|
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
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 11976
|
| Hospital Charge Code |
11976
|
| Min. Negotiated Rate |
$58.79 |
| Max. Negotiated Rate |
$268.22 |
| Rate for Payer: Aetna Commercial |
$119.14
|
| Rate for Payer: Aetna Medicare |
$92.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.03
|
| Rate for Payer: BCBS Complete |
$61.73
|
| Rate for Payer: BCBS MAPPO |
$88.91
|
| Rate for Payer: BCBS Trust/PPO |
$268.22
|
| Rate for Payer: BCN Commercial |
$212.08
|
| Rate for Payer: BCN Medicare Advantage |
$88.91
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$128.03
|
| Rate for Payer: Cofinity Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.36
|
| Rate for Payer: Meridian Medicaid |
$61.73
|
| Rate for Payer: Nomi Health Commercial |
$106.69
|
| Rate for Payer: PACE SWMI |
$88.91
|
| Rate for Payer: PHP Commercial |
$124.47
|
| Rate for Payer: PHP Medicare Advantage |
$88.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.08
|
| Rate for Payer: Priority Health Medicare |
$88.91
|
| Rate for Payer: Priority Health Narrow Network |
$125.08
|
| Rate for Payer: Priority Health SBD |
$125.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.91
|
| Rate for Payer: UHC Medicare Advantage |
$88.91
|
| Rate for Payer: UHCCP Medicaid |
$58.79
|
| Rate for Payer: UMR Bronson Commercial |
$110.86
|
|
|
PR REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
11976
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$89.17 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$156.65
|
| Rate for Payer: Aetna Commercial |
$204.85
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$727.88
|
| Rate for Payer: BCN Commercial |
$727.88
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| 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: Health Alliance Plan Medicare Advantage |
$689.36
|
| 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: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.85
|
| Rate for Payer: Nomi Health Commercial |
$2,068.08
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$204.85
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$151.83
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.43
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$90.39
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$89.17
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.75
|
|
|
PR REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY
|
Professional
|
Both
|
$438.00
|
|
|
Service Code
|
HCPCS 33241
|
| Min. Negotiated Rate |
$136.32 |
| Max. Negotiated Rate |
$1,338.18 |
| Rate for Payer: Aetna Commercial |
$272.27
|
| Rate for Payer: Aetna Medicare |
$211.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.59
|
| Rate for Payer: BCBS Complete |
$143.14
|
| Rate for Payer: BCBS MAPPO |
$203.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.18
|
| Rate for Payer: BCN Commercial |
$311.29
|
| Rate for Payer: BCN Medicare Advantage |
$203.19
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.35
|
| Rate for Payer: Meridian Medicaid |
$143.14
|
| Rate for Payer: Nomi Health Commercial |
$243.83
|
| Rate for Payer: PACE SWMI |
$203.19
|
| Rate for Payer: PHP Commercial |
$284.47
|
| Rate for Payer: PHP Medicare Advantage |
$203.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.77
|
| Rate for Payer: Priority Health Medicare |
$203.19
|
| Rate for Payer: Priority Health Narrow Network |
$338.77
|
| Rate for Payer: Priority Health SBD |
$338.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.19
|
| Rate for Payer: UHC Medicare Advantage |
$203.19
|
| Rate for Payer: UHCCP Medicaid |
$136.32
|
| Rate for Payer: UMR Bronson Commercial |
$201.48
|
|
|
PR REMOVAL IMPLANT DEEP
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
HCPCS 20680
|
| Hospital Charge Code |
20680
|
| Min. Negotiated Rate |
$272.64 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$540.11
|
| Rate for Payer: Aetna Medicare |
$419.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.42
|
| Rate for Payer: BCBS Complete |
$286.27
|
| Rate for Payer: BCBS MAPPO |
$403.07
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$883.04
|
| Rate for Payer: BCN Medicare Advantage |
$403.07
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$580.42
|
| Rate for Payer: Cofinity Commercial |
$540.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.22
|
| Rate for Payer: Meridian Medicaid |
$286.27
|
| Rate for Payer: Nomi Health Commercial |
$483.68
|
| Rate for Payer: PACE SWMI |
$403.07
|
| Rate for Payer: PHP Commercial |
$564.30
|
| Rate for Payer: PHP Medicare Advantage |
$403.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.76
|
| Rate for Payer: Priority Health Medicare |
$403.07
|
| Rate for Payer: Priority Health Narrow Network |
$646.76
|
| Rate for Payer: Priority Health SBD |
$646.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.07
|
| Rate for Payer: UHC Medicare Advantage |
$403.07
|
| Rate for Payer: UHCCP Medicaid |
$272.64
|
| Rate for Payer: UMR Bronson Commercial |
$499.10
|
|
|
PR REMOVAL IMPLANT DEEP
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
HCPCS 20680
|
| Min. Negotiated Rate |
$272.64 |
| Max. Negotiated Rate |
$8,162.77 |
| Rate for Payer: Aetna Commercial |
$540.11
|
| Rate for Payer: Aetna Medicare |
$419.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.42
|
| Rate for Payer: BCBS Complete |
$286.27
|
| Rate for Payer: BCBS MAPPO |
$403.07
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$883.04
|
| Rate for Payer: BCN Medicare Advantage |
$403.07
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$540.11
|
| Rate for Payer: Cofinity Commercial |
$580.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.22
|
| Rate for Payer: Meridian Medicaid |
$286.27
|
| Rate for Payer: Nomi Health Commercial |
$483.68
|
| Rate for Payer: PACE SWMI |
$403.07
|
| Rate for Payer: PHP Commercial |
$564.30
|
| Rate for Payer: PHP Medicare Advantage |
$403.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.76
|
| Rate for Payer: Priority Health Medicare |
$403.07
|
| Rate for Payer: Priority Health Narrow Network |
$646.76
|
| Rate for Payer: Priority Health SBD |
$646.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.07
|
| Rate for Payer: UHC Medicare Advantage |
$403.07
|
| Rate for Payer: UHCCP Medicaid |
$272.64
|
| Rate for Payer: UMR Bronson Commercial |
$499.10
|
|
|
PR REMOVAL IMPLANT DEEP
|
Facility
|
OP
|
$1,085.00
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
20680
|
| Min. Negotiated Rate |
$401.45 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$759.50
|
| Rate for Payer: Cofinity Commercial |
$933.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$759.50
|
| Rate for Payer: Aetna American Axle |
$705.25
|
| Rate for Payer: Aetna Commercial |
$922.25
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.25
|
| 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 |
$3,631.19
|
| Rate for Payer: BCN Commercial |
$3,631.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$976.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$759.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.75
|
| 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 |
$922.25
|
| Rate for Payer: Nomi Health Commercial |
$8,412.54
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$922.25
|
| 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 |
$705.25
|
| 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 |
$683.55
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.16
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$405.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$401.45
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.75
|
|
|
PR REMOVAL IMPLANT DEEP
|
Facility
|
IP
|
$1,085.00
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
20680
|
| Min. Negotiated Rate |
$477.40 |
| Max. Negotiated Rate |
$976.50 |
| Rate for Payer: Aetna American Axle |
$705.25
|
| Rate for Payer: Aetna Commercial |
$922.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.25
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$759.50
|
| Rate for Payer: Cofinity Commercial |
$933.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$759.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.00
|
| Rate for Payer: Healthscope Commercial |
$976.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$759.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.25
|
| Rate for Payer: PHP Commercial |
$922.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.25
|
| Rate for Payer: Priority Health SBD |
$683.55
|
| Rate for Payer: UMR Bronson Commercial |
$477.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.75
|
|
|
PR REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 36262
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$541.45 |
| Rate for Payer: Aetna Commercial |
$406.74
|
| Rate for Payer: Aetna Medicare |
$315.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.10
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$303.54
|
| Rate for Payer: BCBS Trust/PPO |
$244.60
|
| Rate for Payer: BCN Commercial |
$460.83
|
| Rate for Payer: BCN Medicare Advantage |
$303.54
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$406.74
|
| Rate for Payer: Cofinity Commercial |
$437.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.72
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Nomi Health Commercial |
$364.25
|
| Rate for Payer: PACE SWMI |
$303.54
|
| Rate for Payer: PHP Commercial |
$424.96
|
| Rate for Payer: PHP Medicare Advantage |
$303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$507.36
|
| Rate for Payer: Priority Health Medicare |
$303.54
|
| Rate for Payer: Priority Health Narrow Network |
$507.36
|
| Rate for Payer: Priority Health SBD |
$507.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.54
|
| Rate for Payer: UHC Medicare Advantage |
$303.54
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
| Rate for Payer: UMR Bronson Commercial |
$383.18
|
|
|
PR REMOVAL IMPLANT FROM FINGER/HAND
|
Professional
|
Both
|
$1,044.00
|
|
|
Service Code
|
HCPCS 26320
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Aetna Commercial |
$453.78
|
| Rate for Payer: Aetna Medicare |
$352.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.64
|
| Rate for Payer: BCBS Complete |
$243.11
|
| Rate for Payer: BCBS MAPPO |
$338.64
|
| Rate for Payer: BCBS Trust/PPO |
$140.00
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$338.64
|
| Rate for Payer: Cash Price |
$835.20
|
| Rate for Payer: Cash Price |
$835.20
|
| Rate for Payer: Cofinity Commercial |
$453.78
|
| Rate for Payer: Cofinity Commercial |
$487.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.57
|
| Rate for Payer: Meridian Medicaid |
$243.11
|
| Rate for Payer: Nomi Health Commercial |
$406.37
|
| Rate for Payer: PACE SWMI |
$338.64
|
| Rate for Payer: PHP Commercial |
$474.10
|
| Rate for Payer: PHP Medicare Advantage |
$338.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.52
|
| Rate for Payer: Priority Health Medicare |
$338.64
|
| Rate for Payer: Priority Health Narrow Network |
$546.52
|
| Rate for Payer: Priority Health SBD |
$546.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.64
|
| Rate for Payer: UHC Medicare Advantage |
$338.64
|
| Rate for Payer: UHCCP Medicaid |
$231.53
|
| Rate for Payer: UMR Bronson Commercial |
$480.24
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Facility
|
IP
|
$919.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$404.36 |
| Max. Negotiated Rate |
$827.10 |
| Rate for Payer: Aetna American Axle |
$597.35
|
| Rate for Payer: Aetna Commercial |
$781.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.35
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$643.30
|
| Rate for Payer: Cofinity Commercial |
$790.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.20
|
| Rate for Payer: Healthscope Commercial |
$827.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.15
|
| Rate for Payer: PHP Commercial |
$781.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health SBD |
$578.97
|
| Rate for Payer: UMR Bronson Commercial |
$404.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.25
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Facility
|
OP
|
$919.00
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$138.19 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$597.35
|
| Rate for Payer: Aetna Commercial |
$781.15
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.35
|
| 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 |
$1,616.89
|
| Rate for Payer: BCN Commercial |
$1,616.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$643.30
|
| Rate for Payer: Cofinity Commercial |
$790.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$643.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$827.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.25
|
| 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 |
$781.15
|
| Rate for Payer: Nomi Health Commercial |
$4,762.44
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$781.15
|
| 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 |
$597.35
|
| 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 |
$578.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.01
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$138.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$340.03
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.25
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 20670
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$184.61
|
| Rate for Payer: Aetna Medicare |
$143.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.39
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$137.77
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$422.50
|
| Rate for Payer: BCN Medicare Advantage |
$137.77
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$184.61
|
| Rate for Payer: Cofinity Commercial |
$198.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.66
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Nomi Health Commercial |
$165.32
|
| Rate for Payer: PACE SWMI |
$137.77
|
| Rate for Payer: PHP Commercial |
$192.88
|
| Rate for Payer: PHP Medicare Advantage |
$137.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.88
|
| Rate for Payer: Priority Health Medicare |
$137.77
|
| Rate for Payer: Priority Health Narrow Network |
$222.88
|
| Rate for Payer: Priority Health SBD |
$222.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.77
|
| Rate for Payer: UHC Medicare Advantage |
$137.77
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
| Rate for Payer: UMR Bronson Commercial |
$422.74
|
|
|
PR REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 20670
|
| Hospital Charge Code |
20670
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$22,818.32 |
| Rate for Payer: Aetna Commercial |
$184.61
|
| Rate for Payer: Aetna Medicare |
$143.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.39
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$137.77
|
| Rate for Payer: BCBS Trust/PPO |
$22,818.32
|
| Rate for Payer: BCN Commercial |
$422.50
|
| Rate for Payer: BCN Medicare Advantage |
$137.77
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$198.39
|
| Rate for Payer: Cofinity Commercial |
$184.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.66
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Nomi Health Commercial |
$165.32
|
| Rate for Payer: PACE SWMI |
$137.77
|
| Rate for Payer: PHP Commercial |
$192.88
|
| Rate for Payer: PHP Medicare Advantage |
$137.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.88
|
| Rate for Payer: Priority Health Medicare |
$137.77
|
| Rate for Payer: Priority Health Narrow Network |
$222.88
|
| Rate for Payer: Priority Health SBD |
$222.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.77
|
| Rate for Payer: UHC Medicare Advantage |
$137.77
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
| Rate for Payer: UMR Bronson Commercial |
$422.74
|
|
|
PR REMOVAL INDWELLING URETERAL STENT PRQ
|
Professional
|
Both
|
$1,695.00
|
|
|
Service Code
|
HCPCS 50384
|
| Min. Negotiated Rate |
$142.07 |
| Max. Negotiated Rate |
$3,794.78 |
| Rate for Payer: Aetna Commercial |
$287.50
|
| Rate for Payer: Aetna Medicare |
$223.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.95
|
| Rate for Payer: BCBS Complete |
$149.17
|
| Rate for Payer: BCBS MAPPO |
$214.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,794.78
|
| Rate for Payer: BCN Commercial |
$1,270.56
|
| Rate for Payer: BCN Medicare Advantage |
$214.55
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cash Price |
$1,356.00
|
| Rate for Payer: Cofinity Commercial |
$287.50
|
| Rate for Payer: Cofinity Commercial |
$308.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.28
|
| Rate for Payer: Meridian Medicaid |
$149.17
|
| Rate for Payer: Nomi Health Commercial |
$257.46
|
| Rate for Payer: PACE SWMI |
$214.55
|
| Rate for Payer: PHP Commercial |
$300.37
|
| Rate for Payer: PHP Medicare Advantage |
$214.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,101.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.05
|
| Rate for Payer: Priority Health Medicare |
$214.55
|
| Rate for Payer: Priority Health Narrow Network |
$352.05
|
| Rate for Payer: Priority Health SBD |
$352.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.55
|
| Rate for Payer: UHC Medicare Advantage |
$214.55
|
| Rate for Payer: UHCCP Medicaid |
$142.07
|
| Rate for Payer: UMR Bronson Commercial |
$779.70
|
|
|
PR REMOVAL INTACT BREAST IMPLANT
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 19328
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Aetna Commercial |
$712.16
|
| Rate for Payer: Aetna Medicare |
$552.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.30
|
| Rate for Payer: BCBS Complete |
$377.97
|
| Rate for Payer: BCBS MAPPO |
$531.46
|
| Rate for Payer: BCBS Trust/PPO |
$14.00
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$531.46
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$712.16
|
| Rate for Payer: Cofinity Commercial |
$765.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$558.03
|
| Rate for Payer: Meridian Medicaid |
$377.97
|
| Rate for Payer: Nomi Health Commercial |
$637.75
|
| Rate for Payer: PACE SWMI |
$531.46
|
| Rate for Payer: PHP Commercial |
$744.04
|
| Rate for Payer: PHP Medicare Advantage |
$531.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.48
|
| Rate for Payer: Priority Health Medicare |
$531.46
|
| Rate for Payer: Priority Health Narrow Network |
$754.48
|
| Rate for Payer: Priority Health SBD |
$754.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$531.46
|
| Rate for Payer: UHC Medicare Advantage |
$531.46
|
| Rate for Payer: UHCCP Medicaid |
$359.97
|
| Rate for Payer: UMR Bronson Commercial |
$703.80
|
|
|
PR REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 33968
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$267.85 |
| Rate for Payer: Aetna Commercial |
$43.66
|
| Rate for Payer: Aetna Medicare |
$33.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.92
|
| Rate for Payer: BCBS Complete |
$22.36
|
| Rate for Payer: BCBS MAPPO |
$32.58
|
| Rate for Payer: BCBS Trust/PPO |
$267.85
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$32.58
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$43.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.21
|
| Rate for Payer: Meridian Medicaid |
$22.36
|
| Rate for Payer: Nomi Health Commercial |
$39.10
|
| Rate for Payer: PACE SWMI |
$32.58
|
| Rate for Payer: PHP Commercial |
$45.61
|
| Rate for Payer: PHP Medicare Advantage |
$32.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.64
|
| Rate for Payer: Priority Health Medicare |
$32.58
|
| Rate for Payer: Priority Health Narrow Network |
$52.64
|
| Rate for Payer: Priority Health SBD |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.58
|
| Rate for Payer: UHC Medicare Advantage |
$32.58
|
| Rate for Payer: UHCCP Medicaid |
$21.30
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
|
|
PR REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 20705
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$187.77 |
| Rate for Payer: Aetna Commercial |
$160.18
|
| Rate for Payer: Aetna Medicare |
$124.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.14
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$119.54
|
| Rate for Payer: BCN Commercial |
$180.81
|
| Rate for Payer: BCN Medicare Advantage |
$119.54
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$172.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.52
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Nomi Health Commercial |
$143.45
|
| Rate for Payer: PACE SWMI |
$119.54
|
| Rate for Payer: PHP Commercial |
$167.36
|
| Rate for Payer: PHP Medicare Advantage |
$119.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.77
|
| Rate for Payer: Priority Health Medicare |
$119.54
|
| Rate for Payer: Priority Health Narrow Network |
$187.77
|
| Rate for Payer: Priority Health SBD |
$187.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.54
|
| Rate for Payer: UHC Medicare Advantage |
$119.54
|
| Rate for Payer: UHCCP Medicaid |
$79.24
|
| Rate for Payer: UMR Bronson Commercial |
$117.76
|
|
|
PR REMOVAL INTRAUTERINE DEVICE IUD
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 58301
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$510.34 |
| Rate for Payer: Aetna Commercial |
$85.47
|
| Rate for Payer: Aetna Medicare |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.84
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS MAPPO |
$63.78
|
| Rate for Payer: BCBS Trust/PPO |
$510.34
|
| Rate for Payer: BCN Commercial |
$130.36
|
| Rate for Payer: BCN Medicare Advantage |
$63.78
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$85.47
|
| Rate for Payer: Cofinity Commercial |
$91.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.97
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Nomi Health Commercial |
$76.54
|
| Rate for Payer: PACE SWMI |
$63.78
|
| Rate for Payer: PHP Commercial |
$89.29
|
| Rate for Payer: PHP Medicare Advantage |
$63.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.22
|
| Rate for Payer: Priority Health Medicare |
$63.78
|
| Rate for Payer: Priority Health Narrow Network |
$98.22
|
| Rate for Payer: Priority Health SBD |
$98.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.78
|
| Rate for Payer: UHC Medicare Advantage |
$63.78
|
| Rate for Payer: UHCCP Medicaid |
$42.17
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA
|
Professional
|
Both
|
$6,102.00
|
|
|
Service Code
|
HCPCS 32442
|
| Min. Negotiated Rate |
$640.30 |
| Max. Negotiated Rate |
$4,375.62 |
| Rate for Payer: Aetna Commercial |
$3,929.26
|
| Rate for Payer: Aetna Medicare |
$3,049.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,929.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,222.48
|
| Rate for Payer: BCBS Complete |
$2,013.30
|
| Rate for Payer: BCBS MAPPO |
$2,932.28
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$4,375.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,932.28
|
| Rate for Payer: Cash Price |
$4,881.60
|
| Rate for Payer: Cash Price |
$4,881.60
|
| Rate for Payer: Cofinity Commercial |
$3,929.26
|
| Rate for Payer: Cofinity Commercial |
$4,222.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,932.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,078.89
|
| Rate for Payer: Meridian Medicaid |
$2,013.30
|
| Rate for Payer: Nomi Health Commercial |
$3,518.74
|
| Rate for Payer: PACE SWMI |
$2,932.28
|
| Rate for Payer: PHP Commercial |
$4,105.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,932.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,917.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,966.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,163.32
|
| Rate for Payer: Priority Health Medicare |
$2,932.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,163.32
|
| Rate for Payer: Priority Health SBD |
$4,163.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,932.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,932.28
|
| Rate for Payer: UHCCP Medicaid |
$1,917.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,806.92
|
|
|
PR REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 11982
|
| Min. Negotiated Rate |
$46.43 |
| Max. Negotiated Rate |
$438.68 |
| Rate for Payer: Aetna Commercial |
$93.87
|
| Rate for Payer: Aetna Medicare |
$72.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.87
|
| Rate for Payer: BCBS Complete |
$48.75
|
| Rate for Payer: BCBS MAPPO |
$70.05
|
| Rate for Payer: BCBS Trust/PPO |
$438.68
|
| Rate for Payer: BCN Commercial |
$164.69
|
| Rate for Payer: BCN Medicare Advantage |
$70.05
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$100.87
|
| Rate for Payer: Cofinity Commercial |
$93.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.55
|
| Rate for Payer: Meridian Medicaid |
$48.75
|
| Rate for Payer: Nomi Health Commercial |
$84.06
|
| Rate for Payer: PACE SWMI |
$70.05
|
| Rate for Payer: PHP Commercial |
$98.07
|
| Rate for Payer: PHP Medicare Advantage |
$70.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.44
|
| Rate for Payer: Priority Health Medicare |
$70.05
|
| Rate for Payer: Priority Health Narrow Network |
$98.44
|
| Rate for Payer: Priority Health SBD |
$98.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.05
|
| Rate for Payer: UHC Medicare Advantage |
$70.05
|
| Rate for Payer: UHCCP Medicaid |
$46.43
|
| Rate for Payer: UMR Bronson Commercial |
$116.84
|
|
|
PR REMOVAL OF LUNG PNEUMONECTOMY
|
Professional
|
Both
|
$5,503.00
|
|
|
Service Code
|
HCPCS 32440
|
| Min. Negotiated Rate |
$544.68 |
| Max. Negotiated Rate |
$3,576.95 |
| Rate for Payer: Aetna Commercial |
$2,020.04
|
| Rate for Payer: Aetna Medicare |
$1,567.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,020.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,170.79
|
| Rate for Payer: BCBS Complete |
$1,042.21
|
| Rate for Payer: BCBS MAPPO |
$1,507.49
|
| Rate for Payer: BCBS Trust/PPO |
$544.68
|
| Rate for Payer: BCN Commercial |
$2,254.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,507.49
|
| Rate for Payer: Cash Price |
$4,402.40
|
| Rate for Payer: Cash Price |
$4,402.40
|
| Rate for Payer: Cofinity Commercial |
$2,020.04
|
| Rate for Payer: Cofinity Commercial |
$2,170.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,507.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,582.86
|
| Rate for Payer: Meridian Medicaid |
$1,042.21
|
| Rate for Payer: Nomi Health Commercial |
$1,808.99
|
| Rate for Payer: PACE SWMI |
$1,507.49
|
| Rate for Payer: PHP Commercial |
$2,110.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,507.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$992.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,576.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,150.48
|
| Rate for Payer: Priority Health Medicare |
$1,507.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,150.48
|
| Rate for Payer: Priority Health SBD |
$2,150.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,507.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,507.49
|
| Rate for Payer: UHCCP Medicaid |
$992.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,531.38
|
|
|
PR REMOVAL OF SUTURES
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS S0630
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$66.04 |
| Rate for Payer: Aetna Commercial |
$27.32
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.32
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Trust/PPO |
$66.04
|
| Rate for Payer: BCN Commercial |
$37.93
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
|
|
PR REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY
|
Professional
|
Both
|
$2,257.00
|
|
|
Service Code
|
HCPCS 49402
|
| Min. Negotiated Rate |
$551.46 |
| Max. Negotiated Rate |
$2,108.97 |
| Rate for Payer: Aetna Commercial |
$1,115.39
|
| Rate for Payer: Aetna Medicare |
$865.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.63
|
| Rate for Payer: BCBS Complete |
$579.03
|
| Rate for Payer: BCBS MAPPO |
$832.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.97
|
| Rate for Payer: BCN Commercial |
$1,247.10
|
| Rate for Payer: BCN Medicare Advantage |
$832.38
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cash Price |
$1,805.60
|
| Rate for Payer: Cofinity Commercial |
$1,115.39
|
| Rate for Payer: Cofinity Commercial |
$1,198.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$874.00
|
| Rate for Payer: Meridian Medicaid |
$579.03
|
| Rate for Payer: Nomi Health Commercial |
$998.86
|
| Rate for Payer: PACE SWMI |
$832.38
|
| Rate for Payer: PHP Commercial |
$1,165.33
|
| Rate for Payer: PHP Medicare Advantage |
$832.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$551.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,532.05
|
| Rate for Payer: Priority Health Medicare |
$832.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,532.05
|
| Rate for Payer: Priority Health SBD |
$1,532.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$832.38
|
| Rate for Payer: UHC Medicare Advantage |
$832.38
|
| Rate for Payer: UHCCP Medicaid |
$551.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,038.22
|
|
|
PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 33233
|
| Min. Negotiated Rate |
$147.82 |
| Max. Negotiated Rate |
$702.64 |
| Rate for Payer: Aetna Commercial |
$294.21
|
| Rate for Payer: Aetna Medicare |
$228.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.17
|
| Rate for Payer: BCBS Complete |
$155.21
|
| Rate for Payer: BCBS MAPPO |
$219.56
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: BCN Medicare Advantage |
$219.56
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$294.21
|
| Rate for Payer: Cofinity Commercial |
$316.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.54
|
| Rate for Payer: Meridian Medicaid |
$155.21
|
| Rate for Payer: Nomi Health Commercial |
$263.47
|
| Rate for Payer: PACE SWMI |
$219.56
|
| Rate for Payer: PHP Commercial |
$307.38
|
| Rate for Payer: PHP Medicare Advantage |
$219.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.02
|
| Rate for Payer: Priority Health Medicare |
$219.56
|
| Rate for Payer: Priority Health Narrow Network |
$368.02
|
| Rate for Payer: Priority Health SBD |
$368.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.56
|
| Rate for Payer: UHC Medicare Advantage |
$219.56
|
| Rate for Payer: UHCCP Medicaid |
$147.82
|
| Rate for Payer: UMR Bronson Commercial |
$292.10
|
|
