|
PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 11470
|
| Min. Negotiated Rate |
$275.43 |
| Max. Negotiated Rate |
$591.50 |
| Rate for Payer: Aetna Commercial |
$369.08
|
| Rate for Payer: Aetna Medicare |
$275.43
|
| Rate for Payer: BCBS Complete |
$364.00
|
| Rate for Payer: BCBS MAPPO |
$275.43
|
| Rate for Payer: BCN Medicare Advantage |
$275.43
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cofinity Commercial |
$396.62
|
| Rate for Payer: Cofinity Commercial |
$369.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.43
|
| Rate for Payer: Healthscope Commercial |
$330.52
|
| Rate for Payer: Healthscope Whirlpool |
$330.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.20
|
| Rate for Payer: Nomi Health Commercial |
$330.52
|
| Rate for Payer: PACE SWMI |
$275.43
|
| Rate for Payer: PHP Medicare Advantage |
$275.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$591.50
|
| Rate for Payer: Priority Health Medicare |
$275.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.43
|
| Rate for Payer: UHC Medicare Advantage |
$275.43
|
| Rate for Payer: UHCCP DNSP |
$275.43
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Min. Negotiated Rate |
$488.97 |
| Max. Negotiated Rate |
$1,197.95 |
| Rate for Payer: Aetna Commercial |
$655.22
|
| Rate for Payer: Aetna Medicare |
$488.97
|
| Rate for Payer: BCBS Complete |
$737.20
|
| Rate for Payer: BCBS MAPPO |
$488.97
|
| Rate for Payer: BCN Medicare Advantage |
$488.97
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$704.12
|
| Rate for Payer: Cofinity Commercial |
$655.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.97
|
| Rate for Payer: Healthscope Commercial |
$586.76
|
| Rate for Payer: Healthscope Whirlpool |
$586.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.42
|
| Rate for Payer: Nomi Health Commercial |
$586.76
|
| Rate for Payer: PACE SWMI |
$488.97
|
| Rate for Payer: PHP Medicare Advantage |
$488.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health Medicare |
$488.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$488.97
|
| Rate for Payer: UHC Medicare Advantage |
$488.97
|
| Rate for Payer: UHCCP DNSP |
$488.97
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
OP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$1,197.95 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$1,658.70
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$1,787.71
|
| Rate for Payer: ASR Commercial |
$1,787.71
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.23
|
| Rate for Payer: BCN Commercial |
$1,428.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,732.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,474.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$1,843.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,787.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$1,658.70
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: Nomi Health Commercial |
$1,511.26
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,614.84
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,291.94
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,621.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$488.97 |
| Max. Negotiated Rate |
$1,197.95 |
| Rate for Payer: Aetna Commercial |
$655.22
|
| Rate for Payer: Aetna Medicare |
$488.97
|
| Rate for Payer: BCBS Complete |
$737.20
|
| Rate for Payer: BCBS MAPPO |
$488.97
|
| Rate for Payer: BCN Medicare Advantage |
$488.97
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$704.12
|
| Rate for Payer: Cofinity Commercial |
$655.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.97
|
| Rate for Payer: Healthscope Commercial |
$586.76
|
| Rate for Payer: Healthscope Whirlpool |
$586.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.42
|
| Rate for Payer: Nomi Health Commercial |
$586.76
|
| Rate for Payer: PACE SWMI |
$488.97
|
| Rate for Payer: PHP Medicare Advantage |
$488.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: Priority Health Medicare |
$488.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$488.97
|
| Rate for Payer: UHC Medicare Advantage |
$488.97
|
| Rate for Payer: UHCCP DNSP |
$488.97
|
|
|
PR EXCISION HYDROCELE BILATERAL
|
Facility
|
IP
|
$1,843.00
|
|
|
Service Code
|
CPT 55041
|
| Hospital Charge Code |
55041
|
| Min. Negotiated Rate |
$1,197.95 |
| Max. Negotiated Rate |
$1,843.00 |
| Rate for Payer: Aetna Commercial |
$1,658.70
|
| Rate for Payer: ASR ASR |
$1,787.71
|
| Rate for Payer: ASR Commercial |
$1,787.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.86
|
| Rate for Payer: BCN Commercial |
$1,428.88
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,732.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,474.40
|
| Rate for Payer: Healthscope Commercial |
$1,843.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,787.71
|
| Rate for Payer: Mclaren Commercial |
$1,658.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,566.55
|
| Rate for Payer: Nomi Health Commercial |
$1,511.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,197.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,621.84
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
OP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$816.40 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$1,130.40
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$1,218.32
|
| Rate for Payer: ASR Commercial |
$1,218.32
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.54
|
| Rate for Payer: BCN Commercial |
$973.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,180.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$1,256.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,218.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$1,130.40
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: Nomi Health Commercial |
$1,029.92
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,100.51
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$880.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,105.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Facility
|
IP
|
$1,256.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
55040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$816.40 |
| Max. Negotiated Rate |
$1,256.00 |
| Rate for Payer: Aetna Commercial |
$1,130.40
|
| Rate for Payer: ASR ASR |
$1,218.32
|
| Rate for Payer: ASR Commercial |
$1,218.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.51
|
| Rate for Payer: BCN Commercial |
$973.78
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$1,180.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,004.80
|
| Rate for Payer: Healthscope Commercial |
$1,256.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,218.32
|
| Rate for Payer: Mclaren Commercial |
$1,130.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,067.60
|
| Rate for Payer: Nomi Health Commercial |
$1,029.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,105.28
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
55040
|
| Min. Negotiated Rate |
$324.17 |
| Max. Negotiated Rate |
$816.40 |
| Rate for Payer: Aetna Commercial |
$434.39
|
| Rate for Payer: Aetna Medicare |
$324.17
|
| Rate for Payer: BCBS Complete |
$502.40
|
| Rate for Payer: BCBS MAPPO |
$324.17
|
| Rate for Payer: BCN Medicare Advantage |
$324.17
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$466.80
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.17
|
| Rate for Payer: Healthscope Commercial |
$389.00
|
| Rate for Payer: Healthscope Whirlpool |
$389.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.38
|
| Rate for Payer: Nomi Health Commercial |
$389.00
|
| Rate for Payer: PACE SWMI |
$324.17
|
| Rate for Payer: PHP Medicare Advantage |
$324.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health Medicare |
$324.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.17
|
| Rate for Payer: UHC Medicare Advantage |
$324.17
|
| Rate for Payer: UHCCP DNSP |
$324.17
|
|
|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$324.17 |
| Max. Negotiated Rate |
$816.40 |
| Rate for Payer: Aetna Commercial |
$434.39
|
| Rate for Payer: Aetna Medicare |
$324.17
|
| Rate for Payer: BCBS Complete |
$502.40
|
| Rate for Payer: BCBS MAPPO |
$324.17
|
| Rate for Payer: BCN Medicare Advantage |
$324.17
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$466.80
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.17
|
| Rate for Payer: Healthscope Commercial |
$389.00
|
| Rate for Payer: Healthscope Whirlpool |
$389.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.38
|
| Rate for Payer: Nomi Health Commercial |
$389.00
|
| Rate for Payer: PACE SWMI |
$324.17
|
| Rate for Payer: PHP Medicare Advantage |
$324.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health Medicare |
$324.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.17
|
| Rate for Payer: UHC Medicare Advantage |
$324.17
|
| Rate for Payer: UHCCP DNSP |
$324.17
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$1,617.20 |
| Max. Negotiated Rate |
$2,645.71 |
| Rate for Payer: Aetna Commercial |
$2,461.98
|
| Rate for Payer: Aetna Medicare |
$1,837.30
|
| Rate for Payer: BCBS Complete |
$1,617.20
|
| Rate for Payer: BCBS MAPPO |
$1,837.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,837.30
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cofinity Commercial |
$2,645.71
|
| Rate for Payer: Cofinity Commercial |
$2,461.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,837.30
|
| Rate for Payer: Healthscope Commercial |
$2,204.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,204.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,929.16
|
| Rate for Payer: Nomi Health Commercial |
$2,204.76
|
| Rate for Payer: PACE SWMI |
$1,837.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,837.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,627.95
|
| Rate for Payer: Priority Health Medicare |
$1,837.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,837.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,837.30
|
| Rate for Payer: UHCCP DNSP |
$1,837.30
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$2,005.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$536.34 |
| Max. Negotiated Rate |
$1,303.25 |
| Rate for Payer: Aetna Commercial |
$718.70
|
| Rate for Payer: Aetna Medicare |
$536.34
|
| Rate for Payer: BCBS Complete |
$802.00
|
| Rate for Payer: BCBS MAPPO |
$536.34
|
| Rate for Payer: BCN Medicare Advantage |
$536.34
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cofinity Commercial |
$772.33
|
| Rate for Payer: Cofinity Commercial |
$718.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.34
|
| Rate for Payer: Healthscope Commercial |
$643.61
|
| Rate for Payer: Healthscope Whirlpool |
$643.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.16
|
| Rate for Payer: Nomi Health Commercial |
$643.61
|
| Rate for Payer: PACE SWMI |
$536.34
|
| Rate for Payer: PHP Medicare Advantage |
$536.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.25
|
| Rate for Payer: Priority Health Medicare |
$536.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.34
|
| Rate for Payer: UHC Medicare Advantage |
$536.34
|
| Rate for Payer: UHCCP DNSP |
$536.34
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$322.00 |
| Max. Negotiated Rate |
$551.75 |
| Rate for Payer: Aetna Commercial |
$513.43
|
| Rate for Payer: Aetna Medicare |
$383.16
|
| Rate for Payer: BCBS Complete |
$322.00
|
| Rate for Payer: BCBS MAPPO |
$383.16
|
| Rate for Payer: BCN Medicare Advantage |
$383.16
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$551.75
|
| Rate for Payer: Cofinity Commercial |
$513.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.16
|
| Rate for Payer: Healthscope Commercial |
$459.79
|
| Rate for Payer: Healthscope Whirlpool |
$459.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.32
|
| Rate for Payer: Nomi Health Commercial |
$459.79
|
| Rate for Payer: PACE SWMI |
$383.16
|
| Rate for Payer: PHP Medicare Advantage |
$383.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.25
|
| Rate for Payer: Priority Health Medicare |
$383.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.16
|
| Rate for Payer: UHC Medicare Advantage |
$383.16
|
| Rate for Payer: UHCCP DNSP |
$383.16
|
|
|
PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 28080
|
| Min. Negotiated Rate |
$354.40 |
| Max. Negotiated Rate |
$575.90 |
| Rate for Payer: Aetna Commercial |
$486.75
|
| Rate for Payer: Aetna Medicare |
$363.25
|
| Rate for Payer: BCBS Complete |
$354.40
|
| Rate for Payer: BCBS MAPPO |
$363.25
|
| Rate for Payer: BCN Medicare Advantage |
$363.25
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cofinity Commercial |
$523.08
|
| Rate for Payer: Cofinity Commercial |
$486.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.25
|
| Rate for Payer: Healthscope Commercial |
$435.90
|
| Rate for Payer: Healthscope Whirlpool |
$435.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.41
|
| Rate for Payer: Nomi Health Commercial |
$435.90
|
| Rate for Payer: PACE SWMI |
$363.25
|
| Rate for Payer: PHP Medicare Advantage |
$363.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.90
|
| Rate for Payer: Priority Health Medicare |
$363.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.25
|
| Rate for Payer: UHC Medicare Advantage |
$363.25
|
| Rate for Payer: UHCCP DNSP |
$363.25
|
|
|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$311.59 |
| Max. Negotiated Rate |
$516.10 |
| Rate for Payer: Aetna Commercial |
$417.53
|
| Rate for Payer: Aetna Medicare |
$311.59
|
| Rate for Payer: BCBS Complete |
$317.60
|
| Rate for Payer: BCBS MAPPO |
$311.59
|
| Rate for Payer: BCN Medicare Advantage |
$311.59
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cofinity Commercial |
$448.69
|
| Rate for Payer: Cofinity Commercial |
$417.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.59
|
| Rate for Payer: Healthscope Commercial |
$373.91
|
| Rate for Payer: Healthscope Whirlpool |
$373.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.17
|
| Rate for Payer: Nomi Health Commercial |
$373.91
|
| Rate for Payer: PACE SWMI |
$311.59
|
| Rate for Payer: PHP Medicare Advantage |
$311.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$516.10
|
| Rate for Payer: Priority Health Medicare |
$311.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.59
|
| Rate for Payer: UHC Medicare Advantage |
$311.59
|
| Rate for Payer: UHCCP DNSP |
$311.59
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$204.03 |
| Max. Negotiated Rate |
$382.20 |
| Rate for Payer: Aetna Commercial |
$273.40
|
| Rate for Payer: Aetna Medicare |
$204.03
|
| Rate for Payer: BCBS Complete |
$235.20
|
| Rate for Payer: BCBS MAPPO |
$204.03
|
| Rate for Payer: BCN Medicare Advantage |
$204.03
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cofinity Commercial |
$293.80
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.03
|
| Rate for Payer: Healthscope Commercial |
$244.84
|
| Rate for Payer: Healthscope Whirlpool |
$244.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.23
|
| Rate for Payer: Nomi Health Commercial |
$244.84
|
| Rate for Payer: PACE SWMI |
$204.03
|
| Rate for Payer: PHP Medicare Advantage |
$204.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.20
|
| Rate for Payer: Priority Health Medicare |
$204.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.03
|
| Rate for Payer: UHC Medicare Advantage |
$204.03
|
| Rate for Payer: UHCCP DNSP |
$204.03
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$511.14 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$684.93
|
| Rate for Payer: Aetna Medicare |
$511.14
|
| Rate for Payer: BCBS Complete |
$936.00
|
| Rate for Payer: BCBS MAPPO |
$511.14
|
| Rate for Payer: BCN Medicare Advantage |
$511.14
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cofinity Commercial |
$736.04
|
| Rate for Payer: Cofinity Commercial |
$684.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.14
|
| Rate for Payer: Healthscope Commercial |
$613.37
|
| Rate for Payer: Healthscope Whirlpool |
$613.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.70
|
| Rate for Payer: Nomi Health Commercial |
$613.37
|
| Rate for Payer: PACE SWMI |
$511.14
|
| Rate for Payer: PHP Medicare Advantage |
$511.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.00
|
| Rate for Payer: Priority Health Medicare |
$511.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$511.14
|
| Rate for Payer: UHC Medicare Advantage |
$511.14
|
| Rate for Payer: UHCCP DNSP |
$511.14
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$603.20 |
| Max. Negotiated Rate |
$1,193.86 |
| Rate for Payer: Aetna Commercial |
$1,110.95
|
| Rate for Payer: Aetna Medicare |
$829.07
|
| Rate for Payer: BCBS Complete |
$603.20
|
| Rate for Payer: BCBS MAPPO |
$829.07
|
| Rate for Payer: BCN Medicare Advantage |
$829.07
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cofinity Commercial |
$1,193.86
|
| Rate for Payer: Cofinity Commercial |
$1,110.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.07
|
| Rate for Payer: Healthscope Commercial |
$994.88
|
| Rate for Payer: Healthscope Whirlpool |
$994.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.52
|
| Rate for Payer: Nomi Health Commercial |
$994.88
|
| Rate for Payer: PACE SWMI |
$829.07
|
| Rate for Payer: PHP Medicare Advantage |
$829.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.20
|
| Rate for Payer: Priority Health Medicare |
$829.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$829.07
|
| Rate for Payer: UHC Medicare Advantage |
$829.07
|
| Rate for Payer: UHCCP DNSP |
$829.07
|
|
|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,275.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$910.00 |
| Max. Negotiated Rate |
$1,560.04 |
| Rate for Payer: Aetna Commercial |
$1,451.70
|
| Rate for Payer: Aetna Medicare |
$1,083.36
|
| Rate for Payer: BCBS Complete |
$910.00
|
| Rate for Payer: BCBS MAPPO |
$1,083.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.36
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cofinity Commercial |
$1,560.04
|
| Rate for Payer: Cofinity Commercial |
$1,451.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.36
|
| Rate for Payer: Healthscope Commercial |
$1,300.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,300.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.53
|
| Rate for Payer: Nomi Health Commercial |
$1,300.03
|
| Rate for Payer: PACE SWMI |
$1,083.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.75
|
| Rate for Payer: Priority Health Medicare |
$1,083.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.36
|
| Rate for Payer: UHCCP DNSP |
$1,083.36
|
|
|
PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
HCPCS 27630
|
| Min. Negotiated Rate |
$345.27 |
| Max. Negotiated Rate |
$873.60 |
| Rate for Payer: Aetna Commercial |
$462.66
|
| Rate for Payer: Aetna Medicare |
$345.27
|
| Rate for Payer: BCBS Complete |
$537.60
|
| Rate for Payer: BCBS MAPPO |
$345.27
|
| Rate for Payer: BCN Medicare Advantage |
$345.27
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cofinity Commercial |
$497.19
|
| Rate for Payer: Cofinity Commercial |
$462.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.27
|
| Rate for Payer: Healthscope Commercial |
$414.32
|
| Rate for Payer: Healthscope Whirlpool |
$414.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.53
|
| Rate for Payer: Nomi Health Commercial |
$414.32
|
| Rate for Payer: PACE SWMI |
$345.27
|
| Rate for Payer: PHP Medicare Advantage |
$345.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$873.60
|
| Rate for Payer: Priority Health Medicare |
$345.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.27
|
| Rate for Payer: UHC Medicare Advantage |
$345.27
|
| Rate for Payer: UHCCP DNSP |
$345.27
|
|
|
PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 25110
|
| Min. Negotiated Rate |
$335.52 |
| Max. Negotiated Rate |
$750.75 |
| Rate for Payer: Aetna Commercial |
$449.60
|
| Rate for Payer: Aetna Medicare |
$335.52
|
| Rate for Payer: BCBS Complete |
$462.00
|
| Rate for Payer: BCBS MAPPO |
$335.52
|
| Rate for Payer: BCN Medicare Advantage |
$335.52
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$483.15
|
| Rate for Payer: Cofinity Commercial |
$449.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.52
|
| Rate for Payer: Healthscope Commercial |
$402.62
|
| Rate for Payer: Healthscope Whirlpool |
$402.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.30
|
| Rate for Payer: Nomi Health Commercial |
$402.62
|
| Rate for Payer: PACE SWMI |
$335.52
|
| Rate for Payer: PHP Medicare Advantage |
$335.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health Medicare |
$335.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.52
|
| Rate for Payer: UHC Medicare Advantage |
$335.52
|
| Rate for Payer: UHCCP DNSP |
$335.52
|
|
|
PR EXCISION LESION TONGUE W/O CLOSURE
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 41110
|
| Min. Negotiated Rate |
$121.78 |
| Max. Negotiated Rate |
$247.65 |
| Rate for Payer: Aetna Commercial |
$163.19
|
| Rate for Payer: Aetna Medicare |
$121.78
|
| Rate for Payer: BCBS Complete |
$152.40
|
| Rate for Payer: BCBS MAPPO |
$121.78
|
| Rate for Payer: BCN Medicare Advantage |
$121.78
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$175.36
|
| Rate for Payer: Cofinity Commercial |
$163.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.78
|
| Rate for Payer: Healthscope Commercial |
$146.14
|
| Rate for Payer: Healthscope Whirlpool |
$146.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.87
|
| Rate for Payer: Nomi Health Commercial |
$146.14
|
| Rate for Payer: PACE SWMI |
$121.78
|
| Rate for Payer: PHP Medicare Advantage |
$121.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health Medicare |
$121.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.78
|
| Rate for Payer: UHC Medicare Advantage |
$121.78
|
| Rate for Payer: UHCCP DNSP |
$121.78
|
|
|
PR EXCISION LINGUAL FRENUM FRENECTOMY
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
HCPCS 41115
|
| Min. Negotiated Rate |
$137.52 |
| Max. Negotiated Rate |
$290.55 |
| Rate for Payer: Aetna Commercial |
$184.28
|
| Rate for Payer: Aetna Medicare |
$137.52
|
| Rate for Payer: BCBS Complete |
$178.80
|
| Rate for Payer: BCBS MAPPO |
$137.52
|
| Rate for Payer: BCN Medicare Advantage |
$137.52
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cofinity Commercial |
$198.03
|
| Rate for Payer: Cofinity Commercial |
$184.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.52
|
| Rate for Payer: Healthscope Commercial |
$165.02
|
| Rate for Payer: Healthscope Whirlpool |
$165.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.40
|
| Rate for Payer: Nomi Health Commercial |
$165.02
|
| Rate for Payer: PACE SWMI |
$137.52
|
| Rate for Payer: PHP Medicare Advantage |
$137.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.55
|
| Rate for Payer: Priority Health Medicare |
$137.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.52
|
| Rate for Payer: UHC Medicare Advantage |
$137.52
|
| Rate for Payer: UHCCP DNSP |
$137.52
|
|
|
PR EXCISION LOCAL LESION EPIDIDYMIS
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
HCPCS 54830
|
| Min. Negotiated Rate |
$246.80 |
| Max. Negotiated Rate |
$513.32 |
| Rate for Payer: Aetna Commercial |
$477.67
|
| Rate for Payer: Aetna Medicare |
$356.47
|
| Rate for Payer: BCBS Complete |
$246.80
|
| Rate for Payer: BCBS MAPPO |
$356.47
|
| Rate for Payer: BCN Medicare Advantage |
$356.47
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cofinity Commercial |
$513.32
|
| Rate for Payer: Cofinity Commercial |
$477.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.47
|
| Rate for Payer: Healthscope Commercial |
$427.76
|
| Rate for Payer: Healthscope Whirlpool |
$427.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.29
|
| Rate for Payer: Nomi Health Commercial |
$427.76
|
| Rate for Payer: PACE SWMI |
$356.47
|
| Rate for Payer: PHP Medicare Advantage |
$356.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.05
|
| Rate for Payer: Priority Health Medicare |
$356.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.47
|
| Rate for Payer: UHC Medicare Advantage |
$356.47
|
| Rate for Payer: UHCCP DNSP |
$356.47
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
OP
|
$333.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$299.70
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$323.01
|
| Rate for Payer: ASR Commercial |
$323.01
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$272.69
|
| Rate for Payer: BCN Commercial |
$258.17
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$313.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$333.00
|
| Rate for Payer: Healthscope Whirlpool |
$323.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$299.70
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.05
|
| Rate for Payer: Nomi Health Commercial |
$273.06
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.77
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$233.43
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
IP
|
$333.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$333.00 |
| Rate for Payer: Aetna Commercial |
$299.70
|
| Rate for Payer: ASR ASR |
$323.01
|
| Rate for Payer: ASR Commercial |
$323.01
|
| Rate for Payer: BCBS Trust/PPO |
$271.36
|
| Rate for Payer: BCN Commercial |
$258.17
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$313.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.40
|
| Rate for Payer: Healthscope Commercial |
$333.00
|
| Rate for Payer: Healthscope Whirlpool |
$323.01
|
| Rate for Payer: Mclaren Commercial |
$299.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.05
|
| Rate for Payer: Nomi Health Commercial |
$273.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.04
|
|
