|
BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L
|
Facility
|
IP
|
$394.40
|
|
|
Service Code
|
NDC 24571-102-06
|
| Hospital Charge Code |
118523
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$173.54 |
| Max. Negotiated Rate |
$354.96 |
| Rate for Payer: Aetna American Axle |
$256.36
|
| Rate for Payer: Aetna Commercial |
$335.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.36
|
| Rate for Payer: Cash Price |
$315.52
|
| Rate for Payer: Cofinity Commercial |
$276.08
|
| Rate for Payer: Cofinity Commercial |
$339.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.52
|
| Rate for Payer: Healthscope Commercial |
$354.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$335.24
|
| Rate for Payer: PHP Commercial |
$335.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.08
|
| Rate for Payer: Priority Health SBD |
$248.47
|
| Rate for Payer: UMR Bronson Commercial |
$173.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.80
|
|
|
BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L
|
Facility
|
IP
|
$394.40
|
|
|
Service Code
|
NDC 24571-105-06
|
| Hospital Charge Code |
100176
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$173.54 |
| Max. Negotiated Rate |
$354.96 |
| Rate for Payer: Aetna American Axle |
$256.36
|
| Rate for Payer: Aetna Commercial |
$335.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.36
|
| Rate for Payer: Cash Price |
$315.52
|
| Rate for Payer: Cofinity Commercial |
$276.08
|
| Rate for Payer: Cofinity Commercial |
$339.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.52
|
| Rate for Payer: Healthscope Commercial |
$354.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$335.24
|
| Rate for Payer: PHP Commercial |
$335.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.08
|
| Rate for Payer: Priority Health SBD |
$248.47
|
| Rate for Payer: UMR Bronson Commercial |
$173.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.80
|
|
|
BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET
|
Facility
|
IP
|
$14,362.18
|
|
|
Service Code
|
NDC 61958-2501-1
|
| Hospital Charge Code |
185933
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6,319.36 |
| Max. Negotiated Rate |
$12,925.96 |
| Rate for Payer: Aetna American Axle |
$9,335.42
|
| Rate for Payer: Aetna Commercial |
$12,207.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,335.42
|
| Rate for Payer: Cash Price |
$11,489.74
|
| Rate for Payer: Cofinity Commercial |
$10,053.53
|
| Rate for Payer: Cofinity Commercial |
$12,351.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,489.74
|
| Rate for Payer: Healthscope Commercial |
$12,925.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,053.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,771.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,207.85
|
| Rate for Payer: PHP Commercial |
$12,207.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,053.53
|
| Rate for Payer: Priority Health SBD |
$9,048.17
|
| Rate for Payer: UMR Bronson Commercial |
$6,319.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,771.64
|
|
|
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
|
IP
|
$111,439.58
|
|
|
Service Code
|
MS-DRG 461
|
| Min. Negotiated Rate |
$50,403.16 |
| Max. Negotiated Rate |
$111,439.58 |
| Rate for Payer: Aetna Medicare |
$55,178.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66,319.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66,319.95
|
| Rate for Payer: BCBS MAPPO |
$53,055.96
|
| Rate for Payer: BCBS Trust/PPO |
$111,439.58
|
| Rate for Payer: BCN Medicare Advantage |
$53,055.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53,055.96
|
| Rate for Payer: Mclaren Medicare |
$53,055.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55,708.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61,014.35
|
| Rate for Payer: PACE Medicare |
$50,403.16
|
| Rate for Payer: PACE SWMI |
$53,055.96
|
| Rate for Payer: PHP Medicare Advantage |
$53,055.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97,844.93
|
| Rate for Payer: Priority Health Medicare |
$53,055.96
|
| Rate for Payer: Priority Health Narrow Network |
$78,275.94
|
| Rate for Payer: Railroad Medicare Medicare |
$53,055.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104,009.40
|
| Rate for Payer: UHC Core |
$85,285.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$53,055.96
|
| Rate for Payer: UHC Exchange |
$67,803.16
|
| Rate for Payer: UHC Medicare Advantage |
$54,647.64
|
| Rate for Payer: VA VA |
$53,055.96
|
|
|
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$60,030.67
|
|
|
Service Code
|
MS-DRG 462
|
| Min. Negotiated Rate |
$21,323.73 |
| Max. Negotiated Rate |
$60,030.67 |
| Rate for Payer: Aetna Medicare |
$23,343.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,057.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,057.54
|
| Rate for Payer: BCBS MAPPO |
$22,446.03
|
| Rate for Payer: BCBS Trust/PPO |
$60,030.67
|
| Rate for Payer: BCN Medicare Advantage |
$22,446.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,446.03
|
| Rate for Payer: Mclaren Medicare |
$22,446.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23,568.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,812.93
|
| Rate for Payer: PACE Medicare |
$21,323.73
|
| Rate for Payer: PACE SWMI |
$22,446.03
|
| Rate for Payer: PHP Medicare Advantage |
$22,446.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40,844.18
|
| Rate for Payer: Priority Health Medicare |
$22,446.03
|
| Rate for Payer: Priority Health Narrow Network |
$32,675.34
|
| Rate for Payer: Railroad Medicare Medicare |
$22,446.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43,417.46
|
| Rate for Payer: UHC Core |
$35,601.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$22,446.03
|
| Rate for Payer: UHC Exchange |
$28,303.61
|
| Rate for Payer: UHC Medicare Advantage |
$23,119.41
|
| Rate for Payer: VA VA |
$22,446.03
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$59,877.38
|
|
|
Service Code
|
MS-DRG 409
|
| Min. Negotiated Rate |
$14,815.59 |
| Max. Negotiated Rate |
$59,877.38 |
| Rate for Payer: Aetna Medicare |
$16,219.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,494.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,494.20
|
| Rate for Payer: BCBS MAPPO |
$15,595.36
|
| Rate for Payer: BCBS Trust/PPO |
$59,877.38
|
| Rate for Payer: BCN Medicare Advantage |
$15,595.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,595.36
|
| Rate for Payer: Mclaren Medicare |
$15,595.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,375.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,934.66
|
| Rate for Payer: PACE Medicare |
$14,815.59
|
| Rate for Payer: PACE SWMI |
$15,595.36
|
| Rate for Payer: PHP Medicare Advantage |
$15,595.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,087.10
|
| Rate for Payer: Priority Health Medicare |
$15,595.36
|
| Rate for Payer: Priority Health Narrow Network |
$22,469.68
|
| Rate for Payer: Railroad Medicare Medicare |
$15,595.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,856.65
|
| Rate for Payer: UHC Core |
$24,481.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,595.36
|
| Rate for Payer: UHC Exchange |
$19,463.39
|
| Rate for Payer: UHC Medicare Advantage |
$16,063.22
|
| Rate for Payer: VA VA |
$15,595.36
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$96,806.96
|
|
|
Service Code
|
MS-DRG 408
|
| Min. Negotiated Rate |
$27,735.96 |
| Max. Negotiated Rate |
$96,806.96 |
| Rate for Payer: Aetna Medicare |
$30,363.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,494.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,494.69
|
| Rate for Payer: BCBS MAPPO |
$29,195.75
|
| Rate for Payer: BCBS Trust/PPO |
$96,806.96
|
| Rate for Payer: BCN Medicare Advantage |
$29,195.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,195.75
|
| Rate for Payer: Mclaren Medicare |
$29,195.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30,655.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,575.11
|
| Rate for Payer: PACE Medicare |
$27,735.96
|
| Rate for Payer: PACE SWMI |
$29,195.75
|
| Rate for Payer: PHP Medicare Advantage |
$29,195.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53,413.27
|
| Rate for Payer: Priority Health Medicare |
$29,195.75
|
| Rate for Payer: Priority Health Narrow Network |
$42,730.62
|
| Rate for Payer: Railroad Medicare Medicare |
$29,195.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,778.44
|
| Rate for Payer: UHC Core |
$46,557.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$29,195.75
|
| Rate for Payer: UHC Exchange |
$37,013.56
|
| Rate for Payer: UHC Medicare Advantage |
$30,071.62
|
| Rate for Payer: VA VA |
$29,195.75
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$38,351.88
|
|
|
Service Code
|
MS-DRG 410
|
| Min. Negotiated Rate |
$11,945.14 |
| Max. Negotiated Rate |
$38,351.88 |
| Rate for Payer: Aetna Medicare |
$13,076.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,717.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,717.29
|
| Rate for Payer: BCBS MAPPO |
$12,573.83
|
| Rate for Payer: BCBS Trust/PPO |
$38,351.88
|
| Rate for Payer: BCN Medicare Advantage |
$12,573.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,573.83
|
| Rate for Payer: Mclaren Medicare |
$12,573.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,202.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,459.90
|
| Rate for Payer: PACE Medicare |
$11,945.14
|
| Rate for Payer: PACE SWMI |
$12,573.83
|
| Rate for Payer: PHP Medicare Advantage |
$12,573.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,460.49
|
| Rate for Payer: Priority Health Medicare |
$12,573.83
|
| Rate for Payer: Priority Health Narrow Network |
$17,968.39
|
| Rate for Payer: Railroad Medicare Medicare |
$12,573.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,875.56
|
| Rate for Payer: UHC Core |
$19,577.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,573.83
|
| Rate for Payer: UHC Exchange |
$15,564.35
|
| Rate for Payer: UHC Medicare Advantage |
$12,951.04
|
| Rate for Payer: VA VA |
$12,573.83
|
|
|
BIMATOPROST 0.01 % EYE DROPS
|
Facility
|
IP
|
$778.93
|
|
|
Service Code
|
NDC 0023-3205-03
|
| Hospital Charge Code |
105410
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$342.73 |
| Max. Negotiated Rate |
$701.04 |
| Rate for Payer: Aetna American Axle |
$506.30
|
| Rate for Payer: Aetna Commercial |
$662.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.30
|
| Rate for Payer: Cash Price |
$623.14
|
| Rate for Payer: Cofinity Commercial |
$669.88
|
| Rate for Payer: Cofinity Commercial |
$545.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$623.14
|
| Rate for Payer: Healthscope Commercial |
$701.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$545.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$584.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$662.09
|
| Rate for Payer: PHP Commercial |
$662.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$545.25
|
| Rate for Payer: Priority Health SBD |
$490.73
|
| Rate for Payer: UMR Bronson Commercial |
$342.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$584.20
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$42,126.26
|
|
|
Service Code
|
MS-DRG 478
|
| Min. Negotiated Rate |
$17,937.16 |
| Max. Negotiated Rate |
$42,126.26 |
| Rate for Payer: Aetna Medicare |
$19,636.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,601.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,601.52
|
| Rate for Payer: BCBS MAPPO |
$18,881.22
|
| Rate for Payer: BCBS Trust/PPO |
$42,126.26
|
| Rate for Payer: BCN Medicare Advantage |
$18,881.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,881.22
|
| Rate for Payer: Mclaren Medicare |
$18,881.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19,825.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,713.40
|
| Rate for Payer: PACE Medicare |
$17,937.16
|
| Rate for Payer: PACE SWMI |
$18,881.22
|
| Rate for Payer: PHP Medicare Advantage |
$18,881.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,205.90
|
| Rate for Payer: Priority Health Medicare |
$18,881.22
|
| Rate for Payer: Priority Health Narrow Network |
$27,364.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18,881.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36,360.96
|
| Rate for Payer: UHC Core |
$29,815.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,881.22
|
| Rate for Payer: UHC Exchange |
$23,703.51
|
| Rate for Payer: UHC Medicare Advantage |
$19,447.66
|
| Rate for Payer: VA VA |
$18,881.22
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$53,592.62
|
|
|
Service Code
|
MS-DRG 477
|
| Min. Negotiated Rate |
$25,150.28 |
| Max. Negotiated Rate |
$53,592.62 |
| Rate for Payer: Aetna Medicare |
$27,532.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,092.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,092.48
|
| Rate for Payer: BCBS MAPPO |
$26,473.98
|
| Rate for Payer: BCBS Trust/PPO |
$53,592.62
|
| Rate for Payer: BCN Medicare Advantage |
$26,473.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,473.98
|
| Rate for Payer: Mclaren Medicare |
$26,473.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27,797.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,445.08
|
| Rate for Payer: PACE Medicare |
$25,150.28
|
| Rate for Payer: PACE SWMI |
$26,473.98
|
| Rate for Payer: PHP Medicare Advantage |
$26,473.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48,344.88
|
| Rate for Payer: Priority Health Medicare |
$26,473.98
|
| Rate for Payer: Priority Health Narrow Network |
$38,675.90
|
| Rate for Payer: Railroad Medicare Medicare |
$26,473.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51,390.73
|
| Rate for Payer: UHC Core |
$42,139.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$26,473.98
|
| Rate for Payer: UHC Exchange |
$33,501.34
|
| Rate for Payer: UHC Medicare Advantage |
$27,268.20
|
| Rate for Payer: VA VA |
$26,473.98
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$28,586.75
|
|
|
Service Code
|
MS-DRG 479
|
| Min. Negotiated Rate |
$14,132.57 |
| Max. Negotiated Rate |
$28,586.75 |
| Rate for Payer: Aetna Medicare |
$15,471.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,595.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,595.49
|
| Rate for Payer: BCBS MAPPO |
$14,876.39
|
| Rate for Payer: BCBS Trust/PPO |
$28,586.75
|
| Rate for Payer: BCN Medicare Advantage |
$14,876.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,876.39
|
| Rate for Payer: Mclaren Medicare |
$14,876.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,620.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,107.85
|
| Rate for Payer: PACE Medicare |
$14,132.57
|
| Rate for Payer: PACE SWMI |
$14,876.39
|
| Rate for Payer: PHP Medicare Advantage |
$14,876.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,748.25
|
| Rate for Payer: Priority Health Medicare |
$14,876.39
|
| Rate for Payer: Priority Health Narrow Network |
$21,398.60
|
| Rate for Payer: Railroad Medicare Medicare |
$14,876.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,433.46
|
| Rate for Payer: UHC Core |
$23,314.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,876.39
|
| Rate for Payer: UHC Exchange |
$18,535.62
|
| Rate for Payer: UHC Medicare Advantage |
$15,322.68
|
| Rate for Payer: VA VA |
$14,876.39
|
|
|
BIOPSY, BONE, OPEN; DEEP (EG, HUMERAL SHAFT, ISCHIUM, FEMORAL SHAFT)
|
Facility
|
OP
|
$7,951.14
|
|
|
Service Code
|
CPT 20245
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$335.63 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.19
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$335.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
BIOPSY, BONE, OPEN; SUPERFICIAL (EG, STERNUM, SPINOUS PROCESS, RIB, PATELLA, OLECRANON PROCESS, CALCANEUS, TARSAL, METATARSAL, CARPAL, METACARPAL, PHALANX)
|
Facility
|
OP
|
$7,951.14
|
|
|
Service Code
|
CPT 20240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$136.87 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,100.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.56
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$136.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
BIOPSY, BONE, TROCAR, OR NEEDLE; SUPERFICIAL (EG, ILIUM, STERNUM, SPINOUS PROCESS, RIBS)
|
Facility
|
OP
|
$4,536.73
|
|
|
Service Code
|
CPT 20220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.15 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.56
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$84.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$4,267.42
|
|
|
Service Code
|
CPT 69105
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$62.87 |
| Max. Negotiated Rate |
$4,267.42 |
| Rate for Payer: Aetna Medicare |
$1,409.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,694.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,694.48
|
| Rate for Payer: BCBS Complete |
$778.65
|
| Rate for Payer: BCBS MAPPO |
$1,355.58
|
| Rate for Payer: BCBS Trust/PPO |
$135.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,355.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,355.58
|
| Rate for Payer: Mclaren Medicaid |
$741.50
|
| Rate for Payer: Mclaren Medicare |
$1,355.58
|
| Rate for Payer: Meridian Medicaid |
$778.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,423.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,558.92
|
| Rate for Payer: PACE Medicare |
$1,287.80
|
| Rate for Payer: PACE SWMI |
$1,355.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,355.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,267.42
|
| Rate for Payer: Priority Health Medicare |
$1,355.58
|
| Rate for Payer: Priority Health Narrow Network |
$3,413.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,355.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.16
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,355.58
|
| Rate for Payer: UHC Exchange |
$62.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,396.25
|
| Rate for Payer: VA VA |
$1,355.58
|
|
|
BIOPSY, INTRANASAL
|
Facility
|
OP
|
$4,267.42
|
|
|
Service Code
|
CPT 30100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$67.45 |
| Max. Negotiated Rate |
$4,267.42 |
| Rate for Payer: Aetna Medicare |
$1,409.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,694.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,694.48
|
| Rate for Payer: BCBS Complete |
$778.65
|
| Rate for Payer: BCBS MAPPO |
$1,355.58
|
| Rate for Payer: BCBS Trust/PPO |
$131.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,355.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,355.58
|
| Rate for Payer: Mclaren Medicaid |
$741.50
|
| Rate for Payer: Mclaren Medicare |
$1,355.58
|
| Rate for Payer: Meridian Medicaid |
$778.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,423.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,558.92
|
| Rate for Payer: PACE Medicare |
$1,287.80
|
| Rate for Payer: PACE SWMI |
$1,355.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,355.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,267.42
|
| Rate for Payer: Priority Health Medicare |
$1,355.58
|
| Rate for Payer: Priority Health Narrow Network |
$3,413.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,355.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.20
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,355.58
|
| Rate for Payer: UHC Exchange |
$67.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,396.25
|
| Rate for Payer: VA VA |
$1,355.58
|
|
|
BIOPSY, MUSCLE; DEEP
|
Facility
|
OP
|
$7,951.14
|
|
|
Service Code
|
CPT 20205
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$152.59 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,848.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.85
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$152.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
BIOPSY, MUSCLE; SUPERFICIAL
|
Facility
|
OP
|
$4,536.73
|
|
|
Service Code
|
CPT 20200
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$93.65 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,056.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.02
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$93.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITAL MEGACOLON)
|
Facility
|
OP
|
$7,856.86
|
|
|
Service Code
|
CPT 45100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$300.59 |
| Max. Negotiated Rate |
$7,856.86 |
| Rate for Payer: Aetna Medicare |
$2,595.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,726.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,856.86
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$6,285.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.65
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,495.78
|
| Rate for Payer: UHC Exchange |
$300.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: VA VA |
$2,495.78
|
|
|
BIOPSY OF BREAST; OPEN, INCISIONAL
|
Facility
|
OP
|
$10,666.11
|
|
|
Service Code
|
CPT 19101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$220.70 |
| Max. Negotiated Rate |
$10,666.11 |
| Rate for Payer: Aetna Medicare |
$3,523.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,235.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,235.21
|
| Rate for Payer: BCBS Complete |
$1,946.16
|
| Rate for Payer: BCBS MAPPO |
$3,388.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,806.03
|
| Rate for Payer: BCCCP Commercial |
$352.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,388.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,388.17
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,388.17
|
| Rate for Payer: Meridian Medicaid |
$1,946.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,557.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,896.40
|
| Rate for Payer: PACE Medicare |
$3,218.76
|
| Rate for Payer: PACE SWMI |
$3,388.17
|
| Rate for Payer: PHP Medicare Advantage |
$3,388.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,666.11
|
| Rate for Payer: Priority Health Medicare |
$3,388.17
|
| Rate for Payer: Priority Health Narrow Network |
$8,532.89
|
| Rate for Payer: Railroad Medicare Medicare |
$3,388.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.77
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,388.17
|
| Rate for Payer: UHC Exchange |
$220.70
|
| Rate for Payer: UHC Medicare Advantage |
$3,489.82
|
| Rate for Payer: VA VA |
$3,388.17
|
|
|
BIOPSY OF CERVIX, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, WITH OR WITHOUT FULGURATION (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,249.54
|
|
|
Service Code
|
CPT 57500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$2,249.54 |
| Rate for Payer: Aetna Medicare |
$743.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$893.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$893.22
|
| Rate for Payer: BCBS Complete |
$410.45
|
| Rate for Payer: BCBS MAPPO |
$714.58
|
| Rate for Payer: BCBS Trust/PPO |
$752.29
|
| Rate for Payer: BCN Medicare Advantage |
$714.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.58
|
| Rate for Payer: Mclaren Medicaid |
$390.88
|
| Rate for Payer: Mclaren Medicare |
$714.58
|
| Rate for Payer: Meridian Medicaid |
$410.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$750.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$821.77
|
| Rate for Payer: PACE Medicare |
$678.85
|
| Rate for Payer: PACE SWMI |
$714.58
|
| Rate for Payer: PHP Medicare Advantage |
$714.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,249.54
|
| Rate for Payer: Priority Health Medicare |
$714.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,799.63
|
| Rate for Payer: Railroad Medicare Medicare |
$714.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.40
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.58
|
| Rate for Payer: UHC Exchange |
$74.00
|
| Rate for Payer: UHC Medicare Advantage |
$736.02
|
| Rate for Payer: VA VA |
$714.58
|
|
|
BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS
|
Facility
|
OP
|
$4,536.73
|
|
|
Service Code
|
CPT 47000
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$84.48 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.93
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$84.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
BIOPSY OF NAIL UNIT (EG, PLATE, BED, MATRIX, HYPONYCHIUM, PROXIMAL AND LATERAL NAIL FOLDS) (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$1,968.76
|
|
|
Service Code
|
CPT 11755
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$58.94 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$106.85
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.83
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$58.94
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
BIOPSY OF NERVE
|
Facility
|
OP
|
$5,402.75
|
|
|
Service Code
|
CPT 64795
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$191.88 |
| Max. Negotiated Rate |
$5,402.75 |
| Rate for Payer: Aetna Medicare |
$1,784.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,366.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,402.75
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$4,322.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.07
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,716.23
|
| Rate for Payer: UHC Exchange |
$191.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: VA VA |
$1,716.23
|
|
