92
|
| Rate for Payer: PHP Commercial |
$872.09
|
| Rate for Payer: PHP Medicare Advantage |
$622.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,271.32
|
| Rate for Payer: Priority Health Medicare |
$622.92
|
| Rate for Payer: Priority Health SBD |
$1,271.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,271.32
|
| Rate for Payer: Railroad Medicare Medicare |
$622.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.89
|
| Rate for Payer: UHC Core |
$1,198.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$622.92
|
| Rate for Payer: UHC Exchange |
$1,198.89
|
| Rate for Payer: UHC Medicaid |
$402.78
|
| Rate for Payer: UHCCP Medicaid |
$402.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,188.64
|
|
|
PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 69210
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$36.07
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.76
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS MAPPO |
$26.92
|
| Rate for Payer: BCN Commercial |
$37.70
|
| Rate for Payer: BCN Medicare Advantage |
$26.92
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$36.07
|
| Rate for Payer: Cofinity Commercial |
$38.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.27
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.61
|
| Rate for Payer: Nomi Health Commercial |
$32.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PACE SWMI |
$26.92
|
| Rate for Payer: PHP Commercial |
$37.69
|
| Rate for Payer: PHP Medicare Advantage |
$26.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.23
|
| Rate for Payer: Priority Health Medicare |
$26.92
|
| Rate for Payer: Priority Health SBD |
$47.23
|
| Rate for Payer: Priority Health Tiered Network |
$47.23
|
| Rate for Payer: Railroad Medicare Medicare |
$26.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.90
|
| Rate for Payer: UHC Core |
$58.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.92
|
| Rate for Payer: UHC Exchange |
$58.90
|
| Rate for Payer: UHC Medicaid |
$17.25
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
| Rate for Payer: UMR Bronson Commercial |
$46.00
|
|
|
PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 69209
|
| Min. Negotiated Rate |
$12.42 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Commercial |
$20.93
|
| Rate for Payer: Aetna Medicare |
$16.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.49
|
| Rate for Payer: BCBS MAPPO |
$15.62
|
| Rate for Payer: BCN Commercial |
$23.40
|
| Rate for Payer: BCN Medicare Advantage |
$15.62
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$20.93
|
| Rate for Payer: Cofinity Commercial |
$22.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.18
|
| Rate for Payer: Nomi Health Commercial |
$18.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$15.62
|
| Rate for Payer: PHP Commercial |
$21.87
|
| Rate for Payer: PHP Medicare Advantage |
$15.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.12
|
| Rate for Payer: Priority Health Medicare |
$15.62
|
| Rate for Payer: Priority Health SBD |
$23.12
|
| Rate for Payer: Priority Health Tiered Network |
$23.12
|
| Rate for Payer: Railroad Medicare Medicare |
$15.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.04
|
| Rate for Payer: UHC Core |
$23.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.62
|
| Rate for Payer: UHC Exchange |
$23.04
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
PR REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 57415
|
| Min. Negotiated Rate |
$99.68 |
| Max. Negotiated Rate |
$296.22 |
| Rate for Payer: Aetna Commercial |
$204.67
|
| Rate for Payer: Aetna Medicare |
$158.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.95
|
| Rate for Payer: BCBS Complete |
$104.66
|
| Rate for Payer: BCBS MAPPO |
$152.74
|
| Rate for Payer: BCN Commercial |
$263.44
|
| Rate for Payer: BCN Medicare Advantage |
$152.74
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$219.95
|
| Rate for Payer: Cofinity Commercial |
$204.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.38
|
| Rate for Payer: Meridian Medicaid |
$104.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.01
|
| Rate for Payer: Nomi Health Commercial |
$183.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.50
|
| Rate for Payer: PACE SWMI |
$152.74
|
| Rate for Payer: PHP Commercial |
$213.84
|
| Rate for Payer: PHP Medicare Advantage |
$152.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$266.79
|
| Rate for Payer: Priority Health Medicare |
$152.74
|
| Rate for Payer: Priority Health SBD |
$266.79
|
| Rate for Payer: Priority Health Tiered Network |
$266.79
|
| Rate for Payer: Railroad Medicare Medicare |
$152.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.22
|
| Rate for Payer: UHC Core |
$296.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$152.74
|
| Rate for Payer: UHC Exchange |
$296.22
|
| Rate for Payer: UHC Medicaid |
$99.68
|
| Rate for Payer: UHCCP Medicaid |
$99.68
|
| Rate for Payer: UMR Bronson Commercial |
$157.32
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 11976
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$186.00 |
| Rate for Payer: Aetna Commercial |
$107.75
|
| Rate for Payer: Aetna Medicare |
$83.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.79
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCBS MAPPO |
$80.41
|
| Rate for Payer: BCN Commercial |
$137.45
|
| Rate for Payer: BCN Medicare Advantage |
$80.41
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$107.75
|
| Rate for Payer: Cofinity Commercial |
$115.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.43
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.45
|
| Rate for Payer: Nomi Health Commercial |
$96.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: PACE SWMI |
$80.41
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: PHP Medicare Advantage |
$80.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$125.80
|
| Rate for Payer: Priority Health Medicare |
$80.41
|
| Rate for Payer: Priority Health SBD |
$125.80
|
| Rate for Payer: Priority Health Tiered Network |
$125.80
|
| Rate for Payer: Railroad Medicare Medicare |
$80.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.84
|
| Rate for Payer: UHC Core |
$167.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.41
|
| Rate for Payer: UHC Exchange |
$167.84
|
| Rate for Payer: UHC Medicaid |
$51.12
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
| Rate for Payer: UMR Bronson Commercial |
$114.08
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
IP
|
$248.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$109.12 |
| Max. Negotiated Rate |
$223.20 |
| Rate for Payer: Aetna American Axle |
$161.20
|
| Rate for Payer: Aetna Commercial |
$210.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.20
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Advantage |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$213.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.40
|
| Rate for Payer: Healthscope Commercial |
$223.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: PHP Commercial |
$210.80
|
| Rate for Payer: Priority Health SBD |
$156.24
|
| Rate for Payer: UMR Bronson Commercial |
$109.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.00
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
OP
|
$248.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$91.76 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$161.20
|
| Rate for Payer: Aetna Commercial |
$210.80
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Advantage |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$213.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$223.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.00
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.80
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$210.80
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$156.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$91.76
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.00
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 11976
|
| Hospital Charge Code |
11976
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$186.00 |
| Rate for Payer: Aetna Commercial |
$107.75
|
| Rate for Payer: Aetna Medicare |
$83.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.79
|
| Rate for Payer: BCBS Complete |
$53.68
|
| Rate for Payer: BCBS MAPPO |
$80.41
|
| Rate for Payer: BCN Commercial |
$137.45
|
| Rate for Payer: BCN Medicare Advantage |
$80.41
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$107.75
|
| Rate for Payer: Cofinity Commercial |
$115.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.43
|
| Rate for Payer: Meridian Medicaid |
$53.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.45
|
| Rate for Payer: Nomi Health Commercial |
$96.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: PACE SWMI |
$80.41
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: PHP Medicare Advantage |
$80.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$125.80
|
| Rate for Payer: Priority Health Medicare |
$80.41
|
| Rate for Payer: Priority Health SBD |
$125.80
|
| Rate for Payer: Priority Health Tiered Network |
$125.80
|
| Rate for Payer: Railroad Medicare Medicare |
$80.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.84
|
| Rate for Payer: UHC Core |
$167.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.41
|
| Rate for Payer: UHC Exchange |
$167.84
|
| Rate for Payer: UHC Medicaid |
$51.12
|
| Rate for Payer: UHCCP Medicaid |
$51.12
|
| Rate for Payer: UMR Bronson Commercial |
$114.08
|
|
|
PR REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY
|
Professional
|
Both
|
$451.00
|
|
|
Service Code
|
HCPCS 33241
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$375.89 |
| Rate for Payer: Aetna Commercial |
$260.20
|
| Rate for Payer: Aetna Medicare |
$201.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.62
|
| Rate for Payer: BCBS Complete |
$132.41
|
| Rate for Payer: BCBS MAPPO |
$194.18
|
| Rate for Payer: BCN Commercial |
$318.70
|
| Rate for Payer: BCN Medicare Advantage |
$194.18
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cofinity Commercial |
$260.20
|
| Rate for Payer: Cofinity Commercial |
$279.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.89
|
| Rate for Payer: Meridian Medicaid |
$132.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$213.60
|
| Rate for Payer: Nomi Health Commercial |
$233.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$338.25
|
| Rate for Payer: PACE SWMI |
$194.18
|
| Rate for Payer: PHP Commercial |
$271.85
|
| Rate for Payer: PHP Medicare Advantage |
$194.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$342.73
|
| Rate for Payer: Priority Health Medicare |
$194.18
|
| Rate for Payer: Priority Health SBD |
$342.73
|
| Rate for Payer: Priority Health Tiered Network |
$342.73
|
| Rate for Payer: Railroad Medicare Medicare |
$194.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.89
|
| Rate for Payer: UHC Core |
$375.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$194.18
|
| Rate for Payer: UHC Exchange |
$375.89
|
| Rate for Payer: UHC Medicaid |
$126.10
|
| Rate for Payer: UHCCP Medicaid |
$126.10
|
| Rate for Payer: UMR Bronson Commercial |
$207.46
|
|
|
PR REMOVAL IMPLANT DEEP
|
Professional
|
Both
|
$1,118.00
|
|
|
Service Code
|
HCPCS 20680
|
| Min. Negotiated Rate |
$251.55 |
| Max. Negotiated Rate |
$838.50 |
| Rate for Payer: Aetna Commercial |
$515.47
|
| Rate for Payer: Aetna Medicare |
$400.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.94
|
| Rate for Payer: BCBS Complete |
$264.13
|
| Rate for Payer: BCBS MAPPO |
$384.68
|
| Rate for Payer: BCN Commercial |
$637.42
|
| Rate for Payer: BCN Medicare Advantage |
$384.68
|
| Rate for Payer: Cash Price |
$894.40
|
| Rate for Payer: Cash Price |
$894.40
|
| Rate for Payer: Cofinity Commercial |
$515.47
|
| Rate for Payer: Cofinity Commercial |
$553.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.91
|
| Rate for Payer: Meridian Medicaid |
$264.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$423.15
|
| Rate for Payer: Nomi Health Commercial |
$461.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.50
|
| Rate for Payer: PACE SWMI |
$384.68
|
| Rate for Payer: PHP Commercial |
$538.55
|
| Rate for Payer: PHP Medicare Advantage |
$384.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$251.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$681.39
|
| Rate for Payer: Priority Health Medicare |
$384.68
|
| Rate for Payer: Priority Health SBD |
$681.39
|
| Rate for Payer: Priority Health Tiered Network |
$681.39
|
| Rate for Payer: Railroad Medicare Medicare |
$384.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$734.05
|
| Rate for Payer: UHC Core |
$734.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$384.68
|
| Rate for Payer: UHC Exchange |
$734.05
|
| Rate for Payer: UHC Medicaid |
$251.55
|
| Rate for Payer: UHCCP Medicaid |
$251.55
|
| Rate for Payer: UMR Bronson Commercial |
$514.28
|
|
|
PR REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP
|
Professional
|
Both
|
$858.00
|
|
|
Service Code
|
HCPCS 36262
|
| Min. Negotiated Rate |
$201.71 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Aetna Commercial |
$413.03
|
| Rate for Payer: Aetna Medicare |
$320.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.85
|
| Rate for Payer: BCBS Complete |
$211.80
|
| Rate for Payer: BCBS MAPPO |
$308.23
|
| Rate for Payer: BCN Commercial |
$478.07
|
| Rate for Payer: BCN Medicare Advantage |
$308.23
|
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Cofinity Commercial |
$413.03
|
| Rate for Payer: Cofinity Commercial |
$443.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.64
|
| Rate for Payer: Meridian Medicaid |
$211.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.05
|
| Rate for Payer: Nomi Health Commercial |
$369.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.50
|
| Rate for Payer: PACE SWMI |
$308.23
|
| Rate for Payer: PHP Commercial |
$431.52
|
| Rate for Payer: PHP Medicare Advantage |
$308.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$514.10
|
| Rate for Payer: Priority Health Medicare |
$308.23
|
| Rate for Payer: Priority Health SBD |
$514.10
|
| Rate for Payer: Priority Health Tiered Network |
$514.10
|
| Rate for Payer: Railroad Medicare Medicare |
$308.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.04
|
| Rate for Payer: UHC Core |
$542.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$308.23
|
| Rate for Payer: UHC Exchange |
$542.04
|
| Rate for Payer: UHC Medicaid |
$201.71
|
| Rate for Payer: UHCCP Medicaid |
$201.71
|
| Rate for Payer: UMR Bronson Commercial |
$394.68
|
|
|
PR REMOVAL IMPLANT FROM FINGER/HAND
|
Professional
|
Both
|
$1,075.00
|
|
|
Service Code
|
HCPCS 26320
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$806.25 |
| Rate for Payer: Aetna Commercial |
$436.25
|
| Rate for Payer: Aetna Medicare |
$338.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.81
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$325.56
|
| Rate for Payer: BCN Commercial |
$541.31
|
| Rate for Payer: BCN Medicare Advantage |
$325.56
|
| Rate for Payer: Cash Price |
$860.00
|
| Rate for Payer: Cash Price |
$860.00
|
| Rate for Payer: Cofinity Commercial |
$436.25
|
| Rate for Payer: Cofinity Commercial |
$468.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$358.12
|
| Rate for Payer: Nomi Health Commercial |
$390.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.25
|
| Rate for Payer: PACE SWMI |
$325.56
|
| Rate for Payer: PHP Commercial |
$455.78
|
| Rate for Payer: PHP Medicare Advantage |
$325.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$578.65
|
| Rate for Payer: Priority Health Medicare |
$325.56
|
| Rate for Payer: Priority Health SBD |
$578.65
|
| Rate for Payer: Priority Health Tiered Network |
$578.65
|
| Rate for Payer: Railroad Medicare Medicare |
$325.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$600.89
|
| Rate for Payer: UHC Core |
$600.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$325.56
|
| Rate for Payer: UHC Exchange |
$600.89
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
| Rate for Payer: UMR Bronson Commercial |
$494.50
|
|
