|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$264.03
|
| Rate for Payer: BCBS Complete |
$169.08
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Meridian Medicaid |
$169.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.81
|
| Rate for Payer: Priority Health Narrow Network |
$305.81
|
| Rate for Payer: Priority Health SBD |
$305.81
|
| Rate for Payer: UMR Bronson Commercial |
$213.44
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Facility
|
IP
|
$464.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$204.16 |
| Max. Negotiated Rate |
$417.60 |
| Rate for Payer: Aetna American Axle |
$301.60
|
| Rate for Payer: Aetna Commercial |
$394.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.60
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cofinity Commercial |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$399.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.20
|
| Rate for Payer: Healthscope Commercial |
$417.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$394.40
|
| Rate for Payer: PHP Commercial |
$394.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.80
|
| Rate for Payer: Priority Health SBD |
$292.32
|
| Rate for Payer: UMR Bronson Commercial |
$204.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.00
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Professional
|
Both
|
$464.00
|
|
|
Service Code
|
HCPCS 11462
|
| Min. Negotiated Rate |
$161.03 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$264.03
|
| Rate for Payer: BCBS Complete |
$169.08
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Meridian Medicaid |
$169.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$161.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.81
|
| Rate for Payer: Priority Health Narrow Network |
$305.81
|
| Rate for Payer: Priority Health SBD |
$305.81
|
| Rate for Payer: UMR Bronson Commercial |
$213.44
|
|
|
PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR
|
Facility
|
OP
|
$464.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
11462
|
| Min. Negotiated Rate |
$171.68 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$301.60
|
| Rate for Payer: Aetna Commercial |
$394.40
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.60
|
| 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 |
$371.20
|
| Rate for Payer: Cash Price |
$371.20
|
| Rate for Payer: Cofinity Commercial |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$399.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$417.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.00
|
| 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 |
$394.40
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$394.40
|
| 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 |
$324.80
|
| 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 |
$292.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$247.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$171.68
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.00
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Facility
|
IP
|
$967.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$425.48 |
| Max. Negotiated Rate |
$870.30 |
| Rate for Payer: Aetna American Axle |
$628.55
|
| Rate for Payer: Aetna Commercial |
$821.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.55
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Cofinity Commercial |
$831.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.60
|
| Rate for Payer: Healthscope Commercial |
$870.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$676.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$821.95
|
| Rate for Payer: PHP Commercial |
$821.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health SBD |
$609.21
|
| Rate for Payer: UMR Bronson Commercial |
$425.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.25
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$967.00
|
|
|
Service Code
|
HCPCS 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$676.90 |
| Rate for Payer: Aetna Commercial |
$377.56
|
| Rate for Payer: BCBS Complete |
$237.52
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Meridian Medicaid |
$237.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.77
|
| Rate for Payer: Priority Health Narrow Network |
$430.77
|
| Rate for Payer: Priority Health SBD |
$430.77
|
| Rate for Payer: UMR Bronson Commercial |
$444.82
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Facility
|
OP
|
$967.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
11471
|
| Min. Negotiated Rate |
$347.74 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$628.55
|
| Rate for Payer: Aetna Commercial |
$821.95
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.55
|
| 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 |
$1,787.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Cofinity Commercial |
$831.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$870.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$676.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.25
|
| 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 |
$821.95
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$821.95
|
| 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 |
$676.90
|
| 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 |
$609.21
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$347.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$357.79
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.25
|
|
|
PR EXCISION H/P/P/U COMPLEX REPAIR
|
Professional
|
Both
|
$967.00
|
|
|
Service Code
|
HCPCS 11471
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$676.90 |
| Rate for Payer: Aetna Commercial |
$377.56
|
| Rate for Payer: BCBS Complete |
$237.52
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Meridian Medicaid |
$237.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.77
|
| Rate for Payer: Priority Health Narrow Network |
$430.77
|
| Rate for Payer: Priority Health SBD |
$430.77
|
| Rate for Payer: UMR Bronson Commercial |
$444.82
|
|
|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$892.00
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$624.40 |
| Rate for Payer: Aetna Commercial |
$305.63
|
| Rate for Payer: BCBS Complete |
$194.12
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: Cash Price |
$713.60
|
| Rate for Payer: Cash Price |
$713.60
|
| Rate for Payer: Meridian Medicaid |
$194.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$354.32
|
| Rate for Payer: Priority Health Narrow Network |
$354.32
|
| Rate for Payer: Priority Health SBD |
$354.32
|
| Rate for Payer: UMR Bronson Commercial |
$410.32
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
IP
|
$1,807.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$795.08 |
| Max. Negotiated Rate |
$1,626.30 |
| Rate for Payer: Aetna American Axle |
$1,174.55
|
| Rate for Payer: Aetna Commercial |
$1,535.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,174.55
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cofinity Commercial |
$1,554.02
|
| Rate for Payer: Cofinity Commercial |
$1,264.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,445.60
|
| Rate for Payer: Healthscope Commercial |
$1,626.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,264.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,355.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,535.95
|
| Rate for Payer: PHP Commercial |
$1,535.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,264.90
|
| Rate for Payer: Priority Health SBD |
$1,138.41
|
| Rate for Payer: UMR Bronson Commercial |
$795.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,355.25
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,807.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$327.81 |
| Max. Negotiated Rate |
$1,449.66 |
| Rate for Payer: Aetna Commercial |
$655.83
|
| Rate for Payer: BCBS Complete |
$344.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Meridian Medicaid |
$344.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,264.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.18
|
| Rate for Payer: Priority Health Narrow Network |
$819.18
|
| Rate for Payer: Priority Health SBD |
$819.18
|
| Rate for Payer: UMR Bronson Commercial |
$831.22
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,807.00
|
|
|
Service Code
|
HCPCS 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$327.81 |
| Max. Negotiated Rate |
$1,449.66 |
| Rate for Payer: Aetna Commercial |
$655.83
|
| Rate for Payer: BCBS Complete |
$344.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.66
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Meridian Medicaid |
$344.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$327.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,264.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.18
|
| Rate for Payer: Priority Health Narrow Network |
$819.18
|
| Rate for Payer: Priority Health SBD |
$819.18
|
| Rate for Payer: UMR Bronson Commercial |
$831.22
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
OP
|
$1,807.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$503.93 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$1,174.55
|
| Rate for Payer: Aetna Commercial |
$1,535.95
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,174.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,519.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cash Price |
$1,445.60
|
| Rate for Payer: Cofinity Commercial |
$1,264.90
|
| Rate for Payer: Cofinity Commercial |
$1,554.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,445.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$1,626.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,264.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,355.25
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,535.95
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$1,535.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,264.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$1,138.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$503.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$668.59
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,355.25
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
IP
|
$1,231.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$541.64 |
| Max. Negotiated Rate |
$1,107.90 |
| Rate for Payer: Aetna American Axle |
$800.15
|
| Rate for Payer: Aetna Commercial |
$1,046.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.15
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$1,058.66
|
| Rate for Payer: Cofinity Commercial |
$861.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$984.80
|
| Rate for Payer: Healthscope Commercial |
$1,107.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$861.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$923.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,046.35
|
| Rate for Payer: PHP Commercial |
$1,046.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.70
|
| Rate for Payer: Priority Health SBD |
$775.53
|
| Rate for Payer: UMR Bronson Commercial |
$541.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$923.25
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
55040
|
| Min. Negotiated Rate |
$217.47 |
| Max. Negotiated Rate |
$1,183.92 |
| Rate for Payer: Aetna Commercial |
$433.14
|
| Rate for Payer: BCBS Complete |
$228.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Meridian Medicaid |
$228.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.98
|
| Rate for Payer: Priority Health Narrow Network |
$541.98
|
| Rate for Payer: Priority Health SBD |
$541.98
|
| Rate for Payer: UMR Bronson Commercial |
$566.26
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,231.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$217.47 |
| Max. Negotiated Rate |
$1,183.92 |
| Rate for Payer: Aetna Commercial |
$433.14
|
| Rate for Payer: BCBS Complete |
$228.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Meridian Medicaid |
$228.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$541.98
|
| Rate for Payer: Priority Health Narrow Network |
$541.98
|
| Rate for Payer: Priority Health SBD |
$541.98
|
| Rate for Payer: UMR Bronson Commercial |
$566.26
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
OP
|
$1,231.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$334.32 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$800.15
|
| Rate for Payer: Aetna Commercial |
$1,046.35
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$800.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,978.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cash Price |
$984.80
|
| Rate for Payer: Cofinity Commercial |
$1,058.66
|
| Rate for Payer: Cofinity Commercial |
$861.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$984.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$1,107.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$861.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$923.25
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,046.35
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$1,046.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$775.53
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$334.32
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$455.47
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$923.25
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$3,964.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$1,120.00 |
| Max. Negotiated Rate |
$2,949.71 |
| Rate for Payer: Aetna Commercial |
$2,561.49
|
| Rate for Payer: BCBS Complete |
$1,249.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.00
|
| Rate for Payer: Cash Price |
$3,171.20
|
| Rate for Payer: Cash Price |
$3,171.20
|
| Rate for Payer: Meridian Medicaid |
$1,249.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,190.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,774.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,949.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,949.71
|
| Rate for Payer: Priority Health SBD |
$2,949.71
|
| Rate for Payer: UMR Bronson Commercial |
$1,823.44
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$1,966.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$354.43 |
| Max. Negotiated Rate |
$1,376.20 |
| Rate for Payer: Aetna Commercial |
$757.47
|
| Rate for Payer: BCBS Complete |
$372.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.68
|
| Rate for Payer: Cash Price |
$1,572.80
|
| Rate for Payer: Cash Price |
$1,572.80
|
| Rate for Payer: Meridian Medicaid |
$372.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,376.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$882.52
|
| Rate for Payer: Priority Health Narrow Network |
$882.52
|
| Rate for Payer: Priority Health SBD |
$882.52
|
| Rate for Payer: UMR Bronson Commercial |
$904.36
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$268.38 |
| Max. Negotiated Rate |
$674.64 |
| Rate for Payer: Aetna Commercial |
$522.89
|
| Rate for Payer: BCBS Complete |
$281.80
|
| Rate for Payer: BCBS Trust/PPO |
$674.64
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Meridian Medicaid |
$281.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$552.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$586.68
|
| Rate for Payer: Priority Health Narrow Network |
$586.68
|
| Rate for Payer: Priority Health SBD |
$586.68
|
| Rate for Payer: UMR Bronson Commercial |
$362.94
|
|
|
PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 28080
|
| Min. Negotiated Rate |
$244.74 |
| Max. Negotiated Rate |
$1,100.45 |
| Rate for Payer: Aetna Commercial |
$488.84
|
| Rate for Payer: BCBS Complete |
$256.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.45
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Meridian Medicaid |
$256.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.02
|
| Rate for Payer: Priority Health Narrow Network |
$576.02
|
| Rate for Payer: Priority Health SBD |
$576.02
|
| Rate for Payer: UMR Bronson Commercial |
$399.74
|
|
|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$778.00
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$544.60 |
| Rate for Payer: Aetna Commercial |
$346.57
|
| Rate for Payer: BCBS Complete |
$219.63
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Meridian Medicaid |
$219.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$398.30
|
| Rate for Payer: Priority Health Narrow Network |
$398.30
|
| Rate for Payer: Priority Health SBD |
$398.30
|
| Rate for Payer: UMR Bronson Commercial |
$357.88
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$139.30 |
| Max. Negotiated Rate |
$916.07 |
| Rate for Payer: Aetna Commercial |
$281.48
|
| Rate for Payer: BCBS Complete |
$146.26
|
| Rate for Payer: BCBS Trust/PPO |
$916.07
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Meridian Medicaid |
$146.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$403.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$381.01
|
| Rate for Payer: Priority Health Narrow Network |
$381.01
|
| Rate for Payer: Priority Health SBD |
$381.01
|
| Rate for Payer: UMR Bronson Commercial |
$264.96
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,294.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$343.78 |
| Max. Negotiated Rate |
$1,605.80 |
| Rate for Payer: Aetna Commercial |
$702.81
|
| Rate for Payer: BCBS Complete |
$360.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.67
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Cash Price |
$1,835.20
|
| Rate for Payer: Meridian Medicaid |
$360.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.02
|
| Rate for Payer: Priority Health Narrow Network |
$816.02
|
| Rate for Payer: Priority Health SBD |
$816.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,055.24
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$1,498.16 |
| Rate for Payer: Aetna Commercial |
$1,133.59
|
| Rate for Payer: BCBS Complete |
$573.44
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Meridian Medicaid |
$573.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,498.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,498.16
|
| Rate for Payer: Priority Health SBD |
$1,498.16
|
| Rate for Payer: UMR Bronson Commercial |
$679.88
|
|
