|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 10060
|
| Min. Negotiated Rate |
$10.31 |
| Max. Negotiated Rate |
$147.64 |
| Rate for Payer: Aetna Commercial |
$109.76
|
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Commercial |
$147.64
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.39
|
| Rate for Payer: Priority Health Narrow Network |
$145.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.36
|
| Rate for Payer: UHC Exchange |
$96.36
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
10060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$301.75 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$178.48
|
| Rate for Payer: ASR Commercial |
$178.48
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$150.68
|
| Rate for Payer: BCN Commercial |
$142.66
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$184.00
|
| Rate for Payer: Healthscope Whirlpool |
$178.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$165.60
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.11
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$186.49
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
PR INCISION&DRAINAGE BURSA FOOT
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 28001
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$795.62 |
| Rate for Payer: Aetna Commercial |
$222.73
|
| Rate for Payer: Aetna Medicare |
$222.00
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS Trust/PPO |
$795.62
|
| Rate for Payer: BCN Commercial |
$249.71
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.53
|
| Rate for Payer: Priority Health Narrow Network |
$145.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.52
|
| Rate for Payer: UHC Exchange |
$203.52
|
| Rate for Payer: UHCCP Medicaid |
$61.34
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 10180
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Commercial |
$191.63
|
| Rate for Payer: Aetna Medicare |
$336.50
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$386.55
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$243.37
|
| Rate for Payer: Priority Health Narrow Network |
$243.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.75
|
| Rate for Payer: UHC Exchange |
$184.75
|
| Rate for Payer: UHCCP Medicaid |
$115.87
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 10180
|
| Hospital Charge Code |
10180
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Commercial |
$191.63
|
| Rate for Payer: Aetna Medicare |
$336.50
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$386.55
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$243.37
|
| Rate for Payer: Priority Health Narrow Network |
$243.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$184.75
|
| Rate for Payer: UHC Exchange |
$184.75
|
| Rate for Payer: UHCCP Medicaid |
$115.87
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$673.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$437.45 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$605.70
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$652.81
|
| Rate for Payer: ASR Commercial |
$652.81
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$551.12
|
| Rate for Payer: BCN Commercial |
$521.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$632.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$673.00
|
| Rate for Payer: Healthscope Whirlpool |
$652.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$605.70
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.05
|
| Rate for Payer: Nomi Health Commercial |
$551.86
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,055.76
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,444.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$437.45 |
| Max. Negotiated Rate |
$673.00 |
| Rate for Payer: Aetna Commercial |
$605.70
|
| Rate for Payer: ASR ASR |
$652.81
|
| Rate for Payer: ASR Commercial |
$652.81
|
| Rate for Payer: BCBS Trust/PPO |
$548.43
|
| Rate for Payer: BCN Commercial |
$521.78
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$632.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.40
|
| Rate for Payer: Healthscope Commercial |
$673.00
|
| Rate for Payer: Healthscope Whirlpool |
$652.81
|
| Rate for Payer: Mclaren Commercial |
$605.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.05
|
| Rate for Payer: Nomi Health Commercial |
$551.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.24
|
|
|
PR INCISION & DRAINAGE FOREARM&/WRIST BURSA
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
HCPCS 25031
|
| Min. Negotiated Rate |
$244.31 |
| Max. Negotiated Rate |
$942.49 |
| Rate for Payer: Aetna Commercial |
$487.91
|
| Rate for Payer: Aetna Medicare |
$364.50
|
| Rate for Payer: BCBS Complete |
$256.53
|
| Rate for Payer: BCBS Trust/PPO |
$942.49
|
| Rate for Payer: BCN Commercial |
$547.32
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Meridian Medicaid |
$256.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$577.55
|
| Rate for Payer: Priority Health Narrow Network |
$577.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$419.48
|
| Rate for Payer: UHC Exchange |
$419.48
|
| Rate for Payer: UHCCP Medicaid |
$244.31
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,140.00
|
|
|
Service Code
|
HCPCS 27603
|
| Min. Negotiated Rate |
$252.19 |
| Max. Negotiated Rate |
$1,557.43 |
| Rate for Payer: Aetna Commercial |
$521.21
|
| Rate for Payer: Aetna Medicare |
$570.00
|
| Rate for Payer: BCBS Complete |
$264.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,557.43
|
| Rate for Payer: BCN Commercial |
$777.97
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Meridian Medicaid |
$264.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.48
|
| Rate for Payer: Priority Health Narrow Network |
$601.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.51
|
| Rate for Payer: UHC Exchange |
$446.51
|
| Rate for Payer: UHCCP Medicaid |
$252.19
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 27604
|
| Min. Negotiated Rate |
$216.41 |
| Max. Negotiated Rate |
$661.18 |
| Rate for Payer: Aetna Commercial |
$437.25
|
| Rate for Payer: Aetna Medicare |
$444.00
|
| Rate for Payer: BCBS Complete |
$227.23
|
| Rate for Payer: BCBS Trust/PPO |
$557.88
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Meridian Medicaid |
$227.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.69
|
| Rate for Payer: Priority Health Narrow Network |
$498.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.63
|
| Rate for Payer: UHC Exchange |
$386.63
|
| Rate for Payer: UHCCP Medicaid |
$216.41
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 10081
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$406.41 |
| Rate for Payer: Aetna Commercial |
$186.54
|
| Rate for Payer: Aetna Medicare |
$227.00
|
| Rate for Payer: BCBS Complete |
$115.85
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$406.41
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Meridian Medicaid |
$115.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.53
|
| Rate for Payer: Priority Health Narrow Network |
$232.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.94
|
| Rate for Payer: UHC Exchange |
$177.94
|
| Rate for Payer: UHCCP Medicaid |
$110.33
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 10080
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$297.64 |
| Rate for Payer: Aetna Commercial |
$111.66
|
| Rate for Payer: Aetna Medicare |
$156.50
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$297.64
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.58
|
| Rate for Payer: Priority Health Narrow Network |
$143.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.73
|
| Rate for Payer: UHC Exchange |
$101.73
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
|
|
PR INCISION&DRAINAGE UPPER ARM/ELBOW BURSA
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
HCPCS 23931
|
| Min. Negotiated Rate |
$29.72 |
| Max. Negotiated Rate |
$482.30 |
| Rate for Payer: Aetna Commercial |
$210.92
|
| Rate for Payer: Aetna Medicare |
$371.00
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.72
|
| Rate for Payer: BCN Commercial |
$448.61
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Meridian Medicaid |
$110.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$250.35
|
| Rate for Payer: Priority Health Narrow Network |
$250.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.40
|
| Rate for Payer: UHC Exchange |
$176.40
|
| Rate for Payer: UHCCP Medicaid |
$105.22
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Facility
|
OP
|
$1,175.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
25000
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$763.75 |
| Max. Negotiated Rate |
$2,430.48 |
| Rate for Payer: Aetna Commercial |
$1,057.50
|
| Rate for Payer: Aetna Medicare |
$1,568.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: ASR ASR |
$1,139.75
|
| Rate for Payer: ASR Commercial |
$1,139.75
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$962.21
|
| Rate for Payer: BCN Commercial |
$910.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,104.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,175.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,139.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,568.05
|
| Rate for Payer: Mclaren Commercial |
$1,057.50
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$963.50
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,724.86
|
| Rate for Payer: PHP Medicaid |
$840.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,029.54
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$823.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$2,430.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP DNSP |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Facility
|
IP
|
$1,175.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
25000
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$763.75 |
| Max. Negotiated Rate |
$1,175.00 |
| Rate for Payer: Aetna Commercial |
$1,057.50
|
| Rate for Payer: ASR ASR |
$1,139.75
|
| Rate for Payer: ASR Commercial |
$1,139.75
|
| Rate for Payer: BCBS Trust/PPO |
$957.51
|
| Rate for Payer: BCN Commercial |
$910.98
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,104.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Healthscope Commercial |
$1,175.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,139.75
|
| Rate for Payer: Mclaren Commercial |
$1,057.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$963.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.00
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25000
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$763.75 |
| Rate for Payer: Aetna Commercial |
$452.93
|
| Rate for Payer: Aetna Medicare |
$587.50
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$514.58
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.46
|
| Rate for Payer: Priority Health Narrow Network |
$543.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$383.92
|
| Rate for Payer: UHC Exchange |
$383.92
|
| Rate for Payer: UHCCP Medicaid |
$229.83
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25000
|
| Hospital Charge Code |
25000
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$763.75 |
| Rate for Payer: Aetna Commercial |
$452.93
|
| Rate for Payer: Aetna Medicare |
$587.50
|
| Rate for Payer: BCBS Complete |
$241.32
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$514.58
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Meridian Medicaid |
$241.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.46
|
| Rate for Payer: Priority Health Narrow Network |
$543.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$383.92
|
| Rate for Payer: UHC Exchange |
$383.92
|
| Rate for Payer: UHCCP Medicaid |
$229.83
|
|
|
PR INCISION FLEXOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25001
|
| Min. Negotiated Rate |
$232.17 |
| Max. Negotiated Rate |
$1,124.75 |
| Rate for Payer: Aetna Commercial |
$455.72
|
| Rate for Payer: Aetna Medicare |
$587.50
|
| Rate for Payer: BCBS Complete |
$243.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.75
|
| Rate for Payer: BCN Commercial |
$515.07
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Meridian Medicaid |
$243.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.00
|
| Rate for Payer: Priority Health Narrow Network |
$546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$372.52
|
| Rate for Payer: UHC Exchange |
$372.52
|
| Rate for Payer: UHCCP Medicaid |
$232.17
|
|
|
PR INCISION LABIAL FRENUM FRENOTOMY
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 40806
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$393.58 |
| Rate for Payer: Aetna Commercial |
$37.05
|
| Rate for Payer: Aetna Medicare |
$178.00
|
| Rate for Payer: BCBS Complete |
$20.35
|
| Rate for Payer: BCBS Trust/PPO |
$393.58
|
| Rate for Payer: BCN Commercial |
$146.11
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Meridian Medicaid |
$20.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.10
|
| Rate for Payer: Priority Health Narrow Network |
$53.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.29
|
| Rate for Payer: UHC Exchange |
$39.29
|
| Rate for Payer: UHCCP Medicaid |
$19.38
|
|
|
PR INCISION LEG/ANKLE
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 27607
|
| Min. Negotiated Rate |
$388.73 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$800.75
|
| Rate for Payer: Aetna Medicare |
$867.00
|
| Rate for Payer: BCBS Complete |
$408.17
|
| Rate for Payer: BCBS Trust/PPO |
$864.83
|
| Rate for Payer: BCN Commercial |
$876.69
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Meridian Medicaid |
$408.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$924.09
|
| Rate for Payer: Priority Health Narrow Network |
$924.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$704.32
|
| Rate for Payer: UHC Exchange |
$704.32
|
| Rate for Payer: UHCCP Medicaid |
$388.73
|
|
|
PR INCISION LINGUAL FRENUM FRENOTOMY
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS 41010
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$971.54 |
| Rate for Payer: Aetna Commercial |
$142.03
|
| Rate for Payer: Aetna Medicare |
$183.00
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS Trust/PPO |
$971.54
|
| Rate for Payer: BCN Commercial |
$322.04
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.67
|
| Rate for Payer: Priority Health Narrow Network |
$198.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.31
|
| Rate for Payer: UHC Exchange |
$129.31
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMP
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 10121
|
| Min. Negotiated Rate |
$118.22 |
| Max. Negotiated Rate |
$387.52 |
| Rate for Payer: Aetna Commercial |
$199.20
|
| Rate for Payer: Aetna Medicare |
$250.00
|
| Rate for Payer: BCBS Complete |
$124.13
|
| Rate for Payer: BCBS Trust/PPO |
$234.52
|
| Rate for Payer: BCN Commercial |
$387.52
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Meridian Medicaid |
$124.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.24
|
| Rate for Payer: Priority Health Narrow Network |
$249.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.38
|
| Rate for Payer: UHC Exchange |
$193.38
|
| Rate for Payer: UHCCP Medicaid |
$118.22
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
10120
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$163.15 |
| Max. Negotiated Rate |
$606.75 |
| Rate for Payer: Aetna Commercial |
$225.90
|
| Rate for Payer: Aetna Medicare |
$391.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: ASR ASR |
$243.47
|
| Rate for Payer: ASR Commercial |
$243.47
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$205.54
|
| Rate for Payer: BCN Commercial |
$194.60
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cofinity Commercial |
$235.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$251.00
|
| Rate for Payer: Healthscope Whirlpool |
$243.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.45
|
| Rate for Payer: Mclaren Commercial |
$225.90
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.35
|
| Rate for Payer: Nomi Health Commercial |
$205.82
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$430.60
|
| Rate for Payer: PHP Medicaid |
$209.82
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$412.85
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$330.28
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$220.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$606.75
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP DNSP |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 10120
|
| Hospital Charge Code |
10120
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$110.83
|
| Rate for Payer: Aetna Medicare |
$125.50
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.04
|
| Rate for Payer: Priority Health Narrow Network |
$144.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.38
|
| Rate for Payer: UHC Exchange |
$95.38
|
| Rate for Payer: UHCCP Medicaid |
$68.16
|
|
|
PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE
|
Professional
|
Both
|
$251.00
|
|
|
Service Code
|
HCPCS 10120
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$110.83
|
| Rate for Payer: Aetna Medicare |
$125.50
|
| Rate for Payer: BCBS Complete |
$71.57
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$221.86
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Cash Price |
$200.80
|
| Rate for Payer: Meridian Medicaid |
$71.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.04
|
| Rate for Payer: Priority Health Narrow Network |
$144.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.38
|
| Rate for Payer: UHC Exchange |
$95.38
|
| Rate for Payer: UHCCP Medicaid |
$68.16
|
|
