|
PR EXCISION/UNROOFING CYST KIDNEY
|
Professional
|
Both
|
$2,867.00
|
|
|
Service Code
|
HCPCS 50280
|
| Min. Negotiated Rate |
$600.45 |
| Max. Negotiated Rate |
$3,769.95 |
| Rate for Payer: Aetna Commercial |
$1,243.00
|
| Rate for Payer: BCBS Complete |
$630.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,769.95
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Meridian Medicaid |
$630.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$600.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,006.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,533.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,533.54
|
| Rate for Payer: Priority Health SBD |
$1,533.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,318.82
|
|
|
PR EXCISION VAGINAL CYST/TUMOR
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 57135
|
| Min. Negotiated Rate |
$121.20 |
| Max. Negotiated Rate |
$2,039.77 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: BCBS Complete |
$127.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.77
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Meridian Medicaid |
$127.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.96
|
| Rate for Payer: Priority Health Narrow Network |
$267.96
|
| Rate for Payer: Priority Health SBD |
$267.96
|
| Rate for Payer: UMR Bronson Commercial |
$302.68
|
|
|
PR EXCISION VAGINAL SEPTUM
|
Professional
|
Both
|
$1,132.00
|
|
|
Service Code
|
HCPCS 57130
|
| Min. Negotiated Rate |
$111.61 |
| Max. Negotiated Rate |
$2,624.59 |
| Rate for Payer: Aetna Commercial |
$202.91
|
| Rate for Payer: BCBS Complete |
$117.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,624.59
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Meridian Medicaid |
$117.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.13
|
| Rate for Payer: Priority Health Narrow Network |
$247.13
|
| Rate for Payer: Priority Health SBD |
$247.13
|
| Rate for Payer: UMR Bronson Commercial |
$520.72
|
|
|
PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>
|
Facility
|
IP
|
$1,454.00
|
|
|
Service Code
|
CPT 27337
|
| Hospital Charge Code |
27337
|
| Min. Negotiated Rate |
$639.76 |
| Max. Negotiated Rate |
$1,308.60 |
| Rate for Payer: Aetna American Axle |
$945.10
|
| Rate for Payer: Aetna Commercial |
$1,235.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$945.10
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cofinity Commercial |
$1,017.80
|
| Rate for Payer: Cofinity Commercial |
$1,250.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,163.20
|
| Rate for Payer: Healthscope Commercial |
$1,308.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,017.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,090.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,235.90
|
| Rate for Payer: PHP Commercial |
$1,235.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.80
|
| Rate for Payer: Priority Health SBD |
$916.02
|
| Rate for Payer: UMR Bronson Commercial |
$639.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,090.50
|
|
|
PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,454.00
|
|
|
Service Code
|
HCPCS 27337
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$1,659.39 |
| Rate for Payer: Aetna Commercial |
$560.76
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,659.39
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.93
|
| Rate for Payer: Priority Health Narrow Network |
$643.93
|
| Rate for Payer: Priority Health SBD |
$643.93
|
| Rate for Payer: UMR Bronson Commercial |
$668.84
|
|
|
PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,454.00
|
|
|
Service Code
|
HCPCS 27337
|
| Hospital Charge Code |
27337
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$1,659.39 |
| Rate for Payer: Aetna Commercial |
$560.76
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,659.39
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.93
|
| Rate for Payer: Priority Health Narrow Network |
$643.93
|
| Rate for Payer: Priority Health SBD |
$643.93
|
| Rate for Payer: UMR Bronson Commercial |
$668.84
|
|
|
PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>
|
Facility
|
OP
|
$1,454.00
|
|
|
Service Code
|
CPT 27337
|
| Hospital Charge Code |
27337
|
| Min. Negotiated Rate |
$417.16 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$945.10
|
| Rate for Payer: Aetna Commercial |
$1,235.90
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$945.10
|
| 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 |
$2,326.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cofinity Commercial |
$1,017.80
|
| Rate for Payer: Cofinity Commercial |
$1,250.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,308.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,017.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,090.50
|
| 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 |
$1,235.90
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$1,235.90
|
| 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 |
$1,017.80
|
| 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 |
$916.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$417.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$537.98
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,090.50
|
|
|
PR EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR
|
Professional
|
Both
|
$1,833.00
|
|
|
Service Code
|
HCPCS 43101
|
| Min. Negotiated Rate |
$263.62 |
| Max. Negotiated Rate |
$1,750.39 |
| Rate for Payer: Aetna Commercial |
$1,352.24
|
| Rate for Payer: BCBS Complete |
$669.16
|
| Rate for Payer: BCBS Trust/PPO |
$263.62
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Cash Price |
$1,466.40
|
| Rate for Payer: Meridian Medicaid |
$669.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,283.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,750.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,750.39
|
| Rate for Payer: Priority Health SBD |
$1,750.39
|
| Rate for Payer: UMR Bronson Commercial |
$843.18
|
|
|
PR EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 67840
|
| Min. Negotiated Rate |
$99.47 |
| Max. Negotiated Rate |
$337.06 |
| Rate for Payer: Aetna Commercial |
$203.67
|
| Rate for Payer: BCBS Complete |
$104.44
|
| Rate for Payer: BCBS Trust/PPO |
$337.06
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Meridian Medicaid |
$104.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.64
|
| Rate for Payer: Priority Health Narrow Network |
$271.64
|
| Rate for Payer: Priority Health SBD |
$271.64
|
| Rate for Payer: UMR Bronson Commercial |
$205.16
|
|
|
PR EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 40816
|
| Min. Negotiated Rate |
$195.32 |
| Max. Negotiated Rate |
$839.30 |
| Rate for Payer: Aetna Commercial |
$397.82
|
| Rate for Payer: BCBS Complete |
$205.09
|
| Rate for Payer: BCBS Trust/PPO |
$726.41
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Meridian Medicaid |
$205.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$839.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.30
|
| Rate for Payer: Priority Health Narrow Network |
$533.30
|
| Rate for Payer: Priority Health SBD |
$533.30
|
| Rate for Payer: UMR Bronson Commercial |
$551.54
|
|
|
PR EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR
|
Professional
|
Both
|
$666.00
|
|
|
Service Code
|
HCPCS 40814
|
| Min. Negotiated Rate |
$181.48 |
| Max. Negotiated Rate |
$684.68 |
| Rate for Payer: Aetna Commercial |
$377.24
|
| Rate for Payer: BCBS Complete |
$190.55
|
| Rate for Payer: BCBS Trust/PPO |
$684.68
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Meridian Medicaid |
$190.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$499.77
|
| Rate for Payer: Priority Health Narrow Network |
$499.77
|
| Rate for Payer: Priority Health SBD |
$499.77
|
| Rate for Payer: UMR Bronson Commercial |
$306.36
|
|
|
PR EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR
|
Professional
|
Both
|
$564.00
|
|
|
Service Code
|
HCPCS 40812
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$465.43 |
| Rate for Payer: Aetna Commercial |
$245.47
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS Trust/PPO |
$465.43
|
| Rate for Payer: Cash Price |
$451.20
|
| Rate for Payer: Cash Price |
$451.20
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.39
|
| Rate for Payer: Priority Health Narrow Network |
$323.39
|
| Rate for Payer: Priority Health SBD |
$323.39
|
| Rate for Payer: UMR Bronson Commercial |
$259.44
|
|
|
PR EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 42107
|
| Min. Negotiated Rate |
$207.46 |
| Max. Negotiated Rate |
$618.80 |
| Rate for Payer: Aetna Commercial |
$443.54
|
| Rate for Payer: BCBS Complete |
$217.83
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Meridian Medicaid |
$217.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$578.57
|
| Rate for Payer: Priority Health Narrow Network |
$578.57
|
| Rate for Payer: Priority Health SBD |
$578.57
|
| Rate for Payer: UMR Bronson Commercial |
$406.64
|
|
|
PR EXC LESION PALATE UVULA W/O CLOSURE
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 42104
|
| Min. Negotiated Rate |
$86.90 |
| Max. Negotiated Rate |
$1,644.60 |
| Rate for Payer: Aetna Commercial |
$176.41
|
| Rate for Payer: BCBS Complete |
$91.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Meridian Medicaid |
$91.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.53
|
| Rate for Payer: Priority Health Narrow Network |
$237.53
|
| Rate for Payer: Priority Health SBD |
$237.53
|
| Rate for Payer: UMR Bronson Commercial |
$173.42
|
|
|
PR EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
HCPCS 42106
|
| Min. Negotiated Rate |
$102.88 |
| Max. Negotiated Rate |
$1,938.86 |
| Rate for Payer: Aetna Commercial |
$217.85
|
| Rate for Payer: BCBS Complete |
$108.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,938.86
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Meridian Medicaid |
$108.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$285.75
|
| Rate for Payer: Priority Health Narrow Network |
$285.75
|
| Rate for Payer: Priority Health SBD |
$285.75
|
| Rate for Payer: UMR Bronson Commercial |
$228.16
|
|
|
PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,245.00
|
|
|
Service Code
|
HCPCS 55520
|
| Min. Negotiated Rate |
$295.64 |
| Max. Negotiated Rate |
$2,718.10 |
| Rate for Payer: Aetna Commercial |
$590.37
|
| Rate for Payer: BCBS Complete |
$310.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,718.10
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Cash Price |
$996.00
|
| Rate for Payer: Meridian Medicaid |
$310.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$742.99
|
| Rate for Payer: Priority Health Narrow Network |
$742.99
|
| Rate for Payer: Priority Health SBD |
$742.99
|
| Rate for Payer: UMR Bronson Commercial |
$572.70
|
|
|
PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR
|
Professional
|
Both
|
$1,035.00
|
|
|
Service Code
|
HCPCS 26160
|
| Min. Negotiated Rate |
$78.72 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Aetna Commercial |
$417.83
|
| Rate for Payer: BCBS Complete |
$217.83
|
| Rate for Payer: BCBS Trust/PPO |
$78.72
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Meridian Medicaid |
$217.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$490.74
|
| Rate for Payer: Priority Health Narrow Network |
$490.74
|
| Rate for Payer: Priority Health SBD |
$490.74
|
| Rate for Payer: UMR Bronson Commercial |
$476.10
|
|
|
PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR
|
Professional
|
Both
|
$1,035.00
|
|
|
Service Code
|
HCPCS 26160
|
| Hospital Charge Code |
26160
|
| Min. Negotiated Rate |
$78.72 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Aetna Commercial |
$417.83
|
| Rate for Payer: BCBS Complete |
$217.83
|
| Rate for Payer: BCBS Trust/PPO |
$78.72
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Meridian Medicaid |
$217.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$490.74
|
| Rate for Payer: Priority Health Narrow Network |
$490.74
|
| Rate for Payer: Priority Health SBD |
$490.74
|
| Rate for Payer: UMR Bronson Commercial |
$476.10
|
|
|
PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR
|
Facility
|
IP
|
$1,035.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
26160
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$931.50 |
| Rate for Payer: Aetna American Axle |
$672.75
|
| Rate for Payer: Aetna Commercial |
$879.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.75
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cofinity Commercial |
$724.50
|
| Rate for Payer: Cofinity Commercial |
$890.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$828.00
|
| Rate for Payer: Healthscope Commercial |
$931.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$724.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$776.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$879.75
|
| Rate for Payer: PHP Commercial |
$879.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.50
|
| Rate for Payer: Priority Health SBD |
$652.05
|
| Rate for Payer: UMR Bronson Commercial |
$455.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$776.25
|
|
|
PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR
|
Facility
|
OP
|
$1,035.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
26160
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$318.93 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna American Axle |
$672.75
|
| Rate for Payer: Aetna Commercial |
$879.75
|
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,656.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cofinity Commercial |
$890.10
|
| Rate for Payer: Cofinity Commercial |
$724.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$828.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$931.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$724.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$776.25
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$879.75
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$879.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Priority Health SBD |
$652.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$318.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: UMR Bronson Commercial |
$382.95
|
| Rate for Payer: VA VA |
$1,428.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$776.25
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 28090
|
| Min. Negotiated Rate |
$199.37 |
| Max. Negotiated Rate |
$608.30 |
| Rate for Payer: Aetna Commercial |
$404.59
|
| Rate for Payer: BCBS Complete |
$209.34
|
| Rate for Payer: BCBS Trust/PPO |
$404.15
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Meridian Medicaid |
$209.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.79
|
| Rate for Payer: Priority Health Narrow Network |
$469.79
|
| Rate for Payer: Priority Health SBD |
$469.79
|
| Rate for Payer: UMR Bronson Commercial |
$399.74
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT
|
Facility
|
OP
|
$869.00
|
|
|
Service Code
|
CPT 28090
|
| Hospital Charge Code |
28090
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$306.49 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna American Axle |
$564.85
|
| Rate for Payer: Aetna Commercial |
$738.65
|
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$608.30
|
| Rate for Payer: Cofinity Commercial |
$747.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$782.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$608.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$651.75
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$738.65
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$738.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Priority Health SBD |
$547.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$306.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: UMR Bronson Commercial |
$321.53
|
| Rate for Payer: VA VA |
$1,428.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$651.75
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT
|
Facility
|
IP
|
$869.00
|
|
|
Service Code
|
CPT 28090
|
| Hospital Charge Code |
28090
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$382.36 |
| Max. Negotiated Rate |
$782.10 |
| Rate for Payer: Aetna American Axle |
$564.85
|
| Rate for Payer: Aetna Commercial |
$738.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.85
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$608.30
|
| Rate for Payer: Cofinity Commercial |
$747.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.20
|
| Rate for Payer: Healthscope Commercial |
$782.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$608.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$651.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$738.65
|
| Rate for Payer: PHP Commercial |
$738.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.30
|
| Rate for Payer: Priority Health SBD |
$547.47
|
| Rate for Payer: UMR Bronson Commercial |
$382.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$651.75
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 28090
|
| Hospital Charge Code |
28090
|
| Min. Negotiated Rate |
$199.37 |
| Max. Negotiated Rate |
$608.30 |
| Rate for Payer: Aetna Commercial |
$404.59
|
| Rate for Payer: BCBS Complete |
$209.34
|
| Rate for Payer: BCBS Trust/PPO |
$404.15
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Meridian Medicaid |
$209.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.79
|
| Rate for Payer: Priority Health Narrow Network |
$469.79
|
| Rate for Payer: Priority Health SBD |
$469.79
|
| Rate for Payer: UMR Bronson Commercial |
$399.74
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 28092
|
| Min. Negotiated Rate |
$176.36 |
| Max. Negotiated Rate |
$569.10 |
| Rate for Payer: Aetna Commercial |
$353.01
|
| Rate for Payer: BCBS Complete |
$185.18
|
| Rate for Payer: BCBS Trust/PPO |
$353.43
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Meridian Medicaid |
$185.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$569.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.12
|
| Rate for Payer: Priority Health Narrow Network |
$413.12
|
| Rate for Payer: Priority Health SBD |
$413.12
|
| Rate for Payer: UMR Bronson Commercial |
$373.98
|
|
