|
PR TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM
|
Professional
|
Both
|
$2,482.00
|
|
|
Service Code
|
HCPCS 58200
|
| Min. Negotiated Rate |
$801.31 |
| Max. Negotiated Rate |
$2,384.98 |
| Rate for Payer: Aetna Commercial |
$1,672.53
|
| Rate for Payer: Aetna Medicare |
$1,298.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,672.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,797.35
|
| Rate for Payer: BCBS Complete |
$841.38
|
| Rate for Payer: BCBS MAPPO |
$1,248.16
|
| Rate for Payer: BCN Commercial |
$2,028.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,248.16
|
| Rate for Payer: Cash Price |
$1,985.60
|
| Rate for Payer: Cash Price |
$1,985.60
|
| Rate for Payer: Cofinity Commercial |
$1,672.53
|
| Rate for Payer: Cofinity Commercial |
$1,797.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,248.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,310.57
|
| Rate for Payer: Meridian Medicaid |
$841.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,372.98
|
| Rate for Payer: Nomi Health Commercial |
$1,497.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,861.50
|
| Rate for Payer: PACE SWMI |
$1,248.16
|
| Rate for Payer: PHP Commercial |
$1,747.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,248.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,054.20
|
| Rate for Payer: Priority Health Medicare |
$1,248.16
|
| Rate for Payer: Priority Health SBD |
$2,054.20
|
| Rate for Payer: Priority Health Tiered Network |
$2,054.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,248.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,384.98
|
| Rate for Payer: UHC Core |
$2,384.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,248.16
|
| Rate for Payer: UHC Exchange |
$2,384.98
|
| Rate for Payer: UHC Medicaid |
$801.31
|
| Rate for Payer: UHCCP Medicaid |
$801.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,141.72
|
|
|
PR TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY
|
Professional
|
Both
|
$3,458.00
|
|
|
Service Code
|
HCPCS 58152
|
| Min. Negotiated Rate |
$695.23 |
| Max. Negotiated Rate |
$2,593.50 |
| Rate for Payer: Aetna Commercial |
$1,452.91
|
| Rate for Payer: Aetna Medicare |
$1,127.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,452.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,561.33
|
| Rate for Payer: BCBS Complete |
$729.99
|
| Rate for Payer: BCBS MAPPO |
$1,084.26
|
| Rate for Payer: BCN Commercial |
$1,851.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,084.26
|
| Rate for Payer: Cash Price |
$2,766.40
|
| Rate for Payer: Cash Price |
$2,766.40
|
| Rate for Payer: Cofinity Commercial |
$1,452.91
|
| Rate for Payer: Cofinity Commercial |
$1,561.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,084.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,138.47
|
| Rate for Payer: Meridian Medicaid |
$729.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,192.69
|
| Rate for Payer: Nomi Health Commercial |
$1,301.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,593.50
|
| Rate for Payer: PACE SWMI |
$1,084.26
|
| Rate for Payer: PHP Commercial |
$1,517.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,084.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$695.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,875.67
|
| Rate for Payer: Priority Health Medicare |
$1,084.26
|
| Rate for Payer: Priority Health SBD |
$1,875.67
|
| Rate for Payer: Priority Health Tiered Network |
$1,875.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,084.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,223.23
|
| Rate for Payer: UHC Core |
$2,223.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,084.26
|
| Rate for Payer: UHC Exchange |
$2,223.23
|
| Rate for Payer: UHC Medicaid |
$695.23
|
| Rate for Payer: UHCCP Medicaid |
$695.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,590.68
|
|
|
PR TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY
|
Professional
|
Both
|
$3,312.00
|
|
|
Service Code
|
HCPCS 58150
|
| Min. Negotiated Rate |
$595.12 |
| Max. Negotiated Rate |
$2,484.00 |
| Rate for Payer: Aetna Commercial |
$1,240.41
|
| Rate for Payer: Aetna Medicare |
$962.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,240.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.98
|
| Rate for Payer: BCBS Complete |
$624.88
|
| Rate for Payer: BCBS MAPPO |
$925.68
|
| Rate for Payer: BCN Commercial |
$1,528.80
|
| Rate for Payer: BCN Medicare Advantage |
$925.68
|
| Rate for Payer: Cash Price |
$2,649.60
|
| Rate for Payer: Cash Price |
$2,649.60
|
| Rate for Payer: Cofinity Commercial |
$1,240.41
|
| Rate for Payer: Cofinity Commercial |
$1,332.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$971.96
|
| Rate for Payer: Meridian Medicaid |
$624.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,018.25
|
| Rate for Payer: Nomi Health Commercial |
$1,110.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,484.00
|
| Rate for Payer: PACE SWMI |
$925.68
|
| Rate for Payer: PHP Commercial |
$1,295.95
|
| Rate for Payer: PHP Medicare Advantage |
$925.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,548.35
|
| Rate for Payer: Priority Health Medicare |
$925.68
|
| Rate for Payer: Priority Health SBD |
$1,548.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,548.35
|
| Rate for Payer: Railroad Medicare Medicare |
$925.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,787.50
|
| Rate for Payer: UHC Core |
$1,787.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$925.68
|
| Rate for Payer: UHC Exchange |
$1,787.50
|
| Rate for Payer: UHC Medicaid |
$595.12
|
| Rate for Payer: UHCCP Medicaid |
$595.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,523.52
|
|
|
PR TOTAL DISC ARTHRP ANT 2ND LEVEL CERVICAL
|
Professional
|
Both
|
$1,108.00
|
|
|
Service Code
|
HCPCS 22858
|
| Min. Negotiated Rate |
$286.49 |
| Max. Negotiated Rate |
$911.48 |
| Rate for Payer: Aetna Commercial |
$606.06
|
| Rate for Payer: Aetna Medicare |
$470.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.28
|
| Rate for Payer: BCBS Complete |
$300.81
|
| Rate for Payer: BCBS MAPPO |
$452.28
|
| Rate for Payer: BCN Commercial |
$758.43
|
| Rate for Payer: BCN Medicare Advantage |
$452.28
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cash Price |
$886.40
|
| Rate for Payer: Cofinity Commercial |
$606.06
|
| Rate for Payer: Cofinity Commercial |
$651.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.89
|
| Rate for Payer: Meridian Medicaid |
$300.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$497.51
|
| Rate for Payer: Nomi Health Commercial |
$542.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$831.00
|
| Rate for Payer: PACE SWMI |
$452.28
|
| Rate for Payer: PHP Commercial |
$633.19
|
| Rate for Payer: PHP Medicare Advantage |
$452.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$810.74
|
| Rate for Payer: Priority Health Medicare |
$452.28
|
| Rate for Payer: Priority Health SBD |
$810.74
|
| Rate for Payer: Priority Health Tiered Network |
$810.74
|
| Rate for Payer: Railroad Medicare Medicare |
$452.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$911.48
|
| Rate for Payer: UHC Core |
$911.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$452.28
|
| Rate for Payer: UHC Exchange |
$911.48
|
| Rate for Payer: UHC Medicaid |
$286.49
|
| Rate for Payer: UHCCP Medicaid |
$286.49
|
| Rate for Payer: UMR Bronson Commercial |
$509.68
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE CERVICAL
|
Professional
|
Both
|
$3,521.00
|
|
|
Service Code
|
HCPCS 22856
|
| Min. Negotiated Rate |
$970.64 |
| Max. Negotiated Rate |
$2,888.40 |
| Rate for Payer: Aetna Commercial |
$2,024.99
|
| Rate for Payer: Aetna Medicare |
$1,571.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,024.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,176.11
|
| Rate for Payer: BCBS Complete |
$1,019.17
|
| Rate for Payer: BCBS MAPPO |
$1,511.19
|
| Rate for Payer: BCN Commercial |
$2,458.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,511.19
|
| Rate for Payer: Cash Price |
$2,816.80
|
| Rate for Payer: Cash Price |
$2,816.80
|
| Rate for Payer: Cofinity Commercial |
$2,024.99
|
| Rate for Payer: Cofinity Commercial |
$2,176.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,511.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,586.75
|
| Rate for Payer: Meridian Medicaid |
$1,019.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,662.31
|
| Rate for Payer: Nomi Health Commercial |
$1,813.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,640.75
|
| Rate for Payer: PACE SWMI |
$1,511.19
|
| Rate for Payer: PHP Commercial |
$2,115.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,511.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$970.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,628.11
|
| Rate for Payer: Priority Health Medicare |
$1,511.19
|
| Rate for Payer: Priority Health SBD |
$2,628.11
|
| Rate for Payer: Priority Health Tiered Network |
$2,628.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,511.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,888.40
|
| Rate for Payer: UHC Core |
$2,888.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,511.19
|
| Rate for Payer: UHC Exchange |
$2,888.40
|
| Rate for Payer: UHC Medicaid |
$970.64
|
| Rate for Payer: UHCCP Medicaid |
$970.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,619.66
|
|
|
PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR
|
Professional
|
Both
|
$7,256.00
|
|
|
Service Code
|
HCPCS 22857
|
| Min. Negotiated Rate |
$1,000.46 |
| Max. Negotiated Rate |
$5,442.00 |
| Rate for Payer: Aetna Commercial |
$2,076.77
|
| Rate for Payer: Aetna Medicare |
$1,611.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,076.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,231.76
|
| Rate for Payer: BCBS Complete |
$1,050.48
|
| Rate for Payer: BCBS MAPPO |
$1,549.83
|
| Rate for Payer: BCN Commercial |
$2,631.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,549.83
|
| Rate for Payer: Cash Price |
$5,804.80
|
| Rate for Payer: Cash Price |
$5,804.80
|
| Rate for Payer: Cofinity Commercial |
$2,076.77
|
| Rate for Payer: Cofinity Commercial |
$2,231.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,549.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,627.32
|
| Rate for Payer: Meridian Medicaid |
$1,050.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,704.81
|
| Rate for Payer: Nomi Health Commercial |
$1,859.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,442.00
|
| Rate for Payer: PACE SWMI |
$1,549.83
|
| Rate for Payer: PHP Commercial |
$2,169.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,549.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,000.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,812.82
|
| Rate for Payer: Priority Health Medicare |
$1,549.83
|
| Rate for Payer: Priority Health SBD |
$2,812.82
|
| Rate for Payer: Priority Health Tiered Network |
$2,812.82
|
| Rate for Payer: Railroad Medicare Medicare |
$1,549.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,120.85
|
| Rate for Payer: UHC Core |
$3,120.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,549.83
|
| Rate for Payer: UHC Exchange |
$3,120.85
|
| Rate for Payer: UHC Medicaid |
$1,000.46
|
| Rate for Payer: UHCCP Medicaid |
$1,000.46
|
| Rate for Payer: UMR Bronson Commercial |
$3,337.76
|
|
|
PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY
|
Professional
|
Both
|
$6,062.00
|
|
|
Service Code
|
HCPCS 43112
|
| Min. Negotiated Rate |
$2,039.90 |
| Max. Negotiated Rate |
$6,226.12 |
| Rate for Payer: Aetna Commercial |
$4,296.20
|
| Rate for Payer: Aetna Medicare |
$3,334.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,296.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,616.81
|
| Rate for Payer: BCBS Complete |
$2,141.89
|
| Rate for Payer: BCBS MAPPO |
$3,206.12
|
| Rate for Payer: BCN Commercial |
$5,037.57
|
| Rate for Payer: BCN Medicare Advantage |
$3,206.12
|
| Rate for Payer: Cash Price |
$4,849.60
|
| Rate for Payer: Cash Price |
$4,849.60
|
| Rate for Payer: Cofinity Commercial |
$4,296.20
|
| Rate for Payer: Cofinity Commercial |
$4,616.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,206.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,366.43
|
| Rate for Payer: Meridian Medicaid |
$2,141.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,526.73
|
| Rate for Payer: Nomi Health Commercial |
$3,847.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,546.50
|
| Rate for Payer: PACE SWMI |
$3,206.12
|
| Rate for Payer: PHP Commercial |
$4,488.57
|
| Rate for Payer: PHP Medicare Advantage |
$3,206.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,039.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,137.95
|
| Rate for Payer: Priority Health Medicare |
$3,206.12
|
| Rate for Payer: Priority Health SBD |
$6,137.95
|
| Rate for Payer: Priority Health Tiered Network |
$6,137.95
|
| Rate for Payer: Railroad Medicare Medicare |
$3,206.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,226.12
|
| Rate for Payer: UHC Core |
$6,226.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,206.12
|
| Rate for Payer: UHC Exchange |
$6,226.12
|
| Rate for Payer: UHC Medicaid |
$2,039.90
|
| Rate for Payer: UHCCP Medicaid |
$2,039.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,788.52
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,621.00
|
|
|
Service Code
|
HCPCS 60220
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$1,965.75 |
| Rate for Payer: Aetna Commercial |
$846.42
|
| Rate for Payer: Aetna Medicare |
$656.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.59
|
| Rate for Payer: BCBS Complete |
$428.74
|
| Rate for Payer: BCBS MAPPO |
$631.66
|
| Rate for Payer: BCN Commercial |
$1,065.68
|
| Rate for Payer: BCN Medicare Advantage |
$631.66
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$846.42
|
| Rate for Payer: Cofinity Commercial |
$909.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.24
|
| Rate for Payer: Meridian Medicaid |
$428.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.83
|
| Rate for Payer: Nomi Health Commercial |
$757.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.75
|
| Rate for Payer: PACE SWMI |
$631.66
|
| Rate for Payer: PHP Commercial |
$884.32
|
| Rate for Payer: PHP Medicare Advantage |
$631.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.57
|
| Rate for Payer: Priority Health Medicare |
$631.66
|
| Rate for Payer: Priority Health SBD |
$1,155.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,155.57
|
| Rate for Payer: Railroad Medicare Medicare |
$631.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.09
|
| Rate for Payer: UHC Core |
$1,239.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.66
|
| Rate for Payer: UHC Exchange |
$1,239.09
|
| Rate for Payer: UHC Medicaid |
$408.32
|
| Rate for Payer: UHCCP Medicaid |
$408.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,205.66
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
OP
|
$2,621.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$969.77 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna American Axle |
$1,703.65
|
| Rate for Payer: Aetna Commercial |
$2,227.85
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,703.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$7,323.84
|
| Rate for Payer: BCN Commercial |
$7,323.84
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Advantage |
$1,834.70
|
| Rate for Payer: Cofinity Commercial |
$2,254.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,096.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$2,358.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,834.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,965.75
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,227.85
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.75
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$2,227.85
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$1,651.23
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: UMR Bronson Commercial |
$969.77
|
| Rate for Payer: VA VA |
$6,023.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,965.75
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$2,621.00
|
|
|
Service Code
|
HCPCS 60220
|
| Hospital Charge Code |
60220
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$1,965.75 |
| Rate for Payer: Aetna Commercial |
$846.42
|
| Rate for Payer: Aetna Medicare |
$656.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.59
|
| Rate for Payer: BCBS Complete |
$428.74
|
| Rate for Payer: BCBS MAPPO |
$631.66
|
| Rate for Payer: BCN Commercial |
$1,065.68
|
| Rate for Payer: BCN Medicare Advantage |
$631.66
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$846.42
|
| Rate for Payer: Cofinity Commercial |
$909.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.24
|
| Rate for Payer: Meridian Medicaid |
$428.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$694.83
|
| Rate for Payer: Nomi Health Commercial |
$757.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.75
|
| Rate for Payer: PACE SWMI |
$631.66
|
| Rate for Payer: PHP Commercial |
$884.32
|
| Rate for Payer: PHP Medicare Advantage |
$631.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.57
|
| Rate for Payer: Priority Health Medicare |
$631.66
|
| Rate for Payer: Priority Health SBD |
$1,155.57
|
| Rate for Payer: Priority Health Tiered Network |
$1,155.57
|
| Rate for Payer: Railroad Medicare Medicare |
$631.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.09
|
| Rate for Payer: UHC Core |
$1,239.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$631.66
|
| Rate for Payer: UHC Exchange |
$1,239.09
|
| Rate for Payer: UHC Medicaid |
$408.32
|
| Rate for Payer: UHCCP Medicaid |
$408.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,205.66
|
|
|
PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Facility
|
IP
|
$2,621.00
|
|
|
Service Code
|
CPT 60220
|
| Hospital Charge Code |
60220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,153.24 |
| Max. Negotiated Rate |
$2,358.90 |
| Rate for Payer: Aetna American Axle |
$1,703.65
|
| Rate for Payer: Aetna Commercial |
$2,227.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,703.65
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Advantage |
$1,834.70
|
| Rate for Payer: Cofinity Commercial |
$2,254.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,096.80
|
| Rate for Payer: Healthscope Commercial |
$2,358.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,834.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,965.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,227.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.75
|
| Rate for Payer: PHP Commercial |
$2,227.85
|
| Rate for Payer: Priority Health SBD |
$1,651.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,153.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,965.75
|
|
|
PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC
|
Professional
|
Both
|
$1,480.00
|
|
|
Service Code
|
HCPCS 60225
|
| Min. Negotiated Rate |
$541.66 |
| Max. Negotiated Rate |
$1,637.04 |
| Rate for Payer: Aetna Commercial |
$1,123.34
|
| Rate for Payer: Aetna Medicare |
$871.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,207.17
|
| Rate for Payer: BCBS Complete |
$568.74
|
| Rate for Payer: BCBS MAPPO |
$838.31
|
| Rate for Payer: BCN Commercial |
$1,414.77
|
| Rate for Payer: BCN Medicare Advantage |
$838.31
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,184.00
|
| Rate for Payer: Cofinity Commercial |
$1,123.34
|
| Rate for Payer: Cofinity Commercial |
$1,207.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$838.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$880.23
|
| Rate for Payer: Meridian Medicaid |
$568.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$922.14
|
| Rate for Payer: Nomi Health Commercial |
$1,005.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,110.00
|
| Rate for Payer: PACE SWMI |
$838.31
|
| Rate for Payer: PHP Commercial |
$1,173.63
|
| Rate for Payer: PHP Medicare Advantage |
$838.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,534.08
|
| Rate for Payer: Priority Health Medicare |
$838.31
|
| Rate for Payer: Priority Health SBD |
$1,534.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,534.08
|
| Rate for Payer: Railroad Medicare Medicare |
$838.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,637.04
|
| Rate for Payer: UHC Core |
$1,637.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$838.31
|
| Rate for Payer: UHC Exchange |
$1,637.04
|
| Rate for Payer: UHC Medicaid |
$541.66
|
| Rate for Payer: UHCCP Medicaid |
$541.66
|
| Rate for Payer: UMR Bronson Commercial |
$680.80
|
|
|
PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY
|
Professional
|
Both
|
$5,741.00
|
|
|
Service Code
|
HCPCS 43107
|
| Min. Negotiated Rate |
$1,759.38 |
| Max. Negotiated Rate |
$5,358.88 |
| Rate for Payer: Aetna Commercial |
$3,696.86
|
| Rate for Payer: Aetna Medicare |
$2,869.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,696.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,972.74
|
| Rate for Payer: BCBS Complete |
$1,847.35
|
| Rate for Payer: BCBS MAPPO |
$2,758.85
|
| Rate for Payer: BCN Commercial |
$4,398.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,758.85
|
| Rate for Payer: Cash Price |
$4,592.80
|
| Rate for Payer: Cash Price |
$4,592.80
|
| Rate for Payer: Cofinity Commercial |
$3,696.86
|
| Rate for Payer: Cofinity Commercial |
$3,972.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,758.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,896.79
|
| Rate for Payer: Meridian Medicaid |
$1,847.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,034.74
|
| Rate for Payer: Nomi Health Commercial |
$3,310.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,305.75
|
| Rate for Payer: PACE SWMI |
$2,758.85
|
| Rate for Payer: PHP Commercial |
$3,862.39
|
| Rate for Payer: PHP Medicare Advantage |
$2,758.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,759.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,358.88
|
| Rate for Payer: Priority Health Medicare |
$2,758.85
|
| Rate for Payer: Priority Health SBD |
$5,358.88
|
| Rate for Payer: Priority Health Tiered Network |
$5,358.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,758.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,315.91
|
| Rate for Payer: UHC Core |
$5,315.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,758.85
|
| Rate for Payer: UHC Exchange |
$5,315.91
|
| Rate for Payer: UHC Medicaid |
$1,759.38
|
| Rate for Payer: UHCCP Medicaid |
$1,759.38
|
| Rate for Payer: UMR Bronson Commercial |
$2,640.86
|
|
|
PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY
|
Professional
|
Both
|
$8,204.00
|
|
|
Service Code
|
HCPCS 43124
|
| Min. Negotiated Rate |
$2,266.11 |
| Max. Negotiated Rate |
$6,830.28 |
| Rate for Payer: Aetna Commercial |
$4,773.90
|
| Rate for Payer: Aetna Medicare |
$3,705.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,773.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,130.16
|
| Rate for Payer: BCBS Complete |
$2,379.42
|
| Rate for Payer: BCBS MAPPO |
$3,562.61
|
| Rate for Payer: BCN Commercial |
$5,605.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,562.61
|
| Rate for Payer: Cash Price |
$6,563.20
|
| Rate for Payer: Cash Price |
$6,563.20
|
| Rate for Payer: Cofinity Commercial |
$4,773.90
|
| Rate for Payer: Cofinity Commercial |
$5,130.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,562.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,740.74
|
| Rate for Payer: Meridian Medicaid |
$2,379.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,918.87
|
| Rate for Payer: Nomi Health Commercial |
$4,275.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,153.00
|
| Rate for Payer: PACE SWMI |
$3,562.61
|
| Rate for Payer: PHP Commercial |
$4,987.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,562.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,266.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,830.28
|
| Rate for Payer: Priority Health Medicare |
$3,562.61
|
| Rate for Payer: Priority Health SBD |
$6,830.28
|
| Rate for Payer: Priority Health Tiered Network |
$6,830.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,562.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,804.72
|
| Rate for Payer: UHC Core |
$6,804.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,562.61
|
| Rate for Payer: UHC Exchange |
$6,804.72
|
| Rate for Payer: UHC Medicaid |
$2,266.11
|
| Rate for Payer: UHCCP Medicaid |
$2,266.11
|
| Rate for Payer: UMR Bronson Commercial |
$3,773.84
|
|
|
PR TRABECULOPLASTY BY LASER SURGERY
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 65855
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$951.75 |
| Rate for Payer: Aetna Commercial |
$223.16
|
| Rate for Payer: Aetna Medicare |
$173.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.82
|
| Rate for Payer: BCBS Complete |
$114.73
|
| Rate for Payer: BCBS MAPPO |
$166.54
|
| Rate for Payer: BCN Commercial |
$239.15
|
| Rate for Payer: BCN Medicare Advantage |
$166.54
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$223.16
|
| Rate for Payer: Cofinity Commercial |
$239.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.87
|
| Rate for Payer: Meridian Medicaid |
$114.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.19
|
| Rate for Payer: Nomi Health Commercial |
$199.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$951.75
|
| Rate for Payer: PACE SWMI |
$166.54
|
| Rate for Payer: PHP Commercial |
$233.16
|
| Rate for Payer: PHP Medicare Advantage |
$166.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$355.23
|
| Rate for Payer: Priority Health Medicare |
$166.54
|
| Rate for Payer: Priority Health SBD |
$355.23
|
| Rate for Payer: Priority Health Tiered Network |
$355.23
|
| Rate for Payer: Railroad Medicare Medicare |
$166.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.51
|
| Rate for Payer: UHC Core |
$354.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$166.54
|
| Rate for Payer: UHC Exchange |
$354.51
|
| Rate for Payer: UHC Medicaid |
$109.27
|
| Rate for Payer: UHCCP Medicaid |
$109.27
|
| Rate for Payer: UMR Bronson Commercial |
$583.74
|
|
|
PR TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 31612
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$136.50 |
| Rate for Payer: Aetna Commercial |
$55.90
|
| Rate for Payer: Aetna Medicare |
$43.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.08
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.72
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$41.72
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Cofinity Commercial |
$60.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.81
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.89
|
| Rate for Payer: Nomi Health Commercial |
$50.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.50
|
| Rate for Payer: PACE SWMI |
$41.72
|
| Rate for Payer: PHP Commercial |
$58.41
|
| Rate for Payer: PHP Medicare Advantage |
$41.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$67.99
|
| Rate for Payer: Priority Health Medicare |
$41.72
|
| Rate for Payer: Priority Health SBD |
$67.99
|
| Rate for Payer: Priority Health Tiered Network |
$67.99
|
| Rate for Payer: Railroad Medicare Medicare |
$41.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.22
|
| Rate for Payer: UHC Core |
$84.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.72
|
| Rate for Payer: UHC Exchange |
$84.22
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
| Rate for Payer: UMR Bronson Commercial |
$83.72
|
|
|
PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX
|
Professional
|
Both
|
$598.00
|
|
|
Service Code
|
HCPCS 57530
|
| Min. Negotiated Rate |
$216.62 |
| Max. Negotiated Rate |
$631.17 |
| Rate for Payer: Aetna Commercial |
$444.77
|
| Rate for Payer: Aetna Medicare |
$345.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.96
|
| Rate for Payer: BCBS Complete |
$227.45
|
| Rate for Payer: BCBS MAPPO |
$331.92
|
| Rate for Payer: BCN Commercial |
$564.22
|
| Rate for Payer: BCN Medicare Advantage |
$331.92
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Cofinity Commercial |
$444.77
|
| Rate for Payer: Cofinity Commercial |
$477.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.52
|
| Rate for Payer: Meridian Medicaid |
$227.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.11
|
| Rate for Payer: Nomi Health Commercial |
$398.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$448.50
|
| Rate for Payer: PACE SWMI |
$331.92
|
| Rate for Payer: PHP Commercial |
$464.69
|
| Rate for Payer: PHP Medicare Advantage |
$331.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$571.43
|
| Rate for Payer: Priority Health Medicare |
$331.92
|
| Rate for Payer: Priority Health SBD |
$571.43
|
| Rate for Payer: Priority Health Tiered Network |
$571.43
|
| Rate for Payer: Railroad Medicare Medicare |
$331.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$631.17
|
| Rate for Payer: UHC Core |
$631.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$331.92
|
| Rate for Payer: UHC Exchange |
$631.17
|
| Rate for Payer: UHC Medicaid |
$216.62
|
| Rate for Payer: UHCCP Medicaid |
$216.62
|
| Rate for Payer: UMR Bronson Commercial |
$275.08
|
|
|
PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 57720
|
| Min. Negotiated Rate |
$190.85 |
| Max. Negotiated Rate |
$735.75 |
| Rate for Payer: Aetna Commercial |
$391.25
|
| Rate for Payer: Aetna Medicare |
$303.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$391.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$420.45
|
| Rate for Payer: BCBS Complete |
$200.39
|
| Rate for Payer: BCBS MAPPO |
$291.98
|
| Rate for Payer: BCN Commercial |
$503.46
|
| Rate for Payer: BCN Medicare Advantage |
$291.98
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$391.25
|
| Rate for Payer: Cofinity Commercial |
$420.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.58
|
| Rate for Payer: Meridian Medicaid |
$200.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.18
|
| Rate for Payer: Nomi Health Commercial |
$350.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$735.75
|
| Rate for Payer: PACE SWMI |
$291.98
|
| Rate for Payer: PHP Commercial |
$408.77
|
| Rate for Payer: PHP Medicare Advantage |
$291.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$509.89
|
| Rate for Payer: Priority Health Medicare |
$291.98
|
| Rate for Payer: Priority Health SBD |
$509.89
|
| Rate for Payer: Priority Health Tiered Network |
$509.89
|
| Rate for Payer: Railroad Medicare Medicare |
$291.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.49
|
| Rate for Payer: UHC Core |
$564.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$291.98
|
| Rate for Payer: UHC Exchange |
$564.49
|
| Rate for Payer: UHC Medicaid |
$190.85
|
| Rate for Payer: UHCCP Medicaid |
$190.85
|
| Rate for Payer: UMR Bronson Commercial |
$451.26
|
|
|
PR TRACHEOBRONCHOSCOPY THRU EST TRACHEOSTOMY INC
|
Professional
|
Both
|
$476.00
|
|
|
Service Code
|
HCPCS 31615
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Aetna Commercial |
$134.01
|
| Rate for Payer: Aetna Medicare |
$104.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.01
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$100.01
|
| Rate for Payer: BCN Commercial |
$173.29
|
| Rate for Payer: BCN Medicare Advantage |
$100.01
|
| Rate for Payer: Cash Price |
$380.80
|
| Rate for Payer: Cash Price |
$380.80
|
| Rate for Payer: Cofinity Commercial |
$134.01
|
| Rate for Payer: Cofinity Commercial |
$144.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.01
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.01
|
| Rate for Payer: Nomi Health Commercial |
$120.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$357.00
|
| Rate for Payer: PACE SWMI |
$100.01
|
| Rate for Payer: PHP Commercial |
$140.01
|
| Rate for Payer: PHP Medicare Advantage |
$100.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$163.20
|
| Rate for Payer: Priority Health Medicare |
$100.01
|
| Rate for Payer: Priority Health SBD |
$163.20
|
| Rate for Payer: Priority Health Tiered Network |
$163.20
|
| Rate for Payer: Railroad Medicare Medicare |
$100.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.60
|
| Rate for Payer: UHC Core |
$199.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.01
|
| Rate for Payer: UHC Exchange |
$199.60
|
| Rate for Payer: UHC Medicaid |
$64.97
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
| Rate for Payer: UMR Bronson Commercial |
$218.96
|
|
|
PR TRACHEOPLASTY CERVICAL
|
Professional
|
Both
|
$4,537.00
|
|
|
Service Code
|
HCPCS 31750
|
| Min. Negotiated Rate |
$795.34 |
| Max. Negotiated Rate |
$3,402.75 |
| Rate for Payer: Aetna Commercial |
$1,606.81
|
| Rate for Payer: Aetna Medicare |
$1,247.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,606.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,726.72
|
| Rate for Payer: BCBS Complete |
$835.11
|
| Rate for Payer: BCBS MAPPO |
$1,199.11
|
| Rate for Payer: BCN Commercial |
$2,018.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,199.11
|
| Rate for Payer: Cash Price |
$3,629.60
|
| Rate for Payer: Cash Price |
$3,629.60
|
| Rate for Payer: Cofinity Commercial |
$1,606.81
|
| Rate for Payer: Cofinity Commercial |
$1,726.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,199.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,259.07
|
| Rate for Payer: Meridian Medicaid |
$835.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,319.02
|
| Rate for Payer: Nomi Health Commercial |
$1,438.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,402.75
|
| Rate for Payer: PACE SWMI |
$1,199.11
|
| Rate for Payer: PHP Commercial |
$1,678.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,199.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,900.65
|
| Rate for Payer: Priority Health Medicare |
$1,199.11
|
| Rate for Payer: Priority Health SBD |
$1,900.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,900.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,199.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,342.88
|
| Rate for Payer: UHC Core |
$2,342.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,199.11
|
| Rate for Payer: UHC Exchange |
$2,342.88
|
| Rate for Payer: UHC Medicaid |
$795.34
|
| Rate for Payer: UHCCP Medicaid |
$795.34
|
| Rate for Payer: UMR Bronson Commercial |
$2,087.02
|
|
|
PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
|
Professional
|
Both
|
$1,396.00
|
|
|
Service Code
|
HCPCS 31614
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$1,244.34 |
| Rate for Payer: Aetna Commercial |
$830.44
|
| Rate for Payer: Aetna Medicare |
$644.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$830.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$892.41
|
| Rate for Payer: BCBS Complete |
$430.08
|
| Rate for Payer: BCBS MAPPO |
$619.73
|
| Rate for Payer: BCN Commercial |
$1,065.68
|
| Rate for Payer: BCN Medicare Advantage |
$619.73
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cofinity Commercial |
$830.44
|
| Rate for Payer: Cofinity Commercial |
$892.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.72
|
| Rate for Payer: Meridian Medicaid |
$430.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$681.70
|
| Rate for Payer: Nomi Health Commercial |
$743.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.00
|
| Rate for Payer: PACE SWMI |
$619.73
|
| Rate for Payer: PHP Commercial |
$867.62
|
| Rate for Payer: PHP Medicare Advantage |
$619.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,003.56
|
| Rate for Payer: Priority Health Medicare |
$619.73
|
| Rate for Payer: Priority Health SBD |
$1,003.56
|
| Rate for Payer: Priority Health Tiered Network |
$1,003.56
|
| Rate for Payer: Railroad Medicare Medicare |
$619.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,244.34
|
| Rate for Payer: UHC Core |
$1,244.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$619.73
|
| Rate for Payer: UHC Exchange |
$1,244.34
|
| Rate for Payer: UHC Medicaid |
$409.60
|
| Rate for Payer: UHCCP Medicaid |
$409.60
|
| Rate for Payer: UMR Bronson Commercial |
$642.16
|
|
|
PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Professional
|
Both
|
$939.00
|
|
|
Service Code
|
HCPCS 31613
|
| Min. Negotiated Rate |
$252.62 |
| Max. Negotiated Rate |
$744.35 |
| Rate for Payer: Aetna Commercial |
$509.76
|
| Rate for Payer: Aetna Medicare |
$395.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.80
|
| Rate for Payer: BCBS Complete |
$265.25
|
| Rate for Payer: BCBS MAPPO |
$380.42
|
| Rate for Payer: BCN Commercial |
$632.43
|
| Rate for Payer: BCN Medicare Advantage |
$380.42
|
| Rate for Payer: Cash Price |
$751.20
|
| Rate for Payer: Cash Price |
$751.20
|
| Rate for Payer: Cofinity Commercial |
$509.76
|
| Rate for Payer: Cofinity Commercial |
$547.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.44
|
| Rate for Payer: Meridian Medicaid |
$265.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.46
|
| Rate for Payer: Nomi Health Commercial |
$456.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$704.25
|
| Rate for Payer: PACE SWMI |
$380.42
|
| Rate for Payer: PHP Commercial |
$532.59
|
| Rate for Payer: PHP Medicare Advantage |
$380.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$595.57
|
| Rate for Payer: Priority Health Medicare |
$380.42
|
| Rate for Payer: Priority Health SBD |
$595.57
|
| Rate for Payer: Priority Health Tiered Network |
$595.57
|
| Rate for Payer: Railroad Medicare Medicare |
$380.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$744.35
|
| Rate for Payer: UHC Core |
$744.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.42
|
| Rate for Payer: UHC Exchange |
$744.35
|
| Rate for Payer: UHC Medicaid |
$252.62
|
| Rate for Payer: UHCCP Medicaid |
$252.62
|
| Rate for Payer: UMR Bronson Commercial |
$431.94
|
|
|
PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 31605
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$624.75 |
| Rate for Payer: Aetna Commercial |
$407.96
|
| Rate for Payer: Aetna Medicare |
$316.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.41
|
| Rate for Payer: BCBS Complete |
$202.63
|
| Rate for Payer: BCBS MAPPO |
$304.45
|
| Rate for Payer: BCN Commercial |
$491.51
|
| Rate for Payer: BCN Medicare Advantage |
$304.45
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$407.96
|
| Rate for Payer: Cofinity Commercial |
$438.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.67
|
| Rate for Payer: Meridian Medicaid |
$202.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.89
|
| Rate for Payer: Nomi Health Commercial |
$365.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.75
|
| Rate for Payer: PACE SWMI |
$304.45
|
| Rate for Payer: PHP Commercial |
$426.23
|
| Rate for Payer: PHP Medicare Advantage |
$304.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$462.85
|
| Rate for Payer: Priority Health Medicare |
$304.45
|
| Rate for Payer: Priority Health SBD |
$462.85
|
| Rate for Payer: Priority Health Tiered Network |
$462.85
|
| Rate for Payer: Railroad Medicare Medicare |
$304.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$598.32
|
| Rate for Payer: UHC Core |
$598.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.45
|
| Rate for Payer: UHC Exchange |
$598.32
|
| Rate for Payer: UHC Medicaid |
$192.98
|
| Rate for Payer: UHCCP Medicaid |
$192.98
|
| Rate for Payer: UMR Bronson Commercial |
$383.18
|
|
|
PR TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL
|
Professional
|
Both
|
$1,225.00
|
|
|
Service Code
|
HCPCS 31603
|
| Min. Negotiated Rate |
$177.64 |
| Max. Negotiated Rate |
$918.75 |
| Rate for Payer: Aetna Commercial |
$374.02
|
| Rate for Payer: Aetna Medicare |
$290.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.93
|
| Rate for Payer: BCBS Complete |
$186.52
|
| Rate for Payer: BCBS MAPPO |
$279.12
|
| Rate for Payer: BCN Commercial |
$473.58
|
| Rate for Payer: BCN Medicare Advantage |
$279.12
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cash Price |
$980.00
|
| Rate for Payer: Cofinity Commercial |
$374.02
|
| Rate for Payer: Cofinity Commercial |
$401.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.08
|
| Rate for Payer: Meridian Medicaid |
$186.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.03
|
| Rate for Payer: Nomi Health Commercial |
$334.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$918.75
|
| Rate for Payer: PACE SWMI |
$279.12
|
| Rate for Payer: PHP Commercial |
$390.77
|
| Rate for Payer: PHP Medicare Advantage |
$279.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$445.98
|
| Rate for Payer: Priority Health Medicare |
$279.12
|
| Rate for Payer: Priority Health SBD |
$445.98
|
| Rate for Payer: Priority Health Tiered Network |
$445.98
|
| Rate for Payer: Railroad Medicare Medicare |
$279.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.71
|
| Rate for Payer: UHC Core |
$571.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$279.12
|
| Rate for Payer: UHC Exchange |
$571.71
|
| Rate for Payer: UHC Medicaid |
$177.64
|
| Rate for Payer: UHCCP Medicaid |
$177.64
|
| Rate for Payer: UMR Bronson Commercial |
$563.50
|
|
|
PR TRACHEOSTOMY FENESTRATION W/SKIN FLAPS
|
Professional
|
Both
|
$1,595.00
|
|
|
Service Code
|
HCPCS 31610
|
| Min. Negotiated Rate |
$548.90 |
| Max. Negotiated Rate |
$1,640.80 |
| Rate for Payer: Aetna Commercial |
$1,117.17
|
| Rate for Payer: Aetna Medicare |
$867.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,117.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.54
|
| Rate for Payer: BCBS Complete |
$576.35
|
| Rate for Payer: BCBS MAPPO |
$833.71
|
| Rate for Payer: BCN Commercial |
$1,428.21
|
| Rate for Payer: BCN Medicare Advantage |
$833.71
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cash Price |
$1,276.00
|
| Rate for Payer: Cofinity Commercial |
$1,117.17
|
| Rate for Payer: Cofinity Commercial |
$1,200.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$833.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$875.40
|
| Rate for Payer: Meridian Medicaid |
$576.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$917.08
|
| Rate for Payer: Nomi Health Commercial |
$1,000.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,196.25
|
| Rate for Payer: PACE SWMI |
$833.71
|
| Rate for Payer: PHP Commercial |
$1,167.19
|
| Rate for Payer: PHP Medicare Advantage |
$833.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$548.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,344.95
|
| Rate for Payer: Priority Health Medicare |
$833.71
|
| Rate for Payer: Priority Health SBD |
$1,344.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,344.95
|
| Rate for Payer: Railroad Medicare Medicare |
$833.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,640.80
|
| Rate for Payer: UHC Core |
$1,640.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$833.71
|
| Rate for Payer: UHC Exchange |
$1,640.80
|
| Rate for Payer: UHC Medicaid |
$548.90
|
| Rate for Payer: UHCCP Medicaid |
$548.90
|
| Rate for Payer: UMR Bronson Commercial |
$733.70
|
|
