|
LAPAROSCOPY, SURGICAL; WITH RETROPERITONEAL LYMPH NODE SAMPLING (BIOPSY), SINGLE OR MULTIPLE
|
Facility
|
OP
|
$17,966.53
|
|
|
Service Code
|
CPT 38570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$500.78 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,391.27
|
| Rate for Payer: BCN Commercial |
$3,391.27
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.86
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$500.78
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
LAPAROSCOPY, SURGICAL; WITH REVISION OF PREVIOUSLY PLACED INTRAPERITONEAL CANNULA OR CATHETER, WITH REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL IF PERFORMED
|
Facility
|
OP
|
$17,966.53
|
|
|
Service Code
|
CPT 49325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$404.52 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,175.61
|
| Rate for Payer: BCN Commercial |
$3,175.61
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.97
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$404.52
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;
|
Facility
|
OP
|
$32,060.66
|
|
|
Service Code
|
CPT 58570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$784.81 |
| Max. Negotiated Rate |
$32,060.66 |
| Rate for Payer: Aetna Medicare |
$10,608.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$6,800.24
|
| Rate for Payer: BCN Commercial |
$6,800.24
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Nomi Health Commercial |
$21,421.49
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,060.66
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$25,648.53
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$863.29
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$784.81
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: VA VA |
$10,200.71
|
|
|
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
|
Facility
|
OP
|
$32,060.66
|
|
|
Service Code
|
CPT 58571
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$883.74 |
| Max. Negotiated Rate |
$32,060.66 |
| Rate for Payer: Aetna Medicare |
$10,608.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$7,214.96
|
| Rate for Payer: BCN Commercial |
$7,214.96
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Nomi Health Commercial |
$21,421.49
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,060.66
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$25,648.53
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$972.11
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$883.74
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: VA VA |
$10,200.71
|
|
|
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G;
|
Facility
|
OP
|
$32,060.66
|
|
|
Service Code
|
CPT 58572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$988.78 |
| Max. Negotiated Rate |
$32,060.66 |
| Rate for Payer: Aetna Medicare |
$10,608.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$6,055.81
|
| Rate for Payer: BCN Commercial |
$6,055.81
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Nomi Health Commercial |
$21,421.49
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,060.66
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$25,648.53
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,087.66
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$988.78
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: VA VA |
$10,200.71
|
|
|
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
|
Facility
|
OP
|
$32,060.66
|
|
|
Service Code
|
CPT 58573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,186.23 |
| Max. Negotiated Rate |
$32,060.66 |
| Rate for Payer: Aetna Medicare |
$10,608.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$9,271.89
|
| Rate for Payer: BCN Commercial |
$9,271.89
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Nomi Health Commercial |
$21,421.49
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,060.66
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$25,648.53
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,304.85
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$1,186.23
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: VA VA |
$10,200.71
|
|
|
LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;
|
Facility
|
OP
|
$17,966.53
|
|
|
Service Code
|
CPT 58550
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$859.27 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$6,935.17
|
| Rate for Payer: BCN Commercial |
$6,935.17
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,716.39
|
| Rate for Payer: Mclaren Medicaid |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$945.20
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$859.27
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: VA VA |
$5,716.39
|
|
|
LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
|
Facility
|
OP
|
$32,060.66
|
|
|
Service Code
|
CPT 58552
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$954.74 |
| Max. Negotiated Rate |
$32,060.66 |
| Rate for Payer: Aetna Medicare |
$10,608.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$6,945.33
|
| Rate for Payer: BCN Commercial |
$6,945.33
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Nomi Health Commercial |
$21,421.49
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,060.66
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$25,648.53
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,050.21
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$954.74
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: VA VA |
$10,200.71
|
|
|
LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
|
Facility
|
OP
|
$32,060.66
|
|
|
Service Code
|
CPT 58554
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,271.84 |
| Max. Negotiated Rate |
$32,060.66 |
| Rate for Payer: Aetna Medicare |
$10,608.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$7,519.81
|
| Rate for Payer: BCN Commercial |
$7,519.81
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Nomi Health Commercial |
$21,421.49
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,060.66
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$25,648.53
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.02
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$1,271.84
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: VA VA |
$10,200.71
|
|
|
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$3,425.80
|
|
|
Service Code
|
HCPCS J1931
|
| Hospital Charge Code |
35779
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,507.35 |
| Max. Negotiated Rate |
$3,083.22 |
| Rate for Payer: Aetna American Axle |
$2,226.77
|
| Rate for Payer: Aetna Commercial |
$2,911.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,226.77
|
| Rate for Payer: Cash Price |
$2,740.64
|
| Rate for Payer: Cofinity Commercial |
$2,398.06
|
| Rate for Payer: Cofinity Commercial |
$2,946.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,398.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,740.64
|
| Rate for Payer: Healthscope Commercial |
$3,083.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,398.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,569.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,911.93
|
| Rate for Payer: PHP Commercial |
$2,911.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,226.77
|
| Rate for Payer: Priority Health SBD |
$2,158.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,507.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,569.35
|
|
|
LARONIDASE 2.9 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3,425.80
|
|
|
Service Code
|
HCPCS J1931
|
| Hospital Charge Code |
35779
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.70 |
| Max. Negotiated Rate |
$3,083.22 |
| Rate for Payer: Aetna American Axle |
$2,226.77
|
| Rate for Payer: Aetna Commercial |
$2,911.93
|
| Rate for Payer: Aetna Medicare |
$40.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,226.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.28
|
| Rate for Payer: BCBS Complete |
$21.74
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$104.32
|
| Rate for Payer: BCN Commercial |
$104.32
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$2,740.64
|
| Rate for Payer: Cash Price |
$2,740.64
|
| Rate for Payer: Cofinity Commercial |
$2,946.19
|
| Rate for Payer: Cofinity Commercial |
$2,398.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,398.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,740.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$3,083.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,398.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,569.35
|
| Rate for Payer: Mclaren Medicaid |
$20.70
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$21.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,911.93
|
| Rate for Payer: Nomi Health Commercial |
$115.86
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$2,911.93
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,226.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.38
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health Narrow Network |
$89.10
|
| Rate for Payer: Priority Health SBD |
$2,158.25
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.62
|
| Rate for Payer: UHC Exchange |
$73.81
|
| Rate for Payer: UHC Medicare Advantage |
$38.62
|
| Rate for Payer: UHCCP Medicaid |
$20.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,267.55
|
| Rate for Payer: VA VA |
$38.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,569.35
|
|
|
LARYNGOPLASTY, MEDIALIZATION, UNILATERAL
|
Facility
|
OP
|
$18,216.88
|
|
|
Service Code
|
CPT 31591
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,046.73 |
| Max. Negotiated Rate |
$18,216.88 |
| Rate for Payer: Aetna Medicare |
$6,027.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,245.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,245.06
|
| Rate for Payer: BCBS Complete |
$3,262.02
|
| Rate for Payer: BCBS MAPPO |
$5,796.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,703.90
|
| Rate for Payer: BCN Commercial |
$3,703.90
|
| Rate for Payer: BCN Medicare Advantage |
$5,796.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,796.05
|
| Rate for Payer: Mclaren Medicaid |
$3,106.68
|
| Rate for Payer: Mclaren Medicare |
$5,796.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,085.85
|
| Rate for Payer: Meridian Medicaid |
$3,262.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,665.46
|
| Rate for Payer: Nomi Health Commercial |
$12,171.70
|
| Rate for Payer: PACE Medicare |
$5,506.25
|
| Rate for Payer: PACE SWMI |
$5,796.05
|
| Rate for Payer: PHP Medicare Advantage |
$5,796.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,106.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,216.88
|
| Rate for Payer: Priority Health Medicare |
$5,796.05
|
| Rate for Payer: Priority Health Narrow Network |
$14,573.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5,796.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,151.40
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,796.05
|
| Rate for Payer: UHC Exchange |
$1,046.73
|
| Rate for Payer: UHC Medicare Advantage |
$5,796.05
|
| Rate for Payer: UHCCP Medicaid |
$3,106.68
|
| Rate for Payer: VA VA |
$5,796.05
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY;
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31535
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$181.40 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,860.11
|
| Rate for Payer: BCN Commercial |
$2,860.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.54
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$181.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31536
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$201.46 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,506.63
|
| Rate for Payer: BCN Commercial |
$3,506.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.61
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$201.46
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS;
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31540
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$231.33 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.88
|
| Rate for Payer: BCN Commercial |
$1,740.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.46
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$231.33
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31541
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,936.25 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,353.75
|
| Rate for Payer: BCN Commercial |
$4,353.75
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,168.54
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$6,903.66
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$202.44 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.88
|
| Rate for Payer: BCN Commercial |
$1,740.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.68
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$202.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S), THERAPEUTIC;
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$220.22 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.88
|
| Rate for Payer: BCN Commercial |
$1,740.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.24
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$220.22
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S), THERAPEUTIC; WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31571
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$238.77 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,188.72
|
| Rate for Payer: BCN Commercial |
$4,188.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.65
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$238.77
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, EXCEPT NEWBORN
|
Facility
|
OP
|
$5,310.41
|
|
|
Service Code
|
CPT 31525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$153.90 |
| Max. Negotiated Rate |
$5,310.41 |
| Rate for Payer: Aetna Medicare |
$1,757.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,112.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,112.00
|
| Rate for Payer: BCBS Complete |
$950.91
|
| Rate for Payer: BCBS MAPPO |
$1,689.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,947.19
|
| Rate for Payer: BCN Commercial |
$2,947.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,689.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,689.60
|
| Rate for Payer: Mclaren Medicaid |
$905.63
|
| Rate for Payer: Mclaren Medicare |
$1,689.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,774.08
|
| Rate for Payer: Meridian Medicaid |
$950.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,943.04
|
| Rate for Payer: Nomi Health Commercial |
$3,548.16
|
| Rate for Payer: PACE Medicare |
$1,605.12
|
| Rate for Payer: PACE SWMI |
$1,689.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,689.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$905.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,310.41
|
| Rate for Payer: Priority Health Medicare |
$1,689.60
|
| Rate for Payer: Priority Health Narrow Network |
$4,248.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,689.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.29
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,689.60
|
| Rate for Payer: UHC Exchange |
$153.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,689.60
|
| Rate for Payer: UHCCP Medicaid |
$905.63
|
| Rate for Payer: VA VA |
$1,689.60
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, WITH OPERATING MICROSCOPE OR TELESCOPE
|
Facility
|
OP
|
$5,310.41
|
|
|
Service Code
|
CPT 31526
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$150.65 |
| Max. Negotiated Rate |
$5,310.41 |
| Rate for Payer: Aetna Medicare |
$1,757.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,112.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,112.00
|
| Rate for Payer: BCBS Complete |
$950.91
|
| Rate for Payer: BCBS MAPPO |
$1,689.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,792.94
|
| Rate for Payer: BCN Commercial |
$1,792.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,689.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,689.60
|
| Rate for Payer: Mclaren Medicaid |
$905.63
|
| Rate for Payer: Mclaren Medicare |
$1,689.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,774.08
|
| Rate for Payer: Meridian Medicaid |
$950.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,943.04
|
| Rate for Payer: Nomi Health Commercial |
$3,548.16
|
| Rate for Payer: PACE Medicare |
$1,605.12
|
| Rate for Payer: PACE SWMI |
$1,689.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,689.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$905.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,310.41
|
| Rate for Payer: Priority Health Medicare |
$1,689.60
|
| Rate for Payer: Priority Health Narrow Network |
$4,248.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,689.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.72
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,689.60
|
| Rate for Payer: UHC Exchange |
$150.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,689.60
|
| Rate for Payer: UHCCP Medicaid |
$905.63
|
| Rate for Payer: VA VA |
$1,689.60
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; FOR ASPIRATION
|
Facility
|
OP
|
$1,195.78
|
|
|
Service Code
|
CPT 31515
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$106.34 |
| Max. Negotiated Rate |
$1,195.78 |
| Rate for Payer: Aetna Medicare |
$395.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$475.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$475.58
|
| Rate for Payer: BCBS Complete |
$214.12
|
| Rate for Payer: BCBS MAPPO |
$380.46
|
| Rate for Payer: BCBS Trust/PPO |
$440.84
|
| Rate for Payer: BCN Commercial |
$440.84
|
| Rate for Payer: BCN Medicare Advantage |
$380.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.46
|
| Rate for Payer: Mclaren Medicaid |
$203.93
|
| Rate for Payer: Mclaren Medicare |
$380.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.48
|
| Rate for Payer: Meridian Medicaid |
$214.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$437.53
|
| Rate for Payer: Nomi Health Commercial |
$798.97
|
| Rate for Payer: PACE Medicare |
$361.44
|
| Rate for Payer: PACE SWMI |
$380.46
|
| Rate for Payer: PHP Medicare Advantage |
$380.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,195.78
|
| Rate for Payer: Priority Health Medicare |
$380.46
|
| Rate for Payer: Priority Health Narrow Network |
$956.62
|
| Rate for Payer: Railroad Medicare Medicare |
$380.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.97
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.46
|
| Rate for Payer: UHC Exchange |
$106.34
|
| Rate for Payer: UHC Medicare Advantage |
$380.46
|
| Rate for Payer: UHCCP Medicaid |
$203.93
|
| Rate for Payer: VA VA |
$380.46
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, INITIAL
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31528
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$138.48 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.88
|
| Rate for Payer: BCN Commercial |
$1,740.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.33
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$138.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, SUBSEQUENT
|
Facility
|
OP
|
$11,353.72
|
|
|
Service Code
|
CPT 31529
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$154.64 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.88
|
| Rate for Payer: BCN Commercial |
$1,740.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.10
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$154.64
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: VA VA |
$3,612.40
|
|
|
LARYNGOSCOPY, FLEXIBLE; DIAGNOSTIC
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 31575
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$197.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.76
|
| Rate for Payer: BCBS Complete |
$107.05
|
| Rate for Payer: BCBS MAPPO |
$190.21
|
| Rate for Payer: BCBS Trust/PPO |
$202.06
|
| Rate for Payer: BCN Commercial |
$202.06
|
| Rate for Payer: BCN Medicare Advantage |
$190.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.21
|
| Rate for Payer: Mclaren Medicaid |
$101.95
|
| Rate for Payer: Mclaren Medicare |
$190.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.72
|
| Rate for Payer: Meridian Medicaid |
$107.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.74
|
| Rate for Payer: Nomi Health Commercial |
$399.44
|
| Rate for Payer: PACE Medicare |
$180.70
|
| Rate for Payer: PACE SWMI |
$190.21
|
| Rate for Payer: PHP Medicare Advantage |
$190.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$597.84
|
| Rate for Payer: Priority Health Medicare |
$190.21
|
| Rate for Payer: Priority Health Narrow Network |
$478.27
|
| Rate for Payer: Railroad Medicare Medicare |
$190.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.93
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.21
|
| Rate for Payer: UHC Exchange |
$65.39
|
| Rate for Payer: UHC Medicare Advantage |
$190.21
|
| Rate for Payer: UHCCP Medicaid |
$101.95
|
| Rate for Payer: VA VA |
$190.21
|
|
