|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
IP
|
$431.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$189.64 |
| Max. Negotiated Rate |
$387.90 |
| Rate for Payer: Aetna American Axle |
$280.15
|
| Rate for Payer: Aetna Commercial |
$366.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.15
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$301.70
|
| Rate for Payer: Cofinity Commercial |
$370.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.80
|
| Rate for Payer: Healthscope Commercial |
$387.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$366.35
|
| Rate for Payer: PHP Commercial |
$366.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.70
|
| Rate for Payer: Priority Health SBD |
$271.53
|
| Rate for Payer: UMR Bronson Commercial |
$189.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.25
|
|
|
PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS
|
Facility
|
OP
|
$431.00
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
46220
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$120.50 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$280.15
|
| Rate for Payer: Aetna Commercial |
$366.35
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$301.70
|
| Rate for Payer: Cofinity Commercial |
$370.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$387.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.25
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$366.35
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$366.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$271.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$120.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$159.47
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.25
|
|
|
PR EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY
|
Professional
|
Both
|
$2,600.00
|
|
|
Service Code
|
HCPCS 15830
|
| Min. Negotiated Rate |
$226.01 |
| Max. Negotiated Rate |
$1,820.00 |
| Rate for Payer: Aetna Commercial |
$1,270.12
|
| Rate for Payer: BCBS Complete |
$787.03
|
| Rate for Payer: BCBS Trust/PPO |
$226.01
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Cash Price |
$2,080.00
|
| Rate for Payer: Meridian Medicaid |
$787.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,820.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,439.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,439.87
|
| Rate for Payer: Priority Health SBD |
$1,439.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,196.00
|
|
|
PR EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$663.00
|
|
|
Service Code
|
HCPCS 69145
|
| Min. Negotiated Rate |
$166.35 |
| Max. Negotiated Rate |
$2,204.60 |
| Rate for Payer: Aetna Commercial |
$284.48
|
| Rate for Payer: BCBS Complete |
$174.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,204.60
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Meridian Medicaid |
$174.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$366.79
|
| Rate for Payer: Priority Health Narrow Network |
$366.79
|
| Rate for Payer: Priority Health SBD |
$366.79
|
| Rate for Payer: UMR Bronson Commercial |
$304.98
|
|
|
PR EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY
|
Professional
|
Both
|
$586.00
|
|
|
Service Code
|
HCPCS 54840
|
| Min. Negotiated Rate |
$206.61 |
| Max. Negotiated Rate |
$2,153.88 |
| Rate for Payer: Aetna Commercial |
$412.87
|
| Rate for Payer: BCBS Complete |
$216.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,153.88
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Cash Price |
$468.80
|
| Rate for Payer: Meridian Medicaid |
$216.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$517.12
|
| Rate for Payer: Priority Health Narrow Network |
$517.12
|
| Rate for Payer: Priority Health SBD |
$517.12
|
| Rate for Payer: UMR Bronson Commercial |
$269.56
|
|
|
PR EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND
|
Professional
|
Both
|
$2,227.00
|
|
|
Service Code
|
HCPCS 42440
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$1,558.90 |
| Rate for Payer: Aetna Commercial |
$546.03
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS Trust/PPO |
$437.96
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$736.15
|
| Rate for Payer: Priority Health Narrow Network |
$736.15
|
| Rate for Payer: Priority Health SBD |
$736.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.42
|
|
|
PR EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA
|
Professional
|
Both
|
$1,015.00
|
|
|
Service Code
|
HCPCS 30120
|
| Min. Negotiated Rate |
$270.08 |
| Max. Negotiated Rate |
$710.50 |
| Rate for Payer: Aetna Commercial |
$537.29
|
| Rate for Payer: BCBS Complete |
$283.58
|
| Rate for Payer: BCBS Trust/PPO |
$589.05
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Meridian Medicaid |
$283.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$582.97
|
| Rate for Payer: Priority Health Narrow Network |
$582.97
|
| Rate for Payer: Priority Health SBD |
$582.97
|
| Rate for Payer: UMR Bronson Commercial |
$466.90
|
|
|
PR EXCISION SYNOVIAL CYST POPLITEAL SPACE
|
Professional
|
Both
|
$1,608.00
|
|
|
Service Code
|
HCPCS 27345
|
| Min. Negotiated Rate |
$317.37 |
| Max. Negotiated Rate |
$1,594.41 |
| Rate for Payer: Aetna Commercial |
$645.18
|
| Rate for Payer: BCBS Complete |
$333.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.41
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Cash Price |
$1,286.40
|
| Rate for Payer: Meridian Medicaid |
$333.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.68
|
| Rate for Payer: Priority Health Narrow Network |
$751.68
|
| Rate for Payer: Priority Health SBD |
$751.68
|
| Rate for Payer: UMR Bronson Commercial |
$739.68
|
|
|
PR EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 26180
|
| Min. Negotiated Rate |
$146.34 |
| Max. Negotiated Rate |
$872.90 |
| Rate for Payer: Aetna Commercial |
$596.15
|
| Rate for Payer: BCBS Complete |
$309.53
|
| Rate for Payer: BCBS Trust/PPO |
$146.34
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Meridian Medicaid |
$309.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$698.06
|
| Rate for Payer: Priority Health Narrow Network |
$698.06
|
| Rate for Payer: Priority Health SBD |
$698.06
|
| Rate for Payer: UMR Bronson Commercial |
$573.62
|
|
|
PR EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 26170
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$764.40 |
| Rate for Payer: Aetna Commercial |
$541.73
|
| Rate for Payer: BCBS Complete |
$280.91
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Meridian Medicaid |
$280.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$634.23
|
| Rate for Payer: Priority Health Narrow Network |
$634.23
|
| Rate for Payer: Priority Health SBD |
$634.23
|
| Rate for Payer: UMR Bronson Commercial |
$502.32
|
|
|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS
|
Professional
|
Both
|
$2,033.00
|
|
|
Service Code
|
HCPCS 60280
|
| Min. Negotiated Rate |
$293.51 |
| Max. Negotiated Rate |
$3,383.23 |
| Rate for Payer: Aetna Commercial |
$571.08
|
| Rate for Payer: BCBS Complete |
$308.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,383.23
|
| Rate for Payer: Cash Price |
$1,626.40
|
| Rate for Payer: Cash Price |
$1,626.40
|
| Rate for Payer: Meridian Medicaid |
$308.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.79
|
| Rate for Payer: Priority Health Narrow Network |
$646.79
|
| Rate for Payer: Priority Health SBD |
$646.79
|
| Rate for Payer: UMR Bronson Commercial |
$935.18
|
|
|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT
|
Professional
|
Both
|
$2,154.00
|
|
|
Service Code
|
HCPCS 60281
|
| Min. Negotiated Rate |
$384.04 |
| Max. Negotiated Rate |
$3,474.63 |
| Rate for Payer: Aetna Commercial |
$753.00
|
| Rate for Payer: BCBS Complete |
$403.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,474.63
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Cash Price |
$1,723.20
|
| Rate for Payer: Meridian Medicaid |
$403.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,507.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$848.82
|
| Rate for Payer: Priority Health Narrow Network |
$848.82
|
| Rate for Payer: Priority Health SBD |
$848.82
|
| Rate for Payer: UMR Bronson Commercial |
$990.84
|
|
|
PR EXCISION TONSIL TAGS
|
Professional
|
Both
|
$373.00
|
|
|
Service Code
|
HCPCS 42860
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$890.19 |
| Rate for Payer: Aetna Commercial |
$249.27
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS Trust/PPO |
$890.19
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.55
|
| Rate for Payer: Priority Health Narrow Network |
$344.55
|
| Rate for Payer: Priority Health SBD |
$344.55
|
| Rate for Payer: UMR Bronson Commercial |
$171.58
|
|
|
PR EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL
|
Professional
|
Both
|
$3,871.00
|
|
|
Service Code
|
HCPCS 31785
|
| Min. Negotiated Rate |
$686.29 |
| Max. Negotiated Rate |
$2,709.70 |
| Rate for Payer: Aetna Commercial |
$1,372.02
|
| Rate for Payer: BCBS Complete |
$720.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.22
|
| Rate for Payer: Cash Price |
$3,096.80
|
| Rate for Payer: Cash Price |
$3,096.80
|
| Rate for Payer: Meridian Medicaid |
$720.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,487.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,487.77
|
| Rate for Payer: Priority Health SBD |
$1,487.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,780.66
|
|
|
PR EXCISION TROCHANTERIC BURSA/CALCIFICATION
|
Professional
|
Both
|
$1,645.00
|
|
|
Service Code
|
HCPCS 27062
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$4,466.25 |
| Rate for Payer: Aetna Commercial |
$606.20
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCBS Trust/PPO |
$4,466.25
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,151.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.17
|
| Rate for Payer: Priority Health Narrow Network |
$703.17
|
| Rate for Payer: Priority Health SBD |
$703.17
|
| Rate for Payer: UMR Bronson Commercial |
$756.70
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Facility
|
IP
|
$730.00
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
21931
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$321.20 |
| Max. Negotiated Rate |
$657.00 |
| Rate for Payer: Aetna American Axle |
$474.50
|
| Rate for Payer: Aetna Commercial |
$620.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.50
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cofinity Commercial |
$511.00
|
| Rate for Payer: Cofinity Commercial |
$627.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$584.00
|
| Rate for Payer: Healthscope Commercial |
$657.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$511.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$547.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$620.50
|
| Rate for Payer: PHP Commercial |
$620.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.00
|
| Rate for Payer: Priority Health SBD |
$459.90
|
| Rate for Payer: UMR Bronson Commercial |
$321.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$547.50
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Professional
|
Both
|
$730.00
|
|
|
Service Code
|
HCPCS 21931
|
| Hospital Charge Code |
21931
|
| Min. Negotiated Rate |
$303.31 |
| Max. Negotiated Rate |
$9,087.30 |
| Rate for Payer: Aetna Commercial |
$629.51
|
| Rate for Payer: BCBS Complete |
$318.48
|
| Rate for Payer: BCBS Trust/PPO |
$9,087.30
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Meridian Medicaid |
$318.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$720.53
|
| Rate for Payer: Priority Health Narrow Network |
$720.53
|
| Rate for Payer: Priority Health SBD |
$720.53
|
| Rate for Payer: UMR Bronson Commercial |
$335.80
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Facility
|
OP
|
$730.00
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
21931
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$270.10 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$474.50
|
| Rate for Payer: Aetna Commercial |
$620.50
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,348.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cofinity Commercial |
$511.00
|
| Rate for Payer: Cofinity Commercial |
$627.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$584.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$657.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$511.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$547.50
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$620.50
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$620.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$459.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$466.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$270.10
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$547.50
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Professional
|
Both
|
$730.00
|
|
|
Service Code
|
HCPCS 21931
|
| Min. Negotiated Rate |
$303.31 |
| Max. Negotiated Rate |
$9,087.30 |
| Rate for Payer: Aetna Commercial |
$629.51
|
| Rate for Payer: BCBS Complete |
$318.48
|
| Rate for Payer: BCBS Trust/PPO |
$9,087.30
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Meridian Medicaid |
$318.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$720.53
|
| Rate for Payer: Priority Health Narrow Network |
$720.53
|
| Rate for Payer: Priority Health SBD |
$720.53
|
| Rate for Payer: UMR Bronson Commercial |
$335.80
|
|
|
PR EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 28039
|
| Hospital Charge Code |
28039
|
| Min. Negotiated Rate |
$217.90 |
| Max. Negotiated Rate |
$897.58 |
| Rate for Payer: Aetna Commercial |
$461.09
|
| Rate for Payer: BCBS Complete |
$228.80
|
| Rate for Payer: BCBS Trust/PPO |
$897.58
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Meridian Medicaid |
$228.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$627.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.35
|
| Rate for Payer: Priority Health Narrow Network |
$520.35
|
| Rate for Payer: Priority Health SBD |
$520.35
|
| Rate for Payer: UMR Bronson Commercial |
$412.16
|
|
|
PR EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>
|
Facility
|
OP
|
$896.00
|
|
|
Service Code
|
CPT 28039
|
| Hospital Charge Code |
28039
|
| Min. Negotiated Rate |
$331.52 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$582.40
|
| Rate for Payer: Aetna Commercial |
$761.60
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.40
|
| 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 |
$2,340.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cofinity Commercial |
$770.56
|
| Rate for Payer: Cofinity Commercial |
$627.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$806.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$627.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$672.00
|
| 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 |
$761.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$761.60
|
| 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 |
$627.20
|
| 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 |
$564.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$334.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$331.52
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$672.00
|
|
|
PR EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 28039
|
| Min. Negotiated Rate |
$217.90 |
| Max. Negotiated Rate |
$897.58 |
| Rate for Payer: Aetna Commercial |
$461.09
|
| Rate for Payer: BCBS Complete |
$228.80
|
| Rate for Payer: BCBS Trust/PPO |
$897.58
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Meridian Medicaid |
$228.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$627.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.35
|
| Rate for Payer: Priority Health Narrow Network |
$520.35
|
| Rate for Payer: Priority Health SBD |
$520.35
|
| Rate for Payer: UMR Bronson Commercial |
$412.16
|
|
|
PR EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>
|
Facility
|
IP
|
$896.00
|
|
|
Service Code
|
CPT 28039
|
| Hospital Charge Code |
28039
|
| Min. Negotiated Rate |
$394.24 |
| Max. Negotiated Rate |
$806.40 |
| Rate for Payer: Aetna American Axle |
$582.40
|
| Rate for Payer: Aetna Commercial |
$761.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.40
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cofinity Commercial |
$770.56
|
| Rate for Payer: Cofinity Commercial |
$627.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.80
|
| Rate for Payer: Healthscope Commercial |
$806.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$627.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$672.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$761.60
|
| Rate for Payer: PHP Commercial |
$761.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$627.20
|
| Rate for Payer: Priority Health SBD |
$564.48
|
| Rate for Payer: UMR Bronson Commercial |
$394.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$672.00
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>
|
Facility
|
IP
|
$639.00
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
21012
|
| Min. Negotiated Rate |
$281.16 |
| Max. Negotiated Rate |
$575.10 |
| Rate for Payer: Aetna American Axle |
$415.35
|
| Rate for Payer: Aetna Commercial |
$543.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.35
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cofinity Commercial |
$447.30
|
| Rate for Payer: Cofinity Commercial |
$549.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.20
|
| Rate for Payer: Healthscope Commercial |
$575.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$447.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$479.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$543.15
|
| Rate for Payer: PHP Commercial |
$543.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.30
|
| Rate for Payer: Priority Health SBD |
$402.57
|
| Rate for Payer: UMR Bronson Commercial |
$281.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$479.25
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>
|
Facility
|
OP
|
$639.00
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
21012
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$415.35
|
| Rate for Payer: Aetna Commercial |
$543.15
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cofinity Commercial |
$447.30
|
| Rate for Payer: Cofinity Commercial |
$549.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$575.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$447.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$479.25
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$543.15
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$543.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$402.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$336.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$236.43
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$479.25
|
|
