|
PR DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN
|
Professional
|
Both
|
$2,180.00
|
|
|
Service Code
|
HCPCS 49040
|
| Min. Negotiated Rate |
$640.83 |
| Max. Negotiated Rate |
$1,763.34 |
| Rate for Payer: Aetna Commercial |
$1,356.51
|
| Rate for Payer: BCBS Complete |
$673.41
|
| Rate for Payer: BCBS Trust/PPO |
$640.83
|
| Rate for Payer: Cash Price |
$1,744.00
|
| Rate for Payer: Cash Price |
$1,744.00
|
| Rate for Payer: Meridian Medicaid |
$673.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$641.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,526.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,763.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,763.34
|
| Rate for Payer: Priority Health SBD |
$1,763.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,002.80
|
|
|
PR DRAINAGE TENDON SHEATH DIGIT&/PALM EACH
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 26020
|
| Min. Negotiated Rate |
$345.00 |
| Max. Negotiated Rate |
$860.45 |
| Rate for Payer: Aetna Commercial |
$737.75
|
| Rate for Payer: BCBS Complete |
$380.43
|
| Rate for Payer: BCBS Trust/PPO |
$663.49
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Meridian Medicaid |
$380.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$860.45
|
| Rate for Payer: Priority Health Narrow Network |
$860.45
|
| Rate for Payer: Priority Health SBD |
$860.45
|
| Rate for Payer: UMR Bronson Commercial |
$345.00
|
|
|
PR DRESSING CHANGE UNDER ANESTHESIA
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 15852
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$50.88
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$450.00
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.32
|
| Rate for Payer: Priority Health Narrow Network |
$56.32
|
| Rate for Payer: Priority Health SBD |
$56.32
|
| Rate for Payer: UMR Bronson Commercial |
$76.82
|
|
|
PR DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS
|
Professional
|
Both
|
$547.00
|
|
|
Service Code
|
HCPCS 41800
|
| Min. Negotiated Rate |
$99.26 |
| Max. Negotiated Rate |
$2,059.31 |
| Rate for Payer: Aetna Commercial |
$204.22
|
| Rate for Payer: BCBS Complete |
$104.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,059.31
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Cash Price |
$437.60
|
| Rate for Payer: Meridian Medicaid |
$104.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.65
|
| Rate for Payer: Priority Health Narrow Network |
$271.65
|
| Rate for Payer: Priority Health SBD |
$271.65
|
| Rate for Payer: UMR Bronson Commercial |
$251.62
|
|
|
PR DRG ABSC CST HMTMA VESTIBULE MOUTH COMP
|
Professional
|
Both
|
$620.00
|
|
|
Service Code
|
HCPCS 40801
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$1,779.31 |
| Rate for Payer: Aetna Commercial |
$262.87
|
| Rate for Payer: BCBS Complete |
$133.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.31
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Meridian Medicaid |
$133.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.32
|
| Rate for Payer: Priority Health Narrow Network |
$346.32
|
| Rate for Payer: Priority Health SBD |
$346.32
|
| Rate for Payer: UMR Bronson Commercial |
$285.20
|
|
|
PR DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV
|
Professional
|
Both
|
$1,037.00
|
|
|
Service Code
|
HCPCS 38305
|
| Min. Negotiated Rate |
$319.50 |
| Max. Negotiated Rate |
$1,074.93 |
| Rate for Payer: Aetna Commercial |
$608.51
|
| Rate for Payer: BCBS Complete |
$335.48
|
| Rate for Payer: BCBS Trust/PPO |
$565.81
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Cash Price |
$829.60
|
| Rate for Payer: Meridian Medicaid |
$335.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$725.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,074.93
|
| Rate for Payer: Priority Health SBD |
$1,074.93
|
| Rate for Payer: UMR Bronson Commercial |
$477.02
|
|
|
PR DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 38300
|
| Min. Negotiated Rate |
$135.47 |
| Max. Negotiated Rate |
$604.38 |
| Rate for Payer: Aetna Commercial |
$255.68
|
| Rate for Payer: BCBS Complete |
$142.24
|
| Rate for Payer: BCBS Trust/PPO |
$604.38
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Meridian Medicaid |
$142.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.88
|
| Rate for Payer: Priority Health Narrow Network |
$454.88
|
| Rate for Payer: Priority Health SBD |
$454.88
|
| Rate for Payer: UMR Bronson Commercial |
$205.16
|
|
|
PR DRG OF SKENE'S GLAND ABSCESS OR CYST
|
Professional
|
Both
|
$603.00
|
|
|
Service Code
|
HCPCS 53060
|
| Min. Negotiated Rate |
$106.50 |
| Max. Negotiated Rate |
$422.10 |
| Rate for Payer: Aetna Commercial |
$213.39
|
| Rate for Payer: BCBS Complete |
$111.82
|
| Rate for Payer: BCBS Trust/PPO |
$283.70
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Meridian Medicaid |
$111.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.56
|
| Rate for Payer: Priority Health Narrow Network |
$268.56
|
| Rate for Payer: Priority Health SBD |
$268.56
|
| Rate for Payer: UMR Bronson Commercial |
$277.38
|
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 16030
|
| Min. Negotiated Rate |
$84.14 |
| Max. Negotiated Rate |
$569.29 |
| Rate for Payer: Aetna Commercial |
$141.99
|
| Rate for Payer: BCBS Complete |
$88.35
|
| Rate for Payer: BCBS Trust/PPO |
$569.29
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Meridian Medicaid |
$88.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.72
|
| Rate for Payer: Priority Health Narrow Network |
$160.72
|
| Rate for Payer: Priority Health SBD |
$160.72
|
| Rate for Payer: UMR Bronson Commercial |
$139.38
|
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 16025
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$2,369.57 |
| Rate for Payer: Aetna Commercial |
$119.21
|
| Rate for Payer: BCBS Complete |
$74.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,369.57
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Meridian Medicaid |
$74.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.82
|
| Rate for Payer: Priority Health Narrow Network |
$134.82
|
| Rate for Payer: Priority Health SBD |
$134.82
|
| Rate for Payer: UMR Bronson Commercial |
$113.16
|
|
|
PR DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 16020
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$3,995.58 |
| Rate for Payer: Aetna Commercial |
$59.06
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,995.58
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.82
|
| Rate for Payer: Priority Health Narrow Network |
$67.82
|
| Rate for Payer: Priority Health SBD |
$67.82
|
| Rate for Payer: UMR Bronson Commercial |
$62.10
|
|
|
PR DRUG-ELUTING STENTS, SINGLE
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS G0290
|
| Min. Negotiated Rate |
$990.00 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: BCBS Complete |
$990.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,138.50
|
|
|
PR DRUG SCREEN MULTI DRUG CLASS
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS G0434
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$26.60 |
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
PR DRUG SCREEN MULTIP CLASS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS G0431
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$42.70 |
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR DRUG SCREEN PANEL 10 WITH BATH SALTS
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 00124
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: UMR Bronson Commercial |
$34.50
|
|
|
PR DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS
|
Professional
|
Both
|
$2,386.00
|
|
|
Service Code
|
HCPCS 36838
|
| Min. Negotiated Rate |
$711.42 |
| Max. Negotiated Rate |
$1,774.08 |
| Rate for Payer: Aetna Commercial |
$1,535.31
|
| Rate for Payer: BCBS Complete |
$746.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.13
|
| Rate for Payer: Cash Price |
$1,908.80
|
| Rate for Payer: Cash Price |
$1,908.80
|
| Rate for Payer: Meridian Medicaid |
$746.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$711.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,670.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,774.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,774.08
|
| Rate for Payer: Priority Health SBD |
$1,774.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,097.56
|
|
|
PR DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 17107
|
| Min. Negotiated Rate |
$230.25 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Aetna Commercial |
$379.73
|
| Rate for Payer: BCBS Complete |
$241.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,712.50
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Meridian Medicaid |
$241.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.76
|
| Rate for Payer: Priority Health Narrow Network |
$437.76
|
| Rate for Payer: Priority Health SBD |
$437.76
|
| Rate for Payer: UMR Bronson Commercial |
$368.92
|
|
|
PR DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 17108
|
| Min. Negotiated Rate |
$337.82 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$559.13
|
| Rate for Payer: BCBS Complete |
$354.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.00
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Meridian Medicaid |
$354.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.46
|
| Rate for Payer: Priority Health Narrow Network |
$642.46
|
| Rate for Payer: Priority Health SBD |
$642.46
|
| Rate for Payer: UMR Bronson Commercial |
$527.62
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
OP
|
$848.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$178.78 |
| Max. Negotiated Rate |
$7,856.86 |
| Rate for Payer: Aetna American Axle |
$551.20
|
| Rate for Payer: Aetna Commercial |
$720.80
|
| Rate for Payer: Aetna Medicare |
$2,595.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,757.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$593.60
|
| Rate for Payer: Cofinity Commercial |
$729.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$678.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$763.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$593.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$636.00
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$720.80
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$720.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,856.86
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$6,285.49
|
| Rate for Payer: Priority Health SBD |
$534.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,495.78
|
| Rate for Payer: UHC Exchange |
$178.78
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: UMR Bronson Commercial |
$313.76
|
| Rate for Payer: VA VA |
$2,495.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$636.00
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
HCPCS 46924
|
| Hospital Charge Code |
46924
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$239.74
|
| Rate for Payer: BCBS Complete |
$122.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Meridian Medicaid |
$122.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.91
|
| Rate for Payer: Priority Health Narrow Network |
$316.91
|
| Rate for Payer: Priority Health SBD |
$316.91
|
| Rate for Payer: UMR Bronson Commercial |
$390.08
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Professional
|
Both
|
$848.00
|
|
|
Service Code
|
HCPCS 46924
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$1,253.66 |
| Rate for Payer: Aetna Commercial |
$239.74
|
| Rate for Payer: BCBS Complete |
$122.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Meridian Medicaid |
$122.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.91
|
| Rate for Payer: Priority Health Narrow Network |
$316.91
|
| Rate for Payer: Priority Health SBD |
$316.91
|
| Rate for Payer: UMR Bronson Commercial |
$390.08
|
|
|
PR DSTRJ LESION ANUS EXTENSIVE
|
Facility
|
IP
|
$848.00
|
|
|
Service Code
|
CPT 46924
|
| Hospital Charge Code |
46924
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$373.12 |
| Max. Negotiated Rate |
$763.20 |
| Rate for Payer: Aetna American Axle |
$551.20
|
| Rate for Payer: Aetna Commercial |
$720.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.20
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cofinity Commercial |
$593.60
|
| Rate for Payer: Cofinity Commercial |
$729.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$678.40
|
| Rate for Payer: Healthscope Commercial |
$763.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$593.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$636.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$720.80
|
| Rate for Payer: PHP Commercial |
$720.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.60
|
| Rate for Payer: Priority Health SBD |
$534.24
|
| Rate for Payer: UMR Bronson Commercial |
$373.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$636.00
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 46900
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$179.17
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.07
|
| Rate for Payer: Priority Health Narrow Network |
$241.07
|
| Rate for Payer: Priority Health SBD |
$241.07
|
| Rate for Payer: UMR Bronson Commercial |
$172.50
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$135.89 |
| Max. Negotiated Rate |
$1,115.78 |
| Rate for Payer: Aetna American Axle |
$243.75
|
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: Aetna Medicare |
$368.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$199.59
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$262.50
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$892.62
|
| Rate for Payer: Priority Health SBD |
$236.25
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
| Rate for Payer: UHC Exchange |
$135.89
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: UMR Bronson Commercial |
$138.75
|
| Rate for Payer: VA VA |
$354.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna American Axle |
$243.75
|
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.75
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$262.50
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health SBD |
$236.25
|
| Rate for Payer: UMR Bronson Commercial |
$165.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
