|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 20200
|
| Min. Negotiated Rate |
$92.88 |
| Max. Negotiated Rate |
$233.35 |
| Rate for Payer: Aetna Commercial |
$124.46
|
| Rate for Payer: Aetna Medicare |
$92.88
|
| Rate for Payer: BCBS Complete |
$143.60
|
| Rate for Payer: BCBS MAPPO |
$92.88
|
| Rate for Payer: BCN Medicare Advantage |
$92.88
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$133.75
|
| Rate for Payer: Cofinity Commercial |
$124.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$111.46
|
| Rate for Payer: Healthscope Whirlpool |
$111.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.52
|
| Rate for Payer: Nomi Health Commercial |
$111.46
|
| Rate for Payer: PACE SWMI |
$92.88
|
| Rate for Payer: PHP Medicare Advantage |
$92.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health Medicare |
$92.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.88
|
| Rate for Payer: UHC Medicare Advantage |
$92.88
|
| Rate for Payer: UHCCP DNSP |
$92.88
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
IP
|
$359.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$233.35 |
| Max. Negotiated Rate |
$359.00 |
| Rate for Payer: Aetna Commercial |
$323.10
|
| Rate for Payer: ASR ASR |
$348.23
|
| Rate for Payer: ASR Commercial |
$348.23
|
| Rate for Payer: BCBS Trust/PPO |
$292.55
|
| Rate for Payer: BCN Commercial |
$278.33
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$337.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Healthscope Commercial |
$359.00
|
| Rate for Payer: Healthscope Whirlpool |
$348.23
|
| Rate for Payer: Mclaren Commercial |
$323.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: Nomi Health Commercial |
$294.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.92
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$92.88 |
| Max. Negotiated Rate |
$233.35 |
| Rate for Payer: Aetna Commercial |
$124.46
|
| Rate for Payer: Aetna Medicare |
$92.88
|
| Rate for Payer: BCBS Complete |
$143.60
|
| Rate for Payer: BCBS MAPPO |
$92.88
|
| Rate for Payer: BCN Medicare Advantage |
$92.88
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$133.75
|
| Rate for Payer: Cofinity Commercial |
$124.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$111.46
|
| Rate for Payer: Healthscope Whirlpool |
$111.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.52
|
| Rate for Payer: Nomi Health Commercial |
$111.46
|
| Rate for Payer: PACE SWMI |
$92.88
|
| Rate for Payer: PHP Medicare Advantage |
$92.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health Medicare |
$92.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.88
|
| Rate for Payer: UHC Medicare Advantage |
$92.88
|
| Rate for Payer: UHCCP DNSP |
$92.88
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
OP
|
$359.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$233.35 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$323.10
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$348.23
|
| Rate for Payer: ASR Commercial |
$348.23
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$293.99
|
| Rate for Payer: BCN Commercial |
$278.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$337.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$359.00
|
| Rate for Payer: Healthscope Whirlpool |
$348.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$323.10
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: Nomi Health Commercial |
$294.38
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.56
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$251.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR BIOPSY NAIL UNIT SEPARATE PROCEDURE
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 11755
|
| Min. Negotiated Rate |
$57.78 |
| Max. Negotiated Rate |
$143.65 |
| Rate for Payer: Aetna Commercial |
$77.43
|
| Rate for Payer: Aetna Medicare |
$57.78
|
| Rate for Payer: BCBS Complete |
$88.40
|
| Rate for Payer: BCBS MAPPO |
$57.78
|
| Rate for Payer: BCN Medicare Advantage |
$57.78
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$77.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.78
|
| Rate for Payer: Healthscope Commercial |
$69.34
|
| Rate for Payer: Healthscope Whirlpool |
$69.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.67
|
| Rate for Payer: Nomi Health Commercial |
$69.34
|
| Rate for Payer: PACE SWMI |
$57.78
|
| Rate for Payer: PHP Medicare Advantage |
$57.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health Medicare |
$57.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.78
|
| Rate for Payer: UHC Medicare Advantage |
$57.78
|
| Rate for Payer: UHCCP DNSP |
$57.78
|
|
|
PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 42804
|
| Min. Negotiated Rate |
$115.15 |
| Max. Negotiated Rate |
$544.70 |
| Rate for Payer: Aetna Commercial |
$154.30
|
| Rate for Payer: Aetna Medicare |
$115.15
|
| Rate for Payer: BCBS Complete |
$335.20
|
| Rate for Payer: BCBS MAPPO |
$115.15
|
| Rate for Payer: BCN Medicare Advantage |
$115.15
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$165.82
|
| Rate for Payer: Cofinity Commercial |
$154.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.15
|
| Rate for Payer: Healthscope Commercial |
$138.18
|
| Rate for Payer: Healthscope Whirlpool |
$138.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.91
|
| Rate for Payer: Nomi Health Commercial |
$138.18
|
| Rate for Payer: PACE SWMI |
$115.15
|
| Rate for Payer: PHP Medicare Advantage |
$115.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health Medicare |
$115.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.15
|
| Rate for Payer: UHC Medicare Advantage |
$115.15
|
| Rate for Payer: UHCCP DNSP |
$115.15
|
|
|
PR BIOPSY NERVE
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 64795
|
| Min. Negotiated Rate |
$192.25 |
| Max. Negotiated Rate |
$469.30 |
| Rate for Payer: Aetna Commercial |
$257.62
|
| Rate for Payer: Aetna Medicare |
$192.25
|
| Rate for Payer: BCBS Complete |
$288.80
|
| Rate for Payer: BCBS MAPPO |
$192.25
|
| Rate for Payer: BCN Medicare Advantage |
$192.25
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$276.84
|
| Rate for Payer: Cofinity Commercial |
$257.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.25
|
| Rate for Payer: Healthscope Commercial |
$230.70
|
| Rate for Payer: Healthscope Whirlpool |
$230.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.86
|
| Rate for Payer: Nomi Health Commercial |
$230.70
|
| Rate for Payer: PACE SWMI |
$192.25
|
| Rate for Payer: PHP Medicare Advantage |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.30
|
| Rate for Payer: Priority Health Medicare |
$192.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.25
|
| Rate for Payer: UHC Medicare Advantage |
$192.25
|
| Rate for Payer: UHCCP DNSP |
$192.25
|
|
|
PR BIOPSY OF LIP
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 40490
|
| Min. Negotiated Rate |
$65.91 |
| Max. Negotiated Rate |
$148.20 |
| Rate for Payer: Aetna Commercial |
$88.32
|
| Rate for Payer: Aetna Medicare |
$65.91
|
| Rate for Payer: BCBS Complete |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$65.91
|
| Rate for Payer: BCN Medicare Advantage |
$65.91
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$94.91
|
| Rate for Payer: Cofinity Commercial |
$88.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.91
|
| Rate for Payer: Healthscope Commercial |
$79.09
|
| Rate for Payer: Healthscope Whirlpool |
$79.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.21
|
| Rate for Payer: Nomi Health Commercial |
$79.09
|
| Rate for Payer: PACE SWMI |
$65.91
|
| Rate for Payer: PHP Medicare Advantage |
$65.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health Medicare |
$65.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.91
|
| Rate for Payer: UHC Medicare Advantage |
$65.91
|
| Rate for Payer: UHCCP DNSP |
$65.91
|
|
|
PR BIOPSY OF SKIN LESION
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 11100
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$111.15 |
| Rate for Payer: Aetna Medicare |
$85.50
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
|
|
PR BIOPSY OROPHARYNX
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 42800
|
| Min. Negotiated Rate |
$103.20 |
| Max. Negotiated Rate |
$167.70 |
| Rate for Payer: Aetna Commercial |
$149.30
|
| Rate for Payer: Aetna Medicare |
$111.42
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCBS MAPPO |
$111.42
|
| Rate for Payer: BCN Medicare Advantage |
$111.42
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$160.44
|
| Rate for Payer: Cofinity Commercial |
$149.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.42
|
| Rate for Payer: Healthscope Commercial |
$133.70
|
| Rate for Payer: Healthscope Whirlpool |
$133.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.99
|
| Rate for Payer: Nomi Health Commercial |
$133.70
|
| Rate for Payer: PACE SWMI |
$111.42
|
| Rate for Payer: PHP Medicare Advantage |
$111.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health Medicare |
$111.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.42
|
| Rate for Payer: UHC Medicare Advantage |
$111.42
|
| Rate for Payer: UHCCP DNSP |
$111.42
|
|
|
PR BIOPSY OVARY UNI/BI SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 58900
|
| Min. Negotiated Rate |
$416.76 |
| Max. Negotiated Rate |
$1,051.05 |
| Rate for Payer: Aetna Commercial |
$558.46
|
| Rate for Payer: Aetna Medicare |
$416.76
|
| Rate for Payer: BCBS Complete |
$646.80
|
| Rate for Payer: BCBS MAPPO |
$416.76
|
| Rate for Payer: BCN Medicare Advantage |
$416.76
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$600.13
|
| Rate for Payer: Cofinity Commercial |
$558.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.76
|
| Rate for Payer: Healthscope Commercial |
$500.11
|
| Rate for Payer: Healthscope Whirlpool |
$500.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.60
|
| Rate for Payer: Nomi Health Commercial |
$500.11
|
| Rate for Payer: PACE SWMI |
$416.76
|
| Rate for Payer: PHP Medicare Advantage |
$416.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.05
|
| Rate for Payer: Priority Health Medicare |
$416.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.76
|
| Rate for Payer: UHC Medicare Advantage |
$416.76
|
| Rate for Payer: UHCCP DNSP |
$416.76
|
|
|
PR BIOPSY PALATE UVULA
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 42100
|
| Min. Negotiated Rate |
$103.99 |
| Max. Negotiated Rate |
$174.20 |
| Rate for Payer: Aetna Commercial |
$139.35
|
| Rate for Payer: Aetna Medicare |
$103.99
|
| Rate for Payer: BCBS Complete |
$107.20
|
| Rate for Payer: BCBS MAPPO |
$103.99
|
| Rate for Payer: BCN Medicare Advantage |
$103.99
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cofinity Commercial |
$149.75
|
| Rate for Payer: Cofinity Commercial |
$139.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.99
|
| Rate for Payer: Healthscope Commercial |
$124.79
|
| Rate for Payer: Healthscope Whirlpool |
$124.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.19
|
| Rate for Payer: Nomi Health Commercial |
$124.79
|
| Rate for Payer: PACE SWMI |
$103.99
|
| Rate for Payer: PHP Medicare Advantage |
$103.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.20
|
| Rate for Payer: Priority Health Medicare |
$103.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.99
|
| Rate for Payer: UHC Medicare Advantage |
$103.99
|
| Rate for Payer: UHCCP DNSP |
$103.99
|
|
|
PR BIOPSY PANCREAS OPEN
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
HCPCS 48100
|
| Min. Negotiated Rate |
$635.20 |
| Max. Negotiated Rate |
$1,241.57 |
| Rate for Payer: Aetna Commercial |
$1,155.35
|
| Rate for Payer: Aetna Medicare |
$862.20
|
| Rate for Payer: BCBS Complete |
$635.20
|
| Rate for Payer: BCBS MAPPO |
$862.20
|
| Rate for Payer: BCN Medicare Advantage |
$862.20
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cofinity Commercial |
$1,241.57
|
| Rate for Payer: Cofinity Commercial |
$1,155.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.20
|
| Rate for Payer: Healthscope Commercial |
$1,034.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,034.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.31
|
| Rate for Payer: Nomi Health Commercial |
$1,034.64
|
| Rate for Payer: PACE SWMI |
$862.20
|
| Rate for Payer: PHP Medicare Advantage |
$862.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.20
|
| Rate for Payer: Priority Health Medicare |
$862.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$862.20
|
| Rate for Payer: UHC Medicare Advantage |
$862.20
|
| Rate for Payer: UHCCP DNSP |
$862.20
|
|
|
PR BIOPSY PENIS DEEP STRUCTURES
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 54105
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$365.95 |
| Rate for Payer: Aetna Commercial |
$272.56
|
| Rate for Payer: Aetna Medicare |
$203.40
|
| Rate for Payer: BCBS Complete |
$225.20
|
| Rate for Payer: BCBS MAPPO |
$203.40
|
| Rate for Payer: BCN Medicare Advantage |
$203.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$292.90
|
| Rate for Payer: Cofinity Commercial |
$272.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.40
|
| Rate for Payer: Healthscope Commercial |
$244.08
|
| Rate for Payer: Healthscope Whirlpool |
$244.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.57
|
| Rate for Payer: Nomi Health Commercial |
$244.08
|
| Rate for Payer: PACE SWMI |
$203.40
|
| Rate for Payer: PHP Medicare Advantage |
$203.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health Medicare |
$203.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.40
|
| Rate for Payer: UHC Medicare Advantage |
$203.40
|
| Rate for Payer: UHCCP DNSP |
$203.40
|
|
|
PR BIOPSY PENIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 54100
|
| Min. Negotiated Rate |
$115.40 |
| Max. Negotiated Rate |
$199.55 |
| Rate for Payer: Aetna Commercial |
$154.64
|
| Rate for Payer: Aetna Medicare |
$115.40
|
| Rate for Payer: BCBS Complete |
$122.80
|
| Rate for Payer: BCBS MAPPO |
$115.40
|
| Rate for Payer: BCN Medicare Advantage |
$115.40
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cofinity Commercial |
$166.18
|
| Rate for Payer: Cofinity Commercial |
$154.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.40
|
| Rate for Payer: Healthscope Commercial |
$138.48
|
| Rate for Payer: Healthscope Whirlpool |
$138.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.17
|
| Rate for Payer: Nomi Health Commercial |
$138.48
|
| Rate for Payer: PACE SWMI |
$115.40
|
| Rate for Payer: PHP Medicare Advantage |
$115.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.55
|
| Rate for Payer: Priority Health Medicare |
$115.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.40
|
| Rate for Payer: UHC Medicare Advantage |
$115.40
|
| Rate for Payer: UHCCP DNSP |
$115.40
|
|
|
PR BIOPSY PROSTATE INCISIONAL ANY APPROACH
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 55705
|
| Min. Negotiated Rate |
$190.80 |
| Max. Negotiated Rate |
$364.56 |
| Rate for Payer: Aetna Commercial |
$339.25
|
| Rate for Payer: Aetna Medicare |
$253.17
|
| Rate for Payer: BCBS Complete |
$190.80
|
| Rate for Payer: BCBS MAPPO |
$253.17
|
| Rate for Payer: BCN Medicare Advantage |
$253.17
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cofinity Commercial |
$364.56
|
| Rate for Payer: Cofinity Commercial |
$339.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.17
|
| Rate for Payer: Healthscope Commercial |
$303.80
|
| Rate for Payer: Healthscope Whirlpool |
$303.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.83
|
| Rate for Payer: Nomi Health Commercial |
$303.80
|
| Rate for Payer: PACE SWMI |
$253.17
|
| Rate for Payer: PHP Medicare Advantage |
$253.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.05
|
| Rate for Payer: Priority Health Medicare |
$253.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.17
|
| Rate for Payer: UHC Medicare Advantage |
$253.17
|
| Rate for Payer: UHCCP DNSP |
$253.17
|
|
|
PR BIOPSY SALIVARY GLAND INCISIONAL
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 42405
|
| Min. Negotiated Rate |
$213.20 |
| Max. Negotiated Rate |
$346.45 |
| Rate for Payer: Aetna Commercial |
$290.51
|
| Rate for Payer: Aetna Medicare |
$216.80
|
| Rate for Payer: BCBS Complete |
$213.20
|
| Rate for Payer: BCBS MAPPO |
$216.80
|
| Rate for Payer: BCN Medicare Advantage |
$216.80
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$312.19
|
| Rate for Payer: Cofinity Commercial |
$290.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.80
|
| Rate for Payer: Healthscope Commercial |
$260.16
|
| Rate for Payer: Healthscope Whirlpool |
$260.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.64
|
| Rate for Payer: Nomi Health Commercial |
$260.16
|
| Rate for Payer: PACE SWMI |
$216.80
|
| Rate for Payer: PHP Medicare Advantage |
$216.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.45
|
| Rate for Payer: Priority Health Medicare |
$216.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.80
|
| Rate for Payer: UHC Medicare Advantage |
$216.80
|
| Rate for Payer: UHCCP DNSP |
$216.80
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK DEEP
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 21925
|
| Min. Negotiated Rate |
$363.92 |
| Max. Negotiated Rate |
$598.00 |
| Rate for Payer: Aetna Commercial |
$487.65
|
| Rate for Payer: Aetna Medicare |
$363.92
|
| Rate for Payer: BCBS Complete |
$368.00
|
| Rate for Payer: BCBS MAPPO |
$363.92
|
| Rate for Payer: BCN Medicare Advantage |
$363.92
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Commercial |
$524.04
|
| Rate for Payer: Cofinity Commercial |
$487.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.92
|
| Rate for Payer: Healthscope Commercial |
$436.70
|
| Rate for Payer: Healthscope Whirlpool |
$436.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.12
|
| Rate for Payer: Nomi Health Commercial |
$436.70
|
| Rate for Payer: PACE SWMI |
$363.92
|
| Rate for Payer: PHP Medicare Advantage |
$363.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.00
|
| Rate for Payer: Priority Health Medicare |
$363.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.92
|
| Rate for Payer: UHC Medicare Advantage |
$363.92
|
| Rate for Payer: UHCCP DNSP |
$363.92
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
|
Professional
|
Both
|
$508.00
|
|
|
Service Code
|
HCPCS 21920
|
| Min. Negotiated Rate |
$147.45 |
| Max. Negotiated Rate |
$330.20 |
| Rate for Payer: Aetna Commercial |
$197.58
|
| Rate for Payer: Aetna Medicare |
$147.45
|
| Rate for Payer: BCBS Complete |
$203.20
|
| Rate for Payer: BCBS MAPPO |
$147.45
|
| Rate for Payer: BCN Medicare Advantage |
$147.45
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cofinity Commercial |
$212.33
|
| Rate for Payer: Cofinity Commercial |
$197.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.45
|
| Rate for Payer: Healthscope Commercial |
$176.94
|
| Rate for Payer: Healthscope Whirlpool |
$176.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.82
|
| Rate for Payer: Nomi Health Commercial |
$176.94
|
| Rate for Payer: PACE SWMI |
$147.45
|
| Rate for Payer: PHP Medicare Advantage |
$147.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.20
|
| Rate for Payer: Priority Health Medicare |
$147.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.45
|
| Rate for Payer: UHC Medicare Advantage |
$147.45
|
| Rate for Payer: UHCCP DNSP |
$147.45
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 25066
|
| Min. Negotiated Rate |
$335.20 |
| Max. Negotiated Rate |
$544.70 |
| Rate for Payer: Aetna Commercial |
$480.67
|
| Rate for Payer: Aetna Medicare |
$358.71
|
| Rate for Payer: BCBS Complete |
$335.20
|
| Rate for Payer: BCBS MAPPO |
$358.71
|
| Rate for Payer: BCN Medicare Advantage |
$358.71
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$516.54
|
| Rate for Payer: Cofinity Commercial |
$480.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.71
|
| Rate for Payer: Healthscope Commercial |
$430.45
|
| Rate for Payer: Healthscope Whirlpool |
$430.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.65
|
| Rate for Payer: Nomi Health Commercial |
$430.45
|
| Rate for Payer: PACE SWMI |
$358.71
|
| Rate for Payer: PHP Medicare Advantage |
$358.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health Medicare |
$358.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.71
|
| Rate for Payer: UHC Medicare Advantage |
$358.71
|
| Rate for Payer: UHCCP DNSP |
$358.71
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS 25065
|
| Min. Negotiated Rate |
$149.48 |
| Max. Negotiated Rate |
$316.55 |
| Rate for Payer: Aetna Commercial |
$200.30
|
| Rate for Payer: Aetna Medicare |
$149.48
|
| Rate for Payer: BCBS Complete |
$194.80
|
| Rate for Payer: BCBS MAPPO |
$149.48
|
| Rate for Payer: BCN Medicare Advantage |
$149.48
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cofinity Commercial |
$215.25
|
| Rate for Payer: Cofinity Commercial |
$200.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.48
|
| Rate for Payer: Healthscope Commercial |
$179.38
|
| Rate for Payer: Healthscope Whirlpool |
$179.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.95
|
| Rate for Payer: Nomi Health Commercial |
$179.38
|
| Rate for Payer: PACE SWMI |
$149.48
|
| Rate for Payer: PHP Medicare Advantage |
$149.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.55
|
| Rate for Payer: Priority Health Medicare |
$149.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.48
|
| Rate for Payer: UHC Medicare Advantage |
$149.48
|
| Rate for Payer: UHCCP DNSP |
$149.48
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP
|
Professional
|
Both
|
$944.00
|
|
|
Service Code
|
HCPCS 27614
|
| Min. Negotiated Rate |
$377.60 |
| Max. Negotiated Rate |
$613.60 |
| Rate for Payer: Aetna Commercial |
$530.64
|
| Rate for Payer: Aetna Medicare |
$396.00
|
| Rate for Payer: BCBS Complete |
$377.60
|
| Rate for Payer: BCBS MAPPO |
$396.00
|
| Rate for Payer: BCN Medicare Advantage |
$396.00
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$570.24
|
| Rate for Payer: Cofinity Commercial |
$530.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$475.20
|
| Rate for Payer: Healthscope Whirlpool |
$475.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.80
|
| Rate for Payer: Nomi Health Commercial |
$475.20
|
| Rate for Payer: PACE SWMI |
$396.00
|
| Rate for Payer: PHP Medicare Advantage |
$396.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health Medicare |
$396.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.00
|
| Rate for Payer: UHC Medicare Advantage |
$396.00
|
| Rate for Payer: UHCCP DNSP |
$396.00
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Facility
|
OP
|
$446.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$289.90 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$401.40
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$432.62
|
| Rate for Payer: ASR Commercial |
$432.62
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$365.23
|
| Rate for Payer: BCN Commercial |
$345.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Commercial |
$419.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$446.00
|
| Rate for Payer: Healthscope Whirlpool |
$432.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$401.40
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.10
|
| Rate for Payer: Nomi Health Commercial |
$365.72
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.79
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$312.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$154.17 |
| Max. Negotiated Rate |
$289.90 |
| Rate for Payer: Aetna Commercial |
$206.59
|
| Rate for Payer: Aetna Medicare |
$154.17
|
| Rate for Payer: BCBS Complete |
$178.40
|
| Rate for Payer: BCBS MAPPO |
$154.17
|
| Rate for Payer: BCN Medicare Advantage |
$154.17
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Commercial |
$222.00
|
| Rate for Payer: Cofinity Commercial |
$206.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.17
|
| Rate for Payer: Healthscope Commercial |
$185.00
|
| Rate for Payer: Healthscope Whirlpool |
$185.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.88
|
| Rate for Payer: Nomi Health Commercial |
$185.00
|
| Rate for Payer: PACE SWMI |
$154.17
|
| Rate for Payer: PHP Medicare Advantage |
$154.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.90
|
| Rate for Payer: Priority Health Medicare |
$154.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.17
|
| Rate for Payer: UHC Medicare Advantage |
$154.17
|
| Rate for Payer: UHCCP DNSP |
$154.17
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Facility
|
IP
|
$446.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$289.90 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna Commercial |
$401.40
|
| Rate for Payer: ASR ASR |
$432.62
|
| Rate for Payer: ASR Commercial |
$432.62
|
| Rate for Payer: BCBS Trust/PPO |
$363.45
|
| Rate for Payer: BCN Commercial |
$345.78
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Commercial |
$419.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.80
|
| Rate for Payer: Healthscope Commercial |
$446.00
|
| Rate for Payer: Healthscope Whirlpool |
$432.62
|
| Rate for Payer: Mclaren Commercial |
$401.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.10
|
| Rate for Payer: Nomi Health Commercial |
$365.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.48
|
|
