|
PR HYSTEROSCOPY REMOVAL LEIOMYOMATA
|
Professional
|
Both
|
$923.00
|
|
|
Service Code
|
HCPCS 58561
|
| Min. Negotiated Rate |
$23.25 |
| Max. Negotiated Rate |
$646.10 |
| Rate for Payer: Aetna Commercial |
$428.81
|
| Rate for Payer: BCBS Complete |
$239.31
|
| Rate for Payer: BCBS Trust/PPO |
$23.25
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Meridian Medicaid |
$239.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.20
|
| Rate for Payer: Priority Health Narrow Network |
$504.20
|
| Rate for Payer: Priority Health SBD |
$504.20
|
| Rate for Payer: UMR Bronson Commercial |
$424.58
|
|
|
PR HYSTEROTOMY ABDOMINAL
|
Professional
|
Both
|
$1,500.00
|
|
|
Service Code
|
HCPCS 59100
|
| Min. Negotiated Rate |
$130.49 |
| Max. Negotiated Rate |
$1,217.73 |
| Rate for Payer: Aetna Commercial |
$936.56
|
| Rate for Payer: BCBS Complete |
$580.38
|
| Rate for Payer: BCBS Trust/PPO |
$130.49
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Meridian Medicaid |
$580.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,217.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,217.73
|
| Rate for Payer: Priority Health SBD |
$1,217.73
|
| Rate for Payer: UMR Bronson Commercial |
$690.00
|
|
|
PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM USE
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 90750
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$187.08 |
| Rate for Payer: Aetna Commercial |
$187.08
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS Trust/PPO |
$175.26
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
| Rate for Payer: UMR Bronson Commercial |
$77.28
|
|
|
PR I131 IODIDE CAP, RX
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS A9517
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$2,124.29 |
| Rate for Payer: Aetna Commercial |
$40.43
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.29
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
PR ICAR CATHETER ABLATION ARRHYTHMIA ADD ON
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 93655
|
| Min. Negotiated Rate |
$190.64 |
| Max. Negotiated Rate |
$2,991.76 |
| Rate for Payer: Aetna Commercial |
$570.63
|
| Rate for Payer: BCBS Complete |
$200.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,991.76
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Meridian Medicaid |
$200.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,024.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.42
|
| Rate for Payer: Priority Health Narrow Network |
$428.42
|
| Rate for Payer: Priority Health SBD |
$428.42
|
| Rate for Payer: UMR Bronson Commercial |
$672.98
|
|
|
PR ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION
|
Professional
|
Both
|
$1,804.00
|
|
|
Service Code
|
HCPCS 93650
|
| Min. Negotiated Rate |
$362.10 |
| Max. Negotiated Rate |
$2,821.65 |
| Rate for Payer: Aetna Commercial |
$791.77
|
| Rate for Payer: BCBS Complete |
$380.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,821.65
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Cash Price |
$1,443.20
|
| Rate for Payer: Meridian Medicaid |
$380.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.33
|
| Rate for Payer: Priority Health Narrow Network |
$813.33
|
| Rate for Payer: Priority Health SBD |
$813.33
|
| Rate for Payer: UMR Bronson Commercial |
$829.84
|
|
|
PR I&D ABSCESS PERITONSILLAR
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 42700
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$492.38 |
| Rate for Payer: Aetna Commercial |
$176.88
|
| Rate for Payer: BCBS Complete |
$92.15
|
| Rate for Payer: BCBS Trust/PPO |
$492.38
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Meridian Medicaid |
$92.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.48
|
| Rate for Payer: Priority Health Narrow Network |
$240.48
|
| Rate for Payer: Priority Health SBD |
$240.48
|
| Rate for Payer: UMR Bronson Commercial |
$138.92
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 42720
|
| Min. Negotiated Rate |
$247.08 |
| Max. Negotiated Rate |
$678.52 |
| Rate for Payer: Aetna Commercial |
$511.86
|
| Rate for Payer: BCBS Complete |
$259.43
|
| Rate for Payer: BCBS Trust/PPO |
$613.88
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Meridian Medicaid |
$259.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$678.52
|
| Rate for Payer: Priority Health Narrow Network |
$678.52
|
| Rate for Payer: Priority Health SBD |
$678.52
|
| Rate for Payer: UMR Bronson Commercial |
$373.06
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR
|
Professional
|
Both
|
$1,449.00
|
|
|
Service Code
|
HCPCS 42725
|
| Min. Negotiated Rate |
$512.90 |
| Max. Negotiated Rate |
$1,402.91 |
| Rate for Payer: Aetna Commercial |
$1,060.45
|
| Rate for Payer: BCBS Complete |
$538.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.83
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Cash Price |
$1,159.20
|
| Rate for Payer: Meridian Medicaid |
$538.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,402.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.91
|
| Rate for Payer: Priority Health SBD |
$1,402.91
|
| Rate for Payer: UMR Bronson Commercial |
$666.54
|
|
|
PR I&D BELOW FASCIA FOOT 1 BURSAL SPACE
|
Professional
|
Both
|
$851.00
|
|
|
Service Code
|
HCPCS 28002
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$595.70 |
| Rate for Payer: Aetna Commercial |
$419.78
|
| Rate for Payer: BCBS Complete |
$93.71
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Meridian Medicaid |
$93.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.92
|
| Rate for Payer: Priority Health Narrow Network |
$211.92
|
| Rate for Payer: Priority Health SBD |
$211.92
|
| Rate for Payer: UMR Bronson Commercial |
$391.46
|
|
|
PR I&D BELOW FASCIA FOOT MULTIPLE AREAS
|
Professional
|
Both
|
$1,219.00
|
|
|
Service Code
|
HCPCS 28003
|
| Min. Negotiated Rate |
$164.22 |
| Max. Negotiated Rate |
$3,691.76 |
| Rate for Payer: Aetna Commercial |
$745.46
|
| Rate for Payer: BCBS Complete |
$172.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,691.76
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Cash Price |
$975.20
|
| Rate for Payer: Meridian Medicaid |
$172.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.22
|
| Rate for Payer: Priority Health Narrow Network |
$394.22
|
| Rate for Payer: Priority Health SBD |
$394.22
|
| Rate for Payer: UMR Bronson Commercial |
$560.74
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS 27301
|
| Min. Negotiated Rate |
$329.94 |
| Max. Negotiated Rate |
$3,899.38 |
| Rate for Payer: Aetna Commercial |
$675.38
|
| Rate for Payer: BCBS Complete |
$346.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,899.38
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Meridian Medicaid |
$346.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$781.29
|
| Rate for Payer: Priority Health Narrow Network |
$781.29
|
| Rate for Payer: Priority Health SBD |
$781.29
|
| Rate for Payer: UMR Bronson Commercial |
$750.72
|
|
|
PR I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR
|
Professional
|
Both
|
$2,412.00
|
|
|
Service Code
|
HCPCS 22010
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,688.40 |
| Rate for Payer: Aetna Commercial |
$1,291.27
|
| Rate for Payer: BCBS Complete |
$660.89
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Meridian Medicaid |
$660.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,688.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,488.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,488.03
|
| Rate for Payer: Priority Health SBD |
$1,488.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,109.52
|
|
|
PR I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC
|
Professional
|
Both
|
$1,691.00
|
|
|
Service Code
|
HCPCS 22015
|
| Min. Negotiated Rate |
$233.52 |
| Max. Negotiated Rate |
$1,462.50 |
| Rate for Payer: Aetna Commercial |
$1,265.29
|
| Rate for Payer: BCBS Complete |
$644.78
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: Cash Price |
$1,352.80
|
| Rate for Payer: Cash Price |
$1,352.80
|
| Rate for Payer: Meridian Medicaid |
$644.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$614.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,462.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,462.50
|
| Rate for Payer: Priority Health SBD |
$1,462.50
|
| Rate for Payer: UMR Bronson Commercial |
$777.86
|
|
|
PR I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 21501
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$801.50 |
| Rate for Payer: Aetna Commercial |
$434.09
|
| Rate for Payer: BCBS Complete |
$229.25
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Meridian Medicaid |
$229.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.24
|
| Rate for Payer: Priority Health Narrow Network |
$515.24
|
| Rate for Payer: Priority Health SBD |
$515.24
|
| Rate for Payer: UMR Bronson Commercial |
$526.70
|
|
|
PR I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI
|
Professional
|
Both
|
$938.00
|
|
|
Service Code
|
HCPCS 21502
|
| Min. Negotiated Rate |
$326.10 |
| Max. Negotiated Rate |
$776.19 |
| Rate for Payer: Aetna Commercial |
$681.32
|
| Rate for Payer: BCBS Complete |
$342.40
|
| Rate for Payer: BCBS Trust/PPO |
$483.43
|
| Rate for Payer: Cash Price |
$750.40
|
| Rate for Payer: Cash Price |
$750.40
|
| Rate for Payer: Meridian Medicaid |
$342.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$776.19
|
| Rate for Payer: Priority Health Narrow Network |
$776.19
|
| Rate for Payer: Priority Health SBD |
$776.19
|
| Rate for Payer: UMR Bronson Commercial |
$431.48
|
|
|
PR I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC
|
Professional
|
Both
|
$1,605.00
|
|
|
Service Code
|
HCPCS 45020
|
| Min. Negotiated Rate |
$364.87 |
| Max. Negotiated Rate |
$1,123.50 |
| Rate for Payer: Aetna Commercial |
$768.90
|
| Rate for Payer: BCBS Complete |
$383.11
|
| Rate for Payer: BCBS Trust/PPO |
$489.21
|
| Rate for Payer: Cash Price |
$1,284.00
|
| Rate for Payer: Cash Price |
$1,284.00
|
| Rate for Payer: Meridian Medicaid |
$383.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,013.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,013.08
|
| Rate for Payer: Priority Health SBD |
$1,013.08
|
| Rate for Payer: UMR Bronson Commercial |
$738.30
|
|
|
PR I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 54700
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$2,037.12 |
| Rate for Payer: Aetna Commercial |
$273.26
|
| Rate for Payer: BCBS Complete |
$143.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,037.12
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.43
|
| Rate for Payer: Priority Health Narrow Network |
$340.43
|
| Rate for Payer: Priority Health SBD |
$340.43
|
| Rate for Payer: UMR Bronson Commercial |
$182.62
|
|
|
PR I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 25028
|
| Min. Negotiated Rate |
$209.74 |
| Max. Negotiated Rate |
$1,072.36 |
| Rate for Payer: Aetna Commercial |
$870.43
|
| Rate for Payer: BCBS Complete |
$469.66
|
| Rate for Payer: BCBS Trust/PPO |
$209.74
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Meridian Medicaid |
$469.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,072.36
|
| Rate for Payer: Priority Health SBD |
$1,072.36
|
| Rate for Payer: UMR Bronson Commercial |
$419.98
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$116.16 |
| Max. Negotiated Rate |
$237.60 |
| Rate for Payer: Aetna American Axle |
$171.60
|
| Rate for Payer: Aetna Commercial |
$224.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.60
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$227.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.20
|
| Rate for Payer: Healthscope Commercial |
$237.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$224.40
|
| Rate for Payer: PHP Commercial |
$224.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health SBD |
$166.32
|
| Rate for Payer: UMR Bronson Commercial |
$116.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.00
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$97.68 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$171.60
|
| Rate for Payer: Aetna Commercial |
$224.40
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.60
|
| 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 |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$227.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$237.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.00
|
| 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 |
$224.40
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$224.40
|
| 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 |
$184.80
|
| 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 |
$166.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$116.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$97.68
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.00
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$184.80 |
| Rate for Payer: Aetna Commercial |
$126.93
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.27
|
| Rate for Payer: Priority Health Narrow Network |
$144.27
|
| Rate for Payer: Priority Health SBD |
$144.27
|
| Rate for Payer: UMR Bronson Commercial |
$121.44
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$184.80 |
| Rate for Payer: Aetna Commercial |
$126.93
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.27
|
| Rate for Payer: Priority Health Narrow Network |
$144.27
|
| Rate for Payer: Priority Health SBD |
$144.27
|
| Rate for Payer: UMR Bronson Commercial |
$121.44
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
OP
|
$722.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$267.14 |
| Max. Negotiated Rate |
$7,856.86 |
| Rate for Payer: Aetna American Axle |
$469.30
|
| Rate for Payer: Aetna Commercial |
$613.70
|
| Rate for Payer: Aetna Medicare |
$2,595.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.30
|
| 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 |
$1,654.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$505.40
|
| Rate for Payer: Cofinity Commercial |
$620.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$649.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$505.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.50
|
| 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 |
$613.70
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$613.70
|
| 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 |
$505.40
|
| 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 |
$454.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,495.78
|
| Rate for Payer: UHC Exchange |
$435.83
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: UMR Bronson Commercial |
$267.14
|
| Rate for Payer: VA VA |
$2,495.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.50
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 46045
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$2,294.94 |
| Rate for Payer: Aetna Commercial |
$588.31
|
| Rate for Payer: BCBS Complete |
$297.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.94
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Meridian Medicaid |
$297.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.94
|
| Rate for Payer: Priority Health Narrow Network |
$774.94
|
| Rate for Payer: Priority Health SBD |
$774.94
|
| Rate for Payer: UMR Bronson Commercial |
$332.12
|
|
