|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$174.85 |
| Max. Negotiated Rate |
$269.00 |
| Rate for Payer: Aetna Commercial |
$242.10
|
| Rate for Payer: ASR ASR |
$260.93
|
| Rate for Payer: ASR Commercial |
$260.93
|
| Rate for Payer: BCBS Trust/PPO |
$219.21
|
| Rate for Payer: BCN Commercial |
$208.56
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$252.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Healthscope Commercial |
$269.00
|
| Rate for Payer: Healthscope Whirlpool |
$260.93
|
| Rate for Payer: Mclaren Commercial |
$242.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.65
|
| Rate for Payer: Nomi Health Commercial |
$220.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.72
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
10140
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$174.85 |
| Rate for Payer: Aetna Commercial |
$150.63
|
| Rate for Payer: Aetna Medicare |
$112.41
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCBS MAPPO |
$112.41
|
| Rate for Payer: BCN Medicare Advantage |
$112.41
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Cofinity Commercial |
$150.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.41
|
| Rate for Payer: Healthscope Commercial |
$134.89
|
| Rate for Payer: Healthscope Whirlpool |
$134.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.03
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: PACE SWMI |
$112.41
|
| Rate for Payer: PHP Medicare Advantage |
$112.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Medicare |
$112.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.41
|
| Rate for Payer: UHC Medicare Advantage |
$112.41
|
| Rate for Payer: UHCCP DNSP |
$112.41
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$174.85 |
| Rate for Payer: Aetna Commercial |
$150.63
|
| Rate for Payer: Aetna Medicare |
$112.41
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCBS MAPPO |
$112.41
|
| Rate for Payer: BCN Medicare Advantage |
$112.41
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Cofinity Commercial |
$150.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.41
|
| Rate for Payer: Healthscope Commercial |
$134.89
|
| Rate for Payer: Healthscope Whirlpool |
$134.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.03
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: PACE SWMI |
$112.41
|
| Rate for Payer: PHP Medicare Advantage |
$112.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Medicare |
$112.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.41
|
| Rate for Payer: UHC Medicare Advantage |
$112.41
|
| Rate for Payer: UHCCP DNSP |
$112.41
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$478.40 |
| Max. Negotiated Rate |
$4,145.63 |
| Rate for Payer: Aetna Commercial |
$662.40
|
| Rate for Payer: Aetna Medicare |
$2,674.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: ASR ASR |
$713.92
|
| Rate for Payer: ASR Commercial |
$713.92
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCBS Trust/PPO |
$602.71
|
| Rate for Payer: BCN Commercial |
$570.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$691.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$736.00
|
| Rate for Payer: Healthscope Whirlpool |
$713.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,674.60
|
| Rate for Payer: Mclaren Commercial |
$662.40
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.60
|
| Rate for Payer: Nomi Health Commercial |
$603.52
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$2,942.06
|
| Rate for Payer: PHP Medicaid |
$1,433.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$644.88
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health Narrow Network |
$515.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Exchange |
$4,145.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP DNSP |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,433.59
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$564.94
|
| Rate for Payer: Aetna Medicare |
$421.60
|
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: BCBS MAPPO |
$421.60
|
| Rate for Payer: BCN Medicare Advantage |
$421.60
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$607.10
|
| Rate for Payer: Cofinity Commercial |
$564.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.60
|
| Rate for Payer: Healthscope Commercial |
$505.92
|
| Rate for Payer: Healthscope Whirlpool |
$505.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.68
|
| Rate for Payer: Nomi Health Commercial |
$505.92
|
| Rate for Payer: PACE SWMI |
$421.60
|
| Rate for Payer: PHP Medicare Advantage |
$421.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Medicare |
$421.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.60
|
| Rate for Payer: UHC Medicare Advantage |
$421.60
|
| Rate for Payer: UHCCP DNSP |
$421.60
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 46045
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$564.94
|
| Rate for Payer: Aetna Medicare |
$421.60
|
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: BCBS MAPPO |
$421.60
|
| Rate for Payer: BCN Medicare Advantage |
$421.60
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$607.10
|
| Rate for Payer: Cofinity Commercial |
$564.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.60
|
| Rate for Payer: Healthscope Commercial |
$505.92
|
| Rate for Payer: Healthscope Whirlpool |
$505.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.68
|
| Rate for Payer: Nomi Health Commercial |
$505.92
|
| Rate for Payer: PACE SWMI |
$421.60
|
| Rate for Payer: PHP Medicare Advantage |
$421.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Medicare |
$421.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.60
|
| Rate for Payer: UHC Medicare Advantage |
$421.60
|
| Rate for Payer: UHCCP DNSP |
$421.60
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$478.40 |
| Max. Negotiated Rate |
$736.00 |
| Rate for Payer: Aetna Commercial |
$662.40
|
| Rate for Payer: ASR ASR |
$713.92
|
| Rate for Payer: ASR Commercial |
$713.92
|
| Rate for Payer: BCBS Trust/PPO |
$599.77
|
| Rate for Payer: BCN Commercial |
$570.62
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$691.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Healthscope Commercial |
$736.00
|
| Rate for Payer: Healthscope Whirlpool |
$713.92
|
| Rate for Payer: Mclaren Commercial |
$662.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.60
|
| Rate for Payer: Nomi Health Commercial |
$603.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$647.68
|
|
|
PR I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$2,127.00
|
|
|
Service Code
|
HCPCS 46060
|
| Min. Negotiated Rate |
$466.27 |
| Max. Negotiated Rate |
$1,382.55 |
| Rate for Payer: Aetna Commercial |
$624.80
|
| Rate for Payer: Aetna Medicare |
$466.27
|
| Rate for Payer: BCBS Complete |
$850.80
|
| Rate for Payer: BCBS MAPPO |
$466.27
|
| Rate for Payer: BCN Medicare Advantage |
$466.27
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cofinity Commercial |
$671.43
|
| Rate for Payer: Cofinity Commercial |
$624.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.27
|
| Rate for Payer: Healthscope Commercial |
$559.52
|
| Rate for Payer: Healthscope Whirlpool |
$559.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.58
|
| Rate for Payer: Nomi Health Commercial |
$559.52
|
| Rate for Payer: PACE SWMI |
$466.27
|
| Rate for Payer: PHP Medicare Advantage |
$466.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.55
|
| Rate for Payer: Priority Health Medicare |
$466.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.27
|
| Rate for Payer: UHC Medicare Advantage |
$466.27
|
| Rate for Payer: UHCCP DNSP |
$466.27
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
IP
|
$924.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$600.60 |
| Max. Negotiated Rate |
$924.00 |
| Rate for Payer: Aetna Commercial |
$831.60
|
| Rate for Payer: ASR ASR |
$896.28
|
| Rate for Payer: ASR Commercial |
$896.28
|
| Rate for Payer: BCBS Trust/PPO |
$752.97
|
| Rate for Payer: BCN Commercial |
$716.38
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$868.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.20
|
| Rate for Payer: Healthscope Commercial |
$924.00
|
| Rate for Payer: Healthscope Whirlpool |
$896.28
|
| Rate for Payer: Mclaren Commercial |
$831.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.40
|
| Rate for Payer: Nomi Health Commercial |
$757.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.12
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
OP
|
$924.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$600.60 |
| Max. Negotiated Rate |
$1,782.39 |
| Rate for Payer: Aetna Commercial |
$831.60
|
| Rate for Payer: Aetna Medicare |
$1,149.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: ASR ASR |
$896.28
|
| Rate for Payer: ASR Commercial |
$896.28
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCBS Trust/PPO |
$756.66
|
| Rate for Payer: BCN Commercial |
$716.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$868.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$924.00
|
| Rate for Payer: Healthscope Whirlpool |
$896.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,149.93
|
| Rate for Payer: Mclaren Commercial |
$831.60
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.40
|
| Rate for Payer: Nomi Health Commercial |
$757.68
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$1,264.92
|
| Rate for Payer: PHP Medicaid |
$616.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.61
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health Narrow Network |
$647.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Exchange |
$1,782.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP DNSP |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$616.36
|
| Rate for Payer: VA VA |
$1,149.93
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
46040
|
| Min. Negotiated Rate |
$369.60 |
| Max. Negotiated Rate |
$600.60 |
| Rate for Payer: Aetna Commercial |
$549.47
|
| Rate for Payer: Aetna Medicare |
$410.05
|
| Rate for Payer: BCBS Complete |
$369.60
|
| Rate for Payer: BCBS MAPPO |
$410.05
|
| Rate for Payer: BCN Medicare Advantage |
$410.05
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$590.47
|
| Rate for Payer: Cofinity Commercial |
$549.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.05
|
| Rate for Payer: Healthscope Commercial |
$492.06
|
| Rate for Payer: Healthscope Whirlpool |
$492.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.55
|
| Rate for Payer: Nomi Health Commercial |
$492.06
|
| Rate for Payer: PACE SWMI |
$410.05
|
| Rate for Payer: PHP Medicare Advantage |
$410.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health Medicare |
$410.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.05
|
| Rate for Payer: UHC Medicare Advantage |
$410.05
|
| Rate for Payer: UHCCP DNSP |
$410.05
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 46040
|
| Min. Negotiated Rate |
$369.60 |
| Max. Negotiated Rate |
$600.60 |
| Rate for Payer: Aetna Commercial |
$549.47
|
| Rate for Payer: Aetna Medicare |
$410.05
|
| Rate for Payer: BCBS Complete |
$369.60
|
| Rate for Payer: BCBS MAPPO |
$410.05
|
| Rate for Payer: BCN Medicare Advantage |
$410.05
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$590.47
|
| Rate for Payer: Cofinity Commercial |
$549.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.05
|
| Rate for Payer: Healthscope Commercial |
$492.06
|
| Rate for Payer: Healthscope Whirlpool |
$492.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.55
|
| Rate for Payer: Nomi Health Commercial |
$492.06
|
| Rate for Payer: PACE SWMI |
$410.05
|
| Rate for Payer: PHP Medicare Advantage |
$410.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health Medicare |
$410.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.05
|
| Rate for Payer: UHC Medicare Advantage |
$410.05
|
| Rate for Payer: UHCCP DNSP |
$410.05
|
|
|
PR I&D OF BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$386.00
|
|
|
Service Code
|
HCPCS 56420
|
| Min. Negotiated Rate |
$104.01 |
| Max. Negotiated Rate |
$250.90 |
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna Medicare |
$104.01
|
| Rate for Payer: BCBS Complete |
$154.40
|
| Rate for Payer: BCBS MAPPO |
$104.01
|
| Rate for Payer: BCN Medicare Advantage |
$104.01
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cash Price |
$308.80
|
| Rate for Payer: Cofinity Commercial |
$149.77
|
| Rate for Payer: Cofinity Commercial |
$139.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.01
|
| Rate for Payer: Healthscope Commercial |
$124.81
|
| Rate for Payer: Healthscope Whirlpool |
$124.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.21
|
| Rate for Payer: Nomi Health Commercial |
$124.81
|
| Rate for Payer: PACE SWMI |
$104.01
|
| Rate for Payer: PHP Medicare Advantage |
$104.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.90
|
| Rate for Payer: Priority Health Medicare |
$104.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.01
|
| Rate for Payer: UHC Medicare Advantage |
$104.01
|
| Rate for Payer: UHCCP DNSP |
$104.01
|
|
|
PR I&D PELVIS/HIP JOINT AREA INFECTED BURSA
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 26991
|
| Min. Negotiated Rate |
$497.60 |
| Max. Negotiated Rate |
$808.60 |
| Rate for Payer: Aetna Commercial |
$677.12
|
| Rate for Payer: Aetna Medicare |
$505.31
|
| Rate for Payer: BCBS Complete |
$497.60
|
| Rate for Payer: BCBS MAPPO |
$505.31
|
| Rate for Payer: BCN Medicare Advantage |
$505.31
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cofinity Commercial |
$727.65
|
| Rate for Payer: Cofinity Commercial |
$677.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.31
|
| Rate for Payer: Healthscope Commercial |
$606.37
|
| Rate for Payer: Healthscope Whirlpool |
$606.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.58
|
| Rate for Payer: Nomi Health Commercial |
$606.37
|
| Rate for Payer: PACE SWMI |
$505.31
|
| Rate for Payer: PHP Medicare Advantage |
$505.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$808.60
|
| Rate for Payer: Priority Health Medicare |
$505.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.31
|
| Rate for Payer: UHC Medicare Advantage |
$505.31
|
| Rate for Payer: UHCCP DNSP |
$505.31
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$605.20 |
| Max. Negotiated Rate |
$983.45 |
| Rate for Payer: Aetna Commercial |
$867.40
|
| Rate for Payer: Aetna Medicare |
$647.31
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: BCBS MAPPO |
$647.31
|
| Rate for Payer: BCN Medicare Advantage |
$647.31
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$932.13
|
| Rate for Payer: Cofinity Commercial |
$867.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.31
|
| Rate for Payer: Healthscope Commercial |
$776.77
|
| Rate for Payer: Healthscope Whirlpool |
$776.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.68
|
| Rate for Payer: Nomi Health Commercial |
$776.77
|
| Rate for Payer: PACE SWMI |
$647.31
|
| Rate for Payer: PHP Medicare Advantage |
$647.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health Medicare |
$647.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.31
|
| Rate for Payer: UHC Medicare Advantage |
$647.31
|
| Rate for Payer: UHCCP DNSP |
$647.31
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$983.45 |
| Max. Negotiated Rate |
$4,904.82 |
| Rate for Payer: Aetna Commercial |
$1,361.70
|
| Rate for Payer: Aetna Medicare |
$3,164.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: ASR ASR |
$1,467.61
|
| Rate for Payer: ASR Commercial |
$1,467.61
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.00
|
| Rate for Payer: BCN Commercial |
$1,173.03
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,422.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,210.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$1,513.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,467.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,164.40
|
| Rate for Payer: Mclaren Commercial |
$1,361.70
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.05
|
| Rate for Payer: Nomi Health Commercial |
$1,240.66
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$3,480.84
|
| Rate for Payer: PHP Medicaid |
$1,696.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,325.69
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.61
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,331.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$4,904.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP DNSP |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 26990
|
| Min. Negotiated Rate |
$605.20 |
| Max. Negotiated Rate |
$983.45 |
| Rate for Payer: Aetna Commercial |
$867.40
|
| Rate for Payer: Aetna Medicare |
$647.31
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: BCBS MAPPO |
$647.31
|
| Rate for Payer: BCN Medicare Advantage |
$647.31
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$932.13
|
| Rate for Payer: Cofinity Commercial |
$867.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.31
|
| Rate for Payer: Healthscope Commercial |
$776.77
|
| Rate for Payer: Healthscope Whirlpool |
$776.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.68
|
| Rate for Payer: Nomi Health Commercial |
$776.77
|
| Rate for Payer: PACE SWMI |
$647.31
|
| Rate for Payer: PHP Medicare Advantage |
$647.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health Medicare |
$647.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.31
|
| Rate for Payer: UHC Medicare Advantage |
$647.31
|
| Rate for Payer: UHCCP DNSP |
$647.31
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$983.45 |
| Max. Negotiated Rate |
$1,513.00 |
| Rate for Payer: Aetna Commercial |
$1,361.70
|
| Rate for Payer: ASR ASR |
$1,467.61
|
| Rate for Payer: ASR Commercial |
$1,467.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.94
|
| Rate for Payer: BCN Commercial |
$1,173.03
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,422.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,210.40
|
| Rate for Payer: Healthscope Commercial |
$1,513.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,467.61
|
| Rate for Payer: Mclaren Commercial |
$1,361.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.05
|
| Rate for Payer: Nomi Health Commercial |
$1,240.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,331.44
|
|
|
PR I&D PENIS DEEP
|
Professional
|
Both
|
$766.00
|
|
|
Service Code
|
HCPCS 54015
|
| Min. Negotiated Rate |
$290.78 |
| Max. Negotiated Rate |
$497.90 |
| Rate for Payer: Aetna Commercial |
$389.65
|
| Rate for Payer: Aetna Medicare |
$290.78
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$290.78
|
| Rate for Payer: BCN Medicare Advantage |
$290.78
|
| Rate for Payer: Cash Price |
$612.80
|
| Rate for Payer: Cash Price |
$612.80
|
| Rate for Payer: Cofinity Commercial |
$418.72
|
| Rate for Payer: Cofinity Commercial |
$389.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.78
|
| Rate for Payer: Healthscope Commercial |
$348.94
|
| Rate for Payer: Healthscope Whirlpool |
$348.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.32
|
| Rate for Payer: Nomi Health Commercial |
$348.94
|
| Rate for Payer: PACE SWMI |
$290.78
|
| Rate for Payer: PHP Medicare Advantage |
$290.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.90
|
| Rate for Payer: Priority Health Medicare |
$290.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.78
|
| Rate for Payer: UHC Medicare Advantage |
$290.78
|
| Rate for Payer: UHCCP DNSP |
$290.78
|
|
|
PR I&D PERIANAL ABSCESS SUPERFICIAL
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 46050
|
| Min. Negotiated Rate |
$96.95 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$129.91
|
| Rate for Payer: Aetna Medicare |
$96.95
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: BCBS MAPPO |
$96.95
|
| Rate for Payer: BCN Medicare Advantage |
$96.95
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$139.61
|
| Rate for Payer: Cofinity Commercial |
$129.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.95
|
| Rate for Payer: Healthscope Commercial |
$116.34
|
| Rate for Payer: Healthscope Whirlpool |
$116.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.80
|
| Rate for Payer: Nomi Health Commercial |
$116.34
|
| Rate for Payer: PACE SWMI |
$96.95
|
| Rate for Payer: PHP Medicare Advantage |
$96.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health Medicare |
$96.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.95
|
| Rate for Payer: UHC Medicare Advantage |
$96.95
|
| Rate for Payer: UHCCP DNSP |
$96.95
|
|
|
PR I&D SHOULDER DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 23030
|
| Min. Negotiated Rate |
$245.68 |
| Max. Negotiated Rate |
$465.40 |
| Rate for Payer: Aetna Commercial |
$329.21
|
| Rate for Payer: Aetna Medicare |
$245.68
|
| Rate for Payer: BCBS Complete |
$286.40
|
| Rate for Payer: BCBS MAPPO |
$245.68
|
| Rate for Payer: BCN Medicare Advantage |
$245.68
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$353.78
|
| Rate for Payer: Cofinity Commercial |
$329.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.68
|
| Rate for Payer: Healthscope Commercial |
$294.82
|
| Rate for Payer: Healthscope Whirlpool |
$294.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.96
|
| Rate for Payer: Nomi Health Commercial |
$294.82
|
| Rate for Payer: PACE SWMI |
$245.68
|
| Rate for Payer: PHP Medicare Advantage |
$245.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$245.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$245.68
|
| Rate for Payer: UHC Medicare Advantage |
$245.68
|
| Rate for Payer: UHCCP DNSP |
$245.68
|
|
|
PR I&D SHOULDER INFECTED BURSA
|
Professional
|
Both
|
$720.00
|
|
|
Service Code
|
HCPCS 23031
|
| Min. Negotiated Rate |
$214.80 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$287.83
|
| Rate for Payer: Aetna Medicare |
$214.80
|
| Rate for Payer: BCBS Complete |
$288.00
|
| Rate for Payer: BCBS MAPPO |
$214.80
|
| Rate for Payer: BCN Medicare Advantage |
$214.80
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cofinity Commercial |
$309.31
|
| Rate for Payer: Cofinity Commercial |
$287.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.80
|
| Rate for Payer: Healthscope Commercial |
$257.76
|
| Rate for Payer: Healthscope Whirlpool |
$257.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.54
|
| Rate for Payer: Nomi Health Commercial |
$257.76
|
| Rate for Payer: PACE SWMI |
$214.80
|
| Rate for Payer: PHP Medicare Advantage |
$214.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.00
|
| Rate for Payer: Priority Health Medicare |
$214.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.80
|
| Rate for Payer: UHC Medicare Advantage |
$214.80
|
| Rate for Payer: UHCCP DNSP |
$214.80
|
|
|
PR I&D SOFT TISSUE ABSCESS SUBFASCIAL
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 20005
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$334.75 |
| Rate for Payer: Aetna Medicare |
$257.50
|
| Rate for Payer: BCBS Complete |
$206.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$334.75
|
|
|
PR I&D SUBMUCOSAL ABSCESS RECTUM
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 45005
|
| Min. Negotiated Rate |
$161.01 |
| Max. Negotiated Rate |
$342.55 |
| Rate for Payer: Aetna Commercial |
$215.75
|
| Rate for Payer: Aetna Medicare |
$161.01
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$161.01
|
| Rate for Payer: BCN Medicare Advantage |
$161.01
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$231.85
|
| Rate for Payer: Cofinity Commercial |
$215.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.01
|
| Rate for Payer: Healthscope Commercial |
$193.21
|
| Rate for Payer: Healthscope Whirlpool |
$193.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$193.21
|
| Rate for Payer: PACE SWMI |
$161.01
|
| Rate for Payer: PHP Medicare Advantage |
$161.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health Medicare |
$161.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.01
|
| Rate for Payer: UHC Medicare Advantage |
$161.01
|
| Rate for Payer: UHCCP DNSP |
$161.01
|
|
|
PR I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$620.00
|
|
|
Service Code
|
HCPCS 23930
|
| Min. Negotiated Rate |
$208.73 |
| Max. Negotiated Rate |
$403.00 |
| Rate for Payer: Aetna Commercial |
$279.70
|
| Rate for Payer: Aetna Medicare |
$208.73
|
| Rate for Payer: BCBS Complete |
$248.00
|
| Rate for Payer: BCBS MAPPO |
$208.73
|
| Rate for Payer: BCN Medicare Advantage |
$208.73
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cash Price |
$496.00
|
| Rate for Payer: Cofinity Commercial |
$300.57
|
| Rate for Payer: Cofinity Commercial |
$279.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.73
|
| Rate for Payer: Healthscope Commercial |
$250.48
|
| Rate for Payer: Healthscope Whirlpool |
$250.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.17
|
| Rate for Payer: Nomi Health Commercial |
$250.48
|
| Rate for Payer: PACE SWMI |
$208.73
|
| Rate for Payer: PHP Medicare Advantage |
$208.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$403.00
|
| Rate for Payer: Priority Health Medicare |
$208.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.73
|
| Rate for Payer: UHC Medicare Advantage |
$208.73
|
| Rate for Payer: UHCCP DNSP |
$208.73
|
|
