|
LAPAROSCOPY, SURGICAL; WITH RETROPERITONEAL LYMPH NODE SAMPLING (BIOPSY), SINGLE OR MULTIPLE
|
Facility
|
OP
|
$16,145.72
|
|
|
Service Code
|
CPT 38570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$508.52 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,233.44
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$559.37
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$508.52
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: VA VA |
$5,128.81
|
|
|
LAPAROSCOPY, SURGICAL; WITH REVISION OF PREVIOUSLY PLACED INTRAPERITONEAL CANNULA OR CATHETER, WITH REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL IF PERFORMED
|
Facility
|
OP
|
$16,145.72
|
|
|
Service Code
|
CPT 49325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$406.03 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,027.81
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.63
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$406.03
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: VA VA |
$5,128.81
|
|
|
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;
|
Facility
|
OP
|
$28,804.18
|
|
|
Service Code
|
CPT 58570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$797.65 |
| Max. Negotiated Rate |
$28,804.18 |
| Rate for Payer: Aetna Medicare |
$9,515.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,483.75
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,804.18
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$23,043.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$877.42
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,149.86
|
| Rate for Payer: UHC Exchange |
$797.65
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: VA VA |
$9,149.86
|
|
|
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
|
Facility
|
OP
|
$28,804.18
|
|
|
Service Code
|
CPT 58571
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$898.17 |
| Max. Negotiated Rate |
$28,804.18 |
| Rate for Payer: Aetna Medicare |
$9,515.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,879.17
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,804.18
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$23,043.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.99
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,149.86
|
| Rate for Payer: UHC Exchange |
$898.17
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: VA VA |
$9,149.86
|
|
|
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G;
|
Facility
|
OP
|
$28,804.18
|
|
|
Service Code
|
CPT 58572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,000.66 |
| Max. Negotiated Rate |
$28,804.18 |
| Rate for Payer: Aetna Medicare |
$9,515.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$5,773.97
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,804.18
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$23,043.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.73
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,149.86
|
| Rate for Payer: UHC Exchange |
$1,000.66
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: VA VA |
$9,149.86
|
|
|
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
|
Facility
|
OP
|
$28,804.18
|
|
|
Service Code
|
CPT 58573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,202.37 |
| Max. Negotiated Rate |
$28,804.18 |
| Rate for Payer: Aetna Medicare |
$9,515.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$8,840.37
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,804.18
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$23,043.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,322.61
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,149.86
|
| Rate for Payer: UHC Exchange |
$1,202.37
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: VA VA |
$9,149.86
|
|
|
LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
|
Facility
|
OP
|
$28,804.18
|
|
|
Service Code
|
CPT 58552
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$967.26 |
| Max. Negotiated Rate |
$28,804.18 |
| Rate for Payer: Aetna Medicare |
$9,515.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,622.09
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,804.18
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$23,043.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.99
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,149.86
|
| Rate for Payer: UHC Exchange |
$967.26
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: VA VA |
$9,149.86
|
|
|
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$3,045.51
|
|
|
Service Code
|
HCPCS J1931
|
| Hospital Charge Code |
35779
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,340.02 |
| Max. Negotiated Rate |
$2,740.96 |
| Rate for Payer: Aetna American Axle |
$1,979.58
|
| Rate for Payer: Aetna Commercial |
$2,588.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,979.58
|
| Rate for Payer: Cash Price |
$2,436.41
|
| Rate for Payer: Cofinity Commercial |
$2,131.86
|
| Rate for Payer: Cofinity Commercial |
$2,619.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,436.41
|
| Rate for Payer: Healthscope Commercial |
$2,740.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,131.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,284.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,588.68
|
| Rate for Payer: PHP Commercial |
$2,588.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,131.86
|
| Rate for Payer: Priority Health SBD |
$1,918.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,340.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,284.13
|
|
|
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3,045.51
|
|
|
Service Code
|
HCPCS J1931
|
| Hospital Charge Code |
35779
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.48 |
| Max. Negotiated Rate |
$2,740.96 |
| Rate for Payer: Aetna American Axle |
$1,979.58
|
| Rate for Payer: Aetna Commercial |
$2,588.68
|
| Rate for Payer: Aetna Medicare |
$38.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,979.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.80
|
| Rate for Payer: BCBS Complete |
$21.51
|
| Rate for Payer: BCBS MAPPO |
$37.44
|
| Rate for Payer: BCBS Trust/PPO |
$120.97
|
| Rate for Payer: BCN Medicare Advantage |
$37.44
|
| Rate for Payer: Cash Price |
$2,436.41
|
| Rate for Payer: Cash Price |
$2,436.41
|
| Rate for Payer: Cofinity Commercial |
$2,131.86
|
| Rate for Payer: Cofinity Commercial |
$2,619.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,436.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.44
|
| Rate for Payer: Healthscope Commercial |
$2,740.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,131.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,284.13
|
| Rate for Payer: Mclaren Medicaid |
$20.48
|
| Rate for Payer: Mclaren Medicare |
$37.44
|
| Rate for Payer: Meridian Medicaid |
$21.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,588.68
|
| Rate for Payer: PACE Medicare |
$35.57
|
| Rate for Payer: PACE SWMI |
$37.44
|
| Rate for Payer: PHP Commercial |
$2,588.68
|
| Rate for Payer: PHP Medicare Advantage |
$37.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,131.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.94
|
| Rate for Payer: Priority Health Medicare |
$37.44
|
| Rate for Payer: Priority Health Narrow Network |
$87.95
|
| Rate for Payer: Priority Health SBD |
$1,918.67
|
| Rate for Payer: Railroad Medicare Medicare |
$37.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.44
|
| Rate for Payer: UHC Medicare Advantage |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,126.84
|
| Rate for Payer: VA VA |
$37.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,284.13
|
|
|
LARYNGOPLASTY, MEDIALIZATION, UNILATERAL
|
Facility
|
OP
|
$16,386.90
|
|
|
Service Code
|
CPT 31591
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,086.78 |
| Max. Negotiated Rate |
$16,386.90 |
| Rate for Payer: Aetna Medicare |
$5,413.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,506.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,506.78
|
| Rate for Payer: BCBS Complete |
$2,989.99
|
| Rate for Payer: BCBS MAPPO |
$5,205.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,531.52
|
| Rate for Payer: BCN Medicare Advantage |
$5,205.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,205.42
|
| Rate for Payer: Mclaren Medicaid |
$2,847.36
|
| Rate for Payer: Mclaren Medicare |
$5,205.42
|
| Rate for Payer: Meridian Medicaid |
$2,989.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,465.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,986.23
|
| Rate for Payer: PACE Medicare |
$4,945.15
|
| Rate for Payer: PACE SWMI |
$5,205.42
|
| Rate for Payer: PHP Medicare Advantage |
$5,205.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,847.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,386.90
|
| Rate for Payer: Priority Health Medicare |
$5,205.42
|
| Rate for Payer: Priority Health Narrow Network |
$13,109.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5,205.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,195.46
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,205.42
|
| Rate for Payer: UHC Exchange |
$1,086.78
|
| Rate for Payer: UHC Medicare Advantage |
$5,361.58
|
| Rate for Payer: VA VA |
$5,205.42
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY;
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31535
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$184.68 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,727.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.15
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$184.68
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31536
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$204.98 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$3,343.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.48
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$204.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS;
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31540
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$235.10 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,659.86
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.61
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$235.10
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31541
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$256.39 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$4,151.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.03
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$256.39
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$205.96 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,659.86
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.56
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$205.96
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S), THERAPEUTIC;
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$223.64 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,659.86
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.00
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$223.64
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S), THERAPEUTIC; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31571
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$242.63 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$3,993.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.89
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$242.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, EXCEPT NEWBORN
|
Facility
|
OP
|
$4,749.35
|
|
|
Service Code
|
CPT 31525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$156.84 |
| Max. Negotiated Rate |
$4,749.35 |
| Rate for Payer: Aetna Medicare |
$1,569.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,885.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,885.82
|
| Rate for Payer: BCBS Complete |
$866.57
|
| Rate for Payer: BCBS MAPPO |
$1,508.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,810.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,508.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,508.66
|
| Rate for Payer: Mclaren Medicaid |
$825.24
|
| Rate for Payer: Mclaren Medicare |
$1,508.66
|
| Rate for Payer: Meridian Medicaid |
$866.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,584.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,734.96
|
| Rate for Payer: PACE Medicare |
$1,433.23
|
| Rate for Payer: PACE SWMI |
$1,508.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,508.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$825.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,749.35
|
| Rate for Payer: Priority Health Medicare |
$1,508.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,799.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,508.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.52
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,508.66
|
| Rate for Payer: UHC Exchange |
$156.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,553.92
|
| Rate for Payer: VA VA |
$1,508.66
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$4,749.35
|
|
|
Service Code
|
CPT 31526
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$153.57 |
| Max. Negotiated Rate |
$4,749.35 |
| Rate for Payer: Aetna Medicare |
$1,569.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,885.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,885.82
|
| Rate for Payer: BCBS Complete |
$866.57
|
| Rate for Payer: BCBS MAPPO |
$1,508.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,508.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,508.66
|
| Rate for Payer: Mclaren Medicaid |
$825.24
|
| Rate for Payer: Mclaren Medicare |
$1,508.66
|
| Rate for Payer: Meridian Medicaid |
$866.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,584.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,734.96
|
| Rate for Payer: PACE Medicare |
$1,433.23
|
| Rate for Payer: PACE SWMI |
$1,508.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,508.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$825.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,749.35
|
| Rate for Payer: Priority Health Medicare |
$1,508.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,799.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,508.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.93
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,508.66
|
| Rate for Payer: UHC Exchange |
$153.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,553.92
|
| Rate for Payer: VA VA |
$1,508.66
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; FOR ASPIRATION
|
Facility
|
OP
|
$1,142.59
|
|
|
Service Code
|
CPT 31515
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$108.71 |
| Max. Negotiated Rate |
$1,142.59 |
| Rate for Payer: Aetna Medicare |
$377.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$453.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$453.69
|
| Rate for Payer: BCBS Complete |
$208.48
|
| Rate for Payer: BCBS MAPPO |
$362.95
|
| Rate for Payer: BCBS Trust/PPO |
$420.33
|
| Rate for Payer: BCN Medicare Advantage |
$362.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.95
|
| Rate for Payer: Mclaren Medicaid |
$198.53
|
| Rate for Payer: Mclaren Medicare |
$362.95
|
| Rate for Payer: Meridian Medicaid |
$208.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$381.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$417.39
|
| Rate for Payer: PACE Medicare |
$344.80
|
| Rate for Payer: PACE SWMI |
$362.95
|
| Rate for Payer: PHP Medicare Advantage |
$362.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.59
|
| Rate for Payer: Priority Health Medicare |
$362.95
|
| Rate for Payer: Priority Health Narrow Network |
$914.07
|
| Rate for Payer: Railroad Medicare Medicare |
$362.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.58
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.95
|
| Rate for Payer: UHC Exchange |
$108.71
|
| Rate for Payer: UHC Medicare Advantage |
$373.84
|
| Rate for Payer: VA VA |
$362.95
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, INITIAL
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31528
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$141.13 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,659.86
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.24
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$141.13
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, SUBSEQUENT
|
Facility
|
OP
|
$10,478.92
|
|
|
Service Code
|
CPT 31529
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$10,478.92 |
| Rate for Payer: Aetna Medicare |
$3,461.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,160.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,160.89
|
| Rate for Payer: BCBS Complete |
$1,912.01
|
| Rate for Payer: BCBS MAPPO |
$3,328.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,659.86
|
| Rate for Payer: BCN Medicare Advantage |
$3,328.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,328.71
|
| Rate for Payer: Mclaren Medicaid |
$1,820.80
|
| Rate for Payer: Mclaren Medicare |
$3,328.71
|
| Rate for Payer: Meridian Medicaid |
$1,912.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,495.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,828.02
|
| Rate for Payer: PACE Medicare |
$3,162.27
|
| Rate for Payer: PACE SWMI |
$3,328.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,328.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,478.92
|
| Rate for Payer: Priority Health Medicare |
$3,328.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,383.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,328.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.25
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,328.71
|
| Rate for Payer: UHC Exchange |
$157.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.57
|
| Rate for Payer: VA VA |
$3,328.71
|
|
|
LARYNGOSCOPY, FLEXIBLE; DIAGNOSTIC
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 31575
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$67.45 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$183.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.09
|
| Rate for Payer: BCBS Complete |
$101.13
|
| Rate for Payer: BCBS MAPPO |
$176.07
|
| Rate for Payer: BCBS Trust/PPO |
$192.65
|
| Rate for Payer: BCN Medicare Advantage |
$176.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.07
|
| Rate for Payer: Mclaren Medicaid |
$96.31
|
| Rate for Payer: Mclaren Medicare |
$176.07
|
| Rate for Payer: Meridian Medicaid |
$101.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.48
|
| Rate for Payer: PACE Medicare |
$167.27
|
| Rate for Payer: PACE SWMI |
$176.07
|
| Rate for Payer: PHP Medicare Advantage |
$176.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.27
|
| Rate for Payer: Priority Health Medicare |
$176.07
|
| Rate for Payer: Priority Health Narrow Network |
$443.42
|
| Rate for Payer: Railroad Medicare Medicare |
$176.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.20
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.07
|
| Rate for Payer: UHC Exchange |
$67.45
|
| Rate for Payer: UHC Medicare Advantage |
$181.35
|
| Rate for Payer: VA VA |
$176.07
|
|
|
LARYNGO-TRACHEAL MUCOSAL ATOMIZATION DEVICE
|
Facility
|
IP
|
$7.61
|
|
|
Service Code
|
NDC 9900-0009-14
|
| Hospital Charge Code |
180497
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$6.85 |
| Rate for Payer: Aetna American Axle |
$4.95
|
| Rate for Payer: Aetna Commercial |
$6.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.95
|
| Rate for Payer: Cash Price |
$6.09
|
| Rate for Payer: Cofinity Commercial |
$5.33
|
| Rate for Payer: Cofinity Commercial |
$6.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.09
|
| Rate for Payer: Healthscope Commercial |
$6.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.47
|
| Rate for Payer: PHP Commercial |
$6.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.33
|
| Rate for Payer: Priority Health SBD |
$4.79
|
| Rate for Payer: UMR Bronson Commercial |
$3.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.71
|
|
|
LASER COAGULATION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY ARE INCLUDED IF PERFORMED)
|
Facility
|
OP
|
$14,479.04
|
|
|
Service Code
|
CPT 52647
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.87 |
| Max. Negotiated Rate |
$14,479.04 |
| Rate for Payer: Aetna Medicare |
$4,783.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,749.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,749.21
|
| Rate for Payer: BCBS Complete |
$2,641.88
|
| Rate for Payer: BCBS MAPPO |
$4,599.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,165.43
|
| Rate for Payer: BCN Medicare Advantage |
$4,599.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,599.37
|
| Rate for Payer: Mclaren Medicaid |
$2,515.86
|
| Rate for Payer: Mclaren Medicare |
$4,599.37
|
| Rate for Payer: Meridian Medicaid |
$2,641.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,829.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,289.28
|
| Rate for Payer: PACE Medicare |
$4,369.40
|
| Rate for Payer: PACE SWMI |
$4,599.37
|
| Rate for Payer: PHP Medicare Advantage |
$4,599.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,515.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,479.04
|
| Rate for Payer: Priority Health Medicare |
$4,599.37
|
| Rate for Payer: Priority Health Narrow Network |
$11,583.23
|
| Rate for Payer: Railroad Medicare Medicare |
$4,599.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.56
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,599.37
|
| Rate for Payer: UHC Exchange |
$636.87
|
| Rate for Payer: UHC Medicare Advantage |
$4,737.35
|
| Rate for Payer: VA VA |
$4,599.37
|
|
