|
BILATERAL SALPINGO-OOPHORECTOMY WITH TOTAL OMENTECTOMY, TOTAL ABDOMINAL HYSTERECTOMY FOR MALIGNANCY
|
Facility
|
OP
|
$6,079.64
|
|
|
Service Code
|
CPT 58956
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,079.64 |
| Max. Negotiated Rate |
$6,079.64 |
| Rate for Payer: BCBS Trust/PPO |
$6,079.64
|
| Rate for Payer: BCN Commercial |
$6,079.64
|
|
|
BILIARY ENDOSCOPY, INTRAOPERATIVE (CHOLEDOCHOSCOPY) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$734.18
|
|
|
Service Code
|
CPT 47550
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$734.18 |
| Max. Negotiated Rate |
$734.18 |
| Rate for Payer: BCBS Trust/PPO |
$734.18
|
| Rate for Payer: BCN Commercial |
$734.18
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$65,410.24
|
|
|
Service Code
|
MSDRG 409
|
| Min. Negotiated Rate |
$17,861.01 |
| Max. Negotiated Rate |
$65,410.24 |
| Rate for Payer: Aetna Medicare |
$19,553.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,501.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,501.33
|
| Rate for Payer: BCBS MAPPO |
$18,801.06
|
| Rate for Payer: BCBS Trust/PPO |
$65,410.24
|
| Rate for Payer: BCN Commercial |
$65,410.24
|
| Rate for Payer: BCN Medicare Advantage |
$18,801.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,801.06
|
| Rate for Payer: Mclaren Medicare |
$18,801.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,741.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,621.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,681.17
|
| Rate for Payer: Nomi Health Commercial |
$28,087.17
|
| Rate for Payer: PACE Medicare |
$17,861.01
|
| Rate for Payer: PACE SWMI |
$18,801.06
|
| Rate for Payer: PHP Medicare Advantage |
$18,801.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35,102.74
|
| Rate for Payer: Priority Health Medicare |
$18,801.06
|
| Rate for Payer: Priority Health Tiered Network |
$28,082.18
|
| Rate for Payer: Railroad Medicare Medicare |
$18,801.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,489.99
|
| Rate for Payer: UHC Core |
$29,691.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,801.06
|
| Rate for Payer: UHC Exchange |
$24,248.59
|
| Rate for Payer: VA VA |
$18,801.06
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$105,752.23
|
|
|
Service Code
|
MSDRG 408
|
| Min. Negotiated Rate |
$28,890.44 |
| Max. Negotiated Rate |
$105,752.23 |
| Rate for Payer: Aetna Medicare |
$31,627.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,013.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,013.74
|
| Rate for Payer: BCBS MAPPO |
$30,410.99
|
| Rate for Payer: BCBS Trust/PPO |
$105,752.23
|
| Rate for Payer: BCN Commercial |
$105,752.23
|
| Rate for Payer: BCN Medicare Advantage |
$30,410.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,410.99
|
| Rate for Payer: Mclaren Medicare |
$30,410.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31,931.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34,972.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$33,452.09
|
| Rate for Payer: Nomi Health Commercial |
$45,996.24
|
| Rate for Payer: PACE Medicare |
$28,890.44
|
| Rate for Payer: PACE SWMI |
$30,410.99
|
| Rate for Payer: PHP Medicare Advantage |
$30,410.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57,485.10
|
| Rate for Payer: Priority Health Medicare |
$30,410.99
|
| Rate for Payer: Priority Health Tiered Network |
$45,988.07
|
| Rate for Payer: Railroad Medicare Medicare |
$30,410.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,119.28
|
| Rate for Payer: UHC Core |
$48,624.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30,410.99
|
| Rate for Payer: UHC Exchange |
$39,710.09
|
| Rate for Payer: VA VA |
$30,410.99
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$41,895.72
|
|
|
Service Code
|
MSDRG 410
|
| Min. Negotiated Rate |
$13,176.90 |
| Max. Negotiated Rate |
$41,895.72 |
| Rate for Payer: Aetna Medicare |
$14,425.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,338.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,338.03
|
| Rate for Payer: BCBS MAPPO |
$13,870.42
|
| Rate for Payer: BCBS Trust/PPO |
$41,895.72
|
| Rate for Payer: BCN Commercial |
$41,895.72
|
| Rate for Payer: BCN Medicare Advantage |
$13,870.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,870.42
|
| Rate for Payer: Mclaren Medicare |
$13,870.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,563.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,950.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,257.46
|
| Rate for Payer: Nomi Health Commercial |
$20,481.33
|
| Rate for Payer: PACE Medicare |
$13,176.90
|
| Rate for Payer: PACE SWMI |
$13,870.42
|
| Rate for Payer: PHP Medicare Advantage |
$13,870.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,597.12
|
| Rate for Payer: Priority Health Medicare |
$13,870.42
|
| Rate for Payer: Priority Health Tiered Network |
$20,477.69
|
| Rate for Payer: Railroad Medicare Medicare |
$13,870.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,879.51
|
| Rate for Payer: UHC Core |
$21,651.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,870.42
|
| Rate for Payer: UHC Exchange |
$17,682.21
|
| Rate for Payer: VA VA |
$13,870.42
|
|
|
BIMATOPROST 0.01 % EYE DROPS
|
Facility
|
OP
|
$876.79
|
|
|
Service Code
|
NDC 00023320503
|
| Hospital Charge Code |
105410
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$324.41 |
| Max. Negotiated Rate |
$789.11 |
| Rate for Payer: Aetna American Axle |
$569.91
|
| Rate for Payer: Aetna Commercial |
$745.27
|
| Rate for Payer: Aetna Medicare |
$438.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.91
|
| Rate for Payer: BCBS Complete |
$350.72
|
| Rate for Payer: Cash Price |
$701.43
|
| Rate for Payer: Cofinity Advantage |
$613.75
|
| Rate for Payer: Cofinity Commercial |
$754.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.43
|
| Rate for Payer: Healthscope Commercial |
$789.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$613.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$657.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$701.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.59
|
| Rate for Payer: PHP Commercial |
$745.27
|
| Rate for Payer: Priority Health SBD |
$552.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.91
|
| Rate for Payer: UHC Core |
$456.81
|
| Rate for Payer: UHC Exchange |
$344.58
|
| Rate for Payer: UMR Bronson Commercial |
$324.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$657.59
|
|
|
BIMATOPROST 0.01 % EYE DROPS
|
Facility
|
IP
|
$876.79
|
|
|
Service Code
|
NDC 00023320503
|
| Hospital Charge Code |
105410
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$385.79 |
| Max. Negotiated Rate |
$789.11 |
| Rate for Payer: Aetna American Axle |
$569.91
|
| Rate for Payer: Aetna Commercial |
$745.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.91
|
| Rate for Payer: Cash Price |
$701.43
|
| Rate for Payer: Cofinity Advantage |
$613.75
|
| Rate for Payer: Cofinity Commercial |
$754.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.43
|
| Rate for Payer: Healthscope Commercial |
$789.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$613.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$657.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.59
|
| Rate for Payer: PHP Commercial |
$745.27
|
| Rate for Payer: Priority Health SBD |
$552.38
|
| Rate for Payer: UMR Bronson Commercial |
$385.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$657.59
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$47,992.58
|
|
|
Service Code
|
MSDRG 478
|
| Min. Negotiated Rate |
$20,100.57 |
| Max. Negotiated Rate |
$47,992.58 |
| Rate for Payer: Aetna Medicare |
$22,004.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,448.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,448.11
|
| Rate for Payer: BCBS MAPPO |
$21,158.49
|
| Rate for Payer: BCBS Trust/PPO |
$47,992.58
|
| Rate for Payer: BCN Commercial |
$47,992.58
|
| Rate for Payer: BCN Medicare Advantage |
$21,158.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,158.49
|
| Rate for Payer: Mclaren Medicare |
$21,158.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,216.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,332.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$23,274.34
|
| Rate for Payer: Nomi Health Commercial |
$31,723.68
|
| Rate for Payer: PACE Medicare |
$20,100.57
|
| Rate for Payer: PACE SWMI |
$21,158.49
|
| Rate for Payer: PHP Medicare Advantage |
$21,158.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39,647.57
|
| Rate for Payer: Priority Health Medicare |
$21,158.49
|
| Rate for Payer: Priority Health Tiered Network |
$31,718.05
|
| Rate for Payer: Railroad Medicare Medicare |
$21,158.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,084.96
|
| Rate for Payer: UHC Core |
$33,536.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21,158.49
|
| Rate for Payer: UHC Exchange |
$27,388.11
|
| Rate for Payer: VA VA |
$21,158.49
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$63,252.59
|
|
|
Service Code
|
MSDRG 477
|
| Min. Negotiated Rate |
$28,008.59 |
| Max. Negotiated Rate |
$63,252.59 |
| Rate for Payer: Aetna Medicare |
$30,662.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36,853.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36,853.41
|
| Rate for Payer: BCBS MAPPO |
$29,482.73
|
| Rate for Payer: BCBS Trust/PPO |
$63,252.59
|
| Rate for Payer: BCN Commercial |
$63,252.59
|
| Rate for Payer: BCN Medicare Advantage |
$29,482.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29,482.73
|
| Rate for Payer: Mclaren Medicare |
$29,482.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,956.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,905.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$32,431.00
|
| Rate for Payer: Nomi Health Commercial |
$44,564.34
|
| Rate for Payer: PACE Medicare |
$28,008.59
|
| Rate for Payer: PACE SWMI |
$29,482.73
|
| Rate for Payer: PHP Medicare Advantage |
$29,482.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$55,695.54
|
| Rate for Payer: Priority Health Medicare |
$29,482.73
|
| Rate for Payer: Priority Health Tiered Network |
$44,556.43
|
| Rate for Payer: Railroad Medicare Medicare |
$29,482.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,309.98
|
| Rate for Payer: UHC Core |
$47,110.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29,482.73
|
| Rate for Payer: UHC Exchange |
$38,473.88
|
| Rate for Payer: VA VA |
$29,482.73
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$31,000.41
|
|
|
Service Code
|
MSDRG 479
|
| Min. Negotiated Rate |
$15,331.45 |
| Max. Negotiated Rate |
$31,000.41 |
| Rate for Payer: Aetna Medicare |
$16,783.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,172.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,172.96
|
| Rate for Payer: BCBS MAPPO |
$16,138.37
|
| Rate for Payer: BCBS Trust/PPO |
$31,000.41
|
| Rate for Payer: BCN Commercial |
$31,000.41
|
| Rate for Payer: BCN Medicare Advantage |
$16,138.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,138.37
|
| Rate for Payer: Mclaren Medicare |
$16,138.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,945.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,559.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,752.21
|
| Rate for Payer: Nomi Health Commercial |
$23,979.81
|
| Rate for Payer: PACE Medicare |
$15,331.45
|
| Rate for Payer: PACE SWMI |
$16,138.37
|
| Rate for Payer: PHP Medicare Advantage |
$16,138.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29,969.45
|
| Rate for Payer: Priority Health Medicare |
$16,138.37
|
| Rate for Payer: Priority Health Tiered Network |
$23,975.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16,138.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,300.07
|
| Rate for Payer: UHC Core |
$25,349.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,138.37
|
| Rate for Payer: UHC Exchange |
$20,702.57
|
| Rate for Payer: VA VA |
$16,138.37
|
|
|
BIOPSY, BONE, TROCAR, OR NEEDLE; DEEP (EG, VERTEBRAL BODY, FEMUR)
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 20225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,960.87
|
| Rate for Payer: BCN Commercial |
$1,960.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
BIOPSY, MUSCLE; DEEP
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 20205
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,608.95
|
| Rate for Payer: BCN Commercial |
$3,608.95
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
BIOPSY, MUSCLE, PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 20206
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.59
|
| Rate for Payer: BCN Commercial |
$1,202.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
BIOPSY, MUSCLE; SUPERFICIAL
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 20200
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.52
|
| Rate for Payer: BCN Commercial |
$1,338.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
BIOPSY; NASOPHARYNX, SURVEY FOR UNKNOWN PRIMARY LESION
|
Facility
|
OP
|
$10,683.35
|
|
|
Service Code
|
CPT 42806
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.42
|
| Rate for Payer: BCN Commercial |
$2,064.42
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITAL MEGACOLON)
|
Facility
|
OP
|
$8,943.95
|
|
|
Service Code
|
CPT 45100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,454.72
|
| Rate for Payer: BCN Commercial |
$3,454.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
BIOPSY OF BREAST; OPEN, INCISIONAL
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 19101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$311.32 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.36
|
| Rate for Payer: BCCCP Commercial |
$311.32
|
| Rate for Payer: BCN Commercial |
$2,288.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY OF CERVIX, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, WITH OR WITHOUT FULGURATION (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,967.88
|
|
|
Service Code
|
CPT 57500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$479.98 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$953.20
|
| Rate for Payer: BCN Commercial |
$953.20
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
BIOPSY OF NAIL UNIT (EG, PLATE, BED, MATRIX, HYPONYCHIUM, PROXIMAL AND LATERAL NAIL FOLDS) (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,281.79
|
|
|
Service Code
|
CPT 11755
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$135.39 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$135.39
|
| Rate for Payer: BCN Commercial |
$135.39
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
BIOPSY OF NERVE
|
Facility
|
OP
|
$6,292.24
|
|
|
Service Code
|
CPT 64795
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,731.83
|
| Rate for Payer: BCN Commercial |
$1,731.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Mclaren Medicaid |
$1,945.70
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: VA VA |
$1,945.70
|
|
|
BIOPSY OF PENIS; (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 54100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,144.50
|
| Rate for Payer: BCN Commercial |
$1,144.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
BIOPSY OF TONGUE; ANTERIOR TWO-THIRDS
|
Facility
|
OP
|
$1,737.88
|
|
|
Service Code
|
CPT 41100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$281.05 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna Medicare |
$558.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$618.99
|
| Rate for Payer: BCN Commercial |
$618.99
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$564.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Nomi Health Commercial |
$1,612.17
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,737.88
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health Tiered Network |
$1,390.30
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: VA VA |
$537.39
|
|
|
BIOPSY OF TONGUE; POSTERIOR ONE-THIRD
|
Facility
|
OP
|
$10,683.35
|
|
|
Service Code
|
CPT 41105
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$185.88 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$185.88
|
| Rate for Payer: BCN Commercial |
$185.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
BIOPSY OF URETHRA
|
Facility
|
OP
|
$6,735.82
|
|
|
Service Code
|
CPT 53200
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,221.94
|
| Rate for Payer: BCN Commercial |
$2,221.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
BIOPSY OF VAGINAL MUCOSA; SIMPLE (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,967.88
|
|
|
Service Code
|
CPT 57100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$479.98 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$953.20
|
| Rate for Payer: BCN Commercial |
$953.20
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
