|
PR EXCISION/UNROOFING CYST KIDNEY
|
Professional
|
Both
|
$3,012.00
|
|
|
Service Code
|
HCPCS 50280
|
| Min. Negotiated Rate |
$542.51 |
| Max. Negotiated Rate |
$2,259.00 |
| Rate for Payer: Aetna Commercial |
$1,126.35
|
| Rate for Payer: Aetna Medicare |
$840.56
|
| Rate for Payer: BCBS Complete |
$569.64
|
| Rate for Payer: BCBS MAPPO |
$840.56
|
| Rate for Payer: BCN Commercial |
$1,413.27
|
| Rate for Payer: BCN Medicare Advantage |
$840.56
|
| Rate for Payer: Cash Price |
$2,409.60
|
| Rate for Payer: Cash Price |
$2,409.60
|
| Rate for Payer: Cofinity Commercial |
$1,210.41
|
| Rate for Payer: Cofinity Commercial |
$1,126.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$840.56
|
| Rate for Payer: Healthscope Commercial |
$1,008.67
|
| Rate for Payer: Healthscope Whirlpool |
$1,008.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$882.59
|
| Rate for Payer: Meridian Medicaid |
$569.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$924.62
|
| Rate for Payer: Nomi Health Commercial |
$1,008.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,259.00
|
| Rate for Payer: PACE SWMI |
$840.56
|
| Rate for Payer: PHP Medicare Advantage |
$840.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$542.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,539.50
|
| Rate for Payer: Priority Health Medicare |
$840.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,539.50
|
| Rate for Payer: Railroad Medicare Medicare |
$840.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,693.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$840.56
|
| Rate for Payer: UHC Exchange |
$1,693.99
|
| Rate for Payer: UHC Medicaid |
$542.51
|
| Rate for Payer: UHCCP DNSP |
$840.56
|
| Rate for Payer: UHCCP Medicaid |
$542.51
|
|
|
PR EXCISION VAGINAL CYST/TUMOR
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 57135
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$518.25 |
| Rate for Payer: Aetna Commercial |
$220.64
|
| Rate for Payer: Aetna Medicare |
$164.66
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$164.66
|
| Rate for Payer: BCN Commercial |
$283.35
|
| Rate for Payer: BCN Medicare Advantage |
$164.66
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Cofinity Commercial |
$220.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.66
|
| Rate for Payer: Healthscope Commercial |
$197.59
|
| Rate for Payer: Healthscope Whirlpool |
$197.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.89
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$181.13
|
| Rate for Payer: Nomi Health Commercial |
$197.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$518.25
|
| Rate for Payer: PACE SWMI |
$164.66
|
| Rate for Payer: PHP Medicare Advantage |
$164.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$286.97
|
| Rate for Payer: Priority Health Medicare |
$164.66
|
| Rate for Payer: Priority Health Narrow Network |
$286.97
|
| Rate for Payer: Railroad Medicare Medicare |
$164.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$164.66
|
| Rate for Payer: UHC Exchange |
$317.71
|
| Rate for Payer: UHC Medicaid |
$107.35
|
| Rate for Payer: UHCCP DNSP |
$164.66
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR EXCISION VAGINAL SEPTUM
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 57130
|
| Min. Negotiated Rate |
$98.19 |
| Max. Negotiated Rate |
$892.50 |
| Rate for Payer: Aetna Commercial |
$201.79
|
| Rate for Payer: Aetna Medicare |
$150.59
|
| Rate for Payer: BCBS Complete |
$103.10
|
| Rate for Payer: BCBS MAPPO |
$150.59
|
| Rate for Payer: BCN Commercial |
$260.44
|
| Rate for Payer: BCN Medicare Advantage |
$150.59
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$216.85
|
| Rate for Payer: Cofinity Commercial |
$201.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.59
|
| Rate for Payer: Healthscope Commercial |
$180.71
|
| Rate for Payer: Healthscope Whirlpool |
$180.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.12
|
| Rate for Payer: Meridian Medicaid |
$103.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$165.65
|
| Rate for Payer: Nomi Health Commercial |
$180.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE SWMI |
$150.59
|
| Rate for Payer: PHP Medicare Advantage |
$150.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$263.77
|
| Rate for Payer: Priority Health Medicare |
$150.59
|
| Rate for Payer: Priority Health Narrow Network |
$263.77
|
| Rate for Payer: Railroad Medicare Medicare |
$150.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$150.59
|
| Rate for Payer: UHC Exchange |
$292.70
|
| Rate for Payer: UHC Medicaid |
$98.19
|
| Rate for Payer: UHCCP DNSP |
$150.59
|
| Rate for Payer: UHCCP Medicaid |
$98.19
|
|
|
PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,527.00
|
|
|
Service Code
|
HCPCS 27337
|
| Min. Negotiated Rate |
$260.29 |
| Max. Negotiated Rate |
$1,145.25 |
| Rate for Payer: Aetna Commercial |
$535.22
|
| Rate for Payer: Aetna Medicare |
$399.42
|
| Rate for Payer: BCBS Complete |
$273.30
|
| Rate for Payer: BCBS MAPPO |
$399.42
|
| Rate for Payer: BCN Commercial |
$640.91
|
| Rate for Payer: BCN Medicare Advantage |
$399.42
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Cash Price |
$1,221.60
|
| Rate for Payer: Cofinity Commercial |
$575.16
|
| Rate for Payer: Cofinity Commercial |
$535.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.42
|
| Rate for Payer: Healthscope Commercial |
$479.30
|
| Rate for Payer: Healthscope Whirlpool |
$479.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.39
|
| Rate for Payer: Meridian Medicaid |
$273.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.36
|
| Rate for Payer: Nomi Health Commercial |
$479.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,145.25
|
| Rate for Payer: PACE SWMI |
$399.42
|
| Rate for Payer: PHP Medicare Advantage |
$399.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$685.11
|
| Rate for Payer: Priority Health Medicare |
$399.42
|
| Rate for Payer: Priority Health Narrow Network |
$685.11
|
| Rate for Payer: Railroad Medicare Medicare |
$399.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$734.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$399.42
|
| Rate for Payer: UHC Exchange |
$734.33
|
| Rate for Payer: UHC Medicaid |
$260.29
|
| Rate for Payer: UHCCP DNSP |
$399.42
|
| Rate for Payer: UHCCP Medicaid |
$260.29
|
|
|
PR EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR
|
Professional
|
Both
|
$1,926.00
|
|
|
Service Code
|
HCPCS 43101
|
| Min. Negotiated Rate |
$617.70 |
| Max. Negotiated Rate |
$1,822.70 |
| Rate for Payer: Aetna Commercial |
$1,290.34
|
| Rate for Payer: Aetna Medicare |
$962.94
|
| Rate for Payer: BCBS Complete |
$648.59
|
| Rate for Payer: BCBS MAPPO |
$962.94
|
| Rate for Payer: BCN Commercial |
$1,495.93
|
| Rate for Payer: BCN Medicare Advantage |
$962.94
|
| Rate for Payer: Cash Price |
$1,540.80
|
| Rate for Payer: Cash Price |
$1,540.80
|
| Rate for Payer: Cofinity Commercial |
$1,386.63
|
| Rate for Payer: Cofinity Commercial |
$1,290.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.94
|
| Rate for Payer: Healthscope Commercial |
$1,155.53
|
| Rate for Payer: Healthscope Whirlpool |
$1,155.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,011.09
|
| Rate for Payer: Meridian Medicaid |
$648.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,059.23
|
| Rate for Payer: Nomi Health Commercial |
$1,155.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,444.50
|
| Rate for Payer: PACE SWMI |
$962.94
|
| Rate for Payer: PHP Medicare Advantage |
$962.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$617.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,822.70
|
| Rate for Payer: Priority Health Medicare |
$962.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,822.70
|
| Rate for Payer: Railroad Medicare Medicare |
$962.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,783.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$962.94
|
| Rate for Payer: UHC Exchange |
$1,783.67
|
| Rate for Payer: UHC Medicaid |
$617.70
|
| Rate for Payer: UHCCP DNSP |
$962.94
|
| Rate for Payer: UHCCP Medicaid |
$617.70
|
|
|
PR EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR
|
Professional
|
Both
|
$1,540.00
|
|
|
Service Code
|
HCPCS 43100
|
| Min. Negotiated Rate |
$355.92 |
| Max. Negotiated Rate |
$1,169.83 |
| Rate for Payer: Aetna Commercial |
$732.66
|
| Rate for Payer: Aetna Medicare |
$546.76
|
| Rate for Payer: BCBS Complete |
$373.72
|
| Rate for Payer: BCBS MAPPO |
$546.76
|
| Rate for Payer: BCN Commercial |
$960.10
|
| Rate for Payer: BCN Medicare Advantage |
$546.76
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cofinity Commercial |
$787.33
|
| Rate for Payer: Cofinity Commercial |
$732.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.76
|
| Rate for Payer: Healthscope Commercial |
$656.11
|
| Rate for Payer: Healthscope Whirlpool |
$656.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.10
|
| Rate for Payer: Meridian Medicaid |
$373.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$601.44
|
| Rate for Payer: Nomi Health Commercial |
$656.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,155.00
|
| Rate for Payer: PACE SWMI |
$546.76
|
| Rate for Payer: PHP Medicare Advantage |
$546.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,169.83
|
| Rate for Payer: Priority Health Medicare |
$546.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,169.83
|
| Rate for Payer: Railroad Medicare Medicare |
$546.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,093.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$546.76
|
| Rate for Payer: UHC Exchange |
$1,093.29
|
| Rate for Payer: UHC Medicaid |
$355.92
|
| Rate for Payer: UHCCP DNSP |
$546.76
|
| Rate for Payer: UHCCP Medicaid |
$355.92
|
|
|
PR EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE
|
Professional
|
Both
|
$469.00
|
|
|
Service Code
|
HCPCS 67840
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$351.75 |
| Rate for Payer: Aetna Commercial |
$173.85
|
| Rate for Payer: Aetna Medicare |
$129.74
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$129.74
|
| Rate for Payer: BCN Commercial |
$232.55
|
| Rate for Payer: BCN Medicare Advantage |
$129.74
|
| Rate for Payer: Cash Price |
$375.20
|
| Rate for Payer: Cash Price |
$375.20
|
| Rate for Payer: Cofinity Commercial |
$186.83
|
| Rate for Payer: Cofinity Commercial |
$173.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.74
|
| Rate for Payer: Healthscope Commercial |
$155.69
|
| Rate for Payer: Healthscope Whirlpool |
$155.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.23
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$142.71
|
| Rate for Payer: Nomi Health Commercial |
$155.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.75
|
| Rate for Payer: PACE SWMI |
$129.74
|
| Rate for Payer: PHP Medicare Advantage |
$129.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$272.41
|
| Rate for Payer: Priority Health Medicare |
$129.74
|
| Rate for Payer: Priority Health Narrow Network |
$272.41
|
| Rate for Payer: Railroad Medicare Medicare |
$129.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$129.74
|
| Rate for Payer: UHC Exchange |
$268.26
|
| Rate for Payer: UHC Medicaid |
$85.63
|
| Rate for Payer: UHCCP DNSP |
$129.74
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
PR EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 40816
|
| Min. Negotiated Rate |
$178.49 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: Aetna Commercial |
$361.51
|
| Rate for Payer: Aetna Medicare |
$269.78
|
| Rate for Payer: BCBS Complete |
$187.41
|
| Rate for Payer: BCBS MAPPO |
$269.78
|
| Rate for Payer: BCN Commercial |
$459.64
|
| Rate for Payer: BCN Medicare Advantage |
$269.78
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cofinity Commercial |
$388.48
|
| Rate for Payer: Cofinity Commercial |
$361.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.78
|
| Rate for Payer: Healthscope Commercial |
$323.74
|
| Rate for Payer: Healthscope Whirlpool |
$323.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$283.27
|
| Rate for Payer: Meridian Medicaid |
$187.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$296.76
|
| Rate for Payer: Nomi Health Commercial |
$323.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$945.00
|
| Rate for Payer: PACE SWMI |
$269.78
|
| Rate for Payer: PHP Medicare Advantage |
$269.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$560.04
|
| Rate for Payer: Priority Health Medicare |
$269.78
|
| Rate for Payer: Priority Health Narrow Network |
$560.04
|
| Rate for Payer: Railroad Medicare Medicare |
$269.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$528.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$269.78
|
| Rate for Payer: UHC Exchange |
$528.65
|
| Rate for Payer: UHC Medicaid |
$178.49
|
| Rate for Payer: UHCCP DNSP |
$269.78
|
| Rate for Payer: UHCCP Medicaid |
$178.49
|
|
|
PR EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
HCPCS 40814
|
| Min. Negotiated Rate |
$168.70 |
| Max. Negotiated Rate |
$524.25 |
| Rate for Payer: Aetna Commercial |
$341.24
|
| Rate for Payer: Aetna Medicare |
$254.66
|
| Rate for Payer: BCBS Complete |
$177.13
|
| Rate for Payer: BCBS MAPPO |
$254.66
|
| Rate for Payer: BCN Commercial |
$429.75
|
| Rate for Payer: BCN Medicare Advantage |
$254.66
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cofinity Commercial |
$366.71
|
| Rate for Payer: Cofinity Commercial |
$341.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.66
|
| Rate for Payer: Healthscope Commercial |
$305.59
|
| Rate for Payer: Healthscope Whirlpool |
$305.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.39
|
| Rate for Payer: Meridian Medicaid |
$177.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$280.13
|
| Rate for Payer: Nomi Health Commercial |
$305.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$524.25
|
| Rate for Payer: PACE SWMI |
$254.66
|
| Rate for Payer: PHP Medicare Advantage |
$254.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$523.63
|
| Rate for Payer: Priority Health Medicare |
$254.66
|
| Rate for Payer: Priority Health Narrow Network |
$523.63
|
| Rate for Payer: Railroad Medicare Medicare |
$254.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$254.66
|
| Rate for Payer: UHC Exchange |
$504.01
|
| Rate for Payer: UHC Medicaid |
$168.70
|
| Rate for Payer: UHCCP DNSP |
$254.66
|
| Rate for Payer: UHCCP Medicaid |
$168.70
|
|
|
PR EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 40812
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$444.00 |
| Rate for Payer: Aetna Commercial |
$217.75
|
| Rate for Payer: Aetna Medicare |
$162.50
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$162.50
|
| Rate for Payer: BCN Commercial |
$216.38
|
| Rate for Payer: BCN Medicare Advantage |
$162.50
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$234.00
|
| Rate for Payer: Cofinity Commercial |
$217.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.50
|
| Rate for Payer: Healthscope Commercial |
$195.00
|
| Rate for Payer: Healthscope Whirlpool |
$195.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.62
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.75
|
| Rate for Payer: Nomi Health Commercial |
$195.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$444.00
|
| Rate for Payer: PACE SWMI |
$162.50
|
| Rate for Payer: PHP Medicare Advantage |
$162.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$334.32
|
| Rate for Payer: Priority Health Medicare |
$162.50
|
| Rate for Payer: Priority Health Narrow Network |
$334.32
|
| Rate for Payer: Railroad Medicare Medicare |
$162.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.50
|
| Rate for Payer: UHC Exchange |
$327.17
|
| Rate for Payer: UHC Medicaid |
$107.35
|
| Rate for Payer: UHCCP DNSP |
$162.50
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE
|
Professional
|
Both
|
$929.00
|
|
|
Service Code
|
HCPCS 42107
|
| Min. Negotiated Rate |
$194.26 |
| Max. Negotiated Rate |
$696.75 |
| Rate for Payer: Aetna Commercial |
$395.70
|
| Rate for Payer: Aetna Medicare |
$295.30
|
| Rate for Payer: BCBS Complete |
$203.97
|
| Rate for Payer: BCBS MAPPO |
$295.30
|
| Rate for Payer: BCN Commercial |
$492.50
|
| Rate for Payer: BCN Medicare Advantage |
$295.30
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cofinity Commercial |
$425.23
|
| Rate for Payer: Cofinity Commercial |
$395.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.30
|
| Rate for Payer: Healthscope Commercial |
$354.36
|
| Rate for Payer: Healthscope Whirlpool |
$354.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.06
|
| Rate for Payer: Meridian Medicaid |
$203.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$324.83
|
| Rate for Payer: Nomi Health Commercial |
$354.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$696.75
|
| Rate for Payer: PACE SWMI |
$295.30
|
| Rate for Payer: PHP Medicare Advantage |
$295.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$600.09
|
| Rate for Payer: Priority Health Medicare |
$295.30
|
| Rate for Payer: Priority Health Narrow Network |
$600.09
|
| Rate for Payer: Railroad Medicare Medicare |
$295.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$295.30
|
| Rate for Payer: UHC Exchange |
$586.26
|
| Rate for Payer: UHC Medicaid |
$194.26
|
| Rate for Payer: UHCCP DNSP |
$295.30
|
| Rate for Payer: UHCCP Medicaid |
$194.26
|
|
|
PR EXC LESION PALATE UVULA W/O CLOSURE
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 42104
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$297.75 |
| Rate for Payer: Aetna Commercial |
$158.52
|
| Rate for Payer: Aetna Medicare |
$118.30
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$118.30
|
| Rate for Payer: BCN Commercial |
$204.18
|
| Rate for Payer: BCN Medicare Advantage |
$118.30
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cofinity Commercial |
$170.35
|
| Rate for Payer: Cofinity Commercial |
$158.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.30
|
| Rate for Payer: Healthscope Commercial |
$141.96
|
| Rate for Payer: Healthscope Whirlpool |
$141.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.22
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.13
|
| Rate for Payer: Nomi Health Commercial |
$141.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.75
|
| Rate for Payer: PACE SWMI |
$118.30
|
| Rate for Payer: PHP Medicare Advantage |
$118.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.77
|
| Rate for Payer: Priority Health Medicare |
$118.30
|
| Rate for Payer: Priority Health Narrow Network |
$248.77
|
| Rate for Payer: Railroad Medicare Medicare |
$118.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.30
|
| Rate for Payer: UHC Exchange |
$234.27
|
| Rate for Payer: UHC Medicaid |
$78.17
|
| Rate for Payer: UHCCP DNSP |
$118.30
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
|
|
PR EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 42106
|
| Min. Negotiated Rate |
$95.64 |
| Max. Negotiated Rate |
$390.75 |
| Rate for Payer: Aetna Commercial |
$194.26
|
| Rate for Payer: Aetna Medicare |
$144.97
|
| Rate for Payer: BCBS Complete |
$100.42
|
| Rate for Payer: BCBS MAPPO |
$144.97
|
| Rate for Payer: BCN Commercial |
$243.51
|
| Rate for Payer: BCN Medicare Advantage |
$144.97
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$208.76
|
| Rate for Payer: Cofinity Commercial |
$194.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.97
|
| Rate for Payer: Healthscope Commercial |
$173.96
|
| Rate for Payer: Healthscope Whirlpool |
$173.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.22
|
| Rate for Payer: Meridian Medicaid |
$100.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.47
|
| Rate for Payer: Nomi Health Commercial |
$173.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.75
|
| Rate for Payer: PACE SWMI |
$144.97
|
| Rate for Payer: PHP Medicare Advantage |
$144.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$296.70
|
| Rate for Payer: Priority Health Medicare |
$144.97
|
| Rate for Payer: Priority Health Narrow Network |
$296.70
|
| Rate for Payer: Railroad Medicare Medicare |
$144.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.97
|
| Rate for Payer: UHC Exchange |
$291.94
|
| Rate for Payer: UHC Medicaid |
$95.64
|
| Rate for Payer: UHCCP DNSP |
$144.97
|
| Rate for Payer: UHCCP Medicaid |
$95.64
|
|
|
PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE
|
Facility
|
OP
|
$1,308.00
|
|
|
Service Code
|
CPT 55520
|
| Hospital Charge Code |
55520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$916.91 |
| Max. Negotiated Rate |
$4,390.39 |
| Rate for Payer: Aetna Commercial |
$1,177.20
|
| Rate for Payer: Aetna Medicare |
$3,512.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: ASR ASR |
$1,268.76
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,078.45
|
| Rate for Payer: BCN Commercial |
$1,078.45
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cofinity Commercial |
$1,229.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,046.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$1,268.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,512.31
|
| Rate for Payer: Mclaren Commercial |
$1,177.20
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$1,928.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,111.80
|
| Rate for Payer: Nomi Health Commercial |
$1,072.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$981.00
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,863.54
|
| Rate for Payer: PHP Medicaid |
$1,882.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,146.07
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Narrow Network |
$916.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP DNSP |
$3,512.31
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,308.00
|
|
|
Service Code
|
HCPCS 55520
|
| Min. Negotiated Rate |
$286.70 |
| Max. Negotiated Rate |
$981.00 |
| Rate for Payer: Aetna Commercial |
$591.14
|
| Rate for Payer: Aetna Medicare |
$441.15
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS MAPPO |
$441.15
|
| Rate for Payer: BCN Commercial |
$697.17
|
| Rate for Payer: BCN Medicare Advantage |
$441.15
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cofinity Commercial |
$635.26
|
| Rate for Payer: Cofinity Commercial |
$591.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.15
|
| Rate for Payer: Healthscope Commercial |
$529.38
|
| Rate for Payer: Healthscope Whirlpool |
$529.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.21
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$485.26
|
| Rate for Payer: Nomi Health Commercial |
$529.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$981.00
|
| Rate for Payer: PACE SWMI |
$441.15
|
| Rate for Payer: PHP Medicare Advantage |
$441.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$759.45
|
| Rate for Payer: Priority Health Medicare |
$441.15
|
| Rate for Payer: Priority Health Narrow Network |
$759.45
|
| Rate for Payer: Railroad Medicare Medicare |
$441.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$801.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$441.15
|
| Rate for Payer: UHC Exchange |
$801.97
|
| Rate for Payer: UHC Medicaid |
$286.70
|
| Rate for Payer: UHCCP DNSP |
$441.15
|
| Rate for Payer: UHCCP Medicaid |
$286.70
|
|
|
PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE
|
Facility
|
IP
|
$1,308.00
|
|
|
Service Code
|
CPT 55520
|
| Hospital Charge Code |
55520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$981.00 |
| Max. Negotiated Rate |
$1,308.00 |
| Rate for Payer: Aetna Commercial |
$1,177.20
|
| Rate for Payer: ASR ASR |
$1,268.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,074.13
|
| Rate for Payer: BCN Commercial |
$1,074.13
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cofinity Commercial |
$1,229.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,046.40
|
| Rate for Payer: Healthscope Commercial |
$1,268.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.00
|
| Rate for Payer: Mclaren Commercial |
$1,177.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,111.80
|
| Rate for Payer: Nomi Health Commercial |
$1,072.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$981.00
|
|
|
PR EXC LESION SPERMATIC CORD SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,308.00
|
|
|
Service Code
|
HCPCS 55520
|
| Hospital Charge Code |
55520
|
| Min. Negotiated Rate |
$286.70 |
| Max. Negotiated Rate |
$981.00 |
| Rate for Payer: Aetna Commercial |
$591.14
|
| Rate for Payer: Aetna Medicare |
$441.15
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS MAPPO |
$441.15
|
| Rate for Payer: BCN Commercial |
$697.17
|
| Rate for Payer: BCN Medicare Advantage |
$441.15
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cash Price |
$1,046.40
|
| Rate for Payer: Cofinity Commercial |
$635.26
|
| Rate for Payer: Cofinity Commercial |
$591.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.15
|
| Rate for Payer: Healthscope Commercial |
$529.38
|
| Rate for Payer: Healthscope Whirlpool |
$529.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.21
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$485.26
|
| Rate for Payer: Nomi Health Commercial |
$529.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$981.00
|
| Rate for Payer: PACE SWMI |
$441.15
|
| Rate for Payer: PHP Medicare Advantage |
$441.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$759.45
|
| Rate for Payer: Priority Health Medicare |
$441.15
|
| Rate for Payer: Priority Health Narrow Network |
$759.45
|
| Rate for Payer: Railroad Medicare Medicare |
$441.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$801.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$441.15
|
| Rate for Payer: UHC Exchange |
$801.97
|
| Rate for Payer: UHC Medicaid |
$286.70
|
| Rate for Payer: UHCCP DNSP |
$441.15
|
| Rate for Payer: UHCCP Medicaid |
$286.70
|
|
|
PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR
|
Professional
|
Both
|
$1,088.00
|
|
|
Service Code
|
HCPCS 26160
|
| Min. Negotiated Rate |
$196.81 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna Commercial |
$397.51
|
| Rate for Payer: Aetna Medicare |
$296.65
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$296.65
|
| Rate for Payer: BCN Commercial |
$490.01
|
| Rate for Payer: BCN Medicare Advantage |
$296.65
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cofinity Commercial |
$427.18
|
| Rate for Payer: Cofinity Commercial |
$397.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.65
|
| Rate for Payer: Healthscope Commercial |
$355.98
|
| Rate for Payer: Healthscope Whirlpool |
$355.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.48
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.31
|
| Rate for Payer: Nomi Health Commercial |
$355.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$816.00
|
| Rate for Payer: PACE SWMI |
$296.65
|
| Rate for Payer: PHP Medicare Advantage |
$296.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$523.81
|
| Rate for Payer: Priority Health Medicare |
$296.65
|
| Rate for Payer: Priority Health Narrow Network |
$523.81
|
| Rate for Payer: Railroad Medicare Medicare |
$296.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$541.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$296.65
|
| Rate for Payer: UHC Exchange |
$541.80
|
| Rate for Payer: UHC Medicaid |
$196.81
|
| Rate for Payer: UHCCP DNSP |
$296.65
|
| Rate for Payer: UHCCP Medicaid |
$196.81
|
|
|
PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR
|
Professional
|
Both
|
$1,088.00
|
|
|
Service Code
|
HCPCS 26160
|
| Hospital Charge Code |
26160
|
| Min. Negotiated Rate |
$196.81 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna Commercial |
$397.51
|
| Rate for Payer: Aetna Medicare |
$296.65
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$296.65
|
| Rate for Payer: BCN Commercial |
$490.01
|
| Rate for Payer: BCN Medicare Advantage |
$296.65
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cofinity Commercial |
$427.18
|
| Rate for Payer: Cofinity Commercial |
$397.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.65
|
| Rate for Payer: Healthscope Commercial |
$355.98
|
| Rate for Payer: Healthscope Whirlpool |
$355.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.48
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.31
|
| Rate for Payer: Nomi Health Commercial |
$355.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$816.00
|
| Rate for Payer: PACE SWMI |
$296.65
|
| Rate for Payer: PHP Medicare Advantage |
$296.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$523.81
|
| Rate for Payer: Priority Health Medicare |
$296.65
|
| Rate for Payer: Priority Health Narrow Network |
$523.81
|
| Rate for Payer: Railroad Medicare Medicare |
$296.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$541.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$296.65
|
| Rate for Payer: UHC Exchange |
$541.80
|
| Rate for Payer: UHC Medicaid |
$196.81
|
| Rate for Payer: UHCCP DNSP |
$296.65
|
| Rate for Payer: UHCCP Medicaid |
$196.81
|
|
|
PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR
|
Facility
|
OP
|
$1,088.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
26160
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$762.69 |
| Max. Negotiated Rate |
$2,002.76 |
| Rate for Payer: Aetna Commercial |
$979.20
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$1,055.36
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$897.06
|
| Rate for Payer: BCN Commercial |
$897.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cofinity Commercial |
$1,022.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$870.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$1,055.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$979.20
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$924.80
|
| Rate for Payer: Nomi Health Commercial |
$892.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$816.00
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$953.31
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$762.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
PR EXC LESION TDN SHTH/JT CAPSL HAND/FNGR
|
Facility
|
IP
|
$1,088.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
26160
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$816.00 |
| Max. Negotiated Rate |
$1,088.00 |
| Rate for Payer: Aetna Commercial |
$979.20
|
| Rate for Payer: ASR ASR |
$1,055.36
|
| Rate for Payer: BCBS Trust/PPO |
$893.47
|
| Rate for Payer: BCN Commercial |
$893.47
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cofinity Commercial |
$1,022.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$870.40
|
| Rate for Payer: Healthscope Commercial |
$1,055.36
|
| Rate for Payer: Healthscope Whirlpool |
$1,088.00
|
| Rate for Payer: Mclaren Commercial |
$979.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$924.80
|
| Rate for Payer: Nomi Health Commercial |
$892.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$816.00
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 28090
|
| Min. Negotiated Rate |
$187.87 |
| Max. Negotiated Rate |
$684.75 |
| Rate for Payer: Aetna Commercial |
$382.34
|
| Rate for Payer: Aetna Medicare |
$285.33
|
| Rate for Payer: BCBS Complete |
$197.26
|
| Rate for Payer: BCBS MAPPO |
$285.33
|
| Rate for Payer: BCN Commercial |
$470.59
|
| Rate for Payer: BCN Medicare Advantage |
$285.33
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$410.88
|
| Rate for Payer: Cofinity Commercial |
$382.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.33
|
| Rate for Payer: Healthscope Commercial |
$342.40
|
| Rate for Payer: Healthscope Whirlpool |
$342.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.60
|
| Rate for Payer: Meridian Medicaid |
$197.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.86
|
| Rate for Payer: Nomi Health Commercial |
$342.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.75
|
| Rate for Payer: PACE SWMI |
$285.33
|
| Rate for Payer: PHP Medicare Advantage |
$285.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$503.04
|
| Rate for Payer: Priority Health Medicare |
$285.33
|
| Rate for Payer: Priority Health Narrow Network |
$503.04
|
| Rate for Payer: Railroad Medicare Medicare |
$285.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$534.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.33
|
| Rate for Payer: UHC Exchange |
$534.13
|
| Rate for Payer: UHC Medicaid |
$187.87
|
| Rate for Payer: UHCCP DNSP |
$285.33
|
| Rate for Payer: UHCCP Medicaid |
$187.87
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 28090
|
| Hospital Charge Code |
28090
|
| Min. Negotiated Rate |
$187.87 |
| Max. Negotiated Rate |
$684.75 |
| Rate for Payer: Aetna Commercial |
$382.34
|
| Rate for Payer: Aetna Medicare |
$285.33
|
| Rate for Payer: BCBS Complete |
$197.26
|
| Rate for Payer: BCBS MAPPO |
$285.33
|
| Rate for Payer: BCN Commercial |
$470.59
|
| Rate for Payer: BCN Medicare Advantage |
$285.33
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$410.88
|
| Rate for Payer: Cofinity Commercial |
$382.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.33
|
| Rate for Payer: Healthscope Commercial |
$342.40
|
| Rate for Payer: Healthscope Whirlpool |
$342.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.60
|
| Rate for Payer: Meridian Medicaid |
$197.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.86
|
| Rate for Payer: Nomi Health Commercial |
$342.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.75
|
| Rate for Payer: PACE SWMI |
$285.33
|
| Rate for Payer: PHP Medicare Advantage |
$285.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$503.04
|
| Rate for Payer: Priority Health Medicare |
$285.33
|
| Rate for Payer: Priority Health Narrow Network |
$503.04
|
| Rate for Payer: Railroad Medicare Medicare |
$285.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$534.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$285.33
|
| Rate for Payer: UHC Exchange |
$534.13
|
| Rate for Payer: UHC Medicaid |
$187.87
|
| Rate for Payer: UHCCP DNSP |
$285.33
|
| Rate for Payer: UHCCP Medicaid |
$187.87
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT
|
Facility
|
IP
|
$913.00
|
|
|
Service Code
|
CPT 28090
|
| Hospital Charge Code |
28090
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$684.75 |
| Max. Negotiated Rate |
$913.00 |
| Rate for Payer: Aetna Commercial |
$821.70
|
| Rate for Payer: ASR ASR |
$885.61
|
| Rate for Payer: BCBS Trust/PPO |
$749.76
|
| Rate for Payer: BCN Commercial |
$749.76
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$858.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.40
|
| Rate for Payer: Healthscope Commercial |
$885.61
|
| Rate for Payer: Healthscope Whirlpool |
$913.00
|
| Rate for Payer: Mclaren Commercial |
$821.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$776.05
|
| Rate for Payer: Nomi Health Commercial |
$748.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.75
|
|
|
PR EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT
|
Facility
|
OP
|
$913.00
|
|
|
Service Code
|
CPT 28090
|
| Hospital Charge Code |
28090
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$640.01 |
| Max. Negotiated Rate |
$2,002.76 |
| Rate for Payer: Aetna Commercial |
$821.70
|
| Rate for Payer: Aetna Medicare |
$1,602.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: ASR ASR |
$885.61
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$752.77
|
| Rate for Payer: BCN Commercial |
$752.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$858.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$885.61
|
| Rate for Payer: Healthscope Whirlpool |
$913.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,602.21
|
| Rate for Payer: Mclaren Commercial |
$821.70
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$879.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$776.05
|
| Rate for Payer: Nomi Health Commercial |
$748.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.75
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,762.43
|
| Rate for Payer: PHP Medicaid |
$858.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$799.97
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Narrow Network |
$640.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP DNSP |
$1,602.21
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
