|
PR EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA
|
Professional
|
Both
|
$2,163.00
|
|
|
Service Code
|
HCPCS 25120
|
| Min. Negotiated Rate |
$327.81 |
| Max. Negotiated Rate |
$1,514.10 |
| Rate for Payer: Aetna Commercial |
$666.80
|
| Rate for Payer: BCBS Complete |
$344.20
|
| Rate for Payer: BCBS Trust/PPO |
$351.32
|
| Rate for Payer: Cash Price |
$1,730.40
|
| Rate for Payer: Cash Price |
$1,730.40
|
| Rate for Payer: Meridian Medicaid |
$344.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,514.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$777.72
|
| Rate for Payer: Priority Health Narrow Network |
$777.72
|
| Rate for Payer: Priority Health SBD |
$777.72
|
| Rate for Payer: UMR Bronson Commercial |
$994.98
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS
|
Professional
|
Both
|
$1,113.00
|
|
|
Service Code
|
HCPCS 28100
|
| Min. Negotiated Rate |
$269.87 |
| Max. Negotiated Rate |
$1,087.24 |
| Rate for Payer: Aetna Commercial |
$551.67
|
| Rate for Payer: BCBS Complete |
$283.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,087.24
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Meridian Medicaid |
$283.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$640.36
|
| Rate for Payer: Priority Health Narrow Network |
$640.36
|
| Rate for Payer: Priority Health SBD |
$640.36
|
| Rate for Payer: UMR Bronson Commercial |
$511.98
|
|
|
PR EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS
|
Professional
|
Both
|
$1,172.00
|
|
|
Service Code
|
HCPCS 24110
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$913.55 |
| Rate for Payer: Aetna Commercial |
$774.56
|
| Rate for Payer: BCBS Complete |
$404.13
|
| Rate for Payer: BCBS Trust/PPO |
$45.96
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Cash Price |
$937.60
|
| Rate for Payer: Meridian Medicaid |
$404.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.55
|
| Rate for Payer: Priority Health Narrow Network |
$913.55
|
| Rate for Payer: Priority Health SBD |
$913.55
|
| Rate for Payer: UMR Bronson Commercial |
$539.12
|
|
|
PR EXCISION/DESTRUCTION INTRANASAL LESION INT APPR
|
Professional
|
Both
|
$1,656.00
|
|
|
Service Code
|
HCPCS 30117
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Aetna Commercial |
$419.52
|
| Rate for Payer: BCBS Complete |
$279.56
|
| Rate for Payer: BCBS Trust/PPO |
$249.89
|
| Rate for Payer: Cash Price |
$1,324.80
|
| Rate for Payer: Cash Price |
$1,324.80
|
| Rate for Payer: Meridian Medicaid |
$279.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,159.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.37
|
| Rate for Payer: Priority Health Narrow Network |
$465.37
|
| Rate for Payer: Priority Health SBD |
$465.37
|
| Rate for Payer: UMR Bronson Commercial |
$761.76
|
|
|
PR EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 42808
|
| Min. Negotiated Rate |
$107.14 |
| Max. Negotiated Rate |
$764.45 |
| Rate for Payer: Aetna Commercial |
$215.57
|
| Rate for Payer: BCBS Complete |
$112.50
|
| Rate for Payer: BCBS Trust/PPO |
$764.45
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Meridian Medicaid |
$112.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$293.99
|
| Rate for Payer: Priority Health Narrow Network |
$293.99
|
| Rate for Payer: Priority Health SBD |
$293.99
|
| Rate for Payer: UMR Bronson Commercial |
$185.84
|
|
|
PR EXCISION/DESTRUCTION OPEN ABDOMINAL TUMOR 5 CM/<
|
Professional
|
Both
|
$3,223.00
|
|
|
Service Code
|
HCPCS 49203
|
| Min. Negotiated Rate |
$599.09 |
| Max. Negotiated Rate |
$2,256.10 |
| Rate for Payer: Aetna Commercial |
$1,606.74
|
| Rate for Payer: BCBS Complete |
$801.79
|
| Rate for Payer: BCBS Trust/PPO |
$599.09
|
| Rate for Payer: Cash Price |
$2,578.40
|
| Rate for Payer: Cash Price |
$2,578.40
|
| Rate for Payer: Meridian Medicaid |
$801.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$763.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,096.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,096.13
|
| Rate for Payer: Priority Health SBD |
$2,096.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,482.58
|
|
|
PR EXCISION DISTAL ULNA PARTIAL/COMPLETE
|
Professional
|
Both
|
$1,529.00
|
|
|
Service Code
|
HCPCS 25240
|
| Min. Negotiated Rate |
$281.80 |
| Max. Negotiated Rate |
$1,623.99 |
| Rate for Payer: Aetna Commercial |
$571.19
|
| Rate for Payer: BCBS Complete |
$295.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,623.99
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Meridian Medicaid |
$295.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,070.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$666.91
|
| Rate for Payer: Priority Health Narrow Network |
$666.91
|
| Rate for Payer: Priority Health SBD |
$666.91
|
| Rate for Payer: UMR Bronson Commercial |
$703.34
|
|
|
PR EXCISION EPIPHYSEAL BAR
|
Professional
|
Both
|
$1,921.00
|
|
|
Service Code
|
HCPCS 20150
|
| Min. Negotiated Rate |
$644.96 |
| Max. Negotiated Rate |
$4,160.00 |
| Rate for Payer: Aetna Commercial |
$1,340.57
|
| Rate for Payer: BCBS Complete |
$677.21
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.00
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Meridian Medicaid |
$677.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,534.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.50
|
| Rate for Payer: Priority Health SBD |
$1,534.50
|
| Rate for Payer: UMR Bronson Commercial |
$883.66
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN
|
Professional
|
Both
|
$852.00
|
|
|
Service Code
|
HCPCS 15847
|
| Min. Negotiated Rate |
$196.94 |
| Max. Negotiated Rate |
$10,615.31 |
| Rate for Payer: Aetna Commercial |
$531.57
|
| Rate for Payer: BCBS Complete |
$206.79
|
| Rate for Payer: BCBS Trust/PPO |
$10,615.31
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Cash Price |
$681.60
|
| Rate for Payer: Meridian Medicaid |
$206.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.40
|
| Rate for Payer: Priority Health Narrow Network |
$603.40
|
| Rate for Payer: Priority Health SBD |
$603.40
|
| Rate for Payer: UMR Bronson Commercial |
$391.92
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM
|
Professional
|
Both
|
$4,500.00
|
|
|
Service Code
|
HCPCS 15836
|
| Min. Negotiated Rate |
$377.57 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna Commercial |
$818.68
|
| Rate for Payer: BCBS Complete |
$536.76
|
| Rate for Payer: BCBS Trust/PPO |
$377.57
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Meridian Medicaid |
$536.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$511.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,150.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$981.15
|
| Rate for Payer: Priority Health Narrow Network |
$981.15
|
| Rate for Payer: Priority Health SBD |
$981.15
|
| Rate for Payer: UMR Bronson Commercial |
$2,070.00
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA
|
Professional
|
Both
|
$2,149.00
|
|
|
Service Code
|
HCPCS 15839
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$1,504.30 |
| Rate for Payer: Aetna Commercial |
$798.50
|
| Rate for Payer: BCBS Complete |
$497.85
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Meridian Medicaid |
$497.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$910.45
|
| Rate for Payer: Priority Health Narrow Network |
$910.45
|
| Rate for Payer: Priority Health SBD |
$910.45
|
| Rate for Payer: UMR Bronson Commercial |
$988.54
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH
|
Professional
|
Both
|
$4,500.00
|
|
|
Service Code
|
HCPCS 15832
|
| Min. Negotiated Rate |
$590.65 |
| Max. Negotiated Rate |
$3,150.00 |
| Rate for Payer: Aetna Commercial |
$990.90
|
| Rate for Payer: BCBS Complete |
$620.18
|
| Rate for Payer: BCBS Trust/PPO |
$634.70
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Cash Price |
$3,600.00
|
| Rate for Payer: Meridian Medicaid |
$620.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,150.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.47
|
| Rate for Payer: Priority Health SBD |
$1,134.47
|
| Rate for Payer: UMR Bronson Commercial |
$2,070.00
|
|
|
PR EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$1,550.00
|
|
|
Service Code
|
HCPCS 69140
|
| Min. Negotiated Rate |
$579.57 |
| Max. Negotiated Rate |
$4,892.06 |
| Rate for Payer: Aetna Commercial |
$1,013.31
|
| Rate for Payer: BCBS Complete |
$608.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,892.06
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Meridian Medicaid |
$608.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,287.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,287.08
|
| Rate for Payer: Priority Health SBD |
$1,287.08
|
| Rate for Payer: UMR Bronson Commercial |
$713.00
|
|
|
PR EXCISION EXTERNAL EAR COMPLETE AMPUTATION
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 69120
|
| Min. Negotiated Rate |
$249.42 |
| Max. Negotiated Rate |
$4,565.04 |
| Rate for Payer: Aetna Commercial |
$447.02
|
| Rate for Payer: BCBS Complete |
$261.89
|
| Rate for Payer: BCBS Trust/PPO |
$4,565.04
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Meridian Medicaid |
$261.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.50
|
| Rate for Payer: Priority Health Narrow Network |
$553.50
|
| Rate for Payer: Priority Health SBD |
$553.50
|
| Rate for Payer: UMR Bronson Commercial |
$326.60
|
|
|
PR EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 69110
|
| Min. Negotiated Rate |
$211.08 |
| Max. Negotiated Rate |
$2,466.10 |
| Rate for Payer: Aetna Commercial |
$365.22
|
| Rate for Payer: BCBS Complete |
$221.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,466.10
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Meridian Medicaid |
$221.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.81
|
| Rate for Payer: Priority Health Narrow Network |
$465.81
|
| Rate for Payer: Priority Health SBD |
$465.81
|
| Rate for Payer: UMR Bronson Commercial |
$281.52
|
|
|
PR EXCISION FACIAL BONE
|
Professional
|
Both
|
$978.00
|
|
|
Service Code
|
HCPCS 21026
|
| Min. Negotiated Rate |
$146.87 |
| Max. Negotiated Rate |
$684.60 |
| Rate for Payer: Aetna Commercial |
$570.63
|
| Rate for Payer: BCBS Complete |
$288.73
|
| Rate for Payer: BCBS Trust/PPO |
$146.87
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Meridian Medicaid |
$288.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.59
|
| Rate for Payer: Priority Health Narrow Network |
$651.59
|
| Rate for Payer: Priority Health SBD |
$651.59
|
| Rate for Payer: UMR Bronson Commercial |
$449.88
|
|
|
PR EXCISION/FULGURATION URETHRAL PROLAPSE
|
Professional
|
Both
|
$847.00
|
|
|
Service Code
|
HCPCS 53275
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$1,384.67 |
| Rate for Payer: Aetna Commercial |
$337.13
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.67
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Cash Price |
$677.60
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$420.94
|
| Rate for Payer: Priority Health Narrow Network |
$420.94
|
| Rate for Payer: Priority Health SBD |
$420.94
|
| Rate for Payer: UMR Bronson Commercial |
$389.62
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 25111
|
| Min. Negotiated Rate |
$130.49 |
| Max. Negotiated Rate |
$758.80 |
| Rate for Payer: Aetna Commercial |
$427.99
|
| Rate for Payer: BCBS Complete |
$224.54
|
| Rate for Payer: BCBS Trust/PPO |
$130.49
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Meridian Medicaid |
$224.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.03
|
| Rate for Payer: Priority Health Narrow Network |
$505.03
|
| Rate for Payer: Priority Health SBD |
$505.03
|
| Rate for Payer: UMR Bronson Commercial |
$498.64
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT
|
Professional
|
Both
|
$1,127.00
|
|
|
Service Code
|
HCPCS 25112
|
| Min. Negotiated Rate |
$25.89 |
| Max. Negotiated Rate |
$788.90 |
| Rate for Payer: Aetna Commercial |
$516.27
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Cash Price |
$901.60
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.14
|
| Rate for Payer: Priority Health Narrow Network |
$606.14
|
| Rate for Payer: Priority Health SBD |
$606.14
|
| Rate for Payer: UMR Bronson Commercial |
$518.42
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Professional
|
Both
|
$821.00
|
|
|
Service Code
|
HCPCS 11451
|
| Min. Negotiated Rate |
$213.43 |
| Max. Negotiated Rate |
$2,369.57 |
| Rate for Payer: Aetna Commercial |
$355.34
|
| Rate for Payer: BCBS Complete |
$224.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,369.57
|
| Rate for Payer: Cash Price |
$656.80
|
| Rate for Payer: Cash Price |
$656.80
|
| Rate for Payer: Meridian Medicaid |
$224.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.99
|
| Rate for Payer: Priority Health Narrow Network |
$408.99
|
| Rate for Payer: Priority Health SBD |
$408.99
|
| Rate for Payer: UMR Bronson Commercial |
$377.66
|
|
|
PR EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
HCPCS 11450
|
| Min. Negotiated Rate |
$169.12 |
| Max. Negotiated Rate |
$2,369.57 |
| Rate for Payer: Aetna Commercial |
$278.60
|
| Rate for Payer: BCBS Complete |
$177.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,369.57
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Meridian Medicaid |
$177.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$503.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$322.66
|
| Rate for Payer: Priority Health Narrow Network |
$322.66
|
| Rate for Payer: Priority Health SBD |
$322.66
|
| Rate for Payer: UMR Bronson Commercial |
$330.74
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,316.25 |
| Rate for Payer: Aetna Commercial |
$356.68
|
| Rate for Payer: BCBS Complete |
$225.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.25
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Meridian Medicaid |
$225.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.45
|
| Rate for Payer: Priority Health Narrow Network |
$411.45
|
| Rate for Payer: Priority Health SBD |
$411.45
|
| Rate for Payer: UMR Bronson Commercial |
$286.58
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Facility
|
OP
|
$623.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$230.51 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$404.95
|
| Rate for Payer: Aetna Commercial |
$529.55
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cofinity Commercial |
$436.10
|
| Rate for Payer: Cofinity Commercial |
$535.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$560.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$436.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.25
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.55
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$529.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$392.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$329.73
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$230.51
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.25
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Facility
|
IP
|
$623.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
11463
|
| Min. Negotiated Rate |
$274.12 |
| Max. Negotiated Rate |
$560.70 |
| Rate for Payer: Aetna American Axle |
$404.95
|
| Rate for Payer: Aetna Commercial |
$529.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.95
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cofinity Commercial |
$436.10
|
| Rate for Payer: Cofinity Commercial |
$535.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.40
|
| Rate for Payer: Healthscope Commercial |
$560.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$436.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.55
|
| Rate for Payer: PHP Commercial |
$529.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.10
|
| Rate for Payer: Priority Health SBD |
$392.49
|
| Rate for Payer: UMR Bronson Commercial |
$274.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.25
|
|
|
PR EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 11463
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,316.25 |
| Rate for Payer: Aetna Commercial |
$356.68
|
| Rate for Payer: BCBS Complete |
$225.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.25
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Meridian Medicaid |
$225.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.45
|
| Rate for Payer: Priority Health Narrow Network |
$411.45
|
| Rate for Payer: Priority Health SBD |
$411.45
|
| Rate for Payer: UMR Bronson Commercial |
$286.58
|
|
