|
PR HEARING AID CHECK MONAURAL
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 92592
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$2,403.24 |
| Rate for Payer: Aetna Commercial |
$23.53
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.24
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.09
|
| Rate for Payer: Priority Health Narrow Network |
$30.09
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$864.19 |
| Rate for Payer: Aetna Commercial |
$76.88
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$864.19
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.12
|
| Rate for Payer: Priority Health Narrow Network |
$96.12
|
| Rate for Payer: Priority Health SBD |
$96.12
|
| Rate for Payer: UMR Bronson Commercial |
$64.40
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$1,399.47 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,399.47
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.46
|
| Rate for Payer: Priority Health Narrow Network |
$75.46
|
| Rate for Payer: Priority Health SBD |
$75.46
|
| Rate for Payer: UMR Bronson Commercial |
$64.40
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,408.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$3,785.60 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: BCBS Complete |
$2,163.20
|
| Rate for Payer: Cash Price |
$4,326.40
|
| Rate for Payer: Cash Price |
$4,326.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,785.60
|
| Rate for Payer: UMR Bronson Commercial |
$2,487.68
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$88.69 |
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS Complete |
$170.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.50
|
| Rate for Payer: UMR Bronson Commercial |
$138.00
|
| Rate for Payer: UMR Bronson Commercial |
$46.00
|
| Rate for Payer: UMR Bronson Commercial |
$195.50
|
|
|
PR HEARING AID RESTOCKING FEE
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 00663
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: UMR Bronson Commercial |
$59.80
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,287.54
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$726.97 |
| Max. Negotiated Rate |
$1,730.08 |
| Rate for Payer: Aetna Commercial |
$1,512.35
|
| Rate for Payer: BCBS Complete |
$763.32
|
| Rate for Payer: BCBS Trust/PPO |
$984.22
|
| Rate for Payer: Cash Price |
$1,830.03
|
| Rate for Payer: Cash Price |
$1,830.03
|
| Rate for Payer: Meridian Medicaid |
$763.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$726.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,730.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,730.08
|
| Rate for Payer: Priority Health SBD |
$1,730.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,052.27
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$683.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$172.53 |
| Max. Negotiated Rate |
$888.60 |
| Rate for Payer: Aetna Commercial |
$351.28
|
| Rate for Payer: BCBS Complete |
$181.16
|
| Rate for Payer: BCBS Trust/PPO |
$888.60
|
| Rate for Payer: Cash Price |
$546.40
|
| Rate for Payer: Cash Price |
$546.40
|
| Rate for Payer: Meridian Medicaid |
$181.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.95
|
| Rate for Payer: Priority Health Narrow Network |
$404.95
|
| Rate for Payer: Priority Health SBD |
$404.95
|
| Rate for Payer: UMR Bronson Commercial |
$314.18
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$293.73 |
| Rate for Payer: Aetna Commercial |
$80.15
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS Trust/PPO |
$293.73
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.77
|
| Rate for Payer: Priority Health Narrow Network |
$94.77
|
| Rate for Payer: Priority Health SBD |
$94.77
|
| Rate for Payer: UMR Bronson Commercial |
$56.58
|
|
|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$584.00
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$408.80 |
| Rate for Payer: Aetna Commercial |
$115.20
|
| Rate for Payer: BCBS Complete |
$67.55
|
| Rate for Payer: BCBS Trust/PPO |
$314.34
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Meridian Medicaid |
$67.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.74
|
| Rate for Payer: Priority Health Narrow Network |
$134.74
|
| Rate for Payer: Priority Health SBD |
$134.74
|
| Rate for Payer: UMR Bronson Commercial |
$268.64
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$1,246.26 |
| Rate for Payer: Aetna Commercial |
$256.42
|
| Rate for Payer: BCBS Complete |
$129.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,246.26
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Meridian Medicaid |
$129.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.26
|
| Rate for Payer: Priority Health Narrow Network |
$339.26
|
| Rate for Payer: Priority Health SBD |
$339.26
|
| Rate for Payer: UMR Bronson Commercial |
$187.22
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
OP
|
$407.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$150.59 |
| Max. Negotiated Rate |
$2,557.47 |
| Rate for Payer: Aetna American Axle |
$264.55
|
| Rate for Payer: Aetna Commercial |
$345.95
|
| Rate for Payer: Aetna Medicare |
$844.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$607.78
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$284.90
|
| Rate for Payer: Cofinity Commercial |
$350.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$366.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.25
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.95
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$345.95
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,557.47
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,045.98
|
| Rate for Payer: Priority Health SBD |
$256.41
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.40
|
| Rate for Payer: UHC Exchange |
$189.92
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: UMR Bronson Commercial |
$150.59
|
| Rate for Payer: VA VA |
$812.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.25
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
IP
|
$407.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$179.08 |
| Max. Negotiated Rate |
$366.30 |
| Rate for Payer: Aetna American Axle |
$264.55
|
| Rate for Payer: Aetna Commercial |
$345.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.55
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$284.90
|
| Rate for Payer: Cofinity Commercial |
$350.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.60
|
| Rate for Payer: Healthscope Commercial |
$366.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.95
|
| Rate for Payer: PHP Commercial |
$345.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health SBD |
$256.41
|
| Rate for Payer: UMR Bronson Commercial |
$179.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.25
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 46221
|
| Hospital Charge Code |
46221
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$1,246.26 |
| Rate for Payer: Aetna Commercial |
$256.42
|
| Rate for Payer: BCBS Complete |
$129.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,246.26
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Meridian Medicaid |
$129.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.26
|
| Rate for Payer: Priority Health Narrow Network |
$339.26
|
| Rate for Payer: Priority Health SBD |
$339.26
|
| Rate for Payer: UMR Bronson Commercial |
$187.22
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$310.13 |
| Max. Negotiated Rate |
$2,501.50 |
| Rate for Payer: Aetna Commercial |
$644.26
|
| Rate for Payer: BCBS Complete |
$325.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Meridian Medicaid |
$325.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,107.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.39
|
| Rate for Payer: Priority Health Narrow Network |
$851.39
|
| Rate for Payer: Priority Health SBD |
$851.39
|
| Rate for Payer: UMR Bronson Commercial |
$727.72
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
IP
|
$1,582.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$696.08 |
| Max. Negotiated Rate |
$1,423.80 |
| Rate for Payer: Aetna American Axle |
$1,028.30
|
| Rate for Payer: Aetna Commercial |
$1,344.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,028.30
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$1,107.40
|
| Rate for Payer: Cofinity Commercial |
$1,360.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,265.60
|
| Rate for Payer: Healthscope Commercial |
$1,423.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,107.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,186.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,344.70
|
| Rate for Payer: PHP Commercial |
$1,344.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,107.40
|
| Rate for Payer: Priority Health SBD |
$996.66
|
| Rate for Payer: UMR Bronson Commercial |
$696.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,186.50
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Facility
|
OP
|
$1,582.00
|
|
|
Service Code
|
CPT 46260
|
| Hospital Charge Code |
46260
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$476.76 |
| Max. Negotiated Rate |
$7,856.86 |
| Rate for Payer: Aetna American Axle |
$1,028.30
|
| Rate for Payer: Aetna Commercial |
$1,344.70
|
| Rate for Payer: Aetna Medicare |
$2,595.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,028.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,755.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cofinity Commercial |
$1,107.40
|
| Rate for Payer: Cofinity Commercial |
$1,360.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,265.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$1,423.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,107.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,186.50
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,344.70
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$1,344.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,107.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,856.86
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$6,285.49
|
| Rate for Payer: Priority Health SBD |
$996.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,495.78
|
| Rate for Payer: UHC Exchange |
$476.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: UMR Bronson Commercial |
$585.34
|
| Rate for Payer: VA VA |
$2,495.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,186.50
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$1,582.00
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
46260
|
| Min. Negotiated Rate |
$310.13 |
| Max. Negotiated Rate |
$2,501.50 |
| Rate for Payer: Aetna Commercial |
$644.26
|
| Rate for Payer: BCBS Complete |
$325.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,501.50
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Cash Price |
$1,265.60
|
| Rate for Payer: Meridian Medicaid |
$325.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,107.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.39
|
| Rate for Payer: Priority Health Narrow Network |
$851.39
|
| Rate for Payer: Priority Health SBD |
$851.39
|
| Rate for Payer: UMR Bronson Commercial |
$727.72
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$2,489.35 |
| Rate for Payer: Aetna Commercial |
$477.30
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.37
|
| Rate for Payer: Priority Health Narrow Network |
$627.37
|
| Rate for Payer: Priority Health SBD |
$627.37
|
| Rate for Payer: UMR Bronson Commercial |
$494.96
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
IP
|
$1,076.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$473.44 |
| Max. Negotiated Rate |
$968.40 |
| Rate for Payer: Aetna American Axle |
$699.40
|
| Rate for Payer: Aetna Commercial |
$914.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.40
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$753.20
|
| Rate for Payer: Cofinity Commercial |
$925.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.80
|
| Rate for Payer: Healthscope Commercial |
$968.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$753.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$807.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.60
|
| Rate for Payer: PHP Commercial |
$914.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.20
|
| Rate for Payer: Priority Health SBD |
$677.88
|
| Rate for Payer: UMR Bronson Commercial |
$473.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$807.00
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Facility
|
OP
|
$1,076.00
|
|
|
Service Code
|
CPT 46255
|
| Hospital Charge Code |
46255
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$351.02 |
| Max. Negotiated Rate |
$7,856.86 |
| Rate for Payer: Aetna American Axle |
$699.40
|
| Rate for Payer: Aetna Commercial |
$914.60
|
| Rate for Payer: Aetna Medicare |
$2,595.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,712.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cofinity Commercial |
$753.20
|
| Rate for Payer: Cofinity Commercial |
$925.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$968.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$753.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$807.00
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.60
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$914.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,856.86
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$6,285.49
|
| Rate for Payer: Priority Health SBD |
$677.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,495.78
|
| Rate for Payer: UHC Exchange |
$351.02
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: UMR Bronson Commercial |
$398.12
|
| Rate for Payer: VA VA |
$2,495.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$807.00
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,076.00
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
46255
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$2,489.35 |
| Rate for Payer: Aetna Commercial |
$477.30
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Cash Price |
$860.80
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.37
|
| Rate for Payer: Priority Health Narrow Network |
$627.37
|
| Rate for Payer: Priority Health SBD |
$627.37
|
| Rate for Payer: UMR Bronson Commercial |
$494.96
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Facility
|
OP
|
$1,107.00
|
|
|
Service Code
|
CPT 46250
|
| Hospital Charge Code |
46250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$315.33 |
| Max. Negotiated Rate |
$7,856.86 |
| Rate for Payer: Aetna American Axle |
$719.55
|
| Rate for Payer: Aetna Commercial |
$940.95
|
| Rate for Payer: Aetna Medicare |
$2,595.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,853.06
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cofinity Commercial |
$952.02
|
| Rate for Payer: Cofinity Commercial |
$774.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$996.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.25
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$940.95
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$940.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,856.86
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$6,285.49
|
| Rate for Payer: Priority Health SBD |
$697.41
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,495.78
|
| Rate for Payer: UHC Exchange |
$315.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: UMR Bronson Commercial |
$409.59
|
| Rate for Payer: VA VA |
$2,495.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.25
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,107.00
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$205.12 |
| Max. Negotiated Rate |
$1,253.13 |
| Rate for Payer: Aetna Commercial |
$425.75
|
| Rate for Payer: BCBS Complete |
$215.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.13
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Meridian Medicaid |
$215.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$563.28
|
| Rate for Payer: Priority Health Narrow Network |
$563.28
|
| Rate for Payer: Priority Health SBD |
$563.28
|
| Rate for Payer: UMR Bronson Commercial |
$509.22
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,107.00
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
46250
|
| Min. Negotiated Rate |
$205.12 |
| Max. Negotiated Rate |
$1,253.13 |
| Rate for Payer: Aetna Commercial |
$425.75
|
| Rate for Payer: BCBS Complete |
$215.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.13
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Meridian Medicaid |
$215.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$563.28
|
| Rate for Payer: Priority Health Narrow Network |
$563.28
|
| Rate for Payer: Priority Health SBD |
$563.28
|
| Rate for Payer: UMR Bronson Commercial |
$509.22
|
|
