|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
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
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
IP
|
$722.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$317.68 |
| Max. Negotiated Rate |
$649.80 |
| Rate for Payer: Aetna American Axle |
$469.30
|
| Rate for Payer: Aetna Commercial |
$613.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.30
|
| 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: 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: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$613.70
|
| Rate for Payer: PHP Commercial |
$613.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health SBD |
$454.86
|
| Rate for Payer: UMR Bronson Commercial |
$317.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.50
|
|
|
PR I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 46060
|
| Min. Negotiated Rate |
$313.54 |
| Max. Negotiated Rate |
$1,459.50 |
| Rate for Payer: Aetna Commercial |
$645.77
|
| Rate for Payer: BCBS Complete |
$329.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,438.03
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Meridian Medicaid |
$329.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,459.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$860.79
|
| Rate for Payer: Priority Health Narrow Network |
$860.79
|
| Rate for Payer: Priority Health SBD |
$860.79
|
| Rate for Payer: UMR Bronson Commercial |
$959.10
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
OP
|
$906.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$335.22 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$588.90
|
| Rate for Payer: Aetna Commercial |
$770.10
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.90
|
| 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 |
$1,987.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$779.16
|
| Rate for Payer: Cofinity Commercial |
$634.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$815.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$634.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.50
|
| 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 |
$770.10
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$770.10
|
| 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 |
$634.20
|
| 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 |
$570.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$422.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$335.22
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.50
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
IP
|
$906.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$398.64 |
| Max. Negotiated Rate |
$815.40 |
| Rate for Payer: Aetna American Axle |
$588.90
|
| Rate for Payer: Aetna Commercial |
$770.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.90
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$634.20
|
| Rate for Payer: Cofinity Commercial |
$779.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.80
|
| Rate for Payer: Healthscope Commercial |
$815.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$634.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.10
|
| Rate for Payer: PHP Commercial |
$770.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health SBD |
$570.78
|
| Rate for Payer: UMR Bronson Commercial |
$398.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.50
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 46040
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,260.52 |
| Rate for Payer: Aetna Commercial |
$564.66
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.43
|
| Rate for Payer: Priority Health Narrow Network |
$751.43
|
| Rate for Payer: Priority Health SBD |
$751.43
|
| Rate for Payer: UMR Bronson Commercial |
$416.76
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
46040
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,260.52 |
| Rate for Payer: Aetna Commercial |
$564.66
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.43
|
| Rate for Payer: Priority Health Narrow Network |
$751.43
|
| Rate for Payer: Priority Health SBD |
$751.43
|
| Rate for Payer: UMR Bronson Commercial |
$416.76
|
|
|
PR I&D OF BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 56420
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$264.60 |
| Rate for Payer: Aetna Commercial |
$128.52
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS Trust/PPO |
$244.07
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.59
|
| Rate for Payer: Priority Health Narrow Network |
$158.59
|
| Rate for Payer: Priority Health SBD |
$158.59
|
| Rate for Payer: UMR Bronson Commercial |
$173.88
|
|
|
PR I&D PELVIS/HIP JOINT AREA INFECTED BURSA
|
Professional
|
Both
|
$1,220.00
|
|
|
Service Code
|
HCPCS 26991
|
| Min. Negotiated Rate |
$342.08 |
| Max. Negotiated Rate |
$854.00 |
| Rate for Payer: Aetna Commercial |
$701.42
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCBS Trust/PPO |
$758.11
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.46
|
| Rate for Payer: Priority Health Narrow Network |
$813.46
|
| Rate for Payer: Priority Health SBD |
$813.46
|
| Rate for Payer: UMR Bronson Commercial |
$561.20
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 26990
|
| Min. Negotiated Rate |
$433.21 |
| Max. Negotiated Rate |
$1,049.90 |
| Rate for Payer: Aetna Commercial |
$895.50
|
| Rate for Payer: BCBS Complete |
$462.50
|
| Rate for Payer: BCBS Trust/PPO |
$433.21
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Meridian Medicaid |
$462.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.90
|
| Rate for Payer: Priority Health SBD |
$1,049.90
|
| Rate for Payer: UMR Bronson Commercial |
$682.18
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Facility
|
OP
|
$1,483.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$548.71 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$963.95
|
| Rate for Payer: Aetna Commercial |
$1,260.55
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$1,038.10
|
| Rate for Payer: Cofinity Commercial |
$1,275.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,334.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,038.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,112.25
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,260.55
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$1,260.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$934.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$744.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$677.15
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$548.71
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,112.25
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$433.21 |
| Max. Negotiated Rate |
$1,049.90 |
| Rate for Payer: Aetna Commercial |
$895.50
|
| Rate for Payer: BCBS Complete |
$462.50
|
| Rate for Payer: BCBS Trust/PPO |
$433.21
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Meridian Medicaid |
$462.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.90
|
| Rate for Payer: Priority Health SBD |
$1,049.90
|
| Rate for Payer: UMR Bronson Commercial |
$682.18
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Facility
|
IP
|
$1,483.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$652.52 |
| Max. Negotiated Rate |
$1,334.70 |
| Rate for Payer: Aetna American Axle |
$963.95
|
| Rate for Payer: Aetna Commercial |
$1,260.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.95
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$1,038.10
|
| Rate for Payer: Cofinity Commercial |
$1,275.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.40
|
| Rate for Payer: Healthscope Commercial |
$1,334.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,038.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,112.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,260.55
|
| Rate for Payer: PHP Commercial |
$1,260.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health SBD |
$934.29
|
| Rate for Payer: UMR Bronson Commercial |
$652.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,112.25
|
|
|
PR I&D PENIS DEEP
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 54015
|
| Min. Negotiated Rate |
$194.26 |
| Max. Negotiated Rate |
$2,212.52 |
| Rate for Payer: Aetna Commercial |
$391.78
|
| Rate for Payer: BCBS Complete |
$203.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,212.52
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Meridian Medicaid |
$203.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$486.31
|
| Rate for Payer: Priority Health Narrow Network |
$486.31
|
| Rate for Payer: Priority Health SBD |
$486.31
|
| Rate for Payer: UMR Bronson Commercial |
$345.46
|
|
|
PR I&D PERIANAL ABSCESS SUPERFICIAL
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 46050
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$1,360.90 |
| Rate for Payer: Aetna Commercial |
$132.59
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.90
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.75
|
| Rate for Payer: Priority Health Narrow Network |
$178.75
|
| Rate for Payer: Priority Health SBD |
$178.75
|
| Rate for Payer: UMR Bronson Commercial |
$202.86
|
|
|
PR I&D SHOULDER DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 23030
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Aetna Commercial |
$338.61
|
| Rate for Payer: BCBS Complete |
$172.88
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Meridian Medicaid |
$172.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.65
|
| Rate for Payer: Priority Health Narrow Network |
$390.65
|
| Rate for Payer: Priority Health SBD |
$390.65
|
| Rate for Payer: UMR Bronson Commercial |
$322.92
|
|
|
PR I&D SHOULDER INFECTED BURSA
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 23031
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$494.20 |
| Rate for Payer: Aetna Commercial |
$287.48
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS Trust/PPO |
$18.68
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.63
|
| Rate for Payer: Priority Health Narrow Network |
$341.63
|
| Rate for Payer: Priority Health SBD |
$341.63
|
| Rate for Payer: UMR Bronson Commercial |
$324.76
|
|
|
PR I&D SOFT TISSUE ABSCESS SUBFASCIAL
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 20005
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$353.50 |
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.50
|
| Rate for Payer: UMR Bronson Commercial |
$232.30
|
|
|
PR I&D SUBMUCOSAL ABSCESS RECTUM
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 45005
|
| Min. Negotiated Rate |
$106.50 |
| Max. Negotiated Rate |
$2,676.37 |
| Rate for Payer: Aetna Commercial |
$217.12
|
| Rate for Payer: BCBS Complete |
$111.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,676.37
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Meridian Medicaid |
$111.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.57
|
| Rate for Payer: Priority Health Narrow Network |
$294.57
|
| Rate for Payer: Priority Health SBD |
$294.57
|
| Rate for Payer: UMR Bronson Commercial |
$237.82
|
|
|
PR I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$608.00
|
|
|
Service Code
|
HCPCS 23930
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$425.60 |
| Rate for Payer: Aetna Commercial |
$288.31
|
| Rate for Payer: BCBS Complete |
$146.04
|
| Rate for Payer: BCBS Trust/PPO |
$18.25
|
| Rate for Payer: Cash Price |
$486.40
|
| Rate for Payer: Cash Price |
$486.40
|
| Rate for Payer: Meridian Medicaid |
$146.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.90
|
| Rate for Payer: Priority Health Narrow Network |
$330.90
|
| Rate for Payer: Priority Health SBD |
$330.90
|
| Rate for Payer: UMR Bronson Commercial |
$279.68
|
|
|
PR I&D VAGINAL HEMATOMA NON-OBSTETRICAL
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 57023
|
| Min. Negotiated Rate |
$205.97 |
| Max. Negotiated Rate |
$2,321.35 |
| Rate for Payer: Aetna Commercial |
$380.17
|
| Rate for Payer: BCBS Complete |
$216.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,321.35
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Meridian Medicaid |
$216.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.97
|
| Rate for Payer: Priority Health Narrow Network |
$454.97
|
| Rate for Payer: Priority Health SBD |
$454.97
|
| Rate for Payer: UMR Bronson Commercial |
$237.36
|
|
|
PR I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 57022
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$3,001.80 |
| Rate for Payer: Aetna Commercial |
$214.36
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,001.80
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$314.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.48
|
| Rate for Payer: Priority Health Narrow Network |
$258.48
|
| Rate for Payer: Priority Health SBD |
$258.48
|
| Rate for Payer: UMR Bronson Commercial |
$206.54
|
|
|
PR I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 56405
|
| Min. Negotiated Rate |
$82.01 |
| Max. Negotiated Rate |
$1,505.13 |
| Rate for Payer: Aetna Commercial |
$146.26
|
| Rate for Payer: BCBS Complete |
$86.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,505.13
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Meridian Medicaid |
$86.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.32
|
| Rate for Payer: Priority Health Narrow Network |
$181.32
|
| Rate for Payer: Priority Health SBD |
$181.32
|
| Rate for Payer: UMR Bronson Commercial |
$125.58
|
|
|
PR IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 90657
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$17.00 |
| Rate for Payer: Aetna Commercial |
$9.50
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
|
|
PR IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 90658
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$17.00 |
| Rate for Payer: Aetna Commercial |
$16.32
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
|
