|
PR REMOVAL FOREIGN BODY DEEP PENILE TISSUE
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 54115
|
| Min. Negotiated Rate |
$275.62 |
| Max. Negotiated Rate |
$2,119.54 |
| Rate for Payer: Aetna Commercial |
$547.19
|
| Rate for Payer: Aetna Medicare |
$424.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.02
|
| Rate for Payer: BCBS Complete |
$289.40
|
| Rate for Payer: BCBS MAPPO |
$408.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,119.54
|
| Rate for Payer: BCN Commercial |
$663.13
|
| Rate for Payer: BCN Medicare Advantage |
$408.35
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cofinity Commercial |
$547.19
|
| Rate for Payer: Cofinity Commercial |
$588.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.77
|
| Rate for Payer: Meridian Medicaid |
$289.40
|
| Rate for Payer: Nomi Health Commercial |
$490.02
|
| Rate for Payer: PACE SWMI |
$408.35
|
| Rate for Payer: PHP Commercial |
$571.69
|
| Rate for Payer: PHP Medicare Advantage |
$408.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$552.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$684.38
|
| Rate for Payer: Priority Health Medicare |
$408.35
|
| Rate for Payer: Priority Health Narrow Network |
$684.38
|
| Rate for Payer: Priority Health SBD |
$684.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.35
|
| Rate for Payer: UHC Medicare Advantage |
$408.35
|
| Rate for Payer: UHCCP Medicaid |
$275.62
|
| Rate for Payer: UMR Bronson Commercial |
$391.00
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 27372
|
| Min. Negotiated Rate |
$262.84 |
| Max. Negotiated Rate |
$3,545.42 |
| Rate for Payer: Aetna Commercial |
$519.52
|
| Rate for Payer: Aetna Medicare |
$403.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.29
|
| Rate for Payer: BCBS Complete |
$275.98
|
| Rate for Payer: BCBS MAPPO |
$387.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,545.42
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$387.70
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$519.52
|
| Rate for Payer: Cofinity Commercial |
$558.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.08
|
| Rate for Payer: Meridian Medicaid |
$275.98
|
| Rate for Payer: Nomi Health Commercial |
$465.24
|
| Rate for Payer: PACE SWMI |
$387.70
|
| Rate for Payer: PHP Commercial |
$542.78
|
| Rate for Payer: PHP Medicare Advantage |
$387.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.29
|
| Rate for Payer: Priority Health Medicare |
$387.70
|
| Rate for Payer: Priority Health Narrow Network |
$620.29
|
| Rate for Payer: Priority Health SBD |
$620.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.70
|
| Rate for Payer: UHC Medicare Advantage |
$387.70
|
| Rate for Payer: UHCCP Medicaid |
$262.84
|
| Rate for Payer: UMR Bronson Commercial |
$512.44
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
IP
|
$1,114.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$490.16 |
| Max. Negotiated Rate |
$1,002.60 |
| Rate for Payer: Aetna American Axle |
$724.10
|
| Rate for Payer: Aetna Commercial |
$946.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.10
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$779.80
|
| Rate for Payer: Cofinity Commercial |
$958.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$779.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.20
|
| Rate for Payer: Healthscope Commercial |
$1,002.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$779.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.90
|
| Rate for Payer: PHP Commercial |
$946.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health SBD |
$701.82
|
| Rate for Payer: UMR Bronson Commercial |
$490.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.50
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 27372
|
| Hospital Charge Code |
27372
|
| Min. Negotiated Rate |
$262.84 |
| Max. Negotiated Rate |
$3,545.42 |
| Rate for Payer: Aetna Commercial |
$519.52
|
| Rate for Payer: Aetna Medicare |
$403.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.29
|
| Rate for Payer: BCBS Complete |
$275.98
|
| Rate for Payer: BCBS MAPPO |
$387.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,545.42
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$387.70
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$519.52
|
| Rate for Payer: Cofinity Commercial |
$558.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.08
|
| Rate for Payer: Meridian Medicaid |
$275.98
|
| Rate for Payer: Nomi Health Commercial |
$465.24
|
| Rate for Payer: PACE SWMI |
$387.70
|
| Rate for Payer: PHP Commercial |
$542.78
|
| Rate for Payer: PHP Medicare Advantage |
$387.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.29
|
| Rate for Payer: Priority Health Medicare |
$387.70
|
| Rate for Payer: Priority Health Narrow Network |
$620.29
|
| Rate for Payer: Priority Health SBD |
$620.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.70
|
| Rate for Payer: UHC Medicare Advantage |
$387.70
|
| Rate for Payer: UHCCP Medicaid |
$262.84
|
| Rate for Payer: UMR Bronson Commercial |
$512.44
|
|
|
PR REMOVAL FOREIGN BODY DEEP THIGH/KNEE
|
Facility
|
OP
|
$1,114.00
|
|
|
Service Code
|
CPT 27372
|
| Hospital Charge Code |
27372
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$388.33 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$724.10
|
| Rate for Payer: Aetna Commercial |
$946.90
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,874.25
|
| Rate for Payer: BCN Commercial |
$1,874.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$958.04
|
| Rate for Payer: Cofinity Commercial |
$779.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$779.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,002.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$779.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.90
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$946.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$701.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.16
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$388.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$412.18
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.50
|
|
|
PR REMOVAL FOREIGN BODY FOOT COMPLICATED
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 28193
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$1,271.09 |
| Rate for Payer: Aetna Commercial |
$466.86
|
| Rate for Payer: Aetna Medicare |
$362.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.70
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS MAPPO |
$348.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.09
|
| Rate for Payer: BCN Commercial |
$756.96
|
| Rate for Payer: BCN Medicare Advantage |
$348.40
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$466.86
|
| Rate for Payer: Cofinity Commercial |
$501.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.82
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Nomi Health Commercial |
$418.08
|
| Rate for Payer: PACE SWMI |
$348.40
|
| Rate for Payer: PHP Commercial |
$487.76
|
| Rate for Payer: PHP Medicare Advantage |
$348.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.78
|
| Rate for Payer: Priority Health Medicare |
$348.40
|
| Rate for Payer: Priority Health Narrow Network |
$561.78
|
| Rate for Payer: Priority Health SBD |
$561.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.40
|
| Rate for Payer: UHC Medicare Advantage |
$348.40
|
| Rate for Payer: UHCCP Medicaid |
$236.43
|
| Rate for Payer: UMR Bronson Commercial |
$433.32
|
|
|
PR REMOVAL FOREIGN BODY FOOT DEEP
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 28192
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: Aetna Commercial |
$399.01
|
| Rate for Payer: Aetna Medicare |
$309.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.79
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$297.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.05
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: BCN Medicare Advantage |
$297.77
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$399.01
|
| Rate for Payer: Cofinity Commercial |
$428.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.66
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Nomi Health Commercial |
$357.32
|
| Rate for Payer: PACE SWMI |
$297.77
|
| Rate for Payer: PHP Commercial |
$416.88
|
| Rate for Payer: PHP Medicare Advantage |
$297.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.32
|
| Rate for Payer: Priority Health Medicare |
$297.77
|
| Rate for Payer: Priority Health Narrow Network |
$477.32
|
| Rate for Payer: Priority Health SBD |
$477.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.77
|
| Rate for Payer: UHC Medicare Advantage |
$297.77
|
| Rate for Payer: UHCCP Medicaid |
$202.35
|
| Rate for Payer: UMR Bronson Commercial |
$351.90
|
|
|
PR REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 28190
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$996.37 |
| Rate for Payer: Aetna Commercial |
$168.76
|
| Rate for Payer: Aetna Medicare |
$130.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.35
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$125.94
|
| Rate for Payer: BCBS Trust/PPO |
$996.37
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$125.94
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$168.76
|
| Rate for Payer: Cofinity Commercial |
$181.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.24
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Nomi Health Commercial |
$151.13
|
| Rate for Payer: PACE SWMI |
$125.94
|
| Rate for Payer: PHP Commercial |
$176.32
|
| Rate for Payer: PHP Medicare Advantage |
$125.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.54
|
| Rate for Payer: Priority Health Medicare |
$125.94
|
| Rate for Payer: Priority Health Narrow Network |
$203.54
|
| Rate for Payer: Priority Health SBD |
$203.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.94
|
| Rate for Payer: UHC Medicare Advantage |
$125.94
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
| Rate for Payer: UMR Bronson Commercial |
$275.08
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES
|
Professional
|
Both
|
$369.00
|
|
|
Service Code
|
HCPCS 30310
|
| Min. Negotiated Rate |
$132.49 |
| Max. Negotiated Rate |
$1,405.81 |
| Rate for Payer: Aetna Commercial |
$256.65
|
| Rate for Payer: Aetna Medicare |
$199.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.80
|
| Rate for Payer: BCBS Complete |
$139.11
|
| Rate for Payer: BCBS MAPPO |
$191.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.81
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Medicare Advantage |
$191.53
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cofinity Commercial |
$256.65
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.11
|
| Rate for Payer: Meridian Medicaid |
$139.11
|
| Rate for Payer: Nomi Health Commercial |
$229.84
|
| Rate for Payer: PACE SWMI |
$191.53
|
| Rate for Payer: PHP Commercial |
$268.14
|
| Rate for Payer: PHP Medicare Advantage |
$191.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.98
|
| Rate for Payer: Priority Health Medicare |
$191.53
|
| Rate for Payer: Priority Health Narrow Network |
$291.98
|
| Rate for Payer: Priority Health SBD |
$291.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.53
|
| Rate for Payer: UHC Medicare Advantage |
$191.53
|
| Rate for Payer: UHCCP Medicaid |
$132.49
|
| Rate for Payer: UMR Bronson Commercial |
$169.74
|
|
|
PR REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 30300
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$829.43 |
| Rate for Payer: Aetna Commercial |
$150.55
|
| Rate for Payer: Aetna Medicare |
$116.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.78
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$112.35
|
| Rate for Payer: BCBS Trust/PPO |
$829.43
|
| Rate for Payer: BCN Commercial |
$311.29
|
| Rate for Payer: BCN Medicare Advantage |
$112.35
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$150.55
|
| Rate for Payer: Cofinity Commercial |
$161.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.97
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Nomi Health Commercial |
$134.82
|
| Rate for Payer: PACE SWMI |
$112.35
|
| Rate for Payer: PHP Commercial |
$157.29
|
| Rate for Payer: PHP Medicare Advantage |
$112.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.41
|
| Rate for Payer: Priority Health Medicare |
$112.35
|
| Rate for Payer: Priority Health Narrow Network |
$172.41
|
| Rate for Payer: Priority Health SBD |
$172.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.35
|
| Rate for Payer: UHC Medicare Advantage |
$112.35
|
| Rate for Payer: UHCCP Medicaid |
$77.96
|
| Rate for Payer: UMR Bronson Commercial |
$180.32
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 20520
|
| Min. Negotiated Rate |
$96.06 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$188.71
|
| Rate for Payer: Aetna Medicare |
$146.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.80
|
| Rate for Payer: BCBS Complete |
$100.86
|
| Rate for Payer: BCBS MAPPO |
$140.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$140.83
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$188.71
|
| Rate for Payer: Cofinity Commercial |
$202.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.87
|
| Rate for Payer: Meridian Medicaid |
$100.86
|
| Rate for Payer: Nomi Health Commercial |
$169.00
|
| Rate for Payer: PACE SWMI |
$140.83
|
| Rate for Payer: PHP Commercial |
$197.16
|
| Rate for Payer: PHP Medicare Advantage |
$140.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.47
|
| Rate for Payer: Priority Health Medicare |
$140.83
|
| Rate for Payer: Priority Health Narrow Network |
$227.47
|
| Rate for Payer: Priority Health SBD |
$227.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.83
|
| Rate for Payer: UHC Medicare Advantage |
$140.83
|
| Rate for Payer: UHCCP Medicaid |
$96.06
|
| Rate for Payer: UMR Bronson Commercial |
$186.30
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
20520
|
| Min. Negotiated Rate |
$96.06 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$188.71
|
| Rate for Payer: Aetna Medicare |
$146.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.80
|
| Rate for Payer: BCBS Complete |
$100.86
|
| Rate for Payer: BCBS MAPPO |
$140.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$318.13
|
| Rate for Payer: BCN Medicare Advantage |
$140.83
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$202.80
|
| Rate for Payer: Cofinity Commercial |
$188.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.87
|
| Rate for Payer: Meridian Medicaid |
$100.86
|
| Rate for Payer: Nomi Health Commercial |
$169.00
|
| Rate for Payer: PACE SWMI |
$140.83
|
| Rate for Payer: PHP Commercial |
$197.16
|
| Rate for Payer: PHP Medicare Advantage |
$140.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.47
|
| Rate for Payer: Priority Health Medicare |
$140.83
|
| Rate for Payer: Priority Health Narrow Network |
$227.47
|
| Rate for Payer: Priority Health SBD |
$227.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.83
|
| Rate for Payer: UHC Medicare Advantage |
$140.83
|
| Rate for Payer: UHCCP Medicaid |
$96.06
|
| Rate for Payer: UMR Bronson Commercial |
$186.30
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$405.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$141.36 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$263.25
|
| Rate for Payer: Aetna Commercial |
$344.25
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.90
|
| Rate for Payer: BCN Commercial |
$1,681.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$283.50
|
| Rate for Payer: Cofinity Commercial |
$348.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$283.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$364.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$283.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.75
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.25
|
| 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 |
$344.25
|
| 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 |
$263.25
|
| 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 |
$255.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.50
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$141.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$149.85
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.75
|
|
|
PR REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$405.00
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
20520
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$178.20 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna American Axle |
$263.25
|
| Rate for Payer: Aetna Commercial |
$344.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.25
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$283.50
|
| Rate for Payer: Cofinity Commercial |
$348.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$283.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.00
|
| Rate for Payer: Healthscope Commercial |
$364.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$283.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.25
|
| Rate for Payer: PHP Commercial |
$344.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health SBD |
$255.15
|
| Rate for Payer: UMR Bronson Commercial |
$178.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.75
|
|
|
PR REMOVAL FOREIGN BODY PELVIS/HIP DEEP
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 27087
|
| Min. Negotiated Rate |
$401.51 |
| Max. Negotiated Rate |
$1,172.30 |
| Rate for Payer: Aetna Commercial |
$801.32
|
| Rate for Payer: Aetna Medicare |
$621.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.12
|
| Rate for Payer: BCBS Complete |
$421.59
|
| Rate for Payer: BCBS MAPPO |
$598.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,172.30
|
| Rate for Payer: BCN Commercial |
$906.01
|
| Rate for Payer: BCN Medicare Advantage |
$598.00
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$801.32
|
| Rate for Payer: Cofinity Commercial |
$861.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.90
|
| Rate for Payer: Meridian Medicaid |
$421.59
|
| Rate for Payer: Nomi Health Commercial |
$717.60
|
| Rate for Payer: PACE SWMI |
$598.00
|
| Rate for Payer: PHP Commercial |
$837.20
|
| Rate for Payer: PHP Medicare Advantage |
$598.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$401.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.55
|
| Rate for Payer: Priority Health Medicare |
$598.00
|
| Rate for Payer: Priority Health Narrow Network |
$950.55
|
| Rate for Payer: Priority Health SBD |
$950.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.00
|
| Rate for Payer: UHC Medicare Advantage |
$598.00
|
| Rate for Payer: UHCCP Medicaid |
$401.51
|
| Rate for Payer: UMR Bronson Commercial |
$628.82
|
|
|
PR REMOVAL FOREIGN BODY PHARYNX
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 42809
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$300.53 |
| Rate for Payer: Aetna Commercial |
$161.31
|
| Rate for Payer: Aetna Medicare |
$125.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.35
|
| Rate for Payer: BCBS Complete |
$85.44
|
| Rate for Payer: BCBS MAPPO |
$120.38
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$300.53
|
| Rate for Payer: BCN Medicare Advantage |
$120.38
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$161.31
|
| Rate for Payer: Cofinity Commercial |
$173.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.40
|
| Rate for Payer: Meridian Medicaid |
$85.44
|
| Rate for Payer: Nomi Health Commercial |
$144.46
|
| Rate for Payer: PACE SWMI |
$120.38
|
| Rate for Payer: PHP Commercial |
$168.53
|
| Rate for Payer: PHP Medicare Advantage |
$120.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$229.08
|
| Rate for Payer: Priority Health Medicare |
$120.38
|
| Rate for Payer: Priority Health Narrow Network |
$229.08
|
| Rate for Payer: Priority Health SBD |
$229.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.38
|
| Rate for Payer: UHC Medicare Advantage |
$120.38
|
| Rate for Payer: UHCCP Medicaid |
$81.37
|
| Rate for Payer: UMR Bronson Commercial |
$139.38
|
|
|
PR REMOVAL FOREIGN BODY SCROTUM
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 55120
|
| Min. Negotiated Rate |
$230.04 |
| Max. Negotiated Rate |
$3,266.48 |
| Rate for Payer: Aetna Commercial |
$456.36
|
| Rate for Payer: Aetna Medicare |
$354.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$490.42
|
| Rate for Payer: BCBS Complete |
$241.54
|
| Rate for Payer: BCBS MAPPO |
$340.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,266.48
|
| Rate for Payer: BCN Commercial |
$514.58
|
| Rate for Payer: BCN Medicare Advantage |
$340.57
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cofinity Commercial |
$456.36
|
| Rate for Payer: Cofinity Commercial |
$490.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.60
|
| Rate for Payer: Meridian Medicaid |
$241.54
|
| Rate for Payer: Nomi Health Commercial |
$408.68
|
| Rate for Payer: PACE SWMI |
$340.57
|
| Rate for Payer: PHP Commercial |
$476.80
|
| Rate for Payer: PHP Medicare Advantage |
$340.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.94
|
| Rate for Payer: Priority Health Medicare |
$340.57
|
| Rate for Payer: Priority Health Narrow Network |
$570.94
|
| Rate for Payer: Priority Health SBD |
$570.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.57
|
| Rate for Payer: UHC Medicare Advantage |
$340.57
|
| Rate for Payer: UHCCP Medicaid |
$230.04
|
| Rate for Payer: UMR Bronson Commercial |
$307.74
|
|
|
PR REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 23330
|
| Min. Negotiated Rate |
$64.52 |
| Max. Negotiated Rate |
$444.20 |
| Rate for Payer: Aetna Commercial |
$215.51
|
| Rate for Payer: Aetna Medicare |
$167.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.60
|
| Rate for Payer: BCBS Complete |
$115.41
|
| Rate for Payer: BCBS MAPPO |
$160.83
|
| Rate for Payer: BCBS Trust/PPO |
$64.52
|
| Rate for Payer: BCN Commercial |
$444.20
|
| Rate for Payer: BCN Medicare Advantage |
$160.83
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$215.51
|
| Rate for Payer: Cofinity Commercial |
$231.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.87
|
| Rate for Payer: Meridian Medicaid |
$115.41
|
| Rate for Payer: Nomi Health Commercial |
$193.00
|
| Rate for Payer: PACE SWMI |
$160.83
|
| Rate for Payer: PHP Commercial |
$225.16
|
| Rate for Payer: PHP Medicare Advantage |
$160.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.03
|
| Rate for Payer: Priority Health Medicare |
$160.83
|
| Rate for Payer: Priority Health Narrow Network |
$260.03
|
| Rate for Payer: Priority Health SBD |
$260.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.83
|
| Rate for Payer: UHC Medicare Advantage |
$160.83
|
| Rate for Payer: UHCCP Medicaid |
$109.91
|
| Rate for Payer: UMR Bronson Commercial |
$207.00
|
|
|
PR REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP
|
Professional
|
Both
|
$907.00
|
|
|
Service Code
|
HCPCS 24201
|
| Min. Negotiated Rate |
$162.72 |
| Max. Negotiated Rate |
$810.72 |
| Rate for Payer: Aetna Commercial |
$518.78
|
| Rate for Payer: Aetna Medicare |
$402.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.50
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$387.15
|
| Rate for Payer: BCBS Trust/PPO |
$162.72
|
| Rate for Payer: BCN Commercial |
$810.72
|
| Rate for Payer: BCN Medicare Advantage |
$387.15
|
| Rate for Payer: Cash Price |
$725.60
|
| Rate for Payer: Cash Price |
$725.60
|
| Rate for Payer: Cofinity Commercial |
$518.78
|
| Rate for Payer: Cofinity Commercial |
$557.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.51
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| Rate for Payer: Nomi Health Commercial |
$464.58
|
| Rate for Payer: PACE SWMI |
$387.15
|
| Rate for Payer: PHP Commercial |
$542.01
|
| Rate for Payer: PHP Medicare Advantage |
$387.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.38
|
| Rate for Payer: Priority Health Medicare |
$387.15
|
| Rate for Payer: Priority Health Narrow Network |
$624.38
|
| Rate for Payer: Priority Health SBD |
$624.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.15
|
| Rate for Payer: UHC Medicare Advantage |
$387.15
|
| Rate for Payer: UHCCP Medicaid |
$264.12
|
| Rate for Payer: UMR Bronson Commercial |
$417.22
|
|
|
PR REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 27090
|
| Min. Negotiated Rate |
$412.60 |
| Max. Negotiated Rate |
$1,368.25 |
| Rate for Payer: Aetna Commercial |
$1,071.02
|
| Rate for Payer: Aetna Medicare |
$831.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,071.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,150.95
|
| Rate for Payer: BCBS Complete |
$565.83
|
| Rate for Payer: BCBS MAPPO |
$799.27
|
| Rate for Payer: BCBS Trust/PPO |
$412.60
|
| Rate for Payer: BCN Commercial |
$1,222.67
|
| Rate for Payer: BCN Medicare Advantage |
$799.27
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.02
|
| Rate for Payer: Cofinity Commercial |
$1,150.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$799.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$839.23
|
| Rate for Payer: Meridian Medicaid |
$565.83
|
| Rate for Payer: Nomi Health Commercial |
$959.12
|
| Rate for Payer: PACE SWMI |
$799.27
|
| Rate for Payer: PHP Commercial |
$1,118.98
|
| Rate for Payer: PHP Medicare Advantage |
$799.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,368.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,278.76
|
| Rate for Payer: Priority Health Medicare |
$799.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,278.76
|
| Rate for Payer: Priority Health SBD |
$1,278.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$799.27
|
| Rate for Payer: UHC Medicare Advantage |
$799.27
|
| Rate for Payer: UHCCP Medicaid |
$538.89
|
| Rate for Payer: UMR Bronson Commercial |
$968.30
|
|
|
PR REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR
|
Professional
|
Both
|
$2,509.00
|
|
|
Service Code
|
HCPCS 64584
|
| Min. Negotiated Rate |
$468.17 |
| Max. Negotiated Rate |
$1,630.85 |
| Rate for Payer: Aetna Commercial |
$933.86
|
| Rate for Payer: Aetna Medicare |
$724.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.86
|
| Rate for Payer: BCBS Complete |
$491.58
|
| Rate for Payer: BCBS MAPPO |
$696.91
|
| Rate for Payer: BCN Commercial |
$1,064.34
|
| Rate for Payer: BCN Medicare Advantage |
$696.91
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cash Price |
$2,007.20
|
| Rate for Payer: Cofinity Commercial |
$1,003.55
|
| Rate for Payer: Cofinity Commercial |
$933.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.76
|
| Rate for Payer: Meridian Medicaid |
$491.58
|
| Rate for Payer: Nomi Health Commercial |
$836.29
|
| Rate for Payer: PACE SWMI |
$696.91
|
| Rate for Payer: PHP Commercial |
$975.67
|
| Rate for Payer: PHP Medicare Advantage |
$696.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,244.91
|
| Rate for Payer: Priority Health Medicare |
$696.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,244.91
|
| Rate for Payer: Priority Health SBD |
$1,244.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$696.91
|
| Rate for Payer: UHC Medicare Advantage |
$696.91
|
| Rate for Payer: UHCCP Medicaid |
$468.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,154.14
|
|
|
PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 69210
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$2,090.48 |
| Rate for Payer: Aetna Commercial |
$41.06
|
| Rate for Payer: Aetna Medicare |
$31.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.12
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$30.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,090.48
|
| Rate for Payer: BCN Commercial |
$55.76
|
| Rate for Payer: BCN Medicare Advantage |
$30.64
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$41.06
|
| Rate for Payer: Cofinity Commercial |
$44.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.17
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Nomi Health Commercial |
$36.77
|
| Rate for Payer: PACE SWMI |
$30.64
|
| Rate for Payer: PHP Commercial |
$42.90
|
| Rate for Payer: PHP Medicare Advantage |
$30.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.18
|
| Rate for Payer: Priority Health Medicare |
$30.64
|
| Rate for Payer: Priority Health Narrow Network |
$47.18
|
| Rate for Payer: Priority Health SBD |
$47.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.64
|
| Rate for Payer: UHC Medicare Advantage |
$30.64
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
| Rate for Payer: UMR Bronson Commercial |
$44.62
|
|
|
PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 69209
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$2,108.45 |
| Rate for Payer: Aetna Commercial |
$18.67
|
| Rate for Payer: Aetna Medicare |
$14.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.06
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$13.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.45
|
| Rate for Payer: BCN Commercial |
$22.48
|
| Rate for Payer: BCN Medicare Advantage |
$13.93
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$18.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.63
|
| Rate for Payer: Nomi Health Commercial |
$16.72
|
| Rate for Payer: PACE SWMI |
$13.93
|
| Rate for Payer: PHP Commercial |
$19.50
|
| Rate for Payer: PHP Medicare Advantage |
$13.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.35
|
| Rate for Payer: Priority Health Medicare |
$13.93
|
| Rate for Payer: Priority Health Narrow Network |
$23.35
|
| Rate for Payer: Priority Health SBD |
$23.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.93
|
| Rate for Payer: UHC Medicare Advantage |
$13.93
|
| Rate for Payer: UMR Bronson Commercial |
$11.96
|
|
|
PR REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 57415
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$1,989.05 |
| Rate for Payer: Aetna Commercial |
$223.03
|
| Rate for Payer: Aetna Medicare |
$173.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.03
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$166.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.05
|
| Rate for Payer: BCN Commercial |
$257.53
|
| Rate for Payer: BCN Medicare Advantage |
$166.44
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$239.67
|
| Rate for Payer: Cofinity Commercial |
$223.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.76
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Nomi Health Commercial |
$199.73
|
| Rate for Payer: PACE SWMI |
$166.44
|
| Rate for Payer: PHP Commercial |
$233.02
|
| Rate for Payer: PHP Medicare Advantage |
$166.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.90
|
| Rate for Payer: Priority Health Medicare |
$166.44
|
| Rate for Payer: Priority Health Narrow Network |
$263.90
|
| Rate for Payer: Priority Health SBD |
$263.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.44
|
| Rate for Payer: UHC Medicare Advantage |
$166.44
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
| Rate for Payer: UMR Bronson Commercial |
$152.72
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$106.04 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Aetna American Axle |
$156.65
|
| Rate for Payer: Aetna Commercial |
$204.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.65
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$168.70
|
| Rate for Payer: Cofinity Commercial |
$207.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$168.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.80
|
| Rate for Payer: Healthscope Commercial |
$216.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.85
|
| Rate for Payer: PHP Commercial |
$204.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health SBD |
$151.83
|
| Rate for Payer: UMR Bronson Commercial |
$106.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.75
|
|
